561 W Central Ave
Delaware OH 43015
Medical School: Ohio State University College Of Medicine - 2000
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 35.081269
Taxonomy Codes:207Q00000X 208M00000X
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Awards & Recognitions
Dr. John Green is associated with these group practices
Medical Malpractice Cases
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Green has made to other doctors
Dynamin function is important for chemokine receptor-induced cell migration. - Cell biochemistry and function
The HIV viral entry co-receptors CCR5 and CXCR4 function physiologically as typical chemokine receptors. Activation leads to cytosolic signal transduction that results in a variety of cellular responses such as cytoskeletal rearrangement and chemotaxis (CTX). Our aim was to investigate the signalling pathways involved in CC and CXC receptor-mediated cell migration. Inhibition of dynamin I and II GTPase with dynasore completely inhibited CCL3-stimulated CTX in THP-1 cells, whereas the dynasore analogue Dyngo-4a, which is a more potent inhibitor, showed reduced ability to inhibit CC chemokine-induced CTX. In contrast, dynasore was not able to block cell migration via CXCR4. The same activation/inhibition pattern was verified in activated T lymphocytes for different CC and CXC chemokines. Cell migration induced by CC and CXC receptors does not rely on active internalization processes driven by dynamin because the blockade of internalization does not affect migration, but it might rely on dynamin interaction with the cytoskeleton. We identify here a functional difference in how CC and CXC receptor migration is controlled, suggesting that specific signalling networks are being employed for different receptor classes and potentially specific therapeutic targets to prevent receptor migration can be identified. Copyright Â© 2015 John Wiley & Sons, Ltd.Copyright Â© 2015 John Wiley & Sons, Ltd.
Prevention of delirium (POD) for older people in hospital: study protocol for a randomised controlled feasibility trial. - Trials
Delirium is the most frequent complication among older people following hospitalisation. Delirium may be prevented in about one-third of patients using a multicomponent intervention. However, in the United Kingdom, the National Health Service has no routine delirium prevention care systems. We have developed the Prevention of Delirium Programme, a multicomponent delirium prevention intervention and implementation process. We have successfully carried out a pilot study to test the feasibility and acceptability of implementation of the programme. We are now undertaking preliminary testing of the programme.The Prevention of Delirium Study is a multicentre, cluster randomised feasibility study designed to explore the potential effectiveness and cost-effectiveness of the Prevention of Delirium Programme. Sixteen elderly care medicine and orthopaedic/trauma wards in eight National Health Service acute hospitals will be randomised to receive the Prevention of Delirium Programme or usual care. Patients will be eligible for the trial if they have been admitted to a participating ward and are aged 65Â years or over. The primary objectives of the study are to provide a preliminary estimate of the effectiveness of the Prevention of Delirium Programme as measured by the incidence of new onset delirium, assess the variability of the incidence of new-onset delirium, estimate the intracluster correlation coefficient and likely cluster size, assess barriers to the delivery of the Prevention of Delirium Programme system of care, assess compliance with the Prevention of Delirium Programme system of care, estimate recruitment and follow-up rates, assess the degree of contamination due to between-ward staff movements, and investigate differences in financial costs and benefits between the Prevention of Delirium Programme system of care and standard practice. Secondary objectives are to investigate differences in the number, severity and length of delirium episodes (including persistent delirium); length of stay in hospital; in-hospital mortality; destination at discharge; health-related quality of life and health resource use; physical and social independence; anxiety and depression; and patient experience.This feasibility study will be used to gather data to inform the design of a future definitive randomised controlled trial.ISRCTN01187372 . Registered 13 March 2014.
A Multidisciplinary Approach to Improving SCIP Compliance. - The American surgeon
The Surgical Care Improvement Project (SCIP) is a national program aimed at reducing perioperative complications and is a quality benchmark metric for Centers for Medicare and Medicaid Services. This study evaluates whether a multidisciplinary program improved an institution's compliance with SCIP measures. Analysis of the facility's performance data identified three key areas of SCIP noncompliance: 1) timely discontinuation of perioperative antibiotics and urinary catheters, 2) initiation of venous thromboembolism prophylaxis, and 3) perioperative beta blocker administration. Multidisciplinary teams collaborated with providers and department chairs in reviewing and enable SCIP compliance. Anesthesia staff managed preoperative antibiotics. SCIP-compliant order sets, venous thromboembolism pop-up alerts, and progress note templates were added to the electronic medical record. Standardized education was provided to explain SCIP requirements, review noncompliant cases, and update teams on SCIP performance. Data were captured from January 2009 to March 2014. Ten SCIP fallouts were reported for general surgery specialties in January 2013, when the SCIP compliance project launched. Specifically, colon-related surgery achieved 100 per cent compliance. Six months after implementation, overall SCIP compliance at our institution improved by 65 per cent (from 90.7-98.6% compliance).
