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Association Between High-Density Lipoprotein Cholesterol and Hyponatremia

In this issue of The American Journal of Medicine Israel and Grossman1 report an interesting observation based on their analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) and the National Health and Nutrition Examination Survey (NHANES) datasets. They used gradient boosting machines to build predictive models for hyponatremia based on SPRINT participant high-density lipoprotein cholesterol (HDL-C) levels, […]

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Gynecomastia: Look Beyond the Obvious

A 29-year-old man was referred to our clinic with a 4-week history of a tender predominant left breast enlargement without nipple discharge. He had been practicing bodybuilding regularly for years, but denied taking anabolic androgenic steroids. His past medical history was unremarkable apart from surgical treatment of undescended testes in childhood. His sexual desire and […]

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Urine Tests for Chronic Hypokalemia: When in Doubt, Check Urine-Sodium-to-Chloride Ratio

Urine tests are very helpful for the diagnosis of renal and electrolyte disorders. However, ordering and interpreting urine tests properly have been an Achilles heel for many primary care physicians and residents. It is particularly difficult for chronic hypokalemia because the pathophysiological mechanisms behind it can be rather complicated. Traditionally, we use transtubular K+ gradient (TTKG) […]

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Hypertestosteronemia and Infertility from a Mediastinal Extragonadal Germ Cell Tumor

Extragonadal germ cell tumors are tumors of gonadal origin representing less than 5% of germ cell malignancies that form outside gonads. These are typically found in the mediastinum, retroperitoneum, or pineal gland. A 26-year-old man presented to the infertility clinic in January 2016 with a 2-year history of infertility. He had known hypertrophic cardiomyopathy due […]

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Does Testerone Supplementation Impact Heart Disease Risk? (video)

Does testosterone supplementation impact heart disease risk? The March 2017 issue of the American Journal of Medicine includes a new meta-analysis that looks at the use of testosterone supplements and cardiovascular disease risk. In this video Dr. Joseph S. Alpert talks about testosterone supplements and risk. Read the Research: Cardiovascular Risks of Exogenous Testosterone Use […]

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