Systems

Chief of Service Rounds: Should You Always Stop Anticoagulating a Bleeding Patient?

January 20, 2010
Chief of Service Rounds: Should You Always Stop Anticoagulating a Bleeding Patient?

Chief-of-service rounds is a new feature of Clinical Correlations.  Here we summarize Bellevue Hospital’s Chief of Service Rounds moderated by the Chief of Medicine, Nate Link, MD.  This multidisciplinary bimonthly conference focuses on a case that presents a diagnostic or treatment challenge.  A clinical question is posed at the end of the case and then answered using the principles of evidence based medicine.

Daria Crittenden , MD

Moderator: Nate Link, MD Associate Professor of Medicine, . GI consultant:  Gerry Villanueva, MD Clinical Assistant Professor of …

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How Do You Advise the Balding Patient?

January 13, 2010
How Do You Advise the Balding Patient?

Sagar Mungekar

Faculty Peer Reviewed

The incidence of male pattern hair loss can reach almost 100% in some ethnic groups.1, 2 While treatment of the condition is usually deferred to dermatologists, it is often the primary care physician (PCP) who is first approached for advice. Several medical and surgical treatments exist for male pattern hair loss. Herbal supplements and products on infomercials make cursory non-FDA-approved claims of hair growth. Minoxidil, once developed for hypertension, is available over the counter as a scalp treatment. Finasteride and …

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Some gleanings from the meeting of the Infectious Diseases Society of America (IDSA) in Philadelphia, October 29-November 1. 2009

January 6, 2010
Some gleanings from the meeting of the Infectious Diseases Society of America (IDSA) in Philadelphia, October 29-November 1. 2009

Neal H. Steigbigel, M.D.

The recent IDSA meeting reviewed many important and interesting findings.  Topics spanned a wide array of subjects, many of which are of importance and interest to all physicians.  These subjects included:

HIV/AID- increasing support for starting HAART earlier Influenza-details regarding pathogenesis, epidemiology, clinical presentation and treatment for the H1N1 2009 Influenza pandemic infections Updates regarding  pyogenic bacterial meningitis and Group A streptococcus necrotizing fasciitis Management information regarding the all too common hospital-associated multiple drug resistant gram-negative bacillary infections (especially, P. aeruginosa…

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Tailoring Colon Cancer Screening

December 19, 2009
Tailoring Colon Cancer Screening

Guidelines for Colorectal Cancer Screening and the Recent Evidence Behind Them

 Nazia Hasan, MD MPH

Faculty peer reviewed

For most residents, screening for colorectal cancer (CRC) may seem as established as that for breast and cervical cancer. In reality, the use of CRC screening has only recently approached that of screening for those other malignancies. We have seen recently changes to the CRC screening guidelines last published by The American College of Gastroenterology in 2000. The updated screening guidelines for colorectal cancer became available in …

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Meeting Perspectives: American Heart Association Scientific Sessions 2009

December 16, 2009
Meeting Perspectives: American Heart Association Scientific Sessions 2009

Steven Sedlis, MD

 

The annual scientific session of the American Heart Association (AHA) was held in Orlando on November 14-18 2009. It felt like a ghost town. I ran into Ira Schulman, my medicine resident at Bellevue when I was a third year medical student; we looked at one another and simultaneously blurted out “where is everybody?” Well Ira remains my role model and hero and it goes to show that although attendance at major medical meetings may wax and wane, the impact of a …

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Tailoring Colon Cancer Screening

December 11, 2009
Tailoring Colon Cancer Screening

Guidelines for Colorectal Cancer Screening and the Recent Evidence Behind Them

 Nazia Hasan, MD MPH

Faculty peer reviewed

For most residents, screening for colorectal cancer (CRC) may seem as established as that for breast and cervical cancer. In reality, the use of CRC screening has only recently approached that of screening for those other malignancies. We have seen recently changes to the CRC screening guidelines last published by The American College of Gastroenterology in 2000. The updated screening guidelines for colorectal cancer became available in …

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Prostate Cancer Screening: Where Do We Stand Now?

December 9, 2009
Prostate Cancer Screening: Where Do We Stand Now?

Annery Garcia

Prostate cancer is the second most common cancer in western men and the second leading cause of cancer-related deaths in men in the U.S.1 In 2007 approximately 218,890 men were diagnosed with prostate cancer, and it is expected that one out of six men will receive the diagnosis in their lifetime.2 Although considered to be a slow-growing tumor, the American Cancer Society estimated that in 2008 186,330 new cases of prostate cancer would be diagnosed, and 26,000 men will die from prostate cancer.3 …

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Continuous Glucose Monitors

December 2, 2009
Continuous Glucose Monitors

Ilena George

Faculty peer reviewed

Are continuous glucose monitors the answer for better glucose control in diabetes?

A poorly controlled type 2 diabetic who is non-compliant with his at-home glucose monitoring comes to Bellevue’s Adult Primary Care Clinic requesting a prescription for a needle-less glucose monitor…

Self-monitoring of glucose levels is a necessary evil of diabetes treatment. As the prospect of numerous needle-sticks each day in perpetuity is daunting to patients, researchers have been developing non- or minimally-invasive methods to measure blood sugar in hopes …

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Myths and Realities: Cell phones and the risk of brain cancer

November 27, 2009
Myths and Realities: Cell phones and the risk of brain cancer

Daria B. Crittenden

Although children today have never known a world without cell phones, the rest of us remember when these devices were created and have watched their popularity soar. The ability to have constant communication, anytime and anywhere, is now taken for granted. Many have asked the question, are we putting our health at risk with this technology? Specifically, with cell phones cradled against our ears many times a day, and sometimes for many hours a day, are we at increased risk for developing …

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Breaking News: Begin Cervical Cancer Screening at 21 Says ACOG

November 20, 2009
Breaking News: Begin Cervical Cancer Screening at 21 Says ACOG

Joshua Strauss, MD

In the second decision of its kind and magnitude in a matter of days, a major medical group has again recommended cutting back on cancer screening for women.  On the heels of Monday’s USPSTF release on reducing mammography, newly revised evidence-based guidelines regarding cervical cancer screening were issued today by The American College of Obstetricians and Gynecologists (ACOG) and published in the December issue of Obstetrics & Gynecology. 

The new guidelines, “based on good and consistent scientific evidence,” recommend beginning cervical cancer …

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What is the Role of Drug Therapy in Treating Obesity?

November 19, 2009
What is the Role of Drug Therapy in Treating Obesity?

Arlene Chung

Faculty Peer Reviewed

Despite the high prevalence of obesity1 and its associated morbidity2 and mortality 3,4, it represents one of the most difficult chronic conditions to treat. Barriers include a metabolically toxic environment, a history of ill-fated weight-loss regimens, and a general view of obesity as primarily a social, not a medical problem. 5 Deep down, the belief that obesity really is the result of gluttony and sloth probably persists. However, as we learn more about the physiology of energy balance, appetite regulation, …

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Breaking News: Initiate Mammography Screening at 50, not 40, Says USPSTF.

November 17, 2009
Breaking News: Initiate Mammography Screening at 50, not 40, Says USPSTF.

Aalok Turakhia, MD

As the debate over when to begin screening mammography in women rages on, the United States Prevention Service Task Force (USPSTF) added fuel to the fire by releasing a new recommendation statement in the November 17th issue of the Annals of Internal Medicine.  Applying to women aged ≥40 who are not at an increased genetic risk or have had chest irradiation, the USPSTF now recommends biennial screening in women between ages 50-74.  In February 2002, the task force first recommended that annual …

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