Coney Island, NY, United States
Coney Island, NY, United States

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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.


Akinyemi E.,Coney Island Hospital | Bercovici S.,Coney Island Hospital | Niranjan S.,Coney Island Hospital | Paul N.,Coney Island Hospital | Hemavathy B.,Coney Island Hospital
American Journal of Therapeutics | Year: 2011

Herbal and dietary supplements for weight loss and in treatment of obesity are growing in popularity and acceptance in the United States. Most of these supplements can be obtained over the counter and can have serious adverse effects associated with their consumption. We describe 2 patients who developed thyrotoxic hypokalemic periodic paralysis 2-3 weeks after consuming thyroxine-containing weight-loss supplements. This is the first known case of thyrotoxic hypokalemic periodic paralysis secondary to dietary supplements. It is important that patients and physicians are aware of the severe adverse reactions associated with dietary supplements. Physicians should as a routine inquire about herbal and dietary supplement consumption during all patient encounters. © 2011 Lippincott Williams & Wilkins.


Guarino H.,U.S. National Institutes of Health | Moore S.K.,U.S. National Institutes of Health | Marsch L.A.,Dartmouth College | Florio S.,Coney Island Hospital
Substance Abuse: Treatment, Prevention, and Policy | Year: 2012

Background: Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection.Methods: In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment providers working with this population. Informed by a grounded theory approach, interview transcripts were inductively coded and analyzed to identify key themes.Results: The "trauma" of the immigration/acculturation experience was emphasized by participants as playing a critical role in motivating opioid use. Interview data suggest that substance use patterns formed in the high-risk environment of the FSU may persist as behavioral norms within New York City FSU immigrant communities - including a predilection for heroin use among youth, a high prevalence of injection, and a tolerance for syringe sharing within substance-using peer networks. Multiple levels of social context may reproduce FSU immigrants' vulnerability to substance abuse and disease such as: peer-based interactional contexts in which participants typically used opioids; community workplace settings in which some participants were introduced to and obtained opioids; and cultural norms, with roots in Soviet-era social policies, stigmatizing substance abuse which may contribute to immigrants' reluctance to seek disease prevention and drug treatment services.Conclusion: Several behavioral and contextual factors appear to increase FSU immigrants' risk for opioid abuse, IDU and infectious disease. Further research on opioid-using FSU immigrants is warranted and may help prevent increases in HIV/HCV prevalence from occurring within these communities. © 2012 Guarino et al; licensee BioMed Central Ltd.


Kruger D.,St. John's University | Kruger D.,Coney Island Hospital
Journal of the American Academy of Physician Assistants | Year: 2014

Dysphagia, or difficulty swallowing, is a common problem. Although most cases are attributable to benign disease processes, dysphagia is also a key symptom in several malignancies, making it an important symptom to evaluate. The differential diagnosis of dysphagia requires an understanding of deglutition, in particular the oropharyngeal versus esophageal stages. Stroke is the leading cause of oropharyngeal dysphagia, which is common in older adults and frequently presents as part of a broader complex of clinical manifestations. In esophageal dysphagia, difficulty swallowing is often the main complaint and is caused by localized neuromuscular disorders or obstructive lesions. Copyright © 2014 American Academy of Physician Assistants.


Arnold K.,Coney Island Hospital | Vakhrusheva J.,Yeshiva University
Psychosis | Year: 2016

It is widely believed that it is countertherapeutic to confront delusions, but the underlying reasons why have not been clearly conceptualized. The present paper endeavors to clarify both (1) why confronting delusions is countertherapeutic, and (2) why therapists can feel tempted to do so. People experiencing delusions can elicit an automatic reaction in the disbelieving therapist that can be termed the negation reflex. The therapist may feel compelled to negate or disconfirm the patient’s delusions to defend his or her own belief in a stable reality. Doing so evokes psychological reactance and strengthens the imperviousness of the delusion. The negation reflex is part of an interpersonal feedback loop that maintains the delusion’s imperviousness. It is the therapist’s task to interrupt that feedback loop by resisting the negation reflex and implementing therapeutic practices designed to minimize reactance. © 2015 Taylor & Francis.


Brailoiu G.C.,Temple University | Gurzu B.,Temple University | Gao X.,Temple University | Parkesh R.,University of Oxford | And 8 more authors.
Journal of Biological Chemistry | Year: 2010

Accumulating evidence implicates nicotinic acid adenine dinucleotide phosphate (NAADP) in the control of Ca2+-dependent functions. Little, however, is known concerning its role in the vascular endothelium, a major regulator of blood pressure. Here, we show that NAADP acetoxymethyl ester (NAADP-AM), a cell-permeant NAADP analog, increases cytosolic Ca2+ concentration in aortic endothelial cells. We demonstrate that these signals and those evoked by acetylcholine are blocked by disrupting acidic organelles with bafilomycin A1. In contrast, Ca2+ signals in response to thrombin are only partially inhibited by bafilomycin A1 treatment, and those to ATP were insensitive, suggesting that recruitment of acidic stores is agonist-specific. We further show that NAADP-evoked Ca2+ signals hyperpolarize endothelial cells and generate NO. Additionally, we demonstrate that NAADP dilates aortic rings in an endothelium- and NO-dependent manner. Finally, we show that intravenous administration of NAADP-AM into anesthetized rats decreases mean arterial pressure. Our data extend the actions of NAADP to the endothelium both in vitro and in vivo, pointing to a previously unrecognized role for this messenger in controlling blood pressure. © 2010 by The American Society for Biochemistry and Molecular Biology, Inc.


