Systems

Prostate Cancer Screening: Where Do We Stand Now?

December 9, 2009
Prostate Cancer Screening: Where Do We Stand Now?

Annery Garcia

Prostate cancer is the second most common cancer in western men and the second leading cause of cancer-related deaths in men in the U.S.1 In 2007 approximately 218,890 men were diagnosed with prostate cancer, and it is expected that one out of six men will receive the diagnosis in their lifetime.2 Although considered to be a slow-growing tumor, the American Cancer Society estimated that in 2008 186,330 new cases of prostate cancer would be diagnosed, and 26,000 men will…

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Continuous Glucose Monitors

December 2, 2009
Continuous Glucose Monitors

Ilena George

Faculty peer reviewed

Are continuous glucose monitors the answer for better glucose control in diabetes?

A poorly controlled type 2 diabetic who is non-compliant with his at-home glucose monitoring comes to Bellevue’s Adult Primary Care Clinic requesting a prescription for a needle-less glucose monitor…

Self-monitoring of glucose levels is a necessary evil of diabetes treatment. As the prospect of numerous needle-sticks each day in perpetuity is daunting to patients, researchers have been developing non- or minimally-invasive methods to measure blood sugar in hopes…

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Myths and Realities: Cell phones and the risk of brain cancer

November 27, 2009
Myths and Realities: Cell phones and the risk of brain cancer

Daria B. Crittenden

Although children today have never known a world without cell phones, the rest of us remember when these devices were created and have watched their popularity soar. The ability to have constant communication, anytime and anywhere, is now taken for granted. Many have asked the question, are we putting our health at risk with this technology? Specifically, with cell phones cradled against our ears many times a day, and sometimes for many hours a day, are we at…

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Breaking News: Begin Cervical Cancer Screening at 21 Says ACOG

November 20, 2009
Breaking News: Begin Cervical Cancer Screening at 21 Says ACOG

Joshua Strauss, MD

In the second decision of its kind and magnitude in a matter of days, a major medical group has again recommended cutting back on cancer screening for women.  On the heels of Monday’s USPSTF release on reducing mammography, newly revised evidence-based guidelines regarding cervical cancer screening were issued today by The American College of Obstetricians and Gynecologists (ACOG) and published in the December issue of Obstetrics & Gynecology. 

The new guidelines, “based on good and…

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What is the Role of Drug Therapy in Treating Obesity?

November 19, 2009
What is the Role of Drug Therapy in Treating Obesity?

Arlene Chung

Faculty Peer Reviewed

Despite the high prevalence of obesity1 and its associated morbidity2 and mortality 3,4, it represents one of the most difficult chronic conditions to treat. Barriers include a metabolically toxic environment, a history of ill-fated weight-loss regimens, and a general view of obesity as primarily a social, not a medical problem. 5 Deep down, the belief that obesity really is the result of gluttony and sloth probably persists. However, as we learn more about the…

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Breaking News: Initiate Mammography Screening at 50, not 40, Says USPSTF.

November 17, 2009
Breaking News: Initiate Mammography Screening at 50, not 40, Says USPSTF.

Aalok Turakhia, MD

As the debate over when to begin screening mammography in women rages on, the United States Prevention Service Task Force (USPSTF) added fuel to the fire by releasing a new recommendation statement in the November 17th issue of the Annals of Internal Medicine.  Applying to women aged ≥40 who are not at an increased genetic risk or have had chest irradiation, the USPSTF now recommends biennial screening in women between ages 50-74.  In February 2002, the task force first recommended that annual…

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Therapeutic Hypothermia

November 12, 2009
Therapeutic Hypothermia

Catherine Lucero, MD

Faculty peer reviewed

A recent article in the New York Times highlighted the remarkable recovery of a doctor who regained essentially all his mental function just six weeks after suffering a cardiac arrest with a post -resuscitation Glasgow coma score of 4.(1) Although the ambulance had originally rushed the doctor to the nearest hospital in Nassau County, he was quickly transferred to New York Presbyterian Hospital, where the receiving team induced hypothermia for the subsequent 24…

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Breaking News: FDA issues new warning for Exenatide (Byetta®)

November 5, 2009
Breaking News: FDA issues new warning for Exenatide (Byetta®)

Kanika Ballani, Pharm.D.
Diana Hubulasvili, Pharm.D.

 Developed by Amylin Pharmaceuticals, Exenatide (Byetta®) is an incretin mimetic that is used as an adjunctive therapy with metformin, a sulfonylurea or a thiazolidinedione to improve glycemic control in type 2 diabetic patients. Mechanistically, Exenatide mimics the actions of endogenous incretin hormone, glucagon-like peptide (GLP-1), causing an increase in insulin secretion which slows gastric emptying and leads to a decrease in food intake. On November 3rd 2009, the FDA issued a safety warning on Exenatide associating…

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How Does Alcohol Cause Cardiomyopathy?

November 4, 2009
How Does Alcohol Cause Cardiomyopathy?

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 research. This report will focus on some of the proposed mechanisms and…

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Tailoring Colon Cancer Screening

October 29, 2009
Tailoring Colon Cancer Screening

Guidelines for Colorectal Cancer Screening and the Recent Evidence Behind Them

 Nazia Hasan, MD MPH

Faculty peer reviewed

For most residents, screening for colorectal cancer (CRC) may seem as established as that for breast and cervical cancer. In reality, the use of CRC screening has only recently approached that of screening for those other malignancies. We have seen recently changes to the CRC screening guidelines last published by The American College of Gastroenterology in 2000.…

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Mystery Quiz- The Answer

October 27, 2009
Mystery Quiz- The Answer

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The answer to the mystery quiz is thoracic splenosis. The key to the solution is the past medical history of a gunshot wound. Shrapnel is seen on the plain CXR (Image 1) as well as in the soft tissue of the back (Image 5). The CXR also shows a lateral diaphragmatic abnormality (Image 1, arrow) likely due to adhesions. The left upper quadrant is notable for colonic gas where one…

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Mystery Quiz

October 23, 2009
Mystery Quiz

Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

A 61 year old man was referred to the pulmonary service for an abnormal pulmonary function test (PFT). The patient was a lifelong smoker and had symptoms suggestive of obstructive sleep apnea. The PFT showed a mixed obstructive and restrictive defect. The latter abnormality was considered to be out of proportion to the patient’s obesity, hence a chest CT scan was obtained to evaluate for possible parenchymal lung disease (shown…

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