Primary Care Corner with Geoffrey Modest MD: Neurology academy recommendations for chronic noncancer pain management

By: Dr. Geoffrey Modest The American Academy of Neurology published a position paper on the use of opioids for chronic noncancer pain, or CNCP, lasting more than 3 months (see doi: 10.1212/WNL.0000000000000839). Their basic argument is that there are no data showing that longer term opioids are effective (though they do acknowledge that none of the randomized controlled […]

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Primary Care Corner with Geoffrey Modest MD: Hepatitis C Reinfection

By: Dr. Geoffrey Modest  A recent article from the Netherlands looking at hepatitis C (HCV) infection and reinfection in HIV positive MSM (men who have sex with men) sheds some light on the murky subject of HCV virology (See Clinical Infectious Diseases 2014;59(12):1678–85).  It has been known that anti-HCV antibody titers can decline in both acute and chronic HCV […]

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Primary Care Corner with Geoffrey Modest MD: Travelers Diarrhea Review

By: Dr. Geoffrey Modest JAMA had an excellent review (I think) of traveler’s diarrhea (see  JAMA. 2015;313(1):71-80​). Some of their major points for those traveling to high-risk countries: –eating food from street vendors certainly increases the risk, though one can get it in a 5-star hotels (esp if food served buffet-style and food exposed to warm environmental […]

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Primary Care Corner with Geoffrey Modest MD: Diabetes Recommendations 2015

By: Dr. Geoffrey Modest The American Diabetes Association just updated their clinical care recommendations, as they do annually. I will highlight the significant changes over last year, though I did repeat a few items of importance which did not change. –They lowered the BMI cutpoint for overweight in Asian Americans from 25 to 23 kg/m2, reflecting […]

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