Who of us does not remember where we were and what we were doing on September 11, 2001? As with the Pearl Harbor attack in 1941, the attack on the twin towers and the Pentagon, and the deliberate crashing of the plane in Pennsylvania on September 11 has become our…
After returning from my first deployment to Iraq in February 2005, I had decided I would separate from the military and enter civilian practice. I had served during some of the bloodiest months of the war and performed about 250 operations on wounded American servicemen, Iraqi soldiers, Iraqi enemy combatants,…
The Centers for Medicare and Medicaid Services have provided incentives for modernization to improve health care quality and efficiency. These include the development of an electronic medical record (EMR). Some federal organizations such as the Department of Veterans Affairs have implemented and improved on the EMR concept over the past…
Objective: A few studies have shown that elevated CA-125 levels are associated with chronic obstructive pulmonary disease (COPD). However, there are no data concerning the associaton between serum CA-125 levels and right ventricular (RV) function in COPD patients. This study aimed to evaluate the relationship between CA-125 level and RV…
Objectives: Accurate and consistent documentation of pain management, including patient responses regarding improvement in pain scores, is essential for improving patient care. The objective of the project was to evaluate the current prescribing patterns and to review the current documentation for opioid-managed, chronic pain patients in an academic continuity of…
Pain management is a complex issue for all practitioners. Current guidelines can be extremely helpful in categorizing various types of pain syndromes and emphasizing various treatment strategies. However, the more I learn about the differentiation and perception of pain in different patients, the more I realize that treating pain properly…
Objectives: Vitamin D deficiency is highly prevalent and has been linked to increased morbidity and mortality. There has been an increase in testing for vitamin D with a concomitant increase in costs. While individual factors are significantly linked to vitamin D status, prior studies have not yielded a model predictive…
Objectives: Racial disparities in therapies and outcomes in adult and neonatal ICUs are well documented; however, little is known regarding racial disparities in pediatric intensive care unit (PICU). Our objective was to determine whether racial disparities exist in the admission of critically ill children to the PICU. Methods: We retrospectively…
Objectives: At a mid-sized community medical school, research was not traditionally strong. Faculty members cited lack of infrastructure support as a significant research barrier. In response, the regional dean developed and funded a research assistance unit (RAU) in 2006 to provide administrative and statistical support to junior faculty beginning their…
The more you know, the more you will learn and possibly the more you can do.1 This is one of the ideas behind using evidence-based medicine in the treatment of patients. The dividend that practitioners can receive from the increased investment in biomedical research could lead to improved diagnosis and…
Objectives: To compare the seasonal frequency of doxycycline prescriptions with tick-related emergency department (ED) visits in North Carolina, and to determine if doxycycline prescriptions are associated in time with an increase in the number of ED visits for a tick-related patient complaint or a subsequent diagnosis of a tick-borne infection….
Cannabinoid hyperemesis syndrome (CHS) is characterized by cyclic vomiting and compulsive bathing behaviors in chronic cannabis users. Patients are typically diagnosed with CHS only after multiple and extensive medical evaluations, consequently without a clear etiology of their symptoms or treatment plan leading to symptomatic improvement. Increased healthcare provider awareness of…
In “Cannabinoid Hyperemesis Syndrome: Literature Review and Proposed Diagnosis and Treatment Algorithm,” Wallace and colleagues1 have reviewed recent findings regarding the role of excessive cannabinoid usage and the resulting hyperemesis syndrome. This topic seems to be very recent as the authors propose that cannabinoid hyperemesis syndrome (CHS) was first described…
To the Editor:I read with great interest the article entitled “Association of Chlamydia pneumonia serology and ischemic stroke” by Hasan1 in the May 2011 issue of the Journal. The study focuses on the long debated issue of Chlamydia pneumonia infection and vascular events, and the result elegantly solidifies the connection….
To the Editor:The association between stroke and Chlamydia pneumonia infections is still unclear. Proposed mechanisms behind the risk of stroke in patients with acute and chronic infections are multiple and variable and include vasculitis, increased platelet adhesiveness, increased leukocyte recruitment, cytokines production and a high association with rheumatologic diseases. Other…
To the Editor:Hepatocellular cancer (HCC) is one of the most dreaded complications of cirrhosis. With the advent of dynamic imaging like triphasic CT scans and MRI with gadoxetate disodium, the diagnosis of HCC can be made with certainty in most cases within a cirrhotic liver. In November 2005, the American…
To the Editor:Cancer remains the second most common cause of death in the United States while atrial fibrillation (AF) is the most common arrhythmia in elderly people. Though there are several proposed risk factors for AF, it is unclear if cancer is a risk factor for AF or vice-versa. Recent…
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