6666 Security Blvd
Gwynn Oak MD 21207
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 15079
Request Appointment Information
Awards & Recognitions
Medical Malpractice Cases
Medical Board Sanctions
Expression of spinal cord GABA transporter 1 in morphine-tolerant male Wistar rats. - European journal of pharmacology
Chronic morphine exposure produces morphine tolerance. One of the mechanisms of morphine tolerance involves Î³-aminobutric acid (GABA), whose level is regulated by GABA transporter 1 (GAT-1). The aim of this study was to investigate the expression of GAT-1 in the spinal cord during morphine treatment. Morphine was administrated to rats via drinking water for 21 days. On day 21, a single dose of morphine (10mg/kg) was injected, followed by the administration of 5% formalin after 30min. Expression of GAT-1 in the lumbar spinal cord during morphine treatment was analyzed by Western blotting and immunohistochemistry assay. In another set of experiments, a morphine-tolerant group was treated with a GAT-1 inhibitor, ethyl nipecotate (60mg/kg), 5min prior to the formalin test. To assess a possible analgesic effect of the GAT-1 inhibitor, a non-tolerant group was injected only with ethyl nipecotate 5min prior to the formalin test. Our results indicated that a chronic consumption of morphine led to morphine tolerance. Morphine tolerance was also concomitant with GAT-1 up-regulation in the lumbar spinal cord. The GAT-1 inhibitor ethyl nipecotate improved the antinociceptive effect of morphine in the morphine-tolerant group. Ethyl nipecotate also had an antinociceptive effect on the non-tolerant group. Thus, our data suggest that GAT-1 overexpression in the spinal cord plays an important role in morphine tolerance.Copyright Â© 2015. Published by Elsevier B.V.
Effects of Multistrain Probiotic Supplementation on Glycemic and Inflammatory Indices in Patients with Nonalcoholic Fatty Liver Disease: A Double-Blind Randomized Clinical Trial. - Journal of the American College of Nutrition
Nonalcoholic fatty liver disease (NAFLD) is a condition defined by exceeding triglycerides accumulation in the liver. The condition can develop into fibrosis, cirrhosis, and hepatocellular carcinoma. Considering the ever-increasing prevalence of NAFLD, the aim of the present study was to investigate the effects of probiotic supplementation on glycemic and inflammatory indices in patients with NAFLD.This randomized clinical trial was conducted on 42 patients with NAFLD who had been referred to a gastroenterology clinic. Subjects in the intervention and control groups consumed 2 capsules/day probiotic or placebo, respectively, for 8 weeks. Fasting blood sugar (FBS), insulin, insulin resistance, tumor necrosis factor alpha (TNF-Î±), and interleukin 6 (IL-6) were measured at baseline and at the end of the study.Means of FBS, insulin, insulin resistance, and IL-6 were significantly different between groups after intervention (p < 0.05), whereas TNF-Î± was not significantly modified (p > 0.05). In the probiotic group, insulin, insulin resistance, TNF-Î±, and IL-6 decreased significantly at the end of the study compared to the beginning of study.Considering the effects of probiotic supplementation on the reduction of glycemic and inflammatory indices in patients with NAFLD, consumption of probiotics is recommended as a complementary therapy in these patients.
Anti-melanogenesis and antigenotoxic activities of eriodictyol in murine melanoma (B16-F10) and primary human keratinocyte cells. - Life sciences
The objective of this study was to examine the effect of eriodictyol on melanogenesis in cultured murine melanoma cells (B16-F10) and its antigenotoxic and antioxidant potentials on primary human keratinocyte (PHK) cells.Anti-melanogenic effect was performed via the determination of melanin content and tyrosinase activity. Antigenotoxicity and antioxidant potentials were assessed by comet and cellular antioxidant assays, respectively.Eriodictyol reduced melanogenesis by inhibiting the tyrosinase activity of B16-F10 cells in a dose dependent manner. Its eventual genotoxicity was investigated by evaluating its capacity to induce DNA degradation of treated cell nuclei. As no genotoxicity was detected at the different tested concentrations, its ability to protect cell DNA against hydrogen peroxide (H2O2) oxidative effect in PHK cells was investigated using the "comet assay. It appears that 50 Î¼M of eriodictyol solution suppressed H2O2 induced genotoxicity. In addition, this molecule revealed a significant cellular antioxidant capacity against reactive oxygen species formation in B16-F10 and PHK cells.Thus, eriodictyol could be introduced as a natural skin depigmenting agent in skin care products.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Preliminary Finnish measures of eating competence suggest association with health-promoting eating patterns and related psychobehavioral factors in 10-17 year old adolescents. - Nutrients
Eating competence is an attitudinal and behavioral concept, based on The Satter Eating Competence Model. In adults, it has been shown to be associated with a higher quality of diet. Eating competence or its association with the quality of diet has not been studied in adolescents. The aim of the current study was to explore the utility of using a preliminary Finnish translation of the ecSI 2.0 for evaluating presumed eating competence and its association with food selection, meal patterns and related psychobehavioral factors in 10-17 year old adolescents. Altogether 976 10-17 years old Finnish adolescents filled in the study questionnaire. When exploring the construct validity of ecSI 2.0, the confirmatory factor analysis (CFA) indicated acceptable model fit and all four components of the ecSI 2.0 (eating attitudes, food acceptance, internal regulation of food intake, management of eating context) correlated with each other and were internally consistent. Over half (58%) of the adolescents scored 32 or higher and were thus classified as presumably eating competent (pEC). Eating competence was associated with greater meal frequency, more frequent consumption of vegetables and fruits, and more health-promoting family eating patterns. In addition the pEC, adolescents more often perceived their body size as appropriate, had less often tried to lose weight and had a higher self-esteem and a stronger sense of coherence than the not pEC ones. Family eating patterns and self-esteem were the main underlying factors of eating competence. In conclusion, this preliminary study suggests eating competence could be a useful concept to characterize eating patterns and related behaviors and attitudes in adolescents. However, these preliminary findings need to be confirmed in further studies with an instrument fully validated for this age group.
