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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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Blood in Urine: A Hard Nut to Crack

A 34-year-old woman presented with a 2-week history of intermittent painless macroscopic hematuria. She had a similar episode of macroscopic hematuria 5 years ago during her last pregnancy, which resolved spontaneously. Apart from this, she had no significant medical history. She was not taking any regular medications or supplements. On examination, she appeared well. She […]

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Cardiovascular Risks of Exogenous Testosterone Use Among Men (videos)

We sought to evaluate whether exogenous testosterone therapy is associated with increased risk of serious cardiovascular events as compared with other treatments or placebo. Methods Study selection included randomized controlled trials (RCTs) and observational studies that enrolled men aged 18 years or older receiving exogenous testosterone for 3 or more days. The primary outcomes were […]

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‘Urinary Tract Infection’ and the Microbiome

The current paradigm for managing uncomplicated “urinary tract infection” (“UTI”) is deeply flawed. “UTI” is ambiguously defined, and coupled with a belief that “bacteria are not normal inhabitants of the urinary tract,”1 the diagnosis often leads to unnecessary, harmful antibiotic treatment. Although bacteriuria identified by standard clinical cultures (which we will call standard bacteriuria) is central […]

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