Testosterone for Old Men

There is a lot that we don’t know about testosterone replacement therapy for older men. We know only a little about its efficacy, and almost nothing about its safety. Not surprisingly then, we don’t know the effective dosage or safe duration of use. And it’s not entirely clear whether it’s FDA-approved. The labeling says testosterone […]

Why Influenza Vaccine?

An upcoming issue of The Medical Letter (October 13, 2014) includes an article on the new influenza vaccine for the 2014-2015 season. We live in a time when many of our patients are suspicious of vaccines. Failure to be vaccinated against flu threatens not only the well-being of the individual patient, but also, when viewed […]

Osteoporosis: A Big Problem

The next issue of The Medical Letter (September 29, 2014) will feature an article on Drugs for Postmenopausal Osteoporosis. In anticipation, it might be worthwhile to consider the scope of the problem, which may be the most common of all those we write about. The numbers here come from guidelines published by the American Association […]

A New Antiplatelet Drug

The September 15, 2014 issue of The Medical Letter includes an article on vorapaxar (Zontivity), an antiplatelet drug that inhibits aggregation of platelets by interfering with the platelet-activating effects of thrombin, a mechanism of action that sets it apart from aspirin and the thienopyridines clopidogrel and prasugrel. Two clinical trials looked at whether adding it […]

Statins and Diabetes Risk: An Elaboration

The next issue of The Medical Letter (1450; September 1, 2014) will include a short article, prompted by an FDA warning, on the risk of developing diabetes from taking a statin. We cite briefly (one sentence) an interesting article that deserves more attention (PM Ridker et al. Cardiovascular benefits and diabetes risks of statin therapy […]

Diclofenac Gel for Osteoarthritis

The September 1, 2014 issue of The Medical Letter includes an article on Drugs for Osteoarthritis, which briefly mentions local application of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac as an alternative to oral NSAIDs. We devoted an entire article to the 1% topical gel formulation of diclofenac (Voltaren Gel) in 2008 when it was first […]

Treatment of Skin and Skin-Structure Infections

The next issue of The Medical Letter (August 18, 2014) will lead off with an article on 2 new drugs for treatment of skin and skin-structure infections. Both appear to be promising, but these infections will undoubtedly continue to be difficult and expensive to treat. A recent editorial in The New England Journal of Medicine […]


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