A New Path for the ACCORD (The Action to Control Cardiovascular Risk in Diabetes) trial: Does Being Sweeter Save Lives?

February 8, 2008
A New Path for the ACCORD (The Action to Control Cardiovascular Risk in Diabetes) trial: Does Being Sweeter Save Lives?

Commentary by Melissa Freeman MD, Endocrinology Section Editor

The ACCORD trial is an ongoing 5-year, North American, randomized study that began in 2001 to evaluate potential interventions to decrease cardiovascular (CV) events in adults living with DM2.  The trial enrolled 10,251 adults, aged 40- 82, with DM2 for 10 or more years, and a history of CV disease or two CV risk factors in addition to DM2. All participants were randomized at enrollment into intensive versus standard glucose control. In addition, participants were…

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Mystery Quiz- The Answer

February 6, 2008
Mystery Quiz- The Answer

Posted By: Vivian Hayashi, MD, Instructor of Clinical Medicine, Division of General Internal Medicine and Robert Smith, MD Associate Professor of Medicine, Division Pulmonary and Critical Care Medicine

The answer to the mystery quiz is lung cancer, in particular, adenocarcinoma with a predominantly bronchoalveolar cell pattern (BAC).  The clue to the mystery was the “cough productive of voluminous frothy, watery sputum,” bronchorrhea, which is often the presenting complaint of patients with BAC. Other entries in the differential diagnosis are characterized by cough that is non-productive such as…

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Shortcuts-This Week in the Journals: The Superbowl Edition

February 5, 2008
Shortcuts-This Week in the Journals: The Superbowl Edition

Commentary By: Joshua Olstein, MD Associate Editor, Clinical Correlations

Let’s begin this week by congratulating the Superbowl XLII champion New York Giants on an excellent victory. As Americans wakes up the day after and begin to recover from our collective binge on nachos, wings, guacamole and all other things trans-fat, let us review some of the recent literature in a vascular disease-themed edition of shortcuts.

Perhaps the most concerning study in light of Sunday’s nail-bitter are the results from a study published…

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Meeting Perspectives: American Heart Association Scientific Sessions 2007- Report from the cardiology fellows

January 31, 2008
Meeting Perspectives: American Heart Association Scientific Sessions 2007- Report from the cardiology fellows

Commentary By: Steven Sedlis, MD Associate Professor of Medicine, Chief, Division of Cardiology Manhattan Veterans Administration Medical Center

This year’s AHA meeting was held in November in Orlando Florida. The cardiology fellows were not overly distracted by the attractions at Disneyworld – the social event of the week, cocktails in the lobby of the Rosen Centre Hotel with Glenn Fishman, Barry Rosenzweig, Jennifer Mieres and me was not much of a distraction either – so the fellows were able to concentrate…

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Grand Rounds: “Hyponatremia: Something Old, Something New”

January 30, 2008
Grand Rounds: “Hyponatremia: Something Old, Something New”

Commentary by Elizabeth Haskins MD, PGY-3

This week’s Grand Rounds was delivered by Dr. Tomas Berl, Chief of the Nephrology Division at the University of Colorado Health Sciences Center in Denver. Dr. Berl’s current research focuses on osmoregulated proteins of the inner medulla.

Hyponatremia, defined as a serum sodium concentration less than 136 mEq/L, is one of the most common electrolyte abnormalities in the hospitalized patient. In one Colorado hospital, the daily incidence of hyponatremia was 1% and the prevalence was 2.5%. The rate…

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Mystery Quiz

January 29, 2008
Mystery Quiz

Posted By: Vivian Hayashi, MD, Instructor of Clinical Medicine, Division of General Internal Medicine and Robert Smith, MD Associate Professor of Medicine, Division Pulmonary and Critical Care Medicine

A 78 year old man with a history of ankylosing spondylitis and known cardiac disease associated with congestive heart failure, presented with breathlessness one year prior to admission.  Over the most recent months, the patient complained of cough productive of voluminous frothy, watery sputum.  Medications included digoxin, furosemide, irbesartan, isosorbide, metoprolol, spirinolactone, simvastatin, and warfarin.  The patient had worked…

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ShortCuts-This Week in the Journals

January 28, 2008
ShortCuts-This Week in the Journals

Commentary by Henry Tran, MD

Old adage: just because it’s new doesn’t necessarily mean it’s better. The FDA approved the usage of drug-eluting stents (DES) in 2003 and these stents were quickly embraced by the cardiology community as a technological breakthrough in the treatment of coronary artery disease. It’s estimated that more than six million people worldwide have been implanted with a DES. In 2006, two studies created a lot of discussion by reporting an increased incidence of late stent thrombosis with DES…

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SSRIs: Do They Increase Rates of Suicide?

January 25, 2008
SSRIs: Do They Increase Rates of Suicide?

Commentary by Arthur Sinkman MD, NYU Department of Psychiatry

Three years ago the FDA began requiring that all selective serotonin reuptake inhibitors (SSRIs) carry a black-box warning stating that their use in children and adolescents is associated with an increase in risk for suicidal thinking, feelings and behavior. Recently the FDA ordered that this warning be extended to include treatment for young adults aged 18 to 24.

The 2004 order had a dramatic impact on the treatment of depression in children. The use of SSRIs dropped…

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