Capital Health System

Pennington, NJ, United States

Capital Health System

Pennington, NJ, United States
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Arshad S.H.,David Hide Asthma and Allergy Research Center | Arshad S.H.,University of Southampton | Karmaus W.,University of South Carolina | Raza A.,David Hide Asthma and Allergy Research Center | And 8 more authors.
Journal of Allergy and Clinical Immunology | Year: 2012

Background: The parent-of-origin effect is important in understanding the genetic basis of childhood allergic diseases and improving our ability to identify high-risk children. Objective: We sought to investigate the parent-of-origin effect in childhood allergic diseases. Methods: The Isle of Wight Birth Cohort (n = 1456) has been examined at 1, 2, 4, 10, and 18 years of age. Information on the prevalence of asthma, eczema, rhinitis, and environmental factors was obtained by using validated questionnaires. Skin prick tests were carried out at ages 4, 10, and 18 years, and total IgE measurement was carried out at 10 and 18 years. Parental history of allergic disease was assessed soon after the birth of the child, when maternal IgE levels were also measured. Prevalence ratios (PRs) and their 95% CIs were estimated, applying log-linear models adjusted for confounding variables. Results: When stratified for sex of the child, maternal asthma was associated with asthma in girls (PR, 1.91; 95% CI, 1.34-2.72; P =.0003) but not in boys (PR, 1.29; 95% CI, 0.85-1.96; P =.23), whereas paternal asthma was associated with asthma in boys (PR, 1.99; 95% CI, 1.42-2.79; P <.0001) but not in girls (PR, 1.03; 95% CI, 0.59-1.80; P =.92). Maternal eczema increased the risk of eczema in girls (PR, 1.92; 95% CI, 1.37-2.68; P =.0001) only, whereas paternal eczema did the same for boys (PR, 2.07; 95% CI, 1.32-3.25; P =.002). Similar trends were observed when the effect of maternal and paternal allergic disease was assessed for childhood atopy and when maternal total IgE levels were related to total IgE levels in children at ages 10 and 18 years. Conclusions: The current study indicates a sex-dependent association of parental allergic conditions with childhood allergies, with maternal allergy increasing the risk in girls and paternal allergy increasing the risk in boys. This has implications for childhood allergy prediction and prevention. © 2012 American Academy of Allergy, Asthma & Immunology.

Singh H.,University of Toronto | Modabber M.,McGill University | Safran S.G.,Capital Health System | Ahmed I.I.K.,University of Toronto | Ahmed I.I.K.,Trillium Health Partners
Journal of Cataract and Refractive Surgery | Year: 2015

Purpose To present cases of uveitis-glaucoma-hyphema (UGH) syndrome due to reverse pupillary block in sulcus-placed posterior chamber intraocular lenses (PC IOLs) that were managed with laser peripheral iridotomy (LPI). Setting Community-based subspecialty clinics. Design Retrospective interventional case series. Methods A chart review of patients with a sulcus-placed PC IOLs presenting with UGH syndrome and reverse pupillary block with posterior iris bowing as diagnosed by gonioscopy and anterior segment optical coherence tomography was carried out. Laser peripheral iridotomy was performed in the eyes included in the study. The main outcome measure was clinical resolution of UGH syndrome. Results The study included 6 eyes of 6 patients with a mean age of 59.8 years (range 43.0 to 66.0 years) who presented with unilateral UGH syndrome a mean of 28.7 months (range 0.3 to 84.0 months) after PC IOL implantation. All patients were previously myopic, with 5 (83.3%) having a history of vitrectomy. The mean axial length was 27.0 mm ± 1.4 (SD). An LPI was used to treat the reverse pupillary block with resultant improvement in iris profile and resolution of UGH syndrome in all eyes. The mean intraocular pressure decreased from 30.5 ± 10.0 mm Hg on 0.5 ± 0.8 glaucoma medications to 15.5 ± 3.2 mm Hg postoperatively on 0.7 ± 1.2 medications. Conclusions The UGH syndrome due to reverse pupillary block occurred after sulcus-placed PC IOLs in susceptible patients, those with axial myopia, and post-vitrectomized eyes. The cases were managed with LPIs. Financial Disclosure Dr. Ahmed is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. No author has a financial or proprietary interest in any material or method mentioned. © 2015 ASCRS and ESCRS.

