Systems

Mystery Quiz- The Answer

January 16, 2009
Mystery Quiz- The Answer

Posted by Daniel Frenkel MD PGY-3 and Jeffrey Lorin MD, Assistant Professor, NYU Division of Cardiology

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

The answer to last week’s mystery quiz is accelerated idioventricular rhythm (AIVR)

AIVR is an ectopic ventricular rhythm with intermediate rates between an escape rhythm (<40 bpm) and ventricular tachycardia (>100-120 bpm). It has the usual features of ventricular arrhythmias including AV dissociation, fusion…

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Coronary Artery Disease in South Asians

January 14, 2009
Coronary Artery Disease in South Asians

Commentary by Muhammad Ghumman MD, PGY-3

Faculty Peer Reviewed

South Asia (India, Pakistan, Bangladesh, Sri Lanka, and Nepal) comprises 25% of the global population yet contributes nearly 60% of the global cardiovascular disease burden. There are over 3 million South Asians living in North America (2 million in United States and nearly a quarter million in New York City alone). It is important to recognize that South Asians develop coronary artery disease (CAD) at a younger age, die from CAD at younger ages, and…

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Mystery Quiz

January 8, 2009
Mystery Quiz

Posted by Daniel Frenkel MD PGY-3 and Jeffrey Lorin MD, Assistant Professor, NYU Division of Cardiology

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

The patient is a 68 year old man with history of smoking, hypertension, hyperlipidemia, and stable exertional angina who presented with an acute posterior wall myocardial infarction. He was found to have a totally occluded left circumflex artery requiring bare metal stent placement. Several hours after stent placement, the nurse calls stating that…

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Grand Rounds: “The Cardiovascular Molecular Basis of CPVT and other arrythmias”

January 7, 2009
Grand Rounds: “The Cardiovascular Molecular Basis of CPVT and other arrythmias”

Commentary by Anjali Grover MD, PGY-2 

Please also see the clinical vignette presented before December 17th’s grand rounds.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is classified as an inherited disorder which manifests itself as an adrenergically driven polymorphic ventricular tachyarrythmias.  The molecular etiology of this arrythmogenic disorder stems from a disruption in the calcium channels found in the sarcoplasmic reticulum.   This type of arrhythmia is an important cause of syncope and sudden cardiac death in those individuals with structurally normal hearts.  Genetic studies…

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Class Act: AGE-RAGE: What we know about the pathophysiology of diabetic neuropathy.

December 26, 2008
Class Act: AGE-RAGE: What we know about the pathophysiology of diabetic neuropathy.

Commentary by Regina Mysliwiec, NYU Medical Student

Faculty Peer Reviewed

G.L. is a 62 year-old African-American male with a six year history of Type 2 Diabetes with variable glucose control and a progressive one year history of burning pain in a unilateral T10 distribution. The pain began at his right abdomen, then spread first to his umbilicus and finally ventrodorsally to his spine. His most recent HgbA1c is 8.0.

One does not have to be a medical student in New York…

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Cardiac MRI: Assessing Myocardial Viability

December 18, 2008
Cardiac MRI: Assessing Myocardial Viability

Commentary by Muhammad Ghumman MD, PGY-3

Faculty Peer Reviewed

Clinical Case:

A 65 year old male with hypertension, iron deficiency anemia, and atrial fibrillation (not anticoagulated due to prior gastrointestinal bleed,) presents with new onset lower extremity edema, dyspnea on exertion, orthopnea, and profound fatigue. Physical exam is significant for jugular venous distention to 17 cm, bilateral basilar crackles on lung exam, 3+ pitting edema in the lower extremities to mid thighs, and guaiac positive brown stool. Labs are significant for hemoglobin of 5.4,…

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Meeting Perspectives: American Heart Association Scientific Sessions 2008- Report from the cardiology fellows

December 16, 2008
Meeting Perspectives: American Heart Association Scientific Sessions 2008- Report from the cardiology fellows

Commentary by Steven Sedlis, MD Associate Professor of Medicine, Chief, Division of Cardiology Manhattan Veterans Administration Medical Center

The annual scientific session of the American Heart Association was held in New Orleans on November 8-12 2008, the second major cardiology meeting in New Orleans since Katrina. The city has obviously not recovered. The crowds on the streets are sparser and the lines at restaurants considerably shorter than they were before the hurricane. Charity Hospital is closed and a large sign for LSU Interim…

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Breaking News: FDA Advisory Committee Calls For Ban on Long Acting Beta Agonists in Asthma

December 12, 2008
Breaking News: FDA Advisory Committee Calls For Ban on Long Acting Beta Agonists in Asthma

Commentary by Denise Pate MD, PGY-1 

The FDA released a 460 page document regarding the safety of long acting beta agonists (LABA) for the use of asthma, in addition to a two day advisory committee meeting this week on the call to ban LABA when used alone and not in combination with an inhaled steroid. The FDA found through a meta-analysis of 110 trials studying 4 drugs—2 LABAs, Foradil and Serevent, and 2 LABA/ICS (Inhaled Corticosteroids) Advair and Symbicort. The study found that there was…

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Tackling Cancer Control Worldwide: Report From the 2008 World Cancer Congress

December 11, 2008
Tackling Cancer Control Worldwide: Report From the 2008 World Cancer Congress

Commentary by Antonella Surbone MD PhD FACP, NYU Department of Medicine and Clinical Correlations Ethics Section Editor

On Tuesday December 9th 2008, leading global cancer organizations met in Atlanta to discuss the 2008 WHO World Cancer Report predicting that cancer will overtake heart disease as the world’s top killer by 2010, and that global cancer cases and deaths will more than double by 2030. They called on governments to act, by ratifying an international tobacco control treaty and by asking the US to…

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Class Act: The Role of Angiotensin II in Renal Fibrosis and Diabetic Kidney Disease

December 9, 2008
Class Act: The Role of Angiotensin II in Renal Fibrosis and Diabetic Kidney Disease

Commentary by Daniel Fine MD

Faculty Peer Reviewed

Diabetic nephropathy is the most frequent cause of end-stage kidney disease in the United States, Europe and Japan. Large scale randomized controlled trials have shown that both ACE inhibitors and angiotensin II receptor antagonists reduce microalbuminuria, slow rate of decline of GFR and delay end stage kidney disease.

The renin-angiotensin system plays a significant role in the human inflammatory process in addition to its well known effects on blood pressure and sodium homeostasis.…

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Grand Rounds: “Combating the Poverty Associated Tropical Diseases”

December 3, 2008
Grand Rounds: “Combating the Poverty Associated Tropical Diseases”

 

Commentary by Alpana Marwaha MD PGY-3

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

This week, the Department of Medicine Grand Rounds was presented by Dr. Peter Hotez MD, PhD and chair of the Department of Microbiology and Tropical Medicine at GW Medical Center. The talk was entitled, “Combating The Poverty Associated Tropical Diseases.”

 

There are a staggering 1.4 Billion people living at wages below $ 1.25 per day known as the “The Bottom Billion.”…

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Class Act: Soy and Breast Cancer – What’s the Connection?

November 26, 2008
Class Act: Soy and Breast Cancer – What’s the Connection?

Commentary by Alexis Melnick, NYU School of Medcine Class of 2009

Faculty peer reviewed

With the increasing popularity of soy foods in the American diet, there has been considerable debate over the link between soy and the risk of cancer, particularly cancer of the breast. The interest in this association stems from soy-containing isoflavones, soybean-derived compounds with chemical structures similar to estrogens that act as weak partial agonists at estrogen receptors. Initial data supported the chemopreventive potential of soy and were based on several findings: the…

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