Systems

The Treatment For Clostridium Difficile? Transplant!

July 29, 2011
The Treatment For Clostridium Difficile? Transplant!

By Andrea Mignatti , MD

Faculty Peer Reviewed

Among all the new medical therapies, this one will probably not be the most elegant or refined that you will read about. But it just may be one of the most unconventional ones you will come across.

From our experiences working on busy hospital wards, we know that Clostridium difficile colitis is an extremely serious infection that is becoming more prevalent due to the development of new hyper-virulent strains (toxinotype III BI/NAP1/027). It has been …

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Mental Health Considerations for Gay and Lesbian Patients

July 27, 2011
Mental Health Considerations for Gay and Lesbian Patients

By Benjamin Cox

Faculty Peer Reviewed

Gay men and lesbian women are members of a stigmatized minority group and evidence suggests that they may disproportionately utilize mental health services. This increased use of mental health services may be related to the concept of minority stress: that stigma, prejudice, discrimination, and violence create a hostile and stressful social environment that can contribute to mental health problems. Examples of external stressors that pose threats to mental health in gay and lesbian patients include verbal and physical violence, …

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Low Dose Vitamin K Supplementation and Anticoagulation Control

July 21, 2011
Low Dose Vitamin K Supplementation and Anticoagulation Control

By Joanna Becker

Faculty Peer Reviewed

Patients who are placed on long-term warfarin (Coumadin) therapy are sent home with a lengthy list of restrictions to minimize variations in warfarin efficacy. The agents that can alter warfarin levels can be divided into 2 categories: (1) those that interact with cytochrome P450, which metabolizes warfarin and (2) those that alter phytonadione (vitamin K) levels.  The majority of inter- and intra-individual warfarin dose variability is attributable to the agents in category 1 above, which include everything from antibiotics, …

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Systemic Lupus Erythematosus and Premature Coronary Artery Disease

July 14, 2011
Systemic Lupus Erythematosus and Premature Coronary Artery Disease

Please enjoy this post from the Clinical Correlations archives first posted June 17, 2009

Ishmeal  Bradley MD

Faculty Peer Reviewed

Ms. W is a 35 yo woman with a history of systemic lupus erythematosus diagnosed 10 years ago. Her only medications are hydroxychloroquine and prednisone for occasional disease flares. She is otherwise healthy. She has no known personal or family history of cardiac disease or stroke, but does smoke ½ pack of cigarettes per day. Currently, she denies any chest pain, shortness of breath, urinary …

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Understanding the Zoster Vaccine

July 13, 2011
Understanding the Zoster Vaccine

By Michael Cohen

Faculty Peer Reviewed

The varicella-zoster virus (VZV) is well known to the majority of the population. In children, it strikes as varicella (chickenpox), characterized by pruritic, vesicular lesions in different stages of development dispersed over the body. A self-resolving and generally limited disease, this form of VZV infection is considered to be a nuisance more than a debilitating affliction, but rarely can have severe sequelae. In adults and the elderly VZV more commonly takes the form of zoster (shingles). This disease results …

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Do Soft Drinks Cause Hypertension?

July 8, 2011
Do Soft Drinks Cause Hypertension?

By Ivan Saraiva, MD

Faculty Peer Reviewed

Sugared soft drinks are among the most heavily consumed drinks in the US. Carbonated soft drinks were first invented as a way to make “healthier” water that looked like natural carbonated waters that were found in European spas in the mountains. The name soda came from the use of bicarbonate of soda, which was used to produce carbonation (for an excellent review of the history of beverages, refer to Wolf et al..  Unfortunately, we no longer realize any …

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ANCA and Small-Vessel Vasculitis

July 7, 2011
ANCA and Small-Vessel Vasculitis

By Eugene Friedman, Class of 2012

Faculty Peer Reviewed

The discovery of anti-neutrophil cytoplasmic antibodies (ANCA) was a serendipitous finding. In 1982, Davies and colleagues published a report detailing their discovery of antibodies that specifically localized to the cytoplasm of neutrophils in patients with necrotizing glomerulonephritis and small-vessel vasculitis–antibodies that disappeared after immunosuppressive therapy and reappeared with disease recurrence. Two years later, Hall and colleagues confirmed this observation , paving the way for the 1985 Lancet article where van der Woude and colleagues proposed …

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Red Yeast Rice: Nature’s Statin?

June 30, 2011
Red Yeast Rice: Nature’s Statin?

By Joshua Farhadian

Faculty Peer Reviewed

M. K.  is a 61-year-old female with hypercholesterolemia who presents to clinic complaining of muscle pain and weakness.  She reports that one month after beginning statin therapy she developed myalgias and immediately stopped taking her medication.  She states that she wants to control her cholesterol level, since both of her parents died of heart disease; however, she is hesitant to take a prescription medication due to the side effects she experienced.  She asks you about red yeast rice (RYR). …

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