Mitchell H Charap, M.D.

Management of perioperative hypertensive urgencies with parenteral medications
Ahuja, Kartikya; Charap, Mitchell H
2010 Feb;5(2):E11-E16, Journal of hospital medicine
BACKGROUND: Hypertension is the major risk factor for cardiovascular (CV) disease such as myocardial infarction (MI) and stroke. This risk is well known to extend into the perioperative period. Although most perioperative hypertension can be managed with the patient's outpatient regimen, there are situations in which oral medications cannot be administered and parenteral medications become necessary. They include postoperative nil per os status, severe pancreatitis, and mechanical ventilation. This article reviews the management of perioperative hypertensive urgency with parenteral medications. METHODS: A PubMed search was conducted by cross-referencing the terms 'perioperative hypertension,' 'hypertensive urgency,' 'hypertensive emergency,' 'parenteral anti-hypertensive,' and 'medication.' The search was limited to English-language articles published between 1970 and 2008. Subsequent PubMed searches were performed to clarify data from the initial search. RESULTS: As patients with hypertensive urgency are not at great risk for target-organ damage (TOD), continuous infusions that require intensive care unit (ICU) monitoring and intraarterial catheters seem to be unnecessary and a possible misuse of resources. CONCLUSIONS: When oral therapy cannot be administered, patients with hypertensive urgency can have their blood pressure (BP) reduced with hydralazine, enalaprilat, metoprolol, or labetalol. Due to the scarcity of comparative trials looking at clinically significant outcomes, the medication should be chosen based on comorbidity, efficacy, toxicity, and cost
— id: 137978, year: 2010, vol: 5, page: E11, stat: Journal Article,

The return visit
Charap, Mitchell
2007 Apr;22(4):553-553, Journal of general internal medicine
— id: 111674, year: 2007, vol: 22, page: 553, stat: Journal Article,

Internal medicine residency training in the 21st century: aligning requirements with professional needs
Charap, Mitchell H; Levin, Richard I; Pearlman, R Ellen; Blaser, Martin J
2005 Sep;118(9):1042-1046, American journal of medicine
— id: 58700, year: 2005, vol: 118, page: 1042, stat: Journal Article,

Reducing resident work hours: Unproven assumptions and unforeseen outcomes
Charap, M
2004 MAY 18 ;140(10):814-815, Annals of internal medicine
— id: 46626, year: 2004, vol: 140, page: 814, stat: Journal Article,

Residents' work hours - In response
Charap, M
2004 NOV 2 ;141(9):742-742, Annals of internal medicine
— id: 46912, year: 2004, vol: 141, page: 742, stat: Journal Article,

Implementation of a hospitalist program in a large public teaching hospital
Leviss, JA; Link, N; Charap, M
2000 APR ;15(5):228-228, Journal of general internal medicine
— id: 54613, year: 2000, vol: 15, page: 228, stat: Journal Article,

Diabetic ketoacidosis in prisoners without access to insulin [see comments]
Keller AS; Link RN; Bickell NA; Charap MH; Kalet AL; Schwartz MD
1993 Feb 3;269(5):619-621, JAMA
OBJECTIVE--To assess the cause and clinical severity of diabetic ketoacidosis in male prisoners hospitalized in New York City. DESIGN--Retrospective chart review. SETTING--A municipal hospital in New York City. PATIENTS--Forty-nine adult male prisoners with a total of 54 hospital admissions for diabetic ketoacidosis between January 1, 1989, and June 30, 1991. MAIN OUTCOME MEASURES--Charts were reviewed for diabetic and medical history, time from arrest until hospitalization, cause of diabetic ketoacidosis, admission laboratory data, and hospital course. RESULTS--Thirty-eight (70%) of the 54 admissions for diabetic ketoacidosis among prisoners occurred because prisoners had not received insulin during the period immediately following arrest (mean number of days from arrest until hospitalization was 2.5). All of these individuals had a history of insulin-dependent diabetes and were reportedly compliant with their insulin regimen at the time of arrest. Admission laboratory data for this group of prisoners included a mean serum glucose level of 27.4 mmol/L (495 mg/dL) and a mean serum bicarbonate level of 14.4 mmol/L. Mean number of days in the hospital was 3.4 including a mean of 1 day in an intensive care unit. CONCLUSIONS--Inadequate access to medication results in serious sequelae for recently arrested prisoners in New York City with insulin-dependent diabetes. Access to health care for recently arrested prisoners needs to be improved
— id: 13252, year: 1993, vol: 269, page: 619, stat: Journal Article,

PRISONERS ACCESS TO MEDICATIONS - REPLY
KELLER, AS; LINK, RN; BICKELL, NA; CHARAP, MH; KALET, AL; SCHWARTZ, MD
1993 MAY 19 ;269(19):2507-2508, JAMA
— id: 54182, year: 1993, vol: 269, page: 2507, stat: Journal Article,

Concerns of medical and pediatric house officers about acquiring AIDS from their patients
Link RN; Feingold AR; Charap MH; Freeman K; Shelov SP
1988 Apr;78(4):455-459, American journal of public health. AJPH
To assess the degree of house officers' concerns about acquiring AIDS (acquired immunodeficiency syndrome) from their patients, we surveyed 263 medical and pediatric interns and residents in four housestaff training programs affiliated with seven New York City hospitals with large AIDS patient populations; 258 questionnaires (98 per cent) were returned. Thirty-six per cent of medical and 17 per cent of pediatric house officers reported percutaneous exposures to needles contaminated with blood of AIDS patients. Forty-eight per cent of medical and 30 per cent of pediatric house officers reported a moderate to major concern about acquiring AIDS from their patients. Greater concern about personal risk was noted in those house officers who were earlier in their residency training, who reported having treated a greater number of AIDS patients, and who were in medicine rather than pediatrics programs. Twenty-five per cent of all respondents reported that they would not continue to care for AIDS patients if given a choice. The results demonstrate a substantial degree of concern about acquiring AIDS among house officers caring for AIDS patients and suggest the need for housestaff program administrators for formally address these concerns
— id: 11133, year: 1988, vol: 78, page: 455, stat: Journal Article,

