About Rena Xu

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All posts by Rena Xu

Déjà Voodoo: Readmission or Observation after the Affordable Care Act

• April 20th, 2016

The hospital where I work has one of the busiest emergency departments in Boston. Patients come in with everything you might imagine, from heart attacks to rabbit bites. A number of these patients, after being evaluated and treated, can be discharged home from the emergency department; others need to be admitted for further management. For… Read More…


Advanced Renal Cancer: What is a Breakthrough Worth?

• November 4th, 2015

When I tell people that I am a resident in urology, they often ask me why I chose this field. There are many reasons, but one of my primary motivations was to treat renal cancer, a disease that has affected several people close to me. With early detection, surgery can be curative. Unfortunately, a third… Read More…


Understanding the Broken Heart

• September 2nd, 2015

In 1897, recently released from prison, the author Oscar Wilde wrote to a close friend, “My desire to live is as intense as ever, and though my heart is broken, hearts are made to be broken: that is why God sends sorrow into the world. The hard heart is the evil thing of life and… Read More…


Blood Clots and Buried Cancers

• August 19th, 2015

An unprovoked blood clot presents a dilemma. Deep vein thrombosis or pulmonary embolism may be the presenting sign of occult cancer, which makes it tempting to search high and low for a source. Early detection could enable prompt treatment and perhaps a better prognosis, in addition to changing the type of anticoagulation a patient receives…. Read More…


Permissive Underfeeding in the ICU

• June 17th, 2015

Nutrition among critically ill patients is widely considered important, but the ideal caloric targets remain a subject of debate.  Some believe higher caloric intake is helpful and can reduce mortality; others argue the exact opposite, pointing to studies linking caloric restriction to lower morbidity, as long as protein intake is adequate. This debate has prompted… Read More…


The Increasing Rate of Neonatal Withdrawal

• May 27th, 2015

When expecting mothers use opioids, their babies are exposed to the drugs in utero and, after birth, are at risk of withdrawal. The neonatal abstinence syndrome frequently necessitates admission to a Neonatal Intensive Care Unit (NICU) for treatment and monitoring. As the rate of opioid use among pregnant women has risen, the incidence of neonatal… Read More…


Detecting Trisomy

• April 1st, 2015

A simple prenatal blood test made national headlines last year after a study published in NEJM reported its superiority to standard prenatal screening. The test, called cell-free fetal DNA (cfDNA), identified common trisomies (21, 18, and 13) by detecting fragments of fetal DNA in maternal blood. Screening could be done early in a pregnancy and… Read More…


Infant Mortality through the Years

• January 21st, 2015

Prematurity has long been recognized as a major contributor to infant mortality. One in every four infants born extremely prematurely (between 22 and 29 weeks’ gestation) does not survive. A large number die within the first 12 hours after birth, and many more never make it out of the hospital, most commonly dying from a… Read More…


Where There’s Smoke: Cytisine versus Nicotine Replacement Therapy

• December 17th, 2014

Motivation, it’s often said, is half the battle of behavior change.  In the battle against nicotine addiction, however, motivation alone may not be enough.  Mass media campaigns have helped to raise awareness about the dangers of smoking.  But for the majority of smokers who already want to quit, the question remains: how? In 2006, a drug… Read More…


The Good Word: Improving Patient Handoffs

• November 5th, 2014

Starting at six in the evening, the surgery residents at my hospital gather for sign-out.  This is when residents from the day shift hand over care of their patients to those working overnight.  Sign-out takes place in the residents’ lounge — a room furnished with computers, couches, and a makeshift ping-pong table — and tends… Read More…