ID

Can you offer a liver transplant to a patient with HIV?

August 28, 2009
Can you offer a liver transplant to a patient with HIV?

Faculty Peer Reviewed

Uzma Sarwar MD

Coincident with greater use of highly active antiretroviral therapy (HAART), chronic liver disease has become one of the leading causes of death amongst HIV patients. This reflects the high prevalence of chronic liver diseases in the HIV-infected; almost a third of HIV-seropositive patients are afflicted with liver disease, predominantly as a result of hepatitis B and/or hepatitis C co-infection. Given their increased life-span, many HIV-infected patients now progress to end-stage liver disease, where…

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Why is Syphilis Still Sensitive to Penicillin?

July 30, 2009
Why is Syphilis Still Sensitive to Penicillin?

Sam Rougas MD

Faculty Peer Reviewed

It seems that every week a new article in a major newspaper is reporting what most infectious disease physicians have been preaching for several years. Antibiotic resistance is rapidly spreading. Infections such as Methicillin Resistant Staphylococcal Aureus, Extremely Drug Resistant Tuberculosis, and Vancomycin Resistant Enterococcus have journeyed from the intensive care units to the locker rooms of the National Football League. That being said, some bacteria have strangely and until recently inexplicably behaved. Syphilis, a disease caused…

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A Primer on H1N1

July 15, 2009
A Primer on H1N1

Liana Barkan MD

Faculty Peer Reviewed 

So much mystery and confusion, and yet so few answers, surround the current H1N1 Pandemic. From where did it come? How did it evolve to have genes from avian, human, and swine flu viruses? How does a virus that normally requires direct contact with the source animal develop the ability to sustain human-to-human transmission? What determines its mechanism of pathogenicity? Before we can attempt to answer these questions we need to review the basic pathophysiology…

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How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

June 11, 2009
How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

Uzma Sarwar MD

Faculty Peer Reviewed

With advancement in therapy, life expectancy has significantly increased among HIV-infected patients, and patients are now more likely to succumb to chronic disease processes. At present, approximately one third of deaths in HIV patients are related to liver disease, which has become the leading cause of death amongst HIV patients. The risk of death from liver disease in HIV patients is inversely related to their CD4 count. Infection with hepatitis C virus (HCV) accounts…

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Breaking News: Swine Flu Reaches New York

April 26, 2009
Breaking News: Swine Flu Reaches New York

Eunice Kang, MD

The Centers for Disease Control (CDC) has confirmed eight cases of swine influenza A (A/H1N1) virus infection in New York City, in addition to a dozen cases caused by the same strain scattered throughout California, Texas, Ohio, and Kansas. The eight confirmed cases in New York are in students who just returned from a trip to Mexico, where officials began reporting three separate outbreaks of influenza-like illness beginning March 18th. According to the New York Times there have…

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BREAKING NEWS: Another Nut that You’d Rather Not…

March 31, 2009
BREAKING NEWS: Another Nut that You’d Rather Not…

FDA ALERTS CONSUMERS TO RECALL OF PISTACHIO PRODUCTS

Commentary by Rebecca Hall MD, PGY-1

Growing concerns over Salmonella  contamination of pistachio products sold by Setton Pistachio of Terra Bella Inc in California have lead the manufacturer to voluntarily recall about a million pounds of its pistachio containing products. 1  The recall involves bulk lots o f roasted shelled pistachios and roasted inshell pistachios shipped on or after September 1st 2008. 2 Because pistachios are a component of numerous other products including many baked…

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Salmonella Update

March 21, 2009
Salmonella Update

Commentary by Sherley Abraham MD, PGY-3

The CDC reports there have been 666 cases and 9 deaths associated with Salmonella Typhimurium infections. The outbreak began September 1st, 2008 and has spread across 45 states, including 30 cases in New York. The source has been traced back to peanut butter and peanut paste made at the production company in Blakely, Georgia which is owned and operated by the Peanut Corporation of America. There is a nationwide product recall which can be found on the…

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Mystery Quiz- The Answer

March 10, 2009
Mystery Quiz- The Answer

Posted by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The answer to the mystery quiz is allergic bronchopulmonary aspergillosis (ABPA). The CXR shows right upper lobe opacities, two of which appear round (Image 3, arrow) and another tubular (Image 3, arrowhead), and a left upper lobe opacity which has the characteristics of subsegmental atelectasis (Image 3, double arrows). The CT scan, performed ten days after the CXR, shows central bronchiectasis of the RUL (Image 4, arrows); tubular branching shadows (Image 6, arrow) as…

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Diseases 2.0: Sepsis

February 5, 2009
Diseases 2.0: Sepsis

Diseases 2.0 – Bringing you the latest updates on disease pathophysiology and treatment

Commentary by Andrew McKinstry MD PGY-1

Faculty Peer Reviewed

For anyone who has stepped into an ICU, the septic patient is a familiar sight. Despite advances in research and management, including goal directed therapy and recombinant human activated protein C (Xigris), sepsis continues to be a major cause of mortality in the critical care setting, with an estimated 215,000 deaths annually, and costing roughly 16.7 billion dollars per year. Despite these staggering…

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Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

January 22, 2009
Should All Patients with Cellulitis Be Treated for Community-Acquired Methicillin-Resistant Staphylococcus Aureus?

Commentary by Melanie Maslow, MD, FACP, Associate Professor of Medicine, NYUSOM, Chief, Infectious Diseases, New York Harbor Healthcare System, NY

Faculty Peer Reviewed

Cellulitis is an acute spreading infection of the skin extending to the deep subcutaneous tissue characterized by pain, swelling, erythema and warmth. Cellulitis in the non-neutropenic patient, in the absence of bite wounds, salt or fresh water exposure, and coexisting ulcers is usually caused by Gram-positive pathogens, the most common being the beta-hemolytic streptococci and S .aureus, including methicillin-sensitive (MSSA) and methicillin-resistant…

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Grand Rounds: “Combating the Poverty Associated Tropical Diseases”

December 3, 2008
Grand Rounds: “Combating the Poverty Associated Tropical Diseases”

 

Commentary by Alpana Marwaha MD PGY-3

Please also see the clinical vignette presented before last week’s grand rounds.

This week, the Department of Medicine Grand Rounds was presented by Dr. Peter Hotez MD, PhD and chair of the Department of Microbiology and Tropical Medicine at GW Medical Center. The talk was entitled, “Combating The Poverty Associated Tropical Diseases.”

 

There are a staggering 1.4 Billion people living at wages below $ 1.25 per day known as the “The Bottom Billion.”…

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Grand Rounds: “Bacterial Meningitis”

September 11, 2008
Grand Rounds: “Bacterial Meningitis”

Commentary by  Stephen Carpenter MD, PGY-2

Dr. Vincent Quagliarello, Professor of Medicine at Yale University, delivered his Medicine Grand Rounds lecture entitled “Bacterial Meningitis in Adults: Principles and Practice in 2008” on Wednesday, September 3rd, 2008. He began with some of the history of the disease and noted that despite all the medical advances, bacterial meningitis still has a mortality rate of 27% and an even higher rate of 54% in poorer nations where high rates of HIV infection confound the problem.…

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