367 Hempstead Ave
West Hempstead NY 11552
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: N005224
Request Appointment Information
Awards & Recognitions
Medical Malpractice Cases
Medical Board Sanctions
Comparison of the correlations between impact loading rates and peak accelerations measured at two different body sites: Intra- and inter-subject analysis. - Gait & posture
High average (VALR) and instantaneous vertical loading rates (VILR) during impact have been associated with many running-related injuries. Peak acceleration (PA), measured with an accelerometer, has provided an alternative method to estimate impact loading during outdoor running. This study sought to compare both intra- and inter-subject correlations between vertical loading rates and PA measured at two body sites during running.Ground reaction force data were collected from 10 healthy adults (age=23.6Â±3.8 years) during treadmill running at different speeds and inclination surfaces. Concurrently, PAs at the lateral malleoli and the distal tibia were measured using synchronized accelerometers.We found significant positive intra-subject correlation between loading rates and PA at the lateral malleoli (r=0.561-0.950, p<0.001) and the distal tibia (r=0.486-0.913, p<0.001). PA measured at the lateral malleoli showed stronger correlation with loading rates (p=0.004) than the measurement at the distal tibia. On the other hand, inter-subject variances were observed in the association between PA and vertical loading rates. The inter-subject variances at the distal tibia were 3.88Â±3.09BW/s and 5.69Â±3.05BW/s in VALR and VLIR respectively. Similarly, the inter-subject variances in the measurement at lateral malleoli were 5.24Â±2.85BW/s and 6.67Â±2.83BW/s in VALR and VLIR respectively.PA measured at lateral malleoli has stronger correlation with VALR or VILR than the measurement at distal tibia. Caution is advised when using PA to conduct inter-subject comparisons of vertical loading rates during running.Copyright Â© 2016 Elsevier B.V. All rights reserved.
Age-related changes in gait adaptability in response to unpredictable obstacles and stepping targets. - Gait & posture
A large proportion of falls in older people occur when walking. Limitations in gait adaptability might contribute to tripping; a frequently reported cause of falls in this group.To evaluate age-related changes in gait adaptability in response to obstacles or stepping targets presented at short notice, i.e.: approximately two steps ahead.Fifty older adults (aged 74Â±7 years; 34 females) and 21 young adults (aged 26Â±4 years; 12 females) completed 3 usual gait speed (baseline) trials. They then completed the following randomly presented gait adaptability trials: obstacle avoidance, short stepping target, long stepping target and no target/obstacle (3 trials of each).Compared with the young, the older adults slowed significantly in no target/obstacle trials compared with the baseline trials. They took more steps and spent more time in double support while approaching the obstacle and stepping targets, demonstrated poorer stepping accuracy and made more stepping errors (failed to hit the stepping targets/avoid the obstacle). The older adults also reduced velocity of the two preceding steps and shortened the previous step in the long stepping target condition and in the obstacle avoidance condition.Compared with their younger counterparts, the older adults exhibited a more conservative adaptation strategy characterised by slow, short and multiple steps with longer time in double support. Even so, they demonstrated poorer stepping accuracy and made more stepping errors. This reduced gait adaptability may place older adults at increased risk of falling when negotiating unexpected hazards.Copyright Â© 2016 Elsevier B.V. All rights reserved.
Instantaneous progression reference frame for calculating pelvis rotations: Reliable and anatomically-meaningful results independent of the direction of movement. - Gait & posture
In motion analysis, pelvis angles are conventionally calculated as the rotations between the pelvis and laboratory reference frame. This approach assumes that the participant's motion is along the anterior-posterior laboratory reference frame axis. When this assumption is violated interpretation of pelvis angels become problematic. In this paper a new approach for calculating pelvis angles based on the rotations between the pelvis and an instantaneous progression reference frame was introduced. At every time-point, the tangent to the trajectory of the midpoint of the pelvis projected into the horizontal plane of the laboratory reference frame was used to define the anterior-posterior axis of the instantaneous progression reference frame. This new approach combined with the rotation-obliquity-tilt rotation sequence was compared to the conventional approach using the rotation-obliquity-tilt and tilt-obliquity-rotation sequences. Four different movement tasks performed by eight healthy adults were analysed. The instantaneous progression reference frame approach was the only approach that showed reliable and anatomically meaningful results for all analysed movement tasks (mean root-mean-square-differences below 5Â°, differences in pelvis angles at pre-defined gait events below 10Â°). Both rotation sequences combined with the conventional approach led to unreliable results as soon as the participant's motion was not along the anterior-posterior laboratory axis (mean root-mean-square-differences up to 30Â°, differences in pelvis angles at pre-defined gait events up to 45Â°). The instantaneous progression reference frame approach enables the gait analysis community to analysis pelvis angles for movements that do not follow the anterior-posterior axis of the laboratory reference frame.Copyright Â© 2016 Elsevier B.V. All rights reserved.
