7164 168Th St
Flushing NY 11365
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Evolution of diagnostic criteria for multiple sclerosis. - Neurologia i neurochirurgia polska
Multiple sclerosis is a chronic demyelinating disease of the central nervous system that occurs primarily in young adults. There is no single diagnostic test to recognize the disease. The diagnostic criteria, based on clinical examination and laboratory tests, have changed considerably over time. The first guidelines involved only the results of the patient's neurological examination. The diagnostic criteria developed by Poser in 1983 were based largely on the results of additional tests, including visual evoked potentials and analysis of cerebrospinal fluid. The McDonald criteria, developed in 2001and updated in 2005 and 2010, reflected the diagnostic breakthrough caused by widespread use of magnetic resonance imaging (MRI). Currently, the diagnosis depends largely on the results of the MRI examination. An early diagnosis is particularly important for starting disease-modifying treatments.Copyright Â© 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.
The influence of emotional state on the masticatory muscles function in the group of young healthy adults. - BioMed research international
Stress may affect the function of all the components of the masticatory system and may ultimately lead to differentiated symptoms and finally to systemic and structural dysfunctions.To determine the effect of stress on the masticatory muscles function in young healthy adults.A total of 201 young, Angle's first class, healthy volunteers, 103 female and 98 male, in the age between 18 and 21 years were recruited into the study. All the participants underwent clinical examination according to the Slavicek scheme, questionnaire survey according to Perceived Stress Scale, and assessment of masticatory muscles function in central occlusion.Symptoms of masticatory system dysfunction were found in the group of 86 subjects (46,24%). All the muscles activity in central occlusion was comparable in female and male groups. Mean values of masseters activities in the group of low stress subjects (75,52â€‰ÂµVÂ±15,97) were statistically different from the groups with medium (82,43â€‰ÂµVÂ±15,04) and high (81,33Â±12,05) perceived stress (P<0.05).Chronic stress may reveal or exacerbate symptoms of masticatory dysfunction.
Ketamine and tramadol for the prevention of shivering during spinal anaesthesia. - La Clinica terapeutica
Anaesthesia and surgery promote significant thermal disorder in the human body. Spinal anaesthesia causes lower limb vasodilation and redistribution of body heat from central to the peripheral compartments.This was a prospective, randomised, double-blind clinical study to compare the effectiveness of IV ketamine and tramadol in the prevention of shivering associated with spinal anaesthesia. We prospectively studied 150 ASA classification I and II patients between 18 and 70 years old scheduled for any elective surgery performed under spinal anaesthesia. Patients were randomly allocated to receive either prophylactic IV ketamine 0.5 mg/kg (Group K), IV tramadol 0.5 mg/kg (Group T) or normal saline as control (Group P) after intrathecal injection of 0.5% hyperbaric bupivacaine 12.5 mg (2.5 ml) and 25 mcg fentanyl. The frequency and degree of shivering, haemodynamic parameters, core body temperature and side effects of the studied drugs were recorded for the first 30 minutes.The incidence of shivering was 8% in Group K, 16% in Group T and 24% in Group P. This result was statistically significant between Groups K and P. Patients from Group K also exhibited significantly higher mean arterial blood pressure and heart rate at 5 and 15 minutes post intrathecal injection while their mean core temperature was also significantly higher. Side effects such as nausea, vomiting, hallucination, agitation and sweating were comparable between all three groups. Patients from Group K however, had significant higher incidence of behavioural changes (blunted affect or catatonic state) and nystagmus.Prophylactic use of IV ketamine 0.5 mg/kg significantly reduced the frequency and the intensity of perioperative shivering associated with spinal anaesthesia but also exhibited some side effects of the drug. Lower doses of prophylactic ketamine should be studied.
