Resume

Resume 2015

Adam Henry Zynger, MD

email: azyng@yahoo.com

Clinical medicine, research, health insurance/call center, teaching/training, graphic design/art

My Interests My interests evolve around upgrading my clinical skills and theoretical knowledge. I would be also interested in a research opportunities and medical improvements. As a result of my dissertation on “Osteoporosis and Exercise” and adventure in running, I have developed an interest in Physical Medicine and related endocrine and metabolic issues. My other current interests are in Clinical Informatics and Telemedicine, both of which will improve practice of medicine. I also have a long-standing interest in the interface of art and science, recently exemplified by my fractal prints exhibits. While working for Health Insurance companies, I presented a PowerPoint project on Preventive Health Insurance.

My Objectives It is to apply my medical and other skills (graphic design teaching, training) to improve health care delivery system, and in particular the increase of the prevention as a primary cost cutting measure.

My Strengths Medicine, Health Insurance, Graphic Design, Teaching

Clinical research and teaching/training, experience in geriatric medicine, health insurance, treadmill exercise and assessment, emergency medicine, medical records abstraction, understanding of computer hardware and operating systems (“A plus” certification training).

Education Medical: University of Rome, School of Medicine and Surgery (Italy), Degree in Medicine and Surgery (M.D.), Doctoral Thesis: Osteoporosis and Exercise –3.93/4.0 avg Undergraduate pre-medical: Towson State University, Johns Hopkins University, Catonsville Community College Other: University of Maryland, C.P. – Art History (M.A.) Stanley Kaplan course for ECFMG exam “A plus” computer training certification – University of Maryland CME (Continuing Medical Education) – Beta-blockers in the Management of Cardiovascular Diseases – Johns Hopkins University,

Licensing and Certification License to practice medicine in Italy ECFMG certificate qualifying for the residency in the U.S.A. – valid indefinitely                   Resident Producer Health Insurance Sales

Medical Experience Health Insurance representation (provider and member side) Clinical rotation in area hospitals (Emergency Department, Hematology, Rheumatology, CHF Research Clinic, Medicine, Cardiology Consults, Psychiatry) Clinical Skills Assessment (GSA) Study at Johns Hopkins School of Medicine sponsored by ECFMG, Baltimore Care of stroke patient, treatment, and rehabilitation, nursing care, Baltimore area hospitals Research Assistant, Geriatrics, University of Maryland Obsevership in Neurology, University of Maryland Observership in Pathology, University of Maryland Externship in Surgery, Sinai Hospital, Baltimore Physical Diagnosis by N.Y.U. professor, Polyclinic, Rome Externship in Primary Care, Pediatrics, City Hospital, Baltimore

Research Research for Dept. of Psychiatry, Mood Disorders Clinic, VAMC (STS, Topomax, SSRI-CAD) Research for HCFA (Health Care Financing Administration) and DOD (Department of Defense): CVD, OB/Neonatology, IHD, GIB, TIA, Stroke, PNE, UTI, DRG, AFIB, CABG, GBS, etc. CHF Research Clinic (VAMC) – Valsartan, Bucindolol, Norvasc protocools for NIH, CIBA, Pfizer UMd: Blood Flow Studies (Plethysmography) with Doppler, Resting Metabolic Rate, Treadmill Exercise for claudicants with EGG, RQ; Dual Photon X-ray Densitometry, Exercise supervision for CHF, claudicants and obese patients, Pre-admission Physical Examination (NIH funded project) Research on Doctor-Patient Relationship, Bayview Hospital CCC: Ultraviolet Induced Mutation by Visible Light in Penicillium

Teaching PNS (Pneumonia National Study – JAMA) – Clinical introduction to CAP (Community Acquired Pneumonia) – HCFA CCP (Cooperative Cardiovascular Project – JAMA) -Clinical aspects CCP Update (Troponin I & T, Cholesterol in CAD, CV cath) Arizona Project (CABG) -HCFA

Work History

  • 2010-2015 – self-employed, graphic design, logos, web pages, Ebay.com sales, etc.

Juried art exhibits, medical research (www.medinq.com), remodeling

  • 2001-2010 – CareFirst BCBS – CSR – handling calls re: benefits, eligibility and claims
  • 1995 – 2000 – FMAS –Forensic Medical Advisory Service – research, abstraction medical charts, clinical teaching
  • 1994 –1995 – volunteer, VAMC, Baltimore – exercising patients wit PAD, CHF, CVA, performing ECG w/treadmill test protocols, Resting Metabolic Rate, DEXA, etc.
  • 1992 – PCU Telemetry technician
  • 1980 – 1990 – Medical School University of Rome, Italy
  • 1977-1979   – pre-med courses (chem.. gen/org, biology, phys w/calc, algebra/ calculus, psych, PR,
  • 1976 – University of Virginia, Charlottesville – PhD program in Art History
  • 1974-1975 – University of South Alabama – university instructor in Art History and Art Appreciation
  • 1974 – teaching at Johns Hopkins Summer School – art appreciation
  • 1974 – Computer Programming – BASIC – TSU, Towson
  • 1971 – 1973   University of Maryland College Park- MA in Art History
  • 1970 – construction worker for Merritt Corp – (Leroy Merritt – landlord)

