Using 5 alpha reductase inhibitors safely: What primary care physicians need to know.

5 Alpha Reductase Inhibitor (ARI) is a widely used class of medication; for benign prostatic hypertrophy, androgenetic alopecia and hirsutism. While generally considered safe, ARIs class of medication does have a number of side effects, which can sometimes persist long after discontinuation of the medication. Since this class of medication is generally thought of as being benign, it can be overlooked as a potential cause of new clinical symptoms patients might experience.

Deprescribing Strategies for Opioids and Benzodiazepines with Emphasis on Concurrent Use: A Scoping Review.

While the Food and Drug Administration's black-box warnings caution against concurrent opioid and benzodiazepine (OPI-BZD) use, there is little guidance on how to deprescribe these medications. This scoping review analyzes the available opioid and/or benzodiazepine deprescribing strategies from the PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases (01/1995-08/2020) and the gray literature. We identified 39 original research studies (opioids: n = 5, benzodiazepines: n = 31, concurrent use: n = 3) and 26 guidelines (opioids: n = 16, benzodiazepines: n = 11, concurrent use: n = 0).

A review of perioperative anemia: A modifiable and not so benign risk factor.

Anemia is a commonly encountered finding either during the preoperative assessment or during the postoperative management of the patient. Anemia often gets overlooked while more emphasis is paid to cardiovascular and pulmonary evaluation. Evidence, however, suggests that the presence of anemia in the perioperative period can predispose patients to other complications.

Attitudes, beliefs, and changing trends of cannabidiol (CBD) oil use among caregivers of individuals with Alzheimer's disease.

Objectives: With the increasing popularity of CBD-based products, especially CBD oil, it is increasingly important to understand what motivates caregivers of individuals with Alzheimer's disease (AD) to use CBD oil as part of treatment. The purpose of this study was to identify the attitudes and beliefs of caregivers of individuals with AD toward CBD oil in Poland, to identify factors that might be associated with the decision to use CBD oil among caregivers, and to explore whether such a decision was discussed with a healthcare professional.

Method: A cross-sectional online survey was conducted in Poland.

Medical Cannabis for the Primary Care Physician.

Medical cannabis use is common in the United States and increasingly more socially acceptable. As more patients seek out and acquire medical cannabis, primary care physicians will be faced with a growing number of patients seeking information on the indications, efficacy, and safety of medical cannabis. We present a case of a patient with several chronic health conditions who asks her primary care provider whether she should try medical cannabis.

The triad that matters: palliative medicine, code status, and health care costs.

Introduction: Delayed discussion of a patient's code status can lead to shortsighted care plans that increase hospital length of stay (LOS) and costs.

Methods: Retrospective study compared intensive care unit (ICU) patients who accepted verses rejected palliation and examined the relationships between 5 predictor variables with the outcome variables ICU LOS and total hospital LOS, and total direct and variable hospital cost.

Results: A significant number of patients who accepted palliative care agreed to a hospice referral or expired in the hospital.

The business of academic medicine is a business like no other: a perspective.

The financial challenges facing the academic medical centers and in particular the departments of medicine continue to escalate. In response, many centers have been increasing their expectations of clinical productivity while holding the physician compensation down. This model of capitalization of such centers intuitively makes little sense from a business perspective but has potential advantages in the short run and may be surprisingly sustainable for a variable period, depending on a number of factors; in some instances, it may last long enough to be considered a long-term success.

An unusual presentation of Burkitt lymphoma.

We describe a 37-year-old non-smoker who presented with dyspnea and a unilateral effusion secondary to Burkitt lymphoma (BL). The diagnosis was made by pleural tissue biopsy using video-assisted thoracoscopic surgery (VATS). Burkitt lymphoma is discussed.