Mystery Quiz

November 18, 2016
Mystery Quiz

Vivian Hayashi MD, Robert Smith MD

The patient is an 86 year old man who presented with weakness, lethargy and falls.  His history was noteworthy for an episode of empyema nine years earlier that was managed with tube thoracostomy followed by decortication.  Seven years prior to this admission, upper endoscopy revealed Barrett’s esophagus and adenocarcinoma of the distal esophagus.  An esophagectomy and gastric pull-up was performed.  The patient had intermittent episodes of aspiration over the subsequent years.  Prior to the current admission, the patient complained …

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Primecuts – This Week In The Journals

November 15, 2016
Primecuts – This Week In The Journals

By Andrew ElDabh, MD

Peer Reviewed

This week finally concluded one of the more bizarre election seasons in American political history, as business magnate Donald Trump defeated heavy favorite Hillary Clinton in the 45th presidential election. The merging of reality television and the most powerful position in the

world wasn’t the only big news, as medical journals also had a “huge, tremendous” week that may have received a little less attention.

While many of us were awake and closely following the election coverage, some patients …

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From The Archives: In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

November 10, 2016
From The Archives: In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

Please enjoy this post from the archives dated April 17, 2013

By David G. Rosenthal and Robert Gianotti, MD

Faculty Peer Reviewed

Case: A 33-year-old man comes to your clinic complaining of worsening acne over the last 6 months. You note a significant increase in both BMI and bicep circumference. After several minutes of denial, he reveals that he has been using both injectable and oral anabolic steroids. He receives these drugs from a local supplier and via the Internet. He confides that his libido …

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Gamechanger? Is Spironolactone the Magic Bullet for Resistant Hypertension?

November 9, 2016
Gamechanger?  Is Spironolactone the Magic Bullet for Resistant Hypertension?

By Amar Parikh, MD

Peer Reviewed

Welcome to Gamechangers, a series that takes a critical look at the latest in medical literature to answer one important question: would the results of this article change my practice? Featuring thorough evidence-based review as well as expert commentary, our aim is for this series to help you decide if the results of a given study are, in fact, a gamechanger.

A 65 year-old Hispanic male with type 2 diabetes, hypertension, hyperlipidemia, and erectile dysfunction presents to clinic for

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Primecuts – This Week In The Journals

November 7, 2016
Primecuts – This Week In The Journals

By Nishan Bingham, MD

Peer Reviewed

This week, Ken Burns announced that he will have to remake his documentary series, Baseball, after the Chicago Cubs won the World Series for the first time in 108 years. While Wrigleyville reveled, health officials urged the remainder of Americans to avoid media through the final days of the presidential election in order to prevent unintentional Xanax overdoses. But to start off Primecuts, we revisit two familiar IM topics: PE and Syncope, after a new study showed the two …

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Mental Pathologies at the Root of Modern Medical Training: Lessons from the Life of Professor William Stewart Halsted

November 3, 2016
Mental Pathologies at the Root of Modern Medical Training: Lessons from the Life of Professor William Stewart Halsted

By Jafar Hamid Al-Mondhiry, MD, MA

Peer Reviewed

A critical care attending once told me that “learning scars” are some of our greatest teachers. And he was right. Many times, a sense of anxiety and rigorous self-criticism has pushed me to improve and develop more than I would have otherwise. This is the natural state of medical trainees: scared to fall behind their well-matched, naturally gifted, and occasionally outright competitive peers; scared to fall short in the eyes of evaluators; scared to stumble in front …

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Primecuts-This Week in the Journals

November 1, 2016
Primecuts-This Week in the Journals

By:  Aditya Sreenivasan, MD

For the Halloween edition of Primecuts, we resisted the temptation to follow the standard media trend and go exclusively with “spooky” or alarming articles. Though the subject of the dreaded Zika virus does come up below, we thought we’d start with some good news regarding improving outcomes for out-of-hospital arrest.

Increasing Access to AEDs and Improved Outcome for Out-of-Hospital Arrest 

The bad news is that survival rates for out of hospital arrest remain low – approximately 10% in industrialized countries. The …

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Mystery Quiz

October 28, 2016
Mystery Quiz

Vivian Hayashi MD, Robert Smith MD

The patient is an 86 year old man who presented with weakness, lethargy and falls.  His history was noteworthy for an episode of empyema nine years earlier that was managed with tube thoracostomy followed by decortication.  Seven years prior to this admission, upper endoscopy revealed Barrett’s esophagus and adenocarcinoma of the distal esophagus.  An esophagectomy and gastric pull-up was performed.  The patient had intermittent episodes of aspiration over the subsequent years.  Prior to the current admission, the patient complained …

Read more »