Liver Cirrhosis and Circadian Rhythm

July 1996 in “ Annals of Internal Medicine ”

Petra Steindl, Phyllis C. Zee, Andrés T. Blei

TLDR Taking high doses of fluconazole for a long time can cause reversible hair loss.

The document from 1996 reports a strong association between long-term, high-dose fluconazole therapy (more than 3 months and 400 mg/d or more) and reversible alopecia, as hair loss was observed in patients only after starting fluconazole and resolved upon cessation of the drug. The paper also suggests wrist actigraphy as a more reliable method than sleep diaries for monitoring sleep in cirrhotic patients and proposes further research into impaired melatonin metabolism in these patients. Additionally, it discusses the comparison of assays for monitoring HCV RNA levels, the behavior of tuberculosis in HIV-infected patients, side effects of itraconazole, and a rare association of enoxaparin with thrombocytosis. In a 1995 study involving 15,119 residents, international medical graduates (IMGs) outperformed United States medical graduates (USMGs) on the Internal Medicine In-Training Examination across all postgraduate year levels, indicating a high quality of training at some international schools.

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