Primary Care
Questions discussed in this category
Thrombophilia testing, including JAK2 is negative. When would you stop anticoagulation?
For example, do you routinely supplement with calcium carbonate, magnesium hydroxide, aluminum hydroxide, simethicone, sucralfate, etc.?
How do you incorporate this into your follow-up care and how do you instruct the patient?
For example, do you find it most useful for outpatient disease assessment/management, consideration of further imaging or specialist referral, or tria...
Do you use the traditional strict limit of 1.5 L, or do you consider removing more volume if a patient appears to tolerate it?
If the ECG was obtained prior to major orthopedic surgery (such as hip replacement) would that change your approach?
E.g., negative sleep study, good sleep hygiene, no offending medications, no psychiatric disorder.
For example, do you find trending WBC, procalcitonin, CRP, etc., more or less helpful?
Do you have a preference for biologics or phosphodiesterase inhibitors?
The controlled trial below demonstrated improvement in dysphagia among Parkinson's patients. Might this have greater potential for benefit than modifi...
Do findings from the REDOX Trial comparing 24 vs 15 hours of supplemental oxygen influence your approach?
(Since there is some suggestion that stains convert vulnerable plaque to stable calcified plaque and increase calcium score)
The patient takes frequent flights for their job, with no prior history of VTE, and has already been taking measures for prevention including frequent...
Should you work to wean patients of benzodiazepines? Is your approach different for patients who have been on benzodiazepines for years? What would yo...
For example, the DASH score, d-dimer, repeat imaging?
This question is part of a collaboration with RheumMadness and is specifically in reference to: CD40L inhibitor for Sjogren's
Would you anticipate a different side effect profile from a different GLP-1 agonist?
Are there any protocols in place? Aside from telling patients to use ice packs or bags or immerse hands/feet in ice water baths from 15" before to 15"...
Given the side effect profile and risk of relapse off oral TXA therapy, do you prefer pulse dosing (i.e., 3 months on, 3 months off) or continuous the...
For instance - any tips regarding coordination of care/transportation, associated lymphedema management, wound care, and pain control would be welcome...
Have you found dose adjustments to be effective?
Additional risk factors could be family history of VTE or thrombophilia, such as antithrombin deficiency.
E.g., during Ramadan, what if extended-release medications aren’t an option?
Considering a growing interest in the use of dextromethorphan for depression (Majeed et al., PMID 33682569).
Have you tried Vitamin K2? In light of a recent publication: Tan et al., PMID 39466236
Would coronary disease anatomy influence your selection of which type of antiplatelet agent to continue?
How would you approach counseling the patient in this situation?
Do you worry about additional increased risk of seizure for patients using medications to assist in weight loss such as GLP-1 agonists?
X-rays without inflammatory changes. RF >120, CCP >250.This question is part of a collaboration with RheumMadness and is specifically in referen...
In light of Straub et al's comparative study of combination vs buprenorphine alone
Any alternatives to drug holiday, bupropion, sildenafil, and yohimbine?
In which intervals do you increase the dose and what is the maximum dose you usually try (before considering levodopa to be ineffective in the particu...
Do you require patients to complete a controlled substance agreement or obtain routine interval urine drug screens?
Ferrell et al., PMID 38448791
Are any effective options available beyond nicotine replacement therapy, varenicline, or bupropion?
Especially in the elderly population
Unlike USPTF and CMS guidelines, NCCN and ACS do not have a criterion for <15 years since quit
Any experience with risankizumab as a treatment option?
For example, patient with sUA <4 already on maximum dose allopurinol or Uloric, but significant tophi that have only marginally reduced in si...
The structure is similar to tricyclic antidepressants, so I was planning to avoid those medications but unsure if there are other medications also.
In light of the long-term follow-up of the LEAP study published in 2024 - Frequin et al., PMID 38644623
Would you consider charging a small fee for managing C-2 prescriptions between appointments instead of requiring the patient to come monthly?
Short-term glucocorticoids are often prescribed as "bridge" therapy to avoid ER visits. What else should we consider?
Lazarus et al., PMID 26752337
Do you avoid certain IV formulations in this population? Are there special considerations for premedications in this population?
McCreary et al., PMID 37310038
The recently published SURMOUNT-OSA trial showed positive results
This question is part of a collaboration with RheumMadness and is specifically in reference to: Cost Effectiveness of HCQ Screening.
McCreary et al., PMID 37310038
Is there a way to determine a safe time period that allows a patient to fulfill their religious obligations or do you just recommend against fasting?
Anderegg et al., PMID 39747681
Would you send to allergy for omalizumab?
How do you evaluate for time off? Return to work? How do you deal with time off requests in the presence of non-adherence to treatment recommendations...
Nye, Endocrinology Advisor 2025
What role do you feel there is for antibiotics in the management of severe perianal Crohn's disease?
Specifically in patients with low resources, poor follow-up, and currently not on biologic therapy. What is the duration of antibiotics?
The patient has no extraocular features of a spondyloarthropathy and is on methotrexate. No active eye disease for past 1 year.
Chen & Zhong, AHA/ASA Journals 2024
If so, is there a quantitative calcium score or a reported severity of CT coronary artery calcification that would lead you to start daily aspirin?
Normal Vitamin D, bone scan showed osteoarthritis.
Either low fiber or high fiber, or other? Or probiotics?
In light of 2025 guidelines for treatment for RLS and PLMD
At times due to limited testing resources, inhaler therapy is started based on clinical suspicion of asthma and bronchoprovocation testing is done lat...
Please share options of treatment without discontinuing the stimulant as that include discontinuing the stimulant and using alternatives.
How do you approach this in patients who are approaching or are over 65 given the contraindications of benzodiazepine use in geriatric populations? Wh...
How do you balance the benefits of treating depression versus the risk of transition to mania? Do you consider stopping the medication as soon as the ...
Currently on 6 mg dexamethasone daily post-hospitalization. Insurance is denying acitretin. Would an IL-23 inhibitor like Skyrizi be appropriate? Otez...
Is this recommended TSH target of 7 or higher based on the fact that globally iatrogenic hyperthyroidism is common in older individuals on levothyroxi...
The last SHINGRIX was about 4 years ago and both doses were given.
Do you first try adding topicals or UV? At what point do you decide to switch biologics and at that point do you try to class switch to a different MO...
Patient is already on topical high potency corticosteroids.
Any updated safety data on IL-17, IL-23 in pregnancy?
Patient is asymptomatic and on therapy but has the finding on bone scan. Do we add therapy or change or do nothing and monitor only?
Primary care providers often check iron studies during workup for fatigue, even if anemia is not present.
Is there strong data for the use of Verapamil, Metformin, Amylin, GLP 1 R agonists or Januvia?
Do you defer or avoid use in patients with untreated simple hypertension or other cardiac history?
Do you generally feel they work well? Have patients tried using this a few days before an activity, such as skiing? Especially for otherwise healthy, ...
Patient did not tolerate NSAIDs and referred 2 weeks after hip surgery for RT.
ACOG 2021 practice guidelines use ferritin >30 ng/mL.
Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?
Do you just switch to alternative therapy, or use medications or supplements to try and improve Raynaud's symptoms?
Are you considering also using it for the treatment of warts?
Do you switch to an acetylcholinesterase inhibitor or combine?
Are these toxicities expected to improve over time?
Is there any data to suggest one time-frame is better than the other?
The CDC states give "2024–2025 Dose 2 (Moderna, Novavax or Pfizer-BioNTec...
Would you favor continuation of plavix or aspirin?
If so, how often do you check?
Would concomitant use of a DOAC ease any concerns?
If not, would you consider a prophylactic cholecystectomy?
What treatment modalities have you tried for "dermal hypersensitivity reaction"?
This question is part of a collaboration with RheumMadness and is specifically in reference to: Bissonnette et al., PMID 38324484
How do you address exacerbation of mood symptoms in patients who want to continue hormone birth control?
Does lamotrigine interfere with baseline estradiol levels in a woman who is not prescribed estrogen otherwise?
Patients may have to stop glp1 a therapy due to supply issues or for other reasons. If they are off for 4 weeks, is it ok to restart at the same dose ...
When using a stimulant, how aggressive are you with an anti-manic mood stabilizer?
Lack of large scale efficacy or safety data for PTh analogue or Evenity in this patient population.
How frequently can you repeat the oral course?
Zarnegar R, et al. The aldsoteronoma resolution score: predicting complete resolution of hypertension after adrenalectomy for aldosteronoma. PMI...
Prattichizzo et al., PMID 39468384
What medications bests treat Intermittent Explosive Disorder?
USPTF and CMS guidelines differ in age criteria, and NCCN guidelines do not have an upper age limit.
EPIC-SR Trial
What about for Effexor, specifically?
When would you consider symptoms to be potentially of other etiology? Would you ever consider a conversion or functional diagnosis?
Specifically, headaches thought not to be related to increased ICP.
There seems to be little guidance on vitamin replacement in these patients. Vitamin K level < 50 yet PT/INR is normal. Is the vitamin K assay usefu...
Does the recommendation change based on the DMARD?
No active joint disease, patient on Hydroxychloroquine and Cimzia. Normal ESR/CRP.
Are you less likely to prescribe it for patients with dyslipidemia or autoimmune disease?
How do you balance concern for causing skin hypopigmentation with many of the traditional treatment modalities we have?
Is isotretinoin the only effective option?
Would your considerations change for a man vs a woman?
Given that Accutane can affect calcium homeostasis, would you recommend continuing Accutane or are additional steps or workups warranted?
Do any special adjustments need to be made for any particular biologic therapies?
Thrombosis of the greater saphenous vein extending from SFJ to mid-calf, unchanged on follow-up Doppler imaging after 3 months of full dose rivaroxaba...
If so, what antibiotic regimens do you use?
In light of research that suggests SSRIs increase the risk of closed-angle glaucoma, Chen et al., PMID 28257449.
If their calcium score and stress tests are normal, would you still treat?
Do you reserve biologics for more systemic involvement? When do you initiate biologics such as secukinumab?
NCCN states that per an AS paradigm for low risk and FIR prostate cancer, a PSA should not be collected any more than every 6 months, with DRE, mpMRI ...
If so, how often would you do this?
Specifically considering individuals with known mutations in MUC5B, TERT/TERC, etc
e.g. for schizophrenia. What would be the best treatment options to minimize long term impacts related to cognition?
Cardiolipin was mildly positive and persistent after 12 weeks (29->28 MPL). No other significant provoking factors. The patient started on LMWH.
W...
Marí-Bauset et al., JCN 2014
Can you include both patient directed and clinician directed resources?
Healthy kid <5 years old with hemangioma measuring 6 cm. No prior therapy was trialed. Lesions not growing or involuting.
Do you avoid using these agents only in patients with history of medullary thyroid cancer or pancreatic cancer? Are there other cancer risks we should...
If so, what do you typically prescribe?
Do anabolic agents have a role?
How will you counsel patients about the risk and what strategies will you use to mitigate the increased risk of fungal infections seen in the BE COMPL...
Are you aware of any data regarding relative risk of molluscum contagiosum infection in reference to DMARDs/biologics?
Randolph & Tosti, PMID 32622136
SLE manifestations include arthralgias and cytopenias which are stable. Previously did well on methotrexate, but developed GI side effects. HCQ is on ...
In light of the publication of results from the EPISODE study.
What DSM-5 diagnosis and or diagnostic code do you use when treating this substance use disorder?
How do you practically approach a tailored elimination diet in young patients with numerous food impactions and esophageal strictures who are intermit...
Have you found significant differences among SSRIs and SNRIs (e.g., paroxetine vs fluoxetine vs sertraline vs escitalopram vs duloxetine)? What data d...
Do you discontinue the use of certain medications that have been associated with microscopic colitis (ie, PPIs, SSRIs)?
Would you anticoagulate for a fixed or indefinite duration? Would you recommend changing her contraception method?
Are your results different in adults whereby a particular trigger is often found and very helpful versus in children?
Would you label this as intermediate or high risk and treat with prophylactic or full dose AC? What duration would you treat for?
No prior hx of DVT/SVT. Negative LE doppler. Would you consider anticoagulating and at what dose, or favor close observation?
Seems like AAP and AAAI support switch to 0.3 woolen at 55lbs and FDA and Woolen package insert at 66lbs.
Any thoughts on when to switch?
Patient has had previous failure of methotrexate. Would you switch to alternative (TNFi or Rituximab) or continue abatacept with regular dermatology...
Given that symptoms can overlap and food allergy symptoms can really be a manifestation of EoE in some patients, how do you decide when to screen for ...
How do you approach increasing urinary citrate levels in a patient with recurrent calcium nephrolithiasis who has hypocitraturia non-acidic urine?
The patient has ongoing inflammatory arthritis despite methotrexate, apremilast, and jak inhibitor trials.
With the time intervals recommended after taking each medicine, I am wondering how patients should be counseled.
The patient was treated with two doses of Rituximab and on MMF. Now with stable lung function and normalized CK.
At what doses do you start? and how do you titrate therapy?
Odawara et al., Clinical Journal of the American Society of Nephrology 2024
Assuming patient already received an initial course of antibiotic treatment in response to a positive urine culture during routine screening early in ...
Is this seen more with high dose vitamin D supplementation?
If a patient has received a kidney transplant for SLE-LN and is stable and doing well. Managed by their transplant team and on chronic immunosuppressi...
How do you counsel patients about any potential risk?
See dapagliflozin drug insert form which states Farxiga is not recommended for patients with PKD.
ESPRIT Trial
For example, a 1 year old healthy female twin in whom a lesion appeared 6 mos ago and has been stable in size.
On exam, left upper back 1.3cm x 1cm s...
Should uric acid levels be monitored regularly while on therapy?
If they are already on a preparation that contains animal products, would you change it?
I have observed a trend where patients who are being tapered off of long-term benzodiazepine (especially in the geriatric population) prescriptions ar...
