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Dr. Deborah  Spencer  Md image

Dr. Deborah Spencer Md

95 Crystal Run Rd
Middletown NY 10941
845 036-6999
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 202263
NPI: 1952383069
Taxonomy Codes:
207V00000X

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Publications

Accuracy of urine pH testing in a regional metabolic renal clinic: is the dipstick accurate enough? - Urolithiasis
Urine pH is a useful marker for assessing treatment need and efficacy in patients with nephrolithiasis. Though the gold standard of measurement is with a pH electrode, dipsticks offer the convenience of cost, ease of use, and the possibility of patients measuring their own values outside the clinic. The aim of this study was to determine whether dipsticks offer the same accuracy as the electrode. Paired measurements of freshly voided urine pH with both electrode and dipstick were analysed in a multidisciplinary renal clinic. We found that although there was a high Pearson correlation between the samples (0.89, p = 0.001), urine dipstick measurements carried an approximately 1 in 4 risk of producing clinically significant differences (pH differences > 0.5 pH unit) from meter values. We also found that at high and low urine pH, the dipstick tended to over- and underestimate true pH readings, respectively. Examining the values in the 98 patients where a need for pharmacological urinary pH manipulation was indicated by the true pH, we found 14 who would not have been appropriately treated, and 5 who would have been unnecessarily medicated, if the stick pH value had been used. We conclude that dipstick pH measurement is insufficiently reliable for guiding clinical decision-making.
Clinical utility of PKD2 mutation testing in a polycystic kidney disease cohort attending a specialist nephrology out-patient clinic. - BMC nephrology
ADPKD affects approximately 1:1000 of the worldwide population. It is caused by mutations in two genes, PKD1 and PKD2. Although allelic variation has some influence on disease severity, genic effects are strong, with PKD2 mutations predicting later onset of ESRF by up to 20 years. We therefore screened a cohort of ADPKD patients attending a nephrology out-patient clinic for PKD2 mutations, to identify factors that can be used to offer targeted gene testing and to provide patients with improved prognostic information.142 consecutive individuals presenting to a hospital nephrology out-patient service with a diagnosis of ADPKD and CKD stage 4 or less were screened for mutations in PKD2, following clinical evaluation and provision of a detailed family history (FH).PKD2 mutations were identified in one fifth of cases. 12% of non-PKD2 patients progressed to ESRF during this study whilst none with a PKD2 mutation did (median 38.5 months of follow-up, range 16-88 months, p < 0.03). A significant difference was found in age at ESRF of affected family members (non-PKD2 vs. PKD2, 54 yrs vs. 65 yrs; p < 0.0001). No PKD2 mutations were identified in patients with a FH of ESRF occurring before age 50 yrs, whereas a PKD2 mutation was predicted by a positive FH without ESRF.PKD2 testing has a clinically significant detection rate in the pre-ESRF population. It did not accurately distinguish those individuals with milder renal disease defined by stage of CKD but did identify a group less likely to progress to ESRF. When used with detailed FH, it offers useful prognostic information for individuals and their families. It can therefore be offered to all but those whose relatives have developed ESRF before age 50.
"It's like we're just renting over here": The Pervasive Experiences of Discrimination of Filipino Immigrant Youth Gang Members in Hawai'i. - AAPI nexus : Asian Americans and Pacific Islanders, policy practice and community
Researchers, service providers, and policymakers must uncover and better understand the issues facing youths in Asian gangs in order to most effectively intervene with appropriate policies and programs. The present investigation sampled young male Filipino gang members in Hawai'i. Thematic analyses of the focus group data challenge the commonly held view of racial harmony in Hawai'i. It appears that racial and social discrimination from peers and authority figures propel Filipino boys to seek out gang membership as a way to protect themselves from being targets of oppression.

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95 Crystal Run Rd Middletown, NY 10941
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