Systems

Should I Consider Antibiotics in My Patient with Irritable Bowel Syndrome?

July 26, 2012

By Jason Chalifoux

Faculty Peer Review

The story of a patient with multiple office visits due to uncontrolled abdominal pain, bloating and diarrhea/constipation is common among primary care doctors and gastroenterologists. The workup is often extensive and rules out many etiologies. After discovering no metabolic, inflammatory, or anatomic pathology, physicians use the Rome III criteria to diagnose irritable bowel syndrome (IBS). IBS is a functional bowel disorder that is diagnosed by symptoms of recurrent abdominal pain or discomfort for at least 3 days per month…

American College of Cardiology 2012

May 29, 2012

By Steven Sedlis, MD

The 2012 Scientific Sessions of the American College of Cardiology were held from March 24-27, 2012 in Chicago. This is always a great city for a conference —terrific restaurants, museums and parks—it almost makes you feel as though you are in New York. The McCormick Place Convention Center is another attraction—it is well laid out and easy to navigate. It allows participants to freely move from session to session spending time on what interests them most. The ACC meetings are also…

Should Patients With Nephrotic Syndrome Receive Anticoagulation?

May 9, 2012

By Jennifer Mulliken

Faculty Peer Reviewed

Case 1:

A 30-year-old African-American male with a history of bilateral pulmonary emboli presents with a 1-week history of bilateral lower extremity edema. Blood pressure is 138/83, cholesterol 385, LDL 250, albumin 2.9. Urinalysis shows 3+ protein. Twenty-four hour urinary protein is 7.2 grams.

Case 2:

A 47-year-old Hispanic male with a history of mild hypertension and venous insufficiency presents with a 3-month history of bilateral lower extremity edema. BP is 146/95, cholesterol 241, LDL 165, albumin 1.9.…

Nothing QT (Cute) about it: rethinking the use of the QT interval to evaluate risk of drug induced arrhythmias

April 27, 2012

By Aneesh Bapat, MD

Faculty Peer Reviewed

Perhaps it’s the French name, the curvaceous appearance on electrocardiogram (EKG), or its elusive and mysterious nature, but Torsades des pointes, a polymorphic ventricular arrhythmia, is certainly the sexiest of all ventricular arrhythmias. Very few physicians and scientists can explain its origin in an early afterdepolarization (EAD), and fewer still can explain its “twisting of the points” morphology on EKG. Despite its rare occurrence (only 761 cases reported to the WHO Drug Monitoring Center between 1983 and 1999)1,…

From The Archives: How Does Alcohol Cause Cardiomyopathy?

April 19, 2012

Please enjoy this post from the archives dated November 4, 2009

Charles Levine

Faculty peer reviewed

Excessive consumption of ethanol (EtOH) has many deleterious effects on the human body. The heart is a target of damage from EtOH consumption, as chronic consumption of EtOH leads to decreased cardiac function and structural heart disease, including dilated cardiomyopathy.(1) The exact mechanism by which EtOH exerts its deleterious effects on the heart remains poorly understood and is an area of active…

A Study of Cultural Complications in the Management of Diabetes

April 18, 2012

By Kimberly Jean Atiyeh

Faculty Peer Reviewed

Ms. KS is a 49- year-old Bangladeshi woman with a history of diabetes mellitus and non-adherence to medical treatment or follow up, who was reluctantly brought to the Bellevue ER by her family for nausea, vomiting, and fevers for one day. Her most recent hospitalization was 9 months prior for epigastric discomfort in the setting of uncontrolled diabetes with a hemoglobin A1C of 12.4%. On arrival, her physical exam was significant for tachypnea, tachycardia, and dry mucus membranes.…

RTS,S/AS01: Is This The Beginning Of The End Of Malaria?

