Medical Specialties Commons^™

Delayed Pneumothorax: A Potential Complication Of Transbronchial Lung Biopsy, N. Narula, F. Siddiqui, A. H. Siddiqui, W. C. Man, M. Chalhoub

Journal Articles

© 2018 The purpose of this article is to report a case of secondary tension pneumothorax presenting seven weeks post Transbronchial Lung biopsy. A 62 year old male with a known history of germ cell tumor was found to have a left-sided pneumothorax which later complicated to a tension pneumothorax.To the best of our knowledge this is the second case being reported for a delayed pneumothorax post a Transbronchial Lung Biopsy.The purpose of this case report is to create awareness among physicians to consider this diagnosis even at a later stage and the importance of patient education regarding the signs …

Initial Experience With A Novel Resection And Plication (Rap) Method For Acid Reflux: A Pilot Study., P. C. Benias, L. D'Souza, G. Lan, C. Gluckman, S. Inamdar, A. J. Trindade, L. S. Miller, D. L. Carr-Locke

Journal Articles

Current endoscopic therapies for gastroesophageal reflux disorder (GERD) are limited by technical complexity, and/or cost. We sought to evaluate the success of a novel resection and plication (RAP) anti-reflux procedure. RAP was performed on 10 patients with GERD refractory to proton pump inhibitor (PPI) therapy. RAP consists of semi-circumferential mucosectomy along with full-thickness plication of the lower esophageal sphincter (LES) and cardia. We assessed the technical success and safety as well as followed GERD-Health Related Quality of Life (GERD-HRQL) scores and medication usage.All patients underwent RAP without adverse events and were discharged on the same day. Only half of the …

Potentially Avoidable Readmissions In United States Hemodialysis Patients, A. T. Mathew, L. Rosen, R. Pekmezaris, A. Kozikowski, D. W. Ross, T. Mcginn, K. Kalantar-Zadeh, S. Fishbane

Journal Articles

© 2017 International Society of Nephrology Introduction: Patients with end-stage kidney disease have a high risk of 30-day readmission to hospital. These readmissions are financially costly to health care systems and are associated with poor health-related quality of life. The objective of this study was to describe and analyze the frequency, causes, and predictors of 30-day potentially avoidable readmission to hospital in patients on hemodialysis. Methods: We conducted a retrospective cohort study using the US Renal Data System data from January 1, 2008, to December 31, 2008. A total of 107,940 prevalent United States hemodialysis patients with 248,680 index hospital …

Nephropathology Education During Nephrology Fellowship Training In The United States, V. Mechery, T. Hernandez, A. T. Mathew, R. Wanchoo, S. V. Seshan, K. D. Jhaveri, H. H. Shah

Journal Articles

No abstract provided.

The Comb Sign In Crohn's Ileocolitis, N. Adlakha, A. Swaminath

Journal Articles

No abstract provided.

Bouveret's Syndrome: Literature Review., F. G. Haddad, W. Mansour, L. Deeb

Journal Articles

It was in 1896 that Bouveret's syndrome acquired its name after the French physician Leon Bouveret, who published two case reports in Revue de Medecin. Bouveret's syndrome describes gastric outlet obstruction secondary to an impacted gallstone. The gallstone reaches the small bowel through a bilioenteric fistula as a consequence of chronic inflammation and adherence between the biliary system and the bowels which increase the intraluminal pressure and leads to secondary wall ischemia and wall perforation with gallstone passage into the bowel. Bouveret's syndrome's prevalence is highest among elderly women. Despite the rarity of Bouveret's syndrome, it can cause notable morbidity …

Hepatitis C Infection Patterns At A Tertiary Care Center In New York: A Cross-Sectional Study., A. Mahgoub, T. El Imad, H. Al Moussawi, D. Daneshvar, F. G. Haddad, J. Saabiye, G. Abdelsayed, S. Andrawes, L. Deeb

Journal Articles

Introduction In the United States, 2.7 to 3.9 million patients are infected with the hepatitis C virus (HCV) with 3,500 new cases reported yearly. According to the Centers for Disease Control and Prevention, HCV was the underlying or contributing cause of death of 19,659 patients in 2014. These facts underscore the need for a better understanding of the scope of this disease. Our epidemiologic study aimed at analyzing the pattern of occurrence of HCV infection at Staten Island University Hospital (SIUH) by evaluating the characteristics of newly infected patients with hepatitis C in 2014. The identified features served to better …

Athlete's Hepatitis In A Young Healthy Marathon Runner, H. Khan, J. Phillipose, M. Ahmed, L. Deeb

Journal Articles

© 2018 The Author(s). Published by S. Karger AG, Basel. Athlete's hepatitis is an uncommon clinical condition characterized by a significant ischemic insult to the liver. The most likely pathogenesis is decreased blood supply to the liver resulting in significant hypoxic hepatocyte injury. We report a case of a 48-year-old healthy young male who presented with athlete's hepatitis confirmed by liver biopsy after a 14-mile marathon run. To our knowledge, this is the second case of athlete's ischemic hepatitis reported in the literature. It is a diagnosis worth considering in patients involved in extreme exercise programs.