Evaluation of zeolite-sand mixtures as reactive materials protecting groundwater at waste disposal sites. - Journal of environmental sciences (China)
To recognize properties of a mixture of Vistula sand (medium sand acc. to USCS) with Slovak zeolite as reactive materials suitable for permeable reactive barriers proposed for protection of groundwater environment in vicinity of old landfills comprehensive laboratory investigations were performed. The present study investigates the removal of contaminants specific for landfill leachates onto zeolite-sand mixtures containing 20%, 50% and 80% of zeolite (ZS20, ZS50 and ZS80). Taking into account the results of batch tests it was concluded that the Langmuir isotherm best fitted the data. It was observed that the presence of ammonium, calcium and magnesium decreases the removal efficiency of copper by 32%. Column tests of contaminant migration through the attenuation zone of the reactive materials were interpreted using the software package CXTFIT, which solves a one-dimensional advection-dispersion equation. Column test results also indicate the strong influence of the presence of interfering substances on copper immobilisation; dynamic sorption capacities decrees twofold. Throughout the landfill leachate flow through ZS80 sample, a constant reduction of NH4+ (at 100%), K+ (at 93%) and Fe(total) (at an average of 86%) were observed. There was no reduction in chemical oxygen demand and biochemical oxygen demand.
The antinociceptive effect of 4-substituted derivatives of 5-(4-chlorophenyl)-2-(morpholin-4-ylmethyl)-2,4-dihydro-3H-1,2,4-triazole-3-thione in mice. - Naunyn-Schmiedeberg's archives of pharmacology
The aim of the present experiments was to examine the antinociceptive activity of 4-substituted derivatives of 5-(4-chlorophenyl)-2-(morpholin-4-ylmethyl)-2,4-dihydro-3H-1,2,4-triazole-3-thione in mice. The compounds were synthesized using the so-called Mannich reaction and their structures were confirmed using IR and 1H-NMR spectra. The antinociceptive activity was investigated in two behavioral tests: the hot plate test and the writhing test. For preliminary estimation of other behavioral effects, the locomotor activity of mice, the motor coordination in the rota-rod test, and the myorelaxation in the chimney test were also studied. The changes in body temperature of animals were also recorded. We demonstrated that all examined compounds produced antinociceptive effect, both in the hot plate test and in the writhing test, without impact on the motor coordination and myorelaxation of animals. The pharmacological effect of all drugs has been developed within 60Â min after administration of drugs; and in two cases (T-103 and T-104), it has been a short-lasting effect (up to 90Â min). Two compounds (T-100 and T-102) also inhibited the locomotor activity of animals. T-104 induced the changes in body temperature of mice. Generally, we demonstrated that combination of two different heterocyclic systems (morpholine and 1,2,4-triazole) might be beneficial for reduction of nociception.
EGFR activating mutations detected by different PCR techniques in Caucasian NSCLC patients with CNS metastases: short report. - Clinical & experimental metastasis
EGFR mutation testing has become an essential determination to decide treatment options for NSCLC. The mutation analysis is often conducted in samples with low percentage of tumour cells from primary tumour biopsies. There is very little evidence that samples from metastatic tissues are suitable for EGFR testing. We had evaluated the frequency of EGFR mutations with three highly sensitive PCR techniques in formalin-fixed, paraffin-embedded samples of 143 NSCLC patients with central nervous system (CNS) metastases. 32 corresponding primary tumours were also examined. We used PCR followed by DNA fragments length analysis (FLA), ASP-PCR and PNA-LNA PCR clamp techniques. We found 9 (6.29 %) EGFR gene mutations in CNS samples: 3 (2.1 %) in exon 19 and 6 (4.2 %) in exon 21. The full concordance between CNS metastases and primary tumour samples was observed. PCR followed by DNA-FLA and PNA-LNA PCR clamp were sensitive enough to detect exon 19 deletions. Two mutations in exon 21 were detected by ASP-PCR only, one L858R substitution was detected only by PNA-LNA PCR clamp. With respect to sensitivity, PCR followed by DNA-FLA achieved a level of detection of at least 10 % of mutated DNA for exon 19 deletion, as for ASP-PCR it was at least 5 % of mutated DNA for L858R substitution. Higher sensitivity of 1 % of mutated DNA was achieved by PNA-LNA PCR clamp technique for both mutations. The use of different methodological techniques authenticates the negative result of molecular tests.
