Ethics Commentary: Communication and Breaking Bad News

July 2, 2009
Ethics Commentary: Communication and Breaking Bad News

Commentary on Dr. Cox’s Tales of Survival by Antonella Surbone MD PhD FACP, Ethics Editor

Commenting on Dr. Cox’s honest heartfelt piece is not an easy task and even less so for me, as Ethics Editor. Why? Because before being a trained, published bioethicist, I’m a physician too. I’ve been through medical training and Fellowship in oncology in Italy and in the US: everywhere I have experienced the same doubts and felt the same anguish that Dr. Cox powerfully describes. During my internship, I still …

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Breaking News: Federal Advisory Panel Recommends Ban on Vicodin and Percocet

July 1, 2009
Breaking News: Federal Advisory Panel Recommends Ban on Vicodin and Percocet

Aalok Turakhia MD

In an attempt to err on the side of safety, an advisory panel to the Federal Food and Drug Administration narrowly voted yesterday to ban the popular prescription pain medications Percocet and Vicodin, in a 20-17 vote.Both medications are a combination of a narcotic and acetaminophen, and according to the New York Times, it was a growing concern over the safety of acetaminophen that prompted the Drug Safety and Risk Management Advisory Committee to assemble in Adelphi, Maryland early this week.…

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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, …

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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...

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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 …

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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 …

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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 …

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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 …

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