Costa Mesa, CA, United States
Costa Mesa, CA, United States

The Boston Medical Group is, a network of medical offices sharing research information and treatment methods for erectile dysfunction and premature ejaculation. Originally founded in Australia, The company opened its first office in the United States in Costa Mesa, California in 1998. Currently, Boston Medical Group has twenty-one office locations across the United States in states including California, Texas, Washington, Michigan, New York, Colorado and Florida as well as over half a dozen additional offices in several other countries, including Mexico, Brazil and Spain. Wikipedia.

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Ost D.E.,University of Houston | Ernst A.,Boston Medical Group | Grosu H.B.,University of Houston | Lei X.,University of Houston | And 18 more authors.
Chest | Year: 2015

BACKGROUND: There are significant variations in how therapeutic bronchoscopy for malignant airway obstruction is performed. Relatively few studies have compared how these approaches affect the incidence of complications. METHODS: We used the American College of Chest Physicians (CHEST) Quality Improvement Registry, Evaluation, and Education (AQuIRE) program registry to conduct a multicenter study of patients undergoing therapeutic bronchoscopy for malignant central airway obstruction. The primary outcome was the incidence of complications. Secondary outcomes were incidence of bleeding, hypoxemia, respiratory failure, adverse events, escalation in level of care, and 30-day mortality. RESULTS: Fift een centers performed 1,115 procedures on 947 patients. There were significant differences among centers in the type of anesthesia (moderate vs deep or general anesthesia, P < .001), use of rigid bronchoscopy ( P < .001), type of ventilation (jet vs volume cycled, P < .001), and frequency of stent use ( P < .001). The overall complication rate was 3.9%, but significant variation was found among centers (range, 0.9%-11.7%; P = .002). Risk factors for complications were urgent and emergent procedures, American Society of Anesthesiologists (ASA) score > 3, redo therapeutic bronchoscopy, and moderate sedation. The 30-day mortality was 14.8%; mortality varied among centers (range, 7.7%-20.2%, P = .02). Risk factors for 30-day mortality included Zubrod score > 1, ASA score > 3, intrinsic or mixed obstruction, and stent placement. CONCLUSIONS: Use of moderate sedation and stents varies significantly among centers. These factors are associated with increased complications and 30-day mortality, respectively. © 2015 AMERICAN COLLEGE OF CHEST PHYSICIANS.

PubMed | McGill University, Boston Medical Group and Jewish General Hospital
Type: Journal Article | Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | Year: 2016

To determine the incidence of pregnancy in liver transplant (LT) patients in a large population-based cohort and to determine the maternal and fetal risks associated with these pregnancies.We conducted an age-matched cohort study using the US Healthcare and Utilization project-Nationwide Inpatient Sample from 2003-2011. We used unconditional logistic regression, adjusted for baseline characteristics, to estimate the likelihood of common obstetric complications in the LT group compared with age-matched nontransplant patients.There were 7288712 deliveries and an estimated incidence of 2.1 LTs/100000 deliveries over the nine-year study period. LT patients had higher rates of maternal complications including hypertensive disorders (OR 6.5, 95% CI: 4.4-9.5), gestational diabetes (OR 1.9, 95% CI: 1.0-3.5), anemia (OR 3.2, 95% CI: 2.1-4.9), thrombocytopenia (OR 27.5, 95% CI: 12.7-59.8) and genitourinary tract infections (OR 4.2, 95% CI: 1.8-9.8). Deliveries among women with LT had higher risks of cesarean section (OR 2.9, 95% CI: 2.0-4.1), postpartum hemorrhage (OR 3.2, 95% CI: 1.7-6.2) and blood transfusion (OR 18.7, 95% CI: 8.5-41.0). Fetal complications in LT patients included preterm delivery (OR 4.7, 95% CI: 3.2-7.0), intrauterine growth restriction (OR 4.1, 95% CI: 2.1-7.7) and congenital anomalies (OR 6.0, 95% CI: 1.1-32.0).Although pregnancies in LT recipients are feasible, they are associated with a high rate of maternal and fetal morbidities. Close antenatal surveillance is recommended.