April 12, 2012

By Nicole Sunseri

Faculty Peer Reviewed

In Africa, there lurks a stealthy and powerful beast. Is it a lion, a black mamba, or a crocodile? No, it is the Anopheles mosquito. Although less than the size of a paperclip, these insects inflict an incapacitating blow, inoculating their larger human prey with Plasmodium spp., the parasites responsible for malaria. According to the World Health Organization, the worldwide incidence of malaria infection in 2009 was 225 million cases with a death toll of 781,000 Most of these…

Use it or Lose it- Do cognitive leisure activities protect against the development of Alzheimer’s?

March 30, 2012

By Courtney Cunningham, MD

Faculty Peer Reviewed

As the world population ages, enormous resources will be required to adequately care for persons suffering from Alzheimer’s disease. The disease is the fifth leading cause of death for adults aged 65 years and older, and is estimated to affect 1 in 8 persons in this age group. Despite recent advances, the cause of Alzheimer’s disease is not well understood. The FDA-approved medications in common use—donepezil (Aricept), galantamine (Razadyne), rivastigmine (Exelon), and memantine (Namenda)–help to manage symptoms; however…

What are the Barriers to Using Low Dose CT to Screen for Lung Cancer?

February 23, 2012

By Benjamin Lok

Faculty Peer Reviewed

Lung cancer is the most common cause of cancer deaths globally and responsible for an estimated 221,120 new cases and 156,940 deaths in 2011 in the United States. Presently, the United States Preventive Services Task Force, the National Cancer Institute (NCI), the American College of Chest Physicians, and most other evidence-based organizations do not recommend screening for lung cancer with chest x-ray or low-dose helical computed tomography (CT) due to inadequate evidence to support mortality reduction. This…

How Should You Choose the Best Anti-platelet Agents for Secondary Stroke Prevention?

February 16, 2012

By Demetrios Tzimas, MD

Faculty Peer Reviewed

You are about to discharge a 75-year-old female with hyperlipidemia, hypertension, peripheral vascular disease, who was admitted to the hospital for an ischemic stroke. Being an astute physician, you would like to mitigate this patient’s risk of having a second stroke. But you ask yourself, “with all of the agents available today, what anti-platelet agents should I put this patient on to decrease her risk for a second stroke?”

The etiology of an ischemic stroke, as defined by…

Myths and Realities: The Fishy Truth about Mercury Toxicity

December 17, 2011

By Nicole Learned

Faculty Peer Reviewed

In an age when patients obtain medical news from the media, and celebrities initiate powerful health trends, clinicians have to be prepared to answer even the most obscure questions about health and nutrition. When Entourage star Jeremy Piven took a leave of absence in 2008 from the Broadway play Speed the Plow due to alleged mercury poisoning from eating sushi twice a day for years, it raised the question: How much fish is too much?

Where Does Mercury Come…

A New Era of Therapy for Hepatitis C

November 4, 2011

By Alexander Jow, MD

Faculty Peer Reviewed

Hepatitis C virus (HCV) is a major public health issue, representing the leading cause of chronic liver disease, death from liver disease, and a principal indication for liver transplantation in the US. It is estimated that 3-4 million people in the world are infected with HCV each year. Globally, 130-170 million people are chronically infected with HCV and more than 350,000 people die from HCV-related liver disease each year. Although the natural history of HCV infection…

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Clinical Correlations

Systems

Should I Consider Antibiotics in My Patient with Irritable Bowel Syndrome?

American College of Cardiology 2012

Should Patients With Nephrotic Syndrome Receive Anticoagulation?

Nothing QT (Cute) about it: rethinking the use of the QT interval to evaluate risk of drug induced arrhythmias

From The Archives: How Does Alcohol Cause Cardiomyopathy?

A Study of Cultural Complications in the Management of Diabetes

RTS,S/AS01: Is This The Beginning Of The End Of Malaria?

Use it or Lose it- Do cognitive leisure activities protect against the development of Alzheimer’s?

What are the Barriers to Using Low Dose CT to Screen for Lung Cancer?

How Should You Choose the Best Anti-platelet Agents for Secondary Stroke Prevention?

Myths and Realities: The Fishy Truth about Mercury Toxicity

A New Era of Therapy for Hepatitis C

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