How Do You Estimate Stroke Risk After a Transient Ischemic Attack?

April 24, 2007
How Do You Estimate Stroke Risk After a Transient Ischemic Attack?

By: Alana Choy-Shan, MD PGY-3
Transient ischemic attacks (TIAs) are known to be a harbinger of stroke, however it is difficult for physicians to estimate individual stroke risk. Previously, the two systems used to predict short-term risk of stroke after a TIA were the California and ABCD scores. Both scores are based on clinical factors with several key elements in common. However, neither scoring system was devised to predict stroke within 48 hours of TIA, a time period which may be most clinically relevant.…

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ShortCuts-This Week in the Journals

April 23, 2007
ShortCuts-This Week in the Journals

I think an unfortunate result of the ACC meetings is the feeling that if a study is not released early and does not make the front page of the New York Times then it is not relevant or worth talking about. We’ll save the debate about releasing results early for another time (although it frequently seems to be a self-serving public relations move by the journal publishing the article) …let’s march forward with several articles that were released this week with little fanfare.…

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Quick Thinking Part 4-The Conclusion

April 20, 2007
Quick Thinking Part 4-The Conclusion

Welcome to Quick Thinking. A case is 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 determining the initial differential diagnoses and diagnostic workups of complicated patient presentations.

Part 1 can be found here.  Part 2 can be found here.  Part 3 can be found here.

Part 3 Case Presentation by Elizabeth Ross, PGY-3:

The patient continued to complain of headache and dizziness and given the patient’s persistent and intermittent fevers…

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New Guidelines on the Diagnosis and Treatment of Venous Thromboembolism-Part 2

April 19, 2007
New Guidelines on the Diagnosis and Treatment of Venous Thromboembolism-Part 2

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.

Part 1-Diagnosis

Part 2 Treatment

The treatment recommendations are summarized as follows:

Low-molecular-weight heparin (LMWH), as opposed to unfractionated

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Don’t Pass the Olives…

April 18, 2007
Don’t Pass the Olives…

This week, olives from several different companies were found to contain Clostridium Botulinum. No cases of botulism have been reported to date, but this is an opportunity to review the pertinent clinical findings.

Botulism is caused by exposure to the botulinum neurotoxin in clostridium botulinum. There are eight toxin strains identified, 4 are known to cause disease in humans. The toxin is produced only in an anaerobic environment, so bottled or canned food products are a good source of infection. Food may smell…

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ShortCuts: This Week in the Journals

April 16, 2007
ShortCuts: This Week in the Journals

Overall, it seemed like a relatively quiet week in the news world. Winter weather perseveres, Larry Birkhead is the father, and Sanjaya is still singing (or trying to). A perusal of the week’s medicine journals, however, is somewhat uplifting as it reminds us of the expansive scope of medicine.

Beginning on the broad public health front, the CDC announced this week that it was changing its recommendations for the treatment of gonorrhea due to increasing drug resistance. Fluoroquinolones, once recommended as first-line treatment…

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Quick Thinking Part 3

April 13, 2007
Quick Thinking Part 3

Welcome to Quick Thinking. A case is 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 determining the initial differential diagnoses and diagnostic workups of complicated patient presentations.

Part 1 can be found here.  Part 2 can be found here.

Part 3 Presented by Elizabeth Ross, PGY-3:

Labs:
WBC–5.0  N63, L26, M10
Hgb-11, HCT-30, Plts 193

Na 128, K 3.6, Cl 95, CO2 23, BUN/creat 15/1.1

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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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