New York-Presbyterian Hospital offers New Yorkers and others from nearby locations cutting edge emergency medical care at no less than three locations: Weill Cornell at 525 East 68th Street; Columbia Hospital at 622 West 168th Street; and at the Allen Hospital at 5141 Broadway at 220th Street.
New York-Presbyterian Hospital prides itself on its goal to provide the highest quality care possible, using the most modern and cutting edge techniques and equipment available, to all New Yorkers no matter their background. The emergency medical facility also offers quaternary referral centers for those arriving at the emergency room with complicated medical or surgical issues from all over the globe.
Josyann Abisaab, MD, is an emergency room physician at New York-Presbyterian, as well as an Assistant Professor of Clinical Medicine at the Weill Cornell Medical College. In her capacity as a physician working in the front lines of emergency care, Dr. Josyann Abisaab is able to bring back to the classroom the lessons of the emergency room. This is just one part of the uniqueness and strength that makes New York-Presbyterian Emergency Medicine strategically positioned, in both the academic and clinical realms, to advance successfully into the future of state-of-the art emergency care.
According to a new study which was published last February in the American Journal of Emergency Medicine, it is estimated that about 700,000 Americans visited emergency rooms due to poisoning related to the wrongful taking of prescription drugs in 2007. The estimated cost for this misuse of drugs was given as close to $1.4 billion, about 41% of which was paid for by either Medicare or Medicaid.
Aim of Study to Fight Drug Abuse
The study was produced out of Nationwide Children’s Hospital, at their Center for Injury Research and Policy in Columbus, Ohio, and was done as part of their efforts to more accurately quantify the problem of and focus in on trends that could help professionals to fight drug abuse in our society.
The director of the Center of Injury Research and Policy, Dr. Gary Smith, admitted being surprised by the size of the problem.
Rural Areas Hit Hardest
The study showed a large difference between urban and rural areas for overdoses among adults taking pain medications and psychotropic drugs. The most common age group for overdosing was the 35 to 54 range, with 3 times the number in rural areas.
Smith said that he could not explain why there was such a wide difference between urban and rural settings. It has been known, however, that at least in Ohio, “pill mills,” places where doctors prescribe large quantities of painkillers, have been of great concern in rural areas.
Children Also Victims
Among children, those five years old or younger had the largest number of accidental poisonings. In most of those cases it was found that children were playing with medicine which was prescribed for older relatives, or else taking too much of something that was meant for them or other children.
It was noted that syrups are especially problematic as far as children’s poisonings is concerned. Dr. Leslie Mihalov, the chief of emergency medicine at Children’s Hospital said that syrups which contain acetaminophen taste good to children, and they can easily drink down an entire bottle if no one is properly supervising them.
An easy way to prevent much of the inadvertent poisoning of children is to be vigilant in making sure that children do not have access to any medicines. As Dr. Mihalov said, prescription drugs should be kept out of reach and out of sight of children.
“I think the biggest problem is, elderly people or people who don’t have children in their home get those caps that are easier to open,” she said.
The problem is that children can often find medicines in Grandma’s purse, or they might fall out of Uncle’s pocket, to be swallowed by a child who does not know these things can be quite harmful.
The National Drug Abuse Warning Network believes that emergency visits due to prescription-drug abuse grew by twice from 2004 until 2008, from half a million visits to one million in 2008.
Dr. Josyann Abisaab is an emergency room physician practicing at New York’s Columbia-Presbyterian Hospital.
Wendy L. Bennett, MD, MPH and her colleagues wanted to know if the new types of medications that have been approved for the treatment of adult onset diabetes are any better than the standard treatment which has been on the market since winning approval from the FDA in 1995.
Dr. Bennet, who is an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine, explained her investigation:
“Metformin works for most people. It’s cheaper, there’s a generic form ‘it’s tried and true.’ Our study shows that even though there are all these newer drugs, metformin works just as well and has fewer side effects. Diabetes is an enormous public health problem, and patients have difficult decisions to make about what medications they should be taking. Our study provides good information comparing drugs and can be used to inform those decisions.”
The use of metformin to reduce blood sugar levels has a long history, beginning in the 1920s when it was first synthesized. At that time diabetes was often treated with insulin and other drugs, until interest in metformin was rekindled in the ‘40s when reports showed that it was helpful in reducing blood sugar. French doctor Jean Sterne published the results of his clinical trial of the medication, the first such study, in 1957, and was consequently introduced into the United Kingdom in 1958. Canada began to treat diabetes with metformin in 1972, and the United States followed suit in 1995. Today metformin is probably the most widely prescribed medication for diabetes in the world, with over 42 million prescriptions for it filled in 2009 in the United States alone.
