Systems

Is Vasopressin Indicated in the Management of Cardiac Arrest?

February 2, 2011
Is Vasopressin Indicated in the Management of Cardiac Arrest?

By Brandon Oberweis, MD

Faculty Peer Reviewed

Case Report:

A 65-year-old male with a past medical history significant for NYHA class IV heart failure was found by his wife to be unresponsive.  Emergency Medical Services was subsequently called and upon arrival, initiated chest compressions and defibrillation for cardiac arrest secondary to ventricular fibrillation.  Intravenous access was obtained and despite two episodes of defibrillation, the patient remained in ventricular fibrillation.  The patient was given one dose of 40 U of vasopressin followed by 1 mg …

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Medicine By Numbers

January 21, 2011
Medicine By Numbers

How to Counsel a Patient on Prostate Cancer Screening in 5 Minutes

By Caprice Cadacio, MD

Faculty Peer Reviewed

A good screening test is relatively inexpensive and noninvasive.  In addition, effective treatment should be available if the disease  being screened for is confirmed.  Lastly, detecting the disease before a patient becomes symptomatic must be more beneficial than detection after the patient experiences signs or symptoms.

The latter point is often debated in prostate cancer screening, which is done by obtaining a serum prostate specific antigen …

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Should You Eradicate Helicobacter Pylori Prior to Chronic NSAID Treatment?

January 19, 2011
Should You Eradicate Helicobacter Pylori Prior to Chronic NSAID Treatment?

By Joshua Smith, MD

Faculty Peer Reviewed

CASE:  A 54-year-old Asian female with no significant past medical history presents to her primary care physician with the complaint of several weeks of pain in her fingers bilaterally along with pronounced, worsening morning stiffness.  She is subsequently diagnosed with rheumatoid arthritis (RA), and the decision is made to start her on long-term, high-dose non-steroidal anti-inflammatory drugs (NSAIDs).  Given the link between NSAIDs and peptic ulcer disease (PUD), should this patient first be tested, and if positive, treated …

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Anthracycline Induced Cardiotoxicity

January 14, 2011
Anthracycline Induced Cardiotoxicity

By Ami Jhaveri, PGY-3

Faculty Peer Reviewed

Clinical Case:

K.M. is a 61-year-old woman with hypertension diagnosed with non-Hodgkin’s lymphoma 1 month ago.  Her only medication is hydrochlorothiazide.  She is about to undergo treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).  Her oncologist explains that doxorubicin may affect the heart and that she needs to obtain a Multi Gated Acquisition scan (MUGA)before proceeding with her treatment.  Her oncologist recently read a study describing benefits of beta-blockers and ACE inhibitor therapy in patients receiving treatment …

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Meeting Perspectives: American Heart Association Scientific Sessions 2010

January 12, 2011
Meeting Perspectives: American Heart Association Scientific Sessions 2010

By Steven Sedlis, MD

The 2010 Scientific Sessions of the American Heart Association were held on November 13-17 in Chicago, IL. Details of all the late breaking trials including presentation slides and commentary are available on the newly redesigned and user friendly meeting web site: http://scientificsessions.americanheart.org/portal/scientificsessions/ss/. The cardiology fellows stayed at the W in the Loop and had a raucous party Monday night hosted by Barry Rosenzweig and Glenn Fishman to which the faculty was invited. There was plenty to celebrate. Two of the fellows …

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Myths and Realities: Does Vitamin C Work for the Common Cold?

January 7, 2011
Myths and Realities: Does Vitamin C Work for the Common Cold?

By Carolyn Bevan,  MD

Faculty Peer Reviewed

It starts with a tickle in your throat.  You feel a bit more tired after a day’s work, maybe your forehead feels a little warm.  You try to will it away, but over the next few days, it hits you: the congestion, runny nose and annoying cough.  Much to your dismay, you have a cold.  Determined not to give in without a fight, you drag yourself to the nearest drug store and buy the first mega-dose vitamin C …

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From The Archives – Deciphering Fact from Fiction in Hypoglycemia

January 6, 2011
From The Archives – Deciphering Fact from Fiction in Hypoglycemia

Please enjoy this post from the Clinical Correlations archives first posted March 26, 2009

By: Melissa Price, MD

Faculty Peer Reviewed

A 42 year-old male phlebotomist with a history of anxiety presented to the emergency room complaining of four hours of dizziness and diaphoresis. He denied taking any medications. His vitals were stable, his physical exam was significant for a lethargic, diaphoretic young man without focal findings, and his fingerstick value was 43mg/dL. His chest X-ray, EKG, and laboratory results, with the exception of plasma …

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Early Repolarization: Not as Innocent as Once Thought!

January 5, 2011
Early Repolarization: Not as Innocent as Once Thought!

By Rachel Bond, MD PGY-2

Faculty Peer Reviewed

For many years, the electrocardiogram, a seemingly simple transthoracic interpretation of the electrical activity of the heart captured and externally recorded, has fascinated healthcare professionals.  An aspect of the electrocardiogram which has piqued curiosity consist of an interesting pattern referred to as “early repolarization.”  Early repolarization is a slurring or notching producing a hump-like feature called a J wave, typically found at the junction at the end of the QRS complex and the beginning of the ST …

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