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microscope and test tubes

The Tradeoff of Cancer Drug Regulatory Policy: Faster Approvals for One Means Less Knowledge for Another

The popular narrative surrounding cancer drugs or other therapies for rare diseases is that patients are willing to assume more risk and uncertainty to gain rapid access to investigational agents. This is, in part, the impetus behind the frequent use of surrogate endpoints by the US Food and Drug Administration (FDA)1 and European Medicines Agency,2 as well […]

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Chest radiograph at initial presentation. Cardiomegaly and moderate left pleural effusion noted.

Drugs, the Thyroid, and the Heart: A Lethal Cocktail

A 53-year-old man was referred for evaluation of a raised international normalized ratio blood result. He had been taking warfarin and amiodarone for 2 years following a transient episode of atrial fibrillation following a percutaneous coronary interventional procedure. He was receiving treatment for severe left ventricular systolic dysfunction and type 2 diabetes mellitus (Table 1). […]

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Asking How Our Patients Understand Addiction

When the President’s Commission on Combating Drug Addiction and the Opioid Crisis declares “addiction [a] chronic relapsing disease of the brain”1 and calls for expanded access to care, within those statements is recognition of the influx of patients with addiction into general medicine settings for chronic disease management. The initial conversations that can shape a patient’s […]

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Cannabis Legalization Does Not Influence Patient Compliance with Opioid Therapy

Prescription opioid use and opioid related deaths continue to increase nationwide. Several states have adopted legislation allowing for recreational use of cannabis. Little is known about how recreational cannabis laws impact compliance in chronic pain patients who have been prescribed opioid therapy. The goals of this study were to (1) retrospectively assess the effect of cannabis […]

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mmj in prescription pill bottle

Marijuana’s Effects on Brain Structure and Function: What Do We Know and What Should We Do? A Brief Review and Commentary

The present epidemic of opioid addiction and the enthusiasm about marijuana use by advocates of its legalization may have diverted attention from its reported adverse health effects. These include clinical studies that demonstrate chronic marijuana use is associated with long-term deleterious effects on cognition.1 Neuroscientists have been carefully pairing neurodiagnostic tools with newer neuroimaging technologies to […]

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Concomitant Use of Direct Oral Anticoagulants with Antiplatelet Agents and the Risk of Major Bleeding in Patients with Nonvalvular Atrial Fibrillation

Patients with nonvalvular atrial fibrillation commonly have comorbidities requiring concurrent use of oral anticoagulants and antiplatelets. There are no real-world data on the comparative safety of concomitant antithrombotic treatments in the era of direct oral anticoagulant (DOACs). Thus, we compared the incidence of intracranial hemorrhage, gastrointestinal bleeding, and other major bleeding between concomitant DOAC-antiplatelet use […]

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