Diseases 2.0

Inhaled insulin: An Elusive Revolution in Diabetes Management.

June 19, 2014
Inhaled insulin: An Elusive Revolution in Diabetes Management.

By Reed Magleby, MD

Peer Reviewed

For many with type II diabetes, initiation of insulin therapy represents a devastating progression of their disease. Patients who are dependent on insulin require constant blood sugar monitoring, adherence to strict dosing algorithms, and up to 4 self-administered injections every day. According to a 2010 survey of non-insulin adherent diabetic patients, both “injection phobia” and inconvenience were found to be important barriers to initiation of insulin therapy. . In response to these concerns, less invasive administration techniques such as…

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Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

June 13, 2014
Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

By Dana Zalkin

Peer Reviewed

In the late 1970s evidence began to emerge that a newly discovered pump, a H+/K+ ATPase in the gastric mucosa, was the final step in the process of acid secretion . With this discovery, further research demonstrated the ability to reduce gastric acid secretion by inhibiting these proton pumps . We now have drugs that do just that: the proton pump inhibitors (PPIs). Proton pump inhibitors have been used since 1989 to treat acid-related gastrointestinal disorders as well as in…

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The Rise in Tick-Borne Diseases: Is Climate Change Responsible?

June 4, 2014
The Rise in Tick-Borne Diseases: Is Climate Change Responsible?

By Nadia Jafar

Peer Reviewed

As a resident of Connecticut, I grew up acutely aware of tick-borne diseases. Nonetheless, I was surprised to see at least 3 cases of tick-borne infections during the month of my Medicine clerkship. This drove me to research the incidence of tick-borne diseases, specifically in the US, and the possible factors contributing to their increased prevalence.

In 1998, the list of reportable tick-borne pathogens in the US included Rocky Mountain spotted fever, tularemia, Lyme disease, human granulocytic ehrlichiosis/anaplasmosis, and human…

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Gay Men, Barebacking and the New Little Blue Pill: The awkward interface of medicine and gay sex.

May 23, 2014
Gay Men, Barebacking and the New Little Blue Pill: The awkward interface of medicine and gay sex.

By Richard E. Greene, MD

Peer Reviewed

In July of 2012, the FDA approved the use of Tenofovir-Emtricitabine (Truvada, a single blue pill) daily as Pre-Exposure Prophylaxis (PrEP) in men with persistent risk for contracting HIV infection. The idea of PrEP has ignited a firestorm of concern among healthcare providers about how, when and in whom to use PrEP, if at all. Indeed, some believe that PrEP will usher in a new era of drug resistant new infections with HIV, or encourage men on…

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Infection Transmission During Air Travel

May 7, 2014
Infection Transmission During Air Travel

By Aaron Smith, MD

Peer Reviewed

It’s become a familiar site to travelers: airline passengers wearing respiratory masks to filter pathogens from the cabin air. To those not wearing masks, the fashion trend can be discomfiting. Are the mask-wearers paranoid or prudent? What is the probability of contracting an illness on an airplane? And how unique is the aircraft environment when it comes to disease transmission?

It is clear that due to lower air exchange rates and decreased sunlight, enclosed spaces such as buildings…

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Type 1 Diabetes: Research for Pancreatic Replacement, Transplantation and Regeneration

April 10, 2014
Type 1 Diabetes: Research for Pancreatic Replacement, Transplantation and Regeneration

By Karin Katz, MD and Loren Wissner Greene, MD, MA

Peer Reviewed

In 1964, Dr. Arnold Kadish used real-time glucose monitoring to adjust insulin infusion in a patient with diabetes and introduced the concept of a closed-loop system of insulin delivery. A decade later, several research groups developed closed-loop systems that linked glucose monitors with insulin pumps and determined how much insulin to deliver based on calculations from a set of algorithms . These big, bulky machines depended on intravenous routes of glucose…

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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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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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RTS,S/AS01: Is This The Beginning Of The End Of Malaria?

April 12, 2012
RTS,S/AS01: Is This The Beginning Of The End Of Malaria?

By Nicole Sunseri

Faculty Peer Reviewed

In Africa, there lurks a stealthy and powerful beast. Is it a lion, a black mamba, or a crocodile? No, it is the Anopheles mosquito. Although less than the size of a paperclip, these insects inflict an incapacitating blow, inoculating their larger human prey with Plasmodium spp., the parasites responsible for malaria. According to the World Health Organization, the worldwide incidence of malaria infection in 2009 was 225 million cases with a death toll of 781,000 Most of these…

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Obesity 2.0: More Than Just the Extra Weight

February 9, 2012
Obesity 2.0: More Than Just the Extra Weight

By Aviva Regev

Faculty Peer Reviewed

Introduction

Few people these days are unaware of the “obesity epidemic,” with its inception here in the United States and its steady, insidious spread around the globe. The numbers are truly staggering: in 2008, the World Health Organization estimated that 1.5 billion adults–over 20% of the earth’s population–were overweight, and 500 million of those were classified as obese, with a body mass index greater than 30. In the United States, over a third of the population is overweight, and…

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A New Era of Therapy for Hepatitis C

November 4, 2011
A New Era of Therapy for Hepatitis C

By Alexander Jow, MD

Faculty Peer Reviewed

Hepatitis C virus (HCV) is a major public health issue, representing the leading cause of chronic liver disease, death from liver disease, and a principal indication for liver transplantation in the US. It is estimated that 3-4 million people in the world are infected with HCV each year. Globally, 130-170 million people are chronically infected with HCV and more than 350,000 people die from HCV-related liver disease each year. Although the natural history of HCV infection…

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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,…

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