Epogen and Anemia-Less is More

November 17, 2006
Epogen and Anemia-Less is More

Singh AK et al. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med 2006 Nov 16; 355:2085-98.

Drüeke TB et al. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med 2006 Nov 16; 355:2071-84.

It’s always been unclear what target hgb we should be shooting for in our patients on epogen/aranesp.  These 2 articles in the NEJM definitely come close to answering this question.  In the CREATE study 603 patients with…

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NYU’s Dr. Hochman Releases OAT Results

November 16, 2006
NYU’s Dr. Hochman Releases OAT Results

                          Hochman JS et al. for the Occluded Artery Trial Investigators. Coronary intervention for persistent occlusion after myocardial infarction. N Engl J Med 2006 Nov 14; 355.

Reperfusion via thrombolytics or PCI in patients with acute STEMI has been shown to reduce mortality and maximize myocardial salvage.  It has been less clear whether patients with late presentations of MI are afforded the same benefits.  Though there was no official consensus, late revascularization of the infarct vessel was frequently employed.  At the AHA meeting yesterday,…

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Should We Screen All Smokers for Lung Cancer?

November 15, 2006

Commentary by Deborah Shapiro, M.D.  Attending Physician, Dept. Veterans Affairs

The International Early Lung Cancer Action Program Investigators. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med 2006;355:1763-1771

Over the last few weeks there has been major press in the lay media about this lead article in the NEJM from 10/26/06.  This study was designed to diagnose lung cancer at an earlier stage and therefore to decrease mortality rates. The authors…

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Tamiflu Patients Need Monitoring

November 14, 2006
Tamiflu Patients Need Monitoring

Over 100 cases have been reported to the FDA involving the use of Tamiflu and the development of hallucinations, delerium and other unusual behavior mainly in Japanese children.  From the Chicago Tribune article "Health officials have been sensitive about taking any action that might dissuade people from taking Tamiflu, since the drug could play an important role in an outbreak of bird flu."

Read more about it in the Chicago Tribune and FDA websites…here are the links:

FDA announcement

Chicago Tribune Story

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Google to Replace Physicians?

November 13, 2006
Google to Replace Physicians?

So someone has finally done an official “study” of what most of us were already aware of.  Online at the BMJ is a study proving Google’s diagnostic ability.  The researchers took 3-5 terms from case reports from the NEJM, fed them into google and then looked at the links that were referenced.  58% (15/26)  of the time the correct diagnosis was found in the links retrieved by google (CI 38-77%).  You can debate whether this is truly research, however we’re getting closer and closer to…

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Getting Published

November 10, 2006
Getting Published

I knew I should have patented my idea for The Journal of Anecdotal Medicine…I certainly joked enough about it for the last several years. Now here comes The Journal of Medical Case Reports. From their website: Journal of Medical Case Reports is an open access, peer-reviewed, online journal soon to be launched by BioMed Central. Journal of Medical Case Reports will consider any original case report that expands the field of general medical knowledge. Reports should show one of the following: …

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Improving Stroke Recovery-The EXCITE Trial

November 9, 2006
Improving Stroke Recovery-The EXCITE Trial

The EXCITE trial was the lead article in last week’s JAMA. It looks at a 2 week program of contstraint induced movement therapy vs. usual care in patients suffering a cva within the previous 3-9 months. Pt’s in the treatment arm wore a restraining mitt on the less-affected hand and engaged in tasks/behaviors with the hemiplegic hand. This group was compared to a control group with usual care. Measures of performance time and motor function ability all showed clinically relevant improvements that persisted out…

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Diagnostic Dilemma #1-Faculty Response

November 8, 2006

Commentary By Michael Poles, M.D. Gastroenterologist, Assistant Professor of Medicine, Mircrobiology and Pathology.

Welcome blog readers to this inauguration of the NYU medicine blog. If the future cases are as interesting as this one, I am sure we will be having a lot of fun, and hopefully some learning.

OK, lets dive right in. We have the case of a young-ish guy who developed abnormal LFTs after starting a statin. Fortunately, the case is more interesting than just that…

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