Volume 1, Issue 2
Resident Education in a Time of Health Care Reform- Editorial
Author: Harry Dym, DDS- Editor-in-Chief
All one hears in the news today is the ongoing unified cry for health care reform:
A) to remove waste and duplication
B) improve access to health care
C) improve the quality of health care
All these perpetual discussions and heated debates speak to everything but the one critical factor that will directly impact all aspects of health care delivery and that is the ongoing continued process of approved resident medical education in the United States.
It seems obvious that no health care delivery system can exist without physicians, Read full text
Disparities in Colon Cancer among an African American Population at a Community Hospital in Brooklyn.
Author: Basir Haque, Zaw Min Bo, Meena Ahluwalia, Gina Villani.
Each year approximately 148,810 new cases of colorectal cancer are diagnosed and nearly 50,000 people die from the disease. Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States and accounts for 15% of all cancers diagnosed annually. Early diagnosis is closely related to survival. Five-year survival exceeds 90% for patients diagnosed with disease localized to the colon or rectum compared with only 60% for patients with regional lymph node involvement. Survival for persons with distant metastasis (spread to organs such as the liver and lungs) is dismal, Read full text
TWIN PREGNANCY COMPLICATED BY MOYAMOYA DISEASE
Author: Tobe Momah MD, MSC; Johannes Jones MD, FACOG, Anders Cohen, MD; George Ahad, MD- The Brooklyn Hospital Center
We report a 22 year old twin gestation female successfully delivered preterm with postpartum complications which turned out to be secondary to Moyamoya disease.
Keywords: Moya moya disease, Cerebro vascular disease
Background: There are only 53 reported cases of Moya Moya disease (MMD) associated with pregnancy in the literature1.
Case: Our report highlights the difficulty in diagnosing and treating newly diagnosed pregnant patients with MMD. Read full text
Eclampsia in HIV Cocaine Abuser at 25 weeks old gestational age
Author: Tobe Momah MD, MSc – Department of Family Medicine, Johannes Jones MD -Department of Obstetrics and Gynecology division of Maternal-Fetal Medicine; The Brooklyn Hospital Center
A 43 year old African American female presented to our facility with high-grade fever, seizures, elevated blood pressure and altered mental status. Our laboratory investigations revealed HIV positive serum, Read full text
A New Technique for Utilizing a Powered Periotome for Preserving Bone During Odotectomy
Author: Adam Weiss DDS, Avichai Stern DDS, Harry Dym DDS- Department of Dentistry & Oral and Maxillofacial Surgery
Implant driven restorative dentistry has superseded traditional crown and bridge and heroic endodontics as the preferred treatment planning modality of many dentists for treatment of the pulpally involved tooth. As the discipline progresses and the surgical and restorative materials reach new heights of perfection, Read full text
Why Am I Here? A Survey of Patent Knowledge on their Care in the E.D.
Author: D. Lehrfeld, B. Yeh, M. Leber, A. Farzad The Brooklyn Hospital Center, Brooklyn, N.Y.
Objective: We observed that admitted patients in the ED were often inadequately informed about the care they were receiving and their admission diagnosis. Our search of the medical literature revealed no study evaluating patients' knowledge of their admission diagnosis. Read full text
Pregnancy Outcome in Patients with “Corrected” Mid-Trimester Placenta Previa
Author: Joanne Andrades MD, Robert Robertazzi, MS, Dominica Yi, BS,Michelle M. Pacis, BS, MPH and Johannes Jones, MD
Placenta Previa, defined as placental implantation over the internal cervical os, occurs in 1 in 300 live births.
Figure 1. Depiction of Normal Gestation (left) versus uncorrected Placenta previa ( right). Read full text
Evaluating the Management of Diabetes Mellitus Type-2 in HIV-Infected Patients
Author: Agnes Cha, PharmD; Eva Berrios-Colon, PharmD, BCPS, CACP; Leonard Berkowitz, MD; Jennifer Huang, PharmD, CACP; Robert DiGregorio, PharmD
Diabetes mellitus (DM) and impaired glucose tolerance in HIV-infected patients are common
Insulin resistance is an important cardiovascular disease risk factor in HIV-infected patients
Hemoglobin A1c (HbA1c) used to monitor glucose control
Literature suggests HbA1c overestimates glucose control
Fructosamine measures glycosylated proteins in the serum or plasma over previous 2-3 weeks
Fructosamine may be more reliable marker of glucose control in HIV patients
If treatment is necessary, Read full text
Clinical Outcome of Nursing Home and Non-Nursing home patients admitted to Intensive Care Unit
Author: I.U.Khan, S.Shahzad, V.P.Vasudevan, R.Ali, F.Arjomand
Catastrophically ill nursing home (NH) residents with high Acute Physiology and Chronic Health Evaluation (APACHE score) are admitted to Medical Intensive Care Unit (MICU) for life prolonging therapy. Read full text
VEXING ISSUES IN COLORECTAL CANCER SCREENING
Author: Shashideep Singhal, Puneet S. Basi, Siddharth Mathur, Manpreet Singh,Amir S. Butt, Mojdeh Momeni, Sury Anand- Gastroenterology Division, Department of Internal Medicine
Colonoscopy is the gold standard test for prevention and early detection of Colorectal Cancer (CRC). The United States Preventive Services Task Force (USPSTF) recommends against routine screening for colorectal cancer (CRC) in adults over 75 years of age. Read full text
Percutaneous Endoscopic Suturing:An effective treatment for Gastrocutaneous fistula.