[Pulmonary thromboembolism: incidence, physiopathology, diagnosis and treatment]. - La Tunisie meÌdicale
The objective of this work was to review current data about the pathophysiology, clinical features, and treatment of pulmonary thromboembolism. Venous thromboembolism (VTE) remains a major challenge in hospitalised especially the care of critically ill patients. Pulmonary embolism (PE) is the major complication of VTE. By occluding the pulmonary arterial bed it may lead to acute life-threatening but potentially reversible right ventricular failure. The outcome of patients with PE is quite variable depending primarily on the cardio-respiratory status and the embolus size. PE is a difficult diagnosis that may be missed because of non-specific clinical presentation. Clinical signs include hypoxia, tachypnea, and tachycardia. Severe cases of untreated PE can lead to circulatory instability, and sudden death. However, in ICU, most of patients require sedation and mechanical ventilation. The clinical manifestations usually observed in this condition (PE) cannot be exhibited by these patients and clinical presentation is usually atypical. For these reasons, the diagnosis of PE is usually suspected when un-explicated hypoxemia and/or shock and arterial hypotension were observed. Positive diagnosis is based on these clinical findings in combination with laboratory tests and imaging studies. D-dimer testing is of clinical use when there is a suspicion of DVT or pulmonary embolism PE. In Emergency department, a negative D-dimer test will virtually rule out thromboembolism with a negative predictive value at 95 to 98%. In massive and submassive PE, dysfunction of the right side of the heart can be seen on echocardiography. While the gold standard for diagnosis is the finding of a clot on pulmonary angiography, CT pulmonary angiography is the most commonly used imaging modality today. When the diagnosis is confirmed, anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments a pivotal role in the management of patients with PE. Severe cases may require thrombolysis with drugs such as tissue plasminogen activator (tPA) or may require surgical intervention via pulmonary thrombectomy. Prevention is highly warranted.
Comparative study between fundus autofluorescence and red reflectance imaging of choroidal nevi using ultra-wide-field scanning laser ophthalmoscopy. - Retina (Philadelphia, Pa.)
To explore the utility of fundus autofluorescence (FAF) and red reflectance (RR) imaging using ultra-wide-field scanning laser ophthalmoscope in choroidal nevi.Retrospective observational case study reviewing clinical data, color, FAF, and RR images of patients with choroidal nevi and comparing the findings. The ultra-wide-field scanning laser ophthalmoscope uses green laser 532 nm and red laser 633 nm that enabled FAF and RR imaging, respectively in separate channels. Superimposition of both images yielded a composite color image.The study included 46 eyes of 45 patients. Nevi were unilateral in 44 patients (98%). Forty-one nevi (89.1%) were located temporally between the macula and the equator. All nevi (100%) were deeply pigmented. The most frequent surface changes were lipofuscin pigments, zones of retinal pigment epithelium atrophy, and retinal pigment epithelium pigment clumps in 31 (67.3%), 18 (39.1%), and 8 eyes (17.3%), respectively. Color photographs were superior to FAF in detecting nevus boundaries and surface changes. Red reflectance correlated strongly with color images, although the nevus boundaries and surface changes were better delineated in RR mode. Red reflectance was superior to FAF in delineating the boundaries and surface changes of the nevus; clear visibility (3+) for RR versus no or poor visibility (0/1+) for FAF. Nevertheless, the areas of retinal pigment epithelium atrophy were better delineated in FAF mode; clear visibility (3+) for FAF versus poor visibility (1+) for FAF.Red reflectance imaging is more sensitive than conventional photography for follow-up of choroidal nevi. Fundus autofluorescence should be considered only as a complementary tool to RR imaging.
