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his regimen.
DIET VS. EXERCISE: WHICH IS SUPERIOR FOR WEIGHT LOSS By Kurtis Carlock, MD. Peer Reviewed. Obesity is a problem that affects over one-third of adults in the US and increases the risk of numerous health problems in these individuals. The question of how best to combat obesity is a problem that has interested physicians and scientists since it was first recognized as a major health issuedecades ago.
THE HISTORY BEHIND ASPIRIN 81 By Joshua Novack. Peer Reviewed. Patients often come into clinics on a grocery list of medications. Common prescriptions include lisinopril20 mg,
IS THERE SUCH A THING AS TOO MUCH INFORMATION? By Mariya Rozenblit, MD Peer Reviewed. On my first day of internship I was faced with the seemingly simple task of consenting a patient for ablood transfusion.
WHY AREN’T PATIENTS USING ADVANCE DIRECTIVES? By Abigail Maller, MD. Faculty Peer Reviewed. Advance directives are a means for patients to communicate their wishes regarding medical decisions to their families and health care professionals once they are unable to make these decisions themselves. CREATINE KINASE: HOW MUCH IS TOO MUCH By Jon-Emile Kenny, MD. Faculty Peer Reviewed. A 37-year-old man, with no past medical history and taking finasteride for male pattern baldness, is admitted to Medicine with profound lower extremity weakness after a weekend of performing multiple quadriceps exercises. CORE IM: 5 PEARLS ON TREATMENT OF ALCOHOL USE DISORDER Podcast: Play in new window | Download Subscribe: Android | RSS By Kate Lawerence MD, Marty Fried MD, Irene Swanenberg MD, Shreya P. Trivedi MD || Illustration by Caroline Srisarajivakul-Klein MD || Audio Editing by Harit Shah.Quiz yourself on the 5 Pearls we will becovering:
ANTIEMETICS AND QT PROLONGATION By Ofer Fass, MD. Peer Reviewed. Introduction. QT interval prolongation is a common side effect shared among the most effective antiemetic classes. The risk of QT prolongation is exacerbated by electrolyte abnormalities observed in patients with ongoing emesis, particularly hypokalemia. SHOULD PATIENTS ON DAPT AFTER ACS RECEIVE PROPHYLACTIC By Peter Sheng, MD, MPH. Peer Reviewed . Dual antiplatelet therapy (DAPT) has become the standard of care for patients after acute coronary syndrome (ACS) .It is important, however, to consider the risk of gastrointestinal (GI) bleeding with DAPT and whether proton pump inhibitors (PPIs) should be prophylactically prescribed to prevent these events. TIME OUT: VENOUS THROMBOEMBOLISM IN PATIENTS WITH CHRONIC By Dana Zalkin, MD. Peer Reviewed . Clinical Scenario: A 63-year-old male with hepatitis C cirrhosis presents to the hospital with abdominal pain and distension. Initial labs are notable for platelets of 63 and an INR of 1.5. He is not taking any anticoagulation or antiplatelet agents. CAN YOU SWITCH A PATIENT FROM INSULIN TO ORAL AGENTS A 48 year old male is diagnosed with type 2 Diabetes Mellitus after presenting to the emergency room with symptoms of hyperglycemia. He was immediately started on insulin and has been very compliant withhis regimen.
DIET VS. EXERCISE: WHICH IS SUPERIOR FOR WEIGHT LOSS By Kurtis Carlock, MD. Peer Reviewed. Obesity is a problem that affects over one-third of adults in the US and increases the risk of numerous health problems in these individuals. The question of how best to combat obesity is a problem that has interested physicians and scientists since it was first recognized as a major health issuedecades ago.
THE HISTORY BEHIND ASPIRIN 81 By Joshua Novack. Peer Reviewed. Patients often come into clinics on a grocery list of medications. Common prescriptions include lisinopril20 mg,
IS THERE SUCH A THING AS TOO MUCH INFORMATION? By Mariya Rozenblit, MD Peer Reviewed. On my first day of internship I was faced with the seemingly simple task of consenting a patient for ablood transfusion.
