The Discharge Summary: A Prerequisite for Quality Care

August 24, 2007
The Discharge Summary: A Prerequisite for Quality Care

Commentary by Cara Litvin MD, Executive Editor, Clinical Correlations

I frowned as my patient handed over some papers to me at a regularly scheduled follow-up clinic visit. For the second time in a row, he had been admitted to an outside hospital for syncope in the interval between his visits with me. The cryptic discharge summaries provided very little information about his work-up. “Follow-up with primary MD” was scribbled on the latest discharge summary, without any test results provided. My initial instinct was to be…

Read more »

X-Ray Visions: Mystery Quiz

August 22, 2007
X-Ray Visions: Mystery Quiz

A 46 year old male with a past medical history of hypertension presents to the emergency room complaining of constant throbbing epigastric pain for one day. He rates the pain as 7/10, with some radiation to his chest. He reports some mild nausea, but denies diarrhea or constipation.  He does endorse a bloated sensation for the past few days. He has not had any fevers and denies melana or hematochezia.  He is an avid biker and reports unlimited exercise tolerance. He denies any previous history of chest pain.

The patient works as…

Read more »

An Update on Multiple Sclerosis

August 21, 2007
An Update on Multiple Sclerosis

Commentary by Jacqueline Friedman, MD, Clinical Associate Professor of Neurology,  Director, New York Region Veterans Administration Multiple Sclerosis Center of Excellence

Multiple sclerosis (MS), a chronic disease of the central nervous system, is thought to be initiated by an inflammatory phase followed by degeneration of both white and grey matter. While there is no cure, great strides have been made in the past ten years—we now believe that the earlier a diagnosis is suspected and treatment is initiated, the better the long-term course…

Read more »

Shortcuts-This Week in the Journals

August 20, 2007
Shortcuts-This Week in the Journals

Commentary By: Neil Shapiro, M.D. Editor-in-Chief Clinical Correlations

As summer winds down and the weather prematurely cools off, this weeks shortcuts finds us focusing on the genetics of coumadin treatment, the very controversial hpv vaccine, and the evils of direct to consumer advertising, and to keep us clean we conclude with a bit about antibacterial soaps and what else you can find at your local drugstore…

The front page of the wall street journal picked up an FDA medwatch advisory approving labeling…

Read more »

Reemergence of the Great Imitator: Overview of the Diagnosis and Treatment of Syphilis

August 17, 2007
Reemergence of the Great Imitator: Overview of the Diagnosis and Treatment of Syphilis

Commentary by Rosemary Adamson, PGY2,  Deena Altman PGY-1 and Harold Horowitz, Professor of Medicine, Section of Infectious Diseases 

Syphilis is back! You know the drill: an 80-something year old man presents with dementia and you send the TSH, B12 and RPR and get a head CT, all the while expecting some microvascular disease & age-related cortical volume loss. Imagine my surprise when my VA patient had a positive RPR and then the lumbar puncture returned a positive VDRL. To be fair, he wasn’t…

Read more »

Clinical Pathology Conference 8/16/07

August 16, 2007
Clinical Pathology Conference 8/16/07

Case Presentation By: Marshall Fordyce, Senior 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 8/16/07 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…

Read more »

Clinical Pharmacology Corner: Beta-Adrenergic Receptors Antagonists

August 14, 2007
Clinical Pharmacology Corner:  Beta-Adrenergic Receptors Antagonists

Commentary by Helen Kourlas, PharmD

Beta-adrenergic receptor antagonists, commonly known as beta-blockers (B-blockers) have been used for decades to treat hypertension, ischemic heart disease and some arrhythmias – and more recently to treat congestive heart failure. (1,2) Typically, B receptors are located in the heart (B1) and in peripheral vessels (B2) and the binding of catecholamines (epinephrine, norepinephrine and dopamine) to B1 receptors produce positive chronotropic and inotropic effects, while the binding of the B2 receptors produce a vasodilatory response in the peripheral…

Read more »

Shortcuts-This Week in the Journals

August 13, 2007
Shortcuts-This Week in the Journals

Commentary By Sean Cavanaugh, M.D. Associate Editor, Clinical Correlations

With the ever-increasing public concern about drug safety, and the profusion of wave-making research into clinical endpoints, occasional very public collisions are inevitable. And so opens this week’s Shortcuts…

Two recent seemingly opposing results were published in the past few weeks concerning the effects of statin therapy on patients with low LDL. Circulation featured a study looking at the safety and clinical outcomes associated with statin therapy in patients with very low LDL…

Read more »