1321 Nw 14Th St Ste. 601
Miami FL 33125
Medical School: Other - 1986
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #: ME0074029
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Awards & Recognitions
Dr. Carlos Vidal is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:96413||Description:Chemo iv infusion 1 hr||Average Price:$686.00||Average Price Allowed
|HCPCS Code:99223||Description:Initial hospital care||Average Price:$412.00||Average Price Allowed
|HCPCS Code:99204||Description:Office/outpatient visit new||Average Price:$343.00||Average Price Allowed
|HCPCS Code:96367||Description:Tx/proph/dg addl seq iv inf||Average Price:$152.00||Average Price Allowed
|HCPCS Code:99214||Description:Office/outpatient visit est||Average Price:$224.00||Average Price Allowed
|HCPCS Code:99232||Description:Subsequent hospital care||Average Price:$157.00||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$148.00||Average Price Allowed
|HCPCS Code:96372||Description:Ther/proph/diag inj sc/im||Average Price:$93.00||Average Price Allowed
|HCPCS Code:85025||Description:Complete cbc w/auto diff wbc||Average Price:$35.00||Average Price Allowed
|HCPCS Code:36415||Description:Routine venipuncture||Average Price:$19.00||Average Price Allowed
|HCPCS Code:J0881||Description:Darbepoetin alfa, non-esrd||Average Price:$15.00||Average Price Allowed
|HCPCS Code:J1100||Description:Dexamethasone sodium phos||Average Price:$1.00||Average Price Allowed
HCPCS Code Definitions
- Injection, dexamethasone sodium phosphate, 1mg
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed 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 presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
- Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive 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 presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
- Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
- Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and 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) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
- 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.
- Injection, darbepoetin alfa, 1 microgram (non-esrd use)
- 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.
Medical Malpractice Cases
Case Number: 05-05435CA22
Incident Date: 10/27/2002
Settlemnt Date: 12/02/2008
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Vidal has made to other doctors
Direct detection of Mycobacterium tuberculosis complex in bovine and bubaline tissues through nested-PCR. - Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]
Post-mortem bacterial culture and specific biochemical tests are currently performed to characterize the etiologic agent of bovine tuberculosis. Cultures take up to 90 days to develop. A diagnosis by molecular tests such as PCR can provide fast and reliable results while significantly decreasing the time of confirmation. In the present study, a nested-PCR system, targeting rv2807, with conventional PCR followed by real-time PCR, was developed to detect Mycobacterium tuberculosis complex (MTC) organisms directly from bovine and bubaline tissue homogenates. The sensitivity and specificity of the reactions were assessed with DNA samples extracted from tuberculous and non-tuberculous mycobacteria, as well as other Actinomycetales species and DNA samples extracted directly from bovine and bubaline tissue homogenates. Regarding the analytical sensitivity, DNA of the M. bovis AN5 strain was detected up to 1.5 pg by nested-PCR, whereas DNA of M. tuberculosis H37Rv strain was detected up to 6.1 pg. The nested-PCR system showed 100% analytical specificity for MTC when tested with DNA of reference strains of non-tuberculous mycobacteria and closely-related Actinomycetales. A clinical sensitivity level of 76.7% was detected with tissues samples positive for MTC by means of the culture and conventional PCR. A clinical specificity of 100% was detected with DNA from tissue samples of cattle with negative results in the comparative intradermal tuberculin test. These cattle exhibited no visible lesions and were negative in the culture for MTC. The use of the nested-PCR assay to detect M. tuberculosis complex in tissue homogenates provided a rapid diagnosis of bovine and bubaline tuberculosis.
