Michael Chu MD
Please also see the clinical vignette presented before Grand Rounds on the 21st of May.
The Medical Grand Rounds presentation on May 21, 2009 titled “Primary Aldosteronism, Beyond Conn’s Syndrome” was delivered by Dr. William F. Young M.D., Professor of Medicine at the Mayo Clinic College of Medicine. Dr. Young’s talk began with the index case of hyperaldosteronism that was described by Dr. Jerome Conn in the 1950’s, through the advances in the diagnosis of…
Does daily use of a multivitamin help prevent illness and chronic disease?
Kate Gibson, MS-4
Faculty Peer Reviewed
A 65 year old male patient with a history of hypertension and hyperlipidemia comes into the clinic for a regular visit. On his way out he asks, “Should I be taking a multivitamin?” You stop and think for a minute and decide, why not? But is there any actual evidence supporting the effectiveness of daily use of a multivitamin?…
Aditya Mattoo MD
Faculty Peer Reviewed
Prompted by personal experience, I thought I would explore the alleged causative role of power lines in hematologic malignancies for the next installment of Myths and Realities. In recent years, two close family friends living at separate locations but in homes adjacent to lots with electrical transformers were diagnosed with Multiple Myeloma and Non-Hodgkin’s Lymphoma. Naturally, the coincidence was not unnoticed, so I decided to put power lines on trial…
Matthew Nayor
Faculty Peer Reviewed
The patient: a 55 year old male nonsmoker with an HDL of 46, LDL of 120, triglycerides of 70, BP of 135/80 (on meds) and total cholesterol of 180. (Framingham 10-year risk of MI = 12%)
Coronary artery disease is the leading cause of death worldwide. Despite our understanding of how family history, toxic habits, cholesterol, and blood pressure affect the risk of myocardial infarction (MI), there is a clear need to…
Seema Pursnani MD
Because your parents have designated you as the family doctor, your Uncle Joe calls to ask you if he should take this medication called Diamox before going trekking in the Himalayas. You work at Bellevue in New York City: who climbs mountains here? What do you say?
Why do illnesses develop from changes in altitude?
The essential culprit is the fall in atmospheric pressure with an increase in altitude. While at sea level, barometric pressure (Pb) is ~760mm Hg (1atm), whereas at…
Michael Owen MD
Please also see the clinical vignette presented before Grand Rounds on the 15th of April.
Grand rounds on April 15th was presented by Dr. Joel Kremer, Pfaff Family Professor of Medicine at Albany Medical College and Director of Research at the Center for Rheumatology. Dr. Kremer informed the NYU community about the role of omega-3 fatty acid supplementation in rheumatoid arthritis.
Dr. Kremer began with an overview of fatty…
Posted by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors
The answer to the mystery quiz is sarcoidosis. The CXR shows diffuse, bilateral infiltration with a predominantly nodular pattern. The pulmonary hila are also prominent. The CT image shows innumerable 2-3mm nodules, many of which have a perilymphatic distribution. The lymphatics, in parallel with the pulmonary vasculature, course through the interstitium. Hence, the perilymphatic nodularity has an interstitial distribution and appears as “studding” along the interstitium which is…
Bani Chander MD
Faculty Peer Reviewed
Autoimmune hepatitis (AIH) is a progressive, inflammatory disease of the liver of unknown etiology and may progress to cirrhosis. While it is does have a predilection for women, this disease entity crosses genders and ethnic groups, and may occur in both adults and children. AIH is characterized by a fluctuating course and is often associated with autoimmune features including hypergammaglobulinemia, circulating serum autoantibodies, and hepatitis with lymphoplasmacytic infiltration on liver biopsy . Autoimmune…
Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors
The patient is a 42 year old man with a history of non-productive cough for several weeks. Three weeks prior to evaluation by the pulmonary service, the patient presented to the ER with a presumed vasovagal syncopal event that occurred on a subway platform. The patient’s prior medical history included allergic sinusitis and nasal polypectomy. Other than cough, the patient denied constitutional symptoms. The patient was not taking any medications.…
Eunice Kang, MD
The Centers for Disease Control (CDC) has confirmed eight cases of swine influenza A (A/H1N1) virus infection in New York City, in addition to a dozen cases caused by the same strain scattered throughout California, Texas, Ohio, and Kansas. The eight confirmed cases in New York are in students who just returned from a trip to Mexico, where officials began reporting three separate outbreaks of influenza-like illness beginning March 18th. According to the New York Times there have…
Michael T. Tees, MD, MPH
On the wards and in the clinic, the physician is frequently presented with a patient with a decreased appetite and alarming weight loss. The patient is likely frustrated with their own fraility, the family is upset at the poor nutritional state of their loved one, but the healthcare provider should be the most concerned. This clinical presentation without a prior diagnosis is worrisome, and if the patient does have an underlying etiology, this likely represents progression.…
Frederick Gandolfo, MD
Case: An 85 year-old woman admitted to the hospital with pneumonia and after a prolonged hospital course developed heparin-induced thrombocytopenia (HIT). She is currently being treated with argatroban and her platelet counts are recovering. You are the covering physician and are called by the lab for an INR of 12 on her routine labs. The patient shows no signs of bleeding and she is not on warfarin. The PTT at the time…
