Mark V. Ragucci, D.O.

Weight lifting and type II aortic dissection. A case report
Ragucci, M V; Thistle, H G
2004 Dec;44(4):424-427, Journal of sports medicine & physical fitness
The case of a 28-year-old previously healthy male with a 13-year history of weight lifting is described. The patient presented to the emergency department complaining of severe anterior chest pain beginning during a workout. Following transthoracic echocardiogram and computerized tomogram the diagnosis of an ascending aortic dissection was made. The patient was taken emergently for surgical repair of an incompetent aortic valve and type II aortic dissection. Histopathologic examination of the aorta showed cystic medial degeneration. This is the first reported case of a type II aortic dissection secondary to cystic medial degeneration and the hemodynamic stresses of weight lifting. Physicians should be aware of this potentially catastrophic entity in weight lifters
— id: 52630, year: 2004, vol: 44, page: 424, stat: Journal Article,

Comprehensive deep venous thrombosis prevention strategy after total-knee arthroplasty
Ragucci, Mark V; Leali, Alex; Moroz, Alex; Fetto, Joseph
2003 Mar;82(3):164-168, American journal of physical medicine & rehabilitation
OBJECTIVE: Venous thromboembolism after total-knee arthroplasty represents a common early postoperative complication resulting in significant morbidity. Despite this, the optimal prophylactic regimen is controversial. The prevalence of venous thromboembolism has been cited as high as 35% in patients receiving pharmacologic prevention alone. We investigated the efficacy of a comprehensive prevention protocol encompassing the use of epidural anesthesia, aspirin, venous foot compression pumps, and early mobilization in a series of consecutive total-knee arthroplasties. DESIGN: A series of 100 consecutive total-knee arthroplasty patients were enrolled into the prospective trial. All patients were allowed full weight bearing on the first postoperative day and ambulation as tolerated. Venous foot compression pumps and aspirin were used immediately after surgery in the totality of subjects. Seventy-five percent of the patients were transferred to an acute rehabilitation service during the first postoperative week. The presence of deep-vein thrombosis was subsequently determined with the routine use of venous duplex scans. RESULTS: Three patients (3%) demonstrated evidence of distal deep-vein thrombosis. No patient had symptomatic pulmonary embolism. CONCLUSION: The combination of epidural anesthesia, aspirin, immediate postoperative venous foot compression pumps, and early ambulation together seem to be a more effective approach to prevent the occurrence of thromboembolic events after knee replacements than pharmacologic prevention alone
— id: 34130, year: 2003, vol: 82, page: 164, stat: Journal Article,

Gabapentin-induced hypersensitivity syndrome
Ragucci MV; Cohen JM
2001 Mar-Apr;24(2):103-105, Clinical neuropharmacology
Hypersensitivity syndrome is a rare but potentially fatal reaction to some pharmacologic agents, including some antiepileptic drugs. Typically, the syndrome presents with fever, rash, tender lymphadenopathy, hepatitis, and eosinophilia. We report a novel case of clinical hypersensitivity syndrome secondary to gabapentin. A patient developed altered mental status, fever, diffuse macular rash, and an enlarged spleen. This constellation of symptoms and signs began 9 days after gabapentin therapy was begun. Quick resolution was noted after gabapentin was discontinued. To our knowledge, there are no reports of hypersensitivity syndrome to gabapentin
— id: 26747, year: 2001, vol: 24, page: 103, stat: Journal Article,

Societal risk factors associated with spinal cord injury secondary to gunshot wound
Ragucci, M V; Gittler, M M; Balfanz-Vertiz, K; Hunter, A
2001 Dec;82(12):1720-1723, Archives of physical medicine & rehabilitation
OBJECTIVES: To determine (1) how many individuals with spinal cord injury (SCI) secondary to gunshot wound (GSW) had previous violent injury requiring medical professional intervention or were previously involved in the criminal justice system, and (2) how many had social service intervention initiated before their SCI to deter future injury. DESIGN: Follow-up survey of patients admitted to an inpatient SCI rehabilitation unit between 1990 and 1998. SETTING: An urban rehabilitation hospital. PARTICIPANTS: Fifty-six patients with SCI secondary to GSW. INTERVENTION: Survey questions inquired about previous GSW, violent injury, and criminal justice involvement. Subjects were queried about social service intervention. MAIN OUTCOME MEASURES: Number and percentage of respondents. RESULTS: Of the 56 respondents, 17 (30%) had a previous GSW; 9 (16%) had another violent injury requiring treatment in the emergency department; and 29 (52%) had prior involvement in the criminal justice system. A total of 55 opportunities for social service intervention were identified. Social service intervention was initiated only once. CONCLUSIONS: Most respondents had preinjury involvement in the criminal justice system and/or previous violent injury. In all of these situations except 1, there was failure to initiate social service intervention. These preliminary data suggest that criminal justice system involvement and violent injury are common among patients who have SCI secondary to GSW. More aggressive efforts at social service intervention could be an effective means to deter future disability
— id: 146036, year: 2001, vol: 82, page: 1720, stat: Journal Article,