3100 E Fletcher Ave
Tampa FL 33613
Medical School: Other - 2001
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: ME0091694
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Awards & Recognitions
Dr. Vimal Patel is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:99291||Description:Critical care first hour||Average Price:$420.00||Average Price Allowed
|HCPCS Code:99236||Description:Observ/hosp same date||Average Price:$350.00||Average Price Allowed
|HCPCS Code:99223||Description:Initial hospital care||Average Price:$310.00||Average Price Allowed
|HCPCS Code:99220||Description:Initial observation care||Average Price:$250.00||Average Price Allowed
|HCPCS Code:99233||Description:Subsequent hospital care||Average Price:$160.00||Average Price Allowed
|HCPCS Code:99239||Description:Hospital discharge day||Average Price:$160.00||Average Price Allowed
|HCPCS Code:99238||Description:Hospital discharge day||Average Price:$110.00||Average Price Allowed
|HCPCS Code:99232||Description:Subsequent hospital care||Average Price:$110.00||Average Price Allowed
|HCPCS Code:99217||Description:Observation care discharge||Average Price:$110.00||Average Price Allowed
|HCPCS Code:99231||Description:Subsequent hospital care||Average Price:$65.00||Average Price Allowed
HCPCS Code Definitions
- Hospital discharge day management; more than 30 minutes
- Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from "observation status" if the discharge is on other than the initial date of "observation status." To report services to a patient designated as "observation status" or "inpatient status" and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])
- Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes
- Hospital discharge day management; 30 minutes or less
- Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually the presenting problem(s) requiring admission are of high severity. Typically, 55 minutes are spent at the bedside and on the patient's hospital floor or unit.
- Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.
- Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
- Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
- Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to "observation status" are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
- Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.
Medical Malpractice Cases
Hillsborough County Florida
Case Number: 08-30115
Incident Date: 01/01/2007
Settlemnt Date: 10/01/2010
Lee County Florida
Case Number: *********
Incident Date: 01/25/2005
Settlemnt Date: 03/07/2006
Lee County Florida
Case Number: *********
Incident Date: 05/07/2005
Settlemnt Date: 10/23/2008
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Patel has made to other doctors
Use of Head Guards in AIBA Boxing Tournaments-A Cross-Sectional Observational Study. - Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
This study looks at the changes in injuries after the implementation of a new rule by the International Boxing Association (AIBA) to remove head guards from its competitions.A cross-sectional observational study performed prospectively. This brief report examines the removal of head guards in 2 different ways. The first was to examine the stoppages due to blows to the head by comparing World Series Boxing (WSB), without head guards, to other AIBA competitions with head guards. Secondly, we examined the last 3 world championships: 2009 and 2011 (with head guards) and 2013 (without head guards).World Series Boxing and AIBA world championship boxing.Boxers from WSB and AIBA world championships.The information was recorded by ringside medical physicians.Stoppages per 10â€‰000 rounds; stoppages per 1000 hours.Both studies show that the number of stoppages due to head blows was significantly decreased without head guards. The studies also showed that there was a notable increase in cuts.Removing head guards may reduce the already small risk of acute brain injury in amateur boxing.
Sir Hugh Cairns and World War II British advances in head injury management, diffuse brain injury, and concussion: an Oxford tale. - Journal of neurosurgery
The authors trace the Oxford, England, roots of World War II (WWII)-related advances in head injury management, the biomechanics of concussion and brain injury, and postwar delineation of pathological findings in severe concussion and diffuse brain injury in man. The prominent figure in these developments was the charismatic and innovative Harvey Cushing-trained neurosurgeon Sir Hugh Cairns. Cairns, who was to closely emulate Cushing's surgical and scholarly approach, is credited with saving thousands of lives during WWII by introducing and implementing innovative programs such as helmets for motorcyclists, mobile neurosurgical units near battle zones, and the military usage of penicillin. In addition, he inspired and taught a generation of neurosurgeons, neurologists, and neurological nurses in the care of brain and spinal cord injuries at Oxford's Military Hospital for Head Injuries. During this time Cairns also trained the first full-time female neurosurgeon. Pivotal in supporting animal research demonstrating the critical role of acceleration in the causation of concussion, Cairns recruited the physicist Hylas Holbourn, whose research implicated rotary acceleration and shear strains as particularly damaging. Cairns' work in military medicine and head injury remain highly influential in efforts to mitigate and manage brain injury.
