New York Methodist Hospital

About: New York Methodist Hospital is a healthcare organization based out in Brooklyn, New York, United States. It is known for research contribution in the topics: Myocardial infarction & Percutaneous coronary intervention. The organization has 948 authors who have published 936 publications receiving 29954 citations.

Duodenal siderosis: a rare clinical finding in a patient with duodenal inflammation.

Abstract: An 84-year-old man without any signifi cant past medical history (PMH) was admitted for anemia and weight loss. Th ere was no history of gastrointestinal bleeding or iron supplement use. Physical examination was benign except for pallor. His labs showed: hemoglobin 6.8 (11.0-15.6) g/dL, serum iron 30 (65-175) μg/dL, total iron binding capacity 141 (179-378) μg/dL, ferritin 416 (22-275) ng/dL, and transferrin 109 (188-341) mg/dL. An esophagogastroduodenoscopy (EGD) was performed which revealed a duodenal polyp, and duodenitis with dark brown pigmentation (Fig. 1A,B). Histopathologic examination of this pigmented mucosa revealed glandular deposition of brown pigments (Fig. 2A), confi rmed to be iron with Prussian blue stain (Fig. 2B). Iron deposition in gastric and duodenal mucosa has been found in association with oral iron medications, alcohol abuse, blood transfusions, hemochromatosis, and decompensated cirrhosis with esophageal varices [1,2]. Th e endoscopic fi nding of mucosal iron deposition is highly variable ranging from yellow-brown to black mucosa, with associated ulcerations or regenerative polyps [3]. Histologically, three main patterns of iron deposition were described by Marginean et al [1]. Type A (“non-specifi c”) variant is free fl oating siderosomes located intracellularly in macrophages, stroma, and epithelium. Type B (“iron-pill gastritis”) is large clumps of fi brillar iron located extracellularly and in blood vessels, macrophages, and epithelium. Type C (“gastric glandular”) variant is free fl oating siderosomes located in deeper glands of the antrum and fundus. Iron deposition in duodenal mucosa is extremely rare and isolated duodenal siderosis has never been reported in the literature. Without signifi cant PMH and predominantly intraglandular, iron deposition not entirely fi tting any of those patterns has been described by Marginean et al [1]. Our case may represent an “idiopathic” variant of gastroduodenal siderosis. Recognition of variable patterns of deposition may guide further workup and treatment of iron overload cases.

Control Release Anesthetics to Enable an Integrated Anesthetic-mesenchymal Stromal Cell Therapeutic.

Abstract: While general anesthetics control pain via consciousness regulation, local anesthetics (LAs) act by decreasing sensation in the localized area of administration by blocking nerve transmission to pain centers. Perioperative intra-articular administration of LAs is a commonly employed practice in orthopedic procedures to minimize patient surgical and post-surgical pain and discomfort. LAs are also co-administered with cellular mesenchymal stromal cell (MSC) therapies for a variety of tissue regenerative and inflammatory applications including osteoarthritis (OA) treatment; however, LAs can affect MSC viability and function. Therefore, finding an improved method to co-administer LAs with cells has become critically important. We have developed a sustained release LA delivery model that could enable the co-administration of LAs and MSCs. Encapsulation of liposomes within an alginate matrix leads to sustained release of bupivacaine as compared to bupivacaine-containing liposomes alone. Furthermore, drug release is maintained for a minimum of 4 days and the alginate-liposome capsules mitigated the adverse effects of bupivacaine on MSC viability.