How public health nurses identify and intervene in child maltreatment based on the national clinical guideline. - Nursing research and practice
Objectives. To describe how Finnish public health nurses identify and intervene in child maltreatment and how they implement the National Clinical Guideline in their work. Design and Sample. Cross-sectional survey of 367 public health nurses in Finland. Measures. A web-based questionnaire developed based on the content areas of the guideline: identifying, intervening, and implementing. Results. The respondents reported they identify child maltreatment moderately (mean 3.38), intervene in it better (4.15), and implement the guideline moderately (3.43, scale between 1 and 6). Those with experience of working with maltreated children reported they identify them better (P < 0.001), intervene better (P < 0.001), and implement the guideline better (P < 0.001) than those with no experience. This difference was also found for those who were aware of the guideline, had read it, and participated in training on child maltreatment, as compared to those who were not aware of the guideline, had not read it, or had not participated in such training. Conclusions. The public health nurses worked quite well with children who had experienced maltreatment and families. However, the results point out several developmental targets for increasing training on child maltreatment, for devising recommendations for child maltreatment, and for applying these recommendations systematically in practice.
[Epidemiology and clinical profile of knee osteoarthrosis in the elderly]. - La Tunisie meÌdicale
Osteoarthris represents one of the most frequent degenerative pathologies. Its prevalence increases with the age as well as the functional consequences which are more considerable at the elderly population. aim : study the epidemiology and clinical features of knee osteoarthritis of older patient. methods: retrospective study made in the department of physical and rehabilitation medicine of the military Tunis hospital, on a sample of 60 patients having osteoarthritis, divided in two groups, the one is constituted by 30 subjects of 65 and more years old, other one of 30 adults aged between 30 and 55 years old. All the patients had a clinical and functional evaluation. results: the comparison between both groups showed a statistically significant difference (P < 0.05) in the following items: the severity of the pain, the bilateral hydarthrosis, the muscular strength of quadriceps, hamstrings and their retraction, the severe reduction of walking perimeter, and the bicompartimental lesion of both knees.clinical and sociofunctional features of knee osteoarthritis in the elderly patient require adapted and multidisciplinary management, in order to avoid the potential impact of knee osteoarthritis on the function and quality of life of the patient.
Psychometric properties of the arabic version of the schizotypal personality questionnaire in Tunisian university students. - La Tunisie meÌdicale
The schizotypal personality disorder is considered as a marker of schizophrenia proneness. The schizotypal personality questionnaire (SPQ) is an instrument to help to the diagnosis of schizotypal personality disorder extensively studied in the literature. aim: To assess psychometric properties (reliability and factor structure) of the Arabic version of the SPQ in a sample of Tunisian university students. method: The sample included 490 students (145 males and 345 females; mean age: 20.4 Â± 1.4 years), from the faculty of medicine and the health sciences school of Monastir. Thirty-three students participated in the second assessment of the SPQ three months later. results: Cronbach's (Î±) internal consistency reliability coefficients were 0.92 for the total SPQ and from 0.62 to 0.75 for the SPQ subscales. The test-retest reliability was good with the intraclass correlation coefficients equal to 0.83 for the total SPQ and from 0.67 to 0.87 for the SPQ subscales (P<0.0001). Factor analysis indicated that the three-factor model (positive or cognitive-perceptual, negative or interpersonal, and disorganized) and the four-factor model (cognitive-perceptual, paranoid, interpersonal, and disorganized) have provided a good fit to the data, accounting for 70.7% and 77.3% of the total variance of the scale, respectively.The results showed that the Arabic version of the SPQ had adequate psychometric properties and confirmed the multidimensional structure of the schizotypal personality in nonclinical populations.
Endoresection technique with/without brachytherapy for management of high posterior choroidal melanoma: extended follow-up results. - Retina (Philadelphia, Pa.)
To evaluate the long-term efficacy and safety of endoresection for high posterior choroidal melanoma.Retrospective nonrandomized interventional case series. Forty-one patients had endoresection as primary treatment for posterior choroidal melanoma. Of these, 21 patients had adjuvant brachytherapy. The inclusion criteria were tumor thickness â‰¥8 mm, base diameter <15 mm, and posterior tumors not extending anterior to the equator. Main outcomes measures were enucleation rate, visual outcome, surgical complications, local recurrence, metastasis, and mortality.Mean follow-up time was 102.5 months. Mean preoperative best-corrected visual acuity was 20/100. Mean tumor thickness was 9.8 mm (range, 7.7-13.5 mm; standard deviation, 1.7 mm), mean base diameter was 9.9 mm (range, 5-15 mm; standard deviation, 2.8 mm). At the latest visit, 36 patients (87.8%) still retained the eye. Mean postoperative best-corrected visual acuity was 20/1,625. Retinal detachment was the main postoperative complication (28.9%). At completion of follow-up, 12% of patients had phthisis bulbi, and 3 developed chronic hypotony. Five patients (12.2%) had local tumor recurrence; none of them had received brachytherapy as initial treatment. At 5 years of follow-up, 3 patients (7.3%) had liver metastasis. On Kaplan-Meier analysis at 10 years, all-cause mortality was 7.3% and specific mortality because of melanoma was 2.4%.Endoresection of high posterior melanomas was not associated with a higher risk of metastasis, death, or local recurrence than other reported techniques used to treat similar melanomas.
Map & Directions
6666 Security Blvd Gwynn Oak, MD 21207
2200 Kernan Dr
4001 Liberty Heights Ave
2200 Kernan Dr