Medical and other Improvements/Concepts/Inventions

Preventive Health Insurance – a 21st Century Product- at BCBS Gastrostomy catheter (resolved leakage) – for my mother Nimodipine in control of blood pressure in ischemic CVA – for my mother FiO2 – algebraic formula for calculating 02 flow (HCFA) – FMAS

Computer skills PC, MAC, A Plus, BASIC, WordPerfect, Windows, MS OFFICE, ACCESS, Paintbrush, Spreadsheets

Other Work Teaching: Art History (college level) – in Maryland and other states Research and Publishing: in art, art and science, as editor of Artist Equity News, Baltimore

Publications (non-medical) USA Newsletter Artists Equity Newsletter – numerous articles City Paper – Subway Art Evening Sun – Adam Zynger: Artist and Scholar, by Elise Chisolm Foreign-trained U.S. doctor, Baltimore Sun      Spooky – fractal print published by Sun Paper Howard Co and Bridges Conference Catalogue

 Exhibits

New York Art Center – Pratt Institute – juried                                                    Baltimore Museum of Art – Artists Equity Exhibit-juried                                PureLove – Digital Art Exhibit at Barnes&Noble Bookstore                                 Digital Prints – BMA Gift Shop                                                                               Paintings and Fractal Prints – University of Maryland, Baltimore, SMC Campus Center                                                                                                                               Digital Forms and Textures – AIA Baltimore (American Institute of Architects)  Art Entrailed – fractal prints exhibit at Teen Gallery of Enoch Pratt Free Library  Arcane Convergence – Art of Linda Trope and Adam Zynger- Slayton House, Columbia,MD                                                                                                            RobotFest – National Electronics Museum, Linthicum, MD (Northrop-Grumman)  Carroll Mansion Art Gallery, Baltimore                                                                  Bridges Conference/ Art and Science- Baltimore Convention Center               Bridges Conference/ Art and Science – Museum of Science, Seoul, Korea  Permanent collection at MathLove Museum, Seoul, Korea                                Bridges University of Baltimore – July 29- Aug. 1, 2015 followed by MathArt Expo in Washington, DC

Other Skills Telemetry, EKG, sutures, Gram stain, resuscitation; legal briefs, drawing, drafting, design, mechanical skills , digital art

Organizations AMA (American Medical Association), JHIS (Johns Hopkins International Society), Sailing Club, Running and Volunteering Club

Languages Italian, Russian, French

Volunteering/Community Activity

Demolishing/renovating old houses (Habitat for Humanity, Impact, Police Athletic League), packing food for        indigent, books for Pratt Library, cleaning up environment

Project proposals: installing underground utilities and creating alternative energy park, Keystone Pipeline alternative: converting oil to electric energy transmitted thru existing network,

TAA – Trade Adjustment Act: to reward workers/professionals who could not pursue their careers due to importation of labor (presently only employees who lost jobs due to exportation of manufacturing are rewarded)

Travel/Sport Poland, Czechoslovakia, Italy, Belgium, Holland, Germany, England Running (Baltimore’s Marathon 2002,2003,2004, 2008), volleyball, swimming, sailing, tennis, softball, chess

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Health Insurance Representation (provider and member side) with call contacts, using various platforms such as USS, CARE/Mainframe, FLEXX, FACETS, Outlook MS 2007, etc. Duties included explanation of benefits, eligibility, claim status research   and resolution, business analysis and implementation of new projects.

Health Insurance Sales – presentation, application submission, spreadsheets, payroll deduction, etc.

Medical Data Abstractor: Specialized governmental data collection projects concentrating on various diagnostic related groups, such as: Pneumonia, Cerebrovascular Accident, Myocardial Infarction, Congestive Heart Failure, Atrial Fibrillation, etc. The data collection was submitted to the Health Care Financing Administration for analysis.

Links: : http://medinq.com/art/ParallelRealityPoster.htmlExhibits

http://bridgesmathart.org/bridges-2014        

arttRun.us

multeculture.com

http://articles.baltimoresun.com/2013-03-14/news/ph-ho-go-kish-gallery-0314-20130314_1_dancers-grid-abstract

 

Iodine Deficiency in Hypertensive Patients

 

  Iodine deficiency in hypertensive patients

Patients diagnosed with hypertension are routinely advised to limit salt intake. However, the correlation between hypertension and salt intake has been questioned by some, while salt-less food is found tasteless by many. ( 1) Also, salt iodized with KI (Potassium Iodide) is an important source of iodine in many countries, especially in areas, where iodine insufficiency has been detected ( 2 ). Insufficient intake of salt if coupled with nutritional iodine deficiency from other sources may lead to hypothyroidism with resulting myriad of related symptoms, such as lack of energy, sadness, and fatigability, sleep and eating disturbances, difficulty concentrating, etc., as part of the overall slowed down metabolism. That includes hyperlipidemia and depression, both independent variables, which may lead to Coronary Artery Disease (CAD) (3).  The Recommended Daily allowance (RDA) for iodine is 80 to 100 µg, with the optimal diet intake between 150 and 300 µg. Doses, which greatly exceed the RDA can lead to either hypothyroidism or hyperthyroidism.

