Coffee Consumption and Cardiovascular Disease Risk: What Should We Tell Our Patients?

The association between coffee and the risk of cardiovascular disease has been studied over the past 20 years. Given the complexity of conducting large, randomized, controlled trials to prove causality, conclusions are based on case reports, retrospective studies, and small physiologic trials. Surveys determine that most physicians advise discontinuing or reducing consumption of caffeine in patients with known heart disease, yet this recommendation lacks strong supporting evidence. The following is a short review of the effects of coffee and caffeine on the cardiovascular system that aims to provide objective advice to physicians and patients based on the published literature.

The Next Steps: Thoughts of a Medical Student-Watcher

Speech given at the Albert Einstein College of Medicine Class of 2011 Transition Ceremony, April 2, 2009

Social Support: A Role for Social Work in the Treatment and Prevention of Hypertension

Researchers have long noticed an association between social relationships and health. More recently, a vast and growing literature has developed, linking various forms of social support to hypertension, often even suggestive of a causal relationship. A detailed survey of this literature is presented, followed by a review of possible psychosocial and physiological explanations for the phenomena. Implications for social workers in various settings are emphasized.

Preparing Einstein Students to Practice in Twenty-first Century Medicine

The current trend in medical education is to introduce clinical teaching early in the medical school curriculum to help students understand the relevance of the basic sciences to clinical practice. The Introduction to Clinical Medicine (ICM) Program for students in the first two years at the Albert Einstein College of Medicine (AECOM) is comprised of three, required, integrated courses providing skills training in both medical interviewing and physical examination, training in diagnostic reasoning skills, and opportunities to discuss broad themes in medicine and the doctor-patient relationship. Competency evaluation of students’ clinical skills is an essential part of the ICM Program. Innovative strategies for weaving themes related to cultural competency have been incorporated into the ICM program to address the wide spectrum of cultural issues affecting medical care and the doctor/patient relationship, including diversity, spirituality, complementary and alternative medical practices, and end-of-life care. A total of 300 medical school faculty members teach in the various ICM courses. Much effort goes into keeping the faculty current, happy, and rewarded for their dedication and hard work in teaching the students. The ICM Program continues to strive for excellence as we prepare AECOM students to face the demands of medical practice in the twenty-first centur

Coal Miners' Health Care: The First Ten Years of the Medical Care Program of the United Mine Workers of America Welfare and Retirement Fund

This paper analyzes the origins and development of the m ical care program of the United Mine Workers America Welfare and Retirement Fund. This pr gram was unique In the histo of health care organ­ Ization in the United States In that Its policies and practices represented a depa ure from the dominant m e of organizing and financing health care. From 1948 to 1978 it was viewed by many as a model for a national health se ice as opposed to a national health Insurance program. The purpose of this a icle Is to analyze the origins of the Fund medical care program and the early development of Its policies. The histo of the program contains impo ant lessons concern­ Ing the politics of health care In the United States and the relationship be n who controls the provision health care se ices and the cost and the quality of those se ices.

Yellow Fever and the Emotional Consequences of Untreatable Epidemic Disease

Yellow fever terrorized communities in tropical and urban settings during its height in the nineteenth-century American south. Carried by Aedes aegypti mosquitoes, which breed in stagnant water, the virus infects humans fervently and is most known for its symptoms of jaundice and vomito negro, a dark vomit of coagulated blood. During the near-annual outbreaks of yellow fever, caregivers struggled to cope with the emotional consequences of failing medicine, sometimes leaving behind clues to their confusion in treating the disease and offering salient reflections on their inadequacies. The disease ravaged the Gulf region for decades. Records of the health workers’ feelings of futility reflect their questions of what to do for others and what to do for themselves, offering a new perspective on yellow-fever scholarship and insight into contemporary clinical practice and research.

Making HIV Testing a Routine: Facing the Truth 

Wrath of God syndrome, Gay-related Immuno- deficiency Syndrome, Gay Cancer, Gay Plague—these are the names AIDS had in the 1980s. False myths made uninfected people afraid to interact with affected individuals. A political cartoon of these times bitterly made fun of the prevailing attitude towards the disease, “It affects homosexual men, drug users, Haitians and hemophiliacs...Thank goodness it hasn’t spread to human beings yet (Black, 1985).

Preemptive Use of Eculizumab for Living-Donor Kidney Transplantation in a Child with Atypical Hemolytic Uremic Syndrome

Eculizumab is an anti-complement C5 monoclonal antibody that has recently been reported as an effective therapy for atypical hemolytic uremic syndrome. However, few data are available on the preemptive use of this medication in pediatric kidney transplantation. This report describes a successful preemptive use of eculizumab in combination with living unrelated kidney transplanta- tion in a 10-year-old child with end-stage renal disease secondary to atypical hemolytic uremic syndrome who has a complement factor H mutation that has not been previously reported. Further observations and clinical trials are required to address the challenges and areas of uncertainty related to preemptive eculizumab therapy for kidney transplantation in children and adults with atypical hemolytic uremic syndrome.