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…

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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…

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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…

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Health Care Reform: An Overview of Recent Proposals

August 9, 2007
Health Care Reform: An Overview of Recent Proposals

Commentary by Zackary Berger MD PhD, PGY-2 

In the political arena, reforming health care is continually a major domestic issue. It’s no surprise that the lead 2008 democratic contenders cite the same statistic on each of their websites, “Nearly 45 million Americans, including 9 million children, are without health insurance.” Moreover, on each of their sites, the candidates ambitiously describe plans that would provide universal and affordable healthcare for all Americans. Their tactics largely entail expanding Medicaid, holding employers more accountable to providing…

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Part II- Subclinical Thyroid Dysfunction: To Treat or Not to Treat?

August 8, 2007
Part II- Subclinical Thyroid Dysfunction: To Treat or Not to Treat?

Commentary by Melissa Freeman MD, PGY2

Please also see Part I of this series

In 2002, the American Association of Clinical Endocrinologists (AACE), the American Thyroid Association (ATA), and The Endocrine Society (TES) sponsored an evidence- based Consensus Development Conference with a panel of thirteen experts to address unresolved issues about subclinical thyroid dysfunction. Though these sponsors agreed with many of the recommendations made by the consensus, they felt that they relied too heavily on evidence-based medicine that did not yet exist. Two years later,…

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ShortCuts-This Week in the Journals

August 6, 2007
ShortCuts-This Week in the Journals

Commentary by Cara Litvin MD, Executive Editor Clinical Correlations 

Avandia again made headlines this week when an FDA advisory committee voted to allow the drug to remain on the market despite new data that suggests it may increase the risk of ischemic heart disease. The committee overwhelmingly agreed that Avandia increases the risk of myocardial infarction in diabetic patients. However, in a remarkable vote of 22 to 1,  the committee nevertheless agreed that the drug should be kept on the market with new labeling.…

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Atrial Fibrillation Part 2: Additional Words of Wisdom

August 3, 2007
Atrial Fibrillation Part 2: Additional Words of Wisdom

Commentary by William Slater, MD Associate Professor of Medicine, Divsion of Cardiology

The vast majority of patients with persistent AF can be rendered asymptomatic with AV nodal blocking drugs and don’t require ablation. Digitalis is underused but is often of major benefit, either
alone, or in combination with beta blockers or calcium channel blockers.

Of paroxysmal fibrillators, most can be managed by reassurance that the episodes are harmless with a normal heart and of minimal risk if brief even in context of…

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Management and Consequences of Atrial Fibrillation

August 2, 2007
Management and Consequences of Atrial Fibrillation

Commentary by Timothy Wong, MD

A group of short articles focusing on the consequences and management of atrial fibrillation (AF) recently appeared in the July 7th issue of the Health section of the New York Times. In brief, the articles highlighted the risks of thromboembolism, the lack of very successful medical therapies, and the growing demand for catheter-based atrial fibrillation ablation procedures.

As a cardiology fellow on the consultation service at a teaching hospital in western Pennsylvania, I find that atrial fibrillation…

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