Systems

Grand Rounds: “Pseudomonas aeruginosa Pathogenesis-Studies of an Opportunist”

November 9, 2007
Grand Rounds: “Pseudomonas aeruginosa Pathogenesis-Studies of an Opportunist”

Welcome to our Grand Rounds Series. Each week, we plan to post a summary of the week’s Medicine Grand Rounds lecture. The summaries are reviewed and approved by the grand rounds speaker prior to posting.

Commentary by Ryan Farley MD, PGY-3

This week’s Medicine Grand Rounds guest lecturer was Dr. Barbara Kazmierczak , currently Associate Professor of Medicine and Microbial Pathogenesis at Yale University School of Medicine.  Dr. Kazmierczak is the principal investigator for several NIH grants studying Pseudomonas aeruginosa virulence and host defense from …

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Inpatient Diabetes Management: Case 6

November 8, 2007
Inpatient Diabetes Management: Case 6

Commentary by Mary Vouyiouklis MD, Fellow, and Ann Danoff MD, Director, Division of Endocrinology, Diabetes and Metabolism, NYU Medical Center

Welcome to Case 6 of our special diabetes series intended to highlight the essentials of diabetes care in the inpatient setting. Over the last several weeks, we have been presenting individual cases followed by some management questions and answers.

Case 6: The Case of Ms. Longshore

Ms. Longshore is a 21 year old female with type 1 diabetes who was admitted to the ICU with …

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Vagally-induced Atrial Fibrillation

November 7, 2007
Vagally-induced Atrial Fibrillation

Case by: Alana Choy-Shan, Chief Resident

Commentary by William Slater MD, Associate Professor of Medicine, Division of Cardiology

Following Thanksgiving dinner, a 36 year-old healthy man developed palpitations and heart racing. He was evaluated in the emergency room and was noted to be in atrial fibrillation with rapid ventricular response. All of his other vital signs were within normal limits. He was treated with a beta-blocker for rate control and was started on anticoagulation. Within a few hours, he spontaneously converted to normal sinus rhythm. …

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Grand Rounds: “Towards Biologically Rational Therapy for Myelodysplastic Sydrome.”

November 2, 2007
Grand Rounds: “Towards Biologically Rational Therapy for Myelodysplastic Sydrome.”

Welcome to our new Grand Rounds Series. Each week, we plan to post a summary of the week’s Medicine Grand Rounds lecture. The summaries are reviewed and approved by the grand rounds speaker prior to posting. Enjoy.

Commentary by Marshall Fordyce MD, Senior Chief Resident 

This week’s Medicine Grand Rounds guest lecturer was Dr. Steven Gore, currently Associate Professor of Oncology, and Faculty Member of Cell and Molecular Medicine, at the Johns Hopkins University School of Medicine. Dr. Gore’s research focuses on improving our understanding …

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Elevated Total Protein and the Interpretation of Serum Protein Electrophoresis

November 1, 2007
Elevated Total Protein and the Interpretation of Serum Protein Electrophoresis

Commentary by Jamie Hoffman, MD 

A healthy 54 year old man without past medical history presents for a routine physical exam for his insurance company. His blood work reveals a total protein (TP) of 9.4 g/dl and an albumin of 3.0 g/dl. What should be included in this patient’s diagnostic workup?

An elevated TP:Albumin ratio often necessitates finding the protein(s) responsible for such an elevation. Plasma proteins largely consist of albumin and globulins such as immunoglobulins, carrier proteins, and acute phase reactants. Elevated globulin levels …

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Targeting Triglycerides

October 31, 2007
Targeting Triglycerides

Commentary by Josh Remick MD, PGY-3

Hypertriglyceridemia is defined by the NCEP guidelines for treatment as a fasting triglyceride level greater than 200 mg/dL after the target LDL-C level has been achieved (1). When triglyceride levels are greater than 1000 mg/dL, the risk of pancreatitis increases and treatment with fibrates should be started immediately. Many physicians would also argue for treatment of a triglyceride level greater than 500mg/dL. However, it is the triglyceride level between 200 and 500 mg/dL that is a bit more difficult …

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Inpatient Diabetes Management: Case 5

October 25, 2007
Inpatient Diabetes Management: Case 5

Commentary by Mary Vouyiouklis MD, Fellow, and Ann Danoff MD, Director, Division of Endocrinology, Diabetes and Metabolism, NYU Medical Center

Welcome to Case 5 of our special diabetes series intended to highlight the essentials of diabetes care in the inpatient setting. Over the last several weeks, we have been presenting individual cases followed by some management questions and answers.

