Systems

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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Analgesia for Cirrhotics: A Practical Approach

November 20, 2008
Analgesia for Cirrhotics:  A Practical Approach

Commentary by Albert B. Knapp MD, NYU Clinical Professor of Medicine (Gastroenterology)

THE CASE:
WS, a 49 yo year old Caucasian male with a known 35 year history of alcohol abuse, now presents with jaundice, tense ascites and a left shoulder fracture following a bar room brawl last night. He is admitted to the orthopedic service for elective pinning but is presently in great pain. You are consulted in regards to pain management….

THE QUESTION:
How should you approach the use…

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Grand Rounds: “Advances in the Therapy of HER2 Positive Breast Cancer

November 19, 2008
Grand Rounds: “Advances in the Therapy of HER2 Positive Breast Cancer

Commentary by Jon-Emile Kenny MD, PGY- 2

 

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

Medical grand rounds on November 12, 2008 was given by Dr. Jose Baselga, MD.  His lecture, ‘Advances in the Therapy of HER2 Positive Breast Cancer’ highlighted the biochemical aspects of HER receptors and the current and future pharmacological implications thereof.

Roughly one in four breast cancers are HER2 receptor positive.  Phenotypically, these cancers tend to present as locally advanced tumours at an…

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Breaking News: The Jupiter Trial

November 12, 2008
Breaking News: The Jupiter Trial

Commentary by Ilana Bragin MD, PGY-3

This week online in the NEJM, the results of a trial known as Jupiter were presented in an article that will likely change the way we approach cardiovascular health protection. The Jupiter trial attempts to answer this perturbing question: “Why do half of all myocardial infarctions and strokes occur in apparently healthy men and women with levels of LDL that are below currently recommended thresholds of treatment?” The study addresses the biomarker C-reactive protein, an inflammatory marker that has long been…

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Mystery Quiz- The Answer

November 8, 2008
Mystery Quiz- The Answer

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

The answer to the mystery quiz is heart failure.  The CXR shows bibasilar opacities with hilar fullness on the right. The CT images are remarkable for bilateral effusions, with dependent opacities that increase in density along the anterior-posterior axis.  The lung appears clear in the anterior zone (Image 5, arrow; Coronal Image 1); ground glass opacification, characterized by parenchymal haziness which does not obscure the underlying pulmonary vessels, is evident in the mid lung (Image…

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Grand Rounds: “A New Mechanism of Platelet Thrombus Regulation Induced by ADAMTS-18: Clinical Implications”

November 6, 2008
Grand Rounds: “A New Mechanism of Platelet Thrombus Regulation Induced by ADAMTS-18: Clinical Implications”

Commentary by Yelena Kopyltsova MD, PGY-2

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

Last week’s grand rounds speaker was Simon Karpatkin MD, NYU Professor of Medicine & Director of the NYU Division of Hematology. In the 80s, multiple cases of autoimmune thrombocytopenic purpura were observed in patients with AIDS.  It was noted that these patients had elevated anti-platelet IgG levels (extracted from immune complexes), which correlated strongly with low platelets.  Dr. Karpatkin and his colleagues became interested in elucidating the mechanism…

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Mystery Quiz

October 30, 2008
Mystery Quiz

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

The patient is a 61 year old man with a history of diabetes, chronic kidney disease, and poorly controlled hypertension on five medications who was in his usual state of health until three days prior to admission when he noted increasing exertional dyspnea associated with chest pain, abdominal distention, bilateral lower extremity edema (left greater than right).

Exam notable for BP 105/54 (lower than all other prior measurements), HR 74, O2 Saturation 90%. PaO2…

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