A5037187995- Orthopedic Surgery and Rehabilitation
- Elbow and Forearm Trauma Treatment
- Medical Malpractice and Liability Issues
- Patient Safety and Medication Errors
- Total Knee Arthroplasty Outcomes
- Skin Protection and Aging
- Diversity and Career in Medicine
- Bone fractures and treatments
- Dermatology and Skin Diseases
- Acne and Rosacea Treatments and Effects
- Orthopaedic implants and arthroplasty
- Shoulder Injury and Treatment
- Orthopedic Infections and Treatments
- Virus-based gene therapy research
- Hip and Femur Fractures
- Innovations in Medical Education
- Healthcare Quality and Management
- Peripheral Nerve Disorders
- Musculoskeletal Disorders and Rehabilitation
- Cardiac, Anesthesia and Surgical Outcomes
- Healthcare cost, quality, practices
- Health and Medical Research Impacts
- Venous Thromboembolism Diagnosis and Management
- Musculoskeletal pain and rehabilitation
- Advancements in Transdermal Drug Delivery
Duke Medical Center
2019
Mass General Brigham
1998-2018
Harvard University
2004-2018
Massachusetts General Hospital
2005-2016
Dermatology Treatment & Research Center
2012-2016
Harvard University Press
2000-2015
Stephens College
2006-2015
University of Aruba
2015
Texas Health Dallas
2004-2013
The Spine Institute
2008
This article describes the clinical application of gene therapy to a nonlethal disease, rheumatoid arthritis (RA). Intraarticular transfer IL-1 receptor antagonist (IL-1Ra) cDNA reduces disease in animal models RA. Whether this procedure is safe and feasible humans was addressed phase I study involving nine postmenopausal women with advanced RA who required unilateral sialastic implant arthroplasty 2nd-5th metacarpophalangeal (MCP) joints. Cultures autologous synovial fibroblasts were...
We measured hormone levels in 59 women and 32 men with longstanding cystic acne resistant to conventional therapy. Affected had higher serum of dehydroepiandrosterone sulfate, testosterone, luteinizing lower sex-hormone-binding globulin than controls. sulfate 17-hydroxyprogesterone To dexamethasone was given men, or an oral contraceptive pill, Demulen (or both), women. Of the patients treated for six months, 97 per cent 81 resolution marked improvement their acne. The dose required reduce...
Two siblings with Refsum's disease, an inherited disorder of lipid metabolism, oxidized intravenously injected uniformly labeled phytanic acid-C14 at rates less than 5 percent those found in normal subjects. The defect oxidation acid persisted cultures fibroblasts from the patients' skin. rate was 1 that However, pristanic acid, previously shown to be first product degradation, a cultures. These results indicate enzymatic disease is step pathway for degradation is, unusual alpha-oxidative...
<h3>Hypothesis</h3>A novel approach to identify at-risk periods among orthopedic surgical residents may direct fatigue risk mitigation and facilitate targeted interventions.<h3>Design</h3>A prospective cohort study with a minimum 2-week continuous assessment period. Data on sleep awake were processed using the sleep, activity, fatigue, task effectiveness model.<h3>Setting</h3>Rotations at 2 academic tertiary care centers.<h3>Participants</h3>Twenty-seven of 33 volunteer (82%) completed...
Defining the epidemiology of adverse events after THA will aid in development strategies to enhance perioperative care.We identified (1) risk factors for Medicare beneficiaries while hospitalized and (2) trends rates events.Data were abstracted from medical records 1809 who underwent 2002 2007. We used hierarchical generalized linear modeling approach assess odds change over time, association with outcomes, relationship patient characteristics by log-odds as a function demographic clinical...
Refsum's disease (heredopathia atactica polyneuritiformis, HAP) is an inherited neurological disorder associated with storage of the branched-chain fatty acid, phytanic acid (3,7,11,15-tetramethylhexadecanoic acid). Cultured fibroblasts derived from skin biopsies HAP patients did not contain elevated levels phytanate, yet showed rates phytanate-C-(14)C oxidation less than 3% those seen in cells control subjects. Cells subjects converted phytanate to alpha-hydroxyphytanate, pristanate (the...
