Commentary by Cara Litvin MD, Executive Editor, Clinical Correlations
As winter quickly approaches and we plunge into flu season, it’s fitting that news of a “killer” cold virus broke last week. According to a CDC report, adenovirus serotype 14 (Ad14) is an emerging strain of adenovirus that may cause severe respiratory illness and even death in people of all ages, including healthy young adults. The virus has been linked to 140 cases in 4 states (including NY) between 2006 and 2007. Over a…
Commentary by Judith Brenner MD, Associate Program Director, NYU Internal Medicine Residency Program
Published early online in NEJM comes the CORONA study “Rosuvastatin in Older Patients with Systolic Heart Failure”. In this trial, 5000 patients with class II, III and IV ischemic, systolic heart failure were randomized to receive placebo or rosuvastatin 10 mg. In prior statin trials, patients with reduced ejection fractions were not included, so this trial is important for that reason. The results surprisingly revealed no significant differences between the…
Commentary by Henry Tran, MD
Hip fractures in the elderly are associated with a very high morbidity and mortality. Often a fracture can be the prelude to an accelerated decline in the health and functionality of a patient. Most hip fractures are related to osteoporosis and the standard of care has been the use of calcium supplementation and bisphosphonates, though long term trial data to support this practice is lacking. This week in the NEJM, Lyles et al. published a trial examining the use of zoledronic…
Commentary by Michael Poles MD, Associate Editor, Clinical Correlations
This week seems like a continuation of last week in a couple of ways. Last week our Editor-In-Chief, Dr. Neil Shapiro, wrote about the epidemic of MRSA. This hit closer to home when it was reported in the lay-press that a 12-year old Brooklyn student died of an overwhelming MRSA infection that arose from a skin lesion. I implore all physicians to consider the effect of indiscriminate use of antibiotics. Furthermore, perhaps it is…
Commentary by Neil Shapiro MD, Editor-In-Chief, Clinical Correlations
As fall begins in earnest and the leaves start to change we find a diverse group of articles that make the cut and a few that didn’t quite make it but should remain on your radar screen…
Suburban parents were panicked this week by the media portraying the end of the world coming in the form of community acquired MRSA. The explosion of media interest stems from a CDC report released this week outlining…
Commentary by Sean Cavanaugh MD, Associate Editor, Clinical Correlations
Moving through the journals this week, it is all about primary care.
There was an interesting article for Primary Care MDs in this week’s NEJM. A long term follow-up of the West of Scotland Coronary Prevention Study, which compared pravastatin vs placebo in the primary prevention of coronary artery disease, demonstrated a durable decrease in events even after the treatment groups re-approximated each other. A succinct conclusion is that 5 years of treatment…
Commentary by Josh Olstein MD, Associate Editor, Clinical Correlations
As a future gastroenterologist, I was drawn to a study in the October 4th edition of the New England Journal of Medicine that compared CT colonography with colonoscopy for the detection of advanced neoplasia. Results from roughly 6300 patients who were non-randomly referred for colon cancer screening by either modality were compared and the main outcome measures included the detection of advanced neoplasia and total number of harvested polyps. Advanced neoplasia included carcinomas or…
Commentary by Danise Schiliro-Chuang MD, NYU Chief Resident
Let’s start on the theme of cardiovascular disease risk reduction, a topic making headlines this week. A September 28 New York Times article previews the release of new guidelines on perioperative care for patients undergoing noncardiac surgery. The guidelines, written by a panel of experts from the ACC and AHA, will recommend that patients undergo evaluation and treatment before noncardiac surgery only for active cardiac diseases such as severe angina, late-stage heart failure, significant arrhythmias and…
Commentary by Cara Litvin MD, Executive Editor, Clinical Correlations
The sensation of déjà vu was likely very common this week. First, we experienced a flashback to 1994 when we saw OJ in handcuffs again…and then Hillary unveiled her new plan for universal health care. Her plan would require everyone to buy insurance, but emphasizes choices, including both the currently existing private options in addition to a public plan similar to Medicare. The plan also includes tax credits for families and small businesses to…
Commentary by Henry Tran, MD
There continues to be accumulating evidence of the beneficial effects of statin therapy. Coming on the heels of the SPARCL trial, which demonstrated that high-dose atorvastatin reduces the incidence of recurrent ischemic strokes in patients with recent TIA or stroke, is a randomized trial examining the effects of statin withdrawal. Many patients with acute strokes have medications temporarily discontinued upon hospitalization, for instance due to dysphagia or apsiration risks. Blanco et al. found that patients who continued statin…
Commentary by Judith Brenner MD, Associate Program Director, NYU Internal Medicine Residency Program
Anemia is very common in ICU patients, but whether to treat this anemia and prevent the need for transfusions is currently unknown. Previous reports have actually suggested a decreased likelihood of survival associated with red cell transfusions. This week’s lead article in NEJM reports on a prospective, randomized placebo-controlled trial in which 1500 critically ill patients were treated with epoetin alfa vs placebo for up to 3 weeks. There was…
Commentary by Michael Poles MD, Associate Editor Clinical Correlations
The latest estimates from the US Census Bureau suggest that the number of uninsured Americans has increased from 44.8 million in 2005 to roughly 47 million in 2006. This jump of 5 percent is the largest one-year increase in the number of uninsured since 2002. In that year, more than 18,000 American deaths were attributable to the lack of insurance and proper health care.
Physicians commonly look to systematic reviews to obtain current…
