Monthly Archives: July 2010

The Ghost in the Machine – A Cautionary Tale

It all started a couple of years ago on a Saturday afternoon.  I turned on the radio to listen to the weekly Metropolitan Op­era broadcast, forgetting that Parsifal was scheduled. Being comfortably settled in a stuffed reclining chair, I was too lazy to turn the radio off.  Besides, nothing can put you to sleep faster…


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Trimethoprim and Hyperkalemia

Trimethoprim and sulfamethoxazole is an antibiotic combination (Bactrim®) commonly used to treat a variety of infections. In general, such therapy is well tolerated. But trimethoprim has a property which can cause trouble. Structurally and pharmacologically it resembles amiloride. The latter is a potassium sparing diuretic that exerts its effect by blocking the Na channel along…


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E Lucevan le Stelle

Everybody know this tune and every tenor sings it. Below is the Italian text followed by an English translation. Just in case anyone is new to opera, the aria occurs near the beginning of the third act of Puccini’s Tosca. E lucevan le stelle, ed olezzava la terra stridea l’uscio dell’orto ed un passo sfiorava…


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Treatment of High Blood Cholesterol

Measurement of blood cholesterol concentration is another screening test that has been widely employed without good evidence for its utility. There is no doubt that patients with coronary artery disease (CAD) benefit from the lowering of their blood cholesterol with statin (Lipitor and similar drugs) therapy – so called secondary prevention. But most primary care…


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