Class Act

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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From the Bellevue Wards: Wellens’ Syndrome Revisited

September 18, 2014
From the Bellevue Wards: Wellens’ Syndrome Revisited

By Matthew Shou Lun Lee, MD

Peer Reviewed

Clinical Questions

-How common are elevated cardiac enzymes during Wellens’ syndrome?

-Can the EKG changes in Wellens’ syndrome be found with other causes?

Background

This post represents a follow-up to the 2009 article in Clinical Correlations by Dr. Erin Ducharme .

Wellens’ syndrome refers to a distinctive combination of clinical and EKG findings in unstable angina associated with high-grade lesions of the left anterior descending artery (LAD) . Initially described in 1982, the criteria has undergone…

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Neoplastic Fever: Pathophysiology, Clinical Features, And Diagnostic Assessment

August 13, 2014
Neoplastic Fever: Pathophysiology, Clinical Features, And Diagnostic Assessment

By David Kudlowitz, MD

Peer Reviewed

Neoplastic fever (aka tumor fever) is a challenging yet essential clinical diagnosis. In fevers of unknown origin, studies estimate that the incidence of neoplastic fever is anywhere from 7 to 31% . In the febrile patient with malignancy, tumor fever is the most common cause of non-infectious pyrexia (41%) . While leukemia, lymphoma, sarcoma, atrial myxoma, renal cell carcinoma, and liver metastases are the most common culprits, neoplastic fever has been reported in several other cancer types…

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Chimeras Could Bridge the Gap Between Treatment and Cure Or Are They Your Silent and Deadly Twin?

August 8, 2014
Chimeras Could Bridge the Gap Between Treatment and Cure Or Are They Your Silent and Deadly Twin?

By Pritha Subramanyam

Peer Reviewed

Mrs. CS is a 66-year-old Indian female who presents for a cardiology follow-up. The patient has a history of mitral regurgitation secondary to rheumatic fever she experienced as a child. As a teenager, her condition was diagnosed when she frequently became short of breath while playing sports in school. She was in good health until 24 years ago, when an acute episode of dyspnea while climbing stairs sent her to the emergency room. Her native mitral valve was found to…

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If You Could Give One Piece Of Advice To A Young Doctor…

July 25, 2014
If You Could Give One Piece Of Advice To A Young Doctor…

By Ali Marisa Mendelson, MD

Peer Reviewed

It was late when I left the call room on my last day as an intern in the step-down unit, and I hesitated before entering the stairwell. I considered turning instead towards the elevators, which would take me swiftly down seventeen floors, a world away from the sickness and disease we had spent the day battling. Instead, I took a detour to say good-bye to a patient I had met earlier in the month. I felt somewhat embarrassed…

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Medical Etymology: Scrofula

July 18, 2014
Medical Etymology: Scrofula

By Sagar S. Mungekar, MD

Peer Reviewed

It was around the 300s BCE when a sow must have had her snout near Mycobacterium intercellularae, an environmental saphrophyte that lives in soil and water. After some time, she—like many of her community—developed tubercles in her cervical lymph nodes. Aristotle noted that this happened to many domesticated animals such as pigs and oxen. Though this phenomenon was likely noted by many of the time, Aristotle’s is the first written record of it. Some time later, a physician…

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