Clinical Questions

Get Your Caffeine fix while lowering your diabetes risk – too good to be true?

July 17, 2014
Get Your Caffeine fix while lowering your diabetes risk – too good to be true?

By Jennifer Ng, MD

Peer Reviewed

Addiction, by definition, is a negative word. It implies the overindulging of something with a high or uncertain risk to benefit ratio, such as coffee. Yet recently, writer Markham Heid informed coffee addicts all over the world, “Drink Coffee, Lower Your Diabetes Risk” . To add to that, it’s not just coffee; tea and decaf can do it too, or so his article proclaims. Skeptical? Let’s review the evidence and judge for ourselves.

It turns out that this same…

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The Rise in Tick-Borne Diseases: Is Climate Change Responsible?

June 4, 2014
The Rise in Tick-Borne Diseases: Is Climate Change Responsible?

By Nadia Jafar

Peer Reviewed

As a resident of Connecticut, I grew up acutely aware of tick-borne diseases. Nonetheless, I was surprised to see at least 3 cases of tick-borne infections during the month of my Medicine clerkship. This drove me to research the incidence of tick-borne diseases, specifically in the US, and the possible factors contributing to their increased prevalence.

In 1998, the list of reportable tick-borne pathogens in the US included Rocky Mountain spotted fever, tularemia, Lyme disease, human granulocytic ehrlichiosis/anaplasmosis, and human…

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Are Probiotics Effective In Preventing Clostridium Difficile Associated Diarrhea?

May 30, 2014
Are Probiotics Effective In Preventing Clostridium Difficile Associated Diarrhea?

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…

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From The Archives: Metabolic Syndrome: Fact or Myth?

May 22, 2014
From The Archives: Metabolic Syndrome: Fact or Myth?

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…

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New Cholesterol Guidelines: How Safe Are High-Potency Statins?

May 14, 2014
New Cholesterol Guidelines: How Safe Are High-Potency Statins?

By Molly Anderson

Peer Reviewed

Managing hyperlipidemia is a mainstay of cardiovascular risk reduction. The 2013 ACC/AHA guidelines no longer target specific low-density lipoprotein (LDL)-cholesterol levels, but recommend lipid-lowering therapies of varying intensity based on the predicted risk of cardiovascular events . Adoption of the new guidelines would result in millions more Americans receiving high-potency statins; it is therefore important to investigate potential dangers associated with aggressive therapy and the long-term implications for patients.

Many studies have shown that strict adherence to lipid-lowering medications improves…

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Is the Funduscopic Exam Worthwhile For the General Practitioner?

May 2, 2014
Is the Funduscopic Exam Worthwhile For the General Practitioner?

By Emily Fisher

Peer Reviewed

Some have said that physical examination is a dying art and the nondilated funduscopic exam may be one of the best examples of this. With the increasing perception that the use of imaging and labs allows physicians to diagnose diseases with more confidence than a history and physical exam alone , the days when an ophthalmoscope was almost as important as the white coat or the stethoscope and was part of a “bag of tools,” are quickly becoming a…

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MSG: Can an Amino Acid Really Be Harmful?

April 30, 2014
MSG: Can an Amino Acid Really Be Harmful?

By Michael Lee, MD

Peer Reviewed

The human taste bud has become increasingly accustomed to the Japanese invention of the early 20th century: monosodium glutamate, better known as MSG. Its basic component, glutamate, is a non-essential amino acid found in many naturally occurring food sources. This universally consumed food additive has historically garnered much attention for its potential threat to human health. To best understand how an amino acid has amassed such a tarnished reputation, we must first consider the history of its discovery and…

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Should Physicians Ask Patients about Guns?

April 11, 2014
Should Physicians Ask Patients about Guns?

By Jennifer Zhu

Peer Reviewed

After the elementary school shooting in Newtown, CT in December 2012 that left 20 children and 6 adults dead, the country reacted as it had following the July 2012 movie theatre shooting in Aurora, CO, and the public meeting shooting involving Representative Gabrielle Giffords on January 11, 2011 in Tucson, AZ. Some called for tighter firearm safety laws, while others stood by the adage that “Guns don’t kill people,” and that this was no time to politicize a tragedy. The…

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Proton Pump Inhibitors and Clostridium Difficile Infection

March 20, 2014
Proton Pump Inhibitors and Clostridium Difficile Infection

By Aaron Smith, MD

Peer Reviewed

First introduced in the late 1980s, proton pump inhibitors (PPIs) have revolutionized the treatment of gastric acid-related disorders and have been described as a miracle drug by patients and physicians alike. As is often the case with miracle drugs, however, long-term use of PPIs has led to unforeseen adverse effects. Chief among the purported side effects of PPI use is an association with Clostridium difficile infection (CDI). CDI, an enterocolitis that leads to voluminous and potentially fatal diarrhea, was…

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From The Archives: Intercessory Prayer: What Do Sneezes and Prayers Have in Common?

March 13, 2014
From The Archives: Intercessory Prayer: What Do Sneezes and Prayers Have in Common?

Please enjoy this post from the archives dated September 21, 2011

By Alon Mass

Faculty Peer Reviewed

The overlap between religion and medicine is ancient. On a recent medical volunteer trip to India I met a medical student who proudly wore a school sweatshirt with the saying: In God we trust. The rest we dominate.

This arrogant approach is probably uncommon, but praying to God for healing–self or intercessory–is not.

Intercessory prayer is a form of prayer conducted by a group or individual…

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Can crossword puzzles prevent dementia?

March 12, 2014
Can crossword puzzles prevent dementia?

By Theresa Sumberac, MD

Peer Reviewed

The 2008 US Census Bureau reported that 14 to 16 percent of the adult population enjoyed crossword puzzles and that half of them played crossword puzzles at least twice a week. Wouldn’t it be wonderful if all those hours spent finishing the Sunday crossword puzzle were good for your health? Recent evidence shows that this may be the case. By 2030 the US population over 65 will double to more than 70 million, highlighting the need to…

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From The Archives: Should My Patient with a Solid Tumor be Anticoagulated in the Absence of Venous Thromboembolism?

March 6, 2014
From The Archives: Should My Patient with a Solid Tumor be Anticoagulated in the Absence of Venous Thromboembolism?

Please enjoy this post from the archives dated September 8, 2011

By David Altszuler, Class of 2012

Faculty Peer Reviewed

An empiric association between occult malignancy and thrombophlebitis has been recognized since Trousseau first reported the syndrome in 1865. The mechanism by which cancer predisposes to thrombophilia has not been fully elucidated; however, it is now clear that this is a symbiotic relationship. The second leading cause of death in hospitalized cancer patients (and a leading cause of death in ambulatory cancer patients) is…

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