Internal Medicine Alert – December 15, 2013

December 15, 2013

• Safety of Testosterone Replacement Questioned

  In a study of men in the Veterans Affairs health care system with low serum testosterone levels, the use of testosterone therapy was associated with an increased risk of mortality, myocardial infarction, or ischemic stroke.

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• Is Dabigatran Better Than Warfarin in Patients with Mechanical Heart Valves?

  The use of dabigatran in patients with mechanical heart valves compared with patients receiving warfarin was associated with increased rates of thromboembolic and bleeding complications, thus demonstrating no benefit and an excess risk.

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• Modern Radiation Therapy and ADT for High-risk Prostate Cancer Result in Improved Survival

  Historically, men with high-risk prostate cancer were believed to have low survival rates after definitive treatment with either surgery or radiation. However, long-term results of dose-escalated radiotherapy of doses ≥ 75.6 Gy, along with long-term androgen deprivation therapy (ADT), demonstrate 5-year survival rate of 92%, 5-year biochemical control rate of 82%, and symptomatic local failure rate of 0%. Death from prostate cancer was only 5.5% at 10 years in men treated with high-dose radiation therapy and ADT.

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• Pharmacology Update: Riociguat Tablets (Adempas®)

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• Clinical Briefs By Louis Kuritzky

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• ECG Review: Does the AV Block Get Worse?

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