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Anticoagulation Therapy in Patients with Liver Cirrhosis is Associated With an Increased Risk of Variceal Hemorrhage

The belief that cirrhotic patients are “auto-anticoagulated” often results in anticoagulation therapy being withheld in these patients. We aimed to understand patterns of use of anticoagulation and to determine the risk of bleeding complications in cirrhotic patients. Methods We retrospectively analyzed 320 cirrhotic patients treated with anticoagulation therapy from July 15, 2014 to January 30, […]

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Genomics and Precision Medicine to Combat Opioid Use Disorder

Chronic pain is a debilitating disorder affecting approximately 100million people, or almost 30% of the adult population of the United States.1 Among patients with chronic pain, about half report its occurrence to be daily and severe. Chronic pain costs about $630 billion annually and is the leading primary complaint by patients to healthcare providers and the […]

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Wanted: Local Medical Experts/Champions to Prevent Gun Violence

In response to the current, horrific US public health crisis—an epidemic of gun violence due primarily to handguns—physician leaders are calling upon health care professionals to become involved in solutions, in both their medical and community lives.1, 2, 3 A lack of knowledge about guns and gun violence is cited by some (personal communication, Michael R. Weiss, www.mikethegunguy.com)4 as an […]

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A Tale of Two Cities: Persistently High Homicide Rates in Baltimore City Compared With Significant Declines in New York City

Deaths from homicide are a major public health problem in the United States and throughout the world. Further, the United States has experienced homicide rates that are 6.9 times higher than those in other high-income countries, and the vast majority are attributable to firearms.1 For many decades there have been striking regional variations among various cities […]

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Sleep Duration and Risk of Fatal Coronary Heart Disease, Sudden Cardiac Death, Cancer Death, and All-Cause Mortality

Sleep duration has been shown to be associated with all-cause mortality; however, its relationship with cause-specific fatal events remains uncertain. We examined the relationship between sleep duration and risk of fatal coronary heart disease, sudden cardiac death, cancer-related death, and all-cause mortality. Methods Sleep duration was self-reported at baseline examinations performed between March 20, 1984, […]

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A rattlesnake bite wound hours after the incident. There is swelling of the digit and palm with hemorrhagic bullous formation circumferentially around the finger. Erythema is present in the affected digit. The patient reported pain. Presentations like this may lead to unnecessary use of antibiotics. In this case, no antibiotics were administered and no infection developed.

Prophylactic Antibiotics Are Not Needed Following Rattlesnake Bites (video)

Antibiotics are sometimes administered to victims of rattlesnake bites in the hope of preventing infections. Experts in the field recommend that prophylactic antibiotics not be used because secondary infections are rare. Current recommendations are based on a small number of studies conducted in the United States. We decided to reexamine the issue by taking advantage […]

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