Latest Articles
Atrial fibrillation: Rate control or rhythm control?Rate control has been preferred as the primary approach, but the pendulum is swinging in favor of rhythm control.
- Confusion in a 22-year-old woman, and diagnostic uncertainty
The patient had been complaining of gradual-onset and progressive headache and neck and back pain for 3 weeks.
- Scaly plaques in a malnourished patient
A markedly low serum zinc level and the characteristic location of the rash in a patient with long-standing alcohol use disorder and cirrhosis led to the correct diagnosis.
- Decongesting heart failure with diuretics: Easier to prescribe than to fully understand
Digging deep into the pathophysiology of diuretic resistance reveals complex interacting pathways. But none of these pathways can fully explain or be used to safely reverse diuretic resistance.
- How do I interpret and use quantitative buprenorphine and norbuprenorphine urine levels?
Confirmatory testing of urine samples can be useful in outpatient settings where buprenorphine dosing is not directly observed. But retaining and engaging the patient in effective treatment should be the ultimate goals of testing.
- How do we maximize diuresis in acute decompensated heart failure?
The initial goal is to maximize loop diuretic therapy using urine output or urinary sodium for guidance. Combination therapy can be used when patients respond poorly to escalating loop diuretic doses.
- Diversifying medical humanities: The case for Jay-Z
Physicians carry considerable power in the patient-physician relationship. Opening our minds to the viewpoints of others diffuses some of that power and grounds us in the communities we serve.
- Balancing the myths of corticosteroid therapy
No class of drug has more mythical attributes, interfaces with different medical specialties, or clinical street lore than corticosteroids.
- Hyperpigmentation as a clue to Addison disease
The 66-year-old woman presented with fatigue, loss of appetite, and hyperpigmentation of the tongue, soft palate, buccal mucosa, lower lip, fingers, and nail beds.
- Phenytoin-induced gingival overgrowth
A young man presented with lower-extremity weakness and slurred speech. He has been on seizure prophylaxis after experiencing a seizure following hemicraniectomy for subdural hematoma.