Author: Vishal Ghevariya, Mahesh Krishnaiah, Sury Anand - Division of Gastroenterology
Development of persistent gastrocutaneous fistula and leakage after removal of a PEG tube is a well-known complication. Various treatments including medications to alter gastric pH, prokinetic agents, endoscopic clipping, Read full text
Diffuse Lung infiltrates in a smoker with HIV infection
Author: Praveen Jinnur MD, Vishal Verma MD, Sasikanth Nallagatla MD, Viswanath Vasudevan MD- The Brooklyn Hospital Center, NewYork
We acknowledge Dr.Philip Xiao MD (Dept of Pathology, The Brooklyn Hospital Center) for providing the photographs of histopathology slides used in this presentation.
ABG-Arterial Blood Gas H&E-Hematoxylin eosin
DLCO-Diffusing capacity of the lung LCH-Langerhans’ Cell Histiocytosis
for carbon monoxide PCO2-Partial pressure of CO2
FEF25-75%-Forced expiratory flow at PO2-Partial pressure of O2
25-75% of the pulmonary volume PFT-Pulmonary function Test
FEV1-Forced Expiratory Volume in 1 sec RV-Residual volume
FVC-Forced vital capacity TLC-Total lung capacity
Opportunistic lung infections are frequently considered when patients with HIV infections present with respiratory symptoms and abnormal Chest. Read full text
Can a Man’s Shirt (collar) size serve as an indicator for an underlying sleep disorder?
Author: Irina Erlikh, MD & Jee Eun Lee Karl, MD- Department of Family Medicine
The importance of chronic sleep insufficiency is under-recognized as a public health problem, despite being associated with numerous physical and mental health problems, injury, loss of productivity, and mortality1. An estimated 50-70 million persons in the United States have chronic sleep and wakefulness disorders. Read full text
New Development in Bone Regeneration Use of rhBMP-2 in Oral Maxillofacial Surgery
Author: James C. Kang, Avi Stern, Harry Dym- Department of Dentistry & Oral and Maxillofacial Surgery
INFUSE Bone Graft is indicated as an alternative to autogenous bone graft .Bone Morphogenetic Proteins (BMP) are cytokines that belong to a family of TGF-beta superproteins. There are 15 BMPs identified BMP2 is the product used).
BMP functions include: the induction of bone and cartilage maturation of osteocytes, Read full text
Assessing Risk Factors and Outcomes of interests in Hospitalized Elderly patients with Delirium
Author: Mohammed Azmir M.D., Rachit Patel, Yonette Davis, M.D.--Div. Of Geriatrics, Dept. of Int. Medicine, Brooklyn Hospital Center
Delirium is frequently found in the elderly hospitalized patient, particularly in the frail elderly. In the acute care setting, delirium can be found in greater than 30% of elderly patients, Read full text
Anti-tussive Medication use among coughing children presenting to the PED
Author: Amit Kamath MD, Pankaj Jain MD, Noah Kondamudi MD.FAAP.FACEP.
Cough medication use is a world wide phenomenon
with sales of 3.5 billion annually in the US.
Every week 4 million children < 12 years old use
There have been several recent reports of toxicity
and death associated with their use.
The AAP recommends against the use of antitussive
medication in children.
The FDA strongly recommends against the usage of
anti-tussive medications in children below 2 years
And even published a black box warning.
Major recognized adverse effects include sedation, Read full text
Gastroenterological Emergencies Part I: Acute Upper Gastrointestinal Bleeding
Author: Vishal Ghevariya MD, Sury Anand MD;Division of Gastroenterology, The Brooklyn Hospital Center, Brooklyn, NY.
Gastrointestinal (GI) bleeding is a common and costly medical condition. Approximately 1,000,000 hospitalizations occur annually for GI bleeding.1 Upper gastrointestinal (UGI) bleeding accounts for about half of these cases, and at a cost of $2.5 billion annually.1,2 The mortality rate of about 10% is unchanged despite widespread use of fiberoptic endoscopy, Read full text
The Captivating Cryptococcoma - A Mystery Lurking in the Brain
Author: Rita Shah, MD, and Ralitsa Tsarnakova, MD Department of Medicine, Brooklyn Hospital, Brooklyn, NY.
Cerebral cryptococcoma is a cryptococcal infection of the CNS presenting as a focal granuloma. These intracranial lesions are uncommon in AIDS patients with cryptococcal meningitis, but when the two entities co-exist, Read full text
Chronotropic Incompetence and Dobutamine Testing in Overweight and Obese Patients
Author: Kenneth Ong, MD Nisha Pillai, MD Unnikrishnan Thampy, MD
Dobutamine stress testing is a pharmacological alternative to exercise-induced tachycardia and is commonly used as a form of cardiac testing in patients unable to exercise. With adequate heart rate response, Read full text
Scholarly Activity – A Program Director’s Observations
Author: Kenneth Ong, MD
"Somewhere, something incredible is waiting to be known." - Carl Sagan
Graduate medical education involves a formal period of training after medical school in order to prepare the physician for independent medical practice. Read full text