Nails and nailbed injuried can be surprisingly complex. A good foundation of nail anatomy and function will help you understand how to treat various nail conditions better.

Submitted by Sandhya Ashokkumar, MD

We do not often give thought to the factors controlling our circadian rhythm. And yet the circadian system modulates many physiologic systems, including brain arousal, cardiovascular function, sympathetic tone, appetite, metabolism and immune system function. Similar to the sinoatrial node pacing the heart, the suprachiasmatic nucleus located in the hypothalamus serves as the central pacemaker for the circadian rhythm, directing sleep, motor activity, temperature and autonomic tone. Rhythmic release of melatonin from the pineal gland helps drive this central clock in addition to other circadian biomarkers, including cortisol and core body temperature. In healthy individuals, plasma melatonin concentrations typically measure 10-fold higher at night than during the daytime. How does critical illness affect circadian rhythm, specifically melatonin secretion?

Submitted by Emily Damuth, MD

52 yo male c/o 4 days of left arm pain

Shoulder reductions - you probably think you're pretty good at these. And you're probably right. But there's often more to learn, and a review of the basics many help tweak your approach or learn a new technique!

Submitted by Alyse Volino, MD