Commentary by Cara Litvin MD, Executive Editor, Clinical Correlations

Published in the NEJM this week was a study intended to conclusively determine whether corticosteroids are an effective adjunctive therapy in severe sepsis. Although corticosteroid use is a widely accepted therapy for the treatment of sepsis, prior evidence supporting this practice has been lacking. In this multicenter randomized double-blind trial (CORTICUS), ICU patients were randomized to receive a full course of hydrocortisone therapy versus placebo. Corticotropin stimulation tests were performed in all patients. The…

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Commentary by Judith Brenner MD, Associate Program Director, NYU Internal Medicine Residency Program

This week’s Annals of Internal Medicine focused on angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). Two studies addressed questions such as: Which class (ACE/ARB or both) is more effective as an anti-hypertensive? Which class is more effective for proteinuria? What are the adverse events of the combination? What are long term outcomes?

The first article was a systematic review that compares these drugs as anti-hypertensive agents.…

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Commentary by Michael Poles MD, Associate Editor, Clinical Correlations 

Another week, another set of shortcuts, so let’s take a quick look around the world of medical happenings. A quick trip into the strange. The blogosphere presented the story of Mr. Paul Karason. Why did we hear about Mr. Karason? Well, he is blue. No, not sad, but really blue. His skin is tinged blue from chronic usage of colloidal silver as an alternative medicine remedy. While completely unproven, some people use colloidal silver as…

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Commentary By: Neil Shapiro, M.D., Editor-In-Chief, Clinical Correlations

It’s hard to believe there was other news this week besides the black cloud that has now been cast over all of baseball.  Barry Bonds must be smiling somewhere knowing that others have now climbed aboard his sinking ship…in fact I had a dream last night that the Yankees were even stripped of their 2000 World Series title just like all those cheating olympic athletes and the title of 2000 World Champions was awarded to the World…

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Commentary By: Sean Cavanaugh, M.D. Associate Editor Clinical Correlations

Science magazine published the first practical application of the induced pluripotent stem (IPS) cells in a mouse model for sickle cell anemia. As was recently published, skin cells can be transformed into pluripotent cells by the insertion of genes Oct4, Sox2, Lif4 and c-Myc, known to act together as master regulators, to keep cells in an embryonic stem cell-like state. In this experiment, gene specific targeting of these cells corrected the sickle cell gene…

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Commentary by Josh Olstein MD, Associate Editor, Clinical Correlations 

Med consults rejoice! The long awaited updated guidelines for perioperative cardiac evaluation and management for non-cardiac surgery were published in last month’s edition of Circulation. There are several key changes in both the approach to pre-operative cardiac evaluation and peri-operative cardiac medication management. Among these changes is the recognition that non-invasive testing for coronary artery disease is unlikely to change management, and is therefore no longer recommended in several situations for which testing was…

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Commentary by Danise Schiliro-Chuang MD, NYU Chief Resident 

While most of us were enjoying way too much turkey this week, some interesting activity in the world of pharmaceuticals was taking place. Let’s take a peak.

Two studies published in the November 22 issue of the New England Journal of Medicine may offer new hope in the treatment of refractory multiple myeloma (MM). Thalidomide, an immunomodulatory drug, has activity in about one third of patients with relapsed or refractory MM, an effect that is…

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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…

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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…

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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…

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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…

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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…

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