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Metformin Because extended-release metformin, compared with the immediate-release presentation, is associated with a lower incidence of gastrointestinal adverse effects, such as nausea, vomiting, dyspepsia, and diarrhea, opting for the extended-release presentation is the first step in preventing the adverse effects related to this medication.9,10 The mechanism of action through which metformin triggers gastrointestinal adverse effects is not known, but there is increasing evidence supporting the idea that the pathophysiologic mechanism is secondary to dysbiosis, given the reports that Intestinibacter spp

As the forearm supinates from a position of full pronation, the volar radioulnar ligament is under stress and lengthens in a viscoelastic manner to accommodate

He then completed an intensive General Surgery Residency at the University of Texas Hermann Hospital before being selected for a highly competitive Plastic Surgery Fellowship at Northwestern University in Chicago, one of the most prestigious training programs in the country