Class Act

Spotlight Case: Oligoarticular Septic Arthritis-A Case of Disseminated Pneumococcal Disease

May 13, 2015
Spotlight Case: Oligoarticular Septic Arthritis-A Case of Disseminated Pneumococcal Disease

By Jennifer S. Mulliken, M.D.

Peer Reviewed

Case Report

A 45-year-old man with a history of mild intermittent asthma presented with two days of right knee pain and swelling accompanied by subjective fevers, shaking chills, and night sweats. He also reported one day of right calf and left groin pain. The patient denied a history of joint trauma, underlying joint disease, or surgery. There was no history of intravenous drug use, recent travel, or preceding illnesses. He was sexually active with women and…

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Iron Deficiency Anemia: A Guide to Oral Iron Supplements

March 26, 2015
Iron Deficiency Anemia: A Guide to Oral Iron Supplements

By Cindy Fei, MD

Peer Reviewed

Iron deficiency is the most common cause of anemia in the United States. Despite this, there are a multitude of questions surrounding the best choice of supplementation. Which formulation of iron is best prescribed? Do newer preparations such as enteric-coated tablets help? How long do you treat for? The following is a review of the literature surrounding these questions.

In order to best understand the dosing regimens, let’s first review the metabolism of iron.

The body contains approximately…

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Diabetic Foot Ulcers: Pathogenesis and Prevention

March 19, 2015
Diabetic Foot Ulcers: Pathogenesis and Prevention

By Shilpa Mukunda, MD

Peer Reviewed

On my first day on inpatient medicine at the VA Hospital, Mr. P came in with an oozing foot ulcer. Mr. P, a 60-year-old man with a 30 pack-year smoking history, poorly controlled diabetes, peripheral vascular disease, and chronic renal disease, had already had toes amputated. He knew all too well the routine of what would happen now with his newest ulcer. After two weeks of IV antibiotics and waiting for operating room time, Mr. P eventually had his…

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Why Do We Do What We Do: Common Hospital Practices Revealed

February 27, 2015
Why Do We Do What We Do: Common Hospital Practices Revealed

By Dana Zalkin

Peer Reviewed

A code is called on the overhead speaker and the on-call teams rush to the scene to see what awaits them. EKG leads are being placed, medications are being ordered, and labs are being drawn. A medical student stands with a bag of ice, ready to grab the arterial blood gas (ABG) and run it down to the lab. “Why do we put the ABG on ice right away?” the student wonders. But in this moment, while a patient teeters…

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Acupuncture and Immune Modulation

January 9, 2015
Acupuncture and Immune Modulation

By Michael Lee, MD

Peer Reviewed

Clinical Case: Ms. A, an 84-year-old retired physician with a history of bronchiectasis of unclear etiology, is admitted with the chief complaint of chronic cough. Further inquiry into her medical history reveals that she contracted malaria as a child while living in Korea. She had been prescribed chloroquine by multiple doctors, but her symptoms of fevers and night sweats did not improve. It was a trial of acupuncture therapy, she says, that finally cured her of malaria.

Acupuncture refers…

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Falls in Older Adults—Risk Factors and Strategies for Prevention

October 15, 2014
Falls in Older Adults—Risk Factors and Strategies for Prevention

By Joseph Plaksin

Peer Reviewed

Falls are a major health problem for older adults. Various reviews and meta-analyses have estimated that 30% of people over age 65 and 50% of people over age 85 who live in the community will fall at least once. The prevalence of falls is even higher in long-term care facilities, occurring in more than 50% of people over age 65 . Fall-related injuries occur in 10-40% of falls and can range from minor bruises or lacerations to…

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It Was Almost Called the Cylinder (& Other Who-Knew Facts about the Stethoscope)

October 10, 2014
It Was Almost Called the Cylinder (& Other Who-Knew Facts about the Stethoscope)

By Cindy Fang, MD

Peer Reviewed

“A wonderful instrument…is now in complete vogue in Paris…It is quite a fashion, if a person complains of cough, to have recourse to the miraculous tube which however cannot effect a cure but should you unfortunately perceive in the countenance of the doctor that he fancies certain symptoms exist it is very likely that a nervous person might become seriously indisposed and convert the supposition into reality.” —The London Times, September 19, 1824.

The novel medical instrument…

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From The Archives: Ethical Considerations on the Use of Fear in Public Health Campaigns

October 9, 2014
From The Archives: Ethical Considerations on the Use of Fear in Public Health Campaigns

Please enjoy this post from the archives dated November 23, 2011

By Ishmeal Bradley, MD

Faculty Peer Reviewed

The goal of public health is to prevent or minimize disease and injury on a population level. How to achieve this end has changed over time, though. In previous decades, communicable diseases posed the greatest health risks. Consequently, public health officials used the tools of isolation, quarantine, and (forced) vaccination to combat these threats. Today, however, the major causes of morbidity and mortality are chronic conditions,…

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Unraveling The Mysteries of Prinzmetal’s Angina: What Is It And How Do We Diagnose It?

October 8, 2014
Unraveling The Mysteries of Prinzmetal’s Angina: What Is It And How Do We Diagnose It?

By Anjali Varma Desai, MD

Peer Reviewed

Mr. Q is a 55-year-old male smoker who presents with recurrent chest pain in the mornings over the past several months. The patient reports being awakened from sleep at approximately 5:00 a.m. each morning with the same diffuse chest “pressure.” The pain typically lasts on the order of minutes, resolves, and then recurs at five-minute intervals in the same fashion for a total duration of two hours. The pain always occurs at rest and is never precipitated…

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Pets Gone Wild: A Review of Animal Attacks

October 1, 2014
Pets Gone Wild: A Review of Animal Attacks

By Thomas Lee

Peer Reviewed

The age-old question that every one of us has been asked at least once: Are you a cat or a dog person? The answer is subjective, as both choices depend on a person’s values, preferences, and lifestyle. A different question, and perhaps a more objective one is: Which would you rather be bitten by? With news stories of pit bull attacks, the common sight of German shepherd police dogs in New York, and the relatively benign appearance of most domesticated…

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Are Health Care Providers PrEPared?

September 24, 2014
Are Health Care Providers PrEPared?

By Nathan King

Faculty Reviewed

Doctors are known to be some of the worst patients, and from personal experience I predict that medical students are not too far behind. That’s why when I finally found the time to take a proactive step in maintaining my good health, the last thing I hoped to run into were barriers, but that’s exactly what I hit. To my surprise, it was not at the hands of insurance companies, overbooked doctors, or the general bureaucracy of the medical system;…

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To Inject, or Not to Inject: Using the Pneumococcal Vaccinations Effectively

September 19, 2014
To Inject, or Not to Inject: Using the Pneumococcal Vaccinations Effectively

By Luke O’Donnell, MD

Peer reviewed

Once formidable diseases, pneumonia, bacteremia, and meningitis are all now considered “bread-and-butter” internal medicine. Streptococcus pneumoniae is one of the major pathogens in these processes, causing 500,000 cases of pneumonia, 50,000 cases of bacteremia, and 3,000 cases of bacterial meningitis in the United States annually, with case fatality rates of 5-7%, 20%, and 30%, respectively .

Efforts to vaccinate against this gram-positive diplococcus started in mining sites near Johannesburg, South Africa around the turn of the last century…

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