Clinical Questions

Is Personalized Medicine Really the Cure? Looking Through the Lens of Breast Cancer

May 3, 2013
Is Personalized Medicine Really the Cure? Looking Through the Lens of Breast Cancer

By Jessica Billig

Faculty Peer Reviewed 

Although millions of dollars are spent towards cancer research every year, progress toward a cure is less than ideal. Last year the New York Times posted a piece about the burgeoning improvements on the genomic front that could lead to a new approach to cancer treatment. “The promise is that low-cost gene sequencing will lead to a new era of personalized medicine, yielding new approaches for treating cancers and other serious diseases” . Through genomic technology, physicians will be able…

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Health Care: Do Celebrities Know Best?

April 25, 2013
Health Care: Do Celebrities Know Best?

By Emma Gorynski

Faculty Peer Reviewed

The power that celebrities have over Americans is undeniable. We look to them for guidance on what to listen to, what to wear, and even what to name our children. Celebrities even affect the decisions we make about our own health care. With the increasing popularity of direct-to-consumer advertising, celebrities are promoting pharmaceuticals and other health-related products.

Is there a role for celebrities in health advocacy? On one hand, celebrities can increase public awareness of medical conditions and encourage…

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Did Abraham Lincoln Have Marfan Syndrome?

April 19, 2013
Did Abraham Lincoln Have Marfan Syndrome?

By Anna Krigel

Faculty Peer Reviewed

The iconic image of Abraham Lincoln is ubiquitous in our lives, from his small face on the penny to his large figure looming over the National Mall in Washington, D.C. Lincoln fascinates historians because of his significant role in American history when our nation was bitterly divided, but he intrigues physicians because of his remarkable stature. A reporter once described the 16th president as a “tall, lank, lean man considerably over six feet in height with stooping shoulders, long…

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Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

April 12, 2013
Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

By Tyler R. McClintock

Faculty Peer Reviewed

“Red Meat Kills.” “Red Meat a Ticket to Early Grave.” “A Hot Dog a Day Raises Risk of Dying.” Such were the headlines circulating in popular press last year when the Annals of Internal Medicine released details of an upcoming article out of Frank Hu’s research group at the Harvard School of Public Health . Analyzing long-term prospective data from two large cohort studies, researchers found that individuals who ate a serving of unprocessed red meat each day…

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White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

March 20, 2013
White Coat Hypertension: Are Doctors Bad for Your Blood Pressure?

By Lauren Foster

Faculty Peer Reviewed

Hypertension is a pervasive chronic disease affecting approximately 65 million adults in the United States, and a significant cause of morbidity and mortality . Antihypertensives are widely prescribed due to their effectiveness in lowering blood pressure, thereby reducing the risk of cardiovascular events. However, the phenomenon of the “white coat effect” may be a complicating factor in the diagnosis and management of hypertensive patients. It is well established that a considerable number of people experience an elevation of their…

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Morgellons: Real Disease or Delusion Turned Internet Meme?

October 3, 2012
Morgellons: Real Disease or Delusion Turned Internet Meme?

By Robert Mazgaj

Faculty Peer Reviewed

Morgellons disease is an “unexplained dermopathy” characterized by fibers emerging from skin lesions, and associated with various cutaneous sensations. Inspired by a curious medical condition reported by a 17th century English physician, Morgellons was actually named in 2002 by Mary Leitao, a layperson, to describe the mysterious set of symptoms reportedly suffered by her then 2-year-old son. Leitao then launched the not-for-profit Morgellons Research Foundation (MRF) along with a (no longer active) website, www.morgellons.org. MRF successfully petitioned members of…

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Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick?

September 5, 2012
Fractional Excretion of Sodium (FENa): Diagnostic Godsend or Gimmick?

By Jon-Emile S Kenny, MD

Faculty Peer Reviwed

A 62- year-old man with a history of hypertension, diastolic dysfunction and chronic kidney disease is admitted 4 days after beginning outpatient treatment of community acquired pneumonia with cefpodoxime and azithromycin; he had been intermittently vomiting for two days, but proudly states that he has been keeping all of his home medications down, including hydrochlorothiazide. The morning after his admission, he was noted to have a serum creatinine of 3.4 mg/dL (from a baseline of 1.7 mg/dL).…

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Should We Measure Apolipoproteins to Evaluate Coronary Heart Disease Risk?

August 24, 2012
Should We Measure Apolipoproteins to Evaluate Coronary Heart Disease Risk?

By Navya Nair, MD

Faculty Peer Reviewed

Coronary heart disease (CHD) is the major cause of mortality worldwide. Lipoproteins play a major role in the development of this disease. Current guidelines advocate that low-density lipoprotein (LDL) cholesterol should be the primary target for lipid lowering therapy. However, there is a growing literature on the atherogenic potential of apolipoprotein B (apo B)-containing lipoproteins and the protective effect of apolipoprotein A-one (apo AI)-containing lipoproteins. Many studies suggest that these apolipoproteins be used as markers to evaluate risk…

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Xopenex: Is it worth the money?

August 16, 2012
Xopenex: Is it worth the money?

By Han Na Kim

Faculty Peer Reviewed

Case:

The patient is a 50-year-old woman with history of steroid-dependent, severe, persistent asthma since childhood and coronary artery disease who presented with dyspnea and URI symptoms admitted for management of asthma exacerbation. Patient received nebulized albuterol treatment every two to four hours, and on hospital day two, patient developed persistent sinus tachycardia to heart rate of 120s believed to be secondary to albuterol therapy. Given her tachycardia, would it be safer to prescribe levalbuterol rather than…

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Should I Consider Antibiotics in My Patient with Irritable Bowel Syndrome?

July 26, 2012
Should I Consider Antibiotics in My Patient with Irritable Bowel Syndrome?

By Jason Chalifoux

Faculty Peer Review

The story of a patient with multiple office visits due to uncontrolled abdominal pain, bloating and diarrhea/constipation is common among primary care doctors and gastroenterologists. The workup is often extensive and rules out many etiologies. After discovering no metabolic, inflammatory, or anatomic pathology, physicians use the Rome III criteria to diagnose irritable bowel syndrome (IBS). IBS is a functional bowel disorder that is diagnosed by symptoms of recurrent abdominal pain or discomfort for at least 3 days per month…

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Bystander CPR: How Much Does It Help?

July 18, 2012
Bystander CPR: How Much Does It Help?

By Andrew L. Weinstein

Faculty Peer Reviewed

You have just completed a certification course in basic life support and are competent at performing cardiopulmonary resuscitation (CPR) using chest compressions, a CPR mask, a bag-valve mask with impedance threshold device, and an automated external defibrillator (AED), all interventions recommended by the American Heart Association (AHA) to improve circulation following a sudden cardiac arrest. On your way home from the training center you see a man collapse and rush over to find him unresponsive, not breathing, and…

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Is a VBG just as good as an ABG?

July 13, 2012
Is a VBG just as good as an ABG?

By Sunnie Kim, MD

Faculty Peer Reviewed

A rapid response is called overhead. As white-coated residents rush to the patient’s bedside, the medical consult starts to shout out orders to organize the chaos. “What’s the one-liner?” “Whose patient is this?” And of course, “Who’s drawing the labs?” Usually, at this point, the intern proceeds to collect the butterfly needle, assorted colored tubes, and the arterial blood gas (ABG) syringe. If lucky, there’s a strong pulse. The intern pauses, directs the needle, and hopes for that…

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