Elevated Total Protein and the Interpretation of Serum Protein Electrophoresis

November 1, 2007
Elevated Total Protein and the Interpretation of Serum Protein Electrophoresis

Commentary by Jamie Hoffman, MD 

A healthy 54 year old man without past medical history presents for a routine physical exam for his insurance company. His blood work reveals a total protein (TP) of 9.4 g/dl and an albumin of 3.0 g/dl. What should be included in this patient’s diagnostic workup?

An elevated TP:Albumin ratio often necessitates finding the protein(s) responsible for such an elevation. Plasma proteins largely consist of albumin and globulins such as immunoglobulins, carrier proteins, and acute phase reactants.…

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Targeting Triglycerides

October 31, 2007
Targeting Triglycerides

Commentary by Josh Remick MD, PGY-3

Hypertriglyceridemia is defined by the NCEP guidelines for treatment as a fasting triglyceride level greater than 200 mg/dL after the target LDL-C level has been achieved (1). When triglyceride levels are greater than 1000 mg/dL, the risk of pancreatitis increases and treatment with fibrates should be started immediately. Many physicians would also argue for treatment of a triglyceride level greater than 500mg/dL. However, it is the triglyceride level between 200 and 500 mg/dL that is a bit more difficult to…

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ShortCuts-This Week in the Journals

October 29, 2007
ShortCuts-This Week in the Journals

Commentary by Michael Poles MD, Associate Editor, Clinical Correlations

This week seems like a continuation of last week in a couple of ways. Last week our Editor-In-Chief, Dr. Neil Shapiro, wrote about the epidemic of MRSA. This hit closer to home when it was reported in the lay-press that a 12-year old Brooklyn student died of an overwhelming MRSA infection that arose from a skin lesion. I implore all physicians to consider the effect of indiscriminate use of antibiotics. Furthermore, perhaps it is…

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Inpatient Diabetes Management: Case 5

October 25, 2007
Inpatient Diabetes Management: Case 5

Commentary by Mary Vouyiouklis MD, Fellow, and Ann Danoff MD, Director, Division of Endocrinology, Diabetes and Metabolism, NYU Medical Center

Welcome to Case 5 of our special diabetes series intended to highlight the essentials of diabetes care in the inpatient setting. Over the last several weeks, we have been presenting individual cases followed by some management questions and answers.

Case 5: The Case of Ms. Samson

Ms. Samson is a 55 year-old woman with Lupus who was admitted to the hospital with a…

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FDA Approves Label Revision for Erectile Dysfunction Drugs

October 24, 2007
FDA Approves Label Revision for Erectile Dysfunction Drugs

Commentary by Kathy Lee, Pharm.D. Pharmacy Practice Resident

On October 18 2007, the FDA announced the approval of labeling changes to erectile dysfunction (ED) drugs in the class known as phosphodiesterase type 5 (PDE-5) inhibitors. This includes drugs Cialis®, Levitra®, Viagra®, as well as Revatio®, a PDE-5 inhibitor indicated for pulmonary arterial hypertension (PAH). The label revisions draw attention to the potential risk of sudden hearing loss, sometimes associated with vestibular symptoms such as tinnitus, vertigo, and dizziness. Based on 29 postmarketing reports of this incidence,…

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ShortCuts-This Week in the Journals

October 22, 2007
ShortCuts-This Week in the Journals

Commentary by Neil Shapiro MD, Editor-In-Chief, Clinical Correlations

As fall begins in earnest and the leaves start to change we find a diverse group of articles that make the cut and a few that didn’t quite make it but should remain on your radar screen…

Suburban parents were panicked this week by the media portraying the end of the world coming in the form of community acquired MRSA. The explosion of media interest stems from a CDC report released this week outlining…

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Clinical Pathology Conference 10/12/07-The Answer

October 19, 2007

Case Presentation by Elizabeth Ross, MD, Chief Resident

Please review the posting of last week’s CPC here.

When you’re ready you can download the CPC Answer.

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Class Act: Relieving the Obstruction – Surgical Approaches to the Management of Obstructive Sleep Apnea

October 18, 2007
Class Act: Relieving the Obstruction – Surgical Approaches to the Management of Obstructive Sleep Apnea

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. Enjoy…

Commentary by Andrew Kleinberger, NYU Medical Student

Obstructive Sleep Apnea (OSA) is a syndrome of sleep-disordered breathing that has gained a great deal of attention…

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