How to interpret troponins in renal disease?

October 21, 2009
How to interpret troponins in renal disease?

Ivan Saraiva MD

Case: A 68-year-old man, with a history of stable angina and end-stage renal disease treated by hemodialysis for the past three years, presents to the hospital with leg swelling and shortness of breath. He also complains of intermittent chest pain unrelated to exertion. Physical exam reveals bilateral pitting lower extremity edema, pulmonary crackles, and an elevated jugular venous pressure. Initial electrocardiogram is notable for some nonspecific repolarization abnormalities. Troponin I levels drawn at 0, 6, and 12 hours after initial presentation are …

Read more »

PrimeCuts: This Week in the Journals

October 19, 2009
PrimeCuts: This Week in the Journals

Chau Che MD

This week ended on a high note in the financial world. The Dow bounced back and crossed the 10,000 mark this week, ultimately ending the week slightly below that mark and Goldman Sachs posted a profit of 3.19 billion in the third quarter, signifying a hopeful return to the days before the financial crisis. However, in retrospect, the financial crisis of 2007 was preventable and could have been avoided if the banks gave out loans with a bit more discretion. The hopeful …

Read more »

It’s Lyme Season: How Should You Manage the Tick-bitten Patient?

October 14, 2009
It’s Lyme Season:  How Should You Manage the Tick-bitten Patient?

Joshua Allen-Dicker

Faculty peer reviewed

A healthy 42-year old patient presents to your office after a day of hiking with his family in Upstate New York. This morning in the shower he found a “big black tick” on his right leg. He is currently asymptomatic and wants to know what his risk of Lyme disease is.

For New York City physicians, the end of summer and beginning of fall herald a spike in cases of Lyme Disease. Each year in the United States, over 19,000 …

Read more »

PrimeCuts: This Week in the Journals

October 12, 2009
PrimeCuts: This Week in the Journals

Michael Tees, MD, MPH

While the news was dominated by President Barack Obama winning the Nobel Peace Prize, other American Nobel Laureates should not be forgotten. After all, Elizabeth Blackburn, Carol Greider and Jack Szostak waited over 20 years for theirs. These American scientists shared the Nobel Prize in Physiology or Medicine this week “for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase”. American scientists this year are also sharing the Nobel Prize in the field of Chemistry as well …

Read more »

Medicine by the Numbers

October 9, 2009
Medicine by the Numbers

Chris Tully MD

Faculty peer reviewed

What is the number of patients needed to prophylax to prevent an episode of venous thromboembolism in a hospitalized medical patient?

 

 The use of prophylactic anticoagulation for venous thromboembolism (VTE) is considered standard of care in the inpatient medical setting in order to prevent deep venous thrombosis (DVT) and fatal and nonfatal pulmonary embolism (PE). While a majority of the knowledge stems of post-surgical patients, there has been an increasing volume of research emphasizing and illustrating the benefit in …

Read more »

What is Wellens’ Syndrome?

October 7, 2009
What is Wellens’ Syndrome?

Erin Ducharme MD

Faculty peer reviewed

Wellens’ syndrome refers to a pattern of ECG signs occurring during chest-pain free periods in patients with unstable angina, heralding critical, proximal left anterior descending artery (LAD) stenosis . The eponym honors Dr. Hein J.J. Wellens who first described this ECG phenomenon in 1982. Wellens and colleagues identified a subgroup of patients with unstable angina who demonstrated a pattern of inverted precordial T-waves which strongly correlated with early large anterior myocardial infarction (MI) and a poor prognosis . In …

Read more »

Primecuts-This Week in the Journals

October 5, 2009
Primecuts-This Week in the Journals

Rachana Jani MD

Faculty Peer Reviewed

As summer officially leaves us and fall sets in, the headlines understandably continue to focus on preventative medicine.  Hopes of an H1N1 vaccine were finally realized last week when Sanofi Pasteur sent out the first batch of this much anticipated vaccine . This week, according to the CDC, 3.4 million doses will be available in the form of a live attenuated nasal spray, which may or may be supplemented with an injectable vaccine.  However, even with the wide availability …

Read more »

Sleep, Memory, and Medical Students

October 2, 2009
Sleep, Memory, and Medical Students

Megan Mulligan

Faculty peer reviewed by Dr. David Rapoport

The role of sleep in memory formation is an intriguing topic that has garnered widespread interest among researchers in recent years. The subject has seen a doubling in the number of publications every decade, yet the mechanism by which memories are formed remains elusive. There is little debate that sleep is important for memory, which begs the question: What does the role of sleep in memory imply for the infamously sleep-deprived medical trainee? This brief review …

Read more »