Ephros H.D.,St Josephs Regional Medical Center Paterson | Ephros H.D.,Seton Hall University | Madani M.,Capital Health System | Madani M.,Temple University | And 4 more authors.
Indian Journal of Medical Research | Year: 2010

Obstructive sleep apnoea (OSA) syndrome is a potentially serious disorder affecting millions of people around the world. Many of these individuals are undiagnosed while those who are diagnosed, often exhibit poor compliance with nightly use of continuous positive airway pressure (CPAP), a very effective nonsurgical treatment. Various surgical procedures have been proposed to manage and, in some cases, treat OSA. In this article we review methods used to assess the sites of obstruction and a number of surgical procedures designed to address OSA. Effective surgical management of OSA depends upon developing a complete database and determining different levels of obstruction, which may include nasal, nasopharyngeal, oropharyngeal, and hypopharyngeal/retrolingual, or a combination of these sites. A systematic approach to clinical evaluation, treatment planning and surgical management is recommended and is likely to result in more predictable outcomes. Surgical treatment may involve various procedures that are performed in different stages depending on the patient's sites of obstruction. The most commonly performed procedures include nasal reconstruction, uvulopalatopharyngoplasty (UPPP), advancement genioplasty, mandibular osteotomy with genioglossus advancement, and hyoid myotomy and suspension. In more severe cases, maxillomandibular advancement (MMA) with advancement genioplasty may be indicated. Even after appropriate surgical treatment, some patients may demonstrate continued obstruction with associated symptoms. Published indications for surgical treatment include an elevated respiratory disturbance index (RDI) with excessive daytime somnolence (EDS), oxygen desaturations below 90 per cent, medical co-morbidities including hypertension and arrhythmias, anatomic abnormalities of the upper airway and failure of medical treatment. The success of surgery in OSA is generally measured by achieving a (RDI) of less than 5, improvement of oxygen nadir to 90 per cent or more with no desaturations below 90 per cent and quality of life improvements with elimination or significant reduction of OSA symptoms. From a practical point of view, achieving these goals may be extremely difficult without patients' co-operation, most notably in the realm of weight loss and maintenance of a healthy lifestyle.

Madani M.,Capital Health System | Madani M.,Temple University | Madani M.,Bala Institute of Oral and Facial Surgery | Veznedaroglu E.,Capital Health System | And 3 more authors.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology | Year: 2010

Pseudoaneurysms, or arteriovenous fistulas, of the extracranial arterial system, particularly the facial artery, are rare. Its occurrence after reconstructive facial surgery has been reported rarely in the literature. In this article we describe a rare case of pseudoaneurysm developing over 4 weeks after an uneventful Le Fort I maxillary osteotomy, sagittal split osteotomy, and advancement genioplasty. A 22-year-old man presented with a severe class III skeletal deformity, mandibular hyperplasia, and maxillary hypoplasia. The patient's immediate postoperative course was uneventful for a 2-week period after surgery. Then the patient, while at home, experienced an accidental injury to his jaw and started to bleed from his left retromandibular side. He was taken to a local hospital where his bleeding was controlled by topical coagulant and pressure. During this short hospital visit he was given 3 units of blood and was subsequently discharged. He had no further bleeding and was monitored on a regular basis. One month after his double jaw surgery and 2 weeks after his bleeding episode, the left facial swelling diminished in size but was still visible. This mass was soft and pulsatile with a palpable thrill and auditory machinery murmur on auscultation. Although the patient was totally asymptomatic at this time, he was sent to the emergency room for a computerized tomography scan with 3-dimensional reconstruction. A Doppler ultrasound was also ordered. The ultrasound revealed the mass to be a pseudoaneurysm. Angiography revealed a pseudoaneurysm of the left facial artery. Coil embolization of the left facial artery was performed with a Cordis Trufill complex coil. The patient tolerated the procedure well and a repeat angiogram demonstrated no further evidence of aneurysm, arteriovenous malformation, vasospasm, or feeding branches to the fistula. The patient made an uneventful recovery and was discharged the day after the procedure. In this article, we review the anatomy of the extracranial arterial system of the head and neck, discuss the pathogenesis and clinical presentation of pseudoaneurysm, and present diagnostic imaging and treatment options for pseudoaneurysms of the face. © 2010 Mosby, Inc.

