Class Act

Preserving Residual Renal Function

May 1, 2013
Preserving Residual Renal Function

By Jerome Lowenstein,  MD

Faculty Peer Reviewed

Two questions that often arise concerning the administration of radio-contrast in patients with advanced renal disease, receiving hemodialysis or peritoneal dialysis, reveal what appear to be widespread and important misconceptions.

The first misconception is that in end-stage renal disease, glomerular filtration is absent or minimal and the removal of wastes (“uremic toxins”) is accomplished only by peritoneal or hemodialysis Most patients who reach the advanced stages of renal disease requiring hemodialysis or peritoneal dialysis are not oliguric and…

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Health Care: Do Celebrities Know Best?

April 25, 2013
Health Care: Do Celebrities Know Best?

By Emma Gorynski

Faculty Peer Reviewed

The power that celebrities have over Americans is undeniable. We look to them for guidance on what to listen to, what to wear, and even what to name our children. Celebrities even affect the decisions we make about our own health care. With the increasing popularity of direct-to-consumer advertising, celebrities are promoting pharmaceuticals and other health-related products.

Is there a role for celebrities in health advocacy? On one hand, celebrities can increase public awareness of medical conditions and encourage…

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Did Abraham Lincoln Have Marfan Syndrome?

April 19, 2013
Did Abraham Lincoln Have Marfan Syndrome?

By Anna Krigel

Faculty Peer Reviewed

The iconic image of Abraham Lincoln is ubiquitous in our lives, from his small face on the penny to his large figure looming over the National Mall in Washington, D.C. Lincoln fascinates historians because of his significant role in American history when our nation was bitterly divided, but he intrigues physicians because of his remarkable stature. A reporter once described the 16th president as a “tall, lank, lean man considerably over six feet in height with stooping shoulders, long…

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Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

April 12, 2013
Have a Cow? How Recent Studies on Red Meat Consumption Apply to Clinical Practice

By Tyler R. McClintock

Faculty Peer Reviewed

“Red Meat Kills.” “Red Meat a Ticket to Early Grave.” “A Hot Dog a Day Raises Risk of Dying.” Such were the headlines circulating in popular press last year when the Annals of Internal Medicine released details of an upcoming article out of Frank Hu’s research group at the Harvard School of Public Health . Analyzing long-term prospective data from two large cohort studies, researchers found that individuals who ate a serving of unprocessed red meat each day…

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Omega-3 Fatty Acids and Atherosclerosis

August 17, 2012
Omega-3 Fatty Acids and Atherosclerosis

By Michael Malone

Faculty Peer Reviewed

Omega-3 long chain polyunsaturated fatty acids (PUFAs) have been popularized in recent years as beneficial nutrients with cardioprotective effects. Omega-3 PUFAs are so named because of a double bond between the 3rd and 4th carbon of the polycarbon chain. They are “poly-unsaturated” with hydrogen atoms, as their carbon chains contain multiple double bonds. Three omega-3 long chain PUFAs are typically discussed in the context of medical therapy, the first being alpha-linolenic acid (ALA). ALA is an essential precursor omega-3…

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BiDil: The Future of Medicine or a Return to a Dark Past?

May 31, 2012
BiDil: The Future of Medicine or a Return to a Dark Past?

By Christopher David Velez, MD

Faculty Peer Reviewed

Given the traumatic and often criminal role that medicine and the larger scientific community played in some of the most shameful acts of the 20th century, it is natural that the consequences of these collaborations have continued to reverberate to the present day. The chills sent down our spines can be sparked from reading treatises purporting to demonstrate the undeniable genetic evidence of racial superiority, or from the revulsion towards the degrees of complicity needed for the…

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Nothing QT (Cute) about it: rethinking the use of the QT interval to evaluate risk of drug induced arrhythmias

April 27, 2012
Nothing QT (Cute) about it: rethinking the use of the QT interval to evaluate risk of drug induced arrhythmias

