Class Act

Is the Funduscopic Exam Worthwhile For the General Practitioner?

May 2, 2014
Is the Funduscopic Exam Worthwhile For the General Practitioner?

By Emily Fisher

Peer Reviewed

Some have said that physical examination is a dying art and the nondilated funduscopic exam may be one of the best examples of this. With the increasing perception that the use of imaging and labs allows physicians to diagnose diseases with more confidence than a history and physical exam alone , the days when an ophthalmoscope was almost as important as the white coat or the stethoscope and was part of a “bag of tools,” are quickly becoming a…

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Direct-to-Consumer Genetic Testing: Impact on Patients and Preventive Medicine

April 25, 2014
Direct-to-Consumer Genetic Testing: Impact on Patients and Preventive Medicine

By Neelesh Rastogi

Peer Reviewed

In reference to the $100,000 he spent to research the genetic basis of the pancreatic cancer that ultimately killed him, Steve Jobs famously said, “I’m either going to be the first to be able to outrun a cancer like this, or I’m going to be one of the last to die from it” . Mr. Jobs was interested in finding the specific genetic mutations his tumor contained so as to allow doctors to optimize his drug therapy. Now other genetic…

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Should Physicians Ask Patients about Guns?

April 11, 2014
Should Physicians Ask Patients about Guns?

By Jennifer Zhu

Peer Reviewed

After the elementary school shooting in Newtown, CT in December 2012 that left 20 children and 6 adults dead, the country reacted as it had following the July 2012 movie theatre shooting in Aurora, CO, and the public meeting shooting involving Representative Gabrielle Giffords on January 11, 2011 in Tucson, AZ. Some called for tighter firearm safety laws, while others stood by the adage that “Guns don’t kill people,” and that this was no time to politicize a tragedy. The…

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Orders Of Magnitude

March 21, 2014
Orders Of Magnitude

By Olivia Richardson, MD

On the order of angstroms,

infinitesimally small

nucleotides pair off

and cling tightly to one another,

inseparable,

hundreds of kilojoules

binding them.

 

Like teenagers they dance,

entangled.

With arms entwined

they spin around one another-

spinning and twirling,

waltzing in neat lines

to the beat of their fate.

 

With endless energy,

they waltz-

in infinite numbers,

in trillions of cells,

with flawless precision,

never a step off beat.

 

On the order of angstroms,

a single nucleotide,

in an…

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The Blue Phone and the Bow-Tie

March 14, 2014
The Blue Phone and the Bow-Tie

By Joseph Zakhar

Peer Reviewed

The Patient:

Fate is the sound of a ringing phone.

I, however, am growing to hate the sound.

I’m strangled by the words, by the rough sheets, the silence as a stranger far away connects us, sitting in some room. There’s a tension, an unsettling sense of doom as I count the doctors’ blinks and wait for the “bonjourno.” I hope the translator – the one who lets me and my doctors talk – is somewhere warm, like Texas.…

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From The Archives: Intercessory Prayer: What Do Sneezes and Prayers Have in Common?

March 13, 2014
From The Archives: Intercessory Prayer: What Do Sneezes and Prayers Have in Common?

Please enjoy this post from the archives dated September 21, 2011

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…

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The Sentinel

March 7, 2014
The Sentinel

By Michael D. O’Donnell

The patient was a 60 year old female with a history heavy chain (AH) amyloidosis with renal and cardiac involvement, nephrotic syndrome, and hyperlipidemia who presented with progressive generalized weakness and fatigue for several weeks and nausea and vomiting for 5 days. The patient was seen in cardiology and hematology clinic one month prior to admission at which time chemotherapy was recommended for treatment of amyloidosis, but the patient needed time to confer with her family. After admission to medicine,…

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West Nile Virus: Just How Bad Is It?

March 5, 2014
West Nile Virus: Just How Bad Is It?

By Julian Horwitz

Peer Reviewed

As of mid-August 2012, the CDC had reported 1118 cases of West Nile virus (WNV) infections and 41 related deaths, which, pro rata, made 2012 the most prolific year for WNV in the United States . Although West Nile’s classification as a public health crisis remains debatable, the lack of treatment and vaccination options make associated severe infections a real threat.

West Nile virus, a single-stranded RNA virus of the Flavivirus family, was first isolated in Uganda in 1937 .…

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What Physicians Should Know About MDMA (Ecstasy)

February 20, 2014
What Physicians Should Know About MDMA (Ecstasy)

By Loren Gorcey

Peer Reviewed

With the recent resurgence of techno music and raves in the United States, the drug MDMA, known worldwide by the name “ecstasy,” has experienced a comeback. In light of a New Year’s Eve rave in Los Angeles in 2010, where 18 MDMA-related emergency room visits and 1 death occurred, MDMA is once again becoming a problem . Locally, 4 MDMA-related emergency room visits and 2 MDMA-related deaths occurred this past summer at Electric Zoo, an annual electronic music festival in…

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From The Archives – The Hangover: Pathophysiology and Treatment of an Alcohol-Induced Hangover

January 16, 2014
From The Archives – The Hangover: Pathophysiology and Treatment of an Alcohol-Induced Hangover

Please enjoy this post from the archives, dated May 27, 2011

By Anthony Tolisano

Faculty Peer Reviewed

The sunlight forces its way into your eyes, stabbing at your cortex. Suddenly, a wave of nausea and diarrhea grips your stomach, threatening to evacuate its contents. You rush to the bathroom, tripping over the clothes that speckle your apartment. Your heart pounds inside your chest and your hands shake ever so subtly. Your mind is in a fog and the details of last night’s party are…

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From The Archives: Fast Hearts and Funny Currents, Part 2: Is Tachycardia Part of the Problem in Heart Failure?

January 9, 2014
From The Archives: Fast Hearts and Funny Currents, Part 2: Is Tachycardia Part of the Problem in Heart Failure?

Please enjoy this post from the archives dated May 25, 2011

By Santosh Vardhana

Faculty Peer Reviewed

Please review Part 1 of this article here.

Mr. M is a 63-year old man with a history of coronary artery disease and systolic congestive heart failure (ejection fraction 32%) on lisinopril, metoprolol, and spironolactone who presents to the Adult Primary Care Center complaining of persistent dyspnea with exertion, two-pillow orthopnea, and severely limited exercise tolerance. His vital signs on presentation are T 98.0˚F, P…

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Barriers to Translating Evidence into Clinical Care: the Zoster Vaccine

December 13, 2013
Barriers to Translating Evidence into Clinical Care: the Zoster Vaccine

Zachary Elkin

Faculty Peer Reviewed

There are more than a million cases of herpes zoster (HZ) in the US annually . The incidence of HZ, or shingles, has been rising in the US since the 1990s . One third of all people in the US will get HZ, with the highest incidence in people aged 50 to 79 . As a result of the Shingles Prevention Study (SPS), the U.S. Food and Drug Administration (FDA) and Advisory Committee on Immunization Practices (ACIP) approved the Zostavax…

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