St Lukes Roosevelt Hospital Center

New York City, NY, United States

St Lukes Roosevelt Hospital Center

New York City, NY, United States
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Branson C.E.,St Lukes Roosevelt Hospital Center
Psychological services | Year: 2013

High rates of missed appointments and attrition are common barriers to treatment for adolescents attending outpatient mental health treatment. Such figures indicate a need for innovative strategies to engage youth in treatment. The current quasi-experimental pilot study examined the feasibility, acceptability, and preliminary efficacy of text message (TM) appointment reminders to improve attendance in a sample of 48 adolescents attending outpatient therapy. The sample was approximately 46% Latino and 40% African American with an equal number of males and females. Adolescents receiving TM reminders demonstrated significantly higher rates of attendance (65%) than a historical control group (49%) (p < .05). Participants in the TM group received reminders for the majority (88%) of their scheduled sessions with only 4% of reminders not received due to phone-related problems. Additionally, TM reminders received high patient satisfaction ratings. Findings from the present study suggest that TM reminders may be a cost-effective and developmentally appropriate strategy for engaging adolescents in treatment. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Silverberg J.I.,Northwestern University | Silverberg N.B.,St Lukes Roosevelt Hospital Center
British Journal of Dermatology | Year: 2014

Background Little is known about the epidemiology of severe acne in the U.S. Objectives We sought to study the U.S. prevalence, determinants and comorbidities of severe acne in adolescence. Methods We analysed data from the 2007 National Health Interview Survey, a cross-sectional questionnaire-based study of 9417 children ages 0-17 years. Prevalence of severe acne, demographics and comorbid disorders were determined. Results The U.S. prevalence of severe acne was virtually nil in the first decade of life, but increased in a linear fashion from 11 years [1·7% (95% confidence interval (CI) 0·4-3·0%)] to 17 years of age [12·1% (95% CI 7·8-16·5%)] (Rao-Scott Chi-square, P < 0·0001). Severe acne was more common in Whites compared with other racial groups at age 14-15 years (P = 0·0004) and girls at age 11-13 (P = 0·02). Severe acne was associated with a number of comorbid disorders. Sinopulmonary disease included sinus infection (P = 0·0003), sore throat other than strep infection (P = 0·0003), asthma (P = 0·03) and nonasthmatic lung disease (P = 0·03). Upper gastrointestinal comorbidities included reflux/heartburn (P = 0·0003), abdominal pain (P = 0·03), nausea/vomiting (P = 0·0001) and food/digestive allergy (P = 0·01). Psychological comorbidities included depression (P = 0·02), anxiety (P < 0·0001), attention deficit disorder/attention deficit hyperactivity disorder (P = 0·01) and insomnia (P = 0·02). Conclusions In conclusion, severe acne was more prevalent in older age, Whites, female sex and higher socioeconomic status. Future studies are needed to confirm the associations with sinopulmonary, upper gastrointestinal and psychological disorders in adolescents. What's already known about this topic? Little is known about racial, ethnic or socioeconomic differences of severe acne prevalence or about the medical comorbid disorders with severe acne. What does this study add? Severe acne is more prevalent in older age, Whites, female sex and higher socioeconomic status. Severe acne was associated with higher prevalences of one or more sinopulmonary, gastrointestinal and psychological comorbid disorders. The results of this study suggest that patients with severe acne are at higher risk for many comorbidities and warrant closer surveillance by dermatologists and primary care healthcare providers alike. © 2014 British Association of Dermatologists.

Silverberg N.B.,St Lukes Roosevelt Hospital Center
Cutis | Year: 2012

Acne vulgaris has been linked to milk ingestion, both whole and skim milk. The milk fraction that promotes acne is unknown. Five case reports are presented of male patients aged 14 to 18 years who experienced onset of acne shortly after initiation of whey protein supplementation; 3 teenagers used the supplement for muscle building in football training and the other 2 for attempting to gain weight. All 5 patients had poor response to acne treatment regimens of oral antibiotics, topical retinoids, and benzoyl peroxide. Lesions fully cleared in 4 patients after discontinuation of whey protein supplementation, but 1 patient's acne flared after reinitiation of the whey protein supplement. Two patients did not immediately discontinue whey protein supplementation; 1 of them cleared after he discontinued whey protein during his second course of isotretinoin and 1 was lost to follow-up. Among these patients, at least 6 different brands of whey protein supplementation had been used, including whey protein shakes and reconstituted powders. Whey protein may be the fraction of dairy products that promote acne formation. Larger studies are needed to determine the mechanism of comedogenesis. © Cutis 2012.

