PrimeCuts: Week of August 24th

August 24, 2009
PrimeCuts: Week of August 24th

Jon-Emile Kenny

Faculty Reviewed

Roughly 40,000 women die each year in the United States from breast cancer, and nearly 200,000 will be newly diagnosed; we have all been affected by this disease, and this week’s PrimeCuts looks at the latest in the treatment, diagnosis and molecular pathophysiology of this common malignancy.

Four years ago, the BIG 1-98 study compared, tamoxifen monotherapy and aromatase inhibitor monotherapy (letrozole) among postmenopausal women with receptor-positive breast cancer. This early study revealed that aromatase inhibitor given alone, as compared with …

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CT Colonography-The Future of Colorectal Cancer Screening?

August 21, 2009
CT Colonography-The Future of Colorectal Cancer Screening?

Ely R. Felker


Faculty Peer Reviewed

The patient is a 52 year-old white male who presented to his internist for a routine examination. He has no family history of colorectal cancer. He has not previously been screened. He recently heard about CT colonography and would like to know how it compares to conventional colonoscopy. Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer death in the United States(1). Multiple studies have demonstrated that most colorectal cancers develop …

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Tales of Survival: Hot Air

August 20, 2009
Tales of Survival: Hot Air

Bellevue Hospital, the nation’s oldest public hospital and the heart of our residency program, provides unique and unforgettable training for new physicians.  It is probably safe to say that every resident who trains at Bellevue graduates with a lifetime of stories about the experience. “Tales of Survival” was created to convey some of those stories.

Benjamin Bergman MD

 

Sometimes surviving a hospital stay is not so easy and the reasons are not so obvious. This is the story of how I realized that doctors frequently …

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Primecuts-This Week in the Journals

August 17, 2009
Primecuts-This Week in the Journals

Ivan Saraiva, MD

Faculty peer reviewed

This week’s edition of PrimeCuts will focus on an old friend, influenza, as well as a couple of other viruses. The novel swine-origin influenza A (H1N1) pandemic has no signs of decreasing its intensity. The New York Times reports on the pandemic reaching India, with nearly 1,200 cases and at least 17 deaths reported thus far. As the flu spreads in the southern hemisphere, the US prepares for a resurgence this fall.

The New England Journal of Medicine features …

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Medicine by the Numbers

August 13, 2009
Medicine by the Numbers

Elizabeth Gaines MD

Faculty Peer Reviewed

$275.50: The cost of routine morning labs at Bellevue in 2008.

Every morning, I sit down with my sign-out and scrawl “N, S, L” in red ink under each of my patients name. This becomes my to-do list, so that each day I remember to write a Note, up-date the Sign-out, and order morning Labs for each of my patients. As objective as I think I am, everyday I order morning labs that I probably don’t need. However, early …

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Class Act: How Do You Diagnose Polymyalgia Rheumatica?

August 12, 2009
Class Act: How Do You Diagnose Polymyalgia Rheumatica?

Eve Wadsworth MD

Faculty Peer Reviewed

Polymyalgia rheumatica (PMR) is a condition that resembles several different disorders including osteoarthritis and can be difficult to diagnose. In addition to osteoarthritis, PMR can resemble conditions as diverse as depression, fibromyalgia, myopathic drug reactions, and malignancy. PMR, however, can be associated with dangerous consequences, namely blindness, and is responsive to well-established treatment regimens. As such, familiarity with PMR’s presentation and its unique features is critical so as to avoid serious complications that can result from a delayed or …

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PrimeCuts: This Week in the Journals

August 10, 2009
PrimeCuts: This Week in the Journals

Jeff Mayne MD

Faculty Peer Reviewed

This weeks PrimeCuts focuses on vertebroplasty for vertebral compression fractures, Clostridium difficile infection (CDI) misconceptions, and the efficacy of screening for intimate partner violence. Vertebroplasty is performed by injecting an acrylic cement into the collapsed vertebral body. On August 6th, the New York Times reported that last year, about 73,000 Americans had the treatment, which costs $2,500 to $3,000…and that results from new studies indicate the procedure is “no better than placebo.” The two articles published in the August …

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Myths and Realities: Does holding your breath really cure hiccups?

August 6, 2009
Myths and Realities: Does holding your breath really cure hiccups?

Cindy Mui MD

Faculty Peer Reviewed

Hiccups, or singultus, are sudden, involuntary contractions of the diaphragm, which are terminated by abrupt closure of the glottis, producing their characteristic sound. Hiccups serve no known physiologic purpose, and descriptions of their causes and “cures” date back to the time of Hippocrates. The sheer number of remedies for hiccups prompted Dr. Charles Mayo, a physician at the turn of the 20th century and one of the founders of the Mayo clinic, to state “there is no disease which …

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