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 on clinical criteria and histologic confirmation at death. Based …

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Primecuts – This Week in the Journals

May 10, 2010
Primecuts – This Week in the Journals

Michael Tanner, MD  Associate Editor, Clinical Correlations

Hemoglobin Targets in Chronic Kidney Disease

Approved by the FDA in 1989, the success of erythropoietin in patients with chronic kidney disease and transfusion-dependent anemia led to trials testing the possible benefits of  progressively higher hemoglobin targets.   This week’s Annals of Internal Medicine (1) features a systematic review by Palmer et al of 27 trials of erythropoietin and darbepoietin titrated to various hemoglobin targets.  The review concludes that  hemoglobin targets of >13.0 g/L are associated with increased risk …

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Revisiting the USPSTF Breast Cancer Screening Guidelines: Ethics, and Patient Responsibilities

May 6, 2010
Revisiting the USPSTF Breast Cancer Screening Guidelines: Ethics, and Patient Responsibilities

David Shabtai

Faculty Peer Reviewed

 In a bold move, the U.S. Preventive Services Task Force recently changed their breast cancer screening guidelines – recommending beginning screening at age 50 and even then only every other year until age 75. Bold, because the Task Force members are certainly aware of the media circus that ensued when in 1997, an NIH group issued similar guidelines, prompting comparisons to Alice in Wonderland. The new guidelines, recommend “against routine screening mammography in women aged 40-49 years” as well as …

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Primecuts-This Week in the Journals

May 3, 2010
Primecuts-This Week in the Journals

 The 21st Running of the City of Pittsburgh Marathon

 Michael Ford, MD

Faculty Peer Reviewed

I am filing this dispatch from Pittsburgh, Pennsylvania.  A former home of steel, bratwurst, Iron City Beer, and cigarettes, Pittsburgh today finds itself lurching somewhat awkwardly along a transitional path toward gleaming healthcare and biotech excellence.  This location seems appropriate, as it was home to me for 10 years prior to relocating to NYC to begin a medical career.  It was here that I became a runner and attained the …

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Physician Assisted Suicide: A Spiritual Challenge

April 30, 2010
Physician Assisted Suicide: A Spiritual Challenge

Commentary on  last week’s “Physician Assisted Suicide—Is now the time?” by Antonella Surbone, MD PhD FACP, Ethics Editor, Clinical Correlations.

Last week’s piece on Physician Assisted Suicide (PAS) by Dr. Juliana Eng addresses in simple and clear terms an issue that, at times, occupies the front pages of our newspapers or becomes the center of heated public debate or the theme of elaborated ethical argumentations. For long periods, however, the request of some of our patients to be helped in putting an end to their …

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Motivational Interviewing: Can You Really Change Behaviors?

April 27, 2010
Motivational Interviewing: Can You Really Change Behaviors?

Emily Stamell

Faculty peer reviewed

As a well-trained fourth year medical student, I inquire about smoking habits as part of almost all my patient encounters. Yet, I do not recall properly counseling a patient on smoking cessation aside from the one liner “You know you should quit, right?” During first and second year of medical school we are taught the stages of change model, which is just as obscure two years later as cell signaling pathways. I was recently introduced to what seemed like an …

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Primecuts: This Week In the Journals

April 26, 2010
Primecuts: This Week In the Journals

Bora Toklu, MD

Faculty Peer Reviewed

As the spring is phasing in, it’s again that time of the year when an uncomfortable guilt sets in as you recover from the sedentary life of winter and confront those extra pounds that the winter has snuck in. People seem to rely mostly on “diet and exercise” to make it into skimpy summer swim suits—a virtual seasonal ritual of our modern society. There is not much of a dispute over how to exercise, but the toughest part seems …

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Physician-assisted Suicide – Is Now the Time?

April 24, 2010
Physician-assisted Suicide – Is Now the Time?

Juliana Eng MD

Several months ago, the U.K. courts ordered Ken Starmer, Director of Public Prosecutions, to delineate the conditions under which his office would be likely or unlikely to prosecute people who helped friends or relatives kill themselves.  This list of conditions is intended to provide information so that those who wish to assist another commit suicide can make an informed decision.  Yet Section 2(1) of the Suicide Act of 1961 provides: “A person who aids, abets, counsels or procures the suicide of another, …

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