Prevalence Of Proteinuria And Albuminuria In An Obese Population And Associated Risk Factors., J. L. Rosenstock, M. Pommier, G. Stoffels, S. Patel, M. F. Michelis

Journal Articles

Obesity has been increasingly recognized as a risk factor for kidney disease and both proteinuria and microalbuminuria have been associated with obesity. The actual prevalence of microalbuminuria and proteinuria in obese patients in the United States (US) has not been clearly described in the literature. Furthermore, obesity is associated with risk factors of kidney disease, such as diabetes and hypertension (HTN), and the prevalence of proteinuria and albuminuria excluding these risk factors is uncertain. In this study, we collected urine albumin/creatinine and urine protein/creatinine ratios on obese patients undergoing bariatric surgery to determine the prevalence of albuminuria and proteinuria in …

Sarcomatoid Carcinoma Of Lung Presenting As Localized Bronchiectasis: A Case Report And Review Of Literature, K. Rajdev, A. H. Siddiqui, U. Ibrahim, S. Agarwal, J. Ding, M. Chalhoub

Journal Articles

© 2018 The Authors Sarcomatoid carcinoma (SC) of the lung is a rare and aggressive biphasic lung tumor with a 5-year survival of 20%. Early detection and treatment is the only way to improve outcomes in patients with SC of the lung. We present a case of primary SC identified early based on high suspicion. A 56-year-old female with a history of chronic obstructive pulmonary disease (COPD) presented with hemoptysis and exertional dyspnea. Chest X-ray revealed right upper lobe (RUL) opacity and patient was started on antibiotics for pneumonia. Due to the persistence of hemoptysis, a computed tomography scan was …

Mesalamine Associated Bradycardia., M. Krzyzak, A. Gupta, E. Antonov, S. M. Mulrooney

Journal Articles

A 38-year-old female presented with an acute flare of ulcerative colitis. She was started on prednisone and mesalamine. Within 24 hours of initiating mesalamine, she developed sinus bradycardia. After holding mesalamine, the heart rate returned to normal within five days. Our case illustrates the third described case, to our knowledge, of severe sinus bradycardia secondary to mesalamine.

From Bouveret's Syndrome To Gallstone Ileus: The Journey Of A Migrating Stone!, F. G. Haddad, W. Mansour, J. Mansour, L. Deeb

Journal Articles

Bouveret's syndrome, first described in 1896, is an unusual cause of gastric outlet obstruction secondary to large gallstone impaction in the proximal duodenum after migration through a cholecystoduodenal fistula. Stone migration has been previously described after endoscopic or surgical fragmentation. However, this is the first reported case, in our knowledge, where the stone migrated after oral contrast administration a few days after the onset of symptoms, causing a distal gallstone ileus.

Update On Relative Value Units And The Cognitive Physician Visit, S. Katz, E. Petrilak

Journal Articles

No abstract provided.

Nicotine Enhances Mesangial Cell Proliferation And Fibronectin Production In High Glucose Milieu Via Activation Of Wnt/Beta-Catenin Pathway, X. Lan, H. Wen, R. Aslam, S. S. Shoshtari, A. Mishra, V. Kumar, H. Wang, G. Wu, A. Malhotra, P. C. Singhal, +1 Additional Author

Journal Articles

No abstract provided.

Alk-Negative Anaplastic Large Cell Lymphoma Presenting As Disseminated Intravascular Coagulation And Hemophagocytic Lymphohistiocytosis: A Potentially Fatal Presentation., U. Ibrahim, A. Saqib, M. Rehan, J. P. Atallah

Journal Articles

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that can be familial in etiology or a result of infections, malignancy, and autoimmune or inflammatory disorders. Disseminated intravascular coagulation (DIC) is common in patients admitted to intensive care units and can confound and delay the diagnosis of HLH. We present a case of a 69-year-old female who presented with dyspnea and malaise. Her condition declined rapidly with laboratory parameters consistent with DIC. In addition, she had a ferritin of 32,522 ng/mL, low haptoglobin, and elevated LDH, and bone marrow biopsy showed hemophagocytic lymphohistiocytes. She was started on HLH-directed therapy, and later, a …

Use Of Volumetric Laser Endomicroscopy For Determining Candidates For Endoscopic Therapy In Superficial Esophageal Squamous Cell Carcinoma, A. J. Trindade, P. C. Benias, S. Inamdar, C. Fan, A. Sethi, N. Fukami, A. Kahn, M. Kahaleh, D. Sejpal, A. Rishi, +1 Additional Author

Journal Articles

No abstract provided.