Development and assessment of a latex agglutination test based on recombinant MSP5 to detect antibodies against Anaplasma marginale in cattle. - Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]
The recombinant protein MSP5 has been established as an important antigen for serological diagnosis of Anaplasma marginale by enzyme-linked immunosorbent assay (ELISA). However, due to the high cost of specialized equipment, this technique is not accessible to all laboratories, especially in developing countries in areas where the disease is endemic. The present study describes the standardization of a latex agglutination test (LAT) to detect antibodies against A. marginale based on recombinant MSP5. Compared with indirect enzyme-linked immunosorbent assay (iELISA), the relative sensitivity and specificity of the LAT were 95.21% and 91.86% respectively, with an almost perfect agreement between tests (kappa index = 0.863). These results can be considered important for the serological diagnosis of A. marginale, as they indicate that the test represents a rapid and low cost alternative to ELISA.
Detection of Mycobacterium bovis in bovine and bubaline tissues using nested-PCR for TbD1. - PloS one
In the present study, a nested-PCR system, targeting the TbD1 region, involving the performance of conventional PCR followed by real-time PCR, was developed to detect Mycobacterium bovis in bovine/bubaline tissue homogenates. The sensitivity and specificity of the reactions were assessed with DNA samples extracted from tuberculous and non-tuberculous mycobacteria, as well as other actinomycetales species and DNA samples extracted directly from bovine and bubaline tissue homogenates. In terms of analytical sensitivity, the DNA of M. bovis AN5 was detected up to 1.56 ng with conventional PCR, 97.6 pg with real-time PCR, and 1.53 pg with nested-PCR in the reaction mixture. The nested-PCR exhibited 100% analytical specificity for M. bovis when tested with the DNA of reference strains of environmental mycobacteria and closely-related Actinomycetales. A clinical sensitivity value of 76.0% was detected with tissue samples from animals that exhibited positive results in the comparative intradermal tuberculin test (CITT), as well as from those with lesions compatible with tuberculosis (LCT) that rendered positive cultures. A clinical specificity value of 100% was detected with tissue samples from animals with CITT- results, with no visible lesions (NVL) and negative cultures. No significant differences were found between the nested-PCR and culture in terms of detecting CITT+ animals with LCT or with NVL. No significant differences were recorded in the detection of CITT- animals with NVL. However, nested-PCR detected a significantly higher number of positive animals than the culture in the group of animals exhibiting LCT with no previous records of CITT. The use of the nested-PCR assay to detect M. bovis in tissue homogenates provided a rapid diagnosis of bovine and bubaline tuberculosis.
Macrophage uptake and accumulation of folates are polarization-dependent in vitro and in vivo and are regulated by activin A. - Journal of leukocyte biology
Vitamin B9, commonly known as folate, is an essential cofactor for one-carbon metabolism that enters cells through three major specialized transporter molecules (RFC, FR, and PCFT), which differ in expression pattern, affinity for substrate, and ligand-binding pH dependency. We now report that the expression of the folate transporters differs between macrophage subtypes and explains the higher accumulation of 5-MTHF-the major folate form found in serum-in M2 macrophages in vitro and in vivo. M1 macrophages display a higher expression of RFC, whereas FRÎ² and PCFT are preferentially expressed by anti-inflammatory and homeostatic M2 macrophages. These differences are also seen in macrophages from normal tissues involved in folate transit (placenta, liver, colon) and inflamed tissues (ulcerative colitis, RA), as M2-like macrophages from normal tissues express FRÎ² and PCFT, whereas TNF-Î±-expressing M1 macrophages from inflamed tissues are RFC+. Besides, we provide evidences that activin A is a critical factor controlling the set of folate transporters in macrophages, as it down-regulates FRÎ², up-regulates RFC expression, and modulates 5-MTHF uptake. All of these experiments support the notion that folate handling is dependent on the stage of macrophage polarization.
