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.

Clavicular tuberculosis following trivial trauma.

Abstract: Tuberculosis of the clavicular bone is a very rare clinical entity, with limited cases reported in the United States. Furthermore, sparing of the sternoclavicular joint is exceedingly unusual. A literature review of the prevalence of clavicular tuberculosis identified fewer than 80 cases reported since the discovery of the tubercular bacillus, over a century ago. To our knowledge, there have been no cases reported over the last decade in the United States. A rare case of tuberculous osteomyelitis of the clavicle in an immunocompetent patient who presented with swelling of the upper chest is reported.

Postaortic Valve Replacement Bradycardia Induced Torsades de Pointes

Abstract: The authors present an unusual case of torsades de pointes (Tdp) in an elderly woman with a history of aortic stenosis, status post aortic valve replacement. She was admitted for atrial fibrillation with a slow ventricular response. At the time of admission, the patient was asymptomatic and not taking any medications known to be associated with QT prolongation. During hospitalization, she developed episodes of Tdp without any provocable cause. This case highlights the occurrence of Tdp secondary to conduction disturbance caused by aortic valve surgery.

Recurrent pleural effusion due to duropleural fistula.

Abstract: A 76-year-old woman with history of multiple spinal surgeries was found to have chronic recurrent pleural effusion. Thoracentesis was performed, which showed a clear, "water-like" transudative fluid with a total protein level of 0.2 g/dL, glucose level equivalent to serum (118 mg/dL), low LDH level (76 U/dL), and low nucleated cell count. Given the appearance of the fluid, β-2-transferrin was checked, which confirmed the presence of cerebrospinal fluid in the pleural space. On the basis of the clinical presentation, pleural fluid analysis, clear appearance of the pleural fluid, and β-2-transferrin positivity, the patient was diagnosed with duropleural fistula.

The Effects of Intravenous Levofloxacin on the QT Interval and QT Dispersion

Abstract: The QT dispersion (QTd) is a non-invasive means of identifying those patients at an increased risk of developing sudden cardiac death (SCD). Although levofloxacin has a minimal effect on the QTc interval, isolated reports of QT prolongation, polymorphic ventricular tachycardia with a normal QT interval and TdP have been reported. The purpose of this study was to examine the effect of intravenous levofloxacin on the QT interval and QTd. Of the 50 patients who were deemed candidates to receive intravenous levofloxacin, 29 met the eligibility criteria and were enrolled in this study. A 12-lead ECG was performed before the initiation of levofloxacin (baseline), and on days 3 and 5. The QTc min, QTc max and the QTd were calculated. Measurements where made by two independent observers blinded to the patients’ clinical status. The QTd increased significantly on days 3 and 5 following the initiation of therapy [QTd (baseline) 33.3 ± 20 ms, QTd (day 3) 64.4 ± 31.3 ms (p = 0.023), QTd (day 5) 66.8 ± 20.3 ms, (p = 0.008)]. The increase in the QTd was significantly longer in men than women. Although women had a shorter baseline QTd compared to men, this did not achieve statistical significance. Intravenous levofloxacin was found to significantly increase the QTd, which was more pronounced in men compared to women. Its effect on the QTd may increase the risk of developing a potentially fatal ventricular arrhythmia. Therefore, care must be taken when prescribing this medication to patients with a pre-existing risk of developing SCD.