Systems

Decoding the APOL1 Kidney

September 25, 2013
Decoding the APOL1 Kidney

By Areeba Sadiq

Faculty Peer Reviewed

African American patients have a higher risk of developing end-stage renal disease (ESRD) than their Caucasian counterparts . If over the age of 70, that risk is 3 times higher. If between the ages of 60-69, the risk is 8 times higher. And, if between 30 and 39, African American patients are an astounding 11 times more likely to develop ESRD . Why are African Americans more likely to develop ESRD? What is different about the African American kidney?…

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The DLO: Does FFP Correct INR?

September 20, 2013
The DLO: Does FFP Correct INR?

By Nicole A Lamparello, MD

Faculty Peer Reviewed

Page from the hematology laboratory: critical lab value; INR 1.9. Liver biopsy scheduled for tomorrow. What is a knowledgeable physician practicing evidence-based medicine to do?

Fresh frozen plasma (FFP) is the liquid, acellular component of blood. FFP contains water, electrolytes, and the majority of the coagulation proteins . It is frequently transfused to patients with an elevated prothrombin time (PT), a measure of the activity of the common coagulation pathway (involving factors X, V, prothrombin and fibrinogen)…

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Diagnostic Dilemma-Poststreptococcal Reactive Arthritis in a Pregnant Woman

September 18, 2013
Diagnostic Dilemma-Poststreptococcal Reactive Arthritis in a Pregnant Woman

By Bryan Stierman and Todd Cutler, MD

Faculty Peer Reviewed

Case Presentation

A 35-year-old Hispanic woman presented to the emergency room with severe joint pain and swelling for one week.

The patient had a history of hypothyroidism and hepatitis C which was treated with interferon therapy two years prior. She was recently discovered to be pregnant and, at the time of presentation, was in her tenth week of pregnancy. Three weeks prior to admission she developed a sore throat. She saw an outside care provider…

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Does Running Cause Knee Osteoarthritis?

September 14, 2013
Does Running Cause Knee Osteoarthritis?

By Karin Katz, MD

Faculty Peer Reviewed

Post-summer is here. Despite the heat and what feels like 100% humidity, the East River Path is packed with runners. No amount of car fumes pouring onto the path could stop those in training. Others are circling the 6-mile-loop around Central Park. Or, if you are bored of running the typical routes, for a few Saturdays, Park Avenue will be shut down for automobile traffic. New Yorkers love to run (well, some do). And while unforeseen circumstances…

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An Evaluation of Basic Running Techniques: A Guide for Health Practitioners and the Novice Runner

September 11, 2013
An Evaluation of Basic Running Techniques: A Guide for Health Practitioners and the Novice Runner

By Austin Peters, MD

Faculty Peer Reviewed

Introduction

Running injuries are common, afflicting greater than two-thirds of frequent runners each year. Despite the abundance of available resources, there are no clear guidelines to extend to patients on the subject of proper running technique in order to avoid repeat or worsening injuries. Though specialized intervention may be in order for more severe cases, novice runners and those who have not been active in the sport for some time may benefit from basic instructional advice. The purpose…

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Confocal Microscopy To Noninvasively Detect Skin Cancer: An Emerging Technology To Avoid Unnecessary Skin Biopsy

September 6, 2013
Confocal Microscopy To Noninvasively Detect Skin Cancer: An Emerging Technology To Avoid Unnecessary Skin Biopsy

By Brian Park

Faculty Peer Reviewed

Skin cancer is the most common type of cancer worldwide. In the United States, the incidence is rising, with over two million people diagnosed each year . More cases of skin cancer are diagnosed each year than breast, prostate, lung, and colon cancer combined. The lifetime risk of developing skin cancer is estimated to be 20% . Although nonmelanoma skin cancer is rarely fatal and associated with a very low mortality rate, melanoma can be highly fatal. Approximately 76,000…

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Down-And-Out With Diabetes: Caring For The Homeless Diabetic Patient

August 23, 2013
Down-And-Out With Diabetes: Caring For The Homeless Diabetic Patient

By Sara Gallant

Faculty Peer Reviewed

Each year in the US, an estimated 2.3–3.5 million individuals are homeless . Homelessness has a complicated association with poor health. People at risk for losing their home tend to have heavier disease burdens. In New York City, 6.3% of a subset of newly homeless people had diabetes mellitus, compared to 1.9% of the same age group in the general US population . In return, homelessness poses unique challenges to receiving and adhering to treatment for diabetes. The rewards…

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From The Archives: Does Heyde Syndrome Exist?

August 8, 2013
From The Archives: Does Heyde Syndrome Exist?

Please enjoy this post from the Archives dated September 29, 2010

By Lara Dunn, MD

Faculty Peer Reviewed

In 1958, EC Heyde published 10 cases of aortic stenosis (AS) and arteriovenous malformations (AVMs) of the gastrointestinal tract in the New England Journal of Medicine . Thus, the association between aortic stenosis and intestinal angiodysplasia became known as Heyde Syndrome. Yet the existence of this syndrome has been controversial.

Contrasting conclusions have been obtained by studies conducted to evaluate this association. In a prospective study, Bhutani…

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Transfusions By The Numbers

July 19, 2013
Transfusions By The Numbers

By Karen Chang Kan, MD

Faculty Peer Reviewed

Blood transfusions are one of the most common interventions seen in the inpatient setting. While hanging a unit of blood appears simple enough in day-to-day practice, many of us forget what this simple action actually entails. Taking a moment to reflect, Clinical Correlations breaks down this basic, everyday intervention by the numbers.

How much blood are we transfusing?

In the United States, it is estimated that approximately 14.65 million units of whole blood/RBCs are transfused each year.…

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The Health Risks and Benefits of Drinking Coffee

July 17, 2013
The Health Risks and Benefits of Drinking Coffee

By Anish Parikh, MD

Faculty Peer Reviewed

At some point during my medical training, drinking coffee went from being an enjoyable, even indulgent, activity to being my primary weapon against fatigue and its associated decline in cognitive function. Although realizing this made me critically, and somewhat resentfully, evaluate my own consumption of coffee, it also made me think more generally about the role of coffee in today’s world. In the hospital, where many of us spend most of our time, coffee is ubiquitous. However, such…

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From The Archives: Why Does Multiple Myeloma Treat The Kidneys So Poorly?

July 11, 2013
From The Archives: Why Does Multiple Myeloma Treat The Kidneys So Poorly?

Please enjoy this post from the Archives dated September 22, 2010

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…

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Are We Too Hesitant to Anticoagulate Elderly Patients with Atrial Fibrillation? A Risk-Benefit Analysis

June 28, 2013
Are We Too Hesitant to Anticoagulate Elderly Patients with Atrial Fibrillation? A Risk-Benefit Analysis

By Sunny N. Shah, MD

Faculty Peer Reviewed

Background:

Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence increases with age. In fact, the lifetime incidence of AF is approximately 25% in individuals by age 80, with the incidence nearly doubling with each decade of life after age 50. (1) Multiple randomized controlled trials have shown that oral antithrombotic therapy with warfarin or aspirin decreases the risk of ischemic stroke in patients with AF. (2-6) Meta-analyses reveal a relative risk reduction of…

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