When Should You Order a Serum Fructosamine Level for a Diabetic Patient?

March 14, 2007
When Should You Order a Serum Fructosamine Level for a Diabetic Patient?

Commentary By: Christopher Johnson, MSIV and Glenn Matfin, MD Clinical Associate Professor of Medicine, Divsion of Endocrinology

When was the last time you had a diabetic patient in clinic whose hemoglobin A1C was elevated, prompting you to modify their diabetic regimen? You may have scheduled a repeat hemoglobin A1C in 3 months, since you know A1C measures glycemic control over a 3 month period. A serum fructosamine may help give you a snapshot of more recent control.

What is fructosamine?
Fructosamine is…

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The Most Intriguing Medical Facts of 2006

March 13, 2007
The Most Intriguing Medical Facts of 2006

Although it’s almost spring and the spate of “best of the year” lists are now long gone, I recently came across this list from the AMA news. It’s a summary of their most intriguing facts of 2006. It’s fascinating stuff. Some of the highlights with links are below. Click here to view the entire list.

 

65% of elderly patients were on a drug they didn’t need; 64% didn’t get what they needed. People born in 2000 have an average life expectancy

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Does the Overuse of Macrolides Lead to Antibiotic Resistance?

March 12, 2007
Does the Overuse of Macrolides Lead to Antibiotic Resistance?

Commentary By: Danise Schiliro, PGY-3

Although intuitively we always worry about creating drug resistance when using antibiotics, there is a surprising lack of well done studies that show a clear causal effect of antibiotic use on the development of subsequent drug resistance. A recent study in Lancet may however lead us to re-evaluate our use of macrolides in everyday practice.

Azithromycin and clarithromycin are two of the most commonly used macrolides for treating respiratory infections. Azithromycin has a long half-life, making it convenient for once…

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How Do You Approach A Patient with a Non-Ischemic Cardiomyopathy

March 7, 2007
How Do You Approach A Patient with a Non-Ischemic Cardiomyopathy

A 26 year old woman developed uncontrolled hypertension peripartum 5 years prior to this presentation After diagnosis she was intermittently compliant with her medication although remained asymptomatic. She now presents with new onset congestive heart failure. On admission, she was in mild respiratory distress. Her physical exam was notable for tachycardia with a blood pressure ranging from 160/100-200/110. She had a jugular-venous pressure of 8cm, +S4, crackles were present bilaterally 1/2 way up, but no peripheral edema. Labs were notable only for renal insufficiency…

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More Breaking News: Rosiglitazone Linked to Fractures

March 6, 2007
More Breaking News: Rosiglitazone Linked to Fractures

Commentary By: Cara Litvin PGY-3

The FDA recently informed physicians of a report issued by GlaxoSmithKline acknowledging that Avandia (rosiglitazone) has been linked to increased fractures in females (1). The report stems from a review of the safety data from ADOPT (A Diabetes Outcome and Progression Trial) (2), which was a recently published randomized trial of 4,360 patients designed to compare glycemic control with rosiglitazone relative to metformin and glyburide monotherapies. In the published study, there were no unexpected adverse events reported, although…

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Gone Fishin’

February 23, 2007
Gone Fishin’

Due to vital conflicting commitments (vacation), Clinical Correlations will be closed until March 6th when we will resume posting new content. This is the perfect opportunity to catch up on our previous content and to think about what you’d like to see on clinical correlations in the future. Search by date or by category with the toolbar at the right of this post. As always send us any comments or feedback to clinicalcorrelations@gmail.com. Have a great week.

Fishing from Wikipedia

Vacation from Wikipedia

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The Vioxx Wars

February 23, 2007
The Vioxx Wars

Commentary By: Sandeep Mangalmurti MD, JD PGY-1

The continuing legal battles over Vioxx remain at the center of a fascinating intersection of law and medicine. Most physicians are well acquainted with the basics of the case, but like most complicated health care issues, the deeper one probes, the more interesting it becomes.

The Vioxx saga begins in 2000, with the VIGOR trial. (1) This study was a randomized control trial comparing the gastrointestinal toxicity of Vioxx to naproxen, and was notable for…

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Safety of Long-Acting Beta-Agonists in the Treatment of Asthma: Should they be used?

February 21, 2007
Safety of Long-Acting Beta-Agonists in the Treatment of Asthma: Should they be used?

Commentary By: Sarah Huen, PGY-3 and David Chong, Director of Critical Care, Bellevue Hospital, Associate NYU Internal Medicine Residency Program Director

The role of long-acting b-agonists (LABAs) in the treatment of asthma continues to be controversial. Growing evidence that LABAs may cause an increased risk of asthma exacerbations and asthma-related deaths prompted the U.S. Food and Drug Administration (FDA) to approve “black box” safety warning labels for Serevent Diskus (salmeterol xinafoate), Advair Diskus (fluticasone propionate; salmeterol xinafoate), and Foradil (formoterol fumarate). Concern about…

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