Systems

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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How Do You Approach a Patient with Arthritis and Hepatitis C?

August 7, 2008
How Do You Approach a Patient with Arthritis and Hepatitis C?

Commentary by Peter Izmirly MD, NYU Division of Rheumatology

A 54 year old male with a past medical history significant for hepatitis C genotype 1a s/p ifn/ribavarin 2003-2004 with HCV Qual negative in 2005 presents with 3 weeks of bilateral wrist pain. The pain is worst with extension. His exam is notable for diffuse tenderness when pressure is applied to his wrists. He has no obvious swelling, erythema, deformity or subcutaneous nodules. The remainder of his musculoskeletal exam in unremarkable. In addition, he has no stigmata of cirrhosis. Labs…

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Breaking News: USPSTF Issues New Prostate Cancer Screening Guidelines

August 5, 2008

Commentary by Cara Litvin MD, Executive Editor, Clinical Correlations

The US Preventive Services Task Force issued new guidelines for prostate cancer screening on Monday.  For the first time, the task force recommends AGAINST routine screening in patients over 75 years of age, citing the “moderate to substantial” harms over small to no benefits from screening. The task force reports that there continues to be inadequate evidence that the PSA improves healthcare outcomes at any age.  However, even if there is eventual evidence that screening is beneficial in younger patients, because men over…

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Class Act: Polycystic Ovarian Syndrome 2.0

August 1, 2008
Class Act: Polycystic Ovarian Syndrome 2.0

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. These posts focus on evidenced based answers to clinical questions related to patients seen by our students in the clinics or on the wards. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

Commentary by Marty Wolff MS-4, and Susan Zweig MD, Clinical Instructor, NYU Division of Endocrinology

NH is a 32 year-old obese Hispanic female with a history of…

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