Systems

The Forgotten Influenza of 1918: When a Strong Immune System Becomes a Weakness

September 23, 2009
The Forgotten Influenza of 1918: When a Strong Immune System Becomes a Weakness

Emily Breidbart

Faculty peer reviewed

As the threat of the swine flu surfaced in early 2009, doctors and the media referenced the influenza of 1918. Also known as the Spanish flu, this pandemic spread to nearly every part of the world and killed more humans than any other disease in a similar period in known history. According to an epidemiological study done in 2002, this unusually virulent strain of influenza A, subtype H1N1, is said to have killed approximately 50 million people worldwide. At least …

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Diseases 2.0: Rheumatoid Arthritis

September 18, 2009
Diseases 2.0: Rheumatoid Arthritis

Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment

Rachana Jani MD

Faculty peer reviewed

Rheumatoid arthritis is a well-recognized but enigmatic disease afflicting the lives of thousands of individuals each year. The mysterious nature of RA has become increasingly uncovered as research has mapped various pathways of cytokine production and interleukin activation. However, in practice, we use clinical criteria to diagnose RA and evaluate the effectiveness of these new therapies.Though soon to be updated, the American College of Rheumatology (ACR) …

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The Utility of GlycoMark ™: 1,5 Anhydroglucitol as a Marker for Glycemic Control

September 16, 2009
The Utility of GlycoMark ™: 1,5 Anhydroglucitol as a Marker for Glycemic Control

David R. Friedmann MD

Faculty Peer Reviewed

Hemoglobin A1 (Hb A1c) is the standard method for monitoring diabetic patients’ long-term glycemic control by indicating average blood glucose levels over a period of two months, or half of the average life span of red blood cells. A new biochemical marker GlycoMarkTM is a test that measures serum levels of 1,5-anhydroglucitol (1,5-AG), a monosaccharide derived from ingestion of food, slightly different in structure from glucose. The test has been available in Japan since the early 1990s but …

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PrimeCuts: This Week in the Journals

September 14, 2009
PrimeCuts: This Week in the Journals

Michael Ford MD

Faculty Peer Reviewed

Last spring, The New York Times published a series of articles that examined the status of “the War on Cancer,” initiated some 40 years ago by then president Richard Nixon. The halting pace of this war was made more poignant with the recent death of Senator Edward M. Kennedy, who had championed the effort from its inception. Certainly, much has been learned about cancer in the intervening decades, but while other illnesses saw dramatic improvement in outcome (since 1950, …

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Wheal and Flare: Chronic Urticaria Revisited

September 9, 2009
Wheal and Flare: Chronic Urticaria Revisited

Erin Ducharme MD

Faculty peer reviewed by Rardi Feigenbaum MD

Urticaria is a common cutaneous disorder characterized by transient edematous plaques resulting from acute dermal edema and surrounding erythema. Roughly 20% of the general population will manifest urticaria at some point in their lives, qualifying it as a condition caregivers should be able to recognize and treat. When the unsightly wheal and flare reaction combined with periods of intense pruritis persists for greater than six weeks without an identifiable causative agent, the condition is referred …

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Myths and Realities: Ginger Ale in Treating Nausea and Vomiting

September 3, 2009
Myths and Realities: Ginger Ale in Treating Nausea and Vomiting

Chau Che MD

Faculty peer reviewed

Despite the numerous medications available for the treatment of nausea and vomiting, some patients and doctors insist that ginger ale will alleviate gastrointestinal symptoms. As early as the first century AD, the Greek physician Dioscorides praised ginger root because it “gently stimulates the gut and is profitable for the stomach” (4). During the 16th century, the physician Lonicerus similarly wrote, “Ginger does good for a bad stomach” (4). Ginger has long medicinal roots in both India and China and …

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Can you offer a liver transplant to a patient with HIV?

August 28, 2009
Can you offer a liver transplant to a patient with HIV?

Faculty Peer Reviewed

Uzma Sarwar MD

Coincident with greater use of highly active antiretroviral therapy (HAART), chronic liver disease has become one of the leading causes of death amongst HIV patients. This reflects the high prevalence of chronic liver diseases in the HIV-infected; almost a third of HIV-seropositive patients are afflicted with liver disease, predominantly as a result of hepatitis B and/or hepatitis C co-infection. Given their increased life-span, many HIV-infected patients now progress to end-stage liver disease, where they used to succumb to the …

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Diseases 2.0: Calcific Uremic Arteriolopathy (CUA)

August 26, 2009
Diseases 2.0: Calcific Uremic Arteriolopathy (CUA)

Rebecca Hall MD

Faculty Peer Reviewed

Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment

Patient S.J. is a 36 year old female with a 20 year history of lupus and lupus nephritis now with end stage renal disease (ESRD) on hemodialysis. She presented with indurated, violaceous skin lesions with ulceration on both thighs. The lesions worsened and became increasingly painful over the last 6 months. Her extensive four month hospital course has been complicated by numerous episodes of superinfection and …

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CT Colonography-The Future of Colorectal Cancer Screening?

August 21, 2009
CT Colonography-The Future of Colorectal Cancer Screening?

Ely R. Felker


Faculty Peer Reviewed

The patient is a 52 year-old white male who presented to his internist for a routine examination. He has no family history of colorectal cancer. He has not previously been screened. He recently heard about CT colonography and would like to know how it compares to conventional colonoscopy. Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer death in the United States(1). Multiple studies have demonstrated that most colorectal cancers develop …

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Class Act: How Do You Diagnose Polymyalgia Rheumatica?

August 12, 2009
Class Act: How Do You Diagnose Polymyalgia Rheumatica?

Eve Wadsworth MD

Faculty Peer Reviewed

Polymyalgia rheumatica (PMR) is a condition that resembles several different disorders including osteoarthritis and can be difficult to diagnose. In addition to osteoarthritis, PMR can resemble conditions as diverse as depression, fibromyalgia, myopathic drug reactions, and malignancy. PMR, however, can be associated with dangerous consequences, namely blindness, and is responsive to well-established treatment regimens. As such, familiarity with PMR’s presentation and its unique features is critical so as to avoid serious complications that can result from a delayed or …

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Why is Syphilis Still Sensitive to Penicillin?

July 30, 2009
Why is Syphilis Still Sensitive to Penicillin?

Sam Rougas MD

Faculty Peer Reviewed

It seems that every week a new article in a major newspaper is reporting what most infectious disease physicians have been preaching for several years. Antibiotic resistance is rapidly spreading. Infections such as Methicillin Resistant Staphylococcal Aureus, Extremely Drug Resistant Tuberculosis, and Vancomycin Resistant Enterococcus have journeyed from the intensive care units to the locker rooms of the National Football League. That being said, some bacteria have strangely and until recently inexplicably behaved. Syphilis, a disease caused by the …

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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 a night out, there is evidence …

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