Are there characteristics which could help identify whether a follicular lymphoma might behave more indolently vs aggressively and inform treatment se...
The case prompting the question is a female in her late teens who was diagnosed with Class IV LN at her prepubescent age and was treated with HCQ and ...
Aluminum hydroxide/magnesium hydroxide (i.e. Maalox).
What treatment regimen have you found most effective?
Do you recommend any lifestyle changes or prescribe oral azoles?
Any experience with topical r...
Have any long-term studies been conducted to collect data on adults who were prescribed SSRIs throughout their childhood?
Would you consider testosterone therapy if he is otherwise asymptomatic?
How often do you recommend monitoring thyroid function tests in these situations?
What factors do you discuss when counseling the patient?
Cholesterol Treatment Trialists' (CTT) Collaboration
Ahmad et al., PMID 36106278
BMI>40
While remission rates after lowering or discontinuing therapy are lower, there is still a population of patients who do not require full-dose therapy ...
Do you start/trial them on another biologic or just rely on topical therapies?
Which csDMARD do you taper in order, and is there a tapering strategy (duration/dose)?
Given the drug-drug interaction, do you monitor more closely for methotrexate toxicity, counsel on symptoms of methotrexate toxicity, or avoid the com...
Is there evidence for the use of varenicline, bupropion, or other medication therapies to assist in tobacco vaping cessation?
Female in her early 40s with chronic spontaneous urticaria occurring consistently only at night for the past 4 years. Lesions develop only at night wh...
Assume patient requires anticoagulation in the setting of acute thrombosis, with no need for IVC filter, but is approaching the end of her third trime...
For example, when would you recommend clinical exam for surveillance versus imaging with MRI, CT or PET?
What treatment do you initiate before you have a clear diagnosis?
Yue et al., PMID 38554774
Drug elimination is often helpful, but some triggers are not easy to identify because they are found in food items.
How do you counsel patients in this scenario?
I have a patient with recently diagnosed primary biliary cholangitis/cirrhosis (PBC) with SSc. Her laboratory values are within normal limits, but end...
Herold et al., PMID 31180194
Dao et al., PMID 38663923
Are the INRs reliable? In what scenarios would you not recommend POC INR use for warfarin monitoring?
Are these typically covered by insurance? Are t...
Can sotalol initiation for atrial fibrillation be performed safely outpatient, and if so, what would be a reasonable approach to accomplishing this?&n...
Bergman et al., PMID 38458916
Liang et al., PMID 35900801
Do you discontinue HCQ?
How do you guide what contraceptive type when asked by the medical team?
Chiung-Hui Peng et al., PMID 38436957
Do you empirically treat itchy patients -with a non specific rash- for scabies without obvious clinical findings for scabies?
Given the lack of efficacy of most treatment options, do you generally try to treat calcinosis cutis that is not bothering the patient even if it is q...
The REPRIEVE trial included participants who were between 40 and 75 years old.
Back and chest who deferred systemic antibiotic.
Do you have a preference on type of adjunct AV nodal blocker to use, and do propafenone and flecainide have similar safety profiles?
Can cefpodoxime susceptibility be reliably extrapolated from ceftriaxone susceptibility?
Have you had experience continuing low dose Accutane past the goal dosage recommendation?
Do you use combination therapies such as betamethasone and calcipotriene foam?
If so, how long?
Do you consider the appearance of a new rheumatoid nodule as a sign of RA activity?
This question is part of a collaboration with RheumMadness and is specifically in reference to: ULT During Gout Flare.
Does the type of breast cancer factor into your decision making?
Demay, et al., PMID 38828931
If so, what is the typical duration?
Is there any data on the use of anabolic agents in Paget's disease?
We know canagliflozin is not given to patients with amputations, what about other SGLT2 inhibitors
The patient is actively breastfeeding.
How do you monitor response and what do you consider a satisfactory response? Do you aim for a certain threshold of proteinuria?
Many patients are interested in romosozumab for "maximizing bone gain" and preventing future fractures. Some have had anabolic therapy with teriparati...
What is your treatment algorithm?
Do you routinely offer latent TB treatment in these cases?
And what factors push you towards the selection of a specific treatment modality?
When a PCP calls with concern for GCA and is wondering whether to start empiric steroids what data do you prioritize to make that decision and do you ...
Dutasteride versus Finasteride
What topical therapies have you found most effective? Have you found laser therapy to be effective?
What side effects do you highlight in conversation with them? How do you approach toxicity monitoring?
Bergman et al., PMID 38458916
Are there patients that you find respond best to these therapies?
Especially in light of the results of the randomized clinical trial published on 8/2024 in Jama Internal Medicine by Hayward et al., PMID 38587819.
Do you ever start mycophenolate without steroids?
Patients sometimes ask for annual urinalysis and ultrasound to monitor, but it is unclear if this is indicated.
Mother's insurance plan has a high deductible and phototherapy is inconvenient (family lives 50 minutes away).
Would you combine antibiotics with isotretinoin?
Would it be safe to resume and if so, when?
I found a study in which 32 patients continued on Botox for the treatment of chronic migraine. Only one had a miscarriage at 9 weeks and the rest seem...
I have an elderly patient with a history of biopsy-proven psoriasis on IL-17 biologic therapy. She has developed an intense itch without a primary ras...
Are there specific safety or efficacy benefits associated with prolonged infusion times in this population?
With no high-risk exposure do you repeat quant gold?
Do you order blood work to evaluate for underlying dyslipidemia or other metabolic diseases?
Do you favor one treatment over the other?
Do you find one treatment more effective than the other?
(preschool-aged patients)
Have you had success with deroofing or surgical excision? Is ILK the best option?
Individual times in the therapeutic range while on VKA treatment was not registered in FRAIL-AF.
Marcus et al., PMID 34775507
Sabatine et al., PMID 28304224
The ASH 2020 guidelines have "recommended that adults with HbSS or HbSβ0 thalassemia be screened at least once for silent cerebral infarcts even ...
This would apply to gynecologic and GI cancers as well. And as long as the patient's partner is within the recommend age of <45 yo
There was a recall on viscous lidocaine and many of our patients cannot find it. What would you recommend as alternatives?
Do you insist on ambulatory/home blood pressures to rule in/out white coat hypertension? Does your practice have a system to log patients' BPs to supp...
And how would you monitor response?
After replacing Vitamin D, what will be your first treatment of choice? Labs including ALP and calcium levels are normal. T scores are -3 or above. Th...
Do you frequently order liver biopsies for these patients?This question is part of a collaboration with RheumMadness and is specifically in reference ...
Do you refer all patients with suspected LN, patients with confirmed LN, or patients with specific features (not responding to usual therapy, certain ...
Have you recommended supplementing less common supplements such as zinc or selenium?
This question is part of a collaboration with RheumMadness and is specifically in reference to: Prevention of Autoimmune Disease: Vitamin D and O...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Allopurinol vs. Febuxostat
Do your recommendations differ depending on the fragrance category (i.e fragrance mix I, II or balsam of Peru)?
