Medicine and Health Sciences Commons^™

A New Guideline For Diagnosis And Treatment Of Syncope In Children And Adolescents That Stimulates Further Thought And Discussion, Julian M. Stewart

NYMC Faculty Publications

No abstract provided.

Physician-Assisted Suicide (Pas)/Physician-Assisted Death (Pad): The Rise Of Lifeboat Ethics, Jeffrey H. Dobken

NYMC Faculty Publications

No abstract provided.

Intraoperative Blood Loss During Induced Abortion: A Comparison Of Anesthetics, Camille A. Clare, Gabrielle E. Hatton, Neela Shrestha, Michael Girshin, Andre Broumas, Danielle Carmel, Mario A. Inchiosa Jr.

NYMC Faculty Publications

Objective: To determine whether there is a difference in intraoperative bleeding with inhalational versus noninhalational anesthetic agents for patients undergoing suction dilatation and curettage for first-trimester induced abortion. Methods: This is an IRB-approved retrospective chart review of the electronic medical records of patients undergoing induced abortion at gestational ages between 5 0/7 and 14 0/7 weeks of pregnancy at the New York City Health + Hospitals/Metropolitan. The records of 138 patients who underwent suction dilatation and curettage for induced abortion between June 2012 and June 2014 were reviewed for an association between anesthetic technique and intraoperative hemorrhage. Twenty patients received …

Effects Of Novel Calpain Inhibitors In Transgenic Animal Model Of Parkinson's Disease/Dementia With Lewy Bodies, Getaw Hassen, Leo Kesner, Alfred Stracher, Abraham Shulman, Edward Rockenstein, Michael Mante, Eliezer Masliah

NYMC Faculty Publications

Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are neurodegenerative disorders of the aging population characterized by the accumulation of alpha-synuclein (alpha-syn). The mechanisms triggering alpha-syn toxicity are not completely understood, however, c-terminus truncation of alpha-syn by proteases such as calpain may have a role. Therefore, inhibition of calpain may be of value. The main objective of this study was to evaluate the effects of systemically administered novel low molecular weight calpain inhibitors on alpha-syn pathology in a transgenic mouse model. For this purpose, non-tg and alpha-syn tg mice received the calpain inhibitors - Gabadur, Neurodur or a vehicle, …

A 54-Year-Old Woman With Myelofibrosis And Massive Hemothorax Due To Primary Extramedullary Hematopoiesis Of The Pleura, Michael Karass, Katherine Linder, Anup Agarwal, Alexandra Budhai, Yasmin Yusuf, Oleg Epelbaum

NYMC Faculty Publications

No abstract provided.

Recent Updates In Cancer Immunotherapy: A Comprehensive Review And Perspective Of The 2018 China Cancer Immunotherapy Workshop In Beijing, Zihai Li, Wenru Song, Mark Rubinstein, Delong Liu

NYMC Faculty Publications

The immune system is the hard-wired host defense mechanism against pathogens as well as cancer. Five years ago, we pondered the question if the era of cancer immunotherapy was upon us (Li et al., Exp Hem Oncol 2013). Exciting progresses have been made at all fronts since then, including (1) sweeping approval of six agents by the US Food and Drug Administration (FDA) to block the PD-1/PD-L1 pathway for treatment of 13 cancer types; (2) a paradigm shifting indication of PD-1 and CTLA4 blockers for the management of a broad class of cancers with DNA mismatch repair defect, the first-ever …

Controversies About Lyme Disease-Reply, Eugene D. Shapiro, Gary P. Wormser

NYMC Faculty Publications

No abstract provided.

Evolution And Mutations Predisposing To Daptomycin Resistance In Vancomycin-Resistant Enterococcus Faecium St736 Strains, Guiqing Wang, Weihua Huang, Abhay Dhand, Changhong Yin, Marisa Montecalvo, Nevenka Dimitrova, John T. Fallon

NYMC Faculty Publications

We recently identified a novel vancomycin-resistant Enterococcus faecium (VREfm) clone ST736 with reduced daptomycin susceptibility. The objectives of this study were to assess the population dynamics of local VREfm strains and genetic alterations predisposing to daptomycin resistance in VREfm ST736 strains. Multilocus sequence typing and single nucleotide variant data were derived from whole-genome sequencing of 250 E. faecium isolates from 1994-1995 (n = 43), 2009-2012 (n = 115) and 2013 (n = 92). A remarkable change was noticed in the clonality and antimicrobial resistance profiles of E. faecium strains between 1994-1995 and 2013. VREfm sequence type 17 (ST17), the prototype …

Regional Tissue Oxygen Extraction And Severity Of Anemia In Very Low Birth Weight Neonates: A Pilot Nirs Analysis, Jonathan Mintzer, Boriana Parvez, Edmund F. La Gamma

NYMC Faculty Publications

Objective: Anemia causes blood flow redistribution and altered tissue metabolic behavior to sustain homeostatic oxygen consumption. We hypothesized that anemia severity would correlate with increased regional fractional tissue oxygen extraction among premature neonates.