Madani M.,Capital Health System | Madani M.,Temple University | Madani M.,Center for Corrective Jaw Surgery | Berardi T.,University of Pennsylvania | Stoopler E.T.,University of Pennsylvania
Medical Clinics of North America | Year: 2014

Patients often present to their physician with complaints of dental and/or oral pain. It is important for physicians to understand the complexities of oral anatomy and how to perform a basic clinical examination of this area to evaluate and potentially manage patients with these complaints. This article discusses anatomic structures of the oral cavity and systematic clinical examination of this area. © 2014 Elsevier Inc.

Tehrani O.S.,Capital Health System | Chen E.Q.,Capital Health System | Schaebler D.L.,Capital Health System | Mughal A.W.,Capital Health System
Familial Cancer | Year: 2010

Two probands with thymoma and other primary malignancies with multiple cancer patients in the family are described. Types of malignancies, pattern of pedigree and age of the patients do not match the known familial cancer syndromes. One proband was a very rare case with five discrete primary malignancies; TP53 sequencing and karyotyping did not reveal any mutations. These cases suggest thymoma associated malignancies may herald a hereditary cancer syndrome. © 2010 Springer Science+Business Media B.V.

Two patients with high axial myopia, bilateral cataracts, and astigmatism had cataract surgery with implantation of a toric intraocular lens (IOL) without a capsular tension ring (CTR) in the first eye. Rotation of the IOL occurred shortly after surgery. In the second eye of both patients, a toric IOL of the same type and power and with a similar axial orientation as in the first eye was used; however, a CTR was placed at the time of surgery. In both cases, there was no IOL rotation in the second eye. Placement of a CTR at the time of cataract surgery in highly myopic eyes may help prevent postoperative rotation of a toric IOL. Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. © 2015 ASCRS and ESCRS.

Wang T.P.,Second Street | Safran S.G.,Capital Health System | Richter J.R.,Second Street | Siegel D.S.,Second Street | Vesole D.H.,Second Street
Clinical Lymphoma, Myeloma and Leukemia | Year: 2014

Crystalline deposition in the cornea can be an early manifestation of paraproteinemia, which may paralleldisease activity. Local treatment with superficial keratectomy orpenetrating keratoplasty provides symptomatic butonly transient improvement. Treatment of systemic disease often leads to resolutionof corneal involvement. © 2014 Elsevier Inc. All rights reserved.

PubMed | Capital Health System
Type: Case Reports | Journal: Familial cancer | Year: 2010

Two probands with thymoma and other primary malignancies with multiple cancer patients in the family are described. Types of malignancies, pattern of pedigree and age of the patients do not match the known familial cancer syndromes. One proband was a very rare case with five discrete primary malignancies; TP53 sequencing and karyotyping did not reveal any mutations. These cases suggest thymoma associated malignancies may herald a hereditary cancer syndrome.

PubMed | Capital Health System
Type: Case Reports | Journal: Archives of Iranian medicine | Year: 2012

A case of a 31-year-old woman with sudden respiratory distress is presented. Preliminary evaluations and imaging studies did not reveal the underlying cause. Workup during hospital stay showed advanced metastatic cancer of unknown primary origin. This is an unusual presentation of cancer of an unknown primary involving the thyroid with sudden suffocation. It suggests that malignancies involving the thyroid gland should be considered in patients with abrupt onset of respiratory distress. Also, this case shows the application of fine needle aspiration in diffuse thyroid enlargements mimicking thyroiditis without nodules. Diagnostic approach to cancer of unknown primary origin (CUP) is reviewed in further detail.

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