Internal Carotid Artery Web: Doppler Ultrasound with CT Angiography correlation. - Journal of radiology case reports
We present a case of an internal carotid web, detected on duplex ultrasound and confirmed by CT angiography. To our knowledge, this is only the third reported ultrasound case in the imaging literature. This vascular abnormality can cause a clinically significant carotid stenosis and is a risk factor for recurrent embolic cerebrovascular events. Due to small size and poor awareness among radiologists, carotid webs are often under-diagnosed on non-invasive imaging modalities. Improved awareness including knowledge of salient imaging features is useful as early diagnosis leading to appropriate intervention can eliminate the risk of future cerebrovascular events.
Extracellular volume quantification in isolated hypertension - changes at the detectable limits? - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
Diffuse myocardial fibrosis (DMF) is important in cardiovascular disease, however until recently could only be assessed by invasive biopsy. We hypothesised that DMF measured by T1 mapping is elevated in isolated systemic hypertension.In a study of well-controlled hypertensive patients from a specialist tertiary centre, 46 hypertensive patients (median age 56, range 21 to 78, 52Â % male) and 50 healthy volunteers (median age 45, range 28 to 69, 52Â % male) underwent clinical CMR at 1.5Â T with T1 mapping (ShMOLLI) using the equilibrium contrast technique for extracellular volume (ECV) quantification. Patients underwent 24-hours Automated Blood Pressure Monitoring (ABPM), echocardiographic assessment of diastolic function, aortic stiffness assessment and measurement of NT-pro-BNP and collagen biomarkers.Late gadolinium enhancement (LGE) revealed significant unexpected underlying pathology in 6 out of 46 patients (13Â %; myocardial infarction nâ€‰=â€‰3; hypertrophic cardiomyopathy (HCM) nâ€‰=â€‰3); these were subsequently excluded. Limited, non-ischaemic LGE patterns were seen in 11 out of the remaining 40 (28Â %) patients. Hypertensives on therapy (mean 2.2 agents) had a mean ABPM of 152/88Â mmHg, but only 35Â % (14/40) had left ventricular hypertrophy (LVH; LV mass maleâ€‰>â€‰90Â g/m(2); femaleâ€‰>â€‰78Â g/m(2)). Native myocardial T1 was similar in hypertensives and controls (955â€‰Â±â€‰30Â ms versus 965â€‰Â±â€‰38Â ms, pâ€‰=â€‰0.16). The difference in ECV did not reach significance (0.26â€‰Â±â€‰0.02 versus 0.27â€‰Â±â€‰0.03, pâ€‰=â€‰0.06). In the subset with LVH, the ECV was significantly higher (0.28â€‰Â±â€‰0.03 versus 0.26â€‰Â±â€‰0.02, pâ€‰<â€‰0.001).In well-controlled hypertensive patients, conventional CMR discovered significant underlying diseases (chronic infarction, HCM) not detected by echocardiography previously or even during this study. T1 mapping revealed increased diffuse myocardial fibrosis, but the increases were small and only occurred with LVH.