By Aneesh Bapat, MD

Faculty Peer Reviewed

Perhaps it’s the French name, the curvaceous appearance on electrocardiogram (EKG), or its elusive and mysterious nature, but Torsades des pointes, a polymorphic ventricular arrhythmia, is certainly the sexiest of all ventricular arrhythmias. Very few physicians and scientists can explain its origin in an early afterdepolarization (EAD), and fewer still can explain its “twisting of the points” morphology on EKG. Despite its rare occurrence (only 761 cases reported to the WHO Drug Monitoring Center between 1983 and 1999)1,…

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A Study of Cultural Complications in the Management of Diabetes

April 18, 2012
A Study of Cultural Complications in the Management of Diabetes

By Kimberly Jean Atiyeh

Faculty Peer Reviewed

Ms. KS is a 49- year-old Bangladeshi woman with a history of diabetes mellitus and non-adherence to medical treatment or follow up, who was reluctantly brought to the Bellevue ER by her family for nausea, vomiting, and fevers for one day. Her most recent hospitalization was 9 months prior for epigastric discomfort in the setting of uncontrolled diabetes with a hemoglobin A1C of 12.4%. On arrival, her physical exam was significant for tachypnea, tachycardia, and dry mucus membranes.…

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Tales of Survival: An Open Letter to My Patient Mrs. B.

March 2, 2012
Tales of Survival: An Open Letter to My Patient Mrs. B.

By Vivek Murthy

Case report:

Mrs. B is a 68-year-old female with a PMH of small cell lung CA metastatic to the liver s/p last chemo six weeks ago presenting with RUQ pain migrating to her RLQ for the last 24 hours. Physical exam reveals a fatigued but pleasant African-American female appearing her stated age, in obvious pain that is making her eyes water. Exam is significant for R supraclavicular LAD, a distended abdomen, + Murphy’s sign, and exquisite tenderness to palpation and guarding in…

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FROM THE ARCHIVES: How Do You Diagnose Polymyalgia Rheumatica?

March 1, 2012
FROM THE ARCHIVES: How Do You Diagnose Polymyalgia Rheumatica?

Please enjoy this post from the archives dated August 12, 2009

By Eve Wadsworth MD

Faculty Peer Reviewed

Polymyalgia rheumatica (PMR) is a condition that resembles several different disorders including osteoarthritis and can be difficult to diagnose. In addition to osteoarthritis, PMR can resemble conditions as diverse as depression, fibromyalgia, myopathic drug reactions, and malignancy. PMR, however, can be associated with dangerous consequences, namely blindness, and is responsive to well-established treatment regimens. As such, familiarity with PMR’s presentation and its unique features is critical so…

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Cardiac Murmur Websites: An Internet Review of Common Cardiac Auscultation Websites

February 29, 2012
Cardiac Murmur Websites: An Internet Review of Common Cardiac Auscultation Websites

By Rachel Bond, MD

Faculty Peer Reviewed

In the field of medicine including the art of physical diagnosis, there is nothing more nerve provoking then having to master the art of cardiac auscultation. Imagine the concern of medical students, residents, internists and freshly starting cardiologists all alike who are asked by patients time and time again, “does my heart sound okay?!” With the advancement in technology and the rapid surge of echocardiogram usage, the use of a stethoscope has not been very provocative. However, being…

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EKG Websites: A Review of the Most Viewed Websites

February 3, 2012
EKG Websites: A Review of the Most Viewed Websites

By Melissa Mroz and Rachel Bond

Faculty Peer Reviewed

The electrocardiogram (EKG) is a test not only interpreted by cardiologists.

In fact, it is usually early in the year that the new medical student is handed an EKG; top flipped down as not to “cheat” and asked to interpret the rhythmic black squiggles on red graph paper. I still remember the anxiety provoking questions asked on my Medicine Clerkship. As with many skills I thought would magically become part of my repertoire on July 1st…

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