Clinical Questions

Is Potassium Supplementation Beneficial in Hospitalized Patients?

October 25, 2017
Is Potassium Supplementation Beneficial in Hospitalized Patients?

By Sara Stream, MD

Peer Reviewed

As resident physicians, we are taught to supplement serum potassium to a goal level of 4.0 mEq/L in all hospitalized patients. While the dangers of severe potassium abnormalities are well established, the benefit of routine potassium supplementation of normal serum levels in the general hospitalized population is unclear.

Potassium is predominantly an intracellular ion with 98% of total body potassium located in the intracellular space. The accepted reference range for serum potassium levels is 3.5 to 5.0 mEq/L. The …

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Stem cells for heart failure: What is the evidence?

September 27, 2017
Stem cells for heart failure: What is the evidence?

By Maxine Wallis Stachel, MD

Peer Reviewed

The Scale of the Problem

Despite decades of rigorous data collection, drug research, patient education and evidence-based practice, ischemic heart disease (IHD) and congestive heart failure (CHF) remain among the most deadly diagnoses in America. The standardization of medical therapy and surgical revascularization have reduced morbidity and mortality, but these measures have not kept pace with the burden and cost of disease, which continue to expand as the population ages and more patients survive acute myocardial infarction. IHD …

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Should Beta Blockers be Used in Heart Failure with Preserved Ejection Fraction?

August 23, 2017
Should Beta Blockers be Used in Heart Failure with Preserved Ejection Fraction?

By Lauren Christene Strazzulla

Peer Reviewed

The lifetime risk for developing heart failure from age 55 on is 33% for men and 28.5% for women, and as the population ages, there is an increasing prevalence of this disease along with its associated health care costs . Heart failure is divisible into 2 distinct entities: those with left ventricular systolic dysfunction and those with cardiovascular compromise that does not decrease LV ejection fraction, which is termed heart failure with persevered ejection fraction (HFpEF) . While …

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Are Electronic Cigarettes Safer Than Traditional Cigarettes?

August 9, 2017
Are Electronic Cigarettes Safer Than Traditional Cigarettes?

By Gabriel Lutz

Peer Reviewed

Due to the pervasiveness of television and print marketing of electronic cigarettes (e-cigs) in a multitude of flavors and device designs, e-cig use is on the rise in the general population. As physicians, how should we advise our patients looking to quit smoking or those looking for a “healthier” alternative? What does the evidence say about the health risks of e-cigs in first-time smokers?

Generally, e-cigs are composed of a battery and a vaporization chamber that heats a liquid solution …

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How Reliable Is Hemoglobin A1c?

April 6, 2017
How Reliable Is Hemoglobin A1c?

By Alexa Yuen

Peer Reviewed 

According to the CDC, there are 22 million people with an established diagnosis of diabetes mellitus in the United States, but more frightening is that the rate of diabetes continues to rise both nationally and globally, with predictions that 7.7% of the world’s adult population will be afflicted with the disease in 2030., Preventing, monitoring, and managing this disease is of utmost importance in responding to the growing epidemic. The hemoglobin A1c (HbA1c) blood test has become a powerful tool …

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Why Does Our Hair Turn Gray?

March 30, 2017
Why Does Our Hair Turn Gray?

By Chio Yokose, MD and Aaron Smith, MD

Peer Reviewed 

All but a lucky few of us will one day see our locks lose their color. But what is the physiologic basis for this unsightly transformation, known scientifically as canities? Why does our hair turn gray?

Hair pigment is derived from the compound melanin, which is formed during melanogenesis in lysosome-like organelles called melanosomes, found in the cytoplasm of melanocytes . Melanocytes are ectodermal cells that migrate from the neural crest to the skin during …

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Gamechanger? Should Steroids be Added to Treat Community Acquired Pneumonia?

March 23, 2017
Gamechanger?  Should Steroids be Added to Treat Community Acquired Pneumonia?

By Martin Fried, MD

Peer Reviewed

Welcome to Gamechangers, a series that takes a critical look at the latest in medical literature to answer one important question: would the results of this article change my practice? Featuring thorough evidence-based review as well as expert commentary, our aim is for this series to help you decide if the results of a given study are, in fact, a gamechanger. 

Why does this matter?

Community-acquired pneumonia (CAP) is a common and potentially serious infection that can lead to …

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Is there such a thing as too much information?

December 1, 2016
Is there such a thing as too much information?

By Mariya Rozenblit, MD  

Peer Reviewed

On my first day of internship I was faced with the seemingly simple task of consenting a patient for a blood transfusion. I went over the informed consent form with the patient, explaining the benefits and possible risks, and asked the patient if he had any questions. He did not and happily signed the form. However, I was left wondering if he truly comprehended the information. How much did he know about hepatitis C and HIV and how these …

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