311 Broadfield Rd Ward Elementary School
New Rochelle NY 10804
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The burden of HIV-associated neurocognitive disorder (HAND) in the Asia-Pacific region and recommendations for screening. - Asian journal of psychiatry
HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment.This review seeks to redress the imbalance by promoting awareness and education among physicians concerning the neurovirulence of HIV and thereby increase screening efforts to improve diagnosis rates and clinical outcomes for underserved patients in this region. The Asia, Australia, and Middle East (AAME) HAND Advisory Board convened expert regional representatives to review current practice and recommend appropriate measures related to the implementation of standardised screening programmes and treatment recommendations to curb the developing HAND epidemic in the region. In particular, we recommend basic neuropsychological testing protocols that could be efficiently introduced into clinical practice for routine screening.We also propose simple guidelines for the management of HAND. We believe that HAND is a significant and under-reported diagnosis in HIV patients that warrants both greater recognition and further clinical investigation of the underlying pathophysiology and the impact of HIV disease progression, with HAND being associated with worse medication adherence and therefore possibly increased risk of ARV treatment failure.Widespread screening will lead to greater recognition of HAND and earlier intervention, which may lead to improved management strategies in the future.Copyright Â© 2015 Elsevier B.V. All rights reserved.
Effects of a Neonatal Experience Involving Reward Through Maternal Contact on the Noradrenergic System of the Rat Prefrontal Cortex. - Cerebral cortex (New York, N.Y. : 1991)
The noradrenergic system plays an important role in prefrontal cortex (PFC) function. Since early life experiences play a crucial role in programming brain function, we investigated the effects of a neonatal experience involving reward through maternal contact on the noradrenergic system of the rat PFC. Rat pups were exposed during Postnatal days (PNDs) 10-13, to a T-maze in which contact with the mother was used as a reward (RER). RER males had higher norepinephrine levels in the PFC both on PND 13 and in adulthood. The RER experience resulted in adulthood in increased levels of the active demethylase GADD45b, hypomethylation of the Î²1 adrenergic receptor (ADRB1) gene promoter, and consequent enhanced expression of its mRNA in the PFC. In addition, protein and binding levels of the ADRB1, as well as those of its downstream effector phosphorylated cAMP response element-binding protein were elevated in RER males. The higher activity of the PFC noradrenergic system of the RER males was reflected in their superior performance in the olfactory discrimination and the contextual fear extinction, 2 PFC noradrenergic system-dependent behavioral tasks.Â© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: firstname.lastname@example.org.
Gender-specific outcomes after balloon aortic valvuloplasty: Inhospital and long-term outcomes. - American heart journal
Increasing numbers of balloon aortic valvuloplasty (BAV) are performed in the management of symptomatic aortic stenosis as bridge and therapeutic challenge in the work-up for transcatheter aortic valve replacement. However, the significance of gender in outcomes following BAV remains controversial.We retrospectively reviewed 664 consecutive patients who underwent BAV from January 2005 to December 2012. Patients were stratified according to gender. Clinical and procedural characteristics as well as in-hospital outcomes and 1-year mortality were collected. Cumulative survival curves for women and men were constructed using the Kaplan-Meier method and were compared by the log-rank test. Cox regression analysis was performed to identify the independent effect of sex on 1-year mortality.Of the 664 patients, 333 (52%) were women. Women had lower body surface area, tended to be frailer and were less likely to have history of coronary artery disease. Women were more likely to present with heart failure whereas men presented more commonly with chest pain. In hospital death was significantly higher in women compared to men, mainly driven by the difference in cardiac death (8.1% vs 3.9%, P = .02 and 6.3% vs 2.6%, P = .02 respectively). One-year mortality rates were similar in women and men (25.4% vs 29.4%, P = .42) and after multivariate analysis gender had no association with 1-year mortality (HR = 0.9, P = .65).Significant differences exist in baseline characteristics and presentation between genders. Although in hospital mortality after BAV was significantly higher in women, 1-year mortality was similar between women and men.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Ectopic thyroid tissue in the head and neck: a case series. - BMC research notes
Through a review of three cases, the etiopathogenetic, clinical-diagnostic, and therapeutic aspects of ectopic thyroid tissue are herein discussed to highlight the main presentations of this polymorphous disease.The first case involved an ectopic thyroid gland in the lingual area in a 45-year-old Caucasian woman who presented with dysphagia and midline swelling at the base of the tongue. The second case involved a 22-year-old Caucasian woman with a submandibular mass comprising ectopic thyroid tissue. The third case involved a 33-year-old Caucasian man with a typical thyroglossal duct cyst characterized by the presence of thyroid tissue upon histological analysis.Surgery seems to be the most appropriate treatment for patients with ectopic thyroid tissue showing clinical signs of upper airway obstruction or when the lesion shows signs of infection or malignant degeneration. When a site of ectopic thyroid tissue is the only such site in the body, removal of this tissue will usually lead to hypothyroidism that requires medical thyroid hormone replacement.
