Pulmonary/Critical Care

Mystery Quiz- The Answer

November 8, 2008
Mystery Quiz- The Answer

Posted by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The answer to the mystery quiz is heart failure.  The CXR shows bibasilar opacities with hilar fullness on the right. The CT images are remarkable for bilateral effusions, with dependent opacities that increase in density along the anterior-posterior axis.  The lung appears clear in the anterior zone (Image 5, arrow; Coronal Image 1); ground glass opacification, characterized by parenchymal haziness which does not obscure the underlying pulmonary vessels, is evident in the …

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Mystery Quiz

October 30, 2008
Mystery Quiz

Posted by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The patient is a 61 year old man with a history of diabetes, chronic kidney disease, and poorly controlled hypertension on five medications who was in his usual state of health until three days prior to admission when he noted increasing exertional dyspnea associated with chest pain, abdominal distention, bilateral lower extremity edema (left greater than right).

Exam notable for BP 105/54 (lower than all other prior measurements), HR 74, O2 Saturation …

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Propofol Infusion Syndrome: An Unusual Case of Lactic Acidosis

October 1, 2008
Propofol Infusion Syndrome: An Unusual Case of Lactic Acidosis

Commentary by Bani Chander MD, PGY-3 and Reviewed by Laura Evans MD, NYU Division of Pulmonary and Critical Care Medicine

Case presentation:

The patient is a 26 year-old female with long-standing refractory epilepsy, status post corpus callosotomy, and vagus nerve stimulator placement, who was admitted to the intensive care unit for management of status epilepticus. The patient was initially admitted to the inpatient epilepsy unit and placed on multiple anti-epileptic medications with little response. However, after having more than ninety seizures over the course of …

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Mystery Quiz- The Answer

September 27, 2008
Mystery Quiz- The Answer

Posted by Vivian Hayashi MD and Robert Smith MD,

Mystery Quiz Section Editors

The answer to last week’s mystery quiz is pneumatocele/pseudocyst likely due to ventilator associated lung injury (VALI) in a patient with ARDS. The patient had

ARDS on the basis of diffuse infiltrates, hypoxemia with a PaO2/FiO2 <200mmHg, and no strong evidence of LV heart failure. His risk factor for ARDS was pneumonia, evident on his admission CXR with bibasilar infiltrates (R>L); Streptococcus pneumoniae grew on sputum culture. The overall clinical picture is …

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Mystery Quiz

September 19, 2008
Mystery Quiz

Posted by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The patient is a 76 year old man with history of moderate-to-severe COPD who presented with three days of fever, breathlessness, and productive cough. Past surgical history is significant for vagotomy and partial gastrectomy 16 years earlier and a cholecystectomy 10 months prior to admission. On exam, the patient appeared acutely ill with a blood pressure of 75/45 mmHg, tachycardia, marked hypoxemia and course breath sounds throughout all lung fields. Labs revealed …

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Grand Rounds: “Acute Respiratory Distress Syndrome and Acute Lung Injury”

September 17, 2008
Grand Rounds: “Acute Respiratory Distress Syndrome and Acute Lung Injury”

Commentary by Matthias Kugler MD, PGY-3

Please also see the Grand Rounds Clinical Vignette

Leonhard D Hudson, M.D., Professor of Medicine, Pulmonary and Critical Division, University of Washington, Seattle, spoke at Medical Grand Rounds about the Acute Respiratory Distress Syndrome (ARDS) and Acute Lung Injury (ALI). He started his lecture with a history of the disease, starting with the first published description of ARDS in The Lancet 1967, where it was defined by the presence of diffuse alveolar damage, increasing pulmonary capillary leak, non-cardiogenic pulmonary …

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Meeting Perspectives: 2008 American Thoracic Society Meeting

June 18, 2008
Meeting Perspectives: 2008 American Thoracic Society Meeting

Commentary by Laura Evans MD, NYU Division of Pulmonary and Critical Care Medicine 

The 2008 American Thoracic Society (ATS) meeting took place from May 16-21 in Toronto, Ontario.  Over 16,000 physicians, nurses and respiratory therapists attended the meeting.  There were more than 400 sessions, 800 speakers and 5,500 original research abstracts focusing on pulmonary, critical care and sleep medicine. 

The NYU Division of Pulmonary and Critical Care medicine was well represented.  The division presented more than 20 original research abstracts and symposia in areas such …

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Its okay to smoke…we’ll screen you

May 9, 2008
Its okay to smoke…we’ll screen you

Commentary by Shrujal Baxi MD, NYU Chief Resident

One of the first things you learn about critically analyzing a medical journal piece is to go to the end and see who sponsored the study. Corporate financing is known to have subtle effects on research which can lead to an unconscious bias. Disclosure of funding is paramount for a researcher in order to remain above reproach.

In a recent New York Times article, the impact of such relationships is investigated. In 2006, Dr. Claudia Hensheke, a …

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