Latest Story

Mystery Quiz-The Answer

December 17, 2014
Mystery Quiz-The Answer

Vivian Hayashi MD, Robert Smith MD

The answer to the mystery quiz is pleural effusions, specifically, bilateral subpulmonic effusions. The chest radiograph shows a number of findings: (1) the apparent diaphragm shadow is in fact fluid sandwiched between the undersurface of the lung and the actual diaphragm (Image 2a, arrow); (2) the density of this shadow is homogenously white (Image 2a, asterisk) and differs from a normal diaphragm which has a graded density (Image 2b, triangle) due to superimposed air that progressively decreases towards the…

Read more »

Primecuts – This Week In The Journals

December 15, 2014
Primecuts – This Week In The Journals

By Joseph Plaksin

Peer Reviewed

This week, the Senate Intelligence Committee declassified a 500-page report that outlined and described uses of torture by the CIA to interrogate suspected terrorists after the attacks of 9/11 . While CIA Director John Brennan tried to defend his agency’s actions, Senator Dianne Feinstein, who chaired the committee that released the report, described the CIA’s interrogation program “a stain on our values and our history.”

Amidst these new revelations, protests in response to the grand jury decisions in the deaths…

Read more »

Mechanisms of Angiotensin Blockade in the Management of Diabetic Nephropathy

December 11, 2014
Mechanisms of Angiotensin Blockade in the Management of Diabetic Nephropathy

By Miguel A. Saldivar, MD

Peer Reviewed 

When a patient with diabetes comes into a clinic or hospital, it is not uncommon to hear the question, “Is he/she on an angiotensin-converting-enzyme (ACE) inhibitor (ACEI) or an angiotensin-receptor blocker (ARB)?” Most clinicians know the mantra: ACEIs are renoprotective in diabetes. Most are aware that clinical studies dating back to the 1990s have indeed shown the protective effects of ACEIs, such as captopril, against renal function deterioration in diabetes . Most are even aware that there are…

Read more »

Primecuts – This Week In The Journals

December 8, 2014
Primecuts – This Week In The Journals

By Amar Parikh, MD

Peer Reviewed

This week, the nation was rocked by the decision of a Staten Island grand jury to not indict Officer Daniel Pantaleo in the death of Eric Garner, who was killed after resisting arrest for suspicion of selling “loosies”, or single cigarettes from packs. This comes on the heels of the recent decision by the grand jury in Ferguson, Missouri to not indict Officer Darren Wilson in the shooting death of unarmed black teenager Michael Brown. In…

Read more »

From The Archives: Does Perioperative Smoking Cessation Improve outcomes?

December 4, 2014
From The Archives: Does Perioperative Smoking Cessation Improve outcomes?

Please enjoy this Post from the archives dated January 6, 2012

By Benjamin Wu, MD

Faculty Peer Reviewed

Mr. T is a 53-year-old man, with history significant for cholelithiasis. He decides to have an elective cholecystectomy after years of biliary colic. Mr. T is an active smoker and wanted to know if he should stop smoking prior to surgery?

Smoking is associated with adverse outcomes in surgery, however debate continues regarding the safety of perioperative smoking cessation. The current understanding of perioperative smoking cessation follows…

Read more »

Mystery Quiz

December 2, 2014
Mystery Quiz

Vivian Hayashi MD, Robert Smith MD

The patient is an 82 year old man with frequent breathlessness. The patient had been admitted several times in the past two years for congestive heart failure. Two years earlier, the patient suffered an NSTEMI. A diagnostic cardiac catheterization revealed triple vessel coronary disease. A decision to perform CABG vs coronary stenting was delayed pending an evaluation of iron-deficiency anemia associated with a positive test for fecal occult blood. A recent echocardiogram showed normal left ventricular function but diastolic…

Read more »

Myths and Realities: Airline Travel and Deep Venous Thrombosis-Does Economy Class Syndrome Really Exist?

November 26, 2014
Myths and Realities: Airline Travel and Deep Venous Thrombosis-Does Economy Class Syndrome Really Exist?

By Matthew Weiss, MD

Peer Reviewed

Background:

The number of worldwide air travelers is expected to surpass 3.3 billion by next year and possibly double by 2030 . The major growth areas for airline travel are international markets where growth rates were twice that of domestic flights within the U.S. during the past two years . With more passengers taking to the skies and enduring longer international and transoceanic flights, the general practitioner is increasingly asked to advise on the risk of travel-associated venous thromboembolism…

Read more »

Primecuts – This Week In The Journals

November 24, 2014
Primecuts – This Week In The Journals

By Chio Yokose, MD

Peer Reviewed

As temperatures took a noticeable dip earlier this week in New York City, prompting many of us to begrudgingly pull out our heavy down coats and boots from our closets, no place was hit harder than Buffalo, NY. Although no stranger to snow in this part of the country, even lifelong residents of Buffalo were shocked to wake up to a wall of white on Wednesday morning as a lake-effect storm, which rapidly developed over Lake Erie late Tuesday…

Read more »