Systems

Meeting Perspectives: The 2010 Infectious Disease Society of America (IDSA) Meeting

December 22, 2010
Meeting Perspectives: The 2010 Infectious Disease Society of America (IDSA) Meeting

Neal H. Steigbigel, M.D.

The recent IDSA meeting reviewed many important and interesting findings.  Topics spanned a wide array of subjects, many of which are of importance and interest to all physicians.  These subjects included:

Treating severe Clostridial Difficile infection with fecal transplantation Isolation for extended spectrum beta lactamase (ESBL’s) bacteremia Update in multi-resistant gram negative infections Update on Pneumococccal infections Treatment dilemmas in immunocompromised hosts Update on invasive fungal infections

This high quality meeting has many simultaneous sessions and therefore one individual cannot cover …

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Is a Low Vitamin D Level a Risk Factor for Colon Cancer?

December 16, 2010
Is a Low Vitamin D Level a Risk Factor for Colon Cancer?

By Nelson Sanchez, MD and Fritz Francois, MD, MS

Faculty Peer Reviewed

Case: A 45-year-old woman presents to your office for an annual check-up.  She states that her grandmother was recently diagnosed with colon cancer at the age of 90, and she wants to know what she can do to reduce her own risk for the disease.  She recently read an article about the benefits of vitamin D and wants to know if they extend to protecting against colon cancer. In particular, she is concerned

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The Polymyxins: Why am I using them all the time, and what are they?

December 8, 2010
The Polymyxins: Why am I using them all the time, and what are they?

By Jon-Emile S Kenny

Faculty Peer Reviewed

A 65-year-old female with locally advanced rectal cancer is admitted to the ICU, hypotensive and febrile.  Her PICC line is removed and blood cultures drawn.  Fourty-eight hours later all cultures return ESBL Klebsiella with susceptibility only to polymyxin.

I sat on the venerable call-room couch staring mindlessly at the cluttered, nauseating walls repeating the word ‘polymyxin’ like an endless antimicrobial mantra.  What strange dosing it has, and an even more peculiar name.

The polymyxins (B and E – …

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Branched Chain Amino Acid Supplementation for Patients with Cirrhosis

December 3, 2010
Branched Chain Amino Acid Supplementation for Patients with Cirrhosis

By Nicole Leigh Aaronson,MD,  Loren Wissner Greene, MD, and  Denise Pate, MD

Faculty Peer Reviewed

Introduction:

Whereas there are specially designed diets for patients with hypertension, diabetes, and renal failure, NYU Medical Center, like most medical centers, does not have a specific diet for patients with cirrhosis. In considering what dietary modifications might benefit these patients, it is useful to first examine the nutritional status of the cirrhotic patient. Cirrhosis is a disease characterized by progressive liver injury and hepatocyte death, which eventually produces fibrosis …

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Kayexalate: What is it and does it work?

December 1, 2010
Kayexalate: What is it and does it work?

By Todd Cutler, MD

Faculty Peer Reviewed

A 62-year-old male is hospitalized with an acute congestive heart failure exacerbation. On hospital day three, the patient’s symptoms have significantly improved with twice daily furosemide 80mg IV. He is continued on IV diuretics and aggressive electrolyte repletion. On day five of his admission, his basic metabolic panel is significant for a creatinine of 2.3 mg/dL (increased from 1.3 on admission) and a potassium concentration of 5.9 mEq/L. His EKG is unchanged from admission. His furosemide is discontinued

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Proton Pump Inhibitors 2.0

November 26, 2010
Proton Pump Inhibitors 2.0

By Mary C. Whitman, MD

Faculty Peer Reviewed

Proton pump inhibitors (PPIs) are generally considered “safe” medications and are prescribed to over 100 million patients per year for a variety of indications, often for long durations. Recently, new data has emerged that suggests that we should be more judicious in prescribing PPIs.

In a recent development, the FDA announced that it will require new labeling of PPIs indicating that their use at high dosage and for prolonged durations is associated with an increased risk of …

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Grand Rounds: Influenza Pandemic

November 18, 2010
Grand Rounds: Influenza Pandemic

Summary by Lakshmi Tummala, MD

The Medical Grand Rounds lecture on October 6, 2010 titled “Influenza 2010: Update after the 2009 Pandemic was presented by Dr. Alicia Fry, M.D., MPH an epidemiologist from the United States Centers for Disease Control and Prevention. I’m sure that those of us who were fortunate enough to be on the wards at that time recall the wonder of seeing a small piece of history unfold firsthand. Now, let’s take the journey again with Dr. Fry, from reports of the …

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Mystery Quiz- The Answer

November 13, 2010
Mystery Quiz- The Answer

Dana Clutter, MD

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

Faculty peer reviewed

The answer to the mystery quiz is bacillary angiomatosis (BA). BA is a disease that most frequently affects individuals infected with the human immunodeficiency virus (HIV) and typically presents with multiple cutaneous papules and nodules. Visceral manifestations also occur and can involve the bone, lungs, lymph nodes, spleen, liver (termed peliosis hepatis) and the central nervous system.(1) Since the relatively recent first description of the disease …

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