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(William T. Elliott, MD, FACP, )Tj
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(patients were randomized to a seven-day taper with )Tj
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(clonidine, tramadol, or buprenorphine. Patients then were )Tj
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[(crossed over to double-blind placebo during post-taper)111.2 (. )]TJ
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(The authors suggested that data warrant further exami)Tj
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(nation of long-acting tramadol as a method to manage )Tj
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(opioid withdrawal. This study is important because it )Tj
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(for medically supervised detox. Clonidine must be admin)Tj
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(istered several times a day and can cause hypotension and )Tj
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(sedation. Buprenorphine is a schedule III drug that is ef)Tj
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(fective but has abuse potential and requires a special Drug )Tj
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[(Enforcement Agency certi\037cation for this indication. T)67.3 (ra)]TJ
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(madol is schedule IV and inexpensive, with minimal side )Tj
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[(once a day)92 (. \()]TJ
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[(How Long Should P)35.7 (atients T)101.5 (ake Antibiotics?)]TJ
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(Is it necessary to \223complete the course of antibiotics\224 as )Tj
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(we have extolled our patients for years? Probably not, ac)Tj
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(cording to authors from the United Kingdom who recent)Tj
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(ly published a paper titled, \223The antibiotic course has had )Tj
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[(its day)92 (.\224 The authors argued that there is little evidence )]TJ
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(that failing to complete an antibiotic course contributes )Tj
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(to antibiotic resistance, and, in fact, the opposite is true. )Tj
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(Longer antibiotic courses have been shown to put pa)Tj
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(tients at risk for antibiotic resistance. They suggested that )Tj
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(\223antibiotic courses\224 are based on poor evidence and that )Tj
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(patients may be better off stopping antibiotics when they )Tj
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[(feel better)111.1 (. There is evidence that for community-acquired )]TJ
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(pneumonia, using fever resolution as a guide to stopping )Tj
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(antibiotics halved the average treatment duration without )Tj
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(affecting clinical success. They acknowledged that further )Tj
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(studies are needed, and that data suggest that longer treat)Tj
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(ment duration probably is bene\037cial for treating otitis )Tj
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(media. All this is contrary to current guidelines, including )Tj
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[(those from the W)86.1 (orld Health Organization, so it is likely )]TJ
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(tients who were anticoagulated with dabigatran required )Tj
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(an urgent procedure. Patients received 5 g of IV idaruci)Tj
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(zumab as two infusions 15 minutes apart. The maximum )Tj
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(percentage reversal of dabigatran was 100%. In bleeding )Tj
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(patients, the median time to cessation of bleeding was )Tj
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(2.5 hours. In the procedure group, 93.4% of patients )Tj
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[(W)18 (ithin three months, thrombotic events occurred in 6.3% )]TJ
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(The FDA has approved neratinib for the extended )Tj
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(lapatinib and afatinib. Neratinib is indicated for adults )Tj
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(neratinib was established in a randomized trial of 2,840 )Tj
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(patients with early-stage HER-2 positive breast cancer )Tj
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(who had completed treatment with trastuzumab within )Tj
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(free survival was 94.2% with neratinib compared )Tj
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(to 91.9% with placebo. The drug commonly causes )Tj
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(diarrhea, and loperamide should be administered )Tj
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[(routinely for the \037rst eight weeks of therapy)92.2 (. Neratinib is )]TJ
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(cirrhosis or with mild cirrhosis. The \037xed-dose combina)Tj
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[(and velpatasvir)111 (, along with a new drug, voxilaprevir)111 (. It)-5 ( )]TJ
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[(the combination resulted in 96-97% cure rates \(no virus)-5 ( )]TJ
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[(detected at 12 weeks\) in patients with all genotypes, some)-5 ( )]TJ
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