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Mark Joseph

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Papers by Mark Joseph

Research paper thumbnail of Abstract #12: Idiopathic Nephrotic Syndrome Manifesting Soon After Diagnosis of Juvenile Diabetes: Case Report and Review of the Literature

Research paper thumbnail of Composite Material for Custom Fitted Products

Research paper thumbnail of Continuous glucose monitor shows potential for early hypoglycemia detection in hospitalized patients

Diabetes technology & therapeutics, 2009

This study shows the potential of continuous glucose monitoring (CGM) for the detection of hypogl... more This study shows the potential of continuous glucose monitoring (CGM) for the detection of hypoglycemia in hospitalized patients. A Medtronic Diabetes (Northridge, CA) CGMS iPro continuous glucose recorder was inserted into the subcutaneous tissue of a hospitalized orthopedic surgery patient with type 1 diabetes the day after a moderate hypoglycemia event. The interstitial fluid glucose concentration was recorded every 5 min. Both the patient and the hospital staff were blinded to the CGM data. Bedside capillary blood glucose measurements were performed per hospital protocol. The CGM recorded a repeat severe episode of hypoglycemia the next day. The hospital-defined threshold for hypoglycemia (70 mg/dL) was crossed 4.5 h prior to the patient being found unconscious by the nursing staff. Data from the CGMS iPro Recorder illustrate the potential benefit of using a real-time CGM in the hospital to detect hypoglycemia in a more timely fashion compared to infrequent point-of-care glucose...

Research paper thumbnail of Early Extracorporeal Life Support as Rescue for Wegener Granulomatosis With Diffuse Alveolar Hemorrhage and Acute Respiratory Distress Syndrome

Pediatric Emergency Care, 2011

The study's objective was to report a case and review the literature on the use of extracorporeal... more The study's objective was to report a case and review the literature on the use of extracorporeal life support in the face of severe pulmonary hemorrhage for acute respiratory distress syndrome. Study Selection: This study is a single case report of a pediatric patient who was successfully managed on venovenous extracorporeal life support for severe acute respiratory distress syndrome with acute pulmonary hemorrhage secondary to Wegener disease. Conclusions: Extracorporeal life support can be used successfully in selected patients with respiratory failure with pulmonary hemorrhage. The cautious use of anticoagulation should be balanced with the risk of bleeding, mindful of the need for other measures to mitigate severe bleeding if this should occur.

Research paper thumbnail of Clinical Need for Continuous Glucose Monitoring in the Hospital

Journal of Diabetes Science and Technology, 2009

Automation and standardization of the glucose measurement process have the potential to greatly i... more Automation and standardization of the glucose measurement process have the potential to greatly improve glycemic control, clinical outcome, and safety while reducing cost. The resources required to monitor glycemia in hospitalized patients have thus far limited the implementation of intensive glucose management to patients in critical care units. Numerous available and up-and-coming technologies are targeted for the hospital patient population. Advantages and limitations of these devices are discussed herewith in.

Research paper thumbnail of Hypertension in a Patient with Aldosterone Deficiency

Endocrine Practice, 2005

Objective: To describe a patient with aldosterone synthase deficiency, who presented with failure... more Objective: To describe a patient with aldosterone synthase deficiency, who presented with failure to thrive, hypovolemic hyponatremia, and the unexpected finding of hypertension. Methods: We present a case report, review the related literature, and outline a possible mechanism for the concomitant occurrence of high blood pressure and hyponatremia in this patient. Results: A 5-month-old infant with unambiguous female genitalia was admitted to our hospital with failure to thrive and hyponatremia. Her blood pressure was 115/88 mm Hg (>95% for age). The serum sodium concentration was 123 mEq/L (normal for age, >130), and the potassium level was 5.3 mEq/L (normal, 3.5 to 5.3). A direct renin measurement by immunochemiluminescence assay was 11,400 µU/mL (normal, <5), and the aldosterone level was 4 ng/dL (normal, 2 to 70). These findings indicated a diagnosis of aldosterone synthase deficiency. Treatment with fludrocortisone and sodium chloride was begun, but the hypertension worsened. Therapy with an angiotensin-converting enzyme inhibitor was transiently required. Conclusion: Angiotensin II, a potent vasoconstrictor, is an intermediate in the renin-angiotensin system. We believe that this protein was the cause of the hypertension in the setting of aldosterone deficiency in our patient.

