PrimeCuts: This Week in the Journals

June 29, 2009
PrimeCuts: This Week in the Journals

Sarah Moore MD

Faculty peer reviewed

If you’ve seen the news or even the cover this week’s Economist on newsstands (Obama as surgeon with a very large needle promising that yes, it’s going to hurt- a lot), you may think that healthcare in the U.S. is all about the money. In keeping with this theme the journals this past week have included a flurry of Markov models and QALY’s to answer the same question- is it worth it?

In this week’s Archives of Internal Medicine, …

Read more »

Tales of Survival

June 25, 2009
Tales of Survival

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 experiences.

Nathan Cox MD

Entering internship, I fully expected to be presented with a wide variety of situations for which I was woefully unprepared. These situations are the reasons...

Read more »

Medicine by the Numbers

June 24, 2009
Medicine by the Numbers

Rebecca Hall MD

50:  The number of patients on >100mg/day of methadone needed to be screened with an EKG to detect 1 person with a QTc >500 ms

A recent review in the Annals of Internal Medicine suggested guidelines for QTc interval screening in methadone users. The “number needed to treat” was thus calculated from several studies reviewed which show that about 2% of patients on methadone maintenance therapies (at doses >100 mg daily) developed QTc intervals in excess of 500 ms.

Torsade …

Read more »

PrimeCuts: This Week in the Journals

June 22, 2009
PrimeCuts: This Week in the Journals

Microbes and Molecules

Jon-Emile Kenny MD

Faculty Peer Reviewed

With the recent sensory overload regarding swine flu, I’ve spent considerable time pondering our immune system – and what an amazing system it is! From minor respiratory tract infections, to chronic viral replication and overwhelming bacterial sepsis, the immune system mobilizes a myriad of macromolecules to maintain our health.

In the Journal of the American Medical Association this week, Cruz et al. reported on the use of Polymyxin Hemoperfusion in septic shock. Recall that plasma endotoxin …

Read more »

Practicing Medicine in Rural America

June 20, 2009
Practicing Medicine in Rural America

Erin Ducharme MD

Part I. Tales from the barn

In the first of this three part series about life as a small town family physician, I introduce the doc (and rock band member) who spinal tapped my eight-year old lumbar spine to diagnose encephalitis and MC’d my wedding reception; share an unbelievable story about a home (i.e. barn) delivery , and hint at the all-encompassing nature of this still-revered position in rural America.

While my medical career began in the Big Apple and all I’ve …

Read more »

Myths and Realities: Is Breakfast the Most Important Meal of the Day?

June 18, 2009
Myths and Realities: Is Breakfast the Most Important Meal of the Day?

Chau Che MD

Faculty Peer Reviewed

In an age when two thirds of adults are either overweight or obese and obesity rates in children continue to rise, would an intervention such as consuming breakfast daily help combat this problem? Skipping breakfast has become increasingly common in adults and adolescents in the United States, with the proportion of adults and children skipping breakfast increasing from fourteen to twenty-five percent between 1965 and 1991 (1,3). Additionally, skipping breakfast may be detrimental to other functions. To examine the …

Read more »

Systemic Lupus Erythematosus and Premature Coronary Artery Disease

June 17, 2009
Systemic Lupus Erythematosus and Premature Coronary Artery Disease

Ishmeal  Bradley MD

Faculty Peer Reviewed

Ms. W is a 35 yo woman with a history of systemic lupus erythematosus diagnosed 10 years ago. Her only medications are hydroxychloroquine and prednisone for occasional disease flares. She is otherwise healthy. She has no known personal or family history of cardiac disease or stroke, but does smoke ½ pack of cigarettes per day. Currently, she denies any chest pain, shortness of breath, urinary symptoms, lower extremity edema, or menstrual irregularities, but does report occasional mild joint pain …

Read more »

PrimeCuts: This Week in the Journals

June 15, 2009
PrimeCuts: This Week in the Journals

Aditya Matoo MD

Faculty Peer Reviewed

The New York Times was on our case again this week reminding us (meaning Americans) of our poor lifestyle habits. They reported that middle-aged Americans are eating fewer fruits and vegetables, drinking more alcohol, exercising less, and, as we all know, becoming more obese, according to a study published in the American Journal of Medicine.Admittedly…mea culpa. With the long hours and late nights of residency, it’s pretty difficult to eat well and exercise as much as we preach to …

Read more »