Endocrine disrupting effect of the UV filter benzophenone-3 in zebrafish, Danio rerio. - Environmental toxicology and chemistry / SETAC
The chemical UV filter benzophenone-3 (BP-3) is suspected to be an endocrine disruptor based on results from in vitro and in vivo testing. However, studies including endpoints of endocrine adversity are lacking. The present study investigated the potential endocrine disrupting effects of BP-3 in zebrafish (Danio rerio) in the Fish Sexual Development Test (OECD TG 234) and a 12 day adult male zebrafish study. In TG 234, exposure from 0 to 60 d post hatch caused a monotone dose dependent skewing of the phenotypic sex ratio towards less males and more female zebrafish (NOEC: 191â€‰Âµg/L, LOEC: 388â€‰Âµg/L). Besides, gonad maturation was affected in both female fish (NOEC 191â€‰Âµg/L, LOEC 388â€‰Âµg/L) and male fish (NOEC 388â€‰Âµg/L, LOEC 470â€‰Âµg/L). Exposure to BP-3 did not affect the vitellogenin concentration in TG 234. After 12 d exposure of adult male zebrafish, a slight but yet significant increase in the vitellogenin concentration was observed at 268â€‰Âµg/L but not at 63â€‰Âµg/L and 437â€‰Âµg/l BP-3. Skewing of the sex ratio is a marker of an endocrine mediated mechanism as well as a marker of adversity and therefore the conclusion of the investigation is that BP-3 is an endocrine disrupting chemical in accordance with the WHO definition. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.
Physical exercise affects attentional orienting behavior through noradrenergic mechanisms. - Behavioral neuroscience
Spontaneously hypertensive rats (SHRs), a commonly used animal model of attention-deficit/hyperactivity disorder, exhibit little habituation of the orienting response to repeated presentations of a nonreinforced visual stimulus. However, SHRs that have access to a running wheel for 5, 10, or 21 days exhibit robust habituation that is indistinguishable from normo-active rats. Two days of exercise, in comparison, is not sufficient to affect habituation. Here we tested the hypothesis that the effect of exercise on orienting behavior in SHRs is mediated by changes in noradrenergic function. In Experiment 1, we found that 5, 10, or 21 days of access to a running wheel, but not 2 days, significantly reduced levels of the norepinephrine transporter in medial prefrontal cortex. In Experiment 2, we tested for a causal relationship between changes in noradrenergic function and orienting behavior by blocking noradrenergic receptors during exercise. Rats that received propranolol (beta adrenergic/noradrenergic receptor blocker) during 10 days of exercise failed to exhibit an exercise-induced reduction in orienting behavior. The results inform a growing literature regarding the effects of exercise on behavior and the potential use of exercise as a treatment for mental disorders.(c) 2015 APA, all rights reserved).
A retrospective observational analysis to identify patient and treatment-related predictors of outcomes in a community mental health programme. - BMJ open
This study aims to identify patient and treatment factors that affect clinical outcomes of community psychological therapy through the development of a predictive model using historic data from 2 services in London. In addition, the study aims to assess the completeness of data collection, explore how treatment outcomes are discriminated using current criteria for classifying recovery, and assess the feasibility and need for undertaking a future larger population analysis.Observational, retrospective discriminant analysis.2 London community mental health services that provide psychological therapies for common mental disorders including anxiety and depression.A total of 7388 patients attended the services between February 2009 and May 2012, of which 4393 (59%) completed therapy, or there was an agreement to end therapy, and were included in the study.Different combinations of the clinical outcome scores for anxiety Generalised Anxiety Disorder-7 and depression Patient Health Questionnaire-9 were used to construct different treatment outcomes.The predictive models were able to assign a positive or negative clinical outcome to each patient based on 5 independent pre-treatment variables, with an accuracy of 69.4% and 79.3%, respectively: initial severity of anxiety and depression, ethnicity, deprivation and gender. The number of sessions attended/missed were also important factors identified in recovery.Predicting whether patients are likely to have a positive outcome following treatment at entry might allow suitable modification of scheduled treatment, possibly resulting in improvements in outcomes. The model also highlights factors not only associated with poorer outcomes but inextricably linked to prevalence of common mental disorders, emphasising the importance of social determinants not only in poor health but also poor recovery.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Psychological therapies for sickle cell disease and pain. - The Cochrane database of systematic reviews