Levobupivacaine for postoperative epidural analgesia in orthopaedic surgery. - La Clinica terapeutica
Levobupivacaine is the S(-)enantiomer of bupivacaine, a long acting amino-ester local anaesthetic agent. Cocktail mixture of levobupivacaine and fentanyl infusion is commonly given via epidural for post-operative analgesia. The concentration of levobupivacaine for optimal pain relief with least side effects remained uncertain.This was a prospective, randomized double-blind study to evaluate the effectiveness and safety of two different concentrations of levobupivacaine as epidural infusion for postoperative pain relief. Fifty patients who underwent orthopaedic lower limb surgeries were recruited and given a standardized combined spinal epidural anaesthesia during operation. They were then allocated to receive either 0.1% (Group A) or 0.2% levobupivacaine (Group B) with 2 Mi g/ml fentanyl as epidural infusion for postoperative pain relief over 24 hours. Pain score, motor blockade, hemodynamic parameters and the need for rescue analgesia were recorded.Group B patients had significant lower pain score at 4 and 8 hours post operation. There was no significant difference in degree of motor blockade and need for rescue analgesia in both groups. However, patients from Group B had significant hypotension (24% vs 4%) that responded to volume resuscitation without life-threatening complications.0.2% levobupivacaine with 2 Mi g/ml fentanyl provided more superior analgesia compared to 0.1% levobupivacaine with 2 Mi g/ ml fentanyl in patients who underwent lower limb orthopaedic surgery, but with a significant higher incidence of hypotension that responded to volume replacement.
Testicular adrenal rest tumors (TARTs) as a male infertility factor. Case report. - Ginekologia polska
Since testes and adrenal cortex derive from the same urogenital ridge, adrenal tissue with descending gonads may migrate in early embryonic period. Although most often ectopic tissue undergoes atrophy in some cases, when adrenocorticotrophic (ACTH) overstimulation occurs, the adrenal remnants in the testes may become hypertrophic and form testicular adrenal rest tumors (TARTs). The growth of TARTs in the testes leads to obstruction of the seminiferous tubules which can mechanically impair the function of the gonads and cause irreversible azoospermia. We describe a patient suffering since neonatal period from congenital adrenal hyperplasia (CAH), disorder with defected pathway of cortisol production, which leads to increased ACTH production and to overstimulation of adrenal cortex. He had very poor disease control and therefore in late puberty he was diagnosed with TARTs. At the age of 19.5 he was diagnosed with azoospermia, most likely caused by TARTs. It is the first evidence of TARTs in Polish literature. Although not many cases have been published so far the incidence of TARTs seems to be highly underdiagnosed, so it seems reasonable to consider the disease in differential diagnosis of male infertility.
Investigation of the effects of a centrally applied lumbar sustained natural apophyseal glide mobilization on lower limb sympathetic nervous system activity in asymptomatic subjects. - Journal of manipulative and physiological therapeutics
The purpose of this study was to investigate the effects of a manual mobilization technique on indirect measures of sympathetic nervous system activity.Forty-five healthy volunteers participated in this randomized, single-blinded, parallel-group 3-arm design (experimental, sham [placebo], and control group), comprising 15 subjects each. For the experimental group, lumbar mobilization involving an active movement, the Mulligan sustained natural apophyseal glide (SNAG), was applied on L4 spinous process by an experienced manual therapist. Sustained natural apophyseal glides were performed in sitting with active flexion (6 times Ã— 3 sets). The sham technique simulated the SNAG without applying any force. In the control group, participants were placed in a static sitting position throughout the experiment. Measures of skin conductance in the lower limbs (L4 dermatome) were recorded to reflect sympathetic nervous system activity in the preintervention, periintervention, and postintervention periods. Differences in percentage change of skin conductance were analyzed with analysis of variance and post hoc tests.Lumbar SNAG produced sympathoexcitation compared with the control group in the intervention period (P = .04). No significant difference was found between SNAG and sham groups, and no statistically significant difference was found between groups in the final rest period.The results of this study showed that, in asymptomatic participants, both lumbar SNAG and sham techniques performed on L4/5 intervertebral joint with active flexion induced a sympathoexcitatory response in lower limbs compared with the control group.Copyright Â© 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.
Carotid revascularization in patient with asymptomatic unilateral carotid stenosis undergoing coronary bypass--a futile effort! - La Clinica terapeutica
The best management of asymptomatic carotid artery disease in patient who needs coronary bypass remains controversial. We report the neurological outcome of four patients with asymptomatic unilateral significant carotid artery disease who underwent conventional coronary bypass without carotid revascularization. Our review highlighted the risk of perioperative stroke is not increased despite carotid revascularization was not performed. Asymptomatic carotid artery disease is not the cause for cerebral infarct but soft aortic atheroma encountered during surgery is the main culprit.
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