Case 5: The Case of Ms. Samson

Ms. Samson is a 55 year-old woman with Lupus who was admitted to the hospital with a Lupus flare. …

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FDA Approves Label Revision for Erectile Dysfunction Drugs

October 24, 2007
FDA Approves Label Revision for Erectile Dysfunction Drugs

Commentary by Kathy Lee, Pharm.D. Pharmacy Practice Resident

On October 18 2007, the FDA announced the approval of labeling changes to erectile dysfunction (ED) drugs in the class known as phosphodiesterase type 5 (PDE-5) inhibitors. This includes drugs Cialis®, Levitra®, Viagra®, as well as Revatio®, a PDE-5 inhibitor indicated for pulmonary arterial hypertension (PAH). The label revisions draw attention to the potential risk of sudden hearing loss, sometimes associated with vestibular symptoms such as tinnitus, vertigo, and dizziness. Based on 29 postmarketing reports of this …

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Class Act: Relieving the Obstruction – Surgical Approaches to the Management of Obstructive Sleep Apnea

October 18, 2007
Class Act: Relieving the Obstruction – Surgical Approaches to the Management of Obstructive Sleep Apnea

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. Enjoy…

Commentary by Andrew Kleinberger, NYU Medical Student

Obstructive Sleep Apnea (OSA) is a syndrome of sleep-disordered breathing that has gained a great deal of attention over the past decade …

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Clinical Pharmacy Corner: How Do Sulfonylureas Work?

October 17, 2007
Clinical Pharmacy Corner: How Do Sulfonylureas Work?

Commentary by Helen Kourlas, PharmD and John Papadopoulas, PharmD, Pharmacology Section Editors

The sulfonylureas are members of a class of substituted arylsulfonylureas that have been used clinically since the 1950s. These agents are usually divided into two categories or generations. First generation agents include acetohexamide, chlorpropamide, tolazamide, and tolbutamide (the first widely utilized agent). The more potent second-generation agents include glimepiride, glipizide, and glyburide.

Sulfonylureas acutely lower plasma glucose by stimulating the release of insulin. The primary mechanism is through binding to sulfonylurea receptors (SUR-1) …

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Inpatient Diabetes Management: Case 4

October 11, 2007
Inpatient Diabetes Management: Case 4

Commentary by Mary Vouyiouklis MD, Fellow, and Ann Danoff MD, Director, Division of Endocrinology, Diabetes and Metabolism, NYU Medical Center 

Welcome to Case 4 of our special diabetes series intended to highlight the essentials of diabetes care in the inpatient setting. Over the last several weeks, we have been presenting individual cases followed by some management questions and answers.

Case 4: The Case of Mr. Gary

Mr. Gary is a 54 year-old diabetic male admitted with acute renal failure who is being evaluated for long-term …

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Why Does Hypertriglyceridemia Lead to Pancreatitis?

October 4, 2007
Why Does Hypertriglyceridemia Lead to Pancreatitis?

Commentary by Daniel Frenkel, PGY-2

Case: A 46 year old male with diabetes on oral hypoglycemic medications is admitted to the hospital with one day of constant epigastric pain, nausea, vomiting, and an inability to tolerate oral intake. You are concerned about pancreatitis but laboratory analysis reveals amylase levels that are within the normal reference range. You notice that his glucose level is 410mg/dL and that the specimen is described as lactescent. Should you still be concerned about acute pancreatitis?

Lactescent or lipemic blood samples …

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