New Guidelines on the Diagnosis and Treatment of Venous Thromboembolism-Part 1

April 12, 2007
New Guidelines on the Diagnosis and Treatment of Venous Thromboembolism-Part 1

Commentary By: Margaret Horlick, MD, PGY-3

New guidelines on the diagnosis and treatment of venous thromboembolism (VTE) were recently jointly issued by the American Academy of Family Physicians and the American College of Physicians. The guidelines are based on a systematic review of the evidence and are published, along with the systematic reviews, in the 2/2007 and 3/2007 issues of the Annals of Internal Medicine.

According to the reviews, there are 600,000 cases of VTE in the US annually, and the…

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Does Screening for Lung Cancer Improve Mortality?

April 10, 2007
Does Screening for Lung Cancer Improve Mortality?

Commentary By: Anna Dvorak, MDPGY-3

Lung cancer is the number one cause of cancer mortality in both men and women. Screening patients at risk for lung cancer might reduce mortality if it helps find cancers at an early stage while they are still resectable. Randomized studies done in the 1970s showed that screening for lung cancer with chest x-ray did not support this theory. Chest x-rays identified more small tumors, but resecting them did not improve mortality. The question of whether screening with chest CT…

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ShortCuts-This Week in the Journals

April 9, 2007
ShortCuts-This Week in the Journals

The April 3rd issue of the Annals provides guidelines for screening mammography in women age 40-49. In the article and an accompanying editorial, the authors suggest that in women younger than age 50, the possible modest benefit of routine mammography screening for women in their 40s may be outweighed by the risk of false-positive results and the resultant repeated exams, biopsies, etc. As always, we should individualize our recommendations to our patients. Annals Link

As long as we are discussing mammography,…

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Quick Thinking Part 2

April 6, 2007
Quick Thinking Part 2

Welcome to Quick Thinking a new feature of Clinical Correlations. A case will be presented in short sections to a faculty expert who will comment on their approach to the patient as the case unfolds. These posts will focus on the thought process involved in determining the initial differential diagnoses and diagnostic workups of complicated patient presentations.

Part 1 can be found here.

Part 2 of Case Presentation By:Elizabeth Ross PGY-3

He was originally seen at Elmhurst Hospital and transferred to Bellevue Hospital.  On presentation…

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Meeting Perspectives: The 2007 American College of Cardiology Scientific Session

April 5, 2007
Meeting Perspectives: The 2007 American College of Cardiology Scientific Session

Commentary By: Steven Sedlis, MD Associate Professor of Medicine, Chief, Division of Cardiology Manhattan Veterans Administration Medical Center

The 56th annual scientific session of the American College of Cardiology was held in New Orleans on March 24-27.  The site of the meeting had been selected before hurricane Katrina; the ACC re-affirmed its commitment last year when the devastation caused by the storm was still fresh and when future prospects for southern Louisiana were still uncertain. The ACC meeting was by far the largest…

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Book Review: How Doctors Think-Jerome Groopman, MD

April 3, 2007
Book Review: How Doctors Think-Jerome Groopman, MD

Commentary By David Shapiro, MD, Former Chief of Allergy and Immunology, Winthrop University Medical Center and New York Ear Infirmary Hospital, Attending Physician OPD Allergy and Immunology, New York Hospital (and most importantly, father of Neil Shapiro, MD)

I highly recommend a new book that has become an instant bestseller, How Doctors Think published two weeks ago by Houghton Mifflin. The author, Dr. Jerome Groopman, is Professor of Medicine (Oncology and Immunology) at Harvard School of Medicine and Chief of Experimental Medicine at…

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ShortCuts: This Week in the Journals

April 2, 2007
ShortCuts: This Week in the Journals

JAMA reported on two important “negative” trials: The results of the EVEREST trial, comparing tolvaptan (a novel vasopressin V2 receptor blocker) to placebo for the treatment of acute CHF exacerbation, indicate that this agent had no effect on the primary endpoint of all-cause mortality or the composite endpoint of cardiovascular death, hospitalization for heart failure; secondary endpoints were also not effected. The TRIUMPH trial looked at the effect of tilarginine (an isoform-nonselective NOS inhibitor) in patients with MI and refractory cardiogenic shock and…

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Quick Thinking #1

March 30, 2007
Quick Thinking #1

Welcome to Quick Thinking a new feature of Clinical Correlations. A case will be presented piece by piece to a faculty expert who will comment on their approach to the case as it unfolds. Differential diagnoses and diagnostic workups will form the basis of these posts of difficult clinical cases. So for the next 4 Fridays we present our first case to our discussant Mitchell Charap:

The Case Presented by Elizabeth Ross, PGY-3: The patient is a 35 year old African American male…

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