Mystery Quiz-The Answer

December 20, 2013
Mystery Quiz-The Answer

Vivian Hayashi MD, Robert Smith MD

The answer to the Mystery Quiz is diaphragmatic hernia, specifically a Bochdalek hernia. The CXR shows increased density behind the heart that has a smooth superior border (Image 2, arrows). This density does not obscure the left heart border, denoting a posterior location behind the heart. Furthermore, the lateral aspect of the opacity demonstrates low attenuation (hypo-dense) suggesting the presence of fat (Image 2, asterisk). The left hemidiaphragm is not visible indicating that the abnormality is contiguous with the…

Read more »

Breaking News: JNC 8 Guidelines Released

December 19, 2013
Breaking News: JNC 8 Guidelines Released

By Monica Gupta, MD

On December 18, 2013, the long awaited JNC 8 guidelines were published. Two major deviations from JNC 7 are: 1) more relaxed blood pressure goals and cutoffs for initiation of treatment, and 2) recommendations for first line therapy.

Simplified, JNC 8’s major recommendations are as follows:

In those 60 years or older, blood pressure lowering agents should be initiated to achieve a goal SBP < 150 mmHg and a goal DBP < 90 mmHg. In those 60 years or younger,

Read more »

Clinical Correlations Awarded Platinum eHealthcare Leadership Award

December 18, 2013
Clinical Correlations Awarded Platinum eHealthcare Leadership Award

We are very pleased to announce that Clinical Correlations has been awarded a 2013 Platinum eHealthcare Leadership Award. Now in it’s 14th year, this awards program, is the largest web-oriented awards program that is focused exclusively on healthcare. The program attracts over 1100 entrants. Winners were recently recognized during a special presentation at the Seventeenth Annual Healthcare Internet Conference held in New Orleans. Although we have won prior Gold awards, this is the first time we have been recognized at the platinum level in the Best…

Read more »

Mystery Quiz

December 17, 2013
Mystery Quiz

Vivian Hayashi MD, Robert Smith MD

The patient is a 78 year old man who presented to the emergency room with fever, pain, swelling, and erythema of the right leg over a two day period. The patient denied abdominal symptoms, cough or breathlessness over his baseline. His past medical history included Waldenstrom’s macroglobulinemia ten years earlier that responded to treatment with chlorambucil. Other morbidities included severe chronic obstructive pulmonary disease, myocardial infarction 20 years previously, and chronic venous insufficiency resulting in lower extremity edema. The…

Read more »

Primecuts – This Week In The Journals

December 16, 2013
Primecuts – This Week In The Journals

By Cilian White, MD

Peer reviewed

With the holiday season upon us, the streets are laden with trees waiting to be adorned, bunches of mistletoe to be hung for that special moment; and New Yorkers are wiping away the cobwebs from snow boots and thermal gear in preparation for the chill effect awaiting them as they step outside their homes. People adorn their homes with decorations, and enjoy delectable delights with loved ones. The NYU community continues to work harder than ever to provide…

Read more »

Barriers to Translating Evidence into Clinical Care: the Zoster Vaccine

December 13, 2013
Barriers to Translating Evidence into Clinical Care: the Zoster Vaccine

Zachary Elkin

Faculty Peer Reviewed

There are more than a million cases of herpes zoster (HZ) in the US annually . The incidence of HZ, or shingles, has been rising in the US since the 1990s . One third of all people in the US will get HZ, with the highest incidence in people aged 50 to 79 . As a result of the Shingles Prevention Study (SPS), the U.S. Food and Drug Administration (FDA) and Advisory Committee on Immunization Practices (ACIP) approved the Zostavax…

Read more »

From The Archives: Fast Hearts and Funny Currents: Is Tachycardia Part of the Problem in Heart Failure? Part 1

December 12, 2013
From The Archives: Fast Hearts and Funny Currents: Is Tachycardia Part of the Problem in Heart Failure? Part 1

Please enjoy this post from the archives dated May 18, 2011

By Santosh Vardhana

Faculty Peer Reviewed

Mr. M is a 63-year-old man with a history of coronary artery disease and systolic CHF (ejection fraction 32%) on lisinopril, metoprolol, and spironolactone who presents to Primary Care Clinic complaining of persistent dyspnea with exertion, two-pillow orthopnea, and severely limited exercise tolerance. His vital signs on presentation are T 98.0º F, BP 122/76, HR 84 bpm. What are his therapeutic options?

A Race Against…

Read more »

Primecuts – This Week In The Journals

December 9, 2013
Primecuts – This Week In The Journals

By Iulia Giuroiu, MD

Peer reviewed

As we mourn the death of Nelson Mandela and reflect upon his legacy, let us remember to embrace our differences as we strive toward well being for all. This week, the journals highlight the importance of paying attention to genetic risk factors unique to gender and ethnic backgrounds as we seek to provide optimal therapy for a variety of conditions.

This week’s first article challenges the assumption of gender equality in the use of drug-eluting stents (DES) (1). With…

Read more »