The natural history of osteoarthritis after a slipped capital femoral epiphysis/the pistol grip deformity. - Journal of pediatric orthopedics
The presence of femoroacetabular impingement (FAI) after a slipped capital femoral epiphysis is thought to predispose the subsequent development of osteoarthritis (OA); however, there is a lack of evidence to support this hypothesis.One hundred twenty-one patients with stable slipped capital femoral epiphysis treated with in situ fixation were reviewed at a minimum of 20-year follow-up; the presence of a pistol grip deformity and FAI was determined. The Harris Hip Score (HHS) was used to measure clinical outcome, and the TÃ¶nnis grade for qualifying the presence of OA was determined.One hundred twenty-one patients were followed up at a mean of 22.3 years (range, 20.1 to 32.5 y); the slip was considered grade 1 in 34 hips, grade 2 in 65 hips, and grade 3 in 22 hips. Ninety-six patients had clinical and radiographic signs of FAI. The mean HHS for the entire cohort was 75.6; however, for the 25 patients without FAI it was 89.3 and for the 96 patients with FAI it was 75.4 (P=0.004). We found radiographic signs of OA in all 121 patients: considered grade 1 in 14 hips, grade 2 in 32 hips, and grade 3 in 75 hips. The mean TÃ¶nnis grade of OA was 2.5. A direct relationship between the radiographic grade of OA and the HHS was observed.The occurrence of FAI (or a pistol grip deformity) after even a low-grade slip is common. We found clinical and radiographic signs of FAI in most of our patients, and also found that the degree of deformity is directly related to the presence of OA in early adulthood.
Screening of recombinant proteins as antigens in indirect ELISA for diagnosis of bovine tuberculosis. - SpringerPlus
Bovine tuberculosis is an important infectious disease caused by Mycobacterium bovis, which is responsible for considerable economic losses. This disease constitutes a serious public health problem. Control programs in most countries, including Brazil, are based on the identification and slaughter of infected animals, as defined by the skin tuberculin test, which has its constraints. In the present study, the recombinant proteins CFP-10, ESAT-6, Mb0143, MPB83, PE5, PE13, TB10.4, TB15.3 and a chimera of ESAT-6/MPB70/MPB83 (fusion protein) were tested as ELISA antigens for the diagnosis of bovine tuberculosis. The proteins were produced in Escherichia coli, purified and tested in ELISAs with sera from 126 cattle having tested negative in the comparative intradermal tuberculin test (CITT) and 107 sera from cattle having tested positive in the CITT. Also, 236 sera from two BTB-free beef cattle herds were tested. Among the proteins tested, only the ESAT-6/MPB70/MPB83 chimera demonstrated satisfactory agreement with the CITT (kappa index: 0.688), reflecting in 83.2% sensitivity and 86.5% specificity. The ELISA absorbances of the cattle sera from BTB-free herds showed similar levels to those of CITT positive cattle, probably as the result of successive skin tuberculinizations to define the BTB-free status of the herds. However, the ELISA with the ESAT-6/MPB70/MPB83 chimera was useful to discriminate BTB positive and negative cattle in herds prior to the tuberculin skin test.
[Attempted suicide: prognostic factors and estimated excess mortality]. - Cadernos de sauÌde puÌblica
This retrospective cohort study aimed to analyze the epidemiological profile of individuals that attempted suicide from 2003 to 2009 in Barbacena, Minas Gerais State, Brazil, to calculate the mortality rate from suicide and other causes, and to estimate the risk of death in these individuals. Data were collected from police reports and death certificates. Survival analysis was performed and Cox multiple regression was used. Among the 807 individuals that attempted suicide, there were 52 deaths: 12 by suicide, 10 from external causes, and 30 from other causes. Ninety percent of suicide deaths occurred within 24 months after the attempt. Risk of death was significantly greater in males, married individuals, and individuals over 60 years of age. Standardized mortality ratio showed excess mortality by suicide. The findings showed that the mortality rate among patients that had attempted suicide was higher than expected in the general population, indicating the need to improve health care for these individuals.