Academic Performance in Children of Mothers With Schizophrenia and Other Severe Mental Illness, and Risk for Subsequent Development of Psychosis: A Population-Based Study. - Schizophrenia bulletin
We examined the academic performance at age 12 years of children of mothers diagnosed with schizophrenia or other severe mental illness using a large whole-population birth cohort born in Western Australia. We investigated the association between academic performance and the subsequent development of psychotic illness.The sample comprised 3169 children of mothers with severe mental illness (schizophrenia, bipolar disorder, unipolar major depression, delusional disorder or other psychoses; ICD-9 codes 295-298), and 88 353 children of comparison mothers without known psychiatric morbidity. Academic performance of children was indexed on a mandatory state-wide test of reading, spelling, writing and numeracy.A larger proportion of children (43.1%) of mothers with severe mental illness performed below the acceptable standard than the reference group (30.3%; children of mothers with no known severe mental illness). After adjusting for covariates, children of mothers with any severe mental illness were more likely than the reference group to perform below-benchmark on all domains except reading. For all children, poor spelling was associated with the later development of psychosis, but particularly for those at familial risk for severe mental illness (hazard ratio [HR] = 1.81; 95% CI for HR = 1.21, 2.72).Children of mothers with a severe mental illness are at increased risk for sub-standard academic achievement at age 12 years, placing these children at disadvantage for the transition to secondary school. For children with familial risk for severe mental illness, very poor spelling skills at age 12 years may be an indicator of risk for later psychotic disorder.Â© The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: email@example.com.
Measuring water ingestion from spray exposures. - Water research
Characterisation of exposure levels is an essential requirement of health risk assessment; however for water exposures other than drinking, few quantitative exposure data exist. Thus, regulatory agencies must use estimates to formulate policy on treatment requirements for non-potable recycled water. We adapted the use of the swimming pool chemical cyanuric acid as a tracer of recreational water ingestion to permit detection of small water volumes inadvertently ingested from spray exposures. By using solutions of 700-1000Â mg/L cyanuric acid in an experimental spray exposure scenario, we were able to quantify inadvertent water ingestion in almost 70% of participants undertaking a 10Â min car wash activity using a high pressure spray device. Skin absorption was demonstrated to be negligible under the experimental conditions, and the measured ingestion volumes ranged from 0.06 to 3.79Â mL. This method could be applied to a range of non-potable water use activities to generate exposure data for risk assessment processes. The availability of such empirical measurements will provide greater assurance to regulatory agencies and industry that potential health risks from exposure to non-potable water supplies are well understood and adequately managed to protect public health.Copyright Â© 2016 Elsevier Ltd. All rights reserved.
The oral health of people with anxiety and depressive disorders - a systematic review and meta-analysis. - Journal of affective disorders
Many psychological disorders are associated with comorbid physical illness. There are less data on dental disease in common psychological disorders such as depression and anxiety in spite of risk factors in this population of diet, lifestyle or antidepressant-induced dry mouth.We undertook a systematic search for studies of the oral health of people with common psychological disorders including depression, anxiety and dental phobia. We searched MEDLINE, PsycInfo, EMBASE and article bibliographies. Results were compared with the general population. Outcomes included partial or total tooth-loss, periodontal disease, and dental decay measured through standardized measures such as the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS).There were 19 papers on depression and/or anxiety, and seven on dental phobia/anxiety (total n=26). These covered 334,503 subjects. All the psychiatric diagnoses were associated with increased dental decay on both DMFT and DMFS scores, as well as greater tooth loss (OR=1.22; 95%CI=1.14-1.30). There was no association with periodontal disease, except for panic disorder.Cross-sectional design of included studies, heterogeneity in some results, insufficient studies to test for publication bias.The increased focus on the physical health of psychiatric patients should encompass oral health including closer collaboration between dental and medical practitioners. Possible interventions include oral health assessment using standard checklists that can be completed by non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral. Mental health clinicians should also be aware of the oral consequences of inappropriate diet and psychotropic medication.Copyright Â© 2016 Elsevier B.V. All rights reserved.
Risperidone induces long-lasting changes in the conditioned avoidance response and accumbal gene expression selectively in animals treated as adolescents. - Neuropharmacology
Adolescence is a period of dynamic remodeling and maturation in the brain. Exposure to psychotropic drugs during adolescence can potentially alter neural maturation in the adolescent brain subsequently altering neural function at maturity. In this regard, antipsychotic drugs (APDs) are important given a notable global increase in prescription of these APDs to adolescents for a variety of behavioural symptoms and conditions over the past twenty years. However, there is a paucity of data on the long-term consequences of APDs on the adolescent brain. In this preclinical study, we have examined whether the adolescent brain is more susceptible than the adult brain to long-term neural changes induced by risperidone, which is the APD most frequently prescribed to adolescents. Rats were chronically treated (21 days) with 1.3Â mg/kg/day risperidone or vehicle either as adolescents (postnatal day (PND) 36-56)) or adults (PND80-100). Behaviour was assessed using the well-described suppression of the conditioned avoidance response (CAR) by APDs. We examined CAR after all animals had reached maturity (PND127). We show that mature rats treated with risperidone as adolescents had increased CAR suppression compared to adults when rechallenged with this same drug. In the nucleus accumbens, significant downregulation of serotonergic 5HT2A receptors and catechol-o-methyl transferase mRNA levels was observed only in the adolescent treated animals. Impaired 5HT2A receptor signaling may explain the increased CAR suppression observed in rats treated with risperidone as adolescents. Magnetic resonance imaging (MRI), however, did not detect any risperidone-induced long-term brain structural change at maturity. These findings confirm that APD administration during adolescence may produce long-term behavioural and neurochemical alterations.Copyright Â© 2016. Published by Elsevier Ltd.
