Bedside Rounds: What is Lasegue’s Sign?

July 10, 2007
Bedside Rounds: What is Lasegue’s Sign?

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

A 66 year old woman with a history of dyslipidemia and remote tobacco use presents with a sudden onset of pain located in her posterior left thigh radiating down her left leg below the knee. The pain began during the course of an upper respiratory illness with a cough. The pain is burning in quality and is bothersome day and night. NSAIDs have been taken and relieve the pain temporarily.…

Read more »

ShortCuts-This Week in the Journals

July 9, 2007
ShortCuts-This Week in the Journals

This week finds us talking about markers for chronic kidney disease (remember we’re no longer allowed to use terms such as renal insufficiency),  a bit of positive news about a popular alternative medicine, a new inflammatory marker for coronary artery disease, a genetic basis for atrial fibrillation and most importantly the value of an adequate intake of chocolate.

The 7/3 issue of the Annals of Internal Medicine furthers our knowledge of cystatin c as an eventual replacement for creatinine and gfr.  Cystatin c is a serum…

Read more »

How do you assess a patient’s risk for recurrent DVT?

July 6, 2007
How do you assess a patient’s risk for recurrent DVT?

Commentary by Sean Cavanaugh MD, Associate Editor, Clinical Correlations

A 51-year-old man with a history of DVT diagnosed seven months ago presents to your clinic for follow up. He has no family history of blood clots. He has been on coumadin since his DVT was diagnosed. No testing for thrombophilia has been done. How do you proceed?

Recently, The Annals of Internal Medicine released an excellent statement about the treatment of venous thrombosis (see prior post). Unfortunately, it does not address the more interesting questions…

Read more »

Meeting Perspectives: The ADA Scientific Sessions: Advances in the Pharmacologic Management of Type 2 Diabetes Mellitus

July 5, 2007
Meeting Perspectives: The ADA Scientific Sessions:  Advances in the Pharmacologic Management of Type 2 Diabetes Mellitus


Commentary by Mitchell Charap MD, Senior Associate Program Director, NYU Internal Medicine Residency Program

Caveat: What follows below reflects my perspective on new and old pharmacologic approaches to Type 2 Diabetes. It is not intended to be a comprehensive review of this topic.

TZDs

The ADA did not mount a serious attack on the Nissen NEJM metanalysis of Rosiglitazone. They suggested that patients speak to their physicians regarding the drug. I missed the Nissen/ADA debate that occurred, but gather…

Read more »

Should All Patients with Hepatitis C Be Screened for Hepatocelluar Carcinoma?

July 3, 2007
Should All Patients with Hepatitis C Be Screened for Hepatocelluar Carcinoma?

Should patients with Hepatitis C (HCV) with no evidence of cirrhosis undergo screening for hepatocellular carcinoma (HCC)? Is there any reason to check for HCC when the liver associated enzymes (LAEs) are normal?

-Sandeep Mangalmurti, PGY-2

Commentary by Mike Poles MD, Associate Editor Clinical Correlations and Assistant Professor, Division of Gastroenterology

HCC continues to be one of the most common solid malignancies worldwide. Further, almost all cases of HCC occur in the background of a histologically-abnormal liver; approximately 90% of cases of HCC occur in…

Read more »

Shortcuts-This Week in the Journals

July 2, 2007
Shortcuts-This Week in the Journals

Commentary By: Josh Olstein, M.D. Chief Resident Internal Medicine

This week, the NEJM released the results of a survey about needlestick injuries among surgical residents. The frequency of needlestick injuries were quite high, residents averaged 3.8 injuries across all years of training. By their fifth year of training 99% of residents had experienced at least one needlestick injury. Perhaps the most shocking statistics however were the frequency of unreported needlestick injuries, including those related to high-risk patients. When surveyed about their latest exposure,…

Read more »

How Do you Approach a Patient with Primary Hyperaldosteronism?

June 28, 2007
How Do you Approach a Patient with Primary Hyperaldosteronism?

An 80 year old male with atrial fibrillation, hypertension, hypokalemia is diagnosed with hyperaldosteronism with an aldosterone to renin ratio of 34.5/0.15=230 . CT scan reveals a right adrenal 1 cm presumed adenoma

Questions:
1. How do you accurately diagnose primary hyperaldosteronism?
2. Do medications which the patient is taking influence the work-up?
3. Can you have primary hyperaldosteronism in the absence of hypokalemia?
4. Can the adrenal mass be incidental? Should the patient have additional testing?

-Anna Dvorak PGY-3

Read more »

Meeting Perspectives-ASCO 2007

June 26, 2007
Meeting Perspectives-ASCO 2007

Commentary By: Theresa Ryan, M.D. Assistant Professor, Division of Oncology

During the first five days in June, the American Society of Clinical Oncology met in Chicago for their 43rd annual meeting. The theme of this meeting was “Translating Research into Practice,” emphasizing the society’s goal of enhancing patient care by creating a forum wherein the latest advances in translational and clinical cancer research are presented in the context of our current understanding of cancer biology. Many abstracts presented will lay the groundwork for…

Read more »