The Design And Evaluation Of The Comprehensive Hospitalist Assessment And Mentorship With Portfolios (Champ) Ultrasound Program, B. K. Mathews, K. Reierson, V. Khuong, A. Mehta, P. Miller, S. Koenig, M. Narasimhan

Journal Articles

No abstract provided.

Prevalence Of Proteinuria And Albuminuria In An Obese Population And Associated Risk Factors, J. L. Rosenstock, M. Pommier, G. Stoffels, S. Patel, M. F. Michelis

Journal Articles

©2018 Rosenstock, Pommier, Stoffels, Patel and Michelis. Obesity has been increasingly recognized as a risk factor for kidney disease and both proteinuria and microalbuminuria have been associated with obesity. The actual prevalence of microalbuminuria and proteinuria in obese patients in the United States (US) has not been clearly described in the literature. Furthermore, obesity is associated with risk factors of kidney disease, such as diabetes and hypertension (HTN), and the prevalence of proteinuria and albuminuria excluding these risk factors is uncertain. In this study, we collected urine albumin/creatinine and urine protein/creatinine ratios on obese patients undergoing bariatric surgery to determine …

An Elderly Patient's Complete Response To Steroid Therapy For Collagenous Gastritis, H. Lim, B. Y. Wong, D. Elkowitz, K. Sultan

Journal Articles

No abstract provided.

Modulation Of Apolipoprotein L1-Microrna-193a Axis Prevents Podocyte Dedifferentiation In High-Glucose Milieu, A. Mishra, K. Ayasolla, V. Kumar, X. Lan, H. Vashistha, R. Aslam, A. Hussain, S. Chowdhary, A. Malhotra, P. C. Singhal, +6 Additional Authors

Journal Articles

No abstract provided.

Intravenous Epoetin Alfa-Epbx Versus Epoetin Alfa For Treatment Of Anemia In End-Stage Kidney Disease, S. Fishbane, B. Singh, S. Kumbhat, W. A. Wisemandle, N. E. Martin

Journal Articles

© 2018 by the American Society of Nephrology. Background and objectives This study was conducted to compare the safety and efficacy of intravenous epoetin alfa-epbx, an epoetin alfa biosimilar, to epoetin alfa in patients on hemodialysis with ESKD and anemia. Design, setting, participants, & measurements In this 24-week, multicenter, double-blind comparative efficacy and safety study, 612 patients on hemodialysis with ESKD and anemia who had stable hemoglobin and were receiving stable doses of intravenous epoetin alfa were randomized (1:1) to intravenous epoetin alfa or epoetin alfa-epbx. Dosing was adjusted according to the epoetin alfa prescribing information. The coprimary efficacy endpoints …

Indwelling Pleural Catheters: Complications And Management Strategies, M. Chalhoub, A. Saqib, M. Castellano

Journal Articles

©Journal of Thoracic Disease. Indwelling pleural catheters (IPCs) are increasingly being used for patients with recurrent malignant pleural effusions. They are simple to place and can be done on an outpatient basis under local anesthesia. IPCs uniformly relieve dyspnea and improve quality of life of patients with malignant pleural effusions. In some patients with recurrent non-malignant pleural effusions, IPCs proved to be effective as well. With increasing use of IPCs, physicians and patients are faced with complications related to the presence of an indwelling catheter for extended periods of time. The purpose of this review is to describe the various …

Apol1 Risk Variants Cause Podocytes Injury Through Enhancing Endoplasmic Reticulum Stress, H. Wen, V. Kumar, X. Lan, S. S. Shoshtari, J. M. Eng, X. Zhou, F. Wang, H. Wang, A. Malhotra, P. C. Singhal, +4 Additional Authors

Journal Articles

c 2018 The Author(s). Two coding sequence variants (G1 and G2) of Apolipoprotein L1 (APOL1) gene have been implicated as a higher risk factor for chronic kidney diseases (CKD) in African Americans when compared with European Americans. Previous studies have suggested that the APOL1 G1 and G2 variant proteins are more toxic to kidney cells than the wild-type APOL1 G0, but the underlying mechanisms are poorly understood. To determine whether endoplasmic reticulum (ER) stress contributes to podocyte toxicity, we generated human podocytes (HPs) that stably overexpressed APOL1 G0, G1, or G2 (Vec/HPs, G0/HPs, G1/HPs, and G2/HPs). Propidium iodide staining showed …

Renal Involvement In Chronic Lymphocytic Leukemia., R. Wanchoo, C. Bernabe Ramirez, J. Barrientos, K. D. Jhaveri

