483 W. Seed Farm Rd.
Sacaton AZ 85247
Medical School: Umdnj-New Jersey Medical School - 1994
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: Yes
Participates In EHR: No
License #: 5203
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Dr. Michael Goldman is associated with these group practices
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|HCPCS Code:80061||Description:Lipid panel||Average Price:$68.50||Average Price Allowed
|HCPCS Code:80053||Description:Comprehen metabolic panel||Average Price:$58.50||Average Price Allowed
|HCPCS Code:85025||Description:Complete cbc w/auto diff wbc||Average Price:$36.50||Average Price Allowed
|HCPCS Code:36415||Description:Routine venipuncture||Average Price:$15.50||Average Price Allowed
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Medical Board Sanctions
*These referrals represent the top 10 that Dr. Goldman has made to other doctors
Guidelines for urinary tract infections and antenatal hydronephrosis shouldÂ be gender specific. - Acta paediatrica (Oslo, Norway : 1992)
Febrile urinary tract infections (UTIs) may be associated with long-term renal damage. Our goal was to identify risk factors for future UTIs in children who had voiding cystourethrography (VCUG) as a part of an antenatal hydronephrosis (ANH) assessment or after a febrile UTI.We conducted a cohort study based on the medical records of children aged 0-24 months who underwent a VCUG between January 2004 and December 2011 and had at least six months of follow-up. The incidence of future UTIs was assessed.We included 285 children: 176 had a primary UTI and 109 had ANH. We recorded 28 UTIs during the follow-up period, and the risk was 12.5% after a primary UTI and 5.5% after an ANH (p = 0.049). Multivariate analysis showed no risk difference was found between the groups. Females had a greater risk of febrile UTIs (hazard ratio 3.3, 95% confidence interval 1.03-9.2, p = 0.04), but the UTI risk did not differ between children with or without VURs.Female infants were at greater risk of febrile UTIs, regardless of the presence of VUR, VUR degree, ANH or a previous UTI. Clinical guidelines for UTI and ANH assessment should preferably be gender specific.Â©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
The Risk of Serious Bacterial Infection in Neutropenic Immunocompetent Febrile Children. - Journal of pediatric hematology/oncology
Only few reports have looked into the risk of invasive bacterial infection in children with neutropenia that is not malignancy related. The objective of the current study was to determine the clinical significance of neutropenia as a predictor of serious bacterial infection (SBI) in immunocompetent children. We conducted a retrospective case-control study including children 3 months to 18 years of age with fever â‰¥ 38Â°C hospitalized or presenting to the emergency department. Patients who had neutropenia â‰¤ 1000 ANC/Î¼L and had a blood culture taken were matched for age with the consecutive febrile patients for whom a blood culture was taken. The main outcome was the rate of SBI. SBIs were more prevalent among the control group than in the group of children with neutropenia, 19/71 and 6/71, respectively (P = 0.0005). More children were treated with antibiotics among the control group than in the group of children with neutropenia, 39/71 and 20/71, respectively (P < 0.0001). Acute-phase reactants including CRP and platelets were higher in the control group. We concluded that immunocompetent patients with fever and moderate neutropenia do not carry a higher risk for SBIs compared with patients with fever who do not have neutropenia.
Inherent Anticipation in the Pharmaceutical and Biotechnology Industries. - Cold Spring Harbor perspectives in medicine
Pharmaceutical and biotech research often involves discovering new properties of, or new methods to use, existing compositions. The doctrine of inherent anticipation, however, prevents the issuance and/or validity of a patent for discoveries deemed to have been implicitly disclosed in the prior art. This can be a barrier to patent rights in these technologies. Inherent anticipation therefore creates uncertainty for patent protection in the pharmaceutical and biotech sciences. Despite this uncertainty, Federal Circuit jurisprudence provides guidance on the boundaries of the inherent anticipation doctrine. In view of the case law, certain strategies may be employed to protect inventions that may potentially be viewed as inherent in the prior art.Copyright Â© 2015 Cold Spring Harbor Laboratory Press; all rights reserved.