Apoptotic cells activate AMP-activated protein kinase (AMPK) and inhibit epithelial cell growth without change in intracellular energy stores. - The Journal of biological chemistry
Apoptosis plays an indispensable role in the maintenance and development of tissues. We have shown that receptor-mediated recognition of apoptotic target cells by viable kidney proximal tubular epithelial cells (PTECs) inhibits the proliferation and survival of PTECs. Here, we examined the effect of apoptotic targets on PTEC cell growth (cell size during G1 phase of the cell cycle). Using a cell culture model, we show that apoptotic cells potently activate AMP-activated protein kinase (AMPK), a highly sensitive sensor of intracellular energy stores. AMPK activation leads to decreased activity of its downstream target, ribosomal protein p70 S6 kinase (p70S6K), and concomitant inhibition of cell growth. Importantly, these events occur without detectable change in intracellular levels of AMP, ADP, or ATP. Inhibition of AMPK, either pharmacologically by compound C or molecularly by shRNA, diminishes the effects of apoptotic targets and largely restores p70S6K activity and cell size to normal levels. Apoptotic targets also inhibit Akt, a second signaling pathway regulating cell growth. Expression of a constitutively active Akt construct partially relieved cell growth inhibition but was less effective than inhibition of AMPK. Inhibition of cell growth by apoptotic targets is dependent on physical interaction between apoptotic targets and PTECs but independent of phagocytosis. We conclude that receptor-mediated recognition of apoptotic targets mimics the effects of intracellular energy depletion, activating AMPK and inhibiting cell growth. By acting as sentinels of environmental change, apoptotic death may enable nearby viable cells, especially nonmigratory epithelial cells, to monitor and adapt to local stresses.Â© 2015 by The American Society for Biochemistry and Molecular Biology, Inc.
Neutrophil-Derived MMP-8 Drives AMPK-Dependent Matrix Destruction in Human Pulmonary Tuberculosis. - PLoS pathogens
Pulmonary cavities, the hallmark of tuberculosis (TB), are characterized by high mycobacterial load and perpetuate the spread of M. tuberculosis. The mechanism of matrix destruction resulting in cavitation is not well defined. Neutrophils are emerging as key mediators of TB immunopathology and their influx are associated with poor outcomes. We investigated neutrophil-dependent mechanisms involved in TB-associated matrix destruction using a cellular model, a cohort of 108 patients, and in separate patient lung biopsies. Neutrophil-derived NF-kB-dependent matrix metalloproteinase-8 (MMP-8) secretion was up-regulated in TB and caused matrix destruction both in vitro and in respiratory samples of TB patients. Collagen destruction induced by TB infection was abolished by doxycycline, a licensed MMP inhibitor. Neutrophil extracellular traps (NETs) contain MMP-8 and are increased in samples from TB patients. Neutrophils lined the circumference of human pulmonary TB cavities and sputum MMP-8 concentrations reflected TB radiological and clinical disease severity. AMPK, a central regulator of catabolism, drove neutrophil MMP-8 secretion and neutrophils from AMPK-deficient patients secrete lower MMP-8 concentrations. AMPK-expressing neutrophils are present in human TB lung biopsies with phospho-AMPK detected in nuclei. These data demonstrate that neutrophil-derived MMP-8 has a key role in the immunopathology of TB and is a potential target for host-directed therapy in this infectious disease.
Clinical and genetic predictors of major cardiac events in patients with Anderson-Fabry Disease. - Heart (British Cardiac Society)
Anderson-Fabry Disease (AFD) is an X linked lysosomal storage disorder caused by mutations in the Î±-galactosidase A gene. Some mutations are associated with prominent and, in many cases, exclusive cardiac involvement. The primary aims of this study were to determine the incidence of major cardiac events in AFD and to identify clinical and genetic predictors of adverse outcomes.We studied 207 patients with AFD (47% male, mean age 44 years, mean follow-up 7.1 years). Fifty-eight (28%) individuals carried mutations that have been previously associated with a cardiac predominant phenotype. Twenty-one (10%) developed severe heart failure (New York Heart Association functional class (NYHA) â‰¥3), 13 (6%) developed atrial fibrillation (AF), 13 (6%) received devices for the treatment of bradycardia; there were a total of 7 (3%) cardiac deaths. The incidence of the primary endpoint (a composite of new onset AF, NYHA â‰¥ 3 symptoms, device insertion for bradycardia and cardiac death) was 2.64 per 100 person-years (CI 1.78 to 3.77). Age (HR 1.04, CI 1.01 to 1.08, p=0.004), Mainz Severity Score Index score (HR 1.05, CI 1.01 to 1.09, p=0.012) and QRS duration (HR 1.03, CI 1.00 to 1.05, p=0.020) were significant independent predictors of the primary endpoint. The presence of a cardiac genetic variant did not predict the primary end point.AFD is associated with a high burden of cardiac morbidity and mortality. Adverse cardiac outcomes are associated with age, global disease severity and advanced cardiac disease but not the presence of cardiac genetic variants.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.