Journal Articles

Chronic lymphocytic leukemia (CLL) is the most commonly diagnosed adult leukemia in the USA and Western Europe. Kidney disease can present in patients with CLL as a manifestation of the disease process such as acute kidney injury with infiltration or with a paraneoplastic glomerular disease or as a manifestation of extra renal obstruction and tumor lysis syndrome. In the current era of novel targeted therapies, kidney disease can also present as a complication of treatment. Tumor lysis syndrome associated with novel agents such as the B-cell lymphoma 2 inhibitor venetoclax and the monoclonal antibody obinutuzumab are important nephrotoxicities associated with …

Chylothorax In Patients With Chronic Lymphocytic Leukemia: A Case Series., D. Sammartino, S. Khanijo, S. Koenig, J. F. Katsetos, A. Tufano, K. R. Rai, J. C. Barrientos

Journal Articles

Chylothorax, which is defined as the presence of chyle in the pleural space, is often caused by malignancy. However, chylothorax as a result of underlying CLL is exceedingly rare in the literature. Chyle contains fat soluble vitamins and lymphocytes, meaning that its collection into the pleural space may further exacerbate the immunosupressed state of an individual with CLL. Here, we report three cases of patients with CLL who developed chylothorax, and their management. Chylothorax, although rare with CLL, should be considered in the differential diagnosis when patients with CLL present with pleural effusions, especially if recurrent. Discovery of a chylothorax …

Giant Cell Carcinoma Of The Lung Successfully Treated With Surgical Resection And Adjuvant Vinorelbine And Cisplatin, S. Habib, L. E. Leifer, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub

Journal Articles

© 2018 Giant Cell Carcinoma of the lung, a subtype of Sarcomatoid lung cancer is a poorly differentiated Non-Small-Cell Lung Cancer. GCCL has exceptionally aggressive characteristics, and its prognosis is much poorer than any other NSCLCs. Herein, we present a rare case of Giant Cell Carcinoma of lung treated successfully with surgical resection and adjuvant vinorelbine and cisplatin. A 48-year-old African American man with a history of smoking and chronic obstructive pulmonary disease was admitted to the hospital for chief complaints of shortness of breath. He was found to have a 3.5 cm × 3.3 cm x 2.8 cm cavitary …

Severe De Novo Ulcerative Colitis Following Ixekizumab Therapy, J. Philipose, M. Ahmed, P. S. Idiculla, S. M. Mulrooney, V. V. Gumaste

Journal Articles

© 2018 The Author(s). Published by S. Karger AG, Basel. Ixekizumab is a selective monoclonal antibody targeting interleukin-17A, approved for the treatment of chronic plaque psoriasis. It has rarely been associated with inflammatory bowel disease (IBD) in randomized trials only. We report a unique case of severe new-onset ulcerative colitis in a young male complicated by cytomegalovirus infection who was on ixekizumab therapy for plaque psoriasis. We recommend that clinicians should exercise caution before prescribing ixekizumab as it seems to induce and exacerbate IBD.

Relevance Of B-Lines On Lung Ultrasound In Volume Overload And Pulmonary Congestion: Clinical Correlations And Outcomes In Patients On Hemodialysis., Marc M Saad, Jeanne Kamal, E. Moussaly, B. Karam, W. Mansour, Emad Gobran, Saqib Hussen Abbasi, Ahmed Mahgoub, Puja Singh, Ross Hardy, D. Das, C. Brown, M. Kapoor, S. Demissie, M. J. Kleiner, E. El Charabaty, S. E. El Sayegh

Journal Articles

BACKGROUND: Volume overload in patients on hemodialysis (HD) is an independent risk factor for cardiovascular mortality. B-lines detected on lung ultrasound (BLUS) assess extravascular lung water. This raises interest in its utility for assessing volume status and cardiovascular outcomes.

METHODS: End-stage renal disease patients on HD at the Island Rehab Center being older than 18 years were screened. Patients achieving their dry weight (DW) had a lung ultrasound in a supine position. Scores were classified as mild (0-14), moderate (15-30), and severe (>30) for pulmonary congestion. Patients with more than 60 were further classified as very severe. Patients were …

Connexin 43 Hemichannel As A Novel Mediator Of Sterile And Infectious Inflammatory Diseases, W. Li, W. Chen, S. Zhu, M. He, G. Ma, Y. Al-Abed, H. Yang, K. J. Tracey, P. Wang, J. D'Angelo, H. Wang, +4 Additional Authors

Journal Articles

No abstract provided.

Epigallocatechin-3-Gallate Confers Protection Against Corticosterone-Induced Neuron Injuries Via Restoring Extracellular Signal-Regulated Kinase 1/2 And Phosphatidylinositol-3 Kinase/Protein Kinase B Signaling Pathways, X. Zhao, R. Li, H. Jin, H. Jin, Y. Wang, W. Zhang, H. Wang, W. Chen

Journal Articles

No abstract provided.