By Nathan King
Faculty Reviewed
Doctors are known to be some of the worst patients, and from personal experience I predict that medical students are not too far behind. That’s why when I finally found the time to take a proactive step in maintaining my good health, the last thing I hoped to run into were barriers, but that’s exactly what I hit. To my surprise, it was not at the hands of insurance companies, overbooked doctors, or the general bureaucracy of the medical system; …
By Luke O’Donnell, MD
Peer reviewed
Once formidable diseases, pneumonia, bacteremia, and meningitis are all now considered “bread-and-butter” internal medicine. Streptococcus pneumoniae is one of the major pathogens in these processes, causing 500,000 cases of pneumonia, 50,000 cases of bacteremia, and 3,000 cases of bacterial meningitis in the United States annually, with case fatality rates of 5-7%, 20%, and 30%, respectively .
Efforts to vaccinate against this gram-positive diplococcus started in mining sites near Johannesburg, South Africa around the turn of the last century . …
By Matthew Shou Lun Lee, MD
Peer Reviewed
Clinical Questions
-How common are elevated cardiac enzymes during Wellens’ syndrome?
-Can the EKG changes in Wellens’ syndrome be found with other causes?
Background
This post represents a follow-up to the 2009 article in Clinical Correlations by Dr. Erin Ducharme .
Wellens’ syndrome refers to a distinctive combination of clinical and EKG findings in unstable angina associated with high-grade lesions of the left anterior descending artery (LAD) . Initially described in 1982, the criteria has undergone minor …
By Pritha Subramanyam
Peer Reviewed
Mrs. CS is a 66-year-old Indian female who presents for a cardiology follow-up. The patient has a history of mitral regurgitation secondary to rheumatic fever she experienced as a child. As a teenager, her condition was diagnosed when she frequently became short of breath while playing sports in school. She was in good health until 24 years ago, when an acute episode of dyspnea while climbing stairs sent her to the emergency room. Her native mitral valve was found to …
By Aditya K. Sreenivasan
Peer Reviewed
The Huffington Post recently publicized a large study on the health habits of doctors. The study, a survey done by Medscape with 31,399 participants, revealed that more than half of doctors take some form of dietary supplement. The most common form of supplement taken was a multivitamin . With the way doctors find themselves in constant discussions about “evidence based medicine” these days, we can assume that there are solid data showing that multivitamins are beneficial to long-term health. …
By Reed Magleby, MD
Peer Reviewed
For many with type II diabetes, initiation of insulin therapy represents a devastating progression of their disease. Patients who are dependent on insulin require constant blood sugar monitoring, adherence to strict dosing algorithms, and up to 4 self-administered injections every day. According to a 2010 survey of non-insulin adherent diabetic patients, both “injection phobia” and inconvenience were found to be important barriers to initiation of insulin therapy. . In response to these concerns, less invasive administration techniques such as …
By Dana Zalkin
Peer Reviewed
In the late 1970s evidence began to emerge that a newly discovered pump, a H+/K+ ATPase in the gastric mucosa, was the final step in the process of acid secretion . With this discovery, further research demonstrated the ability to reduce gastric acid secretion by inhibiting these proton pumps . We now have drugs that do just that: the proton pump inhibitors (PPIs). Proton pump inhibitors have been used since 1989 to treat acid-related gastrointestinal disorders as well as in …
By Joshua Michael Lader, MD
Peer Reviewed
As physicians, we are frequently asked to weigh-in on dinnertime discussions about topics that, despite their relevance to everyday life, were never formally addressed in our medical training. For example, at a recent family gathering the conversation turned to a 78 year-old uncle who was recently diagnosed with atrial fibrillation. While this uncle had longstanding and likely poorly controlled hypertension, he would also typically drink 4 to 5 cups of coffee between breakfast and lunch. The debate then …
By Theresa Sumberac, MD
Peer Reviewed
Antibiotic associated diarrhea is a common complication of antibiotic therapy, occurring in 5% to 39% of all patients receiving treatment. Nearly one third of these cases are attributed to the gram –positive spore forming rod, Clostridium difficile . A primary Clostridium difficile associated diarrhea (CDAD) is estimated to add $2871 to $4846 to in hospital costs while a recurrent infection is estimated to cost $13,655 to $18,067 . The emergence of the hyper-virulent NAP1/B1/027 strain of C. difficile together …
By Richard E. Greene, MD
Peer Reviewed
In July of 2012, the FDA approved the use of Tenofovir-Emtricitabine (Truvada, a single blue pill) daily as Pre-Exposure Prophylaxis (PrEP) in men with persistent risk for contracting HIV infection. The idea of PrEP has ignited a firestorm of concern among healthcare providers about how, when and in whom to use PrEP, if at all. Indeed, some believe that PrEP will usher in a new era of drug resistant new infections with HIV, or encourage men on prep …
Please enjoy this post from the archives dated September 30, 2011
By Vicky Jones, MD
A 40-year-old female presented to her primary care provider with a chief complaint of weight gain over the past year. She wants to be fully evaluated for any kind of medical disorder that could have caused it. She has been seen by multiple specialists but no one can give her a “straight diagnosis”. Their advice is for her to lose weight. She insists she never had problems with her weight …
By Jonathan Gursky
Peer Reviewed
Approximately 5.2 million Americans are currently living with Alzheimer’s disease (AD) , with this number expected to triple by the year 2050 . Alzheimer’s disease is now the sixth leading cause of death in the United States and accounts for $100 billion in healthcare expenditures each year . Nevertheless, the most devastating and far-reaching effects of Alzheimer’s disease hit close to home. While those with the disease progressively lose their memory, speech, and independence, it is the caretaker who …