Bellmunt J.,University of the Sea | Dutcher J.,St Lukes Roosevelt Hospital Center
Annals of Oncology | Year: 2013

Background: Targeted therapies have shown profound effects on the outcome of patients with advanced renal cell carcinoma (RCC). However, the optimal treatment for RCC of non-clear cell histology (nccRCC)-typically excluded from trials of targeted agents-remains uncertain. Materials and methods: By carrying out extensive searches of PubMed and ASCO databases, we identified and summarised research into the biological characteristics, clinical behaviour and treatment of different histological subtypes of nccRCC, focusing on targeted therapy. Results: The available data suggest that treatments currently approved for RCC are active in ncc subtypes, although the overall clinical benefit may be less than for clear cell RCC. Temsirolimus has proven benefit over interferon-alfa (IFN-α) in patients with nccRCC, based on phase III data, while everolimus, sunitinib and sorafenib have all demonstrated some degree of activity in nccRCC in expanded-access trials. No clear picture has emerged of whether individual histological subtypes are particularly responsive to any individual treatment. Conclusions: Further molecular studies into the pathogenesis of RCC histological subtypes will help direct the development of novel, appropriate targeted agents. Clinical trials specifically designed to evaluate the role of targeted agents in nccRCC are ongoing, and data from trials with sunitinib and everolimus will be reported soon. © The Author 2013. All rights reserved.

Silverberg J.I.,80 Lake Shore Drive | Silverberg N.B.,Northwestern University | Silverberg N.B.,St Lukes Roosevelt Hospital Center
Journal of Allergy and Clinical Immunology | Year: 2014

Background Previous studies suggested that atopic dermatitis (AD) is associated with aberrant immune responses, which might predispose toward both cutaneous and extracutaneous infections. The goal of this study was to determine whether childhood AD is associated with increased risk of warts, extracutaneous infections, and other atopic diseases and how these disorders cosegregate. Methods The 2007 National Health Interview Survey from a nationally representative sample of 9417 children age 0 to 17 years was used. Results Children with AD and other atopic disease had higher odds of warts. In contrast, children with AD with or without other atopic disease had higher odds of extracutaneous infections, including strep throat, other sore throat, head or chest cold, influenza/pneumonia, sinus infections, recurrent ear infections, chickenpox, and urinary tract infections (P <.0001). Children with AD and other atopic disease had a higher number of infections than those with either disorder by itself (P <.0001). Warts were also associated with increased odds of all extracutaneous infections (P <.0001), except recurrent ear infections. Children with warts and AD had a higher number of infections than those with either disorder alone (P <.0001). Finally, children with AD and warts had higher odds of ever receiving a diagnosis of asthma, current asthma, asthma exacerbation in the past year, hay fever, and food allergy. Children with AD with warts had even higher odds of asthma, hay fever, and food allergies than those with AD and no warts. Conclusions The associations between childhood AD, atopic disease, warts, and extracutaneous infections suggest that barrier disruption, immune disruption, or both contribute to susceptibility to warts and extracutaneous infections in children. © 2013 American Academy of Allergy, Asthma & Immunology.

Greenberg J.A.,Brooklyn College | Greenberg J.A.,New York Obesity Research and Nutrition Center | Greenberg J.A.,St Lukes Roosevelt Hospital Center
American Journal of Clinical Nutrition | Year: 2013

Background: Recently a number of studies have found a lower risk of dying for obese individuals than for normal-weight individuals. The explanation for these paradoxical findings has not yet been identified. Objective: The objective was to assess whether this paradoxical pattern exists in the US population and whether it can be explained by reverse causation. Design: Survival analyses were used to calculate the RR of all-cause mortality for obesity by using data from 35,673 participants in NHANES I (1971-1975), NHANES II (1976-1980), and NHANES III (1988-1994), which reported 7087 deaths during 3 different 15-y follow-up periods. Results: With normal weight as a referent, a lower relative mortality risk of obesity was found only in NHANES III and only among men with a wide variety of preexisting serious illnesses. For this subgroup, the relative mortality risks in NHANES I, II, and III were 2.22 (95% CI: 1.45, 3.40), 0.89 (95% CI: 0.70, 1.15), and 0.65 (95% CI: 0.47, 0.91), respectively. Whereas the mortality rate among seriously ill normal-weight men did not change significantly between NHANES I and III, it did decrease significantly among seriously ill obese men, suggesting that reverse causation was not responsible for the lower relative mortality risk among seriously ill obese men in NHANES III. Conclusions: Only obese NHANES male participants with a wide variety of serious illnesses experienced lower mortality risk than their normal-weight counterparts and only in NHANES III. Reverse causation seems unlikely to have played a role. These conclusions require confirmation. © 2013 American Society for Nutrition.