Study Design: Regional oxygen extraction was calculated using pulse oximetry and near-infrared spectroscopy data among neonates

Results: Twenty-seven neonates with gestational age 27 ± 2 weeks and birth weight 966 ± 181 g underwent 116 hematocrit determinations. Cerebral and flank oxygen extraction inversely correlated with hematocrit (cerebral r = −0.527, p = 0.005; flank r = −0.485, p = 0.01). Increased cerebral oxygen extraction was observed for …

Decreasing Mortality And Hospitalizations With Rising Costs Related To Gastric Cancer In The Usa: An Epidemiological Perspective, Delong Liu, Dhruv Mehta, Supreet Kaur, Arun Kumar, Kaushal Parikh, Lavneet Chawla, Aparna Saha

NYMC Faculty Publications

BACKGROUND: There is no convincing data on the trends of hospitalizations, mortality, cost, and demographic variations associated with inpatient admissions for gastric cancer in the USA. The aim of this study was to use a national database of US hospitals to evaluate the trends associated with gastric cancer. METHODS: We analyzed the National Inpatient Sample (NIS) database for all patients in whom gastric cancer (ICD-9 code: 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9) was the principal discharge diagnosis during the period, 2003-2014. The NIS is the largest publicly available all-payer inpatient care database in the US. It contains …

Nrh:Quinone Oxidoreductase 2 (Nqo2) And Glutaminase (Gls) Both Play A Role In Large Extracellular Vesicles (Lev) Formation In Preclinical Lncap-C4-2b Prostate Cancer Model Of Progressive Metastasis, Thambi Dorai, Ankeeta Shah, Faith Summers, Rajamma Mathew, Jing Huang, Tze-Chen Hsieh, Joseph M. Wu

NYMC Faculty Publications

In the course of studies aimed at the role of oxidative stress in the development of metastatic potential in the LNCaP-C4-2B prostate cancer progression model system, we found a relative decrease in the level of expression of the cytoplasmic nicotinamide riboside: quinone oxidoreductase (NQO2) and an increase in the oxidative stress in C4-2B cells compared to that in LNCaP or its derivatives C4 and C4-2. It was also found that C4-2B cells specifically shed large extracellular vesicles (LEVs) suggesting that these LEVs and their cargo could participate in the establishment of the osseous metastases. The level of expression of caveolin-1 …

Zinc Enhances Hippocampal Long-Term Potentiation At Ca1 Synapses Through Nr2b Containing Nmda Receptors, John Sullivan, Xiao-Lei Zhang, Arthur P. Sullivan, Linnea R. Vose, Alexander A. Moghadam, Victor A. Fried, Patric K. Stanton

NYMC Faculty Publications

The role of zinc (Zn2+), a modulator of N-methyl-D-aspartate (NMDA) receptors, in regulating long-term synaptic plasticity at hippocampal CA1 synapses is poorly understood. The effects of exogenous application of Zn2+ and of chelation of endogenous Zn2+ were examined on long-term potentiation (LTP) of stimulus-evoked synaptic transmission at Schaffer collateral (SCH) synapses in field CA1 of mouse hippocampal slices using whole-cell patch clamp and field recordings. Low micromolar concentrations of exogenous Zn2+ enhanced the induction of LTP, and this effect required activation of NMDA receptors containing NR2B subunits. Zn2+ elicited a selective increase in NMDA/NR2B fEPSPs, and removal of endogenous Zn2+ …

Home Return Following Invasive Mechanical Ventilation For The Oldest-Old Patients In Medical Intensive Care Units From Two Us Hospitals, Puthiery Va, Parth Rali, Harshitha Kota, Vivian Keenan, Sobia Mujtaba, Win Naing, Reka Salgunan, Irene Galperin, Oleg Epelbaum

