Diseases 2.0

Vegetative State 2.0

May 13, 2011
Vegetative State 2.0

By Ivan Saraiva, MD

Faculty Peer Reviewed

 “Mr. Dockery was a police officer in the town of Walden, northwest of Chattanooga, when he was shot in the forehead as he responded to a call on Sept. 17, 1988. He has been motionless and speechless in a nursing home most of the time since then but was recently moved to Columbia Parkridge Medical Center here because of a lung infection. Suddenly, on Monday, he spoke, amazing his family and physicians.” (NY…

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The Myth of the Helminth: Can Worms be the Next Therapeutic Breakthrough for IBD Patients?

March 16, 2011
The Myth of the Helminth: Can Worms be the Next Therapeutic Breakthrough for IBD Patients?

By Michael Guss, Class of  2012

Faculty Peer Reviewed

Helminths–parasitic worms that have co-evolved with humans and colonized our gastrointestinal (GI) tract for millennia–have developed the ability to modulate our inflammatory responses and evade our immune systems to survive . Until the 1930s, the helminth colonization of humans was almost universal, owing to poor sanitation conditions and an impure food supply . This changed as the economic development of the last century created improved sanitary conditions: clean running water,…

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Anthracycline Induced Cardiotoxicity

January 14, 2011
Anthracycline Induced Cardiotoxicity

By Ami Jhaveri, PGY-3

Faculty Peer Reviewed

Clinical Case:

K.M. is a 61-year-old woman with hypertension diagnosed with non-Hodgkin’s lymphoma 1 month ago.  Her only medication is hydrochlorothiazide.  She is about to undergo treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).  Her oncologist explains that doxorubicin may affect the heart and that she needs to obtain a Multi Gated Acquisition scan (MUGA)before proceeding with her treatment.  Her oncologist recently read a study describing benefits of beta-blockers…

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Kayexalate: What is it and does it work?

December 1, 2010
Kayexalate: What is it and does it work?

By Todd Cutler, MD

Faculty Peer Reviewed

A 62-year-old male is hospitalized with an acute congestive heart failure exacerbation. On hospital day three, the patient’s symptoms have significantly improved with twice daily furosemide 80mg IV. He is continued on IV diuretics and aggressive electrolyte repletion. On day five of his admission, his basic metabolic panel is significant for a creatinine of 2.3 mg/dL (increased from 1.3 on admission) and a potassium concentration of 5.9 mEq/L. His EKG is

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Proton Pump Inhibitors 2.0

November 26, 2010
Proton Pump Inhibitors 2.0

By Mary C. Whitman, MD

Faculty Peer Reviewed

Proton pump inhibitors (PPIs) are generally considered “safe” medications and are prescribed to over 100 million patients per year for a variety of indications, often for long durations. Recently, new data has emerged that suggests that we should be more judicious in prescribing PPIs.

In a recent development, the FDA announced that it will require new labeling of PPIs indicating that their use at high dosage and for prolonged…

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Creatine Kinase: How Much is Too Much?

November 3, 2010
Creatine Kinase: How Much is Too Much?

By Jon-Emile Kenny, MD

Faculty Peer Reviewed

A 37-year-old man, with no past medical history and taking finasteride for male pattern baldness, is admitted to Medicine with profound lower extremity weakness after a weekend of performing multiple quadriceps exercises. His measured creatine phosphokinase (CPK) is over 35,000 IU/liter. I wonder to myself, what is the risk to his kidneys and can I mitigate the damage?

 Rhabdomyolysis means destruction of striated muscle. Physical manifestations range from an asymptomatic…

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Why Does Multiple Myeloma Treat The Kidneys So Poorly?

September 22, 2010
Why Does Multiple Myeloma Treat The Kidneys So Poorly?

By Jon Emile Kenny, MD

Faculty Peer Reviewed

“You mean I’ve got cancer and my kidneys are failing, doc?” said my frail patient on the Bellevue oncology service shortly after a medical student had told him that his kidneys were damaged. Indeed, his new diagnosis of multiple myeloma was accompanied by an admission creatinine of 2.5 mg/dL.

About a quarter of patients with multiple myeloma have renal insufficiency at diagnosis . There are a number of clinicopathologic…

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The Challenge of Measles Control

September 15, 2010
The Challenge of Measles Control

By Taher Modarressi

Faculty Peer Reviewed

Measles remains one of the leading causes of preventable child mortality worldwide, despite the development of an effective vaccine in the 1960s. Even as late as the early 1990s, measles continued to infect tens of millions of people and claimed over a million lives each year (51]. Although mortality dropped by 78% from 2000 to 2008 due to aggressive control initiatives, the disease is still responsible for 164,000 deaths annually . Morbidity…

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The Role of Serologic Testing in the Diagnosis of Celiac Disease

August 18, 2010
The Role of Serologic Testing in the Diagnosis of Celiac Disease

By Todd Cutler

Faculty Peer Reviewed

A 31-year-old woman presents to the clinic with chronic fatigue. She was diagnosed with iron  deficiency anemia when she was 25 years old and has since taken oral contraceptives to limit bleeding during menstruation which she describes as minimal. She has a family history significant for an older brother with celiac disease. She is thin and her exam is significant for conjunctival pallor. Her laboratory findings are significant for a hemoglobin of 9.7

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Chronic Stable Angina 2.0

August 4, 2010
Chronic Stable Angina 2.0

By Brad Pfeffer, MD

Faculty Peer Reviewed

Case: A 75- year-old non-smoking male with a history of type II diabetes, hypertension and hyperlipidemia comes to clinic with several months of stable anginal chest pain provoked by ten blocks of exercise with no change in exercise tolerance. He has seen you several times over the past year and has been placed on aspirin, beta blockers, calcium channel blockers and long acting nitrates with some relief of symptoms. In addition, he…

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Alzheimer’s Disease 2.0

May 12, 2010
Alzheimer’s Disease 2.0

Jeffrey Mayne MD

Faculty peer reviewed

Dr. Okonkwo’s post this past summer to PrimeCuts summarized ongoing research in Alzheimer’s Disease (AD), the most common cause of dementia affecting 15 million individuals worldwide and more than 5 million in the United States. It is a disease marked by cognitive deterioration that slowly breaks down one’s ability to perform activities of daily living and leaves individuals unable to care for themselves.

Briefly, the diagnosis of AD is based…

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Alzheimer’s Disease 2.0

April 21, 2010
Alzheimer’s Disease 2.0

Jeffery Mayne MD

Faculty peer reviewed

Dr. Okonkwo’s post this past summer to PrimeCuts summarized ongoing research in Alzheimer’s Disease (AD), the most common cause of dementia affecting 15 million individuals worldwide and more than 5 million in the United States. It is a disease marked by cognitive deterioration that slowly breaks down one’s ability to perform activities of daily living and leaves individuals unable to care for themselves.

Briefly, the diagnosis of AD is based on…

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