Systems

Admission screening cultures for MRSA: Is it time?

July 9, 2008
Admission screening cultures for MRSA: Is it time?

Commentary by Howard Leaf, M.D. Assistant Professor, Division of Infectious Diseases and Immunology 

Pressure continues to build for healthcare facilities to act to decrease hospital-acquired infections, particularly those associated with MRSA. This is partly data-driven, with one study reporting that 25% of patients acquiring MRSA colonization during a hospitalization subsequently become infected . The call to act is also partly a political response to concerns in the lay press about “superbugs” wreaking havoc both in hospitals and in the community. Seven states have…

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Diseases 2.0: Uric acid stones linked to diabetes

July 3, 2008
Diseases 2.0: Uric acid stones linked to diabetes

Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment

Commentary By David Goldfarb, M.D. Professor of Medicine, NYU Medical Center, Chief Nephrology Section VA New York Harbor

At the recent meeting of the National Kidney Foundation in Dallas, Dr. Orson Moe reviewed the links between diabetes and uric acid stones . Uric acid stones are most often caused by low urine pH. With a low urine pH, even relatively little uric acid can precipate, as it forms the protonated form, which…

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Aspirin Use in the Primary Prevention of Cardiovascular Disease

June 25, 2008
Aspirin Use in the Primary Prevention of Cardiovascular Disease

Commentary by Daniel Frenkel, MD PGY-2 and Aleksandar Adzic, MD PGY-2 (in consultation with Greg Mints, MD Attending Physician, General Internal Medicine)

Case #1: A 47 year old man with no significant medical history, nonsmoker, and no family history of CAD. Blood pressure 124/72 Cholesterol 202, LDL 129, HDL 35, Triglycerides 190.
Case #2: A 36 year old man history of hypertension controlled with hydrochlorothiazide, smoker, with no family history of CAD. Blood pressure 134/72 Cholesterol 168, LDL 91, HDL 46, Triglycerides 155.

Would you…

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Mystery Quiz

June 19, 2008
Mystery Quiz

Posted by Athena Kritharis MS-3, Vivian Hayashi MD, Instructor of Clinical Medicine, Division of General Internal Medicine and Robert Smith MD, Associate Professor of Medicine, Division Pulmonary and Critical Care Medicine

The patient is a 42 year old Caucasian woman with no significant past medical history who presents with diffuse abdominal pain for two months that progressed to acute epigastric pain followed by nausea and vomiting. The vomitus was “milky” and contained only food particles. Symptoms were not relieved with over-the-counter antacids. The patient recalls eating scallops…

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Meeting Perspectives: 2008 American Thoracic Society Meeting

June 18, 2008
Meeting Perspectives: 2008 American Thoracic Society Meeting

Commentary by Laura Evans MD, NYU Division of Pulmonary and Critical Care Medicine 

The 2008 American Thoracic Society (ATS) meeting took place from May 16-21 in Toronto, Ontario.  Over 16,000 physicians, nurses and respiratory therapists attended the meeting.  There were more than 400 sessions, 800 speakers and 5,500 original research abstracts focusing on pulmonary, critical care and sleep medicine. 

The NYU Division of Pulmonary and Critical Care medicine was well represented.  The division presented more than 20 original research abstracts and…

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Neutropenic Precautions Demystified

June 13, 2008
Neutropenic Precautions Demystified

Commentary by Rachana Jani MD, PGY-1 and Neal Steigbigel MD, Professor of Medicine (Infectious Diseases/Immunology)

Rachana Jani MD:  Walking onto an oncology floor, one cannot help but notice the precautionary signs that segregate these patients from the rest of the hospital. “No fresh fruits or flowers.” “Neutropenic isolation, please see nurse before entering.” The idea of neutropenic precautions first emerged in the 1960s when myelosuppressive therapy came to the forefront of cancer treatment. It only made sense that patients with an impaired immune…

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Should H. pylori Eradication Be Confirmed?

June 12, 2008
Should H. pylori Eradication Be Confirmed?

Commentary by Fritz Francois, MD, MS, NYU Division of Gastroenterology

Humans are essentially the only reservoir for Helicobacter pylori, which is estimated to colonize the stomach of about half the world’s population (1). Although the bacteria generally do not invade the mucosa, attachment to the epithelium leads to an inflammatory reaction with neutrophils, lymphocytes, plasma cells, and macrophages. Over time, the persistent inflammation leads to changes in the gastric mucosa that may predispose to the development of dysplasia(2).

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Some say tomato, some say nationwide outbreak of Samonellosis

June 10, 2008
Some say tomato, some say nationwide outbreak of Samonellosis

Commentary by Chirayu Gor, MD

The CDC has issued an alert regarding the outbreak of a rare type of Salmonella, termed Salmonella Saintpaul. Since mid-April, over 140 persons have been identified in 16 states with this uncommon serotype of Salmonella. Preliminary investigation has implicated tomatoes.

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Grand Rounds: “Nephrogenic systemic fibrosis”

June 5, 2008
Grand Rounds: “Nephrogenic systemic fibrosis”

Commentary by Jatin Roper MD, PGY-3

Medical Grand Rounds today was presented last week by Dr. Shawn Cowper, Assistant Professor of Dermatology and Pathology at Yale University School of Medicine. Grand Rounds began with the presentation of a case from Tisch Hospital:

A 46 year old female with a history of end-stage renal disease secondary to diffuse-proliferative glomerulonephritis on hemodialysis, systemic lupus erythematosis, antiphospholipid antibody syndrome, and IVC thrombosis presents to a dermatology consultant for progressive hardness, tightness, and tenderness…

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Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 2

May 29, 2008
Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 2

Commentary by Brian Bronson, MD, Chief of Psychosomatic Medicine, VA New York Harbor, New York Campus

Summary: Symptoms of depression in the medical setting may not respond to usual pharmacologic antidepressant treatment for a number of reasons. These may include an incorrect psychiatric diagnosis; failure to consider underlying medical causes of the symptoms; or insufficient antidepressant medication trial due to poor patient adherence, insufficient dose or length of trial. There is no consensus as to the definition of ‘treatment refractory’ depression. However,…

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Meeting Perspectives: American College of Cardiology, Part 3

May 22, 2008
Meeting Perspectives: American College of Cardiology, Part 3

Commentary by Rob Donnino MD, NYU Division of Cardiology

The annual meeting of the ACC was held last month in Chicago. A good number of NYU faculty and fellows either presented at or attended the meetings. The cardiology fellows exhibited an impressive balance between exploring the Chicago nightlife and diligent attendance at the meetings. Several of the cardiology fellows presented some of the highlights of the ACC meeting at a recent journal club conference for the Cardiology Division. The third and final installment…

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Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 1

May 15, 2008
Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 1

Commentary by Brian Bronson, MD, Chief of Psychosomatic Medicine, VA New York Harbor, New York Campus 

Summary: Symptoms of depression in the medical setting may not respond to usual pharmacologic antidepressant treatment for a number of reasons. These may include an incorrect psychiatric diagnosis; failure to consider underlying medical causes of the symptoms; or insufficient antidepressant medication trial due to poor patient adherence, insufficient dose or length of trial. There is no consensus as to the definition of ‘treatment refractory’ depression. However, when…

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