Systems

Does Dietary Modification Help GERD?

June 18, 2010
Does Dietary Modification Help GERD?

By Ramya Srinivasan, MD

Faculty Peer Reviewed

The patient is a 29 year old overweight male presenting to clinic with complaints of reflux symptoms. He says that spicy foods aggravate these symptoms. In addition to weight loss counseling, he is given a prescription for esomeprazole along with a patient handout containing recommendations on foods to avoid and other behavior modifications that may ameliorate his symptoms.

Gastroesophageal reflux disease (GERD) is defined as the abnormal reflux of gastric contents into the esophagus at least once a …

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Appropriateness for Revascularization in Stable Angina

June 9, 2010
Appropriateness for Revascularization in Stable Angina

Introduction to Cases:

During the upcoming weeks, we will post a series of cases addressing the appropriate treatment for patients with stable coronary artery disease. We will be focus on indications for revascularization in stable angina. In all of the cases, the patients will be at high enough risk that stress tests and coronary angiography will be performed.

There has been recent data and recommendations on the appropriate indications for revascularization in stable angina. These recommendations are based on clinical symptoms, non-invasive imaging, and catheterization …

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Marijuana and Multiple Sclerosis- Half-Baked? The Evidence Behind Cannabinoid Use for the Treatment of Pain and Spasticity in MS Patients

June 3, 2010
Marijuana and Multiple Sclerosis- Half-Baked? The Evidence Behind Cannabinoid Use for the Treatment of Pain and Spasticity in MS Patients

By Maura RZ Madou, MD

Faculty Peer Reviewed

When the New Jersey legislature approved a measure to legalize the use of marijuana for patients with chronic illnesses early this year, multiple sclerosis (MS) patient Charles Kwiatkowski, of Hazlet, N.J., rhetorically asked the New York Times; “The M.S. Society has shown that this drug will help slow the progression of my disease. Why would I want to use anything else?”1 New Jersey was the 14th state in the nation to approve such legislation. Does the drug …

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Oral Contraceptive Pills: Is It Really Safe to Eliminate Your Period?

May 21, 2010
Oral Contraceptive Pills: Is It Really Safe to Eliminate Your Period?

By Rachel Edlin, MD

Faculty peer reviewed

A 29-year-old female patient with a history of iron deficiency anemia and heavy menstrual periods comes into the clinic for a regular visit. She is tired of iron supplementation and its associated constipation. As she is currently on oral contraceptive pills, you recommend using these to reduce her menstrual period to four times a year. She asks, “Is that really safe?”

Is menstruation necessary?

Monthly menstruation is not the historical norm. Compared with modern women, women in prehistoric …

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Appropriateness for Revascularization in Stable Angina

May 19, 2010
Appropriateness for Revascularization in Stable Angina

Introduction to Cases:

During the upcoming weeks, we will post a series of cases addressing the appropriate treatment for patients with stable coronary artery disease. We will be focus on indications for revascularization in stable angina. In all of the cases, the patients will be at high enough risk that stress tests and coronary angiography will be performed.

There has been recent data and recommendations on the appropriate indications for revascularization in stable angina. These recommendations are based on clinical symptoms, non-invasive imaging, and catheterization …

Read more »

Alzheimer’s Disease 2.0

May 12, 2010
Alzheimer’s Disease 2.0

Jeffrey Mayne MD

Faculty peer reviewed

Dr. Okonkwo’s post this past summer to PrimeCuts summarized ongoing research in Alzheimer’s Disease (AD), the most common cause of dementia affecting 15 million individuals worldwide and more than 5 million in the United States. It is a disease marked by cognitive deterioration that slowly breaks down one’s ability to perform activities of daily living and leaves individuals unable to care for themselves.

Briefly, the diagnosis of AD is based on clinical criteria and histologic confirmation at death. Based …

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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 aged 40-49 years” as well as …

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Motivational Interviewing: Can You Really Change Behaviors?

April 27, 2010
Motivational Interviewing: Can You Really Change Behaviors?

Emily Stamell

Faculty peer reviewed

As a well-trained fourth year medical student, I inquire about smoking habits as part of almost all my patient encounters. Yet, I do not recall properly counseling a patient on smoking cessation aside from the one liner “You know you should quit, right?” During first and second year of medical school we are taught the stages of change model, which is just as obscure two years later as cell signaling pathways. I was recently introduced to what seemed like an …

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Alzheimer’s Disease 2.0

April 21, 2010
Alzheimer’s Disease 2.0

Jeffery Mayne MD

Faculty peer reviewed

Dr. Okonkwo’s post this past summer to PrimeCuts summarized ongoing research in Alzheimer’s Disease (AD), the most common cause of dementia affecting 15 million individuals worldwide and more than 5 million in the United States. It is a disease marked by cognitive deterioration that slowly breaks down one’s ability to perform activities of daily living and leaves individuals unable to care for themselves.

Briefly, the diagnosis of AD is based on clinical criteria and histologic confirmation at death. Based …

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Which Thyroid Antibody Assays Should be Checked in Patients with Thyroid Disease?

April 14, 2010
Which Thyroid Antibody Assays Should be Checked in Patients with Thyroid Disease?

Michael Chu MD

Faculty peer reviewed

Case:

A 44-year old female presented to the emergency room with complaints of a lower extremity rash and swelling.  The patient had been in her usual state of health when she presented to her primary care physician with complaints of palpitations, weight loss and insomnia.  Lab tests were performed and she was given a diagnosis of hyperthyroidism.  She was started on propranolol and methimazole, which the patient took intermittently due to intolerance of side effects, which she perceived as …

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Antimicrobial Therapy Geared at Pseudomonas aeruginosa for Bronchiectasis

April 7, 2010
Antimicrobial Therapy Geared at Pseudomonas aeruginosa for Bronchiectasis

Diana Hubulashvili, Pharm.D.

Edited by Tania Ahuja, Pharm.D., BCPS

Faculty peer reviewed

Bronchiectasis is an uncommon condition that is characterized by irreversible dilation of the bronchi. Chronic pulmonary infections and airway inflammation cause bronchial damage through destruction of the muscular and elastic layer of the bronchial wall leading to bronchiectasis. Bronchiectasis is associated with serious pulmonary infections, inflammation, chronic cough, and increased sputum production...

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Breaking News: The Crestor Controversy

April 1, 2010
Breaking News: The Crestor Controversy

Devyani Kothari, MD

Patients are already talking about a New York Times front page article highlighting the risks associated with statin use as a preventive measure for cardiovascular events in relatively “healthy” people. The piece examines the newest FDA indications for the use of Crestor along with the controversies surrounding the drug.

Last month, the FDA approved Rosuvastatin Calcium, marketed as Crestor by AstraZeneca for use in a new patient population , based on the JUPITER trial. Crestor now carries the indication for the primary …

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