Class Act

Tales of the Bellevue Hospital Internal Medicine House Staff from the ‘60s to Now

November 17, 2017
Tales of the Bellevue Hospital Internal Medicine House Staff from the ‘60s to Now

In honor of the 10th Anniversary of Clinical Correlations we are presenting a wonderful 4 part series of life as a house officer at Bellevue Hospital in the 60’s, 70’s, 80’s and 90’s.   Former resident Olivia Begasse de Dhaem conducted extensive interviews with our faculty who worked at Bellevue in each of these decades.   With guidance from David Oshinksy, Olivia has written a story of what binds our students, residents and faculty and patients together through Bellevue’s rich history.  While much has changed in our …

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Reducing Readmission in Sickle Cell Disease: The Role of the Patient-Centered Medical Home

October 6, 2017
Reducing Readmission in Sickle Cell Disease: The Role of the Patient-Centered Medical Home

By Leonard Naymagon, MD

Peer Reviewed

Vaso-occlusive crisis (VOC), or pain crisis, is the most common clinical manifestation of sickle cell disease (SCD) and is responsible for the majority of emergency department (ED) visits and inpatient hospitalizations among sickle cell patients . A retrospective analysis of over 100,000 in-hospital encounters for VOC in 2005 and 2006 demonstrated 30-day and 14-day rehospitalization rates of 33.4% and 22.1% respectively . These findings were most pronounced among 18- to 30-year-olds, with 41.1% rehospitalized within 30 days and 28.4% …

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Alzheimer’s Disease: State of Diagnosis

October 4, 2017
Alzheimer’s Disease: State of Diagnosis

By Karen McCloskey, MD

Peer Reviewed

In May 2012, The U.S. Department of Health and Human Services unveiled the “National Plan to Address Alzheimer’s Disease,” in response to legislation signed by President Obama in January, 2011 establishing the National Alzheimer’s Project Act.  The overarching goal of the Plan is to “prevent or effectively treat Alzheimer’s Disease by 2025.”   We now have an estimated 5.5 million people who are living with this illness and these numbers are only expected to grow with the aging population̶ the …

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Life and Limb: Battlefield Medicine from WWII to Today

September 29, 2017
Life and Limb:  Battlefield Medicine from WWII to Today

By Eric Jeffrey Nisenbaum, MD

Peer Reviewed

Mr. O is a 93-year-old man with a past medical history notable for severe Alzheimer’s dementia and amputation of the left upper extremity secondary to wounds received in WWII who was brought in from his nursing home with fever and dyspnea for two days.  His physical exam was notable for inspiratory crackles at the right lung base.  His CBC was notable for an elevated WBC with left-shift and a chest x-ray revealing a right lower lobe infiltrate. He …

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50% of the Daily Salt Intake Recommended by the JNC-8 Is Consumed in a New York Minute

September 13, 2017
50% of the Daily Salt Intake Recommended by the JNC-8 Is Consumed in a New York Minute

By Andrew Sideris

Peer Reviewed

Reduction of dietary sodium is a well-known nonpharmacologic therapy to reduce blood pressure. The 8th Joint National Commission (JNC-8) recommends that the general population limit daily intake of sodium to less than 2.4 grams. On average, a mean reduction in systolic blood pressure of 2-8 mmHg is expected if dietary sodium intake is limited to no more than 2.4 grams per day.1 Further reduction of sodium to 1.5 grams is desirable for people with hypertension because it is associated with …

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Slow Respiration to Lower Blood Pressure

September 7, 2017
Slow Respiration to Lower Blood Pressure

By Omotayo Arowojolu

Peer Reviewed

Approximately 32% of American adults have high blood pressure (>140/90 mmHg),1 or hypertension, and only 54% of these individuals have well-controlled hypertension.2,3 Hypertension costs $48.6 billion each year in healthcare services, medications, and missed days of work. Additionally, one in three Americans have pre-hypertension (120-139/80-89 mmHg) and are considered at risk for developing hypertension.1 These individuals benefit from management of risk factors with changes in diet (reduced sodium), weight loss, increased physical activity, and smoking or alcohol cessation. On the …

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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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When Doctors Get Personal

August 18, 2017
When Doctors Get Personal

By Leland Soiefer

Peer Reviewed

Mrs. S sat up straight and made excellent eye contact. Her tone was pleasant. She wore a colorful yellow shirt and dark green pants, and was accompanied by her husband; her gilded rings and earrings added flair to her outfit. Her neutral expression, however, stood out to me. She had seen a doctor several weeks ago regarding her first vaginal bleeding since menopause, and a uterine biopsy showing a precancerous lesion was subsequently performed. Surely by this point she had …

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