WHY AREN’T PATIENTS USING ADVANCE DIRECTIVES? By Abigail Maller, MD. Faculty Peer Reviewed. Advance directives are a means for patients to communicate their wishes regarding medical decisions to their families and health care professionals once they are unable to make these decisions themselves. CREATINE KINASE: HOW MUCH IS TOO MUCH By Jon-Emile Kenny, MD. Faculty Peer Reviewed. A 37-year-old man, with no past medical history and taking finasteride for male pattern baldness, is admitted to Medicine with profound lower extremity weakness after a weekend of performing multiple quadriceps exercises. CORE IM: 5 PEARLS ON TREATMENT OF ALCOHOL USE DISORDER Podcast: Play in new window | Download Subscribe: Android | RSS By Kate Lawerence MD, Marty Fried MD, Irene Swanenberg MD, Shreya P. Trivedi MD || Illustration by Caroline Srisarajivakul-Klein MD || Audio Editing by Harit Shah.Quiz yourself on the 5 Pearls we will becovering:
BLOODLETTING: A BRIEF HISTORICAL PERSPECTIVE AND MODERN By Oliver Stewart, MD. Peer Reviewed. As physicians, we are trained to utilize the most up-to-date medical guidelines to guide our clinical decision-making process. CLINICAL CORRELATIONS By Oliver Stewart. Peer Reviewed. Growing up in a Caribbean household, spicy foods were a pillar of my diet as an adolescent. I distinctly remember the joy that I would feel during the holiday season when my father ignited the grill and began cooking TIME OUT: VENOUS THROMBOEMBOLISM IN PATIENTS WITH CHRONIC By Dana Zalkin, MD. Peer Reviewed . Clinical Scenario: A 63-year-old male with hepatitis C cirrhosis presents to the hospital with abdominal pain and distension. Initial labs are notable for platelets of 63 and an INR of 1.5. He is not taking any anticoagulation or antiplatelet agents. CLINICAL CORRELATIONS By Jamie Oliver. Peer Reviewed. Colorectal cancer (CRC) is the second most common cause of cancer death in the US.Almost all CRC develops from precancerous polyps, and with appropriate colonoscopy screening most polyps can be detected INPATIENT DIABETES: IS THERE A ROLE FOR METFORMIN By Jamie Oliver. Peer Reviewed “Hold metformin, start sliding-scale insulin, diabetic diet, subcutaneous heparin.” Just 10 words. For almost all admitted type 2 diabetics receiving metformin, this 10-word phrase is automatic. CLINICAL CORRELATIONS By Sophia Chen. Peer Reviewed. Once considered a disease of the West, type 2 diabetes mellitus is now a global epidemic whose incidence correlates with economic growth. CLINICAL CORRELATIONS By Kate Otto Chebly Peer Reviewed “She refused the ultrasound!” my resident announced with exasperation, updating our attending on 17-year old, pregnant Mariana, who arrived four hours ago with abdominal pain and an unpleasant attitude VAGALLY-INDUCED ATRIAL FIBRILLATION Tim Madden on August 1st, 2012 - 10:04pm I have been having AF episodes since 1998, I am now 45. most episodes correct them selves. But there have been a few that I needed the hospital to be safe. 1 time , it came on as I just sat watching tv, after eating a big bowl of mac and cheese, I stood up, and my heart raced lke never before. called an ambulance, they hooked up ekg. my rate was 260 per mn. DID ABRAHAM LINCOLN HAVE MARFAN SYNDROME? By Anna Krigel. Faculty Peer Reviewed. The iconic image of Abraham Lincoln is ubiquitous in our lives, from his small face on the penny to his large figure looming over the National Mall in Washington, D.C. Lincoln fascinates historians because of his significant role in American history when our nation was bitterly divided, but he intrigues physicians because of his remarkable stature. CLINICAL CORRELATIONS Welcome to HotSpots. In this series, we highlight unique websites of interest to the medical profession. Feel free to make suggestions for sites that should be featured in this series by clicking the comment field or sending us an email. CLINICAL CORRELATIONS Primecuts – This Week in the Journals. April 16, 2021. PrimeCuts 6 min read. By Lily Cao, MD. Peer Reviewed. A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis Nonalcoholic steatohepatitis (NASH) is commonly diagnosed in primary care. We often counsel patients on diet and exercise, recommend ANTIEMETICS AND QT PROLONGATION Introduction. QT interval prolongation is a common side effect shared among the most effective antiemetic classes. The risk of QT prolongation is exacerbated by electrolyte abnormalities observed in patients with ongoing emesis, particularly hypokalemia. While QT prolongation in itself is not harmful, it increases the risk fordeveloping a
