1626 Common St
New Braunfels TX 78130
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: M8550
Taxonomy Codes:207RC0000X 207RI0011X 207UN0901X
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Genetic and biochemical consequences of adenosine deaminase deficiency in humans. - Indian journal of biochemistry & biophysics
Adenosine deaminase deficiency accounts for approximately 15-20% of severe combined immunodeficiency in humans. The gene for adenosine deaminase is located on chromosome 20q12-q13.11 and codes for an aminohydrolase that catalyzes the deamination of adenosine and deoxyadenosine to inosine and deoxyinosine, respectively. Absence of the enzyme causes a build-up of the substrates in addition to excess deoxyadenosine triphosphate, thereby compromising the regenerative capacity of the immune system. Due to underlying allelic heterogeneity, the disorder manifests as a spectrum, ranging from neonatal onset severe combined immunodeficiency to apparently normal partial adenosine deaminase deficiency. Tandem mass spectrometry coupled with high efficiency separation systems enables postnatal diagnosis of the disorder, while prenatal diagnosis relies on assaying enzyme activity in cultured amniotic fibroblasts or chorionic villi sampling. Screening of adenosine deaminase deficiency for relatives-at-risk may reduce costs of treatment and ensure timely medical intervention as applicable. This article reviews the genetic, biochemical and clinical aspects of adenosine deaminase deficiency.
Use of Angio-Seal closure device when the arteriotomy is above or below the common femoral artery. - Clinical cardiology
The majority of vascular complications during diagnostic coronary angiography occur while accessing the femoral artery. Angio-Seal vascular closure devices are indicated for closure of arteriotomies of the femoral artery, but not when the puncture site is above or below the femoral artery.Under certain circumstances, use of the Angio-Seal closure device above or below the common femoral artery may be safe and effective.Consecutive patients at a single high-volume medical center having documented high or low arteriotomies were closed using an Angio-Seal closure device. Patients were chosen when they received a single arterial puncture, the arteriotomy was away from branch vessels, and the diameter of the artery at the site of sheath entry was of large enough caliber to suggest placement would be successful. Patients were then followed longitudinally for complications.Sixty-two patients had non-femoral artery sheath placement. Twenty-two patients had "high" puncture sites, and 40 patients had "low" puncture sites. All were successfully closed using the Angio-Seal vascular closure device and had no complications.Although not approved for placement in areas above or below the femoral artery, off-label use of the Angio-Seal arteriotomy closure may be safely performed when patient characteristics are favorable.Â© 2011 Wiley Periodicals, Inc.
The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study: a single-center experience. - Proceedings (Baylor University. Medical Center)
The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study is a multicenter randomized prospective controlled trial evaluating the safety of and patient satisfaction with same-day discharge following ambulatory percutaneous intervention with a closure device. This article reviews the findings from a single center, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, from October 2008 through April 2010, with 23 patients in the same-day discharge group and 21 patients in the next-day discharge group. There were no differences between the groups in demographic or procedure characteristics. Outcomes were measured by a questionnaire and 7-day and 30-day follow-up phone calls. Results showed that same-day discharge after percutaneous intervention with a closure device is as safe as next-day discharge. However, there was a trend for a higher comfort level among patients in the next-day discharge group.
Successful percutaneous retrieval of methyl methacrylate orthopedic cement embolism from the pulmonary artery. - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Vertebroplasty cement embolization into the venous system has long been recognized as a potential complication, but the true incidence of systemic embolization is unknown. Clinical presentations range from patients who are asymptomatic or have incidental findings on imaging to massive pulmonary embolism resulting in death. Optimal treatment is controversial and the natural history is unknown. We present the case of an 85-year-old female undergoing combined laminectomy and vertebroplasty with subsequent pulmonary embolism of the cement which was successfully retrieved from a percutaneous approach.(c) 2010 Wiley-Liss, Inc.
Identifying cardiovascular syphilis at operation. - The American journal of cardiology
To describe the morphologic features so the process can be easily identified during surgery, we studied 34 patients with cardiovascular syphilis, 32 of whom underwent excision and replacement of the ascending aorta or aortic valve or both. Of the 34 patients, 22 were treated at Baylor University Medical Center from 1998 to 2008 and 12 at non-Baylor University Medical Center hospitals from 1958 to 1987. In all 34 patients, the tubular portion of the aorta was diffusely thickened and the sinus portion of the aorta was apparently uninvolved. The process involved all 3 layers of the aorta, with thickening of the adventitia, mainly by fibrous tissue. Within the fibrous tissue were collections of plasma cells and lymphocytes, focal destruction of the media without thickening, and marked thickening of the intima by atherosclerotic-appearing lesions. Serologic tests for syphilis were done in only 14 patients (41%) and were positive (reactive) in 6 (43%) of them. The ascending aorta, however, was similar in all 34 patients. In conclusion, cardiovascular syphilis has not disappeared. Its identification during surgery can prompt appropriate antibiotic therapy postoperatively. Although the serologic test results for syphilis might be negative, antibiotic therapy is recommended for patients with panaortitis requiring resection of the ascending aorta with or without aortic regurgitation.
Luminescent Solar Concentrators--a review of recent results. - Optics express
Luminescent solar concentrators (LSCs) generally consist of transparent polymer sheets doped with luminescent species. Incident sunlight is absorbed by the luminescent species and emitted with high quantum efficiency, such that emitted light is trapped in the sheet and travels to the edges where it can be collected by solar cells. LSCs offer potentially lower cost per Wp. This paper reviews results mainly obtained within the framework of the Full-spectrum project. Two modeling approaches are presented, i.e., a thermodynamic and a ray-trace one, as well as experimental results, with a focus on LSC stability.
Safety of drug-eluting stents in the coronary artery in ST-elevation myocardial infarction at a single high-volume medical center. - The American journal of cardiology
Several trials have shown the effectiveness of drug-eluting stents (DES) in reducing restenosis. Acute ST-elevation myocardial infarction (STEMI) has been an exclusion criterion in most trials evaluating the safety and efficacy of DES. There is recent randomized trial data evaluating the use and safety of DES for acute myocardial infarction. However, there is a need for "real world" data on the efficacy and safety of DES in STEMI. A single-center retrospective analysis was performed on 188 consecutive patients with STEMI treated with primary or rescue coronary angioplasty between March 2004 and July 2005. The study consisted of 3 groups: 115 patients treated with paclitaxel-eluting stents, 55 with sirolimus-eluting stents, and 18 with bare metal stents. Outcomes were assessed from 12 to 28 months (mean 20, median 19) for major adverse cardiac events (MACEs) including myocardial infarction, in-stent thrombosis, clinical restenosis, and death. There were 4 in-stent thromboses in the paclitaxel group (3.4%) and 2 in-stent thromboses in the sirolimus group (3.6%). The thromboses ranged from acute (within 24 hours) to as late as 8 months. Clinical restenosis occurred in 4 patients (3.4%) in the paclitaxel group and in 2 patients (3.6%) in the sirolimus. None of the 18 patients with bare metal stents had thrombosis or clinical restenosis. There were 7 total deaths, all related to complications from the index STEMI: 1 in the bare metal group, 1 in the sirolimus group, and 5 in the paclitaxel group. The postdischarge MACE rate was 7% with no deaths. In conclusion, the use of DES in acute STEMI is associated with a low postdischarge MACE rate and a 3.5% in-stent thrombosis rate, which is similar to reported rates in earlier randomized trials.
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1626 Common St New Braunfels, TX 78130
189 E Austin St Ste 106
2660 E Common St Suite 201
1099 N Walnut Ave Suite D