Systems

Chimeras Could Bridge the Gap Between Treatment and Cure Or Are They Your Silent and Deadly Twin?

August 8, 2014
Chimeras Could Bridge the Gap Between Treatment and Cure Or Are They Your Silent and Deadly Twin?

By Pritha Subramanyam

Peer Reviewed

Mrs. CS is a 66-year-old Indian female who presents for a cardiology follow-up. The patient has a history of mitral regurgitation secondary to rheumatic fever she experienced as a child. As a teenager, her condition was diagnosed when she frequently became short of breath while playing sports in school. She was in good health until 24 years ago, when an acute episode of dyspnea while climbing stairs sent her to the emergency room. Her native mitral valve was found to…

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Vit-a-minute: Are Supplements Worth It?

July 11, 2014
Vit-a-minute: Are Supplements Worth It?

By Aditya K. Sreenivasan

Peer Reviewed

The Huffington Post recently publicized a large study on the health habits of doctors. The study, a survey done by Medscape with 31,399 participants, revealed that more than half of doctors take some form of dietary supplement. The most common form of supplement taken was a multivitamin . With the way doctors find themselves in constant discussions about “evidence based medicine” these days, we can assume that there are solid data showing that multivitamins are beneficial to long-term health.…

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Inhaled insulin: An Elusive Revolution in Diabetes Management.

June 19, 2014
Inhaled insulin: An Elusive Revolution in Diabetes Management.

By Reed Magleby, MD

Peer Reviewed

For many with type II diabetes, initiation of insulin therapy represents a devastating progression of their disease. Patients who are dependent on insulin require constant blood sugar monitoring, adherence to strict dosing algorithms, and up to 4 self-administered injections every day. According to a 2010 survey of non-insulin adherent diabetic patients, both “injection phobia” and inconvenience were found to be important barriers to initiation of insulin therapy. . In response to these concerns, less invasive administration techniques such as…

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Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

June 13, 2014
Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

By Dana Zalkin

Peer Reviewed

In the late 1970s evidence began to emerge that a newly discovered pump, a H+/K+ ATPase in the gastric mucosa, was the final step in the process of acid secretion . With this discovery, further research demonstrated the ability to reduce gastric acid secretion by inhibiting these proton pumps . We now have drugs that do just that: the proton pump inhibitors (PPIs). Proton pump inhibitors have been used since 1989 to treat acid-related gastrointestinal disorders as well as in…

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Caffeine and the Risk of Atrial Fibrillation

June 6, 2014
Caffeine and the Risk of Atrial Fibrillation

By Joshua Michael Lader, MD

Peer Reviewed

As physicians, we are frequently asked to weigh-in on dinnertime discussions about topics that, despite their relevance to everyday life, were never formally addressed in our medical training. For example, at a recent family gathering the conversation turned to a 78 year-old uncle who was recently diagnosed with atrial fibrillation. While this uncle had longstanding and likely poorly controlled hypertension, he would also typically drink 4 to 5 cups of coffee between breakfast and lunch. The debate then…

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Are Probiotics Effective In Preventing Clostridium Difficile Associated Diarrhea?

May 30, 2014
Are Probiotics Effective In Preventing Clostridium Difficile Associated Diarrhea?

By Theresa Sumberac, MD

Peer Reviewed

Antibiotic associated diarrhea is a common complication of antibiotic therapy, occurring in 5% to 39% of all patients receiving treatment. Nearly one third of these cases are attributed to the gram –positive spore forming rod, Clostridium difficile . A primary Clostridium difficile associated diarrhea (CDAD) is estimated to add $2871 to $4846 to in hospital costs while a recurrent infection is estimated to cost $13,655 to $18,067 . The emergence of the hyper-virulent NAP1/B1/027 strain of C. difficile together…

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Gay Men, Barebacking and the New Little Blue Pill: The awkward interface of medicine and gay sex.

May 23, 2014
Gay Men, Barebacking and the New Little Blue Pill: The awkward interface of medicine and gay sex.

By Richard E. Greene, MD

Peer Reviewed

In July of 2012, the FDA approved the use of Tenofovir-Emtricitabine (Truvada, a single blue pill) daily as Pre-Exposure Prophylaxis (PrEP) in men with persistent risk for contracting HIV infection. The idea of PrEP has ignited a firestorm of concern among healthcare providers about how, when and in whom to use PrEP, if at all. Indeed, some believe that PrEP will usher in a new era of drug resistant new infections with HIV, or encourage men on…

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From The Archives: Metabolic Syndrome: Fact or Myth?

May 22, 2014
From The Archives: Metabolic Syndrome: Fact or Myth?

Please enjoy this post from the archives dated September 30, 2011

By Vicky Jones, MD

A 40-year-old female presented to her primary care provider with a chief complaint of weight gain over the past year.  She wants to be fully evaluated for any kind of medical disorder that could have caused it.  She has been seen by multiple specialists but no one can give her a “straight diagnosis”.  Their advice is for her to lose weight.  She insists she never had problems with her weight…

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Help Versus Hope: Acetylcholinesterase Inhibitors in Alzheimer’s Disease

May 21, 2014
Help Versus Hope: Acetylcholinesterase Inhibitors in Alzheimer’s Disease

By Jonathan Gursky

Peer Reviewed

Approximately 5.2 million Americans are currently living with Alzheimer’s disease (AD) , with this number expected to triple by the year 2050 . Alzheimer’s disease is now the sixth leading cause of death in the United States and accounts for $100 billion in healthcare expenditures each year . Nevertheless, the most devastating and far-reaching effects of Alzheimer’s disease hit close to home. While those with the disease progressively lose their memory, speech, and independence, it is the caretaker…

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New Cholesterol Guidelines: How Safe Are High-Potency Statins?

May 14, 2014
New Cholesterol Guidelines: How Safe Are High-Potency Statins?

By Molly Anderson

Peer Reviewed

Managing hyperlipidemia is a mainstay of cardiovascular risk reduction. The 2013 ACC/AHA guidelines no longer target specific low-density lipoprotein (LDL)-cholesterol levels, but recommend lipid-lowering therapies of varying intensity based on the predicted risk of cardiovascular events . Adoption of the new guidelines would result in millions more Americans receiving high-potency statins; it is therefore important to investigate potential dangers associated with aggressive therapy and the long-term implications for patients.

Many studies have shown that strict adherence to lipid-lowering medications improves…

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Lung Cancer Screening with Low-Dose CT Scans

May 9, 2014
Lung Cancer Screening with Low-Dose CT Scans

By Susanna Jeurling

Peer Reviewed

The U.S. Preventive Services Task Force (USPSTF) recently finalized its position regarding annual low-dose computed tomography (LDCT) scanning for early detection of lung cancer. The grade B recommendation states that individuals between the ages of 55 and 80 with a 30 pack-year history or more of smoking who are current smokers or who have quit within the last 15 years should undergo annual LDCT screening, based on the results of the National Lung Screening Trial . Lung cancer is the…

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Infection Transmission During Air Travel

May 7, 2014
Infection Transmission During Air Travel

By Aaron Smith, MD

Peer Reviewed

It’s become a familiar site to travelers: airline passengers wearing respiratory masks to filter pathogens from the cabin air. To those not wearing masks, the fashion trend can be discomfiting. Are the mask-wearers paranoid or prudent? What is the probability of contracting an illness on an airplane? And how unique is the aircraft environment when it comes to disease transmission?

It is clear that due to lower air exchange rates and decreased sunlight, enclosed spaces such as buildings…

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