ShortCuts-This Week in the Journals

March 31, 2008
ShortCuts-This Week in the Journals

Commentary by Sean Cavanaugh MD, Associate Editor, Clinical Correlations

We start this week’s Shortcuts with the cheery news that another drug is being investigated for a possible association with mood disorder and suicidality. First there was Rimonbant, then Varenicline (Chantix) and now Singulair, a leukotriene receptor antagonist used primarily in children to treat asthma and allergic rhinitisis, is getting attention for a potential link with increased dysphoric mood and suicidality. The FDA announced their investigation last week but has not issued specific treatment…

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The Rational Clinical Examination: Does This Patient with Diabetes Have Osteomyelitis of the Lower Extremity?

March 28, 2008
The Rational Clinical Examination: Does This Patient with Diabetes Have Osteomyelitis of the Lower Extremity?

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

The most recent installment in JAMA’s Rational Clinical Exam Series seeks to determine the accuracy of the history, physical exam, radiology and laboratory in making the diagnosis of osteomyelitis in diabetics. This is relevant given its frequency of occurrence and its cost and since the gold standard for diagnosis, namely a bone biopsy and culture, is less than optimal for a variety of reasons.

Less than 10% of the…

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Noninvasive Cardiac Imaging: Coronary CT Angiography

March 26, 2008
Noninvasive Cardiac Imaging: Coronary CT Angiography

Commentary by Matt LaBarbera MD, PGY-3 and Rob Donnino, MD Instructor of Medicine, Division of Cardiology

Coronary CT angiography (CCTA) is a noninvasive imaging modality which can be used to evaluate the anatomy of the coronary arteries. Unlike coronary artery calcium scoring, which utilizes noncontrast CT to assess atherosclerotic disease burden, CCTA allows direct visualization of the coronary artery wall and lumen with the administration of intravenous contrast. The degree of coronary luminal stenosis can be reliably estimated, as can the presence or absence…

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ShortCuts-This Week in the Journals

March 25, 2008
ShortCuts-This Week in the Journals

Commentary by Henry Tran MD

The seasons of the year, like governors of New York, change quickly. And with that, we welcome the new spring, a time of rebirth and renewal!

Well sticking with the spring theme, it seems “newer blood” might be safer than “older blood.” There has been evidence to suggest that during storage, red blood cells undergo functional and structural changes which impair RBC function (termed “storage lesion”). A retrospective study from Cleveland Clinic published in the NEJM examined…

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Class Act: Are beta-blockers really contraindicated for patients with a diagnosis of reactive airway disease?

March 21, 2008
Class Act: Are beta-blockers really contraindicated for patients with a diagnosis of reactive airway disease?

Commentary by Katherine Khvilivitzky, NYU Medical Student

Class act is a feature of Clinical Correlations written by NYU 3rd and 4th year medical students. These posts focus on evidenced based answers to clinical questions related to patients seen by our students in the clinics or on the wards. Prior to publication, each commentary is thoroughly reviewed for content by a faculty member.

In the past, reactive airway disease was considered to be a contraindication to administration of all beta-blockers including ophthalmic preparations.…

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A Brief Glance at the Relationship between Varicocele and Infertility

March 19, 2008
A Brief Glance at the Relationship between Varicocele and Infertility

Commentary by Melissa Freeman MD, PGY-2

A 30 year-old male resident presents to his primary care physician for a routine physical examination. A small, nontender left-sided scrotal mass is felt. The patient states that this asymptomatic mass has been present for one year and was evaluated by a prior physician who felt that further work-up was unnecessary. He is sent for a testicular ultrasound which reveals a grade II varicocele. His testosterone level was low and he later had a semen analysis which was abnormal.…

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ShortCuts-This Week in the Journals

March 17, 2008
ShortCuts-This Week in the Journals

Commentary by Josh Olstein MD, Associate Editor, Clinical Correlations

Let’s begin this St. Patrick’s Day edition of ShortCuts with a look across the pond. An article published in this week’s edition of The Lancet that studied the use of antibiotics for adults with acute rhinosinusitis. Anyone who’s been to clinic this winter knows that rarely a session goes by without at least one patient requesting antibiotics for this more-than-questionable indication. By performing a meta-analysis using individual patient data from nine placebo-controlled trials of…

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Breaking Bad News to Patients- A Challenge for Residents

March 13, 2008
Breaking Bad News to Patients- A Challenge for Residents

Commentary by Parul Gandhi MD, PGY-2

Bad news can be defined as “Situations where there is either a feeling of no hope, a threat to a person’s mental or physical well-being, a risk of upsetting an established lifestyle, or where a message is given which conveys to an individual fewer choices in his or her life.”(1)

As residents, we spend our time caring for patients and their families. Despite all of our valiant efforts, though, there are times when we must deliver…

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