ID

Are Health Care Providers PrEPared?

September 24, 2014
Are Health Care Providers PrEPared?

By Nathan King

Faculty Reviewed

Doctors are known to be some of the worst patients, and from personal experience I predict that medical students are not too far behind. That’s why when I finally found the time to take a proactive step in maintaining my good health, the last thing I hoped to run into were barriers, but that’s exactly what I hit. To my surprise, it was not at the hands of insurance companies, overbooked doctors, or the general bureaucracy of the medical system;…

Read more »

To Inject, or Not to Inject: Using the Pneumococcal Vaccinations Effectively

September 19, 2014
To Inject, or Not to Inject: Using the Pneumococcal Vaccinations Effectively

By Luke O’Donnell, MD

Peer reviewed

Once formidable diseases, pneumonia, bacteremia, and meningitis are all now considered “bread-and-butter” internal medicine. Streptococcus pneumoniae is one of the major pathogens in these processes, causing 500,000 cases of pneumonia, 50,000 cases of bacteremia, and 3,000 cases of bacterial meningitis in the United States annually, with case fatality rates of 5-7%, 20%, and 30%, respectively .

Efforts to vaccinate against this gram-positive diplococcus started in mining sites near Johannesburg, South Africa around the turn of the last century…

Read more »

Chimeras Could Bridge the Gap Between Treatment and Cure Or Are They Your Silent and Deadly Twin?

August 8, 2014
Chimeras Could Bridge the Gap Between Treatment and Cure Or Are They Your Silent and Deadly Twin?

By Pritha Subramanyam

Peer Reviewed

Mrs. CS is a 66-year-old Indian female who presents for a cardiology follow-up. The patient has a history of mitral regurgitation secondary to rheumatic fever she experienced as a child. As a teenager, her condition was diagnosed when she frequently became short of breath while playing sports in school. She was in good health until 24 years ago, when an acute episode of dyspnea while climbing stairs sent her to the emergency room. Her native mitral valve was found to…

Read more »

Are Probiotics Effective In Preventing Clostridium Difficile Associated Diarrhea?

May 30, 2014
Are Probiotics Effective In Preventing Clostridium Difficile Associated Diarrhea?

By Theresa Sumberac, MD

Peer Reviewed

Antibiotic associated diarrhea is a common complication of antibiotic therapy, occurring in 5% to 39% of all patients receiving treatment. Nearly one third of these cases are attributed to the gram –positive spore forming rod, Clostridium difficile . A primary Clostridium difficile associated diarrhea (CDAD) is estimated to add $2871 to $4846 to in hospital costs while a recurrent infection is estimated to cost $13,655 to $18,067 . The emergence of the hyper-virulent NAP1/B1/027 strain of C. difficile together…

Read more »

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…

Read more »

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…

Read more »

Proton Pump Inhibitors and Clostridium Difficile Infection

March 20, 2014
Proton Pump Inhibitors and Clostridium Difficile Infection

By Aaron Smith, MD

Peer Reviewed

First introduced in the late 1980s, proton pump inhibitors (PPIs) have revolutionized the treatment of gastric acid-related disorders and have been described as a miracle drug by patients and physicians alike. As is often the case with miracle drugs, however, long-term use of PPIs has led to unforeseen adverse effects. Chief among the purported side effects of PPI use is an association with Clostridium difficile infection (CDI). CDI, an enterocolitis that leads to voluminous and potentially fatal diarrhea, was…

Read more »

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 .…

Read more »

Can Young Patients Get Diverticular Disease?

January 23, 2014
Can Young Patients Get Diverticular Disease?

By Aaron Smith, MD

Peer Reviewed

Case: A 35 year-old, overweight female presents to the emergency room with five days of left lower quadrant abdominal pain. The pain is 10/10 in severity and accompanied by nausea, bloating, and loss of appetite.

Diverticulosis, the presence of small colonic outpouchings thought to occur secondary to high pressure within the colon, is an extremely common condition in elderly patients. Recent data suggests that up to 50% of people over the age of 60 have colonic diverticula. When…

Read more »

Who Should We Screen for Hepatitis C: By Risk Or Birth Cohort?

January 8, 2014
Who Should We Screen for Hepatitis C: By Risk Or Birth Cohort?

By Jung-Eun Ha

Peer Reviewed

Over the last few years major changes have occurred in the diagnosis and treatment of hepatitis C. In 2011 the U.S. Food and Drug Administration (FDA) approved a rapid finger stick antibody test for hepatitis C virus (HCV) infection . The FDA also approved the protease inhibitors telapravir (Incivek; Vertex Pharmaceuticals, Cambridge, Massachusetts; Johnson & Johnson, New Brunswick, New Jersey) and boceprevir (Victrelis; Merck, Whitehouse Station, New Jersey), for the treatment of genotype 1 hepatitis C . In August…

Read more »

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…

Read more »

From The Archives: The Polymyxins: Why am I using them all the time, and what are they?

November 21, 2013
From The Archives: The Polymyxins: Why am I using them all the time, and what are they?

Please enjoy this post from the archives dated December 8, 2010

By Jon-Emile S Kenny

Faculty Peer Reviewed

A 65-year-old female with locally advanced rectal cancer is admitted to the ICU, hypotensive and febrile. Her PICC line is removed and blood cultures drawn. Fourty-eight hours later all cultures return ESBL Klebsiella with susceptibility only to polymyxin.

I sat on the venerable call-room couch staring mindlessly at the cluttered, nauseating walls repeating the word ‘polymyxin’ like an endless antimicrobial mantra. What strange dosing it has, and…

Read more »