Posts Tagged ‘NEJM’

A Woman with a Skin Ulcer

Posted by Carla Rothaus • February 12th, 2016

Ulceroglandular tularemia is one of several clinical presentations of Francisella tularensis infection. In patients with ulceroglandular tularemia, an ulcer develops at the site of inoculation and is followed by fever, systemic symptoms, and regional lymphadenopathy. Although tularemia can occur year-round, it predominantly occurs during the summer months. The diagnosis of tularemia is quite rare; in… Read More…

Urinary Tract Infections in Older Men

Posted by Carla Rothaus • February 12th, 2016

Urinary tract infection in men without indwelling catheters is uncommon among men younger than 60 years of age, but the incidence increases substantially among men 60 years of age or older. Effective treatment of urinary tract infection in men requires determining whether the infection site is the kidney, bladder, or prostate; the duration and choice of therapy… Read More…

Adjunctive Steroids and Harm in Cryptococcal Meningitis

Posted by Joshua Allen-Dicker • February 10th, 2016

In the recent best-selling book and award-nominated movie, The Martian, astronaut and botanist Mark Watney is stranded alone on Mars.  The story follows his attempts to defy certain death and, through creativity and scientific experimentation, use his limited resources to generate oxygen, grow food, and make it home to Earth.  Recently the medical community has… Read More…

Amoxicillin for Severe Acute Malnutrition

Posted by Carla Rothaus • February 5th, 2016

Severe acute malnutrition affects approximately 19 million children under 5 years of age worldwide and contributes substantially to mortality and the disease burden among children. Only one previous randomized trial has examined the routine use of antibiotics in the community-based treatment of severe acute malnutrition. Isanaka et al. conducted a randomized, double-blind, placebo-controlled trial in… Read More…

Hereditary Breast and Ovarian Cancer

Posted by Carla Rothaus • February 5th, 2016

Hereditary breast and ovarian cancer is a syndrome that involves an increased predisposition to breast cancer, ovarian cancer, or both and an autosomal dominant pattern of transmission. Risk-reducing mastectomy and risk-reducing salpingo-oophorectomy are options for the primary prevention of breast and ovarian cancers, and they have been shown in multiple studies to have efficacy. The risk… Read More…

Residency Duty Hours: FIRST, do no harm

Posted by Andrea Merrill • February 2nd, 2016

When I started general surgery residency in 2011, my training program was on probation for violating the 80 hour work week as mandated by the Accreditation Council for the Graduate Medical Education (ACGME).  In addition, new regulations were being introduced that year that limited the maximum number of hours an intern and resident could work… Read More…

A Girl with Abdominal Pain

Posted by Carla Rothaus • January 29th, 2016

A Case Records of the Massachusetts General Hospital summarizes torsion of an accessory spleen is most commonly reported in children but can also occur in adults. Patients with torsion may present with acute abdominal pain, but intermittent or chronic pain has also been described, and infarction or rupture leading to acute abdominal hemorrhage can occur. A 9-year-old girl… Read More…

Brain Disease Model of Addiction

Posted by Carla Rothaus • January 29th, 2016

Advances in neurobiology have begun to clarify the mechanisms underlying the profound disruptions in decision-making ability and emotional balance displayed by persons with drug addiction. The neurobiology of addiction is pointing the way to potential methods of disrupting the neurocircuitry with both pharmaceutical and behavioral tools. Altering the reward and emotional circuits may prevent and treat the… Read More…

Belatacept and Long-Term Outcome in Kidney Transplantation

Posted by Andrea Merrill • January 27th, 2016

Medicine is a constant balance of risks and benefits.  The importance of maintaining this balance is especially evident in kidney transplantation.   While methods of immunosuppression in kidney transplantation have improved substantially since the use of total body irradiation to induce tolerance in the 1950s, current immunosuppressive agents such as calcineurin inhibitors still come with  clinically… Read More…

Postmenopausal Osteoporosis

Posted by Carla Rothaus • January 22nd, 2016

Osteoporosis results in 1.5 million fractures per year in the United States, with the vast majority occurring in postmenopausal women. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of −2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating… Read More…