Brookdale University Hospital Medical Center

Brooklyn, NY, United States

Brookdale University Hospital Medical Center

Brooklyn, NY, United States
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Kundra A.,Brookdale University Hospital Medical Center | Wang J.C.,Brookdale University Hospital Medical Center
Critical Reviews in Oncology/Hematology | Year: 2017

Interferon (IFN) has been associated with development of thrombotic microangiopathy including thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). We reviewed literature from the earliest reported association in 1993, to July 2016 and found 68 cases. Analysis of this data shows: (1) Mean age at diagnosis was 47 years (95% CI, 44–50). (2) Majority of cases were seen where IFN was used for the treatment of chronic myelogenous leukemia (CML), multiple sclerosis (MS), chronic hepatitis C virus infection (HCV) and one case each for hairy cell leukemia (HCL) and Sezary syndrome. (3) There were no cases reported for polycythemia vera (PV) or lymphoma. (4) Sex distribution was nearly equivalent with the exception in patients with multiple sclerosis where there was female predominance (12 of 16 with reported data). (5) For pooled analysis, the average duration of treatment with IFN before TMA was diagnosed was 40.4 months. (6) Comparative analysis showed that patients with MS required the highest cumulative dose exposure before developing TMA (MS 68.6 months, CML 35.5 months, HCV 30.4 months). (7) Cases of confirmed TTP (where A disintegrin and Metalloprotease with thrombospondin type 1 motif 13: ADAMTS 13 level was measured) showed presence of an inhibitor. (8) In all cases of confirmed TTP, moderate to severe thrombocytopenia was a striking clinical feature at presentation while this was not a consistent finding in all other cases of TMA. (9) Outcome analysis revealed complete remission in 27 (40%), persistent chronic kidney disease (CKD) in 28 (42%) and fatality in 12 patients (18%). (10) Treatment with corticosteroids, plasma exchange and rituximab resulted in durable responses. © 2017 Elsevier B.V.

Goltser A.,Brookdale University Hospital Medical Center | Soleyman-Zomalan E.,Arlington Memorial Hospital | Kresch F.,Maimonides Medical Center | Motov S.,Maimonides Medical Center
American Journal of Emergency Medicine | Year: 2015

A convenience sample of 14 patients received an analgesic dose of ketamine infusion for acute pain in the emergency department (ED). Low-dose ketamine (LDK) was defined as the administration of 0.2 to 0.4 mg/kg of ketamine, and infusion was defined as a drip of ketamine diluted in 50 to 100 mL of normal saline piggyback administered over 10 to 15 minutes. Pain intensity was measured using validated numeric rating scale in 8 of the 14 cases, 5 were documented nonquantitatively, and 1 case was not documented. Fourteen cases in which patients received LDK infusion in the ED were identified. Doses ranged from 10 to 35 mg. Patients received opioids in the ED before LDK infusion in 12 of the 14 cases. Significant improvement in pain was observed in 11 of the 14 cases. None of the patients required rescue analgesia. Two patients reported mild adverse reactions. The administration of analgesic dose of ketamine infusion in the ED may be a safe and effective analgesic modality for ED patients with acute painful conditions who have a history of chronic opioid use or who are refractory to opioid pain medications. More prospective randomized controlled trials are needed before widespread use of LDK infusion for analgesia in the ED can be recommended.

Kafeel M.,Brookdale University Hospital Medical Center | Cheedella N.K.S.,Brookdale University Hospital Medical Center | Wang J.C.,Brookdale University Hospital Medical Center
Case Reports in Oncology | Year: 2013

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and are predominant in the stomach and intestine but rare in the esophagus. Here, we report a case of esophageal GIST which presented as a mediastinal mass on chest X-ray and dyspnea. The case was initially diagnosed as leiomyosarcoma, which could create a diagnostic dilemma. Therefore, recognizing this uncommon presentation as a mediastinal mass with esophageal GIST is important in the differential diagnosis. © 2013 S. Karger AG, Basel.

Poddar N.,Brookdale University Hospital Medical Center | Wang J.C.,Brookdale University Hospital Medical Center
Hematology Reports | Year: 2013

Thrombotic thrombocytopenic purpura (TTP) is a life threatening condition associated with formation of platelet thrombi. Deficiency of ADAM TS 13 with presence of inhibitory anti- ADAM TS 13 Immunoglobulin G antibody is seen in patients with acquired TTP. TTP in patients on interferon therapy for chronic hepatitis C has rarely been reported. Furthermore, successful treatment of an initial episode of acute refractory acquired TTP, in a patient of chronic hepatitis C during interferon therapy with Rituximab, has not been previously reported. Here we describe a case of acute refractory acquired TTP associated with pegylated interferon therapy for her chronic hepatitis C infection. Initially refractory to plasmapheresis and steroids, she was successfully treated with Rituximab and plasmaphersis without any evidence of reactivation of hepatitis. © Copyright N. Poddar and J.C. Wang, 2013.

