Systems

The Brain’s Effect on the Heart After a Stroke

June 22, 2016
The Brain’s Effect on the Heart After a Stroke

By Rory Abrams, MD

Peer Reviewed 

The heart and brain are hopelessly intertwined. Their connection is greater than the tissues and sinews that physically tether them to the human body, and can be understood in three ways: 1) how the heart affects the brain, 2) how the brain affects the heart, and 3) how the heart and brain are both affected by various neuro-cardiac syndromes.  The heart’s effects on the brain are illustrated when there is hypoperfusion of the brain resulting in syncope, or when …

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Outpatient Rhythm Monitoring: Available Options and Diagnostic Yield

March 29, 2016
Outpatient Rhythm Monitoring: Available Options and Diagnostic Yield

By Iulia Giuroiu, MD

Peer Reviewed

A 70-year-old woman with hypertension, early dementia, and non-specific chest pain of unclear etiology presents with recurrent left-sided chest pain. Unfortunately, she is a poor historian; it appears that her chest pain is similar to past episodes. Prior workups, which included an echocardiogram, had been unremarkable. To confound matters further, the patient’s current pain appears to be reproducible when pressure is applied to her chest. She is admitted overnight for close observation. No electrocardiogram (ECG) changes are found and …

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Exercise-Induced Rhabdomyolysis: How Fitness May Actually Be Hurting You

March 17, 2016
Exercise-Induced Rhabdomyolysis: How Fitness May Actually Be Hurting You

By Jessica Morgan

Peer Reviewed

CrossFit and SoulCycle. To many people these words mean nothing. However, ask any twenty-something or college student and they will probably tell you they have participated in a class or two, or have a friend who participates. Depending on whom you approach, you might even get the sense that these are not just exercise classes, but more like a spiritual experience or a tight-knit community of like-minded individuals, all striving for physical excellence. Some have accused these programs of being …

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PTH versus PTHrP — Small Differences, Big Implications

March 3, 2016
PTH versus PTHrP — Small Differences, Big Implications

Samantha Kass Newman, MD

Peer Reviewed 

A 48-year-old depressed male smoker with a bit of an alcohol problem presents to the emergency department with worsening fatigue, severe lower back pain, constipation, abdominal pain, and 4 days of coffee ground emesis.

This could be anything. Viral gastroenteritis? Perhaps. Food poisoning? Probably not. Upper GI bleed? Likely, given his alcohol use. You send off routine labs, and then are called for a critical value: his calcium is 13.8 mg/dL. The albumin is normal. Next, you check the …

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Don’t Tie Me Down! Do Neckties Spread Infection?

February 24, 2016
Don’t Tie Me Down! Do Neckties Spread Infection?

By Gabriel Campion

Peer Reviewed

For over a century, neckties have been a staple accessory in the wardrobe of the American professional man. Although white-collar dress codes have trended toward a more casual style, the quintessential physician still wears the white coat, a stethoscope draped around the neck, and, if male, a necktie. This is understandable. No one would accuse a profession using an oath that originally swore “by Apollo the Physician and by Aesculapius ” to be one that easily strays from tradition. However, …

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Could Metformin be the First Anti-Aging Drug?

February 11, 2016
Could Metformin be the First Anti-Aging Drug?

By Amy Shen Tang, MD

Peer Reviewed

“I would pay you if you took it away from me. I’d try to buy it back,” said Irving Kahn, the late Wall Street investment advisor when asked if he would ever retire from work . Mr. Kahn, who founded Kahn Brothers Group, Inc. with his sons more than 40 years ago, took an active role as chair of his company until his passing last winter at the ripe age of 109 years. Kahn and his siblings all …

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The Persistent HIV Crisis: HIV Prevalence Among Black Men Who Have Sex With Men (MSM)

February 3, 2016
The Persistent HIV Crisis: HIV Prevalence Among Black Men Who Have Sex With Men (MSM)

By Ofole Mgbako, MD

Peer Reviewed

In July 2010, the much-anticipated “National HIV/AIDS Strategy for the United States” was released to the public. In its introduction, the president declared, “Our Nation is at a crossroads…unless we take bold actions, we face a new era of rising infections, greater challenges in serving people living with HIV, and higher health care costs” . Indeed, the incidence of HIV infection in the U.S. has fallen dramatically over the last few decades, from initially 130,000 new infections annually in …

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Hirudotherapy: An Ugly Means of Avoiding Uglier Outcomes

January 22, 2016
Hirudotherapy: An Ugly Means of Avoiding Uglier Outcomes

By Jonathan Bekisz

Peer Reviewed

“Do you want to see something gross? Go into the soiled utility room and check out what’s in the jar.” Never one to pass on the opportunity to “see something gross,” I poked my head in and examined the tiny glass jar that sat on the counter. Living up to its billing, within the container sat about a half dozen leeches. Contrary to my assumption that any role these segmented worms had in the field of medicine went away with …

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