NYMC Faculty Publications

Background: The aging of the US population has been associated with an increase in intensive care unit (ICU) utilization and correspondingly, invasive mechanical ventilation (IMV) among the oldest-old (age >/=80 years). While previous studies have examined ICU and IMV outcomes in the elderly, very few have focused on patient-centered outcomes, specifically home return, in the oldest-old. We investigated the rate of immediate home return following IMV in the medical ICU in previously home-dwelling oldest-old patients relative to that of a comparison group of 50-70-year olds. Methods: Data were extracted retrospectively from patient records at Elmhurst Hospital Center in Elmhurst, NY, …

A Reversible Carnitine Palmitoyltransferase (Cpt1) Inhibitor Offsets Chronic Lymphocytic Leukemia Cell Proliferation, Elena Gugiatti, Claudya Tenca, Silvia Ravera, Marina Fabbi, Fabio Ghiotto, Zbigniew Darzynkiewicz, Silvia Bruno

NYMC Faculty Publications

No abstract provided.

The Prevalence And Volumetry Of Pituitary Cysts In Children With Growth Hormone Deficiency And Idiopathic Short Stature, Nicholas Krasnow, Bradley Pogostin, James Haigney, Brittany Groh, Winston Weiler, Michael Tenner, Marion Kessler, Michael Frey, Richard A. Noto

NYMC Faculty Publications

Background

Pituitary cysts have been speculated to cause endocrinopathies. We sought to describe the prevalence and volumetry of pituitary cysts in patients with growth hormone deficiency (GHD) and idiopathic short stature (ISS).

Methods

Six hundred and eighteen children evaluated for growth failure at the Division of Pediatric Endocrinology at New York Medical College between the years 2002 and 2012, who underwent GH stimulation testing and had a brain magnetic resonance imaging (MRI) prior to initiating GH treatment were randomly selected to be a part of this study. High resolution MRI was used to evaluate the pituitary gland for size and …

Low Risk Monitoring In Neurocritical Care, Christian D. Becker, Christian Bowers, Dipak Chandy, Chad Cole, Meic H. Schmidt, Corey Scurlock

NYMC Faculty Publications

Background/Rationale: Patients are admitted to Intensive care units (ICUs) either because they need close monitoring despite a low risk of hospital mortality (LRM group) or to receive ICU specific active treatments (AT group). The characteristics and differential outcomes of LRM patients vs. AT patients in Neurocritical Care Units are poorly understood. Methods: We classified 1,702 patients admitted to our tertiary and quaternary care center Neuroscience-ICU in 2016 and 2017 into LRM vs. AT groups. We compared demographics, admission diagnosis, goal of care status, readmission rates and managing attending specialty extracted from the medical record between groups. Acute Physiology, Age and …

Multistate Infestation With The Exotic Disease-Vector Tick Haemaphysalis Longicornis - United States, August 2017-September 2018, C. B. Beard, James Occi, Denise L. Bonilla, Andrea M. Egizi, Dina M. Fonseca, Gary P. Wormser, William Halperin

NYMC Faculty Publications

Haemaphysalis longicornis is a tick indigenous to eastern Asia and an important vector of human and animal disease agents, resulting in such outcomes as human hemorrhagic fever and reduction of production in dairy cattle by 25%. H. longicornis was discovered on a sheep in New Jersey in August 2017 (1). This was the first detection in the United States outside of quarantine. In the spring of 2018, the tick was again detected at the index site, and later, in other counties in New Jersey, in seven other states in the eastern United States, and in Arkansas. The hosts included six …

Development Of A Return To Work Tool For Primary Care Providers For Patients With Low Back Pain: A Pilot Study, Lisanne Cruz, Hasanat A. Alamgir, Parag Sheth, Ismail Nabeel

NYMC Faculty Publications

Context: Low back pain (LBP) is a common cause of disability in adults and primary care physicians (PCPs) are commonly the first medical practitioners to assess these patients. Despite this, PCPs often feel unprepared to make return to work (RTW) recommendations. Aims: The purpose of our project was to develop RTW guidelines for patients with LBP in the form of an accessible and adaptable electronic medical records (EMR) integrated tool. Settings and Design: All licensed physicians and physician extenders who see patients over the age of 18 years, presenting with acute LBP who are currently employed were eligible for participation. …

Concussion Knowledge Among Family Physicians In Croatia, Mark Herceg, Linda L. Kalcina, Ivo Lusic

