PrimeCuts: This Week in the Journals

March 22, 2010
PrimeCuts: This Week in the Journals

 
Carolyn Bevan MD

Faculty peer reviewed

 

 This week, as the House passed the Patient Protection and Affordable Care Act, the medical community highlighted some of its most recent achievements in medical science. The 59th Annual Scientific Session of the American College of Cardiology convened from March 14-16. The meeting delivered on its promise of presenting some of the most exciting developments in the field, including new drugs, new data on safety and efficacy, and updates in interventional technology (1). Meanwhile, the Journal of the American …

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Mystery Quiz

March 17, 2010
Mystery Quiz

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

The patient is a 39yo male followed in pulmonary clinic for chronic breathlessness and intermittent sputum production, sometimes blood tinged. Symptoms were first noted eleven years earlier at which time pulmonary function testing revealed mixed obstructive and restrictive defects. The patient experienced some improvement with bronchodilators, occasional courses of oral steroids and antibiotics, but was never entirely free of his symptoms. Over an interval of ten years, the patient required several hospitalizations for treatment …

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PrimeCuts: This Week in the Journals

March 15, 2010
PrimeCuts: This Week in the Journals

Christopher Tully MD

Faculty peer reviewed

Hello again Primecutters and welcome to another edition of your favorite weekly blog. Our fearless editor has allowed me a repeat performance of last week and I am honored to provide the followers of this column with another scintillating tale of the week’s medical knowledge.Dyslipidemia is a common clinical problem and its control is a mainstay of inpatient and outpatient internal medicine. While statins are miraculous in their ability to treat and control abnormal lipid levels, many patients require …

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When Clopidogrel Fails…

March 10, 2010
When Clopidogrel Fails…

Marisa Mizus

Faculty peer reviewed

Clopidogrel (Plavix) has been the standard of care for patients with coronary artery disease following percutaneous coronary intervention (PCI) for the past decade.  Although it is a successful antiplatelet treatment in many patients, like any hero, it has a weakness: formation of its active metabolite depends on two hepatic cytochrome P450 (CYP450)-dependent steps.  Clopidogrel resistance, or non-response, is correlated with an increased risk of major adverse cardiovascular events, including reinfarction and stent thrombosis.(1)  It is often unclear why a patient …

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PrimeCuts: This Week in the Journals

March 8, 2010
PrimeCuts: This Week in the Journals

Christopher Tully MD

Faculty peer reviewed

Although the frequent rounds of snow hitting New York City and First Avenue (hopefully) seem to be coming to an end and the outside world is drawing New Yorkers out of their winter bubbles, Primecuts is still here inside for your indoor reading.  

In an open-label, randomized controlled trial based in South Africa and published in the NEJM,  patients diagnosed with both HIV infection and tuberculosis were assigned to start anti-retroviral therapy either during tuberculosis therapy or after completion …

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When Minutes Matter: Why Do Patients Wait to Seek Treatment Following a Stroke or Heart Attack?

March 3, 2010
When Minutes Matter: Why Do Patients Wait to Seek Treatment Following a Stroke or Heart Attack?

Laurel Geraghty

Faculty peer reviewed

Both stroke and heart attack require rapid treatment following the onset of symptoms to minimize morbidity and mortality, but few patients seek help in a timely manner. Only about half of patients with acute myocardial infarction (AMI) or stroke arrive to the emergency department within four hours of the onset of symptoms.,,, Every 30-minute delay in treatment following AMI increases one-year mortality by 7.5%, and almost half of the 167,000 annual stroke deaths in this country occur before the patient …

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PrimeCuts: This Week in the Journals

March 1, 2010
PrimeCuts: This Week in the Journals

Ishmeal Bradley MD

Faculty peer reviewed

As America enters Year Two of the current economic recession, unemployment and underemployment still remain incontrovertibly high. Not surprisingly, doctors, like other Americans, are working fewer hours these days, too. The New York Times published the result of a study from JAMA this week about the decline in the number of hours that physicians put in per week (1, 2). In their population survey study, they queried over 27,000 doctors from 1977 to 2007 about how much they worked …

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Zolpidem and Uncontrollable Nocturnal Eating Binges

February 24, 2010
Zolpidem and Uncontrollable Nocturnal Eating Binges

John Cruz

Faculty peer reviewed

A number of studies have shown that zolpidem (Ambien), the most commonly prescribed sleep-inducing medication on the market, can produce uncontrollable nocturnal eating behavior among users.  Sleep related eating disorder (SRED) is characterized by partial arousals from sleep to ingest food, usually within the first three hours after sleep onset, occurring one to six times per night.1  Patients describe an “automatic” inclination to eat and an inability to return to sleep unless they eat.  The foods are often high in …

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