PrimeCuts

ShortCuts-This Week in the Journals

July 16, 2007
ShortCuts-This Week in the Journals

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

This week we focus on breast cancer and the outcome associated with hereditary factors and controversies surrounding the seemingly uncontroversial annual physical exam

This week’s New England Journal of Medicine reports on clinical outcomes in patients with breast cancer who carry the BRCA1 and BRCA2 mutations.  The investigators set out to answer the question of whether breast cancers associated with BRCA1 and BRCA2 mutations are associated with a poorer outcome,…

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ShortCuts-This Week in the Journals

July 9, 2007
ShortCuts-This Week in the Journals

This week finds us talking about markers for chronic kidney disease (remember we’re no longer allowed to use terms such as renal insufficiency),  a bit of positive news about a popular alternative medicine, a new inflammatory marker for coronary artery disease, a genetic basis for atrial fibrillation and most importantly the value of an adequate intake of chocolate.

The 7/3 issue of the Annals of Internal Medicine furthers our knowledge of cystatin c as an eventual replacement for creatinine and gfr.  Cystatin c is a serum…

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Shortcuts-This Week in the Journals

July 2, 2007
Shortcuts-This Week in the Journals

Commentary By: Josh Olstein, M.D. Chief Resident Internal Medicine

This week, the NEJM released the results of a survey about needlestick injuries among surgical residents. The frequency of needlestick injuries were quite high, residents averaged 3.8 injuries across all years of training. By their fifth year of training 99% of residents had experienced at least one needlestick injury. Perhaps the most shocking statistics however were the frequency of unreported needlestick injuries, including those related to high-risk patients. When surveyed about their latest exposure,…

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ShortCuts-This Week in The Journals

June 25, 2007
ShortCuts-This Week in The Journals

Commentary By: Sean Cavanaugh MD, Associate Editor Clinical Correlations

Not much in the way of surprise, a lot of the articles in the press this past week focused on cardiovascular health.

In the Lancet, the results of the VALIDD trial (the acronyms are getting a bit ridiculous eh?) were published. Although it seems that valsartan was not more effective than other agents at improving diastolic dysfunction, it seems that lowering the blood pressure aggressively (using any agents) DID effectively improve diastolic functioning.…

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ShortCuts-This Week in The Journals

June 18, 2007
ShortCuts-This Week in The Journals

A study reported in this week’s issue of JAMA attempts to correlate preoperative hematocrit levels with postoperative outcomes in elderly veterans undergoing noncardiac surgery. Both 30-day postoperative mortality and cardiac event rates increased in patients with hematocrits either higher or lower than the normal range (39 to 53.9%). A 1.6% increase in mortality was associated with every percentage point positively or negatively deviating from the normal range. Although compelling, this study does not establish a causal relationship between hematocrit and postoperative complications, and…

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ShortCuts- This Week in the Journals

June 11, 2007
ShortCuts- This Week in the Journals

It has been a little while, but stem cells are back in the news. Congress has passed legislation to provide more money for stem cell research, but did not reach a veto-proof majority. Meanwhile, scientists at MIT have successfully transformed mice skin cells into the equivalent of embryonic stem cells. The presumption is that these cells, which are indistinguishable from embryonic stems cells can then be forced to develop into any tissue under the proper stimulation. While this approach might obviate the need to…

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ShortCuts-This Week in the Journals

June 4, 2007
ShortCuts-This Week in the Journals

Much of the week in the media was spent discussing XDR TB. Andrew Speaker, a man on his way to his wedding in Santorini Greece (the picture of his wedding is to the right) managed to evade US security multiple times. The story is convoluted with many people telling different versions. It appears that he has smear negative, culture positive XDR-TB. His now father-in-law is a TB researcher, who insists that his new son-in-law did not catch it from his lab. Most importantly, when officials…

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ShortCuts-This week in the Journals

May 29, 2007
ShortCuts-This week in the Journals

The big bomb this past week was the Rosiglitazone Effect. Resulting in front page news in various newspapers (on multiple days), the meta-analysis in last week’s NEJM is causing quite the stir. For more information, see the post.

What’s old is what’s new. An interesting editorial on Medpage reviewed the reason that HCTZ is the most commonly prescribed thiazide, and it’s not efficacy. HCTZ is 4 letters and takes a second to write on a pad, chlorthalidone is 14 letters and, while possibly the…

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ShortCuts-This Week in the Journals

May 21, 2007
ShortCuts-This Week in the Journals

This week’s review is a potpourri of interesting if not groundbreaking articles.

The pharmaceutical industry certainly got off easier this week (see last week’s shortcuts) and the New York Times focused instead on the “industrialization” of the art of medicine. A hospital group in central Pennsylvania is offering insurers and patients bypass surgery for a flat fee with a 90 day guarantee. They’ve put 40 measures in place to make sure patients receive evidenced based care. If the any of the 40 measure…

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ShortCuts-The War on the Pharmaceutical Industry Edition

May 14, 2007
ShortCuts-The War on the Pharmaceutical Industry Edition

Welcome to our first theme issue of ShortCuts. This week, we decided to focus on the tribulations of the pharmaceutical industry, which recently seems to be plagued by new FDA advisories and NY Times exposés.

The first bad news for pharmaceutical companies occurred on May 2nd when the FDA expanded its black box warning on antidepressant medications, stating that the drugs may have the potential to increase suicidal symptoms in young adults between the ages of 18 and 24. The warning, previously targeting…

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ShortCuts-This Week in the Journals

May 7, 2007
ShortCuts-This Week in the Journals

9p21. More than just three numbers and one letter, this stretch of DNA, which is present in 1 out of five Caucasians, results in a 64% increase in the risk of myocardial infarction. Two groups, performing genome-wide association studies, made this discovery, which would not have been possible before the work of the Human Genome Project. It should be noted that this mutation is not present in Africans and does not confer an increased risk in African Americans. This stretch of DNA is also…

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ShortCuts-This Week in the Journals

April 30, 2007
ShortCuts-This Week in the Journals

In the present era of almost daily “landmark trial” publications, the literature this past week took a slightly more introspective turn. Two separate journals turned the spotlight back on the uneasy relationship between commerce and science – and well written and thoughtful editorials accompany each.

An analysis in the week before last’s BMJ called attention to the increasing trend toward designing trials with composite endpoints – and suggested that this tendency is potentially misleading. In a sample of 114 cardiovascular trials with composite primary end…

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