Systems

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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How Does Alcohol Affect Hypertension?

June 24, 2011
How Does Alcohol Affect Hypertension?

By Benjamin Kenigsberg

Faculty Peer Reviewed

Alcoholic beverages have been part of human culture for thousands of years and cross nearly every political and demographic boundary. Despite this long history, the interaction between alcohol and human health is still poorly understood. This confusion is particularly true with regard to blood pressure, as multiple studies have debated the association between alcohol intake and the development or management of hypertension.  For this discussion, in America a standard drink is defined as 12 ounces of regular beer, 5 …

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Hepatocellular Carcinoma Screening Guidelines and Bellevue’s High-Risk Population

June 22, 2011
Hepatocellular Carcinoma Screening Guidelines and Bellevue’s High-Risk Population

By Ramoncito David

Faculty Peer Reviewed

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death in the world.  The prevalence of this fatal disease greatly varies among different nations, due to the fact that almost 80% of cases are secondary to hepatitis B or C.

The implementation of an effective vaccine against the hepatitis B virus (HBV) has reduced the prevalence of HBV carriers in North America to 0.1-2%; however, hepatitis B remains a global public health problem due its high prevalence in …

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Mystery Quiz- The Answer

June 17, 2011
Mystery Quiz- The Answer

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

The answer to the mystery quiz is lymphangitic carcinomatosis (LC). The diffuse interstitial and infiltrative pattern seen on CXR is best appreciated on the CT of the chest. On Images 4, 5 and 6, interlobular septal thickening is apparent (arrow) and is due to tumor infiltration of interstitial lymphatics. Also evident on these images (arrowhead) is diffuse peribronchial thickening due to tumor infiltration of the airways. Image 6 (open arrowhead) additionally shows pleural nodules, …

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Mystery Quiz

June 16, 2011
Mystery Quiz

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

The patient is a 62 year old man presenting with increasing breathlessness for the past six weeks. The patient first noted symptoms of mild shortness of breath and cough productive of yellow sputum that he attributed to his yearly winter cold. The sputum cleared and at presentation the patient had largely unproductive cough. A construction worker until six months earlier, the patient’s unlimited exercise tolerance was now limited to minimal exertion. He denied …

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Forgoing the Fear: Contrast Nephropathy

June 15, 2011
Forgoing the Fear: Contrast Nephropathy

By Mario V Fusaro, MD

Faculty Peer Reviewed

There are certain laws in the universe that are just not meant to be broken.  One is gravity.  Another one is relativity.  The third, don’t give contrast to people with bad kidneys.   Perhaps the last one is not so much a law as something we seem to be terrified of doing.  While recently on service, I had a patient with unexplained right lower quadrant pain.  The obvious first or second or fifth step would be a contrast …

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If I Eat Candy and Fatty Foods, Will I Get Acne?

June 3, 2011
If I Eat Candy and Fatty Foods, Will I Get Acne?

By Timothy Wu, MD

Faculty Peer Reviewed

A 17-year-old female comes into the clinic for an annual health checkup.  During the visit she reveals that she has been dealing with acne so severe that she is often embarrassed to go to school.  She states that her diet often consists of lots of candy, fast food, and soft drinks.  She asks, “Am I getting acne because of what I eat?”

Introduction

Acne is a common skin disorder that affects more than 17 million people in the …

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