Donald & Barbara Zucker School of Medicine at Hofstra/Northwell
Hofstra Northwell Academic Works (Hofstra Northwell School of Medicine)Not a member yet
9590 research outputs found
Sort by
Problems with interpreting troponins in chronic kidney disease patients for ruling out acute coronary syndrome
No full textChest pain is one of the most common reasons for emergency department visits worldwide, and troponins play a central role in diagnosing acute coronary syndrome (ACS) in these patients. Hence, the tests for these molecules are imperative in triage for ACS. Presently, multiple high-sensitivity troponin tests are available, including those for troponin T and I. However, in the presence of physiological and pathological alterations such as chronic kidney disease (CKD) and muscle dysfunction, these tests lose their sensitivity and specificity, especially if not interpreted in the right clinical background. Further, no guidelines exist for interpreting the results in patients with CKD. We identified studies that compared the relative efficacy, sensitivity, and specificity of tests for troponin T and I in patients with CKD to understand the practical problems in the clinical interpretation of these results in the specific setting of CKD and highlight the measures to be taken into consideration
Objective Improvements in Peripheral Arterial Disease from Dorsal Root Ganglion Stimulation: A Case Series
No full textBackground: The sympathetic nervous system (SNS) is important in the regulation of perfusion. Dorsal root ganglion stimulation (DRG-S) modulates sympathetic tone and is approved to treat complex regional pain syndrome, a disorder related to SNS dysfunction. We herein present 3 cases of DRG-S therapy to improve blood flow and symptoms of ischemia in peripheral arterial disease (PAD). Methods: Patient 1 is a 44-year-old female with dry gangrene of the third and fourth digits of her right hand due to Raynaud\u27s syndrome who was scheduled for amputation of the affected digits. DRG-S leads were placed at the right C6, 7, and 8 DRG. Pulse volume recordings (PVR) were measured at baseline and after DRG-S. Patient 2 is a 55-year-old female with a non-healing ulcer of her left foot secondary to PAD scheduled for a below the knee amputation who underwent a DRG-S trial with leads placed at the left L4 and L5 DRG followed by a spinal cord stimulation trial with leads placed at the T9–T10 spinal levels for comparison. Transcutaneous oximetry (TcPO2) was measured at baseline and after 3 days of each therapy. Patient 3 is a 69-year-old female with persistent left foot pain at rest secondary to PAD with DRG-S leads placed at the left L4 and S1 levels. Results: All 3 patients experienced a significant reduction in pain with DRG-S, along with improvements in blood flow of the involved extremities, avoiding or limiting amputation. PVR improved dramatically with DRG-S in patient 1. A greater improvement in TcPO2 was seen with the DRG-S trial compared to spinal cord stimulation trial in patient 2. Patient 3 experienced an increase in walking distance and demonstrated long term efficacy and limb salvage at 32 months postimplantation. Conclusions: Modulation of SNS output from DRG-S through orthodromic and antidromic autonomic pathways is likely responsible for improving blood flow. DRG-S may be a treatment option for PAD
Brief communication: A radiology resident\u27s experience with COVID-19 in New York City
Get PDF© 2020 Elsevier Inc. The COVID-19 pandemic impacted New York City severely. As a radiology resident, I was unsure how my role would change as the pandemic unfolded. Like many hospital systems in New York City, my department was asked to assist in the clinical care of patients during the dramatic surge of admissions related to COVID-19. I placed invasive central lines for critically ill patients in the intensive care unit to help reduce the workload on already overwhelmed critical care teams. I also performed direct patient care within dedicated COVID-19 inpatient floors
Dorsal Root Ganglion Stimulation Normalizes Measures of Pain Processing in Patients with Chronic Low-Back Pain: A Prospective Pilot Study using Quantitative Sensory Testing
No full textDose-Dependent Association between Perioperative Blood Transfusions and Postoperative Thromboembolism in Total Joint Arthroplasty Patients
No full textCOVID-19 and Anosmia: Retrospective Review of Olfactory Anatomy and Pathology Affected by the SARS-CoV-2 Virus
No full textPreliminary Findings: A Retrospective Analysis of Cognition, Anxiety and Depression in COVID-19 Patients Admitted to Acute Rehabilitation
No full text
