Systems

How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

June 11, 2009
How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

Uzma Sarwar MD

Faculty Peer Reviewed

With advancement in therapy, life expectancy has significantly increased among HIV-infected patients, and patients are now more likely to succumb to chronic disease processes. At present, approximately one third of deaths in HIV patients are related to liver disease, which has become the leading cause of death amongst HIV patients. The risk of death from liver disease in HIV patients is inversely related to their CD4 count. Infection with hepatitis C virus (HCV) accounts…

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Grand Rounds: Primary Aldosteronism, Beyond Conn’s Syndrome

June 4, 2009
Grand Rounds: Primary Aldosteronism, Beyond Conn’s Syndrome

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…

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Class Act: A Multivitamin a Day – Does It Really Keep the Doctor Away?

June 3, 2009
Class Act: A Multivitamin a Day – Does It Really Keep the Doctor Away?

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?…

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Myths and Realities: Do Power Lines Cause Cancer?

May 20, 2009
Myths and Realities: Do Power Lines Cause Cancer?

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…

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Class Act: Cardiac CT to Assess Coronary Artery Calcium

May 17, 2009
Class Act: Cardiac CT to Assess Coronary Artery Calcium

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…

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Does Acetazolamide Prevent Altitude Sickness?

May 7, 2009
Does Acetazolamide Prevent Altitude Sickness?

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…

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Grand Rounds: The Role of Omega-3 fatty Acids in Rheumatoid Arthritis

May 6, 2009
Grand Rounds: The Role of Omega-3 fatty Acids in Rheumatoid Arthritis

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…

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Mystery Quiz- The Answer

May 1, 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 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…

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Should we treat asymptomatic autoimmune hepatitis?

April 30, 2009
Should we treat asymptomatic autoimmune hepatitis?

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…

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Mystery Quiz

April 28, 2009
Mystery Quiz

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.…

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Breaking News: Swine Flu Reaches New York

April 26, 2009
Breaking News: Swine Flu Reaches New York

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…

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The Skinny on Cachexia…Can it be Treated?

April 22, 2009
The Skinny on Cachexia…Can it be Treated?

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.…

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