Clinical Pharmacy Corner: How Do Sulfonylureas Work?

October 17, 2007
Clinical Pharmacy Corner: How Do Sulfonylureas Work?

Commentary by Helen Kourlas, PharmD and John Papadopoulas, PharmD, Pharmacology Section Editors

The sulfonylureas are members of a class of substituted arylsulfonylureas that have been used clinically since the 1950s. These agents are usually divided into two categories or generations. First generation agents include acetohexamide, chlorpropamide, tolazamide, and tolbutamide (the first widely utilized agent). The more potent second-generation agents include glimepiride, glipizide, and glyburide.

Sulfonylureas acutely lower plasma glucose by stimulating the release of insulin. The primary mechanism is through binding to sulfonylurea receptors (SUR-1)…

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ShortCuts-This Week in the Journals

October 15, 2007
ShortCuts-This Week in the Journals

Commentary by Sean Cavanaugh MD, Associate Editor, Clinical Correlations

Moving through the journals this week, it is all about primary care.

There was an interesting article for Primary Care MDs in this week’s NEJM.  A long term follow-up of the West of Scotland Coronary Prevention Study, which compared pravastatin vs placebo in the primary prevention of coronary artery disease, demonstrated a durable decrease in events even after the treatment groups re-approximated each other.  A succinct conclusion is that 5 years of treatment…

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Inpatient Diabetes Management: Case 4

October 11, 2007
Inpatient Diabetes Management: Case 4

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

Welcome to Case 4 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 4: The Case of Mr. Gary

Mr. Gary is a 54 year-old diabetic male admitted with acute renal failure who is being evaluated for…

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Clinical Pathology Conference 10/12/07

October 10, 2007
Clinical Pathology Conference 10/12/07

Case presentation by Elizabeth Ross MD, Chief Resident

Welcome to the monthly posting of our NYU Department of Medicine’s Clinical Pathology Conference. Use the links below to review the case and the radiological findings. Our faculty and medical students will be attempting to diagnose this unknown case Friday 10/12/07 in the 17 West Conference Room at Bellevue Hospital. Feel free to make your diagnosis by clicking the comment field below. For those who are unable to attend the live conference, we will reveal the answer next…

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ShortCuts-This Week in the Journals

October 9, 2007
ShortCuts-This Week in the Journals

Commentary by Josh Olstein MD, Associate Editor, Clinical Correlations

As a future gastroenterologist, I was drawn to a study in the October 4th edition of the New England Journal of Medicine that compared CT colonography with colonoscopy for the detection of advanced neoplasia.  Results from roughly 6300 patients who were non-randomly referred for colon cancer screening by either modality were compared and the main outcome measures included the detection of advanced neoplasia and total number of harvested polyps.  Advanced neoplasia included carcinomas or…

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Why Does Hypertriglyceridemia Lead to Pancreatitis?

October 4, 2007
Why Does Hypertriglyceridemia Lead to Pancreatitis?

Commentary by Daniel Frenkel, PGY-2

Case: A 46 year old male with diabetes on oral hypoglycemic medications is admitted to the hospital with one day of constant epigastric pain, nausea, vomiting, and an inability to tolerate oral intake. You are concerned about pancreatitis but laboratory analysis reveals amylase levels that are within the normal reference range. You notice that his glucose level is 410mg/dL and that the specimen is described as lactescent. Should you still be concerned about acute pancreatitis?

Lactescent or lipemic blood samples…

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Bedside Rounds: How Do You Diagnose and Treat Diabetic Neuropathy

October 3, 2007
Bedside Rounds: How Do You Diagnose and Treat Diabetic Neuropathy

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

Diabetic neuropathy is one of the most commonly encountered complications of diabetes mellitus. It is seen in up to 20% of diabetics. Patients typically present with neuropathic pain in a “glove and stocking” distribution with the earliest signs in the feet. Night time complaints of “my feet are on fire” are common. Relying on a patient’s complaint of “pain” or “numbness” is inadequate in the diagnosis of peripheral neuropathy since…

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ShortCuts-This Week in the Journals

October 2, 2007
ShortCuts-This Week in the Journals

Commentary by Danise Schiliro-Chuang MD, NYU Chief Resident

Let’s start on the theme of cardiovascular disease risk reduction, a topic making headlines this week. A September 28 New York Times article previews the release of new guidelines on perioperative care for patients undergoing noncardiac surgery. The guidelines, written by a panel of experts from the ACC and AHA, will recommend that patients undergo evaluation and treatment before noncardiac surgery only for active cardiac diseases such as severe angina, late-stage heart failure, significant arrhythmias and…

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