Systems

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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MSG: Can an Amino Acid Really Be Harmful?

April 30, 2014
MSG: Can an Amino Acid Really Be Harmful?

By Michael Lee, MD

Peer Reviewed

The human taste bud has become increasingly accustomed to the Japanese invention of the early 20th century: monosodium glutamate, better known as MSG. Its basic component, glutamate, is a non-essential amino acid found in many naturally occurring food sources. This universally consumed food additive has historically garnered much attention for its potential threat to human health. To best understand how an amino acid has amassed such a tarnished reputation, we must first consider the history of its discovery and…

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Type 1 Diabetes: Research for Pancreatic Replacement, Transplantation and Regeneration

April 10, 2014
Type 1 Diabetes: Research for Pancreatic Replacement, Transplantation and Regeneration

By Karin Katz, MD and Loren Wissner Greene, MD, MA

Peer Reviewed

In 1964, Dr. Arnold Kadish used real-time glucose monitoring to adjust insulin infusion in a patient with diabetes and introduced the concept of a closed-loop system of insulin delivery. A decade later, several research groups developed closed-loop systems that linked glucose monitors with insulin pumps and determined how much insulin to deliver based on calculations from a set of algorithms . These big, bulky machines depended on intravenous routes of glucose…

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Proton Pump Inhibitors and Clostridium Difficile Infection

March 20, 2014
Proton Pump Inhibitors and Clostridium Difficile Infection

By Aaron Smith, MD

Peer Reviewed

First introduced in the late 1980s, proton pump inhibitors (PPIs) have revolutionized the treatment of gastric acid-related disorders and have been described as a miracle drug by patients and physicians alike. As is often the case with miracle drugs, however, long-term use of PPIs has led to unforeseen adverse effects. Chief among the purported side effects of PPI use is an association with Clostridium difficile infection (CDI). CDI, an enterocolitis that leads to voluminous and potentially fatal diarrhea, was…

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Can crossword puzzles prevent dementia?

March 12, 2014
Can crossword puzzles prevent dementia?

By Theresa Sumberac, MD

Peer Reviewed

The 2008 US Census Bureau reported that 14 to 16 percent of the adult population enjoyed crossword puzzles and that half of them played crossword puzzles at least twice a week. Wouldn’t it be wonderful if all those hours spent finishing the Sunday crossword puzzle were good for your health? Recent evidence shows that this may be the case. By 2030 the US population over 65 will double to more than 70 million, highlighting the need to…

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From The Archives: Should My Patient with a Solid Tumor be Anticoagulated in the Absence of Venous Thromboembolism?

March 6, 2014
From The Archives: Should My Patient with a Solid Tumor be Anticoagulated in the Absence of Venous Thromboembolism?

Please enjoy this post from the archives dated September 8, 2011

By David Altszuler, Class of 2012

Faculty Peer Reviewed

An empiric association between occult malignancy and thrombophlebitis has been recognized since Trousseau first reported the syndrome in 1865. The mechanism by which cancer predisposes to thrombophilia has not been fully elucidated; however, it is now clear that this is a symbiotic relationship. The second leading cause of death in hospitalized cancer patients (and a leading cause of death in ambulatory cancer patients) is…

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West Nile Virus: Just How Bad Is It?

March 5, 2014
West Nile Virus: Just How Bad Is It?

By Julian Horwitz

Peer Reviewed

As of mid-August 2012, the CDC had reported 1118 cases of West Nile virus (WNV) infections and 41 related deaths, which, pro rata, made 2012 the most prolific year for WNV in the United States . Although West Nile’s classification as a public health crisis remains debatable, the lack of treatment and vaccination options make associated severe infections a real threat.

West Nile virus, a single-stranded RNA virus of the Flavivirus family, was first isolated in Uganda in 1937 .…

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The Yolk Or The Egg

February 27, 2014
The Yolk Or The Egg

By Nicole A. Lamparello, MD and Molly Somberg, MD, MPA

Peer Reviewed

You hear it wherever you eat, whether at the deli ordering a breakfast sandwich or at the diner for Sunday brunch, “Egg whites only, please.” For the last decade, there has been a strong movement toward avoiding egg yolks; instead people are opting for only the ‘healthier’ egg white when ordering or cooking their breakfast.

However, are egg whites truly ‘healthier’ than eating whole eggs? What is the basis for this decision being…

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An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

February 21, 2014
An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

By Gabriel Schneider, MD

Peer Reviewed

The new oral anticoagulants (NOACs) are an appealing alternative to the burdensome vitamin K antagonists such as warfarin. These novel agents include direct thrombin inhibitors such as dabigatran (which inhibits thrombin) and factor Xa inhibitors such as rivaroxaban and apixaban (which prevent thrombin generation). Compared to warfarin, NOACs have fewer food and drug interactions, as well as a more predictable pharmacodynamic profile that serves to obviate the need for the frequent outpatient monitoring in most patients. In addition…

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Mammograms in the News, Yet Again

February 13, 2014
Mammograms in the News, Yet Again

By Miguel A. Saldivar, MD

Peer Reviewed

Mammograms are far from strangers to the paparazzi. It was only recently that a television news reporter from a prominent broadcasting company reluctantly agreed to have a mammogram performed on live television to promote breast cancer screening and help “save lives” . That same study diagnosed her with breast cancer, which was followed by the impressive statement from her physicians: “that mammogram just saved your life”. But over the last day or two several major newspapers are presenting…

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Should Beta-Blockers Be Used In The Setting Of Cocaine-Related Chest Pain?

February 5, 2014
Should Beta-Blockers Be Used In The Setting Of Cocaine-Related Chest Pain?

By Matthew A. Haber

Peer Reviewed

The following is a hypothetical example of a classic exam question that one might come across as a medical student:

A 50-year-old male presents to the emergency department with severe chest pain. His past medical history is significant for congestive heart failure and stent placement. His vitals are significant for a blood pressure of 220/110 and a heart rate of 170. On physical exam he appears to be profusely sweating, and his pupils are markedly dilated. Troponin I is…

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