Primecuts – This Week In The Journals

October 28, 2013
Primecuts – This Week In The Journals

By Michael Lee, MD

Faculty Peer Reviewed

In 2013, the state of New York mandated healthcare workers who do not receive influenza vaccination to wear surgical masks in healthcare settings. This historically unprecedented regulation is in part a response to the high influenza-associated morbidity and mortality witnessed during the 2012-2013 flu season, causing more than a thousand hospitalizations and five pediatric deaths in New York state alone. Although it has faced its fair share of oppositions from the healthcare workers, this new state-wide initiatiive…

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From The Archives: Creatine Kinase: How Much is Too Much?

October 24, 2013
From The Archives: Creatine Kinase: How Much is Too Much?

Please enjoy this post from the archives dated November 3, 2010

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…

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Why Aren’t Patients Using Advance Directives?

October 23, 2013
Why Aren’t Patients Using Advance Directives?

By Abigail Maller, MD

Faculty Peer Reviewed

Advance directives are a means for patients to communicate their wishes regarding medical decisions to their families and health care professionals once they are unable to make these decisions themselves. These documents, together with the assignment of health care proxies, help avoid a discrepancy between what a patient wanted in terms of end-of-life care and the level of care that they end up receiving . These resources also prevent confusion and promote mutual understanding between providers and family…

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Primecuts – This Week In The Journals

October 21, 2013
Primecuts – This Week In The Journals

By Sherif Shoucri, MD

Faculty Peer Reviewed

Extra! Extra! National Parks Reopen! In fact, so did the rest of the federal government, after an 11th hour budget deal brokered by Senate leaders extended federal borrowing powers for three months and reopened Uncle Sam’s doors for business. The House of Representatives quickly passed “big-brother’s” bill and the US narrowly averted a financial default with global economic repercussions. What is the price tag of a 16 day government shutdown? Experts are estimating this will cost the economy…

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Generation A(dderall)

October 17, 2013
Generation A(dderall)

By Michael Weinstock

Faculty Peer Reviewed

Neurocognitive enhancement with mixed amphetamine salts (MAS) has grown commonplace in academic settings. Over 34% of college students at a large public university reported using MAS as a study aid at least once in their life . Other researchers have found prevalence rates ranging from 13.7% lifetime use at another large public university to 55% lifetime use among fraternity members at a large public university . Abuse and misuse of stimulants does not stop after four years of college,…

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Primecuts – This Week In The Journals

October 15, 2013
Primecuts – This Week In The Journals

By Kerrilynn Carney, MD

Faculty Peer Reviewed

Talks between President Obama and House Republicans were described as “cordial but fruitless,” as they again failed to reach an agreement on a six-week extension of the nation’s borrowing authority over the holiday weekend. As elected officials try to sway public opinion on which party bears responsibility for the shutdown, and salvage the greater portion of the 5% approval rating currently enjoyed by Congress, the roll out of Obamacare begins slowly but visibly in the community. Despite…

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Is there a Non-Invasive Method to Diagnose Cirrhosis/Hepatic Fibrosis?

October 11, 2013
Is there a Non-Invasive Method to Diagnose Cirrhosis/Hepatic Fibrosis?

By Becky Naoulou, MD

Faculty Peer Reviewed

Clinical Question:

You are asked to see a 45 year-old male with a medical history significant for untreated hepatitis C (HCV RNA 5,000,000 copies/mL, genotype 1a). He presents complaining of worsening fatigue and weakness for several months. Labs are remarkable for mildly elevated transaminases, low albumin, and an elevated INR. The patient is very worried because he has heard that hepatitis C can cause liver cancer and asks you if there is a non-invasive screening test for liver…

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Barriers to Translating Evidence into Clinical Care: the Zoster Vaccine

October 10, 2013
Barriers to Translating Evidence into Clinical Care: the Zoster Vaccine

By 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…

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