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Off-label and oft-prescribed
When prescribing drugs for uses beyond their FDA indications, we need to explain their anticipated side effects and benefits.
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A link between A-fib and sleep apnea is no surprise, but why?
The two conditions commonly coexist, and treating the sleep apnea results in better rhythm-directed outcomes in the A-fib.
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A few pearls can help prepare the mind
The caregiver with a prepared mind is more likely to experience the diagnostic epiphany.
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Clinical outcomes in diabetes: It’s not just the glucose (and it’s not so simple)
As we dig deeper into the reduction in cardiovascular deaths seen with some newer drugs, several questions arise.
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Deciding when a picture is worth a thousand words and several thousand dollars
Physical examination is cheap but not highly reproducible. Imaging is expensive but may be more sensitive and specific.
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Clinical trials: More to learn than the results
The details of the GIACTA trial challenge and reaffirm some of our clinical impressions about giant cell arteritis.
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The return of measles—an unnecessary sequel
Why are we having such a tough time convincing people to get routine vaccines for themselves and for their kids?
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Infection or not infection, that is the question—Is procalcitonin the answer?
What is it about procalcitonin that allows it to succeed as a biomarker where CRP and the ESR fail?
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Can a humanities background prevent physician burnout?
Osler urged physicians to study the humanities. Can it prevent professional dissatisfaction and burnout?
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The tests that we order define us
In practice we balance the inputs from Watson, “Dr. Google,” our experience, and the specific data from the patient.
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There is more to the TSH than a number
Management of subclinical hypothyroidism should be nuanced and based on both clinical and laboratory parameters.
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MGUS: It’s about the protein, not just the marrow
What is a cause of a high erythrocyte sedimentation rate with a normal C-reactive protein and a low anion gap?
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A new reason to reconsider that antibiotic prescription: The microbiome
The impact of antibiotics on the gut microbiome may be implicated in the rise in obesity and diabetes.
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A physician’s response to observational studies of opioid prescribing
Not long ago, we were told we needed to do better at relieving pain.
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Small fibers, large impact
The wide interest in small fiber neuropathy may reflect our current apparent epidemic of chronic pain.