Heme/Onc

From The Archives: Myths and Realities: Do Power Lines Cause Cancer?

April 14, 2011
From The Archives: Myths and Realities: Do Power Lines Cause Cancer?

Please enjoy this post from the Clinical Correlations archives first posted May 20, 2009

By Aditya Mattoo, MD

Faculty Peer Reviewed

Prompted by personal experience, I thought I would explore the alleged causative role of power lines in hematologic malignancies for the next installment of Myths and Realities. In recent years, two close family friends living at separate locations but in homes adjacent to lots with electrical transformers were diagnosed with Multiple Myeloma and Non-Hodgkin’s Lymphoma.…

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From The Archives: The Skinny on Cachexia…Can it be Treated?

March 24, 2011
From The Archives: The Skinny on Cachexia…Can it be Treated?

Please enjoy this post from the Clinical Correlations archives first posted April 22, 2009

Michael T. Tees, MD, MPH

On the wards and in the clinic, the physician is frequently presented with a patient with a decreased appetite and alarming weight loss. The patient is likely frustrated with their own fraility, the family is upset at the poor nutritional state of their loved one, but the healthcare provider should be the most concerned. This clinical presentation without…

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Medicine by the Numbers: Blood Count

March 4, 2011
Medicine by the Numbers: Blood Count

By Michael Ford, MD

Faculty Peer Reviewed

  

                                             

2.65 x 10 # of erythrocytes in circulation, assuming Hematocrit 45%         120 Lifespan in days of an erythrocyte         2.5 million # of new erythrocytes produced each second to replace dying cells†         5.3 million # of erythrocytes per microliter of blood†,*         4,000 – 11,000 # leukocytes per microliter of blood         150,000 – 400,000 # platelets

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Erythrocyte Index

February 10, 2011
Erythrocyte Index

By Michael Ford, MD

Faculty Peer Reviewed

“Blood Count”

2.65 x 10 # of erythrocytes in circulation, assuming Hematocrit 45% 120 Lifespan in days of an erythrocyte 2.5 million # of new erythrocytes produced each second to replace dying cells† 5.3 million # of erythrocytes per microliter of blood†,* 4,000 – 11,000 # leukocytes per microliter of blood 150,000 – 400,000 # platelets per microliter of blood 15.9 Grams of

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Medicine By Numbers

January 21, 2011
Medicine By Numbers

How to Counsel a Patient on Prostate Cancer Screening in 5 Minutes

By Caprice Cadacio, MD

Faculty Peer Reviewed

A good screening test is relatively inexpensive and noninvasive.  In addition, effective treatment should be available if the disease  being screened for is confirmed.  Lastly, detecting the disease before a patient becomes symptomatic must be more beneficial than detection after the patient experiences signs or symptoms.

The latter point is often debated in prostate cancer screening,…

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Anthracycline Induced Cardiotoxicity

January 14, 2011
Anthracycline Induced Cardiotoxicity

By Ami Jhaveri, PGY-3

Faculty Peer Reviewed

Clinical Case:

K.M. is a 61-year-old woman with hypertension diagnosed with non-Hodgkin’s lymphoma 1 month ago.  Her only medication is hydrochlorothiazide.  She is about to undergo treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).  Her oncologist explains that doxorubicin may affect the heart and that she needs to obtain a Multi Gated Acquisition scan (MUGA)before proceeding with her treatment.  Her oncologist recently read a study describing benefits of beta-blockers…

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Breaking News: Lung Cancer Screening Shows Mortality Benefit

November 5, 2010
Breaking News: Lung Cancer Screening Shows Mortality Benefit

By David Hormozdi, MD

The weather outside may be cooling off but the debate surrounding lung cancer screening is heating up once again as preliminary results released from The National Lung Screening Trial (NLST) showed 20% fewer lung cancer deaths in individuals that underwent screening with low-dose helical CT scans compared to chest X-ray. This is the first study to show a mortality benefit from lung cancer screening and could impact millions of people considered high-risk for lung cancer.  The study’s…

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Why Does Multiple Myeloma Treat The Kidneys So Poorly?

September 22, 2010
Why Does Multiple Myeloma Treat The Kidneys So Poorly?

By Jon Emile Kenny, MD

Faculty Peer Reviewed

“You mean I’ve got cancer and my kidneys are failing, doc?” said my frail patient on the Bellevue oncology service shortly after a medical student had told him that his kidneys were damaged. Indeed, his new diagnosis of multiple myeloma was accompanied by an admission creatinine of 2.5 mg/dL.

About a quarter of patients with multiple myeloma have renal insufficiency at diagnosis . There are a number of clinicopathologic…

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Polycythemia Vera Presenting as a Hypercoagulable State: What is the Pathophysiologic Role of JAK2 in the Mechanism, Manifestations, and Treatment of the Disease?

August 11, 2010
Polycythemia Vera Presenting as a Hypercoagulable State:  What is the Pathophysiologic Role of JAK2 in the Mechanism, Manifestations, and Treatment of the Disease?

By Emily Slater

Faculty Peer Reviewed

Mr. R is a 46-year-old man with a past medical history of polycythemia vera on hydroxyurea and chronic hepatitis B and C who presented with acutely worsening left upper-quadrant abdominal pain.  This occurred in the context of 3 months of worsening abdominal pain and 1.5 years of increasing abdominal distension.  His physical exam was remarkable for massive splenomegaly (18cm span) and a non-palpable liver.

Laboratory findings are significant for microcytic anemia with an elevated

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Myths & Realities: Is Shiftwork Tumorgenic?

June 23, 2010
Myths & Realities: Is Shiftwork Tumorgenic?

By David Ecker, MD

Faculty Peer Reviewed

Over the last several decades, Westernized countries have become 24-hour societies.  Approximately 21 million workers in the US are on non-standard work shifts, including almost 4 million on regular overnight shifts. In 1972, Taylor and Pocock published a mortality study, in which they reported a significantly increased incidence of neoplasms in shift workers compared to the general population. After several published cancer incidence studies, Kerenyi explicitly proposed that changes in light exposure could be…

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Revisiting the USPSTF Breast Cancer Screening Guidelines: Ethics, and Patient Responsibilities

May 6, 2010
Revisiting the USPSTF Breast Cancer Screening Guidelines: Ethics, and Patient Responsibilities

David Shabtai

Faculty Peer Reviewed

 In a bold move, the U.S. Preventive Services Task Force recently changed their breast cancer screening guidelines – recommending beginning screening at age 50 and even then only every other year until age 75. Bold, because the Task Force members are certainly aware of the media circus that ensued when in 1997, an NIH group issued similar guidelines, prompting comparisons to Alice in Wonderland. The new guidelines, recommend “against routine screening mammography in women…

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Chief of Service Rounds: Should You Always Stop Anticoagulating a Bleeding Patient?

January 20, 2010
Chief of Service Rounds: Should You Always Stop Anticoagulating a Bleeding Patient?

Chief-of-service rounds is a new feature of Clinical Correlations.  Here we summarize Bellevue Hospital’s Chief of Service Rounds moderated by the Chief of Medicine, Nate Link, MD.  This multidisciplinary bimonthly conference focuses on a case that presents a diagnostic or treatment challenge.  A clinical question is posed at the end of the case and then answered using the principles of evidence based medicine.

Daria Crittenden , MD

Moderator: Nate Link, MD Associate Professor of Medicine, . GI consultant:  Gerry Villanueva, MD Clinical Assistant Professor of Medicine…

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