Heat-damaged RBC scan: a case of intrahepatic splenosis. - Clinical nuclear medicine
Intrahepatic splenosis results from autotransplantation of splenic tissue within the liver, usually after splenic trauma or splenectomy. We present a case of a 43-year-old male patient with an incidental liver lesion discovered on abdominal ultrasound. The diagnosis of intrahepatic splenosis was considered after CT and MRI before being definitively made with Tc-labeled heat-damaged RBC scintigraphy. The case report illustrates the imaging characteristics of this rare location of abdominal splenosis.
A multifactorial screening strategy to identify anti-idiotypic reagents for bioanalytical support of antibody therapeutics. - Analytical biochemistry
Antibodies are critical tools for protein bioanalysis; their quality and performance dictate the caliber and robustness of ligand binding assays. After immunization, polyclonal B cells generate a diverse antibody repertoire against constant and variable regions of the therapeutic antibody immunogen. Herein we describe a comprehensive and multifactorial screening strategy to eliminate undesirable constant region-specific antibodies and select for anti-idiotypic antibodies with specificity for the unique variable region. Application of this strategy is described for the therapeutic antibody Mab-A case study. Five different factors were evaluated to select a final antibody pair for the quantification of therapeutics in biological matrices: (i) matrix effect in preclinical and clinical matrices, (ii) assay sensitivity with lower limit of quantification goal of single-digit ng/ml (low pM) at a signal-to-background ratio greater than 5, (iii) epitope distinction or nonbridging antibody pair, (iv) competition with target and inhibitory capacity enabling measurement of free drug, and (v) neutralizing bioactivity using bioassay. The selected antibody pair demonstrated superior assay sensitivity with no or minimal matrix effect in common biological samples, recognized two distinct binding epitopes on the therapeutic antibody variable region, and featured inhibitory and neutralizing effects with respect to quantification of free drug levels.Copyright Â© 2014 Elsevier Inc. All rights reserved.
The potential for DHA to mitigate mild traumatic brain injury. - Military medicine
Scientific knowledge of omega-3 fatty acids (FAs) has grown in the last decade to a greater understanding of their mechanisms of action and their potential therapeutic effects. Omega-3 FAs have shown therapeutic potential with respect to hyperlipidemia, depression, attention-deficit hyperactivity disorder, and mild cognitive impairment. Laboratory evidence and clinical interest have grown such that omega-3 FAs have now assumed a role in concussion management. This has coincided with recent research that has also helped to increase the scientific understanding of cerebral concussion; although concussion or mild traumatic brain injury was assumed to be a malfunctioning brain without anatomical damage, we now know that there is the potential for damage and dysfunction at the cellular and microstructural levels. Specifically, with concussion abnormal metabolism of glucose may occur and intracellular mitochondrial dysfunction can persist for several days. In this article, we discuss the role of omega-3 FAs, particularly docosahexaenoic acid, in concussion management.Reprint & Copyright Â© 2014 Association of Military Surgeons of the U.S.
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3100 E Fletcher Ave Tampa, FL 33613
3535 E. Fletcher Ave. Usf Psychiatry
3000 E Fletcher Ave Ste 340
3100 E Fletcher Ave Florida Hospital, Tampa
14547 Bruce B. Downs Blvd.