11 Whitehall Rd Anesthesia Department
Rochester NH 03867
Medical School: Boston University School Of Medicine - 1989
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 12389
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Awards & Recognitions
Dr. Michael Lane is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:00810||Description:Anesth low intestine scope||Average Price:$1,046.98||Average Price Allowed
|HCPCS Code:00740||Description:Anesth upper gi visualize||Average Price:$1,014.45||Average Price Allowed
|HCPCS Code:00104||Description:Anesth electroshock||Average Price:$820.77||Average Price Allowed
|HCPCS Code:01810||Description:Anesth lower arm surgery||Average Price:$703.15||Average Price Allowed
|HCPCS Code:00142||Description:Anesth lens surgery||Average Price:$596.18||Average Price Allowed
|HCPCS Code:99231||Description:Subsequent hospital care||Average Price:$366.83||Average Price Allowed
|HCPCS Code:76942||Description:Echo guide for biopsy||Average Price:$182.35||Average Price Allowed
HCPCS Code Definitions
- 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.
- Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation
Medical Malpractice Cases
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Lane has made to other doctors
Impact of Sepsis Classification and Multidrug-Resistance Status on Outcome Among Patients Treated With Appropriate Therapy. - Critical care medicine
To assess the impact of sepsis classification and multidrug-resistance status on outcome in patients receiving appropriate initial antibiotic therapy.A retrospective cohort study.Barnes-Jewish Hospital, a 1,250-bed teaching hospital.Individuals with Enterobacteriaceae sepsis, severe sepsis, and septic shock who received appropriate initial antimicrobial therapy between June 2009 and December 2013.Clinical outcomes were compared according to multidrug-resistance status, sepsis classification, demographics, severity of illness, comorbidities, and antimicrobial treatment.We identified 510 patients with Enterobacteriaceae bacteremia and sepsis, severe sepsis, or septic shock. Sixty-seven patients (13.1%) were nonsurvivors. Mortality increased significantly with increasing severity of sepsis (3.5%, 9.9%, and 28.6%, for sepsis, severe sepsis, and septic shock, respectively; p < 0.05). Time to antimicrobial therapy was not significantly associated with outcome. Acute Physiology and Chronic Health Evaluation II was more predictive of mortality than age-adjusted Charlson comorbidity index. Multidrug-resistance status did not result in excess mortality. Length of ICU and hospital stay increased with more severe sepsis. In multivariate logistic regression analysis, African-American race, sepsis severity, Acute Physiology and Chronic Health Evaluation II score, solid-organ cancer, cirrhosis, and transfer from an outside hospital were all predictors of mortality.Our results support sepsis severity, but not multidrug-resistance status as being an important predictor of death when all patients receive appropriate initial antibiotic therapy. Future sepsis trials should attempt to provide appropriate antimicrobial therapy and take sepsis severity into careful account when determining outcomes.
Late Occurrence of PML in a Patient Treated for Lymphoma with Immunomodulatory Chemotherapies, Bendamustine, Rituximab, and Ibritumomab Tiuxetan. - Case reports in neurological medicine
PML caused by John Cunningham (JC) virus is a rare but an increasingly recognized entity. With the advent of newer immunomodulatory therapies with monoclonal antibodies, there is an increasing incidence of PML. Initially concern was restricted to patients treated for multiple sclerosis with natalizumab but more case reports are being reported during treatment for other conditions like Crohn's disease and lymphoma with agents such as rituximab. We report the case of a 66-year-old woman who developed PML a year after completion of therapy with rituximab, ibritumomab, and bendamustine.
Spinal Interneurons and Forelimb Plasticity after Incomplete Cervical Spinal Cord Injury in Adult Rats. - Journal of neurotrauma
Cervical spinal cord injury (cSCI) disrupts bulbospinal projections to motoneurons controlling the upper limbs, resulting in significant functional impairments. Ongoing clinical and experimental research has revealed several lines of evidence for functional neuroplasticity and recovery of upper extremity function after SCI. The underlying neural substrates, however, have not been thoroughly characterized. The goals of the present study were to map the intraspinal motor circuitry associated with a defined upper extremity muscle, and evaluate chronic changes in the distribution of this circuit following incomplete cSCI. Injured animals received a high cervical (C2) lateral hemisection (Hx), which compromises supraspinal input to ipsilateral spinal motoneurons controlling the upper extremities (forelimb) in the adult rat. A battery of behavioral tests was used to characterize the time course and extent of forelimb motor recovery over a 16 week period post-injury. The retrograde transneuronal tracer - pseudorabies virus - was used to define the motor and pre-motor circuitry controlling the extensor carpi radialis longus (ECRL) muscle in spinal intact and injured animals. In the spinal intact rat, labeling was observed unilaterally within the ECRL motoneuron pool and within spinal interneurons bilaterally distributed within the dorsal horn and intermediate gray matter. No changes in labeling were observed 16 weeks post-injury, despite a moderate degree of recovery of forelimb motor function. These results suggest that recovery of the forelimb function assessed following C2Hx injury does not involve recruitment of new interneurons into the ipsilateral ECRL motor pathway. However, the functional significance of these neurons to motor recovery requires further exploration.
