By Kristen Mattei
Faculty Peer Reviewed
I distinctly remember being 9 years old, sitting in my doctor’s office after a cold left me struggling for breath, doubled over and wheezing, when he told me that I had asthma. At first I didn’t believe the diagnosis, despite the fact that the albuterol inhaler he had given me was like a breath of life after running suicides on the soccer field. I wasn’t sick or weak! My father insisted I needed to “build my breath up,” and…
By Benjamin Wu, MD
Faculty Peer Reviewed
Mr. T is a 53-year-old man, with history significant for cholelithiasis. He decides to have an elective cholecystectomy after years of biliary colic. Mr. T is an active smoker and wanted to know if he should stop smoking prior to surgery?
Smoking is associated with adverse outcomes in surgery, however debate continues regarding the safety of perioperative smoking cessation. The current understanding of perioperative smoking cessation follows that smokers who stop smoking close to surgery have a higher…
By Maryann Kwa, MD
Faculty Peer Reviewed
Clinical Case:
A.D. is a healthy 65-year-old African American male with no prior medical history who presents to his primary care physician for an annual check up. He feels well and has no complaints. Physical exam is normal. Common laboratory tests are ordered which are significant for an elevated total serum protein with normal albumin. A serum protein electrophoresis (SPEP) is then performed. The patient is found to have a monoclonal protein (M protein) of 12 g/L, IgG…
By Keri Herzog, MD
Faculty Peer Reviewed
The patient is a 48-year-old male with a history of heavy alcohol use (he drinks about 1 pint of vodka daily) who presented to the hospital when he noticed that he had become increasingly jaundiced. The patient was hemodynamically stable on admission and afebrile, with jaundice and scleral icterus on exam. Laboratory data was significant for a total bilirubin of 6.6, an INR of 2.3, AST of 83, ALT 72, and a Maddrey’s discriminant function (MDF) that was…
By Neha Jindal
Faculty Peer Reviewed
Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder that affects over 1 million people in the United States. People with PD often demonstrate postural instability, gait difficulties, and impaired functional mobility, which can lead to falls and decreased quality of life. Medical treatments for PD do not fully address gait and balance issues and, consequently, additional approaches are needed. One approach that has recently emerged in clinical studies is the use of dance, particularly the Argentine tango, as…
By Todd Cutler, MD
Faculty Peer Reviewed
An 82-year-old man is admitted to the intensive care unit with fevers, hypoxic respiratory failure and hypotension. He is intubated and resuscitated with intravenous fluids. A central venous catheter is placed via the internal jugular vein. A chest x-ray showed a right lower lobe infiltrate and he is treated empirically with antibiotics for pneumonia. Blood cultures grow out S. pneumoniae. After four days he is successfully extubated. The night following extubation, the patient has a fever of 100.8…
Nicholas Mark, MD & Sarah Buckley, MD
Faculty Peer Reviewed
Background
Publius Aelius Hadrianus, better known as Hadrian, emperor of Rome (117-138 CE), traveler, warrior, and lover of all things Greek, fell ill at the age of 60. He developed progressive edema and episodic epistaxis, fell into a depression soothed by rich food and drink, and succumbed to death within 2 years. The exact cause of Hadrian’s death–whether by heart failure, glomerulonephritis, or even hereditary hemorrhagic telangiectasia–has been a topic of debate among paleopathologists. It was…
By Michael Boffa
Faculty Peer Reviewed
Laura K. sits in the office of her cardiologist waiting for the results of her follow-up aorto-iliac duplex scan. Six months ago, Laura had an endostent placed in her abdominal aorta after a 5.2 cm x 5.4 cm abdominal aortic aneurysm (AAA) was discovered. Though she has recently quit, Laura, now 70, smoked for a large portion of her life. Her advanced age and smoking put her at increased risk of suffering a potentially life-threatening aortic aneurysm rupture. …
By Amy Dinitz
Faculty Peer Reviewed
The lifetime risk of developing diabetes for persons born in 2000 is around 35% and the NHANES database has suggested a greater than fourfold increase in prevalence over the last three generations. While bariatric surgery has become the most effective treatment for obesity, it has also been found to be an extremely effective treatment for type 2 diabetes. It was initially thought that the weight loss experienced by patients after bariatric surgery was responsible for improved glycemic control. However,…
By Katherine Husk
Faculty Peer Reviewed
A healthy 40-year-old woman comes into your office for a routine health exam. After you have performed a clinical breast exam, she asks you whether she should be examining her breasts on her own at home…
Breast self-exam (BSE) seems sensible. Empowering a patient to develop a sense of a personal norm could allow for easier recognition of breast changes, and could perhaps lead to earlier evaluation by a medical professional. There is a great deal of controversy, however,…
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 who petitions a god on behalf of another individual in…
By Nandini Govil
Faculty Peer Reviewed
Empathy is an elusive concept, espoused by many as an integral component of effective doctoring. In the medical literature, empathy is defined as a physician’s ability to recognize and validate a patient’s experiences and perspectives, and to convey this understanding back to the patient. A firm distinction is drawn between sympathy (an emotional attribute) and empathy (a cognitive skill that can be modeled, taught, and assessed).
Research indicates that physician empathy results in better patient compliance and outcomes,…