Glottal Aperture and Buccal Airflow Leaks Critically Affect Forced Oscillometry Measurements. - Chest
The forced oscillation technique (FOT) measures respiratory resistance and reactance; however, the upper airways may affect the results. We quantified the impact of glottal aperture and buccal air leaks.In the glottal aperture study (1) 10 healthy subjects (aged 34 Â± 2 years) performed a total lung capacity maneuver followed by 10-s breath-hold with and without total glottal closure and (2) the effects of humming (incomplete glottal narrowing) on FOT measurements were studied in six healthy subjects. Glottal narrowing was confirmed by direct rhinolaryngoscopy. In the air leak study, holes of increasing diameter (3.5, 6.0, and 8.5 mm) were made to the breathing filters. Eleven healthy subjects (aged 33 Â± 2 years) and five patients with COPD (aged 69 Â± 3 years) performed baseline FOT measurements with the three modified filters.Narrow glottal apertures and humming generated whole-breath resistance at 5 Hz (R5) peaks, increased R5 (1.49 Â± 0.37 kPa/L/s vs 0.34 Â± 0.01 kPa/L/s, P < .001), and decreased whole-breath reactance at 5 Hz (X5) values (-2.10 Â± 0.51 kPa/L/s vs -0.09 Â± 0.01 kPa/L/s, P < .001). The frequency dependency of resistance was increased. Holes in the breathing filters produced indentations on the breathing trace. Even the smaller holes reduced R5 in healthy subjects (0.33 Â± 0.02 to 0.24 Â± 0.02 kPa/L/s, P < .01) and patients with COPD (0.50 Â± 0.04 to 0.41 Â± 0.04 kPa/L/s, P < .05), whereas X5 became less negative (from -0.09 Â± 0.01 to -0.05 Â± 0.01 in healthy subjects, P < .01; from -0.22 Â± 0.06 to -0.11 Â± 0.03 kPa/L/s in patients with COPD, P < .05).Visual inspection of the data is required to exclude glottal narrowing and buccal air leaks identified as R5 peaks and volume indentations, respectively, because these significantly affect FOT measurements.
Plasma and cerebrospinal fluid concentrations of ibuprofen in pediatric patients and antipyretic effect: Pharmacokinetic-pharmacodynamic modeling analysis. - Journal of clinical pharmacology
We aimed to determine the relationship between plasma and cerebrospinal fluid (CSF) concentrations of ibuprofen and the antipyretic effect in pediatric patients. A prospective cohort of infants and children aged 3 months to 15 years and treated with ibuprofen was studied. The patients received ibuprofen (via oral route, median dose of 10.0â€‰mg/kg; 3.4-11.4â€‰mg/kg range), samples of blood and CSF were collected, and body temperature was measured. Sequential analysis of the pharmacokinetic and pharmacodynamic data from 28 patients was performed using a population modeling approach. The observed concentration versus time data indicated substantial pharmacokinetic variability in absorption and distribution of ibuprofen between the patients. The pharmacokinetic modeling outcomes indicate that following a âˆ¼25-minute lag time, ibuprofen is rapidly absorbed to the central compartment and rapidly equilibrates with the CSF, resulting in the total ibuprofen concentration in the CSF versus plasma (CCSF /Cplasma ) of 0.011â€‰Â±â€‰0.007. The antipyretic effect of ibuprofen was best described by an indirect response PK-PD model incorporating patient baseline body temperature and ibuprofen concentration in the CSF. We conclude that the pharmacokinetic-pharmacodynamic modeling can be used to predict the time course of ibuprofen plasma and CSF concentrations and of the antipyretic effects in individual pediatric patients.Â© 2014, The American College of Clinical Pharmacology.
Efficacy of urine alkalinization by oral administration of sodium bicarbonate: a prospective open-label trial. - The American journal of emergency medicine
Urine alkalinization is indicated for various medical conditions. Alkalinization is usually achieved by intravenous administration of alkali substances titrated by repeated urinalyses. Some situations such as mass casualty events might require urine alkalinization by the oral route. We evaluated the efficacy of oral sodium bicarbonate administration for urine alkalinization.In a prospective open-label trial, 4 g of sodium bicarbonate was administered orally 3 times daily to 9 healthy volunteers for 24 hours. Serial blood and urine samples were collected, and urine pH was evaluated. Plasma electrolytes and pH were also measured for safety purposes.All participants had a urine pH of at least 7 after 10 hours. At 20 hours, all participants had a urine pH of at least 8. No adverse effects or abnormal blood results were documented during the 24-hour follow-up.Oral administration of a standard dose of sodium bicarbonate tablets resulted in effective urine alkalinization. Further research is needed to investigate the natural course of urine pH after cessation of our protocol and the efficacy of longer periods of treatment.Â© 2013.
