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Cardiovascular Medicine
It is often the case that the body sends messages that are both
elegant and clear, if only we can read them. Though congestive heart
failure is a leading cause of mortality and hospitalization, the
clinical assessment/management of acute CHF continues to be elusive
and surprisingly challenging. But two diagnostic markers promise to
make the clinician's task easier.
Rebecca Hung, M.D., Assistant Professor of Medicine and Director,
Congestive Heart Failure Laboratory, Richard W. Smalling, M.D.,
Ph.D., Jay Brent Sterling Professor of Cardiovascular Medicine and
Director, The George Bush Heart Center, and Ali H. Shakir, M.D.,
Fellow, University of Texas at Houston, review "The Role of B-Type
Natriuretic Peptide and NT-proBNP in the Diagnosis and Management of
Heart Failure."
One FREE Category I credit towards the AMA PRA.
Emergency Medicine
A young woman is injured in an automobile accident. At the E.R. of the local hospital, after a series of diagnostic procedures, primarily x-rays and CTs, clinicians make a surprising discovery. Unbeknownst to the woman, she is 6-7 weeks pregnant. Has the future health and well-being of her
baby been compromised?
Join Martin J. Carey, M.D., Assistant Professor of Emergency Medicine, University of Arkansas Medical Center, as he presents two cases of Trauma In Pregnancy. One Category I credit toward the AMA PRA.
Endocrinology
In this second of a two-part series, Hyperthyroidism in Pregnancy, Eli Ipp, M.D., Professor of Medicine, UCLA School of Medicine and Tricia Westhoff, M.D., Endocrinology Fellow, Harbor-UCLA Medical Center, look at the effect a too-active thyroid has on the mother, fetus and neonate. One Category I credit toward the AMA PRA.
Gastroenterology
This month's Cyberounds Gastroenterology focuses on physical gall -- gallstones. According to our authors, prompt recognition of the type and severity of complications precipitated by gallstones is crucial for a successful outcome.
Dr. Gary Gray, Professor of Medicine, Stanford University School of Medicine, and guest authors, Nicole D. Simpson, M.D., Tommy Yen, M.D., and Aijaz Ahmed, M.D., Division of General Internal Medicine and Geriatrics, Veteran's Adminstration Medical Center and University of California, San Diego School of Medicine, and the Department of Medicine, Division of Gastroenterology, Stanford University School of Medicine, respectively, present an update on the management and complications of gallstones. One Category I AMA credit.
Geriatrics
It's scary. Over 50% of the elderly are hypertensive.
*Do you know why they are more likely to have elevated systolic pressure and lowered diastolic?
*Are you aware of the effect dangling arms and white-coated caregivers can have on blood pressure?
*And while we are talking about strange and elusive influences, can you recognize pseudohypertension?
John Morley, M.D., Dammert Professor of Gerontology, St. Louis
University School of Medicine, invites Abbas Ali, M.D., Fellow in
Geriatric Medicine, to answer these questions and tell us what's
important, and what works and why in the "Management of Hypertension in the Elderly." One Category I credit toward the AMA PRA.
Health Law
Given that tens of millions of dollars in salary may be at stake, it's no surprise that the lure of so-called "designer steroids" that cannot be detected by existing drug testing regimens is so great, particularly for young athletes. For any practitioner with patient athletes, but particularly for those treating a young competitor, these new performance-enhancing technologies pose significant clinical challenges AND they may put you in a legal bind.
You could find yourself trying to choose whether to risk a suit from a minor for breaching confidentiality, or from the parents, complaining that their child suffered death or serious harm because you failed to alert them -- so maybe it would be a good idea to participate in this week's Cybeounds Health Law?
Max Mehlman, Arthur E. Petersilge Professor of Law and Director of the Law-Medicine Center, Case
Western Reserve University School of Law, looks at the legal and ethical issues concerning "Performance Enhancing Drugs in Sports. " One Category I credit toward the AMA PRA.
