Systems

Pass the Salt? A Look at Population-Based Sodium Reduction Interventions

September 24, 2010
Pass the Salt? A Look at Population-Based Sodium Reduction Interventions

By Ryan Macht, MS4

Faculty Peer Reviewed

On January 11th, the New York City Health Department announced its plans for the National Salt Reduction Initiative, a public health proposal designed to decrease sodium consumption throughout the country. High levels of dietary sodium have frequently been associated with increased rates of hypertension and adverse cardiovascular events. The mean salt intake in the United States is extremely high in all age groups and well above the current recommendations of 5.8 g (2300 mg sodium) for those under …

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Why Does Multiple Myeloma Treat The Kidneys So Poorly?

September 22, 2010
Why Does Multiple Myeloma Treat The Kidneys So Poorly?

By Jon Emile Kenny, MD

Faculty Peer Reviewed

“You mean I’ve got cancer and my kidneys are failing, doc?” said my frail patient on the Bellevue oncology service shortly after a medical student had told him that his kidneys were damaged. Indeed, his new diagnosis of multiple myeloma was accompanied by an admission creatinine of 2.5 mg/dL.

About a quarter of patients with multiple myeloma have renal insufficiency at diagnosis . There are a number of clinicopathologic responses to multiple myeloma that occur within the …

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The Challenge of Measles Control

September 15, 2010
The Challenge of Measles Control

By Taher Modarressi

Faculty Peer Reviewed

Measles remains one of the leading causes of preventable child mortality worldwide, despite the development of an effective vaccine in the 1960s. Even as late as the early 1990s, measles continued to infect tens of millions of people and claimed over a million lives each year (51]. Although mortality dropped by 78% from 2000 to 2008 due to aggressive control initiatives, the disease is still responsible for 164,000 deaths annually . Morbidity and mortality is mostly due to …

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The Heart in Acromegaly

September 1, 2010
The Heart in Acromegaly

By Ari Pollack, MD

Faculty Peer Reviewed

The onset of acromegaly is subtle, and its progression is usually very slow. In fact, the usual interval from the onset of symptoms until diagnosis is about twelve years. The manifestations of acromegaly result from excessive secretion of growth hormone (GH), which targets the liver, resulting in stimulation of hepatic secretion of insulin-like growth factor-1 (IGF-1), which causes many of the clinical manifestations of acromegaly.  The most common cause of acromegaly is a functional pituitary adenoma. The effects …

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Myths and Realities: Heart and Wine

August 26, 2010
Myths and Realities: Heart and Wine

By Aditya Mattoo, MD

Faculty Peer Reviewed

Not too long ago, a patient came to my clinic and said (I’m paraphrasing of course), “I never cared for alcohol, doctor, so I haven’t had much to drink since my college days.  Maybe champagne or wine on the rare special occasion, but I keep hearing about how wine is good for your heart, so I am thinking I should start drinking regularly.”  For years I have been telling patients don’t drink, don’t smoke, don’t do drugs, don’t …

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Selected Discussion of Presentation From The American College of Cardiology 59th Annual Scientific Sessions

August 24, 2010
Selected Discussion of Presentation From The American College of Cardiology 59th Annual Scientific Sessions

By Robert Donnino, MD

Faculty Peer Reviewed

The 59th Annual Scientific Sessions of the American College of Cardiology (ACC) took place in Atlanta on March 14-16, 2010. Despite inclement weather in the northeast causing the cancellation of many flights, a large number of NYU faculty, fellows, and others made it to Atlanta to give talks, presentations, or simply attend the conference.

As usual, the Sessions presented us with many important studies from around the world, some of which may change our clinical practice for years …

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The Role of Serologic Testing in the Diagnosis of Celiac Disease

August 18, 2010
The Role of Serologic Testing in the Diagnosis of Celiac Disease

By Todd Cutler

Faculty Peer Reviewed

A 31-year-old woman presents to the clinic with chronic fatigue. She was diagnosed with iron  deficiency anemia when she was 25 years old and has since taken oral contraceptives to limit bleeding during menstruation which she describes as minimal. She has a family history significant for an older brother with celiac disease. She is thin and her exam is significant for conjunctival pallor. Her laboratory findings are significant for a hemoglobin of 9.7 g/dL, a mean corpuscular volume of

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Polycythemia Vera Presenting as a Hypercoagulable State: What is the Pathophysiologic Role of JAK2 in the Mechanism, Manifestations, and Treatment of the Disease?

August 11, 2010
Polycythemia Vera Presenting as a Hypercoagulable State:  What is the Pathophysiologic Role of JAK2 in the Mechanism, Manifestations, and Treatment of the Disease?

By Emily Slater

Faculty Peer Reviewed

Mr. R is a 46-year-old man with a past medical history of polycythemia vera on hydroxyurea and chronic hepatitis B and C who presented with acutely worsening left upper-quadrant abdominal pain.  This occurred in the context of 3 months of worsening abdominal pain and 1.5 years of increasing abdominal distension.  His physical exam was remarkable for massive splenomegaly (18cm span) and a non-palpable liver.

Laboratory findings are significant for microcytic anemia with an elevated RDW, thrombocytopenia, elevated PT, PTT,

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