1150 N 35Th Ave Ste 300
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The baseline characteristics and interim analyses of the high-risk sentinel cohort of the Vietnam Initiative on Zoonotic InfectiONS (VIZIONS). - Scientific reports
The Vietnam Initiative for Zoonotic Infections (VIZIONS) includes community-based 'high-risk sentinel cohort' (HRSC) studies investigating individuals at risk of zoonotic infection due to occupational or residential exposure to animals. A total of 852 HRSC members were recruited between March 2013 and August 2014 from three provinces (Ha Noi, Dak Lak, and Dong Thap). The most numerous group (72.8%) corresponded to individuals living on farms, followed by slaughterers (16.3%) and animal health workers (8.5%). Nasal/pharyngeal and rectal swabs were collected from HRSC members at recruitment and after notifying illness. Exposure to exotic animals (including wild pigs, porcupine, monkey, civet, bamboo rat and bat) was highest for the Dak Lak cohort (53.7%), followed by Ha Noi (13.7%) and Dong Thap (4.0%). A total of 26.8% of individuals reported consumption of raw blood over the previous year; 33.6% slaughterers reported no use of protective equipment at work. Over 686 person-years of observation, 213 episodes of suspect infectious disease were notified, equivalent of 0.35 reports per person-year. Responsive samples were collected from animals in the farm cohort. There was noticeable time and space clustering of disease episodes suggesting that the VIZIONS set up is also suitable for the formal epidemiological investigation of disease outbreaks.
Synergistic co-delivery of doxorubicin and paclitaxel using multi-functional micelles for cancer treatment. - International journal of pharmaceutics
The main purposes of this study are to demonstrate the synergistic anticancer drug systems with the combined doxorubicin (D) and paclitaxel (P) via the aid of cell penetrating and cell targeting moieties for enhancing the cancer therapeutic effect. Firstly, the synergistic effect of combined free drugs (D/P) was investigated to obtain the suitable dose combination for subsequent studies. The combination of free drugs D/P at molar ratio of 1/0.2 shows synergistic therapeutic effect compared with the treatment of a free single drug D or P. Secondly, sustainable release systems of two single drug-loaded micelles, (i) co-delivered D-FOL micelle & P-FOL micelle system and (ii) co-delivered D-TAT/FOL micelle & P-TAT/FOL micelle system, at D/P molar ratio of 1/0.2 were investigated. The results show synergistic effect with the higher efficacy of the TAT/FOL system compared to FOL only system. Finally, a dual D/P-loaded system with sustainable release rate, synergistic drug interaction, selective targeting to cancer cells and high cell penetrating ability was designed. The D/P-TAT/FOL micelles exhibit an IC50 value of 0.172 Î¼M D/0.043 Î¼M P, which is much lower than the IC50 values of the single drug-loaded micelles without functionalization (3.873 Î¼M for D-micelles and 0.790 Î¼M for P-micelles). Overall, this newly developed dual encapsulation of D and P in the multifunctional carrier would be a promising technology for cancer treatment.Copyright Â© 2013 Elsevier B.V. All rights reserved.
Folate-Conjugated Polymer Micelles with pH-Triggered Drug Release Properties. - Macromolecular rapid communications
Folate has been applied as a targeting moiety for various anticancer drug-delivery agents to avoid non-specific attack of normal tissues as well as to increase cellular uptake at the target tumor cells. Polymer micelles made of poly[(D,L-lactide)-co-glycolide)]-poly(ethylene glycol)-folate (PLGA-PEG-FOL) was fabricated as a tumor targeting carrier for encapsulating the anticancer drug doxorubicin. To accelerate the drug release in the endosome after folate-mediated cellular uptake, pH-sensitive poly(Î²-amino ester)-PEG-FOL (PAE-PEG-FOL) was added together with PLGA-PEG-FOL to form mixed micelles. The results showed that the drug release can be triggered at different pH due to the ionization of PAE. The IC(50) of PLGA-PEG-FOL micelles is 0.46â€‰Ã—â€‰10(-6) M. With 20% PAE in the mixed micelles (20:80 mixed micelles), the IC(50) decreases to 0.34â€‰Ã—â€‰10(-6) M, which is comparable to that of pure PAE-PEG-FOL micelles at pH 7.4. As a result of the pH sensitivity, the PAE-PEG-FOL micelles are not stable at pH 6.5 or lower, and the drug may be released from the micelles into the extracellular environment before uptake by the cells. The 20:80 mixed micelles are relatively stable at this condition. As a result, the micelles retain more drug in the micelles for a higher degree of cellular uptake by folate receptor-mediated endocytosis, and exhibit higher cytotoxicity.Copyright Â© 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Feasibility of using hyperosmolar mannitol as a liquid tumor embolization agent. - AJNR. American journal of neuroradiology
This study assesses the cytotoxicity of hyperosmolar mannitol on human endothelial and meningioma cells in vitro and summarizes the initial clinical experience of using mannitol as a liquid tumor embolization agent.Human umbilical vein endothelial cells and primary meningioma cells from surgical specimens were treated with 300, 600, 900, and 1200 mOsm of mannitol, mannitol and iohexol mixture, saline, and iohexol alone. Cell death was evaluated with a Live/Dead kit and quantified with thymidine incorporation. From 1998 to 2004, 23 patients with meningioma were treated with mannitol and 31 patients were treated with polyvinyl alcohol (PVA) particles alone. Angiographic results, procedural complications, intraoperative observation, and estimated blood loss during surgical resection were retrospectively evaluated.Minimal endothelial cell death was seen after incubation with 300 mOsm of mannitol for 15 minutes, but 43 +/- 2% of endothelial cells were damaged by 1200 mOsm of mannitol after 30 minutes. Five meningioma cell lines exhibited significant cell death (22 +/- 2%; P < .05) after incubation with mannitol. Satisfactory angiographic results were obtained in all 23 patients. Tumor necrosis was observed intraoperatively and confirmed pathologically. There was no significant difference in estimated blood loss between mannitol- and PVA-embolized patients (407 +/- 64 mL vs 381 +/- 50 mL; P > .75).High concentration of mannitol can injure endothelial cells and meningioma cells in a short period of time. It is feasible to use mannitol as a liquid embolic agent to treat meningioma.