Hematology/Oncology
If Shakespeare's Prince Hamlet had been a contemporary medical professional, he might have had doubts about making the diagnosis of vitamin B12 deficiency. It's true that in this age of high tech medicine we know a lot more than we ever did about the etiology of pernicious anemia, but, according to our author, because of the diagnostic tests we use, there's a surprisingly large gray area of uncertainty. This creates a clinical challenge for caregivers, especially since a missed diagnosis has grave consequences for the patient's nervous system.
Cyberounds Hematology, Moderator, Robert G. Lerner, M.D.,
Professor and Vice Chair, Department of Medicine, New York Medical College, focuses on two illustrative cases -- one actual, one hypothetical -- which, hopefully, will raise your antennae while exploring the clinical relevance
of the metabolite, homocysteine. One Category I credit toward the AMA PRA.
Laboratory Medicine
It is often the case that the body sends messages that are both elegant and clear, if only we can read them. Though congestive heart failure is a leading cause of mortality and hospitalization, the clinical assessment/management of acute CHF continues to be elusive and surprisingly challenging. But two diagnostic markers promise to make the clinician's task easier.
Rebecca Hung, M.D., Assistant Professor of Medicine and Director, Congestive Heart Failure Laboratory, Richard W. Smalling, M.D., Ph.D., Jay Brent Sterling Professor of Cardiovascular Medicine and Director, The George Bush Heart Center, and Ali H. Shakir, M.D., Fellow, University of Texas at Houston, review "The Role of B-Type Natriuretic Peptide and NT-proBNP in the Diagnosis and Management of Heart Failure." One FREE Category I credit towards the AMA PRA.
Medical Genetics
Colorectal cancer is the second leading cause of cancer with a lifetime risk of 6% and, unfortunately, there's been no change in incidence in 40 years! Because some colorectal cancers have a strong genetic component, we asked Jim Lupski, M.D., Ph.D., Cullen Professor of Human Genetics and Molecular Biology, Baylor College of Medicine, Houston, to present a Cyberounds on The Genetics of Colon Cancer.
Given, however, that you, our readers, have mentioned that conferences on medical genetics can be daunting, we decided to borrow from the Hollywood folks in the hope this makes the information more accessible. Join presenters Maulik Shah, M.D., Ph.D., Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, and Priya Gopalan, M.D., Ph.D., Washington University, St. Louis, as they give you just the facts. One Category I credit toward the AMA PRA.
Nephrology
If the Feds were smart, they'd designate someone from Health and Human Services, maybe even the Secretary, to read and participate in this week's Cyberounds Nephrology.
Why? Once again, Dr. Eli Friedman & Colleagues question long-held
assumptions which, in this instance, may point us on a path to
lowered medical care costs.
Join Eli A. Friedman, M.D., Distinguished Teaching Professor of Medicine, and Mariya Stratilatova, M.D., Fellow, Renal Disease Division, SUNY Health Sciences, New York,
as they review the evidence for and against the early involvement of specialists in the treatment of chronic kidney disease in "Does Timely Referral to a Nephrologist Alter ESRD Outcome? "
One Category I credit toward the AMA PRA.
Nutrition
When The Wall Street Journal published an article based on
leaked details from the confidential New York Medical Examiner's
report on famed diet doctor, Robert Atkins, reporting that Atkins,
the low-carb guru, weighed a hefty 258 pounds at death and had a
history of congestive heart failure many were upset.
The Atkins folks were justifiably outraged at the release of
confidential medical information. But the question remains
-- how risky is a low-carb, high protein diet?
Because we love a good food fight, we thought we'd ask an expert for
his perspective. Dr. Edward Saltzman, our guest presenter, is
Assistant Professor of Medicine; Director, Obesity Consultation
Center; and Chief, Division of Clinical Nutrition, Tufts-New England
Medical Center, and Tufts University School of Medicine.
Join Ed, as he discusses, "Low Carbohydrate and High Protein Diets
for Treatment of Obesity." Isn't it time we find out if low-carb is
everything it's cracked up to be? One Category I credit toward the AMA PRA.