Comparative study of the quality of life between arthrodesis and total arthroplasty substitution of the ankle. - The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
Our goal was to compare the health status of patients with primary and secondary arthrosis of the ankle before and after arthrodesis or total substitution arthroplasty, and to determine the improvement in quality of life and whether there is any difference between these techniques. A prospective comparative study of clinical-functional evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) scale and quality of life with the short form (SF)-36 questionnaire in patients who underwent arthrodesis (16 cases) or total substitution arthroplasty of the ankle (14 cases) after 2 years (mean, 25.2 months) of follow-up after surgery, in comparison with the baseline preoperative status. In this series of comparable patients, both techniques showed a statistically significant improvement with regard to the clinical evaluation and quality of life after 2 years of follow-up; the arthrodesis group increased from mean AOFAS values of 37.12 to 45.62 (P = .055) and mean SF-36 values of 32.96 to 46.25 (P = .008), whereas in the arthroplasty group the mean values of AOFAS increased from 33 to 62 (P = .024) and SF-36 from 33.62 to 59.84 (P = .001). Nevertheless, in all cases the improvement was statistically greater in patients who underwent arthroplasty than in those who underwent arthrodesis (P = .048 for AOFAS, and P = .026 for SF-36). In conclusion, arthrodesis and arthroplasty represent good options in the surgical treatment of ankle arthrosis, providing both a significant improvement in function and in the health perception and quality of life of the patient. New-generation total ankle substitution arthroplasty provides an improvement in the quality of life and perception of general health of the patient with arthrosis of this joint, when this technique is compared with surgical fusion.Copyright Â© 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Tuberculin skin-test reactions are unaffected by the severity of hyperendemic intestinal helminth infections and co-infections. - The American journal of tropical medicine and hygiene
The tuberculin skin test (TST) quantifies cell-mediated immunity to tuberculosis antigens. Helminths suppress cell-mediated immunity, so we studied the effect of helminth infection and deworming on the TST in a randomized, double-blind, placebo-controlled study in an indigenous Amazon community (N = 195). Stool microscopy diagnosed helminths in 98% and co-infection with multiple species in 24% of study subjects. The TST was positive (> or = 10 mm) for 49%, and responses increased with age (P < 0.001), Bacille Calmette Guerin (BCG) vaccination (P = 0.01), and tuberculosis contact (P = 0.05). TST results had no association with helminth-egg concentrations, species, or co-infections (all P > 0.1). One month after deworming with albendazole (three daily 400-mg doses), helminths were reduced, but 63% remained infected with helminths. Albendazole did not cause a change in TST size (P = 0.8) or positivity (P = 0.9) relative to placebo. Thus, TST reactions were unaffected by albendazole therapy that partially cured intestinal helminth infections, and TST interpretation was unaffected by high-burden helminth infections and co-infection with multiple helminth species.
Factors associated with delayed tuberculosis test-seeking behavior in the Peruvian Amazon. - The American journal of tropical medicine and hygiene
This study aimed to determine the psychosocial factors associated with delayed test-seeking among tuberculosis patients. The duration of symptoms before seeking medical care was assessed by interview for 108 newly diagnosed pulmonary tuberculosis patients in the city of Iquitos in the Peruvian Amazon, which has high tuberculosis incidence. Beliefs associated with test-seeking behavior and delay was assessed in these patients. The median delay from symptom onset to seeking diagnostic testing was 61 days (inter-quartile range 30-91 days). The belief that tuberculosis is curable was associated with a 100% longer test-seeking delay; the perception that tuberculosis was common was associated with a 57% longer delay; male gender was associated with a 48% longer delay; and education less than complete secondary schooling was associated with a 44% longer delay. In conclusion, current health promotion activities that emphasize tuberculosis curability and high prevalence may paradoxically increase test-seeking delay and therefore require prospective evaluation.
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1321 Nw 14Th St Ste. 601 Miami, FL 33125
1295 Nw 14Th St 2Nd Floor, Suite E
1321 Nw 14Th St Suite 304