Characterization of a genotoxicity biomarker in three-spined stickleback (Gasterosteus aculeatus L.): Biotic variability and integration in a battery of biomarkers for environmental monitoring. - Environmental toxicology
As a large array of hazardous substances exhibiting genotoxicity are discharged into surface water, this work aimed at assessing the relevance of adding a genotoxicity biomarker in a battery of biomarkers recently developed in the model fish three-spined stickleback (Gasterosteus aculeatus). First the confounding influence of gender, body length, and season (used as a proxy of age and of the fish reproductive status, respectively) on the level of primary DNA damage in erythrocytes was investigated in wild sticklebacks. Then, the genotoxity biomarker was included in a large battery of biomarkers assessing xenobiotic biotransformation, oxidative stress and neurotoxicity, and implemented in five sites. Gender, age and reproductive status did not influence DNA damage level in fish from the reference site. A significant relationship between the level of primary DNA damage and fish length (as a proxy of age also correlated to the season) was highlighted in the contaminated site. Among all biomarkers investigated in the field, the level of DNA damage was one of the four most discriminating biomarkers with EROD, catalase activity and the level of lipid peroxidation representing together 75.40% of the discriminating power in sampled fish. The level of DNA damage was correlated to the EROD activity and to the level of peroxidation, which mainly discriminated fish from sites under urban pressure. Finally, Integrated Biomarker Response indexes (IBRv2), which were calculated with the whole biomarker response dataset exhibited higher values in the Reveillon (9.62), the Scarpe and Rhonelle contaminated sites (5.11 and 4.90) compared with the two reference sites (2.38 and 2.55). The present work highlights that integration of a genotoxicity biomarker in a multiparametric approach is relevant to assess ecotoxicological risk in freshwater aquatic organisms. Â© 2014 Wiley Periodicals, Inc. Environ Toxicol 31: 415-426, 2016.Â© 2014 Wiley Periodicals, Inc.
Kinetic response of a genotoxicity biomarker in the three-spined stickleback and implication for environmental monitoring. - Ecotoxicology and environmental safety
The ultimate sink for the majority of anthropogenic compounds are the aquatic ecosystems, either through direct discharges or indirectly through hydrologic or atmospheric processes, possibly leading to long-term adverse effects in aquatic living resources. In order to assess exposure, fate and effects of chemical contaminants, aquatic ecotoxicologists have developed a large array of early-warning biomarkers proving that toxicants have entered organisms, have been distributed between organs and have triggered toxic effects regarding critical targets. However, optimal use of biomarkers in environmental studies previously requires in-depth knowledge of the kinetics of response of biomarkers. This work aimed to define as a first step of a validation process the kinetic response of a genotoxicity biomarker recently developed in the three-spined stickleback (Gasterosteus aculeatus). DNA damage was assessed in stickleback erythrocytes after in vivo exposure for 12 days to methylmethanesulfonate (MMS), an alkylating compound, followed by a 20 day-recovery period. Results show a dose-response relationship, time to maximal induction being reached after 6 days at the highest MMS concentration. No acclimation process was noticed during exposure whatever the MMS concentration, and genotoxicity decreased during the recovery phase only in fish exposed to the highest MMS concentration, suggesting more an effect of erythrocyte turn-over than of DNA repair system on the observed DNA damage level. Further field experiments are needed before including this genotoxicity biomarker in a battery of biochemical markers to monitor adverse effects of pollutants on fish health.Copyright Â© 2014 Elsevier Inc. All rights reserved.
Symptomatic Meckel's diverticulum in newborn: two interesting additional cases and review of literature. - Pediatric emergency care
This study aimed to review the literature about symptomatic Meckel's diverticulum (MD) in the neonatal period with 2 additional uncommon cases.The authors describe 2 interesting neonatal cases of symptomatic MD and analyze the literature on this topic, with particular reference to the prevalence of sex, age at presentation, most common signs and symptoms, treatment, histology, associated anomalies, and outcome.The first patient was a term newborn with bowel obstruction by a pseudocystic MD. The second patient was a preterm infant with double perforation of the MD and ileum. Literature search for published case reports and case series on this topic reveals only 18 cases of neonatal symptomatic MD. Males are more frequently involved than females, and even preterm infants may be affected. Bowel obstruction (58.3%) and pneumoperitoneum (33.3%) are the most frequent clinical manifestation. Acute inflammation of the MD is the prominent histopathological finding (75%), although it does not seem to be related with the presence of heterotopic tissue within the MD. Surgical treatment is essential. The association of neonatal symptomatic MD with other anomalies is exceptional but is otherwise life threatening despite surgery.Bowel obstruction and pneumoperitoneum are the most frequent clinical manifestations of symptomatic MD in the newborn. Surgery is required for a definitive diagnosis and successful outcome.