National Resident Matching Plan
Thompson WG; Charap MH
1988 Jul 15;109(2):173-173, Annals of internal medicine
— id: 18893, year: 1988, vol: 109, page: 173, stat: Journal Article,

"HEIRS OF GENERAL-PRACTICE - MCPHEE,J"
Charap, M
1987 Jun;38(6):676-677, Hospital & community psychiatry
— id: 31172, year: 1987, vol: 38, page: 676, stat: Journal Article,

THE 20-MINUTE HOUR - A GUIDE TO BRIEF PSYCHOTHERAPY FOR THE PHYSICIAN - CASTELNUOVOTEDESCO,P
Charap, M
1987 Feb;38(2):207-207, Hospital & community psychiatry
— id: 31284, year: 1987, vol: 38, page: 207, stat: Journal Article,

Physician choices in the treatment of angina pectoris
Charap MH; Levin RI; Weinglass J
1985 Oct;79(4):461-466, American journal of medicine
Uncertainty about optimal treatment for many diseases results in heterogeneous management by definition. It was hypothesized that identifiable characteristics in a physician's background would influence the management of any such condition and thereby explain some of this heterogeneity. A vignette describing a patient with new-onset angina and a questionnaire ascertaining individual physician characteristics and management preferences were sent to attending physicians and house staff in the Department of Medicine at New York University School of Medicine. Although physicians believed very strongly that the patient had angina on the basis of the history, there was no consensus about managing the hypothetic patient. The age of the physician was the single most important predictor of management, with the younger half of the sample more likely to hospitalize (p less than 0.001), less likely to prescribe nitroglycerin as a sole therapy (p less than 0.005), and more likely to prescribe beta blockers (p less than 0.005). The era in which a physician trains may determine practices that persist for a lifetime. These findings may have important implications for medical education and the quality and cost of medical care
— id: 18894, year: 1985, vol: 79, page: 461, stat: Journal Article,

"HEALTH-CARE OF HOMELESS PEOPLE - BRICKNER,PW, SCHARER,LK, CONANAN,B, ELVY,A, SAVARESE,M"
Charap, M
1985 ;36(9):997-998, Hospital & community psychiatry
— id: 30723, year: 1985, vol: 36, page: 997, stat: Journal Article,

"THE PSYCHOSOCIAL DIMENSIONS OF CANCER - GOLDBERG,RT, TULL,RM"
Charap, M
1985 ;36(1):85-86, Hospital & community psychiatry
— id: 31005, year: 1985, vol: 36, page: 85, stat: Journal Article,

On distinguishing pulmonary embolism from other causes of pleuritic chest pain
Charap M
1984 Aug;77(2):A101-A101, American journal of medicine
— id: 18895, year: 1984, vol: 77, page: A101, stat: Journal Article,

ANGINA-PECTORIS - PHYSICIAN CHARACTERISTICS PREDICT MANAGEMENT - A CASE VIGNETTE SURVEY METHOD
CHARAP, MH; LEVIN, R; WEINGLASS, J
1983 ;31(2):A637-A637, Clinical research
— id: 40556, year: 1983, vol: 31, page: A637, stat: Journal Article,

Pseudomembranous colitis: a possible role for Gallium scanning
Kramer EL; Charap M; Sanger JJ; Tiu SS
1983 Oct;78(10):632-633, American journal of gastroenterology
A case of antibiotic-associated pseudomembranous colitis is presented in which the Gallium scan was the first diagnostic modality to alert the clinicians to the existence of an inflammatory bowel process. The mechanism of localization of the radiopharmaceutical in inflammatory bowel disease is discussed. Although colonoscopy is far more specific and should be the first-line diagnostic tool used in assessing the presence of pseudomembranous colitis, Gallium scanning may have a role in the follow-up of treatment and in cases of relapse
— id: 18896, year: 1983, vol: 78, page: 632, stat: Journal Article,

POINTERS ON LOWERING BLOOD-PRESSURE
CHARAP, MH
1982 ;14(15):62-&, Emergency medicine
— id: 40388, year: 1982, vol: 14, page: 62, stat: Journal Article,

The periodic health examination: genesis of a myth
Charap MH
1981 Dec;95(6):733-735, Annals of internal medicine
Although the periodic health examination was introduced over 80 years ago, it remains a controversy in internal medicine. There have been few data from controlled studies to document the examination's efficacy for adults; nevertheless, its popularity is increasing and health screening has become a multimillion-dollar industry in the United States. Conclusions drawn from poorly designed studies 65 years ago led to the acceptance of periodic examination as a means of detecting disease and reducing mortality. First, physicians associated with life insurance companies and, later, private practitioners began offering these examinations. By promoting the periodic health examination, the medical profession created interest among the general population. The impact of health screening is still unknown today, and well-designed studies are needed to resolve the controversy
— id: 18897, year: 1981, vol: 95, page: 733, stat: Journal Article,