Safe reading of chemical pathology reports: the RCPAQAP Report Assessment Survey. - Pathology
Pathology reports are a vital component of the request-test-report cycle communicating pathology results to doctors to support clinical decision making. This should be done in a comprehensive, safe and time-efficient manner. As doctors may receive reports from different laboratories these goals can be achieved more readily if reports are formatted in the same way. This study evaluates the formatting of paper reports produced by Australian laboratories for numerical biochemistry results. As part of the RCPAQAP Liquid Serum Chemistry program in 2015, laboratories were invited to supply a routine paper report displaying the results. A total of 37 reports were received for analysis. These reports were assessed for variation in a range of components and, where possible, against relevant Australian standards and guidelines. In summary, there was a wide variation in most of the report components assessed including test names, result alignment, result flagging, sequence of data elements on the page, date formatting and patient name formatting. In most components there was also variation from the Standards. In order to ensure safe result transmission by printed reports there is a need to promote the adoption of current reporting standards and monitor compliance with similar external quality assurance programs.Crown Copyright Â© 2016. Published by Elsevier B.V. All rights reserved.
Spherical gold nanoparticles and gold nanorods for the determination of gentamicin. - Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy
Gentamicin is an antibiotic indicated to treat mastitis in dairy cattle and for the treatment of bacterial resistance in the context of hospital infections. The effect caused by gentamicin on the optical properties of gold nanoparticles aqueous dispersions were used to develop quantitative methods to determine this antibiotic. Two different aqueous dispersions, one containing spherical Au nanoparticles (AuNPs) and the other containing Au nanorods (AuNRs), had their conditions adjusted to enable a stable and sensitive response towards gentamicin. The use of AuNPs, with measurement at 681nm of the rising coupling plasmon band, enabled a limit of detection (LOD) of 0.4ngmL(-1) (0.02ng absolute LOD), ten times lower than the one achieved by measuring the decreasing of the longitudinal surface plasmon resonance band (at 662nm). The linear analytical response of AuNPs measured at 681nm did not require rationing of signal values to correct for linearity. Stability of the analytical response resulted in intermediary precision below 2%. No significant interference was imposed by excipients traditionally present in injectable solutions for veterinary use. Percent recoveries obtained in such formulations were between 94.5 and 98.2% regardless the existence of any difference in the proportion of the compounds known as gentamicin (C1, C1a and C2) in standard and in the samples. The method requires no derivatization with toxic reagents as usually is required in other spectroscopic approaches.Copyright Â© 2016 Elsevier B.V. All rights reserved.
Risks of Bleeding Recurrence and Cardiovascular Events With Continued Aspirin Use After Lower Gastrointestinal Hemorrhage. - Gastroenterology
It is not clear whether use of low-dose aspirin should be resumed after an episode of lower gastrointestinal (GI) bleeding. We assessed the long-term risks of recurrent lower GI bleeding and serious cardiovascular outcomes after aspirin-associated lower GI bleeding.We performed a retrospective study of patients diagnosed with lower GI bleeding (documented melena or hematochezia, and absence of upper GI bleeding) from January 1, 2000 through December 31, 2007 at the Prince of Wales Hospital in Hong Kong. Using the hospital registry, we analyzed data from 295 patients on aspirin and determined their outcomes over a 5-year period. Outcomes included recurrent lower GI bleeding, serious cardiovascular events, and death from other causes, as determined by an independent, blinded adjudication committee. Outcomes were compared between patients assigned to the following groups, based on cumulative duration of aspirin use: less than 20% of the follow-up period (121 non-users) versus 50% or more of the observation period (174 aspirin users).Within 5 years, lower GI bleeding recurred in 18.9% of aspirin users (95% confidence interval [CI], 13.3%-25.3%) vs 6.9% of non-users (95% CI, 3.2%-12.5%; P=.007). However, serious cardiovascular events occurred in 22.8% of aspirin users (95% CI, 16.6%-29.6%) vs 36.5% of non-users (95% CI, 27.4%-45.6%; P=.017), and 8.2% of aspirin users died from other causes (95% CI, 4.6%-13.2%) vs 26.7% of non-users (95% CI, 18.7%-35.4%; P=.001). Multivariable analysis showed that aspirin use was an independent predictor of rebleeding, but protected against cardiovascular events and death.Among aspirin users with a history of lower GI bleeding, continuation of aspirin is associated with an increased risk of recurrent lower GI bleeding but reduced risk of serious cardiovascular events and death.Copyright Â© 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.
Map & Directions
367 Hempstead Ave West Hempstead, NY 11552
600 Hempstead Tpke 2Nd Floor
146 Trinity Pl