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Bronchoscopy showing pill fragments (arrow) with intense inflammatory granulation response with bronchial stenosis.

Unusual Cause of Persistent Cough: ‘Pill Aspiration’

A 57-year-old woman with carcinoid syndrome was referred to the pulmonary clinic by her primary care physician (PCP) for persistent cough for the past 6 weeks. She was evaluated by her PCP approximately 6 weeks earlier for cough, which the patient thought started after she had aspirated one of her medications. Results from initial clinical […]

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Computed tomography scan demonstrating drug packets.

Ethico-Legal Challenges of Drug Packing—A Case Report

Body-packing, or the internal concealment of illicit drugs, has been described worldwide and is typically used to smuggle drugs across secure borders. Body-packers who swallow or insert packets of illicit drugs into body cavities are at risk for acute toxicity and gastrointestinal obstruction. We present a case of body-packing that exposed the challenging ethical and […]

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man-in-wheelchair-stock

Effectiveness and Safety of Rivaroxaban Versus Warfarin in Frail Patients with Venous Thromboembolism (video)

Frailty predicts poorer outcomes in patients receiving anticoagulation. We assessed the effectiveness and safety of rivaroxaban vs warfarin in frail patients experiencing venous thromboembolism. Methods Using US MarketScan claims data from January 2012-December 2016, we identified frail patients (using the Johns Hopkins Claims-Based Frailty Indicator score) who had ≥1 primary hospitalization/emergency department visit diagnosis codes […]

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close up of gloved hands filling a syringe

Emerging Trends in Pain Medication Management: Back to the Future: A Focus on Ketamine

  Providers face many challenges when faced with pain management. Pain is complex, difficult to understand and diagnose, and especially enigmatic to manage. The discovery of nonopioid agents for pain management has become particularly important considering the ongoing opioid epidemic. This review is focused on revisiting ketamine, an agent that has historically been used for […]

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Present locations of drug cartels operating in the United States. Adapted from Reference 23.

Backstories on the US Opioid Epidemic. Good Intentions Gone Bad, an Industry Gone Rogue, and Watch Dogs Gone to Sleep

Epidemics of opioid use are old news in the United States, but an epidemic that kills over 200,000 Americans is not. A multiplicity of intertwined factors have brought us to this place. From 30,000 feet, it is the story of good intentions gone bad, a drug industry gone rogue, and government watch dog agencies gone […]

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Rupture of the posterior free wall of the left ventricle.

Cardiac Rupture in a Young Male Cocaine User

To the Editor: A 25-year-old man was found unconscious by his wife in the bathroom of his apartment. She called emergency services and cardiopulmonary resuscitation was promptly initiated within a few minutes. The patient was intubated, transferred to the Emergency Department (ED) of a local hospital, and after 1 hour of advanced cardiac life support […]

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