OBJECTIVES: To determine the incidence of distal radius fractures and characteristics those to identify key risk factors. DESIGN: Prospective cohort study, mean follow‐up 9.8 years. SETTING: Four clinical centers, one each in Baltimore, Maryland; Minneapolis, Minnesota; Pittsburgh, Pennsylvania; Portland, Oregon. PARTICIPANTS: Nine thousand seven hundred four white women aged 65 older, enrolled multicenter Study Osteoporotic Fractures. METHODS: Five twenty‐seven were confirmed by physician...
Clinical and laboratory data are presented from a study of group 80 patients with chronic cutaneous discoid lupus erythematosus. These support the contention that if one selects scarring DLE who have no evidence by history or physical examination extracutaneous involvement, then only small percentage will detectable immunologic derangements. It is apparent clinical expression erythematosus depends, in part, upon nature host's immune response.
There is a trend toward decreasing length of hospital stay (LOS) after TKA although it unclear whether this detrimental to the overall postoperative course. Such information important for future decisions related cost containment.We determined decreases in LOS are associated with increases readmission rates.We retrospectively reviewed rates and reasons 4057 Medicare patients from 2002 2007. We abstracted data Patient Safety Monitoring System. Hierarchical generalized linear modeling was used...
There has been widespread interest in medical errors since the publication of To Err Is Human: Building a Safer Health System by Institute Medicine 2000. The Patient Safety Committee American Academy Orthopaedic Surgeons compiled results member survey to identify trends orthopaedic that would help direct quality assurance efforts.Surveys were sent 5540 fellows, and 917 returned (a response rate 16.6%), with 53% (483) reporting an observed error previous six months.A general classification...
To demonstrate fat embolism during total hip replacement, thirty-four unselected patients were studied with an ultrasound probe over the femoral vein; twenty-one of them also had serial analyses control and venous blood for fat. Computer energy-density spectrum analysis sounds recorded by performed; emboli counted in samples two histological techniques; plasma was analyzed triglycerides before after filtration. Characteristic ("chirps") heard Ultrasound insertion component all patients. The...
Rosacea is a chronic skin disease that requires long-term therapy. Oral antibiotics and topical metronidazole successfully treat rosacea. Because use of systemic carries risks for complications adverse reactions, treatments are preferred.To determine if the gel (Metrogel) could prevent relapse moderate to severe rosacea.A combination oral tetracycline was used 113 subjects with rosacea (open portion study). Successfully treated (n = 88) entered randomized, double-blind, placebo-controlled...
Elbow arthroplasty most commonly is performed through a posterior approach by detaching or reflecting the triceps off olecranon. Surgical approaches to elbow joint that dissociate from olecranon have distinct disadvantages. Triceps avulsion, weakness, and wound healing problems been reported. Such complications necessitate more surgery predispose an infection. To avoid these modified preserves muscle insertion on was used in 10 consecutive arthroplasties. This method provides adequate...
Abstract The interosseous membrane is a structure deep in the forearm that joins radius and ulna. It made up of membranous ligamentous regions. Two main structures have been described: prominent central fiber group, “central band,” smaller proximal fibrous band, “oblique cord.” Many authors believe band plays biomechanical role normal fractured it may function much like ligament. objective this study was to determine tensile properties band. Eighteen fresh frozen forearms from cadavers...
Summary: In a prospective study 40 of 236 individuals with Down syndrome were found to have atlantoaxial instability. Whereas most the affected children asymptomatic, seven patients exhibited various neuropathology. Historical data, neurologic findings, radiologic interpretations, and surgical management these are described in detail. addition, case reports other symptomatic subluxation from literature analyzed. We conclude that early identification appropriate management, including...
Predictors of success orthopaedic residents on the American Board Orthopaedic Surgery (ABOS) examination are controversial. We therefore evaluated numerous variables that may suggest or predict candidate performance ABOS examination. reviewed files 161 (all graduates) from one residency program distributed into two study groups based whether they passed failed their first attempt Part I II 1991 through 2005. success/failure included mean percentile score In-Training Examination (OITE) (Years...