THE NEW KID ON THE BLOCK: HEART FAILURE WITH MID-RANGE By Pamela Boodram, MD. Peer Reviewed. A 68-year-old woman with a history of hypertension and well controlled type 2 diabetes presents to the ED with five days of progressively worsening dyspnea on exertion, orthopnea, and bilateral leg swelling. SHOULD PATIENTS ON DAPT AFTER ACS RECEIVE PROPHYLACTIC By Peter Sheng, MD, MPH. Peer Reviewed . Dual antiplatelet therapy (DAPT) has become the standard of care for patients after acute coronary syndrome (ACS) .It is important, however, to consider the risk of gastrointestinal (GI) bleeding with DAPT and whether proton pump inhibitors (PPIs) should be prophylactically prescribed to prevent these events. BEDSIDE ROUNDS: DIAGNOSING FUNCTIONAL NEUROLOGICAL For these reasons, the terms “nonepileptic seizures” (NES) and “functional neurological disorders” are preferred by experts because they are the most neutral sounding to patients. As we will see, FND is a challenging diagnosis to make. Part of the challenge is that FNDs are common and often co-morbid with other neurologicconditions .
INTERMITTENT VS. INDWELLING URINARY CATHETERIZATION By Scarlett Murphy, MD. Peer Reviewed. We are all too aware of the dreaded indwelling Foley catheter and the complications it invites. We know that its smooth, plastic surface becomes the perfect nidus for biofilms: impermeable matrices of low-lying, slowly reproducing bacteria safely encased in their own secreted polymers, providing extra virulence against even the most bactericidal of DIAGNOSIS AND TREATMENT OF DIABETIC FOOT INFECTIONS Guidelines for Diabetic Foot Infections • CID 2004:39 (1 October) • 885 IDSA GUIDELINES Diagnosis and Treatment of Diabetic Foot Infections Benjamin A. Lipsky,1,a Anthony R. Berendt,2,a H. Gunner Deery,3 John M. Embil,4 Warren S. Joseph,5 Adolf W. Karchmer,6 Jack L. LeFrock,7 Daniel P. Lew,8 Jon T. Mader,9,b Carl Norden,10 and James S. Tan11 1Medical Service, Veterans Affairs Puget Sound CAN YOU SWITCH A PATIENT FROM INSULIN TO ORAL AGENTS Commentary by Terry Seltzer MD, Department of Endocrinology. Before deciding to convert the patient from insulin to an oral agent, one must first be certain that he is a Type 2 Diabetic. Thus the lean 20 year old patient should be considered a possible Type 1 Diabetic, even though thus far he phenotypically appears to be a Type 2. SHOULD BETA-BLOCKERS BE USED IN THE SETTING OF COCAINE Recently the debate on the use of beta-blockers in the setting of cocaine related chest pain has been reopened. When taking an evidence-based approach to this subject, we see that beta-blockers may not be harmful, and may actually be beneficial in the setting of cocaine-related chest pain. Cocaine may induce myocardial ischemiathrough various
ETHICS 101-HOW DO YOU APPROACH A JEHOVAH’S WITNESS PATIENT A 76 year old man with a history of coronary artery disease, diabetes and hypertension was brought in by his wife with two days of lethargy, slurred speech and right arm weakness. CLINICAL CORRELATIONS Primecuts – This Week in the Journals. April 16, 2021. PrimeCuts 6 min read. By Lily Cao, MD. Peer Reviewed. A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis Nonalcoholic steatohepatitis (NASH) is commonly diagnosed in primary care. We often counsel patients on diet and exercise, recommend ANTIEMETICS AND QT PROLONGATION Introduction. QT interval prolongation is a common side effect shared among the most effective antiemetic classes. The risk of QT prolongation is exacerbated by electrolyte abnormalities observed in patients with ongoing emesis, particularly hypokalemia. While QT prolongation in itself is not harmful, it increases the risk fordeveloping a
THE NEW KID ON THE BLOCK: HEART FAILURE WITH MID-RANGE By Pamela Boodram, MD. Peer Reviewed. A 68-year-old woman with a history of hypertension and well controlled type 2 diabetes presents to the ED with five days of progressively worsening dyspnea on exertion, orthopnea, and bilateral leg swelling. SHOULD PATIENTS ON DAPT AFTER ACS RECEIVE PROPHYLACTIC By Peter Sheng, MD, MPH. Peer Reviewed . Dual antiplatelet therapy (DAPT) has become the standard of care for patients after acute coronary syndrome (ACS) .It is important, however, to consider the risk of gastrointestinal (GI) bleeding with DAPT and whether proton pump inhibitors (PPIs) should be prophylactically prescribed to prevent these events. BEDSIDE ROUNDS: DIAGNOSING FUNCTIONAL NEUROLOGICAL For these reasons, the terms “nonepileptic seizures” (NES) and “functional neurological disorders” are preferred by experts because they are the most neutral sounding to patients. As we will see, FND is a challenging diagnosis to make. Part of the challenge is that FNDs are common and often co-morbid with other neurologicconditions .
