Class Act

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…

Read more »

What are the Barriers to Using Low Dose CT to Screen for Lung Cancer?

February 23, 2012
What are the Barriers to Using Low Dose CT to Screen for Lung Cancer?

By Benjamin Lok

Faculty Peer Reviewed

Lung cancer is the most common cause of cancer deaths globally and responsible for an estimated 221,120 new cases and 156,940 deaths in 2011 in the United States. Presently, the United States Preventive Services Task Force, the National Cancer Institute (NCI), the American College of Chest Physicians, and most other evidence-based organizations do not recommend screening for lung cancer with chest x-ray or low-dose helical computed tomography (CT) due to inadequate evidence to support mortality reduction. This…

Read more »

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…

Read more »

When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

February 1, 2012
When Is Hemoglobin A1c Inaccurate In Assessing Glycemic Control?

By Joseph Larese

Faculty Peer Reviewed

Hemoglobin A1C (HbA1c) is an invaluable tool for monitoring long-term glycemic control in diabetic patients. However, many clinicians managing diabetics have encountered the problem of HbA1c values that do not agree with fingerstick glucose logs. Before suspecting an improperly calibrated glucometer or poor patient record keeping, it is useful to consider the situations in which HbA1c may be spuriously elevated or depressed. These issues are best understood after reviewing how HbA1c is defined and measured–topics fraught with considerable confusion.…

Read more »

Death, Be Not Proud: The Case for Organ Donation

January 27, 2012
Death, Be Not Proud: The Case for Organ Donation

By Tracie Lin

Faculty Peer Reviewed

DEATH, be not proud, though some have callèd thee

Mighty and dreadfull, for, thou art not so;

For those whom thou think’st thou dost overthrow

Die not, poore death, nor yet canst thou kill me.

From rest and sleepe, which but thy pictures bee,

Much pleasure, then from thee, much more must flow,

And soonest our best men with thee doe goe,

Rest of their bones, and soul’s deliverie.

Thou art slave to Fate, Chance, kings, and desperate…

Read more »

Male Hormonal Contraception

January 20, 2012
Male Hormonal Contraception

By Kaley Myer, Class of 2012

Faculty Peer Reviewed

As a female, I like the idea of males taking hormonal contraceptives. In a semi-sadistic way, I relish the idea of a man taking a pill every day to prevent impregnation of my gender. Traditionally, contraception has been a female responsibility, from diaphragms to oral contraceptive pills to intrauterine devices. Male condoms, coitus interruptus, and the more permanent vasectomy require male participation, but these methods do not dominate the contraceptive market. Indeed, couples are encouraged to…

Read more »

Why Are Asthma Patients Noncompliant With Their Inhalers?

January 11, 2012
Why Are Asthma Patients Noncompliant With Their Inhalers?

By Kristen Mattei

Faculty Peer Reviewed

I distinctly remember being 9 years old, sitting in my doctor’s office after a cold left me struggling for breath, doubled over and wheezing, when he told me that I had asthma. At first I didn’t believe the diagnosis, despite the fact that the albuterol inhaler he had given me was like a breath of life after running suicides on the soccer field. I wasn’t sick or weak! My father insisted I needed to “build my breath up,” and…

Read more »

Dance Therapy in Parkinson’s Disease: Can the Argentine Tango Improve Motor Function?

December 2, 2011
Dance Therapy in Parkinson’s Disease: Can the Argentine Tango Improve Motor Function?

By Neha Jindal

Faculty Peer Reviewed

Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder that affects over 1 million people in the United States. People with PD often demonstrate postural instability, gait difficulties, and impaired functional mobility, which can lead to falls and decreased quality of life. Medical treatments for PD do not fully address gait and balance issues and, consequently, additional approaches are needed. One approach that has recently emerged in clinical studies is the use of dance, particularly the Argentine tango, as…

Read more »

Does Cranberry Juice Prevent Urinary Tract Infections?

November 9, 2011
Does Cranberry Juice Prevent Urinary Tract Infections?

By Jessie Yu

Faculty Peer Reviewed

A healthy 21-year-old female college student presents to clinic after one day of dysuria and increased frequency. You diagnose her with a recurrent urinary tract infection (UTI), and as you hand her a prescription for empiric antibiotic treatment, she asks you if drinking cranberry juice will prevent these in the future…

Drinking cranberry juice to prevent urinary tract infections (UTIs) has been a traditional folk remedy for hundreds of years. Stroll into any New York City pharmacy and…

Read more »

Breast Self-Examination: Worth the Effort?

October 5, 2011
Breast Self-Examination: Worth the Effort?

By Katherine Husk

Faculty Peer Reviewed

A healthy 40-year-old woman comes into your office for a routine health exam.  After you have performed a clinical breast exam, she asks you whether she should be examining her breasts on her own at home…

Breast self-exam (BSE) seems sensible. Empowering a patient to develop a sense of a personal norm could allow for easier recognition of breast changes, and could perhaps lead to earlier evaluation by a medical professional. There is a great deal of controversy,…

Read more »

Stemming the Tide: The Promise and Pitfalls of HIV Prevention Research

September 28, 2011
Stemming the Tide: The Promise and Pitfalls of HIV Prevention Research

By Benjamin Bearnot

Faculty Peer Reviewed 

Since the discovery of zidovudine (AZT) in the mid-1980s, advances in antiretroviral (ARV) therapy for patients with chronic human immunodeficiency virus (HIV) infection have, until recently, outpaced concomitant improvements in methods for HIV prevention. Over the past few years, HIV prevention research has been building an impressive head of steam. While a completely effective vaccine for HIV prevention has continued to prove elusive, results of a modestly successful (~30% protective) vaccine trial based in Thailand were announced in 2009,…

Read more »

They’re all the ‘roid rage: origins and mechanisms of corticosteroid therapy.

September 23, 2011
They’re all the ‘roid rage: origins and mechanisms of corticosteroid therapy.

By Santosh Vardhana, MD

A 36-year-old obese male with hypertension and hyperlipidemia presents to the ER with new knee pain, swelling, and erythema.  Joint aspiration reveals negatively birefringent crystals.  He is started on oral prednisone.

A 26-year-old woman with lupus presents to ER with edema, hematuria, and fevers.  On exam she hypertensive, febrile to 100.4C, and has periorbital and lower extremity edema.  Urine dipstick reveals 2+blood and protein.  She is started on IV methylprednisolone.

A 60-year-old man with HIV on HAART presents to the ER…

Read more »