Systems

The Asian Glow: A unique screening tool to evaluate for an elevated risk of esophageal cancer

July 29, 2009
The Asian Glow: A unique screening tool to evaluate for an elevated risk of esophageal cancer

Cindy Mui MD

Faculty Peer Reviewed

The alcohol flushing response is a physiologic response to ingestion of alcohol and is characterized by facial flushing, nausea, tachycardia, and hypotension, felt to be due to an inherited deficiency in the enzyme aldehyde dehydrogenase 2 (ALDH2). It is experienced by one third of East Asians and is more commonly known as the “Asian glow” or the “Asian flush”(1). Although the alcohol flushing response is generally seen as cosmetic and even embarrassing on…

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Mystery Quiz- The Answer

July 23, 2009
Mystery Quiz- The Answer

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

The answer to the mystery quiz is bland alveolar hemorrhage. The CXR (image 1) shows cardiomegaly with mild increase in opacification of the right middle and right lower lobes. The CT images show areas of multifocal ground glass opacification, that is, the underlying interstitium is visible through the opacification, and the variably sized opacities are widely distributed throughout the lungs (images 2, 3, and 4). Image 4 shows prominent interstitium…

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Mystery Quiz

July 18, 2009
Mystery Quiz

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

The patient is a 74 year old man complaining of hemoptysis for four days. The patient has a history of hypertension, but had not been followed medically for many years until two weeks earlier when he presented with leg swelling, breathlessness, and atrial flutter. He was admitted, diuresed, begun on antihypertensive medications including hydralazine, aspirin, and anti-coagulated with enoxaparin and warfarin. After discharge, the patient felt well for a few days before…

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Myths and Realities: Colon Cleansing: Healthful or just a load of @$%!

July 16, 2009
Myths and Realities: Colon Cleansing: Healthful or just a load of @$%!

Chau Che MD

Faculty Peer Reviewed

You’ll have increased energy, radiant skin, reduced joint pain, improved asthma symptoms, and best of all…you will lose weight. These are some of the purported benefits of removing “toxins” (otherwise known as undigested material) from the colon through cleansing. As with fashion, music, and art, what’s old has a way of becoming trendy again…especially when celebrities such as Beyonce talk about it on the Oprah Winfrey show. Colon cleansing has become popular but it…

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A Primer on H1N1

July 15, 2009
A Primer on H1N1

Liana Barkan MD

Faculty Peer Reviewed 

So much mystery and confusion, and yet so few answers, surround the current H1N1 Pandemic. From where did it come? How did it evolve to have genes from avian, human, and swine flu viruses? How does a virus that normally requires direct contact with the source animal develop the ability to sustain human-to-human transmission? What determines its mechanism of pathogenicity? Before we can attempt to answer these questions we need to review the basic pathophysiology…

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Meeting Perspectives: The 2009 American Thoracic Society (ATS) International Conference

July 8, 2009
Meeting Perspectives: The 2009 American Thoracic Society (ATS) International Conference

Commentary by Kristy Bauer MD and Nishay Chitkara MD, NYU Division of Pulmonary and Critical Care Medicine

The 2009 meeting of the American Thoracic Society took place in sunny San Diego, California from May 15-20. The ATS meeting is the largest gathering of pulmonologists, thoracic surgeons, nurses, respiratory therapists and other healthcare professionals, and features over 5300 original research studies and scientific presentations. San Diego has long been a frequent host to the ATS meeting, with its ideal location. The large…

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Breaking News: Federal Advisory Panel Recommends Ban on Vicodin and Percocet

July 1, 2009
Breaking News: Federal Advisory Panel Recommends Ban on Vicodin and Percocet

Aalok Turakhia MD

In an attempt to err on the side of safety, an advisory panel to the Federal Food and Drug Administration narrowly voted yesterday to ban the popular prescription pain medications Percocet and Vicodin, in a 20-17 vote.Both medications are a combination of a narcotic and acetaminophen, and according to the New York Times, it was a growing concern over the safety of acetaminophen that prompted the Drug Safety and Risk Management Advisory Committee to assemble in Adelphi,…

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Myths and Realities: Is Breakfast the Most Important Meal of the Day?

June 18, 2009
Myths and Realities: Is Breakfast the Most Important Meal of the Day?

Chau Che MD

Faculty Peer Reviewed

In an age when two thirds of adults are either overweight or obese and obesity rates in children continue to rise, would an intervention such as consuming breakfast daily help combat this problem? Skipping breakfast has become increasingly common in adults and adolescents in the United States, with the proportion of adults and children skipping breakfast increasing from fourteen to twenty-five percent between 1965 and 1991 (1,3). Additionally, skipping breakfast may be detrimental to…

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Systemic Lupus Erythematosus and Premature Coronary Artery Disease

June 17, 2009
Systemic Lupus Erythematosus and Premature Coronary Artery Disease

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 symptoms, lower extremity edema, or menstrual irregularities, but does…

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How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

June 11, 2009
How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

Uzma Sarwar MD

Faculty Peer Reviewed

With advancement in therapy, life expectancy has significantly increased among HIV-infected patients, and patients are now more likely to succumb to chronic disease processes. At present, approximately one third of deaths in HIV patients are related to liver disease, which has become the leading cause of death amongst HIV patients. The risk of death from liver disease in HIV patients is inversely related to their CD4 count. Infection with hepatitis C virus (HCV) accounts…

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Grand Rounds: Primary Aldosteronism, Beyond Conn’s Syndrome

June 4, 2009
Grand Rounds: Primary Aldosteronism, Beyond Conn’s Syndrome

Michael Chu MD

Please also see the clinical vignette presented before Grand Rounds on the 21st of May.

The Medical Grand Rounds presentation on May 21, 2009 titled “Primary Aldosteronism, Beyond Conn’s Syndrome” was delivered by Dr. William F. Young M.D., Professor of Medicine at the Mayo Clinic College of Medicine. Dr. Young’s talk began with the index case of hyperaldosteronism that was described by Dr. Jerome Conn in the 1950’s, through the advances in the diagnosis of…

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Class Act: A Multivitamin a Day – Does It Really Keep the Doctor Away?

June 3, 2009
Class Act: A Multivitamin a Day – Does It Really Keep the Doctor Away?

Does daily use of a multivitamin help prevent illness and chronic disease?

Kate Gibson, MS-4

Faculty Peer Reviewed

A 65 year old male patient with a history of hypertension and hyperlipidemia comes into the clinic for a regular visit. On his way out he asks, “Should I be taking a multivitamin?” You stop and think for a minute and decide, why not? But is there any actual evidence supporting the effectiveness of daily use of a multivitamin?…

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