There is literature showing small changes in both free T4 and TSH (despite steady state) in the first few hours after ingestion of L-T4. In occasional...
Do you advocate to taper the TNF-i or simply continue to monitor for long term adverse events? This question is part of a collaboration with Rheu...
What disease activity index do you find more useful and most practical in a busy clinical setting? How often do you assess it?This question is part of...
How do you navigate insurance coverage?
If not, what can be possible causes for a postmenopausal woman to have FSH, LH < 0.3 with low E2, and being asymptomatic and doing well otherwise? ...
What formulation of topical nitroglycerin do you use?
Do you utilize a standardized script or questionnaire and if so, what types of questions are you including? Would you use JAK inhibitors in patients w...
How do you approach ongoing screening for TB in patients with history of treated latent TB, but have ongoing use of DMARDs and/or biologics given quan...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Exercise in Knee OA
A male patient in his 30s with two lumbar compression fractures (non-traumatic) and a Z-score of -2.6 in the spine, Z-score -0.5 in hips. History of 3...
For example, when switching from MMF to azathioprine, do you overlap the treatments as you lower the dose of one and add the other?
Assuming follow-up IV bisphosphonate x2 infusions to prevent rebound fractures
Do you feel differently about using these in patients with a history of HR-negative breast cancer?
For example - keeping a baby under 1 year on tacrolimus ointment for 3 months BID
How has this impacted your counseling and management?
Do you recommend a six-month wait period? Have you had patients that developed poor outcomes due to pursuing cosmetic procedures too early after compl...
And if so how soon after do you start?
Are oral bisphosphonates contraindicated with all types of bariatric procedures?
Is the interaction considered severe?
If so, do you routinely recommend use of an additional form of contraception?
Would you still plan for lifelong anticoagulation in this scenario?
Would you start with a baseline ultrasound and then pursue further workup such as fibroscan if fatty liver is present, or other?
Patient taken off methotrexate.
If so, for how long afterwards do you think the patient needs to continue the exercises?
E.g. young male, morbid obesity, with BMI >50
How much cumulative prednisone exposure do you tolerate and how many attempts at tapering will you pursue before considering addition of a steroid spa...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Antibodies Before SLE.
While follow up ultrasound is not usually recommended in provoked DVT, it often is done either for other reasons or by other physicians. Would this in...
How do you counsel patients and caregivers? Do you prescribe medications (''appetite stimulants'') with the goal to improve appetite even if they do n...
Her gynecologist wants her on hormone replacement therapy.
What’s your preferred NSAIDs and next steps?
I have a longstanding patient with diabetes and a consistently significant difference between CGM average and that predicted by serum A1c. The CGM avg...
In patients with chronic migraine and possible medication overuse headaches due to chronic narcotic use, what’s your strategy for those patients...
Anemia is secondary to menorrhagia. No gynecologic interventions were possible.
How do you compare safety to other oral immunosuppressants such as Methotrexate, CellCept, or Azathioprine?
What is your experience with ritlecitinib and how does it compare to baricitinib?
PMID 35939577
In FRAIL-AF, switching VKA therapy to a NOAC was associated with higher risk of bleeding in elderly, frail patients.
After what interval of sustained remission will you attempt to taper, and will you do so by first widening the dosing interval?
How do you determine duration of therapy for Tafamidis, or is it continued indefinitely for the patient?
Would you consider further imaging like coronary calcium scoring or coronary CTA to further risk stratify them?
Have you had success with topical lovastatin or PDT?
Do you universally perform baseline DEXA and Hgb A1C? How often are you obtaining routine labs?
https://www.jaad.org/action/showPdf?pii=S0190-9622%2824%2903329-2
If so, would you start immediately or wait for the second set of labs to confirm before initiating blood thinners?
I’ve seen several such patients who have no secondary causes for bone loss, on adequate calcium/vitamin D, and compliant with denosumab who do n...
Patient has received treatment with Rituximab and is taking hydroxychloroquine.
For example, patients who have been maintained on 5mg of prednisone for years without previous tapering attempts and the rheumatic disease is not acti...
Should this patient population be treated differently?
At our institution, we have started using EPIC to screen many patients for osteoporosis and ou...
NCCN cervical cancer guidelines added a new statement - Patients who have received prior pelvic radiation therapy and have osteoporosis may benef...
Does active smoking status influence this decision?
Do anti-inflammatory topicals such as niacinamide or sulfur-based products help with this type of rosacea?
Do you recommend any dietary changes or supplements? Do you modify your recommendations if the patient is breast feeding?
Is there an approach to tapering the other two medications while uptitrating Droxidopa dosing to reduce the risk of supine hypertension?
Patient is on antibiotics for chronic spinal hardware infection.
Have any patients reported side effects?
Specifically, what is your approach to outpatient monitoring to assess atrial fibrillation burden for patients with CHADS2Vasc score>2?
Assuming patient is <45 years old with cervical, vulvar, vaginal, anal, or head/neck cancers, or with CIN/VIN/VaIN/AIN/oropharyngeal precancerous l...
Have you tried any of the newer biologics?
Is patch or gel HRT with ASA prophylaxis a reasonable option after counseling? Or do you add a prophylactic DOAC?
Recent AHA guidelines state that all women who have had a diagnosis of preeclampsia in a prior pregnancy should receive an evaluation of cardiac risk....
How would you assess response to bempedoic acid and its safety on outpatient labs, and how frequently would you have labs monitored?
Patients in their later 40s with favorable intermediate-risk prostate cancer s/p 7000cGy/28 EBRT only.
The patient is on a dose of 22 mg of methotrexate weekly for severe rheumatoid arthritis.
If you would discontinue the methotrexate, how long would y...
How often should cardiac MRI be ordered in this context?
In patients with CKD, does urate lowering therapy have an effect (positive or negative) on progression of CKD?
Do you typically order a systemic workup? And, after topical corticosteroids, what other treatment options do you prefer?
Is lifelong LMWH the anticoagulant of choice? Would DOACs be an option?
Are higher levels of exercise in patients with PD potentially even more beneficial to brain health?
I feel like it’s nearly impossible to take carafate QID and avoid food and medications for 1-2 hours before and after. How do you counsel patien...
Do you do blood work? Or do you rely on review of systems?
No evidence of malignancy on serial CT scans.
What doses of allopurinol do you use, and how frequently do you titrate the dose?
(C3 just below normal, C4 undetectable)
Are dilute bleach baths enough? Should they use any topical therapies? Is there a need for Staph decolonization with something like mupirocin?
Data is clear that we should hold methotrexate at least one week after COVID and flu vaccines. How do you approach methotrexate management around Shin...
If a patient is has GERD or avoids NSAIDs, do you avoid Ketorolac IV?
And if so, what is a reasonable length of time for outpatient cardiac monitoring?
Do you rechallenge with lower dose? What is your tolerance for mild persistent transaminitis?
B5 deficiency can be seen in patients with burning feet syndrome, do you typically screen for this when assessing for neuropathy?
Would you consider low dose indefinite anticoagulation in any scenario? Any difference in approach between hematological malignancy and solid tum...