Type 2 diabetes, also known as adult onset diabetes, is a huge problem today in the US, with over 25 million Americans suffering from this serious illness. The annual price Americans pay for this epidemic is about $132 billion, and the figure is increasing, with most of the costs going to complications from this disease.
The research of Dr. Bennett showed that while most of the drugs available to treat diabetes do indeed lower blood sugar levels, metformin was consistently associated with fewer side effects. In addition, because the newer medications do not have generic alternatives for patients to purchase, metformin is considerably cheaper than its newer substitutes. For instance, in the case of Januvia 30 pills can cost almost $200, close to $7 per pill; metformin costs about $35 for 100 pills, or 35 cents each, a difference of a factor of 20.
Josyann Abisaab, MD is an emergency room physician in New York’s Presbyterian Hospital.
Statistics show that most people that come to the emergency room are not in need of emergency care. Here are some things that you need to know so that you do not become part of this statistic.
• First of all, use good judgment. Become knowledgeable about the signs of serious illnesses which need immediate attention such as heart attacks and strokes, and trust your instincts.
• Call your family doctor and describe to him/her your symptoms. If your doctor feels it’s warranted, then he/she will recommend a trip to the emergency room. If the problem is not urgent enough for a trip to the emergency room, but nevertheless urgent, your doctor will make room in his schedule to see you. Also, a good primary care physician should ideally be available 24/7 or else he/she takes turns covering after-hours on-call responsibilities with other doctors. In other words there are alternatives to getting off-hour or last-minute care instead of going to the emergency room.
• Keep a booklet in your home which is easily accessible which describes the types of symptoms which need emergency room treatment.
Dr. Josyann Abisaab is an emergency room physician practicing in New York City at New York Presbyterian Hospital.
Next month, a conference will take place from November 11-13 in Beirut, Lebanon of The Lebanese Society of Emergency Medicine. This 4th annual conference, where Dr. Josyann Abisaab is on the Scientific and Organizational Committees, will include lectures and workshops about everything from Neuropsych and Trauma to Oncology, Cardiovascular Emergency, and even a Wilderness Medicine Track.
The conference is being co-sponsored by The Global Emergency Medicine Program at Weill Cornell Medical College/Division of Emergency Medicine, where Dr. Josyann Abisaab is a faculty member. In addition to Dr. Abisaab, ten other faculty members from New York Presbyterian Hospital will participate in the conference in Lebanon.
Lyme disease is an infection which is often misunderstood by parents and misidentified by the health community. One of the reasons for the confusion is that Lyme disease manifests in many different ways in the body. Another reason is that it varies so widely from state to state.
The most classic symptom of Lyme disease, and the one that most doctors like Dr. Josyann Abisaab, will ask you about is a rash. The circular rash occurs at the site of the tick bite approximately 7-14 days after the initial bite. The rash actually resembles a bulls-eye. Other symptoms are commonly flu-like symptoms including fever, muscle aches, chills, headache, fatigue and joint pains.
Unfortunately, when Lyme disease goes untreated, it can cause many problems including continued fever and fatigue, swollen glands, pink eye, aseptic meningitis, Bell’s palsy, arthritis and concentration problems.
If you live in an area where Lyme disease is more common, like in the Northeastern area of the United States, and you are exhibiting these types of symptoms, you should seek attention from a medical professional.
Recent news from the NewYork-Presbyterian Hospital is that a five month old baby underwent a liver transplant due to liver failure that was caught after she was born 10 weeks early. She breaks records in that at just 4 pounds, she was one of “the smallest babies ever to successfully receive a liver transplant.” It was Dr. Tomoaki Kato, surgical director of liver and intestine transplant programs at NewYork-Presbyterian Hospital/Columbia University Medical Center, and chief of abdominal organ transplantation and professor of surgery at Columbia University College of Physicians and Surgeons who performed the surgery a few months ago. Shortly after she was born, she was sent to NewYork-Presbyterian/Morgan Stanley Children’s Hospital where an “irreversible liver injury of unknown origin” was diagnosed. A suitable liver had to be found for her which took two weeks. The NewYork-Presbyterian Hospital is known as being a highly reputable institution but this latest surgery will add to its prestige.
Physicians working at New York-Presbyterian Hospital – like Josyann Abisaab who serves as the Assistant Attending Physician in the hospital’s ER department – should take pride in the latest prestige attached to the institution. For the tenth consecutive year, it has “the most physicians listed in New York magazine’s ‘Best Doctors’ issue.” President and CEO of the hospital Dr. Herbert Pardes spoke about what this means for his staff members: “Being a good doctor means having the experience and expertise to diagnose and treat complex medical problems, while employing exceptional communication skills and empathy. Most of all, it means caring for and improving the lives of patients and their families as a top priority.” This indicates that the New York-Presbyterian Hospital is a place that employs extremely high caliber staff, which is something its workers can take pride in.