Silverberg N.B.,St Lukes Roosevelt Hospital Center
Current Opinion in Pediatrics | Year: 2010

Purpose of review: This review addresses recent changes in the understanding and the treatment of vitiligo vulgaris. Recent findings: Two target genes for vitiligo have been identified, NACHT-leucine-rich-repeat protein-1 (NALP1), part of the inflammasome cascade, and tyrosinase, the enzyme that produces melanin. Identification of reactive oxidation species has furthered the understanding of melanocyte destruction. Comorbid autoimmune disease, including thyroid autoimmunity seen in 25%, is genetically linked to generalized vitiligo and is noted in both childhood vitiligo patients and their families. Screening for vitamin deficiencies and concurrent autoimmunity can be beneficial to the overall health of the child with vitiligo. About half of all vitiligo vulgaris patients have onset of their illness during childhood, causing increased psychological stress during the formative years. Fortunately, therapy has improved as well, with the development of newer topical agents for vitiligo, including topical calcineurin inhibitors; new topical combinations such as topical corticosteroids and calcipotriene; and new technological advances including narrowband ultraviolet B and excimer laser. Summary: A cyclic approach to therapy should be used wherein topical agents are altered every 6-8 months and technology is used as an alternative after achievement of maximal topical response. With cyclic therapy and early disease intervention, good cosmetic outcomes may be achievable, particularly in localized cases. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Newman L.C.,St Lukes Roosevelt Hospital Center
Headache | Year: 2013

Background Results of randomized, double-blind, controlled studies establish the efficacy of triptans in the acute treatment of migraine, but triptan benefits demonstrated in clinical trials have not consistently been realized in clinical practice. This paper explores the contribution of gastrointestinal manifestations of migraine - namely nausea (with or without vomiting) and gastroparesis - to triptan treatment failure. Synthesis Migraine-related nausea and vomiting and migraine-associated gastroparesis appear to be prevalent and highly impactful and have been characterized as being among the greatest challenges affecting migraine care today. These gastrointestinal signs and symptoms have not been satisfactorily taken into account in the management of migraine, which is dominated by the use of oral therapies. Oral triptans are not the optimal therapy in the presence of migraine-related nausea because nausea predicts poor response to oral triptans and because nausea can cause patients to delay oral treatment, which can further compromise therapeutic efficacy. Oral triptans are not the optimal therapy in the presence of migraine-associated gastroparesis because these agents rely on gastric motility and gastrointestinal absorption and may be ineffective or slowly or inconsistently effective in the presence of gastroparesis. Health care providers need to work with their patients to address the still-all-too- frequent problem of treatment failure in migraine. First, health care providers need to have greater appreciation of the importance of nausea, vomiting, and gastroparesis as factors affecting migraine prognosis and treatment success. Second, health care providers need to systematically assess migraine patients for gastrointestinal signs and symptoms. Finally, patients and health care providers need to be willing to practice customized migraine care, in which patients tailor the treatment and formulation to the characteristics and context of the individual migraine episode. © 2013 American Headache Society.

Greenberg J.A.,Brooklyn College | Greenberg J.A.,St Lukes Roosevelt Hospital Center
Obesity | Year: 2013

Objective: Although obesity is a serious public health problem, there are few reliable measures of its health hazards in the United States. The objective of this study was to estimate how much earlier mortality is likely to occur for Americans who are obese (body mass index [BMI], ≥ 30). Design and Methods: Data from the National Health and Nutrition Examination Survey (NHANES) I (1971-1975), NHANES II (1976-1980), and NHANES III (1988-1994) for 37,632 participants who experienced 8,791 deaths during 15 years of follow-up were prospectively analyzed. The relative risk of death from all causes and its advancement period, adjusted for covariates, were calculated. Stratification was used to investigate the effects of pre-existing illness, smoking, and older age on the advancement period. Results: Compared to the participants of reference weight (BMI, 23 to <25 kg/m2), mortality was likely to occur 9.44 years (95% confidence interval [CI]: 0.72, 18.16) earlier for those who were obese (BMI, ≥ 30). For overweight (25 to <30 kg/m2), grade 1 obesity (BMI, 30 to <35) and grades 2-3 obesity (BMI, ≥ 35.0), the mortality was likely to occur earlier by 4.40 (-3.90, 12.70), 6.69 (-2.06, 15.43), and 14.16 (3.35, 24.97) years, respectively. These estimates apply to healthy nonsmoker young- and middle-aged (21-55 years) adults, who constituted an estimated 32.8% of Americans with age of >21 years between 1988 and 1994. Without stratifying simultaneously for preexisting illness, smoking, and age, values of the advancement period for obesity were markedly smaller than those observed for healthy nonsmoker young and middle-aged adults. Conclusions: For healthy nonsmokers young- and middle-aged adults who constitute about one-third of American adults, being obese is likely to hasten mortality by 9.44 years.

St Lukes Roosevelt Hospital Center | Date: 2013-07-16

Here provided are a pharmaceutical composition containing an X-DING-CD4 peptide, a derivative of the X-DING-CD4 peptide, or a combination thereof a method for preventing or treating a pathological condition in a subject using the above pharmaceutical composition; and a process of making the above pharmaceutical composition. Also provided are isolated X-DING-CD4 cDNAs and isolated X-DING-CD4 peptides. Further provided are the composition and method for cell-based therapy using polynucleotides encoding X-DING-CD4 peptide, its derivative, or a combination thereof.

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