If so, how long would you monitor PTH levels?
No prior thrombosis; no family history of thrombosis. As per endocrine, the only useful therapy for the osteoporosis is estrogen.
Are there any significant benefits to lowering moderately elevated lipoprotein A levels?
Parks et al., PMID 11912373
The patient has no known history of autoimmune disease.
How does pravastatin differ in advantage from other high-intensity statins?
(i.e. frequency of serial BNP, troponin, cMRI)
Such as Leflunomide, Sulfasalazine, Mycophenolate or Azathioprine, since all of these medications have potential to cause liver enzyme elevation and i...
(Patient with active RA despite hydroxychloroquine)
In what cases do you discontinue the medication?
When adding nintedanib what sort of treatment course do you counsel the patient on? Do you plan to continue it indefinitely as long as the patient tol...
If so, when do you resume?
Do you attempt to taper fully or maintain at a low dose?
Are there ways to overcome barriers in insurance coverage of this combination of treatments?
Would you switch to a non TNFi biologic or continue current regimen with careful monitoring for evolution of lupus manifestations?
Would you bridge with enoxaparin 0.7 mg/kg/day in an ESKD patient, as described in a previous retrospective study (Pon et al., PMID: 24718051)?
For example: In a patient presenting with left arm swelling and found to have a left cephalic vein occlusive thrombus on ultrasound
Should they be placed on routine EGD surveillance and if yes at what intervals?
Any evidence behind this practice?
For example, if low GAIL and high Tyrer-Cuzick?
Do you prescribe JAK inhibitors as first-line treatments?
Do you perform any lab monitoring?
How would you educate Parkinson's patients about the benefits of exercise based off of this study?
In addition to the usual pharmcotherapy (CCBs, etc.)
E.g. pulmonary embolism, portal vein thrombosis, cerebral venous sinus thrombosis
What is the ideal approach for female adolescent athletes if they have complaints of fatigue and dizziness and are diagnosed with mild iron deficiency...
Do you charge for it? Do you bring them in to complete the paperwork? Or do you send them to PT for Functional Capacity Evaluation?
Have you tried hyaluronidase?
What labs do you order? How often do you order labs?
Have you ever needed to discontinue isotretinoin due to lab abnormalities?
Do you use anticoagulation in cancer patients who develop an unprovoked superficial vein thrombosis?
If so, do you treat for a limited period of time or indefinitely?
Since both pregnancy and cancer are risk factors for VTE, is there data to guide when or if we should prophylactically anticoagulate? If so, what shou...
What would you suggest to help address these disparities in our own practices?
MPN work-up negative
Although testing was not indicated, what do u do with these results?
Other hypercoagulability work up negative
There have been reports suggesting that patients with CTCL may be at increased risk for other malignancies.
Are there cases where food or environmental allergies significantly worsen eczema in children?
The serum testosterone is minimally low at 250 and the patient has some fatigue.
Does your treatment management differs for oral erosive lichen planus?
How would you approach patients with active malignancy on chemo and radiation?
E.g. low dose DOAC
Would the answer differ if the index event was arterial vs venous?
How is your approach different from or similar to those who undergo surgical menopause?
When do you refer to genetics? Does your approach change if they have an additional finding such as mitral valve prolapse or a prolapsed bladder/uteru...
Significant impact on ADLs and no response to doxycycline, hydroxychloroquine, sulfasalazine or methotrexate.
Continue MTX with monitoring of LFTs vs switching to another oral DMARD (aza, lef) vs GI for fibroscan?
Previous provoking factors resolved (CVC, malignancy, etc)
When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?
Do you advise against combination OCPs?
If work-up is sent and the patient is found to have a persistently positive antiphospholipid antibody, particularly lupus anticoagulant, would you con...
If so, where can patients find it? And besides topical clindamycin, what other topicals do you find helpful for individual lesions?
Currently on nonwarfarin therapeutic anticoagulation
I have heard of long-term pentoxifylline and Vitamin E daily combination that can prevent and even reverse radiation fibrosis (Delanian et al., PMID 1...
Assume a life expectancy of approximately 5-10 years. What factors would influence your consideration of intermittent ADT vs. watchful waiting?
The symptoms can be really miserable.I try to control it with antihistamines (don't find these helpful in most cases) and topical steroids, but that d...
Isotretinoin provides a permanent benefit to acne because it atrophies sebaceous glands. My assumption is that it leaves the skin and eyes permanently...
Is long-term oral ivermectin ok? What topical therapies other than topical ivermectin do you recommend/prescribe?
Do you refer them to Ophthalmology? Have you had to switch patients off of Dupixent due to their ocular side effects?
Would you offer it to a woman with a history of a provoked DVT?
Infection risk being primarily chronic venous stasis ulcers
Data is mixed based on the results of ORAL surveillance, STAR-RA and nationwide cohort studies.
Is a positive thimerosal test always a false positive?
What is the risk of pregnancy loss in absence of anticoagulation? What would you suggest if the patient had anticoagulation in prior pregnancies and r...
Patient had significant GI side effects with Trental. (This particular case involved a second course of radiation for a secondary lung cancer 30+ year...
I prefer dutasteride for its safety and efficacy compared with minoxidil which can interact with different drugs and food.
Also, minoxidil is a hyper...
Does topical 5FU cause eruptive keratoacanthomas or have any other concerning side effects?
Have you had success with therapies such as L- carnitine and other remedies?
What is your preferred approach to a pregnant patient who is in status migrainosus that is refractory to first line treatments?
Do you recommend any changes to their personal hygiene practices? or changes to their environment?
Especially after surgical procedures
Any success with hydroxychloroquine?
Especially forms of non-pharmacologic treatment, such as physical therapy or special devices.
What recommendations do you provide if there is concern that the patient is beginning to flare? Have you prescribed any of the new JAK inhibitors?
When would you de-escalate therapy?
The patient has no personal history of VTE, but has positive family history of VTE.
Any prophylactic anticoagulation options?
How would manage...
With studies showing rare risk of developing epilepsy after PRES do you just taper medications over the following weeks-months? Any need for outpatien...
Is it time limited since it may have been triggered by the pregnancy or is it indefinite since it is APLS associated?
I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...
Is there a difference in monitoring frequency for legacy drugs like bosentan vs newer agents (macitentan, ambrisentan)?
i.e. long car rides or plane rides
Is there a role for monitoring for relapse or increased disease activity as opposed to scheduled dosing?
What are your preferred treatment methods other than topical Vitamin E and azole antifungals?
How soon is too soon after surgery to check PSA?
In contrast to TNF inhibitors for psoriatic arthritis, which seem to peak and maintain response percentages, the DISCOVER-2 Trial (McInnes et al., PMI...
How do you counsel young adults with antibody-negative necrotizing myopathy on prognosis, risk of recurrence, and long-term monitoring/treatment?
Do you perform routine screening for coronary artery disease in aging patients already taking these therapies?
Is there any available therapy?
Would starting spironolactone be a good option?
In your experience, do specific patient features predict a better response?
Which holistic treatments for migraine without aura do you recommend for patients who are refractory to standard treatments?
