Systems

Grand Rounds: Thyroid Disease and the Heart

September 24, 2008
Grand Rounds: Thyroid Disease and the Heart

 Commentary by Sarika Modi MD, PGY-2  

Dr. Irwin Klein MD, Professor of Medicine and Cell Biology, of North Shore University Hospital, gave grand rounds on “Thyroid Disease and the Heart” on September 17, 2008.  He began his talk by giving an overview of the broad spectrum of cardiac manifestations seen in hyperthyroidism.  Palpitations are seen in 90% of patients with hyperthyroidism.  Atrial fibrillation is seen in 5-15%, especially in the elderly.  In fact, as Dr Klein pointed out, former president George Bush Senior was…

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Mystery Quiz

September 19, 2008
Mystery Quiz

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

The patient is a 76 year old man with history of moderate-to-severe COPD who presented with three days of fever, breathlessness, and productive cough. Past surgical history is significant for vagotomy and partial gastrectomy 16 years earlier and a cholecystectomy 10 months prior to admission. On exam, the patient appeared acutely ill with a blood pressure of 75/45 mmHg, tachycardia, marked hypoxemia and course breath sounds throughout all lung fields. Labs revealed a white…

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Grand Rounds: “Acute Respiratory Distress Syndrome and Acute Lung Injury”

September 17, 2008
Grand Rounds: “Acute Respiratory Distress Syndrome and Acute Lung Injury”

Commentary by Matthias Kugler MD, PGY-3

Please also see the Grand Rounds Clinical Vignette

Leonhard D Hudson, M.D., Professor of Medicine, Pulmonary and Critical Division, University of Washington, Seattle, spoke at Medical Grand Rounds about the Acute Respiratory Distress Syndrome (ARDS) and Acute Lung Injury (ALI). He started his lecture with a history of the disease, starting with the first published description of ARDS in The Lancet 1967, where it was defined by the presence of diffuse alveolar damage, increasing pulmonary…

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Grand Rounds: “Bacterial Meningitis”

September 11, 2008
Grand Rounds: “Bacterial Meningitis”

Commentary by  Stephen Carpenter MD, PGY-2

Dr. Vincent Quagliarello, Professor of Medicine at Yale University, delivered his Medicine Grand Rounds lecture entitled “Bacterial Meningitis in Adults: Principles and Practice in 2008” on Wednesday, September 3rd, 2008. He began with some of the history of the disease and noted that despite all the medical advances, bacterial meningitis still has a mortality rate of 27% and an even higher rate of 54% in poorer nations where high rates of HIV infection confound the problem.…

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Perioperative Beta-blockade: Will POISE Change Management?

September 10, 2008
Perioperative Beta-blockade: Will POISE Change Management?

Commentary by Michael LoCurcio MD, Michael Janjigian MD and Michael C Brabeck MD, FACP, NYU Division of General Internal Medicine

Cardiovascular complications continue to be a major cause of morbidity and mortality in the perioperative period. Although progress has been made in terms of risk stratification, an effective invasive or pharmacologic intervention that decreases this risk remains elusive. Well designed studies have shown that prophylactic invasive measures are not effective in decreasing this risk, leaving clinicians uncertain as to the best way to maximize the…

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Addiction 2.0 Part 2

September 4, 2008
Addiction 2.0 Part 2

Commentary by Joshua Lee MD, Ellie Grossman MD and Marc Gourevitch MD, NYU Division of General Internal Medicine

Please also see Part 1 of this series, posted last week

Alcohol treatment in primary care: evidence for effectiveness and neharmacotherapies

Brief interventions by primary care physicians to address unhealthy alcohol use have been shown in multiple studies and settings to promote reduced drinking and engagement in other treatment, although long-term impact on alcohol-related morbidity and mortality is not clear.(Saitz 2005) Standard brief intervention techniques are based…

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Case Presentation: Acute Rheumatic Fever

August 29, 2008
Case Presentation: Acute Rheumatic Fever

Commentary by Bani Chander MD, PGY-3. and Ben Bergman MD, PGY-3

Please also see last week’s Class Act Post on the pathogenesis of Rheumatic Heart Disease 

A 34-year-old Hispanic male presents with the chief complaint of chest pain. The patient had been well until 10 days prior to admission, when he developed a severe sore throat accompanied by fever, rigors, and diffuse myalgias. There was no associated cough. Three days later, he visited his primary care physician at an outside facility and was prescribed…

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Class Act: The Use of MRI in Breast Cancer Screening

August 28, 2008
Class Act: The Use of MRI in Breast Cancer Screening

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

Commentary by Daniel Green MSIV and Boris Kobrinsky MD, Assistant Professor, NYU Division of Oncology

In 2008, an estimated 182,460 women in the United States will be diagnosed with invasive breast cancer, and 40,480 women will die of the disease as it remains the demographic’s second leading cause of cancer mortality.(1) Fortunately, breast cancer…

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Addiction 2.0 Part 1

August 27, 2008
Addiction 2.0 Part 1

Commentary by Joshua Lee MD, Ellie Grossman MD and Marc Gourevitch MD, NYU Division of General Internal Medicine

Substance abuse remains a leading cause of disease and mortality in the US, yet it is rarely addressed in general practice settings. In the past, clinicians could point to a relative paucity of effective interventions by way of explaining their disengagement in the care of these medical disorders. In recent years, however, effective pharmacotherapies have emerged for two classes of substances that are particularly destructive when abused,…

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Breaking News: Revenge of the Gila Monster?

August 20, 2008
Breaking News: Revenge of the Gila Monster?

Commentary by Rachana Jani MD, PGY-2

As recently reported in ShortCuts, Byetta recently made headlines after the suggestion of a mortality benefit for patients taking the drug in a small subset of the Accord study.  So is this the new golden drug for diabetics? Perhaps not. This week, the FDA updated a previous alert warning providers about the risks of pancreatitis in patients taking Byetta. Last October, the FDA first issued an alert after there had been 30 postmarketing reports of acute pancreatitis in patients who had recently been started on Byetta. Though…

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Class Act: Pathogenesis of Rheumatic Heart Disease

August 14, 2008
Class Act: Pathogenesis of Rheumatic Heart Disease

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

Commentary by Matt Stein MS-4; Reviewed by Harold Horowitz MD, Professor, NYU Division of Infectious Diseases and Immunology

In general, acute rheumatic fever (ARF) is a delayed sequela of a group A streptococcus (GAS) pharyngeal infection. Following an initial throat infection, which is often either untreated or incompletely treated, there exists a latent period of two…

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FRAX: A Brand New Tool For the Management of Osteoporosis

August 13, 2008
FRAX: A Brand New Tool For the Management of Osteoporosis

Commentary by Judith Brenner MD, Associate Editor, Clinical Correlations. Reviewed by Valerie Peck MD, NYU Division of Endocrinology.

An 81 year old Caucasian woman with a history of diabetes and hypertension who was admitted to the orthopedic service with a hip fracture after falling in her home.

This is a typical story and represents the end stages of osteoporosis. It is the myocardial infarction of the bone world. Like cardiovascular disease, prevention and identification of at-risk individuals is the most powerful tool clinicians have…

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