Latest Articles
- Vertebroplasty, cognitive dissonance, and evidence-based medicine: What do we do when the ‘evidence’ says we are wrong?
Two recent trials call into question the efficacy of vertebroplasty for treating osteoporotic vertebral compression fractures and are leading many of us to question our assumptions about vertebroplasty.
- Fragility fractures in chronic kidney disease: An opinion-based approach
When a patient with chronic kidney disease suffers a fragility fracture, a key question is whether the patient has osteoporosis or, instead, renal osteodystrophy. Bone densitometry does not help in this distinction.
- Prasugrel for acute coronary syndromes: Faster, more potent, but higher bleeding risk
Prasugrel (Effient) is faster and more consistent in its effects, but patients at high bleeding risk should still receive clopidogrel (Plavix).
- An algorithm for managing warfarin resistance
Some patients need higher-than-expected doses of warfarin to reach their target INR. The cause can be acquired (poor compliance, drug interactions) or hereditary.
- Low bone density is not always bisphosphonate deficiency
Low bone density is not a one-size-fits-all disorder. We need to carefully consider the diagnostic and therapeutic options before assuming that low bone density is osteoporosis.
- Treating the renal patient who has a fracture: Opinion vs evidence
The patient with chronic renal disease who has a fracture remains a unique management challenge. Opinions on treatment abound, but without adequate evidence to back them up.
Acute pancreatitis: Problems in adherence to guidelinesEvidence-based guidelines on managing acute pancreatitis are available, but many physicians are not following them.
- Is an ACE inhibitor plus an ARB more effective than either drug alone?
No. Dual renin-angiotensin system blockade has never been shown to reduce the rates of morbidity or death from any cause.