El-Hennawy A.S.,Coney Island Hospital | Zaib S.,Coney Island Hospital
American Journal of Therapeutics | Year: 2010

Muscle cramps are not uncommon complications of hemodialysis (HD) treatments and lead to early termination of HD sessions and are therefore a significant cause of under-dialysis. The etiology of cramps in dialysis patients remains a matter of debate. Many reports suggested that vitamin E (vit. E) may be effective for the prevention of HD-associated cramps. We decided to perform a selected controlled trial of supplementary vit. E for treatment of patients on HD who experience frequent attacks during and between HD sessions. The goal was to compare the number of attacks of muscle cramps with the patient's baseline over a specific period of time. In this study, 19 HD patients were randomly selected of different age groups and ethnicity. Patient must have had at least 60 attacks of muscle cramps during and between HD sessions over a 12-week period. All selected patients received vit. E at a dose of 400 international units daily for 12 weeks, and the number of attacks of muscle cramps was recorded. The frequency of muscle cramps decreased significantly during vit. E therapy, and, at the end of the trial, vit. E led to cramp reductions of 68.3%. The reduction in number of attacks of muscle cramps had no significant correlation with age, sex, etiology of end-stage renal disease, serum electrolytes, or HD duration, and it showed a statistically positive correlation (P = 0.0001) with vit. E therapy. No vit. E-related adverse effects were encountered during the trial. Short-term treatment with vit. E is safe and effective in reducing number of attacks of muscle cramps in HD patients, as shown in our study. © 2010 Lippincott Williams & Wilkins.


Arnold K.,Coney Island Hospital
Psychosis | Year: 2016

A central problem of delusions is their imperviousness to counterargument. Although several existing theories account for aspects of delusional imperviousness, they omit the context of social interactions in which it occurs. Delusions elicit a specific and powerful social response from others: disbelief. Recent research has identified a backfire effect that happens when efforts to correct false beliefs strengthen, rather than weaken, conviction in those beliefs. It is proposed that delusional imperviousness is a special case of a backfire effect, in which repeated efforts to correct delusions paradoxically strengthen them. Delusions become impervious because they are strengthened by the counterarguments they elicit in others. © 2016 Informa UK Limited, trading as Taylor & Francis Group


PubMed | Coney Island Hospital
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016

6699 Background: BCL (Body Cavity Lymphoma) is an uncommon primary NHL (Non-Hodgkins lymphoms) that proliferates within serous body cavities - pleural, pericardial or peritoneal, resulting in recurrent effusions. It is common in young to middle-aged HIV (Human Immunodeficiency Virus) positive homosexual males. In the absence of HIV infection, it almost universally develops in the background of HHV-8/KSHV (Human Herpes Virus-8/ Kaposis Sarcoma Herpes Virus) infection with or without EBV (Epstein Barr Virus). Rare BCLs have been reported in elderly populations, which are both HIV negative and HHV-8 negative. We report an unusual case of BCL, which is HHV-8 negative and EBV positive. Abstract: 75 yrs old Immigrant Ashkenazi Jew from Russia was admitted with shortness of breath for 1 month and leg edema. No B-symptoms. His Karnofsky performance status was 80. He is heterosexual, monogamous, non-smoker and denied alcohol or intravenous drug abuse. Clinical examination revealed a right-sided pleural effusion only. Complete Blood Count showed mild normocytic normochromic anemia with hemoglobin -11.5 gm/dl. Total white count, differential, renal and liver function tests were normal. Serum LDH 200 U/L, serum 2 Microglobulin 2.8. Pleural fluid was frankly hemorrhagic with 80,000 RBC/cu mm, 16,800 WBC/ cu mm with 65% lymphocytes and 26% monocytes. Pleural fluid LDH 4500 U/L and cytology revealed Large cell lymphoma. CT scan of chest, abdomen and pelvis failed to demonstrate any lymphadenopathy or organomegaly. There was no pericardial effusion or ascites. Pleural fluid flow-cytometry demonstrated monoclonal lambda B-cell population lacking CD5 or CD10. The cells were positive for CD19, CD20, CD22 and CD45 and negative for CD2, CD3, CD4, CD5, CD7, CD9, CD10, CD11c and CD13/33. Bone marrow aspiration biopsy and flow-cytometry were negative for disease. Serum PCR for HHV-8, Human T Cell Leukemia Virus 1 and 2, Hepatitis C Virus negative, serum EBV IgG positive. CD4 count was 400 and CD8 was 300 with a ratio of 1.3. A diagnosis of BCL was made. He underwent therapeutic thoracentesis with relief of respiratory symptoms.Standard CHOP-like chemotherapy has been planned for this patient. No significant financial relationships to disclose.


PubMed | Coney Island Hospital
Type: | Journal: Case reports in cardiology | Year: 2016

Synthetic marijuana is an uptrending designer drug currently widely spread in the US. We report a case of acute deterioration of nonischemic left ventricular dysfunction after exposure to synthetic marijuana. This case illustrates the importance of history taking in cardiac patients and identifies a negative cardiovascular effect of synthetic marijuana known as K2, not yet well detected by urine toxicology screening tools.

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