Nitrofurantoin versus Fosfomycin for Acute Uncomplicated Cystitis

By Martina McGrath, MD
May 9, 2018

Acute uncomplicated cystitis is defined as infection localized to the bladder without signs of further extension such as fever, flank pain/tenderness, or systemic symptoms. It is a highly prevalent problem and over half of all women experience at least one urinary tract infection (UTI) in their lifetime.1 In otherwise healthy women, with normal urinary tract anatomy, treatment can commonly be instituted without the need for urine culture. Both nitrofurantoin and fosfomycin are currently recommended as first-line agents for treatment of uncomplicated cystitis. However, some older studies have suggested that fosfomycin may have inferior efficacy.2 Continue reading “Nitrofurantoin versus Fosfomycin for Acute Uncomplicated Cystitis”

Increased Risk of Adverse Pregnancy Outcomes after Recovery from Acute Kidney Injury

By Martina McGrath, MD
September 26, 2017

Women with advanced chronic kidney disease (CKD) have long been known to be at increased risk of complications in pregnancy including preeclampsia, pre-term birth, small-for-dates offspring, and progression of underlying CKD following pregnancy.1 However, several recent studies have highlighted a less obvious connection between earlier stages of renal disease and adverse pregnancy outcomes.2,3 Continue reading “Increased Risk of Adverse Pregnancy Outcomes after Recovery from Acute Kidney Injury”

Results of Scalp Cooling to Prevent Chemotherapy-Induced Alopecia

By Charbel C. Khoury, MD
August 8, 2015

Being diagnosed with cancer can be devastating and life-changing. Furthermore, the side effects of chemotherapy are often very distressing, and hair loss is one of the more feared complications. When a patient, and particularly a woman, loses her hair to chemotherapy, she is faced with the stigma of the disease, and may feel that she is losing her identity, femininity, and sexuality.1 Patients with chemotherapy-associated alopecia are confronted with the lethal nature of cancer, and a minority of patients even choose to avoid chemotherapy for fear of losing their hair. Continue reading “Results of Scalp Cooling to Prevent Chemotherapy-Induced Alopecia”

Chocolate Intake and Risk of Atrial Fibrillation

By Martina M. McGrath, MD
June 7, 2017

Cocoa beans were highly prized by the Aztecs, used in religious ceremonies, traded for goods, and believed to have medicinal purposes.1 While cocoa beans are a rich source of anti-inflammatory flavonols and antioxidants, it is reported that modern manufacturing processes destroy most of these potentially beneficial substances.2 Furthermore, modern chocolate typically contains large quantities of sugar, meaning this popular indulgence is an unlikely health food supplement. Despite this, epidemiological studies have associated moderate chocolate consumption with reduced risk of myocardial infarction and several cardiovascular end points.3,4 Continue reading “Chocolate Intake and Risk of Atrial Fibrillation”

Bariatric Surgery or Intensive Medical Therapy for Diabetes?

By Charbel C. Khoury, MD
May 11, 2017

Obesity has grown at epidemic rates over the past few decades. According to the most recent data from the Behavioral Risk Factor Surveillance System, adult obesity prevalence now exceeds 35% in four US states, 30% in 25 states and is above 20% in all states.1 Numerous studies have established excess weight as a risk factor for type 2 diabetes, thus adding to the morbidity and mortality of obese patients. While dieting, behavioral approaches, and tight glucose control can limit the long-term complications of diabetes, sustaining adherence is often difficult for most patients. Continue reading “Bariatric Surgery or Intensive Medical Therapy for Diabetes?”

A Thiazide a Day to Keep Fractures Away?

By Martina M. McGrath, MD
March 7, 2017

Observational data have indicated a reduction in fracture risk in patients treated for hypertension with thiazide diuretics.1 Thiazides reduce urinary calcium losses (hence their use in patients with calcium-based renal calculi) and have been postulated to have a stimulatory effect on osteoblasts, leading to improvements in bone density. However, there have been no randomized trials to demonstrate benefit of one antihypertensive class over another in protection against fractures. Patients with hypertension are at increased risk of falls and fractures, making this an important consideration, particularly in the elderly. Continue reading “A Thiazide a Day to Keep Fractures Away?”

Migraine in Women—An aura for cardiovascular disease risk?

By Martina M. McGrath, MD
July 6, 2016

Migraine occurs in up to 20% of the population and disproportionately affects women. Migraine with aura has previously been linked with increased risk of ischemic stroke. Proposed mechanisms include the coexistence of vascular risk factors, underlying endothelial dysfunction or increased thrombogenic potential. Continue reading “Migraine in Women—An aura for cardiovascular disease risk?”