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Corticosteroid Weaning In Stable Heart Transplant Patients: Guidance By Serum Cortisol Level, David A. Baran, Cheryl Rosenfeld, Mark J. Zucker

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Background: Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, the majority of patients are maintained on steroid therapy for life. We examined a strategy based on a single morning serum cortisol measurement.

Methods: We assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into one of two groups based on a screening morning cortisol level. Patients with a cortisol < 8 micrograms/deciliter were assigned to a "maintenance" group and the others were assigned to the weaning group and steroids were tapered off over 4-6 weeks. Patients were monitored on subsequent office visits for adrenal insufficiency and allograft rejection.

Results: Thirty-one patients were enrolled (6 patients in the maintenance group and 25 in the steroid-weaning group). Mean follow-up was 10.2 ± 4 years for the weaning group and 9.0 ± 4.9 …

Exposure To High Levels Of Noise Poses Hazards And Risks For Development Of Hypertension And Heart Disease: Potential Roles Of Unrecognized Ionized Hypomagnesemia And Release Of Ceramides And Platelet-Activating Factor, Burton M. Altura, Asefa Gebrewold, Anthony Carella, Nilank C. Shah, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

It has been demonstrated in numerous human and animal studies that audiogenic stress (AS) can induce elevation of arterial blood pressure and cardiac damage and that noise –induced hearing loss may be associated with alterations in magnesium (Mg) metabolism. Our laboratories, over a period of approximately 40 years, have been investigating why AS causes high blood pressure and cardiac damage. This review focuses on a number of newer discoveries on why AS causes dysfunctions of the cardiovascular system (CVS) This review discusses the pivotal physiological and biochemical importance of Mg to body health and the fact that most Americans and …

Human Chronic Necrotizing Granulomatous Meningoencephalitis: A Novel Case Report, Alexus P. Taddonio, Eric J. Veloso, Kelly J. Baldwin

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Necrotizing and granulomatous meningoencephalitis are common central nervous system diseases known to affect canines. To date, necrotizing granulomatous meningoencephalitis has yet to be described in humans. Current studies of presumed pathogenesis and possible treatment options have only been described in canines. This is a case report of a 55-year-old female patient who was diagnosed with necrotizing granulomatous meningoencephalitis in the setting of new-onset neurological symptoms without any infectious or malignant source.