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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Primecuts – This Week In The Journals

October 7, 2013
Primecuts – This Week In The Journals

By David Kudlowitz, MD

Faculty Peer Reviewed

For the first time since 1996, the government has shut down due to lack of Congressional funding. Most of the wrangling behind this political stalemate surrounds support of the Affordable Care Act. Meanwhile, 800,000 non-essential federal employees are out of work and various services are offline. While legislators continue to argue over the politics of health care reform, the Affordable Care Act’s online health exchanges opened on October 1. In other news, at the United…

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From The Archives: Asking the Potentially Answerable Clinical Question

October 3, 2013
From The Archives: Asking the Potentially Answerable Clinical Question

Please enjoy this post from the Archives, dated October 1, 2010

By Dorice L. Vieira M.A., M.L.S.

Faculty Peer Reviewed

The title to this feature may seem a bit odd, but there is a proper way to ask evidence-based clinical questions.  “What is the treatment for diabetes?” is not a well-defined question.  A PubMed literature search using the terms “diabetes” and “treatment” retrieves a total of 167,843 citations covering a myriad of approaches to the treatment of diabetes:  type I (26,884…

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Primecuts – This Week In The Journals

September 30, 2013
Primecuts – This Week In The Journals

By Darya Rudym, MD

Faculty Peer Reviewed

Lighter, faster, cheaper. This useful promo phrase applicable to almost all technological developments, was put forth by Amazon.com as they launched their new Kindle Fire this week. This came conveniently a day after Microsoft released the second generation of their much talked about Surface tablet. While the technology giants battled to appeal to the interests of a modern day reader, President Barack Obama endorsed democratic candidate Bill de Blasio for mayor of New York City. President Obama…

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Decoding the APOL1 Kidney

September 25, 2013
Decoding the APOL1 Kidney

By Areeba Sadiq

Faculty Peer Reviewed

African American patients have a higher risk of developing end-stage renal disease (ESRD) than their Caucasian counterparts . If over the age of 70, that risk is 3 times higher. If between the ages of 60-69, the risk is 8 times higher. And, if between 30 and 39, African American patients are an astounding 11 times more likely to develop ESRD . Why are African Americans more likely to develop ESRD? What is different about the African American kidney?…

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Primecuts – This Week In The Journals

September 23, 2013
Primecuts – This Week In The Journals

By Gabriel Schneider, MD

Faculty Peer Reviewed

Fueling concern over the continued dysfunction in Washington, the Republican-led House of Representatives produced a budget on Friday that included defunding of the Affordable Care Act, commonly referred to as Obamacare. This marks the 42nd attempt to repeal Obamacare and will almost certainly be rejected by the Democratic-led Senate, risking a government shut down on Sept. 30th if a budget is not ratified. This political folly in Washington stands in juxtaposition to the admirable example set earlier last…

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The DLO: Does FFP Correct INR?

September 20, 2013
The DLO: Does FFP Correct INR?

By Nicole A Lamparello, MD

Faculty Peer Reviewed

Page from the hematology laboratory: critical lab value; INR 1.9. Liver biopsy scheduled for tomorrow. What is a knowledgeable physician practicing evidence-based medicine to do?

Fresh frozen plasma (FFP) is the liquid, acellular component of blood. FFP contains water, electrolytes, and the majority of the coagulation proteins . It is frequently transfused to patients with an elevated prothrombin time (PT), a measure of the activity of the common coagulation pathway (involving factors X, V, prothrombin and fibrinogen)…

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Diagnostic Dilemma-Poststreptococcal Reactive Arthritis in a Pregnant Woman

September 18, 2013
Diagnostic Dilemma-Poststreptococcal Reactive Arthritis in a Pregnant Woman

By Bryan Stierman and Todd Cutler, MD

Faculty Peer Reviewed

Case Presentation

A 35-year-old Hispanic woman presented to the emergency room with severe joint pain and swelling for one week.

The patient had a history of hypothyroidism and hepatitis C which was treated with interferon therapy two years prior. She was recently discovered to be pregnant and, at the time of presentation, was in her tenth week of pregnancy. Three weeks prior to admission she developed a sore throat. She saw an outside care provider…

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