Article
There is more to the TSH than a number
Management of subclinical hypothyroidism should be nuanced and based on both clinical and laboratory parameters.
Article
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?
Article
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.
Article
We can learn a lot from drug adverse effects
No one likes adverse effects, but they can teach us important things about human biology.
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The bias of word choice and the interpretation of laboratory tests
Words matter. Calling ALT and AST “liver function tests” can lead to premature diagnosis of liver disease.
Article
How well do we understand calcium and vitamin D?
I do not believe we truly understand the ideal amount of dietary and supplemental calcium or vitamin D for a given patient.
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Training physician leaders to save the health system…and us
The success of the health system and the emotional well-being and clinical skills of its physicians are clearly interrelated.
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The algorithm less traveled
At Bellevue, the RPR was a routine test; at the University of Pennsylvania, not so much—it all depends on context.
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Understanding the tests we order: Comments and an invitation
Some new laboratory tests go through a life cycle, first being used by subspecialists and then by physicians everywhere.
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Deprescribing: When trying for less is more
We should periodically revisit the goals and rationale for all prescribed medications
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Can a shared decision be wrong if made for the ‘right’ reasons?
Providing information alone is not enough; we need to understand the patient’s biases, fears, and priorities.
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A New Year’s transition and looking forward
Time to take stock of advances in—and obstacles to—the delivery of quality healthcare.
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To have not and then to have: A challenging immune paradox
The immune reactivation syndrome can occur when the immune system in an immunosuppressed patient with a partially controlled indolent infection is...