Sickle cell disease comprises a group of genetic blood disorders. It occurs when the sickle haemoglobin gene is inherited from both parents. The effects of the condition are: varying degrees of anaemia which, if severe, can reduce mobility; a tendency for small blood capillaries to become blocked causing pain in muscle and bone commonly known as 'crises'; damage to major organs such as the spleen, liver, kidneys, and lungs; and increased vulnerability to severe infections. There are both medical and non-medical complications, and treatment is usually symptomatic and palliative in nature. Psychological interventions for individuals with sickle cell disease might complement current medical treatment, and studies of their efficacy have yielded encouraging results. This is an update of a previously published Cochrane Review.To examine the evidence that psychological interventions improve the ability of people with sickle cell disease to cope with their condition.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, which comprises references identified from comprehensive electronic database searches and the Internet, handsearches of relevant journals and abstract books of conference proceedings.Date of the most recent search of the Group's Haemoglobinopathies Trials Register: 17 February 2015.All randomised or quasi-randomised controlled trials comparing psychological interventions with no (psychological) intervention in people with sickle cell disease.Both authors independently extracted data and assessed the risk of bias of the included studies.Twelve studies were identified in the searches and seven of these were eligible for inclusion in the review. Five studies, involving 260 participants, provided data for analysis. One study showed that cognitive behaviour therapy significantly reduced the affective component of pain (feelings about pain), mean difference -0.99 (95% confidence interval -1.62 to -0.36), but not the sensory component (pain intensity), mean difference 0.00 (95% confidence interval -9.39 to 9.39). One study of family psycho-education was not associated with a reduction in depression. Another study evaluating cognitive behavioural therapy had inconclusive results for the assessment of coping strategies, and showed no difference between groups assessed on health service utilisation. In addition, family home-based cognitive behavioural therapy did not show any difference compared to disease education. One study of patient education on health beliefs showed a significant improvement in attitudes towards health workers, mean difference -4.39 (95% CI -6.45 to -2.33) and medication, mean difference -1.74 (95% CI -2.98 to -0.50). Nonetheless, these results may not apply across all ages, severity of sickle cell disease, types of pain (acute or chronic), or setting.Evidence for the efficacy of psychological therapies in sickle cell disease is currently limited. This systematic review has clearly identified the need for well-designed, adequately-powered, multicentre randomised controlled trials assessing the effectiveness of specific interventions in sickle cell disease.
2014 UK national guideline for the management of anogenital herpes. - International journal of STD & AIDS
These guidelines concern the management of anogenital herpes simplex virus infections in adults and give advice on diagnosis, management, and counselling of patients. This guideline replaces the 2007 BASHH herpes guidelines and includes new sections on herpes proctitis, key points to cover with patients regarding transmission and removal of advice on the management of HSV in pregnancy which now has a separate joint BASHH/RCOG guideline.Â© The Author(s) 2015.
Essentials of sepsis management. - The Surgical clinics of North America
Despite remarkable advances in the knowledge of infection and human response to it, sepsis continues to be one of the most common challenges surgeons and critical care providers face. Surgeons confront the problem of infection every day, in treating established infections or reacting to a consequence of surgical intervention. Infections after surgery continue to be a problem despite massive efforts to prevent them. Patients rely on the surgeon's ability to recognize infection and treat it. Also, preventing nosocomial infection and antibiotic resistance is a primary responsibility. This article describes diagnostic and therapeutic measures for sepsis in the perioperative surgical patient.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Aquatic hazard, bioaccumulation and screening risk assessment for 6:2 fluorotelomer sulfonate. - Chemosphere
This study assessed the aquatic toxicity and bioaccumulation potential of 6:2 fluorotelomer sulfonate (6:2 FTSA). Acute and chronic aquatic hazard endpoints indicate 6:2 FTSA is not classified for aquatic hazard according to GHS or European CLP legislation. The aqueous bioconcentration factors for 6:2 FTSA were <40 and the dietary assimilation efficiency, growth corrected half-life and dietary biomagnification factor (BMF) were 0.435, 23.1d and 0.295, respectively. These data indicate that 6:2 FTSA is not bioaccumulative in aquatic organisms. Comparison of PNECs with the reported surface water concentrations (non-spill situations) suggests low risk to aquatic organisms from 6:2 FTSA. Future studies are needed to elucidate the biotic and abiotic fate of commercial AFFF surfactants in the environment.Copyright Â© 2015 Elsevier Ltd. All rights reserved.
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