Iodine deficiency in adults also occurs when iodine intake is less than 20 mg/day. ( 4) Most of iodine is obtained by ingestion of iodized salt (70 mg/g), some from water (varies from 2 to 10 mg/L depending on proximity to the sea), soil , seaweeds (in Asia) and from fish.    Other forms of iodization employed are: iodized water, iodized oil, and salt iodization with potassium iodate  (5). Iodine sufficiency is assessed by measurement of urinary iodide excretion, which is expected to be more than 10 mg/dl (6).  The deficiency of iodine causes thyroid hypertrophy (elevated TSH), which is an attempt to concentrate iodine, while maintaining euthyroid state (normal FT4). This deficiency could be due to deliberate avoidance of salt in iodine-poor environment, as often the hypertensive patients are advised to.

The range of normal TSH level has been under discussion recently and by some accounts normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L. It would put anyone above this level in a hypothyroid status. ( 7  ) Once a diagnosis of iodine deficiency related hypothyroidism is made (TSH, FT4, urine I ), iodide supplementation then becomes essential as in the form of KI  to prevent a further progression to myxedema . Plasma thyroid-stimulating hormone levels are monitored until they are in the normal range.

The usual intake of iodide in healthy persons is 100 to 200 µg/day, mostly from iodized salt (70 µg/g).  The recommended dose in perceived deficiency is 1500 µg/day–about 10 times the recommended daily allowance (80-100mg)–for several weeks to restore the iodine content of the depleted gland and permit thyroxin synthesis  ( 8 ). The dose becomes toxic at 2 mg/day. Improper iodine supplementation may lead to either hypo- or hyperthyroidism and thyroiditis ( 4 ).  By monitoring TSH levels, and responding therapeutically to even the low normal ones, one can prevent a cascade of events leading not only to hypothyroidism but also to depression, myocardial infarct and many other compilations. There is a need to inform the public about proper iodine supplementation, especially so when advising to use (iodized) salt sparingly, as in the case of hypertensive patients.

Adam H. Zynger, M.D. © 2004 Feb.20, 2004

 

H&Ps’ – samples of medical reports , LORS, scores and dissertation

click on underscored headline and then on the link :

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VAMC in Washington, DC – Medical Reports


hp4[1]  – hyponatremia

hp3[1]  – nose bleed, CRF, HTN, etc.

hp2[1] –  angioedema

hp1[1] – polyuria, DM?

Letters of Recommendation


DEANSLETTER[1] – Dean of Medical School Letter based on 3 LOR ( Internal Medicine, Surgery and OB/GYN)

LORABRAMS[1]   –  surgery

LORBOLTON[1]   –  ER

LORCARSON[1] –  Cardiology

LORGrayson1 – Doctor – Patient  Studies

LORPalagi LORGOLDEN[1]– Dissertation Advisor- on “Osteoporosis and Exercise”

LORGOLDEN[1]  – Pediatrics

LORGARDNER[2] – Vascular Physiology

LORSARGEANT[1]  – Emergency Medicine

LORKling  – Psychiatry

LORHOFFBERG[1] – Physiatry

 

Scores

SCORES1[1]

SCORES2[1]

csa96

USMLE1[1]

FMGEMS2[1]

FLEX1[2]

ecfmg[1]  –  certificate indefinitely valid



 

OSTEOPOROSIS AND EXERCISE

Synopsis of the dissertation

The exercise, as it appears from the extensive research on the subject, is helpful in promoting and maintaining the bone health. Both, the tensional and the compression forces may have an impact on bone, possibly through piezo-electric and streaming effects. The weight bearing exercise seems to be more effective than the resistive one. However, it ought to be site-specific in order to obtain results at the most affected sites, such as the vertebrae, pelvis, femoral neck, and the radius. The intensity of loading was found more important than its frequency. Equally important is moderation in exercise. lt should be performed below the exertional threshold in an aerobic manner, so as not to induce the release of excess stress factors such as cortisol, or to lower the estrogen – testosterone level that may affect negatively the bone formation.

The exercise ought to be initiated early in life to permit peak bone formation and ought to be continuous, because of its transitory effect. The effect of exercise depends also on the type of osteoporosis. ln the post-menopausal type, a delay in the evolution is more likely than the reversal. An adjunct therapy is recommended with calcium, estrogen, calcitonin, and biphosphonates. In addition to a direct action, the physical activity, the active life-style, and adequate diet may help to maintain physical fitness and independence of the osteoporosis-prone individuals.

It should be emphasized that the cross-sectional and longitudinal studies a like have been criticized for inadequate sample size, lack of randomization of subjects to treatment and control groups, and failure to take into account other variables, such as medications, diet, or additional exercise.

Adam H. Zynger, MD


OsteoporosisEx1

OsteoporosisEx2

OsteoporosisEx3

OsteoporosisEx4

OsteoporosisExBibliographyPage