A blind insertion airway device in dogs as an alternative to traditional endotracheal intubation. - Veterinary journal (London, England : 1997)
Endotracheal intubation is the standard of care to establish a secure airway; however, laryngeal airway management systems are increasingly being used in human patients for elective surgical procedures and in emergency settings. In this study, a double lumen, blind insertion airway device (BIAD) was placed in the esophagus of dogs and evaluated for its ability to ventilate the lungs. Initially, 10 euthanazed dogs were evaluated, followed by a group of 15 mixed breed dogs that were undergoing elective spay or neuter procedures, and a group of 10 healthy dogs. Post-procedure evaluation included visual examination with a laryngoscope to inspect for signs of inflammation or mucosal damage. The device provided adequate ventilation in all subjects; the dogs were under anesthesia or heavily sedated for 10â€‰min to 2â€‰h and recovered uneventfully. No evidence of esophagitis, aspiration pneumonia, tracheitis, subcutaneous emphysema or esophageal laceration was observed. In conclusion, the use of double lumen airway devices warrants further study as an alternative airway management system in dogs.Copyright Â© 2014 Elsevier Ltd. All rights reserved.
Interdisciplinary approaches of transcranial magnetic stimulation applied to a respiratory neuronal circuitry model. - PloS one
Respiratory related diseases associated with the neuronal control of breathing represent life-threatening issues and to date, no effective therapeutics are available to enhance the impaired function. The aim of this study was to determine whether a preclinical respiratory model could be used for further studies to develop a non-invasive therapeutic tool applied to rat diaphragmatic neuronal circuitry. Transcranial magnetic stimulation (TMS) was performed on adult male Sprague-Dawley rats using a human figure-of-eight coil. The largest diaphragmatic motor evoked potentials (MEPdia) were recorded when the center of the coil was positioned 6 mm caudal from Bregma, involving a stimulation of respiratory supraspinal pathways. Magnetic shielding of the coil with mu metal reduced magnetic field intensities and improved focality with increased motor threshold and lower amplitude recruitment curve. Moreover, transynaptic neuroanatomical tracing with pseudorabies virus (applied to the diaphragm) suggest that connections exist between the motor cortex, the periaqueductal grey cell regions, several brainstem neurons and spinal phrenic motoneurons (distributed in the C3-4 spinal cord). These results reveal the anatomical substrate through which supraspinal stimulation can convey descending action potential volleys to the spinal motoneurons (directly or indirectly). We conclude that MEPdia following a single pulse of TMS can be successfully recorded in the rat and may be used in the assessment of respiratory supraspinal plasticity. Supraspinal non-invasive stimulations aimed to neuromodulate respiratory circuitry will enable new avenues of research into neuroplasticity and the development of therapies for respiratory dysfunction associated with neural injury and disease (e.g. spinal cord injury, amyotrophic lateral sclerosis).
Advances in the directed evolution of proteins. - Current opinion in chemical biology
Natural evolution has produced a great diversity of proteins that can be harnessed for numerous applications in biotechnology and pharmaceutical science. Commonly, specific applications require proteins to be tailored by protein engineering. Directed evolution is a type of protein engineering that yields proteins with the desired properties under well-defined conditions and in a practical time frame. While directed evolution has been employed for decades, recent creative developments enable the generation of proteins with previously inaccessible properties. Novel selection strategies, faster techniques, the inclusion of unnatural amino acids or modifications, and the symbiosis of rational design approaches and directed evolution continue to advance protein engineering.Copyright Â© 2014 Elsevier Ltd. All rights reserved.
Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians. - Infection control and hospital epidemiology
To identify current outpatient parenteral antibiotic therapy practice patterns and complications.We administered an 11-question survey to adult infectious disease physicians participating in the Emerging Infections Network (EIN), a Centers for Disease Control and Prevention-sponsored sentinel event surveillance network in North America. The survey was distributed electronically or via facsimile in November and December 2012. Respondent demographic characteristics were obtained from EIN enrollment data.Overall, 555 (44.6%) of EIN members responded to the survey, with 450 (81%) indicating that they treated 1 or more patients with outpatient parenteral antimicrobial therapy (OPAT) during an average month. Infectious diseases consultation was reported to be required for a patient to be discharged with OPAT by 99 respondents (22%). Inpatient (282 [63%] of 449) and outpatient (232 [52%] of 449) infectious diseases physicians were frequently identified as being responsible for monitoring laboratory results. Only 26% (118 of 448) had dedicated OPAT teams at their clinical site. Few infectious diseases physicians have systems to track errors, adverse events, or "near misses" associated with OPAT (97 [22%] of 449). OPAT-associated complications were perceived to be rare. Among respondents, 80% reported line occlusion or clotting as the most common complication (occurring in 6% of patients or more), followed by nephrotoxicity and rash (each reported by 61%). Weekly laboratory monitoring of patients who received vancomycin was reported by 77% of respondents (343 of 445), whereas 19% of respondents (84 of 445) reported twice weekly laboratory monitoring for these patients.Although use of OPAT is common, there is significant variation in practice patterns. More uniform OPAT practices may enhance patient safety.