Reddy K.,New York University | Lowenstein E.J.,New York University | Lowenstein E.J.,Brookdale University Hospital Medical Center
Journal of the American Academy of Dermatology | Year: 2011

The evaluation of skin findings is critical in identifying many types of injury, whether self- inflicted or accidentally or intentionally inflicted. Specific causes of injury include homicide, abuse, neglect, assault, self-inflicted injury, suicide, torture, poisoning, and bioterrorism. Forensic findings in hair and nails are also discussed. This overview of dermatologic findings in forensic pathology highlights the significance of the cutaneous manifestations of injury. © 2010 by the American Academy of Dermatology, Inc.

Tabrizian P.,Mount Sinai Medical Center | Shrager B.,Morristown Medical Center | Jibara G.,Brookdale University Hospital Medical Center | Yang M.-J.,Mount Sinai Medical Center | And 4 more authors.
Journal of Gastrointestinal Surgery | Year: 2014

Background: Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) is an effective but morbid procedure in the treatment of peritoneal carcinomatosis. We report our outcomes at a single tertiary institution. Method: A total of 170 consecutive patients underwent CRS-HIPEC for peritoneal carcinomatosis between July 2007 and August 2012. The peritoneal cancer index (1-39) was used for peritoneal carcinomatosis (PC) staging. Mitomycin C (88.8 %) was administered intraperitoneally at 42 °C for 90 mins. Risk factors associated with major morbidities were analyzed. The Kaplan-Meier method was used for survival analyses. Results: The mean age was 55.1 (±11.3) years, and the majority (77.1 %) of patients had complete cytoreduction (CC0-1). Tumor types included colorectal (n = 51, 30.0 %), appendiceal (n = 50, 29.4 %), pseudomyxoma peritonei (n = 16, 9.4 %), and other (n = 53, 31.2 %). Factors associated with major complications were estimated blood loss (>400 ml), length of stay (>1 week), intraoperative blood transfusion, operative time (>6 h), and bowel anastomosis. Intraoperative blood transfusion was the only independent prognostic factor on multivariate analysis (p = 0.031). Median follow-up was 15.7 months (±1.2). The recurrence rates for colorectal and appendiceal carcinoma at 1 and 3 years were 40 %, 53.5 % and 68 %, 79.1 %, respectively. The 1- and 3-year overall survival for colorectal and appendiceal carcinomatosis was 74.0 %, 32.5 % and 89.4 %, 29.3 %, respectively. Intraoperative peritoneal cancer index (PCI) score (>16) and need for blood transfusion were factors independently associated with poor survival (p < 0.05). Conclusion: Our single institution experience of CRS/HIPEC procedures for peritoneal carcinomatosis demonstrates acceptable perioperative outcome and long-term survival. Optimal cytoreduction was achieved in the majority of cases. Intraoperative PCI > 16 was associated with poor survival. This series supports the safety of CRS-HIPEC in selected patients. © 2014 The Society for Surgery of the Alimentary Tract.

Wang J.C.,Brookdale University Hospital Medical Center | Kafeel M.I.,Brookdale University Hospital Medical Center | Avezbakiyev B.,Brookdale University Hospital Medical Center | Chen C.,Brookdale University Hospital Medical Center | And 6 more authors.
Oncology | Year: 2011

Background: Elevated histone deacetylase (HDAC) isoenzyme levels have been described in patients with carcinomas and leukemias. HDAC inhibitors (HDACi) have shown promise in the treatment of carcinomas and are currently under intense research. To make better use of HDACi in treating chronic lymphocytic leukemia (CLL), HDAC isoenzyme levels were studied. Methods: Quantitative reverse transcriptase polymerase chain reaction for HDAC isoenzyme was measured in 32 patients with CLL and compared with 17 normal volunteer controls. ZAP-70, CD38 and CD44 were also assayed and correlated to HDAC isoenzyme levels. Results: The results showed: (1) HDAC iso enzyme levels in CLL were significantly increased in class I including HDAC1 and HDAC3, in class II including HADC6, HDAC7, HDAC9 and HDAC10, and in class III including SIRT1 and SIRT6; (2) higher expression of HDAC isoenzyme levels was found in ZAP-70+ compared to ZAP-70-patients, and CD44 expression levels were correlated with HDAC isoenzyme expression levels in the majority of HDAC classes. Conclusions: These results suggest: (1) in CLL, elevated HDAC isoenzyme activity is not restricted to one class, and therefore, HDACi therapy may need to be directed to more than one specific class of HDAC; (2) higher HDAC expression activity may indicate a poor prognosis and more advanced disease stage (through indirect evidence), since higher values were found in patients with ZAP-70+ and higher CD44 expression levels. Copyright © 2012 S. Karger AG, Basel.

