Inhaled insulin: An Elusive Revolution in Diabetes Management.

June 19, 2014
Inhaled insulin: An Elusive Revolution in Diabetes Management.

By Reed Magleby, MD

Peer Reviewed

For many with type II diabetes, initiation of insulin therapy represents a devastating progression of their disease. Patients who are dependent on insulin require constant blood sugar monitoring, adherence to strict dosing algorithms, and up to 4 self-administered injections every day. According to a 2010 survey of non-insulin adherent diabetic patients, both “injection phobia” and inconvenience were found to be important barriers to initiation of insulin therapy. . In response to these concerns, less invasive administration techniques such as…

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Primecuts – This Week In The Journals

June 17, 2014
Primecuts – This Week In The Journals

By Christopher Maulion, MD

Peer Reviewed

The last week was certainly a treat for sports fans. Thursday marked the start of the World Cup, and the month where the United States begins to care about fútbol. Martin Kaymer set a US Open record by beating the field at Pinehurst No. 2 by 8 strokes. Last but not least, Lebron James and the Miami Heat’s attempt at a three-peat was thwarted by Timmy and the Spurs. As we watch these exciting events unfold, let us turn…

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Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

June 13, 2014
Proton Pump Inhibitors: Acid Suppression with a Nutritional Cost

By Dana Zalkin

Peer Reviewed

In the late 1970s evidence began to emerge that a newly discovered pump, a H+/K+ ATPase in the gastric mucosa, was the final step in the process of acid secretion . With this discovery, further research demonstrated the ability to reduce gastric acid secretion by inhibiting these proton pumps . We now have drugs that do just that: the proton pump inhibitors (PPIs). Proton pump inhibitors have been used since 1989 to treat acid-related gastrointestinal disorders as well as in…

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Medical Eponyms: Recognizing the Medical Greats

June 11, 2014
Medical Eponyms: Recognizing the Medical Greats

By David Kudlowitz, MD

Peer Reviewed

Whether assessing for a Babinski sign, listening to Korotkoff sounds, or diagnosing Wolf-Parkinson-White Syndrome, we are surrounded by names of the medical greats in day-to-day medical practice. Medical eponyms for diseases, physical exam signs, procedures, and anatomic parts are considered by many practitioners to be tributes to their physician discoverers. However, over the past several years there has been an increasing resistance to the excessive use of eponyms, especially those associated with Nazi physicians . A compilation of medical…

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Primecuts – This Week In The Journals

June 9, 2014
Primecuts – This Week In The Journals

By Mark Adelman, MD

Peer Reviewed

This week marked the anniversaries of several major events in 20th century world history. June 4th was the 25th anniversary of the Tiananmen Square Massacre, during which the Chinese military forcibly removed pro-democracy protestors that had been camped outside of Beijing’s Forbidden City. Estimates vary widely due to the Chinese government’s official prohibition on public discussion of the events, but anywhere from a few hundred to several thousand people were killed in the process . Seventy years ago on…

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Caffeine and the Risk of Atrial Fibrillation

June 6, 2014
Caffeine and the Risk of Atrial Fibrillation

By Joshua Michael Lader, MD

Peer Reviewed

As physicians, we are frequently asked to weigh-in on dinnertime discussions about topics that, despite their relevance to everyday life, were never formally addressed in our medical training. For example, at a recent family gathering the conversation turned to a 78 year-old uncle who was recently diagnosed with atrial fibrillation. While this uncle had longstanding and likely poorly controlled hypertension, he would also typically drink 4 to 5 cups of coffee between breakfast and lunch. The debate then…

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The Rise in Tick-Borne Diseases: Is Climate Change Responsible?

June 4, 2014
The Rise in Tick-Borne Diseases: Is Climate Change Responsible?

By Nadia Jafar

Peer Reviewed

As a resident of Connecticut, I grew up acutely aware of tick-borne diseases. Nonetheless, I was surprised to see at least 3 cases of tick-borne infections during the month of my Medicine clerkship. This drove me to research the incidence of tick-borne diseases, specifically in the US, and the possible factors contributing to their increased prevalence.

In 1998, the list of reportable tick-borne pathogens in the US included Rocky Mountain spotted fever, tularemia, Lyme disease, human granulocytic ehrlichiosis/anaplasmosis, and human…

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Primecuts – This Week In The Journals

June 2, 2014
Primecuts – This Week In The Journals

By Ian Henderson, MD

Peer Reviewed

In the week after honoring those who have passed while serving our country, the challenges facing our nation’s veterans have become increasingly evident. The recent controversy and frustrations with delayed care of veterans culminated on Friday with the resignation of Secretary of The Department of Veteran Affairs, Eric Shinseki . After an internal audit of the department’s health system showed chronic delays in care, manipulated waiting lists, and a scheduling scandal, President Barack Obama met with the Secretary on…

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