NYMC Faculty Publications

Aim: The objective of this study was to administer and analyze results of a survey targeting knowledge about concussion symptoms, diagnosis, treatment and expected recovery among family medicine specialists in the Split-Dalmatia County of Croatia. Methods: An electronic survey questionnaire was developed utilizing concepts from previously published studies on concussion knowledge, attitudes and beliefs completed by physicians. The survey was intended to briefly and broadly assess concussion knowledge of Croatian healthcare providers. The first section of the survey included five questions clarifying professional practice, years of experience and experience with concussions; the second section included 15 questions about typical concussion …

Development And Utilization Of 3d Printed Material For Thoracotomy Simulation, Evan Yates, Roger Chirurgi, Frosso Adamakos, Rania Habal, Rajnish Jaiswal, Hossein Kalantari, Getaw W. Hassen

NYMC Faculty Publications

Medical simulation is a widely used training modality that is particularly useful for procedures that are technically difficult or rare. The use of simulations for educational purposes has increased dramatically over the years, with most emergency medicine (EM) programs primarily using mannequin-based simulations to teach medical students and residents. As an alternative to using mannequin, we built a 3D printed models for practicing invasive procedures. Repeated simulations may help further increase comfort levels in performing an emergency department (ED) thoracotomy in particular, and perhaps this can be extrapolated to all invasive procedures. Using this model, a simulation training conducted with …

The Basics Of Clinical Trial Centralized Monitoring, Adam Beauregard, Vadim Tantsyura, Fernand Labrie

NYMC Faculty Publications

No abstract provided.

Global, Regional, And National Disability-Adjusted Life-Years (Dalys) For 359 Diseases And Injuries And Healthy Life Expectancy (Hale) For 195 Countries And Territories, 1990–2017: A Systematic Analysis For The Global Burden Of Disease Study 2017, Hmwe Hmwe Kyu, Degu Abate, Kalkidan Hassen Abate, Solomon M. Abay, Cristiana Abbafati, Mohammad Tavakkoli, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Gbd 2017 Dalys And Hale Collaborators

NYMC Faculty Publications

BACKGROUND: How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for …

Upregulation Of Pdl1 Expression By Resveratrol And Piceatannol In Breast And Colorectal Cancer Cells Occurs Via Hdac3/P300-Mediated Nfkappab Signaling, Justin Lucas, Tze-Chen Hsieh, Dorota Halicka, Zbigniew Darzynkiewicz, Joseph M. Wu

NYMC Faculty Publications

Programmed cell death ligand 1 (PDL1) expressed in cancer cells interacting with its receptor programmed cell death 1 (PD1) expressed in immune cells represents a regulatory axis linked to the suppression and evasion of host immune functions. The blockade of PD1/PDL1 interaction using monoclonal antibodies has emerged as an effective therapy for several solid tumors; however, durable response has been observed in a subset of patients with PDL1-positive tumors. Thus, the understanding of the mechanisms responsible for the expression of PDL1 in tumor cells may help to improve the response to PDL1 blockade therapies. In this study, we investigated whether …

Cystamine And Cysteamine As Inhibitors Of Transglutaminases In Vivo, Thomas M. Jeitner, John T. Pinto, Arthur J. L. Cooper

NYMC Faculty Publications

Cystamine is commonly used as a transglutaminase inhibitor. This disulfide undergoes reduction in vivo to the aminothiol compound, cysteamine. Thus, the mechanism by which cystamine inhibits transglutaminase activity in vivo could be due to either cystamine or cysteamine, which depends on the local redox environment. Cystamine inactivates transglutaminases by promoting the oxidation of two vicinal cysteine residues on the enzyme to an allosteric disulfide, whereas cysteamine acts as a competitive inhibitor for transamidation reaction catalyzed by this enzyme. The latter mechanism is likely to result in the formation of a unique biomarker, N -(gamma-glutamyl)cysteamine that could serve to indicate how …

Early Detection And Management Of Massive Intraoperative Pulmonary Embolism In A Patient Undergoing Repair Of A Traumatic Acetabular Fracture, Tobechi E. Okoronkwo, Xuewei Zhang, Jessica Dworet, Matthew Wecksell

NYMC Faculty Publications

A 73-year-old male with history of hyperlipidemia and osteoarthritis was transferred from an outside hospital after a fall from a ladder at home. He sustained a severe right sided acetabular fracture involving the femoral head, requiring operative repair. Preoperative evaluation was unremarkable except for oxygen saturation < 95 %. After induction of anesthesia and surgical positioning, the patient went into cardiac arrest. After intraoperative cardiopulmonary resuscitation (CPR) and placement on extracorporeal membrane oxygenation (ECMO), the patient stabilized. Cardiac catheterization revealed a large left pulmonary embolism. Here, we discuss the etiology and management of intraoperative pulmonary embolism.

