Category Archives: Featured

Prevention of Contrast-Associated Acute Kidney Injury

Tweet The infusion of iodinated contrast materials as an aid to a variety of imaging studies is associated with the development of acute renal failure (now typically called acute kidney injury). This nephropathy almost always occurs in predisposed patients. Risk factors include pre-existing kidney disease, advanced age (>75), diabetic nephropathy, and congestive heart failure. The…


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New Blood Pressure Guidelines – Think First

Tweet The press with an assist from the American College of Cardiology is trying to drive the American public crazier than it usually is. Here’s a quotation typical of those floating around the media: “Nearly half of Americans have high blood pressure under the new guidelines issued Monday by heart organizations and the medical community….


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How Go Completely Crazy in 25 Easy Steps

Tweet The first thing to accept is that you don’t have to do anything crazy to go completely crazy – a series on rational small steps will get you there. A to B seems at least OK. The same with B to C, all the way to Z. Twenty five rational, or semi-rational, steps and…


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Gene Therapy for Sickle Cell Disease

Tweet Sickle Cell Disease is a disorder of hemoglobin production secondary to an alteration in the hemoglobin gene on chromosome 11.  Specifically, there is a single amino acid substitution in “adult” β A -globin (Glu6Val) stemming from a single base substitution (A→T) in the first exon of the human β A -globin gene. The abnormal…


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Ostracism and “high Crimes and Misdemeanors”

Tweet Ostracism was an interesting feature of the Athenian democracy, if you can call a city-state which granted the suffrage only to adult male land owners a democracy. About 30 to 50 thousand of about 300 thousand Athenians were eligible to vote. Unsurprisingly, democracy in Athens lasted little more than a century. Ostracism derives its name from…


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O Soave Fanciulla

Tweet Puccini’s La Boheme is popular beyond comment. It has been performed 1295 times by the Met since the company’s first performance of the opera on tour in Los Angeles in 1900. Incidentally, Los Angeles was also the site of the work’s American premiere three years earlier.  Aida is far behind in the Met’s second…


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Salt Intake in Chronic Kidney Diease

Tweet How much salt people should eat continues to be a murky issue. A paper in the February 2017 issue of the American Journal of Kidney Diseases examines the issue of salt (actually sodium) intake on the prevention of cardiovascular disease in patients with chronic kidney diseases (CKD) stages 2-4. It is a commentary on…


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The Vulture Has Landed

Tweet I’ve been out of the country for a few weeks, but am now back (see below for the gruesome details). Thus regular posting will resume. First the important stuff.  If you take a cruise bring your own salt and a shaker. No cruise line I know of has decent salt shakers. They tend to…


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Life Expectancy in the Elderly

Tweet Americans have a lower life expectancy than people in other developed countries. This lower longevity has been often used to disparage medical care in this country as being inferior to that of other similarly advanced nations.  Such an accusation is made acute by the high cost of American medical care – the highest in the…


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Statins For the Primary Prevention of Cardiovascular Disease

Tweet The use of statins (drugs which lower blood cholesterol) for the primary prevention of CV disease has been controversial since the drugs became available almost 30 years ago. Primary prevention is the prevention of a disease which the patient does not have, eg a stroke or a heart attack. Secondary prevention is the prevention…


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