(assuming that the malignancy evaluation has been completed and the lymphadenopathy is confirmed to be reactive)
What referrals do you recommend/imaging orders?
What do you tell men who want to know if their testosterone has recovered?
Recent articles regarding the use of JAK-Inhibition in RA have suggested to avoid in patients with increased CV risk. However, RA itself is cons...
For kids experiencing moderate to severe urticaria that improve with single-dose antihistamine, do you scale up the manufacturer packaging dosages up ...
Since these patients or their caregivers may not know the symptoms related to sleep disorders and the negative effects on their already compromised ne...
If a patient had prior breast conserving treatment and now has inflammatory breast disease, would you prophylactical send the patient to a cardiologis...
How can one safely taper off and stop clonazepam in a woman of reproductive age with epilepsy who is taking it chronically for epilepsy and is plannin...
How would the approach differ if the patient had a significant bleeding phenotype vs only minor bruising and mucosal bleeding?
Do you prefer restarting the biologic with the loading or maintenance dosing?
Would you switch to itraconazole or perform fungal cultures?
When would you consider repeating the course of treatment?
What medications (ibuprofen, steroids, muscle relaxers) due you use?
Are there any non-medication management options?
Some patients will go on to develop asymptomatic intermittent hematuria which can persist... In patients with scant hematuria, what's your routine car...
If so, how long after diagnosis do you do so?
How do you treat dangerous behavioral disturbances (aggression, nighttime wandering) in patients with dementia with Lewy bodies (DLB)?
If you have significant side effects, GI and/or cardiac with one of the cholinesterase inhibitors, would you try using another medication or would you...
FVL heterozygotes are often treated similarly to the general population. Aside from avoiding other VTE risk factors, are there situations where prophy...
Would you suggest switching to a viral vector vaccine, such as J&J?
Preference for low dose steroids vs attempting colchicine?
In patients diagnosed with pseudotumor cerebri, is vaginal delivery safe? How do you manage this condition during the pregnancy?
Would you hold these agents in the setting of invasive dental procedures?
Since tocilizumab is known to normalize ESR/CRP, are there any markers/blood tests that may be helpful to check for PMR patients with question of exac...
Conversion tables suggest starting the new drug with the next dose but do not seem to answer this question (i.e. if switching from rivaroxaban 20 mg d...
How do you maintain a trusting relationship with your patients when this relapse occurs?
i.e. obstretric APS without thrombosis or SLE
If this is bothersome to the patient, are there any topic ointments or medications that can help if used?
The question is broad and is meant to include patients who have healthy BMD, osteopenia, and osteoporosis, as well as exposure to first generation AED...
Are there specific vaccines you recommend repeating, or do you recommend a catch-up schedule?
Are there implications of reducing urate too much?
Would you offer indefinite anticoagulation if the event is unprovoked and the patient has low bleeding risk?
Would you consider keeping the patient on denosumab or would switch to an anabolic agent?
Specifically in patients of Vietnamese background? An association has been shown between HLA-B*5801 and the risk of allopurinol hypersensitivity react...
Dr. Charles-Schoeman presented data at ACR 21 showing that, paradoxically, there is a U-shaped relationship between inflammation and LDL levels in pat...
If so, what agent(s) do you prefer?
What is your duration of anticoagulation?
Do you routinely recommend any dietary changes or is the evidence not convincing?
What if the patient is triple-positive or has continued seropositivity on repeat lab testing? What is the appropriate interval of monitoring and does ...
Provoked or unprovoked VTE: Do you use D-Dimer (or even repeat imaging to reassess residual clot) in any capacity to guide anticoagulation duration? E...
For a relatively young, medically compliant patient with HFrEF (EF<35%) and h/o embolic stroke, what is the consensus of starting AC for secondary ...
Do you allow patients with breast cancer on tamoxifen to use black cohosh?
How do you manage ADHD in patients with Tourette syndrome in order to prevent exacerbating the tics such as with medications like Aderall?
Is there data that it actually helps?
While low-dose aspirin for primary thrombosis prevention in aPL without APS is not typically recommended outside cardiovascular prevention guidelines ...
While building a trusting patient-physician relationship, what therapies could be discussed that may be aligned with naturopathic medicine? (i.e. L-gl...
Do you switch to SQ MTX, or is it best to add tx, such as a TNFi?
In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?
Presuming that work-up for cardioembolic sources is negative, how would you proceed?
Would appreciate expert opinion on when to reimage and when to restart anticoagulation depending on findings.
Does this add any value?
If yes would you delay initiation of antineoplastic therapy to allow time for the vaccine to start acting?
Do you avoid due to the increased risk of GI adverse events?
Does the answer change on proximity/distance from breast (i.e. what if pelvis or lower extremity?)
Patient with ferritin level <1000 ng/mL and no evidence of end-organ damage
While there are many factors involving:- type (DVT vs PE, unprovoked vs provoked) and severity of venous thromboembolism (VTE) size- duration of antic...
While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...
Is there a role for earlier use of anabolic agents to promote bone healing in patients that develop AFFs?
Are there contra-indications while breast-feeding?
At what point could starting AEDs be considered for patients with recurrent simple febrile seizures?
What steps should be taken to wean them off?
e.g. a genetic mutation picked up through a family member
Do you recommend therapeutic phlebotomy to a certain Hct goal? Any strong evidence for thromboembolic risk related to erythrocytosis or if this is mit...
In follow up to @Jacqueline Casillas presentation at ASCO 2021 regarding models of survivorship care delivery for AYA patients.
Specifically: starting dose, rapidity of up-titration, frequency of lab monitoring, frequency of office visits, and timing of assessment for treatment...
Would you change your practice in light of the recently published studies: OPTIMAS Trial & Elan Trial
We usually recommend copper IUDs, but that's not feasible in all women.
If so, for how long?
While benefits outweigh known harms and limited data, do you worry about vaccination in patients with a history of or active autoimmune cytopenias (e....
Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?
Since desmoid tumors are associated with high estrogen states, is there an optimal contraception approach? Is there an optimal time for pregnancy? How...
E.g., inflammatory polyarthritis or inflammatory myopathy with onset within 2 weeks of documented COVID infection
What is your strategy to prevent and treat constipation in patients initiating or receiving opioids?
What non-pharmacological interventions do you recommend? Do you routinely prescribe prophylactic laxatives to patients initiating opioids? How do you ...
Would your counseling change if she reported a history of unplanned pregnancy? Is there any wording or waiver you might be able to use warning her of ...
AstraZeneca may cause PF4 antibodies leading to vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).
Would you offer low dose or standard dose aspirin instead?
Assuming the patient is a candidate for all anticoagulation options (no mechanical valve, antiphospholipid syndrome, patient-specific contraindication...
While thrombophilia testing is not routinely recommended prior to starting OCPs, how about after the development of a VTE?
Muscle disease is quiescent and no other manifestations such as ILD
There does not appear to be any guidance from the most recent published protocols on this topic. For individuals with dementia, recommendations call f...
