Systems

Circumcision as Primary Protection?

October 8, 2010
Circumcision as Primary Protection?

Emily Taylor, MD  

Faculty Peer Reviewed

The earliest documented evidence of circumcision is in artwork from the Sixth Dynasty in Egypt (2345-2181 BC) found in a wall relief from Saqqara in Lower Egypt. Circumcised North Americans were described by Columbus upon arrival to the continent; circumcision was practiced by Australian aboriginals, native South Americans, and Pacific Islanders. It is unknown if circumcision was common amongst some earlier ancestor of all these peoples, or if it evolved independently in societies…

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Does Vitamin D Supplementation Reduce the Risk of Cardiovascular Events?

October 6, 2010
Does Vitamin D Supplementation Reduce the Risk of Cardiovascular Events?

By Karina Vivar, MS4

Faculty Peer Reviewed

 Vitamin D deficiency is highly prevalent in the U.S. and worldwide, and the problem appears to be worsening.  By definition, vitamin D deficiency is a serum 25-hydroxyvitamin D (25-OH D) level of less than 20 ng/mL.  Vitamin D insufficiency is defined as a serum 25-OH D level from 20 to 30 ng/mL.  Unless there is a high risk for fracture and a clinical suspicion of deficiency, it is not routine to screen…

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Does Heyde Syndrome (The Association Between Aortic Stenosis And Intestinal Angiodysplasia) Exist?

September 29, 2010
Does Heyde Syndrome (The Association Between Aortic Stenosis And Intestinal Angiodysplasia) Exist?

By Laura 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 and colleagues did…

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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…

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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…

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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…

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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…

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Appropriateness for Revascularization in Stable Angina

July 22, 2010
Appropriateness for Revascularization in Stable Angina

Ramin Shayegan Hastings MD, Jonathan Willner MD, and Steven Sedlis MD

Introduction to Cases:

During the past several weeks, we have posted a series of cases addressing the appropriate treatment for patients with stable coronary artery disease. We have focused on indications for revascularization in stable angina. In all of the cases, the patients have been at high enough risk that stress tests and coronary angiography are performed.

There has been recent data and recommendations on the appropriate…

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Appropriateness for Revascularization in Stable Angina

July 1, 2010
Appropriateness for Revascularization in Stable Angina

Introduction to Cases:

During the upcoming weeks, we will post a series of cases addressing the appropriate treatment for patients with stable coronary artery disease. We will be focus on indications for revascularization in stable angina. In all of the cases, the patients will be at high enough risk that stress tests and coronary angiography will be performed.

There has been recent data and recommendations on the appropriate indications for revascularization in stable angina. These recommendations are based…

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Myths & Realities: Is Shiftwork Tumorgenic?

June 23, 2010
Myths & Realities: Is Shiftwork Tumorgenic?

By David Ecker, MD

Faculty Peer Reviewed

Over the last several decades, Westernized countries have become 24-hour societies.  Approximately 21 million workers in the US are on non-standard work shifts, including almost 4 million on regular overnight shifts.  In 1972, Taylor and Pocock published a mortality study, in which they reported a significantly increased incidence of neoplasms in shift workers compared to the general population.  After several published cancer incidence studies, Kerenyi explicitly proposed that changes in light exposure could be…

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Does Dietary Modification Help GERD?

June 18, 2010
Does Dietary Modification Help GERD?

By Ramya Srinivasan, MD

Faculty Peer Reviewed

 The patient is a 29 year old overweight male presenting to clinic with complaints of reflux symptoms. He says that spicy foods aggravate these symptoms. In addition to weight loss counseling, he is given a prescription for esomeprazole along with a patient handout containing recommendations on foods to avoid and other behavior modifications that may ameliorate his symptoms.

 Gastroesophageal reflux disease (GERD) is defined as the abnormal reflux of gastric contents into the esophagus…

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Appropriateness for Revascularization in Stable Angina

June 9, 2010
Appropriateness for Revascularization in Stable Angina

Introduction to Cases:

During the upcoming weeks, we will post a series of cases addressing the appropriate treatment for patients with stable coronary artery disease. We will be focus on indications for revascularization in stable angina. In all of the cases, the patients will be at high enough risk that stress tests and coronary angiography will be performed.

There has been recent data and recommendations on the appropriate indications for revascularization in stable angina. These recommendations are based…

Read more »