Systems

Grand Rounds: The New Frontier of Sleep Disorders

March 18, 2009
Grand Rounds: The New Frontier of Sleep Disorders

Commentary by Melissa Price, MD, PGY-3

Please also see the clinical vignette presented before last week’s Grand Rounds.

At Medical Grand Rounds on March 11th, 2009, the NYU Medical Community had the immense pleasure of hosting Dr. Allan I. Pack, MD, Ch.B, and Ph.D from the University of Pennsylvania Medical Center as he indulged us in his research on the biological functions of sleep and its regulation.

Studying the importance of sleep and its disorders has never been more relevant. Not only is the Accreditation…

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What is the Role of Colchicine in Recurrent Pericarditis?

March 14, 2009
What is the Role of Colchicine in Recurrent Pericarditis?

Commentary by Sabina Berezovskaya MD, PGY-3

Faculty Peer Reviewed

Up to 32% of patients with acute pericarditis will have a recurrent episode. Acute attacks are commonly precipitated by infections, malignancy, cardiac trauma, myocardial infection, or autoimmune disease. Recurrent pericarditis usually presents with symptoms akin to the acute attack, including chest pain, fever, pericardial rub, typical electrocardiographic findings (i.e. diffuse ST elevations and PR depressions), pericardial effusion and, infrequently, tamponade. The time to relapse after acute pericarditis usually occurs within 18 to 20 months; however some report recurrences…

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Grand Rounds: Gout and Hyperuricemia: Some New Thoughts About an Old Disease

March 11, 2009
Grand Rounds: Gout and Hyperuricemia: Some New Thoughts About an Old Disease

Commentary by Deena Altman MD, PGY-2

Please also see the clinical vignette presented before grand rounds on February 18th.

At medical grand rounds on February 18, 2009, our very own Dr. Pillinger gave a unique overview of the history, pathogenesis, and new theories on an ancient and increasingly common disease, gout.

His talk began with a depiction of gout throughout the ages. Podagra was first described in 2600 BC, with the first urate crystals being recognized in 1961 by…

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Mystery Quiz- The Answer

March 10, 2009
Mystery Quiz- The Answer

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

The answer to the mystery quiz is allergic bronchopulmonary aspergillosis (ABPA). The CXR shows right upper lobe opacities, two of which appear round (Image 3, arrow) and another tubular (Image 3, arrowhead), and a left upper lobe opacity which has the characteristics of subsegmental atelectasis (Image 3, double arrows). The CT scan, performed ten days after the CXR, shows central bronchiectasis of the RUL (Image 4, arrows); tubular branching shadows (Image 6, arrow) as…

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Mystery Quiz

March 6, 2009
Mystery Quiz

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

The patient is a 42 year old male non-smoker with history of poorly controlled asthma (first diagnosed in 1994, recurrent need for steroid treatments but never intubated), severe seasonal allergies with chronic sinusitis, hepatic steatosis, GERD and gout who presented with complaints of five to ten days of myalgias, productive cough, wheezing and chest tightness. His medications included albuterol, fluticasone and formoteral inhalers, montelukast, colchicine, indomethacin prn, and fexofenadine. Exam was significant for T 97.6,…

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Prostate Cancer and Antioxidants

February 25, 2009

Commentary by Christopher Tully MD, PGY-1

Faculty Peer Reviewed

An apple a day. . . keeps the prostate cancer away? While it is an overstatement to say that an apple can prevent cancer, the notion of taking “something” to prevent cancer initiation and growth is nothing new. Primary prevention has long been a goal of researchers and physicians with the aim of preventing the morbidity and mortality associated with malignant disease. Prostate cancer is an appropriate choice in studying this topic since we…

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Morning Report: Hepatorenal Syndrome

February 19, 2009
Morning Report: Hepatorenal Syndrome

Commentary by Catherine Lucero MD, PGY-3

Faculty Peer Reviewed

The patient is a 69-year old woman from El Salvador with a chief complaint of worsening abdominal distension for nine months. Three months earlier, the patient was told she had liver problems and was started on diuretics. Prior to presentation, the patient states that she stopped taking her medication and noticed increasing lower extremity edema and abdominal girth, as well as an unintentional 15-pound weight loss. The patient denied any other medical problems, including fever, chills,…

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Real Time Clinical Question: Rheumatology

February 13, 2009
Real Time Clinical Question: Rheumatology

Commentary by Jon-Emile Kenny MD, PGY- 2 

Faculty Peer Reviewed

At morning report, the case of a 55 F with known dermatomyositis (DM), and interstitial lung involvement who had presented to the hospital with increasing dyspnea was presented.  The discussion of the case opened with the cardinal manifestations of DM including proximal muscle weakness as diagnosed with EMG, cutaneous manifestations such as the heliotrope rash, the shawl sign, Gottron’s papules, Reynaud’s, and ‘Mechanics Hand’, and the systemic manifestations such as interstitial lung disease.…

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Diseases 2.0: Sepsis

February 5, 2009
Diseases 2.0: Sepsis

Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment

Commentary by Andrew McKinstry MD PGY-1

Faculty Peer Reviewed

For anyone who has stepped into an ICU, the septic patient is a familiar sight. Despite advances in research and management, including goal directed therapy and recombinant human activated protein C (Xigris), sepsis continues to be a major cause of mortality in the critical care setting, with an estimated 215,000 deaths annually, and costing roughly 16.7 billion dollars per year. Despite these staggering…

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X-Ray Visions: What is your radiation risk?

January 29, 2009
X-Ray Visions: What is your radiation risk?

Commentary by Michael Hanley MD PGY-3 and James D. Koonce MD PGY-3, Department of Radiology, Medical University of South Carolina

www.X-rayRisk.com - A Free Online Calculator that Estimates an Individual’s Additional Risk of Cancer as a Result of Medical Imaging

An estimated 62 million CT scans are obtained in the United States each year.(1) While debated, a recent study suggests that radiation exposure from medical imaging may be responsible for 1-3% of cancers worldwide.(2) With recent media coverage focusing on the risk of cancer from medical…

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Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

January 22, 2009
Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

Commentary by Melanie Maslow, MD, FACP, Associate Professor of Medicine, NYUSOM, Chief, Infectious Diseases, New York Harbor Healthcare System, NY

Faculty Peer Reviewed

Cellulitis is an acute spreading infection of the skin extending to the deep subcutaneous tissue characterized by pain, swelling, erythema and warmth. Cellulitis in the non-neutropenic patient, in the absence of bite wounds, salt or fresh water exposure, and coexisting ulcers is usually caused by Gram-positive pathogens, the most common being the beta-hemolytic streptococci and S .aureus, including methicillin-sensitive (MSSA) and methicillin-resistant…

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Grand Rounds: “VEGF and Renal Thrombotic Microangiopathy”

January 21, 2009
Grand Rounds: “VEGF and Renal Thrombotic Microangiopathy”

Commentary by Ilana Bragin, MD, PGY-3

Please also see the clinical vignette presented before last week’s grand rounds.

Last week’s Medical Grand Rounds was given by guest speaker Dr. Sue Quaggin, Associate Professor of Medicine at the University of Toronto, who shared with the audience her knowledge and passion of the role of Vascular Endothelial Growth Factor (VEGF) in kidney function.  VEGF is a critical family of signaling proteins that is involved in vasculogenesis and angiogenesis. While the discovery of VEGF could be applied to…

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