Psychiatry/Neuroscience
LTP and LTD.
They're not car models or fuel additives but they are key to remembering anything.
Even what happened at exuberant parties.
In this second installment of our 7-part Cyberounds Psychiatry/Neuroscience series,
Cyberounds Psychiatry/Neuroscience Moderator, Bruce McEwen, Ph.D.,
The Alfred E. Mirsky Professor and Head, Harold and Margaret Milliken Hatch
Laboratory of Neuroendocrinology, Rockefeller University, invited the distinguished
neuroscientist, Dr. Howard Eichenbaum, Center for Memory and Brain, Boston University,
to illuminate how long-term potentiation (LTP) and its opposite, long-term depression (LTD),
at the cellular level of excitatory amino acid (EEA) glutamate receptors, enable each of us
to have memories.
Some day, we guarantee, you'll need to remember "Memory and EAA Receptors." FREE: one Category I
credit towards the AMA PRA.
Pulmonary Medicine
Despite rapid technological progress in medicine, malnutrition among
hospitalized patients, especially ICU patients with pulmonary
problems, continues to be a significant problem. Indeed, recent
studies show that nearly 50% of ICU patients are malnourished and
"this degree of malnutrition has a significant negative impact on
clinical outcomes in the hospital."
Join Joel Mason, M.D., Associate Professor Medicine and Acting Chief,
Division of Clinical Nutrition, Tufts University, and Scott Epstein,
M.D., Associate Professor of Medicine, Tufts University School of
Medicine and Director, Medical Intensive Care Unit, Tufts-New England
Medical Center, Boston, as they discuss "Nutritional Management of
the Patient with Acute Respiratory Failure." FREE: one Category I
credit towards the AMA PRA.
Rheumatology
Some words are just beautiful We sometimes find that an exotic word can transport us to flights of fancy that can best be explained as the result of spending too much time indoors. Which is how we reacted to a Cyberounds featuring anakinra.
Were our authors writing, we hoped, about an up and coming Russian female
tennis star? Or at least of a newly-discovered Himalayan peak they had
climbed? Or maybe an unknown Tolstoy heroine?
Join Peter Barland, M.D., Professor Emeritus of Medicine, Albert Einstein
College of Medicine and Director of Immunodiagnostic Laboratory, Montefiore Hospital,
and Chaim Putterman, M.D., Assistant Professor of Medicine and Director of
Montefiore's Arthritis Clinic, as they review all the new drugs for rheumatoid
arthritis, including the most recent, anakinra, an IL-1RA antagonist. One Category I credit toward the AMA PRA.
Women's
Health
It wasn't too long ago that whenever a woman had a problem getting pregnant, her fertility was presumed to be the issue. Now we know that male fertility/infertility is equally likely to be responsible.
"There are dozens of steps that go into creating a completely normal spermatozoon...[and] dozens of opportunities for mistakes," according to our authors, Cyberounds Women's Health moderator, Susan C. Stewart, M.D., Past President, American Medical Women's Association, and her guest
consultant, Anthony J. Thomas, Jr., M.D., Head, Section on Male Infertility, Glickman Urological Institute, Cleveland Clinic Foundation.
Thanks to new research and the latest techniques of assisted reproductive technology (ART), creating the next generation doesn't have to be a completely hit or miss proposition. One Category I credit toward the AMA PRA.
Special
Features
With the continuing concern about bioterrorism, as well as tensions along the borders between nuclear India and nuclear Pakistan, it seemed to us to be the right moment for
medical professionals, who may one day be called upon to respond, to review the relevant science and facts about the use of nuclear weapons and/or "dirty" bombs against a civilian population.
Our guest author, Robert Gould, M.D., President-Elect of Physicians for Social Responsibility, examines what we need to know and offers his op/ed plan on what needs to be done in this week's, "Prevention of Nuclear Terror." One Category I credit toward the AMA PRA.
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