Pfizer Shutting Lights on ILLUMINATE Study

December 4, 2006
Pfizer Shutting Lights on ILLUMINATE Study

Low HDL is a well known independent risk factor for atherosclerotic disease.  As a result, there have been several attempts to develop medications to raise HDL.  Specific targets include the inhibition of cholesteryl ester transfer protein, which plays an essential role in HDL metabolism by facilitating the transfer of cholesterol esters from HDL cholesterol to apolipoprotein B-containing lipoproteins.

Pfizer created just that drug.  Known as Torcetrapib, it was seen as a promising therapeutic to increase HDL and potentially…

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Call For Content

December 2, 2006
Call For Content

Send us your clinical questions…Please include a brief case presentation with any focused clinical questions about management or next steps in diagnosis.  These questions will then be sent to one of our esteemed faculty for a response to be posted on Clinical Correlations…it's your chance to be famous and make your name in cyberspace.  If you prefer anonymous posting we can also do it that way.

Send all cases/questions to neil.shapiro@med.va.gov

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Links: An Example of a Prolific Medical Blogger

December 1, 2006
Links: An Example of a Prolific Medical Blogger

If you want to get a look at what else is going on in the medical blogosphere you should spend some time at this site.  This blog Kevin M.D. is created by a practicing internal medicine physician.  It's updated several times a day mostly with stories from the media regarding malpractice, politics and the pharamceutical industry.  It's a bit less clinically oriented than other medical blogs, but always makes for an interesting read. 

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Fast Facts-Rheumatology

November 30, 2006
Fast Facts-Rheumatology

Bellevue Morning Report Teaching Points 11/27

CC: Left knee swelling and pain x 1 week

54 yo male without past medical history in his usual state of health until 5 weeks prior when he had painful ejaculation and intermittent dysuria, denies penile discharge. Treated for a urinary tract infection with unknown antibiotic. 3 weeks later develops recurrent symptoms and again treated with another course of unknown abx by outside physician. However he develops left knee pain and swelling and is unable to…

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Should You Recommend Surgery or Conservative Care for Disc Herniation?

November 29, 2006
Should You Recommend Surgery or Conservative Care for Disc Herniation?

In the November 22nd issue of JAMA, the results of two studies from the Spine Patient Outcomes Research Trial (SPORT) on lumbar disk surgery for persistent radicular pain are reported.  Both these studies sought to assess the efficacy of surgery for lumbar disk herniation as compared to nonoperative treatment, including counseling, anti-inflammatory medications, injections, and physical therapy. It is important to note that specific inclusion criteria were radicular pain as well as imaging showing disk herniation.  Because a large number of study participants declined randomization,…

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Diagnostic Dilemma #2 How Should You Approach a Low Titer +RPR?

November 28, 2006
Diagnostic Dilemma #2 How Should You Approach a Low Titer +RPR?

45 year old male with history of Hep B ( Hep B Surf Ag + but Hep E Ab+ and E Ag – and DNA viral load was not sent) and syphilis treated in the past.  He has RPRs in the past that were 1:1 for years and then negative x 2 a year apart, the last being over two years ago.  He had labs drawn last week and had an RPR of 1:4.  He does report high-risk unsafe sexual activity (with female prostitutes)…

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Welcome to Clinical Correlations

November 27, 2006
Welcome to Clinical Correlations

Welcome to the official launch of the NYU Internal Medicine Residency Program’s Blog- Clinical Correlations.  We hope this site becomes a part of your daily routine.  Each weekday we will be posting compelling medical content including:

1. clinical cases with difficult management questions answered by faculty members

2. breaking news that should be on everyone’s radar

3. quick journal article reviews with commentary from housestaff/expert faculty

4. morning report teaching points from all 3 hospitals

5. reviews of national meetings by attendees

6. links to…

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Fast Facts-Critical Care

November 22, 2006
Fast Facts-Critical Care

VA MICU Conference 11/22/06

56 y.o. male with PMH ETOH abuse and COPD presented with a LUL PNA and BCx positive for penicillin-resistant pneumococcus.

 

Early Goal-Directed Therapy in Severe Sepsis and Septic Shock

Early broad spectrum antibiotics. Goal directed hemodynamic resuscitation with IV fluids pressors PRBCs (for Hct <30) inotropes To maintain: Central Venous Pressure 8-12 mm Hg Arterial Pressure: MAP >65 mm Hg but <90 mm Hg Central Venous Oxygen Saturation >70% Consider cosyntropin stimulation to evaluate for relative adrenal insufficiency. Consider Recombinant Activated Protein C

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