(Skin thickening in the absence of visceral disease)
While the CKD population is at high thrombotic and bleeding risk, would you consider anticoagulating a patient prophylactically if they had a history ...
How do you decide on resumption or change of therapy?
How would you approach chemoprevention if tamoxifen is
For example, healthcare workers who require these vaccines for employment
Has your medical practice taken any steps either in community outreach or within the clinic to show support for this medically vulnerable population, ...
Ref: EINSTEIN-CHOICE and AMPLIFY-EXT
Would you approach this differently in patients with inherited thrombophilias?
Do you stop methotrexate or adjust the dose?
Are most places administering oral iron as once daily or every other day dosing due to upregulation of hepicidin receptors following oral iron adminis...
There is no uniform guideline in the literature. AAP recommends until 5 years old or 1-year post-splenectomy. Some for 5 years post-splectomy.
In low-risk patients (age < 40) or patients with very obvious causes of blood loss or iron deficiency (menorrhagia, pregnancy), do you routinely pe...
This includes handling saliva, vomit, sweat, vaginal secretions, semen, urine, and stool. Are there recommendations for intimacy, sex, laundry, and&nb...
If so, what is your time threshold for when you'll start PCP prophylaxis--when you anticipate steroid courses greater than 1 week? 1 month? 3 months?&...
Reduced requirements for documentation by CMS in 2021 with respect to billing and coding have raised new questions about what aspects of physician exa...
If so, what test do you use in clinical practice?
If so, what would be an ideal DMARD in this setting?
In a patient with a medical or personal indication to induce oligomenorrhea/amenorrhea, how would you manage OCP therapy if a patient develops a VTE d...
If there are a low-risk patients who can be monitored, how would you do so?
If unprovoked, would you consider stopping anticoagulation?
Are there exercises, massage techniques, or support garments that are effective at preventing or reversing lymphedema of the breast?
How do you counsel these patients about hormonal agents?
After optimizing symptoms and reversible factors, and attempting cognitive-behavioral interventions and exercise, do you recommend pharmacologic agent...
This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet
What do you do/say when a discussion of evidence-based information doesn't convince a patient that this is her best chance of cure? Some patients even...
The recent NELSON trial evaluates screening in a slightly different population than the USPSTF/NLST criteria. Which will you follow?
If this upstages the patient, do you modify treatment recommendations?
Do you encourage patients to take a break from/stop taking Fosamax or similar medications for their osteopenia or osteoporosis in order to prevent dev...
Obviously, patient and caregiver preferences are paramount. But, what factors do you consider? Does expanded hospice (e.g., Medicare Care Choices) inf...
This applies to both de novo cases and patients who have previously received injectable agents.
When a physical exam is important and telehealth is not a good option, should we be proactive and reschedule or should we continue to see them as sche...
For those of us who are just starting out in practice, do the seasoned pros have any advice?
What concerns do you have about a colonoscopy?
Is dental evaluation indicated for edentulous patients?
This question has come up most frequently with respect to the flu vaccine recently. Also, frequently this has been asked about the shingles vaccine an...
Indefinitely seems to be a typical recommendation, but rarely done.
How would you approach a post-menopausal woman who now wishes to start adjuvant endocrine therapy more than 3 years since surgery?
Should this be part of the follow up?
Tamoxifen prophylaxis has not been studied in women <35 years old, but it would be reasonable to assume they would benefit.
For a patient with vaginal adhesions/stenosis, do you recommend any other therapy besides a dilator?
Would estrogen cream be helpful in this scenario?
At what point would you introduce the discussion of weight management, whether for risk reduction or overall health?
Please share your tips on dealing with short and long term xerostomia.
What patient and disease factors may influence your decision?
Do your recommendations differ if patients are pre or postmenopausal given the data?
If a patient is due for their yearly mammogram on the breast that has been diagnosed with cancer but is still undergoing active treatment (chemo or ra...
Which appetite stimulants are the most effective? How do you respond to patients who request medical marijuana?
In view of higher risks of rectal cancer after pelvic radiation, is more frequent screening warranted?
Do you have a "threshold" quantity/dose of opioids above which you are uncomfortable prescribing?
Do you test for pregnancy prior to each cycle?
If there are 3 negative scans, do you continue annual screening?
I have a patient who will be climbing to the base camp of Mount Everest. Does a climb to 15,000 feet increase her risk? Should she wear a compression ...
Knowing that the analysis now is more detailed than it was 10 years ago.
What about non-Ashkenazi Jewish breast cancer patients with suspic...
Patient does not qualify for breast cancer screening by annual MRI per criteria (IBIS lifetime risk<20%, no known genetic predisposition,...
In particular, for men who have no strong indication for ADT?
Do you routinely screen for pituitary dysfunction after radiation therapy for nasopharyngeal cancer?
Studies have shown increased rate of endocrine dysfunction in these patients:
https://www.ncbi.nlm.nih.gov/pubmed/26011172
https://www.ncbi.nlm.nih....
Do you refer all patients who are felt to be at high risk to a genetic counselor for testing or are you comfortable performing a MyRisk panel in your ...
Recent NEJM study showed an increased breast cancer relative risk in longer durations of hormonal contraceptive use that could last up to 5 years. Pre...
In light of two phase III randomized trials showing duloxetine (S1202) and acupuncture (S1200) both improve AIMSS, which would you try first? Wou...
In a patient who has a rising PSA, palpable nodule, MRI findings etc., is it ethical to treat the patient with inadequate information and ri...
If so, how do you manage counseling for someone with low health literacy?
If a patient has a gynecological cancer, how long should one wait after RT before a screening colonoscopy can be completed?
In patients with new bone pain and without any evidence of bone metastases receiving GnRH agonists, how do you manage pain symptoms?
NCCN guidelines offer suggested schedules for interval imaging and laboratory studies, but also make it clear that the quality of evidence for these r...
Two retrospective studies from Stanford showed that patients who received ADT had an increased risk of dementia and Alzheimer's. Is this finding ...
Is there a role for routine use of additional or alternative imaging modalities for these patients, such as tomosynthesis, MRI, or ultrasound? I...
How might a recent (within 6 months) myocardial infarction affect your recommendations?
Do you routinely ask all women of childbearing potential to have a pregnancy test? If so, do you get a pregnancy test before their CT simulation or th...
Does your recommendation change depending on the agents they received?
Our lung cancer screening program does not enroll anyone who has previously been deemed to be a nonsurgical candidate. I see that there is no ev...
Do you treat patients who are clinically hypothyroid but biochemically euthyroid?
Are there specific subsets for whom these results should change management?
With ultra-sensitive PSA, it's unclear to me whether a doubling from 0.01 to 0.02 or 0.02 to 0.04 is significant. Is there a certain value that you wo...
A 40 year old patient receiving post-op RT for breast cancer asked me if there is any risk for her becoming pregnant after completing RT. Eric H...
The 2013 ASCO guidelines and current NCCN guidelines recommend yearly mammograms but our radiologists are still recommending mammograms every 6 m...
More specifically, which cardiac risk factors do you look for? Diabetes? Previous MI? Dyslipidemia? Peripheral vascular disease? CHF?
