X Ray Visions Mystery Quiz- The Answer

August 30, 2007
X Ray Visions Mystery Quiz- The Answer

Before you read the answer, you may want to review the initial Mystery Quiz posted last week.

Commentary by Andrew Hardie MD, Fellow, NYU Department of Radiology

Although this patient’s symptoms were not the most typical of this entity, the CT findings in this case are diagnostic of a perforated anterior duodenal ulcer. The most essential observation, and the one that alters management, is the presence of intraabdominal free air (arrows). The small collections of air in this case are not unusual for bowel perforations,…

Read more »

Inpatient Diabetes Management: Case 1

August 28, 2007
Inpatient Diabetes Management: Case 1

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

Welcome to our special diabetes series intended to highlight the essentials of diabetes care in the inpatient setting. For the next several weeks, we plan to present individual cases followed by some management questions and answers.

Case 1: The case of Mr. Smith
Mr. Smith is a 65 year old obese male admitted to the hospital with acute renal…

Read more »

ShortCuts-This Week in the Journals

August 27, 2007
ShortCuts-This Week in the Journals

Commentary by Josh Olstein MD, Associate Editor, Clinical Correlations

This week, the most popular health-care related story in the lay press was the news about Medicare’s plan to no longer cover the additional costs of treatment for many hospital-related complications such as catheter related infections and decubiti. The plan drew sweeping support from consumer advocacy groups who welcome any policy that would lead to increased patient safety and quickly caught the attention of hospital administrators and physicians. Administrators were unsurprisingly wary of the…

Read more »

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 »