Use of continuous venovenous hemofiltration for acute renal failure due to multiple myeloma cast nephropathy. - Hematology (Amsterdam, Netherlands)
Renal insufficiency is associated with high morbidity and mortality in multiple myeloma. One of the common causes for acute renal failure in multiple myeloma is cast nephropathy. It is important to reduce the levels of light chains to improve renal failure and also the overall outcome. Plasmapheresis has failed to show any significant improvement in renal failure due to cast nephropathy as demonstrated in a recent randomized control trial. Here, we present a case series of three patients who were treated with continuous venovenous hemofiltration as a modality to remove these free light chains. There was improvement in renal failure in these patients with decrease in the levels of free light chains. These patients remained off hemodialysis on follow-up and two of them were able to undergo hematopoietic stem cell transplantation.
Orthostatic hypotension in children with acute febrile illness. - The Journal of emergency medicine
Children presenting to the Pediatric Emergency Department (PED) with fever often describe symptoms such as lightheadedness, dizziness, fatigue, and weakness, and may appear pale. They may also present with a chief complaint of syncope. Such symptoms may result from orthostatic hypotension.To determine whether children with an acute febrile illness have a higher incidence of orthostatic hypotension compared to afebrile children.A prospective cohort study was conducted at the PED at Assaf Harofeh Medical Center, a university-affiliated hospital in Israel. Eighty children aged 4-18 years were recruited. Thirty-nine had fever (>38Â°C for 6-48 h) and 41 were afebrile. All subjects had their blood pressure measured in the supine position (after 5 min of rest) and again after standing for 3 min. The main outcome measure was orthostatic hypotension, that is, a reduction of systolic blood pressure of at least 20 mm Hg, or a fall in diastolic blood pressure of at least 10 mm Hg within 3 min of standing.There were no differences between the groups in gender, age, height, or weight. Orthostatic hypotension was found in 10/39 (25.6%) of febrile children and in 2/41 (5%) of afebrile children (p=0.012).The incidence of orthostatic hypotension among febrile children in the PED is high, and may explain common symptoms such as dizziness or syncope. Such patients should be instructed to drink properly and to avoid rapid changes in body posture.Copyright Â© 2013 Elsevier Inc. All rights reserved.
Severe oxalosis with systemic manifestations. - Journal of clinical medicine research
Ethylene glycol toxicity can have various clinical presentations with different organ system involvements. These presentations are independent of the level of toxicity. We describe a 31 years old male who presented with ethylene glycol toxicity manifesting as anuric renal failure who subsequently developed neurological sequela of its toxicity. Ethylene glycol is known to be metabolized to various metabolites and is ultimately converted to oxalate which results in crystal deposition the renal parenchyma causing renal failure. Oxalate deposition can occur in various organs including the nervous system as seen in our patient. The majority of patients do not recover from severe oxalosis despite the supportive care of hemodialysis in removing the parent compounds. Despite severe oxalosis, our patient was fortunate enough to be left with minimal neurological sequelae, and eventually was able to cease hemodialysis treatments.Ethylene glycol; Oxalate; Oxalosis; Glyoxylic acid.
Rosiglitazone and pioglitazone alter aromatase kinetic properties in human granulosa cells. - PPAR research
We have previously reported that, in human granulosa cells, thiazolidinediones rosiglitazone and pioglitazone inhibit estrogen synthesis by interfering with androgen binding to aromatase, without an effect on aromatase mRNA or protein expression. In the current paper, we explore the effects of rosiglitazone and pioglitazone on the aromatase enzyme kinetic properties in human granulosa cells. The cells were incubated with various concentrations of testosterone or androstenedione, with or without rosiglitazone or pioglitazone. Estradiol and estrone concentrations in the conditioned tissue culture medium were measured by radioimmunoassay or immunosorbent assay. When testosterone was used as substrate, rosiglitazone or pioglitazone inhibited the V(max) by 35% (P < 0.001) and 24% (P < 0.001), respectively. When androstenedione was used as substrate, both rosiglitazone or pioglitazone inhibited V(max) by 13% (P < 0.007). We conclude that rosiglitazone or pioglitazone has no effect on K(m) but inhibits V(max) of aromatase in human granulosa cells, therefore, acting as noncompetitive inhibitors.
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483 W. Seed Farm Rd. Sacaton, AZ 85247
483 W. Seed Farm Rd.