Randomized double-blinded prospective trial of fibrin sealant spray versus mechanical stapling in laparoscopic total extraperitoneal hernioplasty. - Annals of surgery
The aim of the current study was to compare the clinical outcomes of mesh fixation with fibrin sealant (FS) spray or mechanical stapling (MS) in laparoscopic total extraperitoneal hernioplasty (TEP).The most appropriate method of mesh fixation is uncertain.Between June 2007 and June 2011, consecutive patients with primary reducible unilateral inguinal hernia who underwent day-case laparoscopic TEP were recruited. Outcome parameters included the incidence of acute and chronic pain, recurrence rates, morbidity rates, analgesic requirements, quality-of-life (QOL) scores, and direct cost.During the study period, 130 patients were included in the study. Patients in the MS group had significantly worse pain scores on the day after operation (P = 0.006). Analgesic requirements were similar between the 2 groups (P = 0.558). At 6 months, no significant differences in the incidence of chronic pain were observed (at rest, after coughing or cycling). The incidence of seroma formation was similar between the 2 groups (P = 0.64), and no recurrences were observed at 1 year. No differences in the QOL scores were detected. The direct cost of the entire hospitalization in the FS group was less expensive (P < 0.001).FS and MS are both effective methods of providing mesh fixation. FS was associated with reduced acute pain but not chronic pain. The rates of seroma formation were similar. However, the use of FS for mesh fixation was less expensive. [corrected].
Drug utilization review of potassium chloride injection formulations available in a private hospital in kuching, sarawak, malaysia. - The Malaysian journal of medical sciences : MJMS
The concentrated potassium chloride injection is a high-alert medication and replacing it with a pre-mixed formulation can reduce the risks associated with its use. The aim of this study was to determine the clinical characteristics of patients receiving different potassium chloride formulations available at a private institution. The study also assessed the effectiveness and safety of pre-mixed formulations in the correction of hypokalaemia.This was a retrospective observational study consisting of 296 cases using concentrated and pre-mixed potassium chloride injections in 2011 in a private hospital in Kuching, Sarawak, Malaysia.There were 135 (45.6%) cases that received concentrated potassium chloride, and 161 (54.4%) cases that received pre-mixed formulations. The patients' clinical characteristics that were significantly related to the utilization of the different formulations were diagnosis (P < 0.001), potassium serum blood concentration (P < 0.05), and fluid overload risk (P < 0.05). The difference observed for the cases that achieved or maintained normokalaemia was statistically insignificant (P = 0.172). Infusion-related adverse effects were seen more in pre-mixes compared to concentrated formulations (6.8% versus 2.2%, P < 0.05).This study provides insight into the utilization of potassium chloride injections at this specific institution. The results support current recommendations to use pre-mixed formulations whenever possible.
Laparoscopic herniorrhaphy in the pediatric age group: what about the learning curve? - Journal of endourology / Endourological Society
To evaluate the learning curve of pediatric laparoscopic herniorrhaphy (LH), the authors report a retrospective analysis comparing results obtained with this technique and the traditional herniotomy to determine how many procedures are necessary to obtain the results described in the literature.From May 2008 to February 2012, a total of 140 patients (110 boys and 30 girls) with uncomplicated inguinal hernia (IH) consecutively underwent surgery. Patients were divided in two groups: The "Open" group of 83 patients (M:F 64:19) with a mean age of 33.2 months who were operated on with traditional herniotomy and the "Lap" group of 57 patients (M:F 46:11) with a mean age of 34.5 months who were operated on with LH. Operative time and complications of the techniques were analyzed statistically.In the Open group, the mean operative time for monolateral repair was 35.4 Â± 17.7 minutes compared with the Lap group time of 29.9 Â± 15.9 minutes; for bilateral repair, the mean operative time for the Open group was 56.2 Â± 19.3 minutes compared with the Lap group time of 41.5 Â± 10.4 minutes. The analysis shows a shorter operative time for the laparoscopic repair for both monolateral (P=0.73) and bilateral (P=0.0001) hernia. Recurrences occurred in one (0.9%) patient in the Open group and in two (2.7%) patients in the Lap group (P=0.577).This experience shows that LH is a reliable technique. Retrospective analysis revealed a shorter mean operative time for the laparoscopic intervention both for monolateral and bilateral IH repair. Recurrences in the Lap group occurred in the first 10 patients treated, and the mean operative time was reached in 20 monolateral LHs and after 15 bilateral herniorrhaphies. From this analysis, the learning curve for the LH needs a minimum of 20 procedures.
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311 Broadfield Rd Ward Elementary School New Rochelle, NY 10804
77 Quaker Ridge Rd Suite 200A