December 2014

This 27-year old female medical student with recently diagnosed hypertension is seen following a chest x-ray in work up of a positive PPD. Upon questioning, the patient notes what she described as "gray-out spells" when tired and leg numbness with exercise after periods of sitting.

A commonly asked question by physicians pertains to the ideal frequency of urine drug testing. The answer is an unequivocal "it depends".

A 75 year-old man with a history of paroxysmal atrial fibrillation and a single-chamber pacemaker placed for bradycardia 5 years prior presents with dizziness and nausea to clinic. He notes that he has also been feeling short of breath with normal activities of daily living.

A 26-year-old recently married female is seen by you for a 2-day history of urinary urgency and mild "burning" on urination. On questioning, she also notes a slight vaginal discharge. She denies flank pain, hematuria, fevers, or chills.

This cohort study looked at the influence of maintaining a Mediterranean diet on telomere length, which is commonly used as a surrogate marker for longevity.

The highly publicized IMPROVE-IT trial was presented at the American Heart Association Scientific Sessions in mid-November. The conclusion of the study being that for those who are at the highest risk, like those who have suffered myocardial infarction, the combination of ezetimibe plus simvastatin lowered the risk of cardiovascular death, myocardial infarction, or stroke. The significance of this risk lowering is relatively minimal and despite years of research showing no benefit, this presentation was the first time when this drug combination resulted in a benefit.

In the era of reperfusion, beta blockers post myocardial infarction appear to have no mortality benefit.

Eating a low carbohydrate diet compared to a low fat diet leads to greater loss of weight as well as a significant reduction in Framingham Risk Score.

It has been more than a decade since the findings of the Women's Health Initiative and even since that time the question of estrogen treatment remains contentious for the medical community.

This 71-year-old woman presented with an itchy raised erythematous leg lesion that had been present for 10 months. She has a history of significant sun exposure in the past and was prescribed topical triamcinolone 4 months ago which she believes has made it slightly smaller and less itchy.

The use of fecal immunochemical testing was found to be an effective method for colorectal cancer screening; this study found it led to an 8.4% positivity rate. On subsequent colonoscopy, 40% of those with positive FIT tests had advanced adenomas or colorectal cancer.