How should we counsel young women who are receiving treatment for GI/GYN malignancies?
What schedule is best for preventing fibrosis and for patient compliance?
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BJU international, 2014-12
Radiology, 2012-08
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2008-11-01
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Cancer, 2013-04-01
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AJNR. American journal of neuroradiology, 2013-08
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Annals of surgical oncology, 2010-10
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Br. J. Cancer, 2015 Jun 30
Head & neck, 2006-04
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Brain : a journal of neurology, 2017-03-01
Radiat. Res.,
Lipids Health Dis, 2017 Jun 02
JAMA oncology, 2015-11
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-06-20
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-02-20
JAMA oncology, 2016-04
JAMA oncology, 2017-01-01
JAMA, 2009-08-26
European urology, 2015-05
JAMA, 2008-01-23
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-02-01
European radiology, 2022 May 07
The Cochrane database of systematic reviews, 2020 Dec 21
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-04-20
National Cancer Institute (US),
Cancer Nurs, 2017-04-21
Journal of the National Cancer Institute, 2006-12-20
Medicine and science in sports and exercise, 2010-07
J Clin Oncol, 2016 Feb 20
Curr Breast Cancer Rep, 2016-01-01
Crit Rev Food Sci Nutr, 2018 Apr 19
JAMA, 2018-02-20
JAMA Oncol,
International journal of radiation oncology, biology, physics, 2015-04-01
Int. J. Radiat. Oncol. Biol. Phys., 2016-11-01
N. Engl. J. Med.,
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Proc Natl Acad Sci U S A, 2015 Aug 3
Journal of the National Cancer Institute, 2018-01-01
Pediatrics, 2014-04
Vaccine, 2014 Dec 08
The Lancet. Oncology, 2007-01
Radiother Oncol, 2015 Dec 15
Int. J. Radiat. Oncol. Biol. Phys., 2015 Nov 10
Lancet,
Lancet Oncol., 2016 Jun 23
International journal of radiation oncology, biology, physics, 2014-03-01
Breast cancer research and treatment, 2013-11
Annals of surgery, 2016-02
Breast cancer research and treatment, 2013-08
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-03-01
The Lancet. Oncology, 2016-09
Eur. J. Obstet. Gynecol. Reprod. Biol.,
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Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2010-02-01
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Cancer treatment reviews, 2017-02
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JAMA dermatology, 2018-06-01
The New England journal of medicine, 2011-08-04
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J Clin Oncol, 2019 Jul 22
Curr Oncol Rep,
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Arthritis Rheumatol, 2017 Aug
The journal of pain : official journal of the American Pain Society, 2019-06
Arthritis care & research, 2019-03
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Current opinion in rheumatology, 2015-05
Am J Med, 2012 Nov 20
J. Am. Coll. Cardiol.,
Annals of the rheumatic diseases, 1999-04
Pain, 2020 May 18
J. Rheumatol., 2019 Jan 15
Rheumatology (Oxford), 2020 Feb 11
Journal of the National Cancer Institute, 2013-08-21
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2010-02
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Archives of internal medicine, 2008-09-22
Arthritis and rheumatism, 2010-06
Arthritis Care Res (Hoboken), 2017 Aug
Arthritis care & research, 2012-05
JAMA, 2006-12-27
AJR Am J Roentgenol,
Arthritis & rheumatology (Hoboken, N.J.), 2016-11
Annals of the rheumatic diseases, 2019-04
Blood, 2008-05-15
The New England journal of medicine, 2019-02-21
J Thromb Haemost, 2019 Jul 28
N Engl J Med, 2018 Dec 04
Southern medical journal, 2016-11
Annals of the rheumatic diseases, 2011-05
Atherosclerosis, 2015 Aug 28
Ann Intern Med, 2020 Sep 22
Osteoarthritis Cartilage, 2018 Mar 02
Ann Rheum Dis, 2018 Oct 03
Ann Rheum Dis, 2018 Dec 14
Lancet, 2019 Nov 11
Obstet Gynecol,
JAMA,
Cancer Prev Res (Phila), 2019 Aug 16
Int J Urol, 2015 Jul 14
Int J Radiat Oncol Biol Phys,
J Sex Med, 2013 Feb 22
Cancer,
Annals of the rheumatic diseases, 2017-04
Arthritis Care Res (Hoboken), 2018 Aug
Lancet, 2015 Oct 01
Arthritis Care Res (Hoboken),
Blood, 2015 Dec 22
Contraception, 2016 May 03
J Low Genit Tract Dis,
BMJ, 2008 May 20
Circulation,
J Am Dent Assoc,
Arthritis Rheumatol, 2016 Oct 26
Ann Rheum Dis, 2019 Oct 31
Clin Infect Dis,
J Clin Oncol, 2019 Sep 18
Journal of psoriasis and psoriatic arthritis, 2019-04
Front Pharmacol, 2019 Mar 26
Am J Clin Nutr, 2020 Aug 25
Am J Prev Med,
J Natl Med Assoc,
J Adv Nurs, 2015 Sep 09
Issues Ment Health Nurs, 2018 Apr 13
JAMA Netw Open, 2020 May 01
Emerg Infect Dis, 2020 Jul 08
The American journal of medicine, 1984-01
Arthritis Rheum,
Blood, 2013-12-05
Blood Adv,
Blood,
Brachytherapy, 2019 Apr 17
Ann Rheum Dis, 2019 Aug 14
Thrombosis, 2013
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Cochrane Database Syst Rev, 2013 May 31
Circulation, 2020 Feb 17
Lancet,
Ann Rheum Dis,
American journal of hematology, 2023 May 12
The New England journal of medicine, 2014 Aug 21
Lancet Rheumatol, 2021 Apr 06
N Engl J Med, 2020 Nov 20
Haematologica, 2019 Oct 17
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Sleep Med Rev, 2021 Jun 10
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The Journal of rheumatology, 2004-12
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Gut,
Blood,
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Palliative medicine, 2022 Mar 31
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023 Mar 28
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Arthritis and rheumatism, 2001-12
N Engl J Med, 2021 Apr 14
Ann Neurol, 2020 Aug 05
The New England journal of medicine, 2003-10-16
Lupus, 2007
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Nat Rev Rheumatol,
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Int J Clin Pract, 2021 Apr 29
Nutrients, 2020 Dec 11
Trends Mol Med, 2021 Jun 07
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Chest, 2021 Feb
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J Pharm Pract, 2019 Mar 27
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Am J Respir Crit Care Med,
Seminars in arthritis and rheumatism, 2010-12
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Inflamm Bowel Dis,
Am J Clin Dermatol,
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Headache, 2021 Jun 23
Arthritis Rheumatol, 2021 May 24
J Natl Cancer Inst, 2011 Jul 09
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The New England journal of medicine, 2012-05-17
The New England journal of medicine, 2018-10-04
The New England journal of medicine, 2019-05-16
Heart, 2019 Apr 08
Blood, 2010-11-04
Pediatric blood & cancer, 2014-05
British journal of haematology, 2015-05
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