Systems

An Intern In The ER

April 1, 2011
An Intern In The ER

By Demetrios Tzimas, MD

New York City.  Bellevue Hospital Center.  July 17, 2009.  1:53 pm.  Intern Year. Long Call.

“Go down to the ER.  There’s a guy with chest pain for the past three days, EKG shows some non-specific changes, vitals stable.  First set of labs negative.  CXR clear.  They gave him a full-dose aspirin.  This sounds like a rule out chest pain, and since it’s Friday, he’ll go to medicine and not the chest pain unit.  I’d go down with you, but one of …

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From The Archives: Does Acetazolamide Prevent Altitude Sickness?

March 31, 2011
From The Archives: Does Acetazolamide Prevent Altitude Sickness?

Please enjoy this post from the Clinical Correlations archives first posted May 7, 2009

Seema Pursnani, MD

Because your parents have designated you as the family doctor, your Uncle Joe calls to ask you if he should take this medication called Diamox before going trekking in the Himalayas. You work at Bellevue in New York City: who climbs mountains here? What do you say?

Why do illnesses develop from changes in altitude?

The essential culprit is the fall in atmospheric pressure with an increase in …

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Is Dark Chocolate Good For You?

March 30, 2011
Is Dark Chocolate Good For You?

By Lisa Parikh, MD

Faculty Peer Reviewed

I was recently counseling an overweight patient about nutrition and exercise when he asked, “Doc, is it true what they say about dark chocolate being good for you?” I told him that although I had heard about this, I was actually not too sure about the evidence behind this. As a strong supporter of the “I wish that the best tasting foods were good for you” club, I decided this was the type of research that warranted my …

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From The Archives: The Skinny on Cachexia…Can it be Treated?

March 24, 2011
From The Archives: The Skinny on Cachexia…Can it be Treated?

Please enjoy this post from the Clinical Correlations archives first posted April 22, 2009

Michael T. Tees, MD, MPH

On the wards and in the clinic, the physician is frequently presented with a patient with a decreased appetite and alarming weight loss. The patient is likely frustrated with their own fraility, the family is upset at the poor nutritional state of their loved one, but the healthcare provider should be the most concerned. This clinical presentation without a prior diagnosis is worrisome, and if the …

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Educating Patients About Sun Exposure

March 23, 2011
Educating Patients About Sun Exposure

By Courtney Maxey

Faculty Peer Reviewed

At this point it seems that the general public is aware of the relationship between exposure to the sun and skin cancer. It is troubling, however, that our culture still considers a dark tan to be “healthy” despite the World Health Organization’s classification of ultraviolet light emitted from tanning devices as a human carcinogen, based on observational studies that show a 75% increase in cutaneous melanoma in people using tanning devices before age 35. Protection from the harmful ultraviolet …

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The Myth of the Helminth: Can Worms be the Next Therapeutic Breakthrough for IBD Patients?

March 16, 2011
The Myth of the Helminth: Can Worms be the Next Therapeutic Breakthrough for IBD Patients?

By Michael Guss, Class of  2012

Faculty Peer Reviewed

Helminths–parasitic worms that have co-evolved with humans and colonized our gastrointestinal (GI) tract for millennia–have developed the ability to modulate our inflammatory responses and evade our immune systems to survive . Until the 1930s, the helminth colonization of humans was almost universal, owing to poor sanitation conditions and an impure food supply . This changed as the economic development of the last century created improved sanitary conditions: clean running water, hygienic farming practices, and better medical …

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Stroke Prevention in the Setting of a Patent Foramen Ovale: A “Hole” in the Evidence

March 9, 2011
Stroke Prevention in the Setting of a Patent Foramen Ovale: A “Hole” in the Evidence

Brandon Oberweis, MD

Faculty Peer Reviewed

 Case Report:

A 48-year old gentleman with no significant past medical history presents to the emergency department with new-onset left upper extremity hemiparesis, visual field deficits, and decreased level of consciousness.  A non-contrast CT scan was performed and revealed right-sided focal hypoattenuation in the middle cerebral artery distribution.  Following acute management of this patient, further studies were conducted to elucidate the underlying etiology of the cerebrovascular accident.  An echocardiogram with an agitated saline contrast study (“Bubble Study”) was …

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Medicine by the Numbers: Blood Count

March 4, 2011
Medicine by the Numbers: Blood Count

By Michael Ford, MD

Faculty Peer Reviewed

  

                                             

2.65 x 10 # of erythrocytes in circulation, assuming Hematocrit 45%         120 Lifespan in days of an erythrocyte         2.5 million # of new erythrocytes produced each second to replace dying cells†         5.3 million # of erythrocytes per microliter of blood†,*         4,000 – 11,000 # leukocytes per microliter of blood         150,000 – 400,000 # platelets per microliter of blood         15.9 Grams of Hemoglobin A per deciliter of blood†         64,400 Molecular mass in grams of Hemoglobin A (protein tetramer)        …

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