Posts in Internal Medicine

An empty moonlit bedroom at night with white bedding, a knit throw, and a glass of water on the nightstand, illustrating sleep apnea and resistant hypertension.

Sleep Apnea and Resistant Hypertension: When the Blood Pressure Problem Happens at Night

Sleep apnea and resistant hypertension go together: apnea turns up in most people whose pressure stays high on three drugs, and CPAP lowers it modestly.

A woman seen from behind in a sunlit window seat mends a blush-pink knitted sweater, a metaphor for the DNA repair behind PARP inhibitors and BRCA.

BRCA and Synthetic Lethality: Turning a Tumor’s Broken Repair Kit Against It

PARP inhibitors and BRCA: tumors without BRCA repair depend on PARP, so blocking it kills cancer cells while sparing normal ones. Here is how it

Sunlight breaking through dark storm clouds over an autumn prairie as rain falls in the distance, a muddy track leading toward the light, a symbol of ketamine for suicidal thoughts as a bridge through a dark stretch.

Ketamine and the Suicidal Window: A Fast Bridge Across a Dangerous Gap

Ketamine for suicidal thoughts can ease them within a day, but only as a supervised bridge. The mechanism, the evidence, and why ongoing care matters.

A woman seen from behind at a kitchen table raising a glass of water toward an autumn sunset, a single white tablet in a small dish beside her, illustrating medication timing.

The Right Drug at the Right Time: How Chronobiology Reshapes Pharmacology

Medication timing matters for some drugs: short-acting statins work better at night, while long-acting statins and blood pressure pills work at any hour.

A monarch butterfly with open wings resting on dew-covered goldenrod in an autumn meadow at sunrise, a quiet image for an article on TSH and aging.

TSH and the Aging Thyroid: When a Higher Number Is Not a Disease

The upper limit of TSH drifts upward with age. In older adults, a mildly high TSH with a normal free T4 is often a new[…]

An open cryogenic storage vessel pouring white vapor across a stainless steel laboratory bench in cold blue light, illustrating how cord blood stem cells are banked.

The Graft That Has Never Met an Antigen: Cord Blood Stem Cells and the Arithmetic of Engraftment

Cord blood T cells are overwhelmingly CD45RA-positive naive cells that lack whole adult effector populations outright, including the skin-homing CLA-positive subset — which is why[…]

Extreme close-up of a calm brown eye with amber iris fibres and a white, unreddened sclera, accompanying an article on juvenile arthritis uveitis.

The Quiet Eye: Why Juvenile Arthritis Uveitis Is Screened on a Schedule, Not on Symptoms

Key Takeaways: The chronic anterior uveitis associated with juvenile idiopathic arthritis is usually asymptomatic, and the affected eye typically looks entirely normal.

A pregnant woman in an oatmeal sweater cradling her abdomen with both hands beside a sunlit curtain, illustrating Group B strep in pregnancy.

Colonized, Not Infected: Group B Strep in Pregnancy and the Protocol Built Around It

Key Takeaways: The single most useful sentence about Group B strep in pregnancy is that it describes a colonization state, not an infection. Streptococcus agalactiae[…]

Five open hands of different skin tones held palm-up side by side in dappled sunlight, accompanying an article on melanin and vitamin D testing.

Reading the Number in Context: Melanin and Vitamin D Testing

Key Takeaways: July is UV Safety Month, which makes it a good moment to examine the one common lab test where sunlight, skin biology, and[…]

A small unlabeled clear glass vial with a silver screw cap on a steel counter by a bright window, illustrating an article on compounded peptides BPC-157 and KPV.

An FDA Panel Just Backed BPC-157 and KPV. The Evidence Hasn’t Caught Up.

Key Takeaways: On July 23, 2026, an FDA advisory panel did something it rarely does: it overruled its own agency’s scientists. The Pharmacy Compounding Advisory[…]