Systems

Grand Rounds: “Innate Immunity and Viral Pathogenesis”

December 4, 2007
Grand Rounds: “Innate Immunity and Viral Pathogenesis”

Commentary by Urania Rappo, PGY-2

This week’s Medicine Grand Rounds guest lecturer was Dr. Robert Finberg, currently Chair of the Department of Medicine at the University of Massachusetts Medical School. He earned his MD from Albert Einstein College of Medicine and trained in Medicine at Bellevue Hospital starting in 1974. He was a Fellow in Infectious Diseases at Harvard Medical School, and there established a rich research career over the ensuing twenty years. Dr. Finberg’s research focuses on host-microbial interactions, defining the cell surface proteins …

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Grand Rounds: Breast Cancer Genomics

November 20, 2007
Grand Rounds: Breast Cancer Genomics

Commentary by Jonathan Willner MD, PGY-2

This week’s Medicine Grand Rounds speaker was Lisa Carey, MD, Associate Professor in Hematology/Oncology at the University of North Carolina and Medical Director of the UNC Breast Center.  Much of Dr. Carey’s research focuses on how an understanding of breast cancer genomics may tailor clinical therapy.

While the incidence of breast cancer has plateaued over the past few years, there has been a decline in the number of breast cancer deaths. The reason is thought to be two-fold: improved …

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Treatment of obesity with bariatric surgery: evidence and implications

November 15, 2007
Treatment of obesity with bariatric surgery: evidence and implications

Commentary by Jatin Roper MD PGY-3 and Christine Ren MD Associate Professor, Department of Surgery

Bariatric procedures to treat obesity involve the restriction of the gastric reservoir, bypass of part of the gastrointestinal tract, or both. Worldwide, an estimated 300 million people are obese, and in the United States, the percentage of adults who are obese increased from 15% in 1995 to 24% in 2005. (Obesity is defined as a Body Mass Index or BMI of 30 or more, measured as kg / m2; for …

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FDA Approves Raltegravir- A First in New Class of HIV Medications

November 14, 2007
FDA Approves Raltegravir- A First in New Class of HIV Medications

Commentary by Helen Kourlas PharmD, Pharmacology Section Editor

On October 16th the FDA announced the approval of raltegravir (Isentress®) for the treatment of Human Immunodeficiency Virus (HIV)-1 infection in combination with other antiretroviral agents. The use of raltegravir is recommended for patients who have HIV-1 strains resistant to multiple antiretroviral medications. Raltegravir belongs to a new pharmacologic class of antiretrovirals called HIV integrase strand transfer inhibitors. Integrase is one of the three enzymes necessary for the HIV-1 virus to replicate, and integrase inhibitors can stop …

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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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