Reddy K.,New York University | Lowenstein E.J.,New York University | Lowenstein E.J.,Brookdale University Hospital Medical Center
Journal of the American Academy of Dermatology | Year: 2011

Examination of the skin and adnexae is a critical part of the forensic examination. Little information on forensic sciences has been published in the dermatologic literature. Correct forensic terminology and documentation of dermatologic findings is of critical importance in forensic investigations. The skin may reveal clues to the identity of an individual and the time and method of death or injury. Normal postmortem changes in the skin are described along with pseudopathology and damage from postmortem animal activity. The forensic classification of types of injuries is introduced in this first of a two-part paper on forensics in dermatology. © 2010 by the American Academy of Dermatology, Inc.

PubMed | Brookdale University Hospital Medical center and Brookdale University Hospital Medical Center
Type: | Journal: The American journal of case reports | Year: 2016

Patients receiving cancer treatment are at risk for hepatitis B virus (HBV) reactivation. Ifosfamide is an alkylating agent and is considered to be one of the important drugs for the treatment of metastatic sarcoma. No association of ifosfamide and HBV reactivation has been reported so far.We report a case of a 61-year-old Asian man with metastatic retroperitoneal liposarcoma who was HBcAb positive and was treated with ifosfamide and dacarbazine, developed HBV reactivation secondary to ifosfamide requiring treatment with tenofovir. To the best of our knowledge, this is the first report describing HBV reactivation in a patient with positive HBcAb who was treated with ifosfamide.We recommend close surveillance of possible HBV reactivation while employing ifosfamide chemotherapy.

TROY, Mich., Feb. 20, 2017 (GLOBE NEWSWIRE) -- CareTech Solutions, a leader in information technology (IT) and mobility services for U.S. hospitals and health systems, today announced it will present its annual Rising Star customer awards and exhibit at the Healthcare Information Management Systems Society (HIMSS) 2017 Annual Conference and Exhibition from February 19 – 23, 2017, in Orlando, at booth #1923. Healthcare is grappling with how best to address coordinated care challenges, high re-admission rates and value-based care. At HIMSS, CareTech Solutions, a subsidiary of HTC Global Services, will demonstrate its ability to transform the way hospitals and health systems deliver, measure and improve care through business intelligence and other critical IT services across the care continuum. CareTech Solutions will feature its complete suite of IT services to improve the patient experience and lower healthcare costs, including: “As the industry strives to identify and implement new and effective ways to put the patient first in a value-based care world, it’s hypercritical to have the right IT, security, implementation, support and business intelligence – all while meeting ever changing compliance requirements,” said Tommi A. White, president of CareTech Solutions, a subsidiary of HTC Global Services. “We want our customers to not think about the intricacies, added costs or ongoing management of their IT efforts, and instead focus on improving patient care. This is why we continuously strive to be the best partner for our customers, providing solutions from strategic alignment and day-to-day IT operations to managing increasing security risks.” “Our Rising Star winners are a testament to our collaborative partnerships and ongoing commitment to performance excellence in IT,” added White. “It’s my honor to acknowledge some of our clients with outstanding work in IT this past year. They come in all shapes and sizes, from being agents of change at their organizations and achieving HIMSS level 7; to utilizing mobility as a strategic advantage to engage patients and physicians within a single, integrated patient portal; to taking leadership roles in their community to bring together peer organizations; and leveraging metrics and analytics to drive quality and overall IT performance.” CareTech Solutions will honor top customers with 2017 Rising Star Awards, a corporate award program in its tenth year that recognizes clients who exemplify leadership in using information technology as a strategic advantage for their organizations, on Monday, February 20 beginning at 10:30 a.m. ET at HIMSS booth #1923. The winners are (in alphabetical order): Brookdale University Hospital Medical Center (N.Y.), Cancer Treatment Centers of America, Inc. (Ill.), Jupiter Medical Center, Inc. (Fla.), Lafayette General Health (La.), Montefiore Health System (N.Y.) and Nebraska Medical Center (Neb.). To learn more about CareTech Solutions, visit booth #1923 at HIMSS17 from February 19 – 23 in Orlando. About CareTech Solutions CareTech Solutions is a leader in information technology (IT) and end-user interface services for U.S. hospitals and health systems. CareTech’s more than 1,400 U.S.-based professionals create value for clients through customized IT solutions that contribute to improving the patient experience while lowering healthcare costs. From implementing emerging technologies to supporting day-to-day IT operations, CareTech offers clients expert health information technology services earning it the 2008-2011, 2013-2017 Best in KLAS award for IT Outsourcing (Extensive), and the 2012, 2013, 2015/2016 and 2017 Partial IT Outsourcing Award as ranked by healthcare executives and professionals in the respected annual “Best in KLAS Awards: Software & Services” report. CareTech Solutions is a health IT subsidiary of HTC Global Services, a global provider of IT solutions and business process outsourcing services. Learn more about CareTech Solutions at

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