INTERMITTENT VS. INDWELLING URINARY CATHETERIZATION By Scarlett Murphy, MD. Peer Reviewed. We are all too aware of the dreaded indwelling Foley catheter and the complications it invites. We know that its smooth, plastic surface becomes the perfect nidus for biofilms: impermeable matrices of low-lying, slowly reproducing bacteria safely encased in their own secreted polymers, providing extra virulence against even the most bactericidal of DIAGNOSIS AND TREATMENT OF DIABETIC FOOT INFECTIONS Guidelines for Diabetic Foot Infections • CID 2004:39 (1 October) • 885 IDSA GUIDELINES Diagnosis and Treatment of Diabetic Foot Infections Benjamin A. Lipsky,1,a Anthony R. Berendt,2,a H. Gunner Deery,3 John M. Embil,4 Warren S. Joseph,5 Adolf W. Karchmer,6 Jack L. LeFrock,7 Daniel P. Lew,8 Jon T. Mader,9,b Carl Norden,10 and James S. Tan11 1Medical Service, Veterans Affairs Puget Sound CAN YOU SWITCH A PATIENT FROM INSULIN TO ORAL AGENTS Commentary by Terry Seltzer MD, Department of Endocrinology. Before deciding to convert the patient from insulin to an oral agent, one must first be certain that he is a Type 2 Diabetic. Thus the lean 20 year old patient should be considered a possible Type 1 Diabetic, even though thus far he phenotypically appears to be a Type 2. SHOULD BETA-BLOCKERS BE USED IN THE SETTING OF COCAINE Recently the debate on the use of beta-blockers in the setting of cocaine related chest pain has been reopened. When taking an evidence-based approach to this subject, we see that beta-blockers may not be harmful, and may actually be beneficial in the setting of cocaine-related chest pain. Cocaine may induce myocardial ischemiathrough various
ETHICS 101-HOW DO YOU APPROACH A JEHOVAH’S WITNESS PATIENT A 76 year old man with a history of coronary artery disease, diabetes and hypertension was brought in by his wife with two days of lethargy, slurred speech and right arm weakness. CLINICAL CORRELATIONS Primecuts – This Week in the Journals. April 16, 2021. PrimeCuts 6 min read. By Lily Cao, MD. Peer Reviewed. A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis Nonalcoholic steatohepatitis (NASH) is commonly diagnosed in primary care. We often counsel patients on diet and exercise, recommend THE OVERUSE OF PROTON PUMP INHIBITORS: IMPLICATIONS FOR Mario Zacharatos MD on October 16th, 2019 - 10:36am I think your article should have been written 3 months ago. Please reference the study “Safety of Proton Pump Inhibitors Based on a Long, Multi-year, Randomized Trial of patients Receiving Rivaroxaban or Aspirin” in the September 2019 issue of Gastroenterology pages 682-691. CLINICAL CORRELATIONS By Allison Guttman, MD. Peer Reviewed. Last week, Amazon, Berkshire Hathaway and JPMorgan Chase announced their intent to collaborate and establish an independent healthcare company for their employees. THE DLO: DOES FFP CORRECT INR? FFP treatment was minimally effective in correcting mild elevations inINR
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