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The Clinical Relevance of Studies on Borrelia burgdorferi Persisters

In North America, Lyme disease is principally caused by Borrelia burgdorferi sensu stricto, hereafter referred to as “B. burgdorferi.” It is acquired by the bite of an infected Ixodes tick. The most common clinical manifestation is a skin lesion, referred to as “erythema migrans,” which is due to cutaneous infection with B. burgdorferi. Other objective manifestations may involve the nervous […]

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The Coronary (Cardiac) Care Unit at 50 Years: A Major Advance in the Practice of Hospital Medicine

This year, 2017, marks the 50th anniversary commemorating the publication of an article describing the results from the classic study by Killip and Kimball showing a reduction in mortality from acute myocardial infarction in patients sequestered in a specialized hospital unit1 at New York Hospital in New York City. Also described in the article was the […]

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Dr. Joseph S. Alpert

Stem Cell Therapy: The Phoenix in Clinical Medicine?

The Phoenix is a mythical bird with brightly colored plumage known in ancient Greek for the legend of its rebirth. After a long life, the Phoenix dies in a fire of its own making and then rises again reborn from the ashes. This myth parallels current feverish beliefs concerning the ability of stem cell therapy […]

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Concierge Medicine Is Here and Growing!!

An increasing number of primary care physicians are downsizing to a concierge medical practice (also termed “retainer-based medicine”). In a concierge medical practice, the physician limits the number of patients in his practice and offers exclusive services for an annual fee. The patient pays a surcharge for increased access and additional services from their physician.1 […]

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Joseph S. Alpert, MD

Polypharmacy in Elderly Patients: The March Goes On and On

Polypharmacy is a major public health problem in the United States and abroad. Although there is no standard definition of polypharmacy, I see and recognize it every day in the outpatient and inpatient environment. A typical example that I saw yesterday was an 84-year-old man admitted to our internal medicine service for worsening heart failure. […]

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