Dural arteriovenous fistula presents like an ischemic stroke. - Cognitive and behavioral neurology : official journal of the Society for Behavioral and Cognitive Neurology
We report the case of a patient with a dural arteriovenous fistula whose neurobehavioral syndrome was indistinguishable from that of an ischemic stroke.Case studies of dural arteriovenous fistulas primarily describe global cognitive changes like dementia, but detailed neurocognitive evaluations of dural arteriovenous fistula patients are rarely reported.We provide a dural arteriovenous fistula case of a patient who presented with aphasia and other symptoms of stroke. Background history, serial neuropsychological data, and angiographic images are presented.Serial neurocognitive data show the extent to which cognitive deficits are reversed with embolization. The case demonstrates that the mechanisms underlying neurocognitive deficits are specific to the fistula's unique hemodynamic features in addition to the location of the dural arteriovenous fistula.
Intraarterially administered verapamil as adjunct therapy for cerebral vasospasm: safety and 2-year experience. - AJNR. American journal of neuroradiology
Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment.We retrospectively reviewed the procedure reports, anesthesia records, clinical charts, and brain images of 29 patients who received intraarterially administered verapamil in 34 procedures for the treatment of vasospasm after subarachnoid hemorrhage from July 1998 to June 2000. The average changes in mean arterial pressure and heart rate were used to measure cardiovascular side effects. The neurologic effects were assessed by angiographic findings, the results of neurologic examinations performed before and after the procedure, and findings of CT of the head.The average dose of verapamil per patient was 3 +/- 0 mg or 44 +/- 5 mcg/kg. The average changes in mean arterial pressure at 10 and 20 minutes were -5 +/- 1 mm Hg and -2 +/- 1 mm Hg or -3.8 +/- 1.0% and -1.7 +/- 1.1%, respectively. No significant change of heart rate was observed at 10 minutes. The patients showed no sign of increased intracranial pressure by hemodynamic parameters, neurologic examination, or CT of the head. On 10 occasions, when the effect of verapamil infusion was assessed angiographically, there was 44 +/- 9% increase of vessel diameter in the spastic segment. Neurologic improvement was noted after five of 17 procedures when verapamil was used as the sole treatment.Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy.
Clinical utility of quantitative cerebral blood flow measurements during internal carotid artery test occlusions. - Neurosurgery
Internal carotid artery (ICA) balloon test occlusions (BTOs) are performed in the angiography suite to predict whether the patient has adequate collateral circulation to prevent stroke when permanent ICA occlusion (PCO) is required for treatment. Although many criteria have been proposed to facilitate predictions of stroke risk after PCO, no BTO techniques have been subjected to predictive validity testing in outcome studies. We describe a prospective case series study that tests the predictive validity of quantitative cerebral blood flow (CBF) measurements during ICA BTO.Thirty-three patients with clinical indications for PCO underwent ICA BTO and then PCO. During BTO, standard neurological examinations, sustained-attention testing, and quantitative CBF measurements were performed. Two scalp scintillation detectors recorded washout data after ipsilateral intracarotid injection of xenon-133 through a port at the tip of the ICA-occluding balloon. Patients were monitored for the outcome measure of ipsilateral stroke for a mean of 34 months. The variables of quantitative CBF values, neurological examination results, sustained-attention test results, age, sex, and side of occlusion were examined with Kaplan-Meier log-rank tests, predictive validity analyses, and logistic regression analyses.CBF of less than 30 ml/100 g/min during BTO was the only variable that predicted stroke after PCO (log rank = 5.87, P = 0.015). The negative and positive predictive values for CBF findings were superior to those for standard neurological examination findings and sustained-attention test results. Age, sex, and side of occlusion did not predict stroke.Quantitative CBF testing, via the intracarotid injection technique, during BTO seems to be an important predictor of stroke after PCO.
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