Detection Of Lymph Node Metastases In Penile Cancer, Jonathan B. Bloom, Michael Stern, Neel H. Patel, Michael Zhang, John L. Phillips

NYMC Faculty Publications

Penile cancer (PC) is a relatively rare malignancy in the United States (US) but a greater concern in developing nations. Lymph node imaging remains critical to the staging and treatment of this disease as metastases develop in a predictable, anatomic fashion. Early surgical intervention remains a mainstay in treatment and imaging often aids in decision making. This review highlights the indications for imaging in both low-stage and advanced disease. Furthermore, we discuss the benefits and limitations of currently available imaging for staging of inguinal and pelvic lymph nodes in PC and novel modalities in development.

Ethanol Enhances Estrogen Mediated Angiogenesis In Breast Cancer, Rachana Maniyar, Sanjukta Chakraborty, Robert Suriano

NYMC Faculty Publications

Angiogenesis, a highly regulated process, is exploited by tumors like breast cancer to ensure a constant supply of oxygen and nutrients and is key for tumor survival and progression. Estrogen and alcohol independently have been observed to contribute to angiogenesis in breast cancer but their combinatorial effects have never been evaluated. The exact mechanism by which estrogen and alcohol contribute to breast cancer angiogenesis remains to be elucidated. In this study, we defined the in vitro effects of the combination of estrogen and alcohol in breast cancer angiogenesis using the tubulogenesis and scratch wound assays. Conditioned media, generated by culturing …

Evaluation Of Bleeding Disorders In Patients With Noonan Syndrome: A Systematic Review, Diane J. Nugent, Alicia A. Romano, Shreya Sabharwal, David L. Cooper

NYMC Faculty Publications

Background: Noonan syndrome (NS) is an autosomal dominant genetic condition that has a number of clinical features, including bleeding diathesis and a number of hematological abnormalities including clotting factor deficiencies, von Willebrand disease and abnormal platelet count/function. Methods: We evaluated the frequency/types of bleeding disorders, and associated hematological laboratory findings, in patients with NS, using published data from 1965 to 2014. Results: Of 45 studies identified, 31 included data for 428 patients with NS. Of these patients, 43% had reported bleeding, 26% had no reported bleeding and no bleed data was reported for 31%. Most patients (90%) had bleeding-related laboratory …

Regeneration Of Neurotransmission Transcriptome In A Model Of Epileptic Encephalopathy After Antiinflammatory Treatment, Dumitru Iacobas, Libor Velisek

NYMC Faculty Publications

Inflammation is an established etiopathogenesis factor of infantile spasms (IS), a therapy-resistant epileptic syndrome of infancy. We investigated the IS-associated transcriptomic alterations of neurotransmission in rat hypothalamic arcuate nucleus, how they are corrected by antiinflamatory treatments and whether there are sex differences. IS was triggered by repeated intraperitoneal administration of N-methyl-D-aspartic acid following anti-inflammatory treatment (adreno-cortico-tropic-hormone (ACTH) or PMX53) or normal saline vehicle to prenatally exposed to betamethasone young rats. We found that treatments with both ACTH and PMX53 resulted in substantial recovery of the genomic fabrics of all types of synaptic transmission altered by IS. While ACTH represents the …

Impact Of Pre-Existing Treatment With Statins On The Course And Outcome Of Tick-Borne Encephalitis, Petra Bogovic, Lara Lusa, Dasa Stupica, Tereza Rojko, Misa Korva, Gary P. Wormser, Franc Strle

NYMC Faculty Publications

OBJECTIVES: Although statins have anti-inflammatory and potentially also antimicrobial (including antiviral) activity, their therapeutic impact on infectious diseases is controversial. In this study, we evaluated whether pre-existing statin use influenced the course and outcome of tick-borne encephalitis. METHODS: To assess the influence of statin usage on the severity of acute illness and the outcome of tick-borne encephalitis, univariate and multivariable analyses were performed for 700 adult patients with tick-borne encephalitis of whom 77 (11%) were being treated with statins, and for 410 patients of whom 53 (13%) were receiving statins, respectively. RESULTS: Multivariable analyses found no statistically significant association between …