ShortCuts-This Week in the Journals

June 2, 2008
ShortCuts-This Week in the Journals

Commentary by Henry Tran, MD

Opiate-induced constipation is frequently encountered by hospitalized patients. As Ben Franklin said, “An ounce of prevention is worth a pound of cure,” therefore an aggressive bowel regiment of stool softeners and laxatives will often prevent this problem from becoming a serious one. Not shockingly conventional bowel regiments sometimes don’t work and clinicians must resort to other treatments. Oral naloxone (Narcan) in escalating doses has been shown to be a successful treatment for opiate-induced constipation and even for post-op…

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Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 2

May 29, 2008
Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 2

Commentary by Brian Bronson, MD, Chief of Psychosomatic Medicine, VA New York Harbor, New York Campus

Summary: Symptoms of depression in the medical setting may not respond to usual pharmacologic antidepressant treatment for a number of reasons. These may include an incorrect psychiatric diagnosis; failure to consider underlying medical causes of the symptoms; or insufficient antidepressant medication trial due to poor patient adherence, insufficient dose or length of trial. There is no consensus as to the definition of ‘treatment refractory’ depression. However,…

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ShortCuts-This Week in the Journals

May 28, 2008
ShortCuts-This Week in the Journals

Commentary by Josh Olstein MD, NYU Chief Resident 

This week’s edition of shortcuts begins with an article from the NEJM looking at the role of cardiac troponin in patients with acute decompensated heart failure. Many of us have “cycled the trops” countless times to evaluate patients with chest pain. However the utility of troponin measurement in patients with CHF is less clear. In this study the authors examined short-term outcomes of patients admitted with CHF exacerbations that had troponin data available on…

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Riegel v. Medtronic: Vaccination Against Medical Device Liability?

May 24, 2008
Riegel v. Medtronic: Vaccination Against  Medical Device Liability?

Commentary by Sandeep Mangalmurti MD, JD PGY-2

It is difficult to overstate the importance of the Supreme Court’s recent decision in Riegel v. Medtronic the first of a series of cases that may fundamentally alter medical liability lawsuits for decades to come.

The case involves Charles Riegel, who in 1996 suffered complications secondary to coronary angioplasty. During the procedure, the angioplasty balloon burst, and the patient required emergent coronary artery bypass graft to save his life. He later sued Medtronic, the…

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Meeting Perspectives: American College of Cardiology, Part 3

May 22, 2008
Meeting Perspectives: American College of Cardiology, Part 3

Commentary by Rob Donnino MD, NYU Division of Cardiology

The annual meeting of the ACC was held last month in Chicago. A good number of NYU faculty and fellows either presented at or attended the meetings. The cardiology fellows exhibited an impressive balance between exploring the Chicago nightlife and diligent attendance at the meetings. Several of the cardiology fellows presented some of the highlights of the ACC meeting at a recent journal club conference for the Cardiology Division. The third and final installment…

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ShortCuts-This Week in the Journals

May 19, 2008
ShortCuts-This Week in the Journals

Commentary by Michael Tanner, M.D., Section Editor, Clinical Correlations

In the May 15th issue of the Morbidity and Mortality Weekly Report,  the CDC recommends vaccinating all people 60 and older against shingles with one dose of zoster vaccine.  Let’s all get straight with the nomenclature here.  Varicella is chickenpox, zoster is shingles, and varicella zoster is the DNA herpesvirus that causes both of them.  Ninety-eight percent of adult Americans have varicella zoster virus latently lurking in their sensory dorsal root ganglia neurons.  The…

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The Skinny on Hoodia

May 16, 2008
The Skinny on Hoodia

Commentary by Melissa Freeman, PGY-2 

As summertime is just around the corner, many begin to evaluate whether their bodies are ready to expose what has been hidden under those bulky winter clothes. Between busy lives and an innate desire for quick results, people sometimes turn to over-the-counter diet pills for a slimmer physique. With recently banned products like Ephedra, consumers are looking for newer, more promising weight loss products. During a recent clinic visit, a patient asked me about my thoughts on diet pills…

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Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 1

May 15, 2008
Approach to a Patient with ‘Treatment Refractory’ Depression in The Medical Setting: Part 1

Commentary by Brian Bronson, MD, Chief of Psychosomatic Medicine, VA New York Harbor, New York Campus 

Summary: Symptoms of depression in the medical setting may not respond to usual pharmacologic antidepressant treatment for a number of reasons. These may include an incorrect psychiatric diagnosis; failure to consider underlying medical causes of the symptoms; or insufficient antidepressant medication trial due to poor patient adherence, insufficient dose or length of trial. There is no consensus as to the definition of ‘treatment refractory’ depression. However, when…

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