About Joshua Allen-Dicker

Joshua Allen-Dicker

All posts by Joshua Allen-Dicker

Learning More About Living Longer After Myocardial Infarction

• October 5th, 2016

To practice medicine is often to be inundated in metrics. Institutions may spend immense resources collecting data on readmission rates, time to treatment, and adherence to therapy. We know that appropriate measurement is key to health care improvement, improved rankings, and reimbursement. However, for many of these metrics, the connection between short-term performance and long-term… Read More…


Catheter-Associated Urinary Tract Infections

• June 2nd, 2016

In your role as Unit Medical Director, you regularly meet with nursing leadership for 6-West.  Today, they bring to your attention several cases from the last month: a 67-year old female admitted for severe pneumonia who initially rapidly improved on antibiotics, but then developed a new fever and was found to have a urinary tract… Read More…


Fusion for Lumbar Spinal Stenosis?

• April 13th, 2016

Back pain does not respect traditional boundaries in healthcare.  Patients with back pain are present in our emergency rooms, our minute clinics, our surgical subspecialty offices, and our inpatient units.  As such, many of us—orthopedist or internist, rheumatologist or advanced practitioner—have had to think about advising the patient with lumbar spinal stenosis or lumbar spondylolisthesis,… Read More…


Adjunctive Steroids and Harm in Cryptococcal Meningitis

• 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…


Acetaminophen for Fevers in the Critically Ill: Good for Patients, or Are We Treating Ourselves?

• November 11th, 2015

It is 3AM and you are called about Mr. Smith, a 74-year-old man who presented to the hospital tonight with a cough and was found to have pneumonia and sepsis. You have started him on antibiotics, but he now has a temperature of 38.3°C (100.9°F). His nurse asks, “Should we give him something for that… Read More…


Idarucizumab for Dabigatran Reversal — The RE-VERSE AD Trial

• August 5th, 2015

Despite the increasing frequency of direct oral anticoagulant use, some clinicians may remain uncertain about their safety. Direct oral anticoagulants are easier to use, and for certain patients they may have a decreased risk of bleeding. But there is one major concern: how to rapidly reverse the effects of direct oral anticoagulants when there is… Read More…


The Final Nail in Early Goal Directed Therapy’s Coffin?

• March 24th, 2015

You are called to evaluate Ms. Smith urgently.  She reports several days of progressive malaise, weakness and a new cough. On your exam she is tachycardic, tachypneic and febrile.  You diagnose Ms. Smith with sepsis and explain the importance of quickly treating this life-threatening condition.  In the United States, situations like this—presentations leading to the… Read More…


Mortality in Type 1 Diabetes

• November 19th, 2014

There are moments during every physician’s day when she or he gives medical advice based on well-established evidence– “The data show that starting medication A for this disease will reduce the risk of death by 20%.”   There are also moments when she or he may give advice just because it seems like the right thing… Read More…


Learning to Modify the Chronic Neurologic Burden of Sickle Cell Anemia

• August 20th, 2014

The patient sitting in front of you is a smiling, well-adjusted 6-year old boy.  He has a supportive family, eats a healthy diet, and is physically active.  What if, despite all of this, you knew that he had more than a 30 percent chance of developing a condition that would hamper his educational attainment?  Every… Read More…


The Future of Malaria: Rising Rates of Resistance and a Potential New Hope

• July 30th, 2014

What do Emperor Charles V, Thomas Jefferson, and King Tut all have in common?  Each historical figure is thought to have suffered from malaria at some point during his life. Plasmodium, malaria’s causative organism, is known as much for its effects on great civilizations and their leaders as for its present world-wide disease burden.  Yearly, it… Read More…