Accuracy of a vertical jump contact mat for determining jump height and flight time. - Journal of strength and conditioning research / National Strength & Conditioning Association
Several devices are available to measure vertical jump (VJ) height based on flight time, VJ reach height, or ground reaction forces. The purpose of this study was to determine the accuracy of a VJ mat for measuring flight time and VJ height compared with a VJ tester or a force plate. Seventeen men and 18 women (X Â± SD; age = 20.9 Â± 0.7 years, height = 176.1 Â± 0.9 cm, weight = 72.6 Â± 13.5 kg) served as subjects. Subjects performed counter-movement vertical jumps while standing on both a force plate (1,000 Hz) and a VJ mat. A Vertec VJ tester was used to measure jump reach. Compared with the force plate, the VJ mat reported greater VJ height (VJ mat = 0.50 Â± 0.12 m, force plate = 0.34 Â± 0.10 m) and flight time (VJ mat = 0.629 Â± 0.078 seconds, force plate = 0.524 Â± 0.077 seconds). Comparison of VJ heights from the VJ mat and the Vertec revealed no significant differences (Vertec = 0.48 Â± 0.11 m). Regression analyses indicated strong relationships between testing methods and suggested that high VJ performances may be underestimated with the VJ mat. This particular VJ mat compared favorably with the Vertec but not the force plate. It seems that the different flight times derived from the VJ mat may permit the VJ mat to be in closer agreement with VJ heights from the Vertec. Also, the VJ mat may not be an appropriate tool for assessing high VJ performances (i.e., â‰¥0.70 m; â‰ˆ28 inches). Practitioners and researchers using similar VJ mats may not obtain accurate flight times and may underestimate high performers.
Serious bleeding events due to warfarin and antibiotic co-prescription in a cohort of veterans. - The American journal of medicine
Antibiotics may interact with warfarin, increasing the risk for significant bleeding events.This is a retrospective cohort study of veterans who were prescribed warfarin for 30 days without interruption through the US Department of Veterans Affairs between October 1, 2002 and September 1, 2008. Antibiotics considered to be high risk for interaction with warfarin include: trimethoprim/sulfamethoxazole (TMP/SMX), ciprofloxacin, levofloxacin, metronidazole, fluconazole, azithromycin, and clarithromycin. Low-risk antibiotics include clindamycin and cephalexin. Risk of bleeding event within 30 days of antibiotic exposure was measured using Cox proportional hazards regression, adjusted for demographic characteristics, comorbid conditions, and receipt of other medications interacting with warfarin.A total of 22,272 patients met inclusion criteria, with 14,078 and 8194 receiving high- and low-risk antibiotics, respectively. There were 93 and 36 bleeding events in the high- and low-risk groups, respectively. Receipt of a high-risk antibiotic (hazard ratio [HR] 1.48; 95% confidence interval [CI], 1.00-2.19) and azithromycin (HR 1.93; 95% CI, 1.13-3.30) were associated with increased risk of bleeding as a primary diagnosis. TMP/SMX (HR 2.09; 95% CI, 1.45-3.02), ciprofloxacin (HR 1.87; 95% CI, 1.42-2.50), levofloxacin (HR 1.77; 95% CI, 1.22-2.50), azithromycin (HR 1.64; 95% CI, 1.16-2.33), and clarithromycin (HR 2.40; 95% CI, 1.16-4.94) were associated with serious bleeding as a primary or secondary diagnosis. International normalized ratio (INR) alterations were common; 9.7% of patients prescribed fluconazole had INR value >6. Patients who had INR performed within 3-14 days of co-prescription were at a decreased risk of serious bleeding (HR 0.61; 95% CI, 0.42-0.88).Warfarin users who are prescribed high-risk antibiotics are at higher risk for serious bleeding events. Early INR evaluation may mitigate this risk.Copyright Â© 2014 Elsevier Inc. All rights reserved.
Improving cervical cancer screening rates in an urban HIV clinic. - AIDS care
Human immunodeficiency virus (HIV)-infected women are at increased risk of invasive cervical cancer; however, screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multidisciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p < 0.01). Factors associated with lack of screening included fewer visits attended (pre: 4.2 Â± 1.5; post: 3.4 Â± 1.4; p < 0.01). A multidisciplinary quality improvement intervention was successful in overcoming barriers and increasing cervical cancer screening rates in an urban academic HIV clinic.
Map & Directions
11 Whitehall Rd Anesthesia Department Rochester, NH 03867
15 Whitehall Rd Frisbie Memorial Hospital
11 Whitehall Road Frisbie Memorial Hospital
165 Rochester Hill Rd Psychotherapy Associates Inc
21 Whitehall Rd Suite 201