Research paper thumbnail of Use of Extracorporeal Membrane Oxygenation during Resection of Tracheal Papillomatosis

Research paper thumbnail of Abstract #12: Idiopathic Nephrotic Syndrome Manifesting Soon After Diagnosis of Juvenile Diabetes: Case Report and Review of the Literature

Research paper thumbnail of Composite Material for Custom Fitted Products

Research paper thumbnail of Continuous glucose monitor shows potential for early hypoglycemia detection in hospitalized patients

Diabetes technology & therapeutics, 2009

This study shows the potential of continuous glucose monitoring (CGM) for the detection of hypogl... more This study shows the potential of continuous glucose monitoring (CGM) for the detection of hypoglycemia in hospitalized patients. A Medtronic Diabetes (Northridge, CA) CGMS iPro continuous glucose recorder was inserted into the subcutaneous tissue of a hospitalized orthopedic surgery patient with type 1 diabetes the day after a moderate hypoglycemia event. The interstitial fluid glucose concentration was recorded every 5 min. Both the patient and the hospital staff were blinded to the CGM data. Bedside capillary blood glucose measurements were performed per hospital protocol. The CGM recorded a repeat severe episode of hypoglycemia the next day. The hospital-defined threshold for hypoglycemia (70 mg/dL) was crossed 4.5 h prior to the patient being found unconscious by the nursing staff. Data from the CGMS iPro Recorder illustrate the potential benefit of using a real-time CGM in the hospital to detect hypoglycemia in a more timely fashion compared to infrequent point-of-care glucose...

Research paper thumbnail of Early Extracorporeal Life Support as Rescue for Wegener Granulomatosis With Diffuse Alveolar Hemorrhage and Acute Respiratory Distress Syndrome

Pediatric Emergency Care, 2011

The study's objective was to report a case and review the literature on the use of extracorporeal... more The study's objective was to report a case and review the literature on the use of extracorporeal life support in the face of severe pulmonary hemorrhage for acute respiratory distress syndrome. Study Selection: This study is a single case report of a pediatric patient who was successfully managed on venovenous extracorporeal life support for severe acute respiratory distress syndrome with acute pulmonary hemorrhage secondary to Wegener disease. Conclusions: Extracorporeal life support can be used successfully in selected patients with respiratory failure with pulmonary hemorrhage. The cautious use of anticoagulation should be balanced with the risk of bleeding, mindful of the need for other measures to mitigate severe bleeding if this should occur.

Research paper thumbnail of Clinical Need for Continuous Glucose Monitoring in the Hospital

Journal of Diabetes Science and Technology, 2009

Automation and standardization of the glucose measurement process have the potential to greatly i... more Automation and standardization of the glucose measurement process have the potential to greatly improve glycemic control, clinical outcome, and safety while reducing cost. The resources required to monitor glycemia in hospitalized patients have thus far limited the implementation of intensive glucose management to patients in critical care units. Numerous available and up-and-coming technologies are targeted for the hospital patient population. Advantages and limitations of these devices are discussed herewith in.

Research paper thumbnail of Hypertension in a Patient with Aldosterone Deficiency

Endocrine Practice, 2005

Objective: To describe a patient with aldosterone synthase deficiency, who presented with failure... more Objective: To describe a patient with aldosterone synthase deficiency, who presented with failure to thrive, hypovolemic hyponatremia, and the unexpected finding of hypertension. Methods: We present a case report, review the related literature, and outline a possible mechanism for the concomitant occurrence of high blood pressure and hyponatremia in this patient. Results: A 5-month-old infant with unambiguous female genitalia was admitted to our hospital with failure to thrive and hyponatremia. Her blood pressure was 115/88 mm Hg (>95% for age). The serum sodium concentration was 123 mEq/L (normal for age, >130), and the potassium level was 5.3 mEq/L (normal, 3.5 to 5.3). A direct renin measurement by immunochemiluminescence assay was 11,400 µU/mL (normal, <5), and the aldosterone level was 4 ng/dL (normal, 2 to 70). These findings indicated a diagnosis of aldosterone synthase deficiency. Treatment with fludrocortisone and sodium chloride was begun, but the hypertension worsened. Therapy with an angiotensin-converting enzyme inhibitor was transiently required. Conclusion: Angiotensin II, a potent vasoconstrictor, is an intermediate in the renin-angiotensin system. We believe that this protein was the cause of the hypertension in the setting of aldosterone deficiency in our patient.

Research paper thumbnail of Use of Extracorporeal Membrane Oxygenation during Resection of Tracheal Papillomatosis

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