Heffernan K.S.,Boston Medical Group | Heffernan K.S.,Tufts Medical Center | Heffernan K.S.,Molecular Cardiology Research Institute | Karas R.H.,Boston Medical Group | And 6 more authors.
Vascular Medicine | Year: 2010

Smoking is an established cardiovascular risk factor that impairs endothelial function and reduces exercise capacity. Peripheral vascular endothelial function correlates with exercise capacity, but whether this association prevails in smokers is unknown. The purpose of this investigation was to examine the association between endothelial function and exercise capacity in chronic smokers and non-smoking controls. Brachial artery flow-mediated dilation (FMD, endothelium-dependent) following 5 minutes of upper arm occlusion was compared in 26 smokers (age 58 ± 2 years; 15 female; BMI (body mass index) = 28 ± 1) and 39 non-smokers (age 58 ± 2 years; 24 female; BMI = 28 ± 1) using ultrasound. Exercise treadmill time (ETT) was recorded from a standard Bruce protocol during symptom limited stress testing. There was found to be a significant positive association between FMD and ETT in smokers (r = 0.60, p < 0.05) and non-smokers (r = 0.28, p < 0.05). FMD was significantly lower in smokers versus non-smokers (8.9 ± 0.9 vs 12.6 ± 0.7%, p < 0.05). ETT was significantly lower in smokers (425 ± 35 seconds) versus non-smokers (522 ± 25 seconds, p < 0.05). After adjusting for FMD, there were no longer group differences in ETT. When patients were matched according to FMD, there were no differences in ETT between smokers and non-smokers. In conclusion, peripheral endothelial dysfunction is a correlate of low exercise capacity in smokers and non-smokers alike. Future research is needed to examine if improving endothelial function will lead to concomitant increases in exercise capacity in chronic smokers.

Heffernan K.S.,Boston Medical Group | Patvardhan E.A.,Boston Medical Group | Hession M.,Boston Medical Group | Ruan J.,Boston Medical Group | And 2 more authors.
Clinical Physiology and Functional Imaging | Year: 2010

Background: Although typically derived from the contour of arterial pressure waveform, augmentation index (AIx) may also be derived from the digital pulse volume waveform using finger plethysmography (peripheral arterial tonometry, PAT). Little is known regarding the physiologic correlates of AIx derived from PAT. In this study, we investigated the relation of PAT-AIx with measures of ventricular-vascular coupling. Methods: Pulse volume waves were measured via PAT and used to derive AIx. Using 2-dimensional echocardiography, effective arterial elastance index (EaI) was estimated as end-systolic pressure/stroke volume index. Left ventricular (LV) end-systolic elastance index (ELVI) was calculated as end-systolic pressure/end-systolic volume index. Ventricular-vascular coupling ratio was defined as EaI/ELVI. Results: Given the bi-directional nature of ventricular-vascular uncoupling as measured by echocardiography, patients were separated into three groups: low EaI/ELVI (<0·6, n = 21), optimal EaI/ELVI (mean 0·6-1·2, n = 16) and high EaI/ELVI (>1·2, n = 10). Adjusting for potential confounders (age, mean arterial pressure, height and heart rate), patients with optimal EaI/ELVI had lower AIx (1 ± 4%, P<0·05) compared to those with low EaI/ELVI (13 ± 4%) and high EaI/ELVI (19 ± 5%). Conclusions: Abnormal ventricular-vascular coupling, arising from either increased effective arterial elastance or increased ventricular elastance, is associated with increased AIx as measured by PAT. Additional research is needed to examine other vascular correlates of PAT-AIx. © 2010 The Authors. Journal compilation © 2010 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Patvardhan E.A.,Boston Medical Group | Heffernan K.S.,Boston Medical Group | Heffernan K.S.,Molecular Cardiology Research Institute | Ruan J.M.,Boston Medical Group | And 4 more authors.
Cardiology in Review | Year: 2010

Endothelial dysfunction is an important component in the pathogenesis of atherosclerosis. The ability to assess the endothelium in a meaningful manner has been the subject of intense investigation over decades. Since the function of endothelial cells is a gauge of vascular health, assessment of vascular function is emerging as a useful tool for predicting cardiovascular risk and as a surrogate outcome measure for cardiovascular reduction intervention studies. This review highlights techniques for assessing endothelial function, focusing on a novel method of determining peripheral vascular reactivity via arterial tonometry. © 2009 by Lippincott Williams & Wilkins.

PubMed | Boston Medical Group
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016

648 Background: Five years ofadjuvant tamoxifen therapy in estrogen receptor (ER)-positive breast cancer is more effective than two years of use. However information on adjuvant tamoxifen therapy discontinuance is scanty. We aimed to identify predictors of tamoxifen discontinuance in older women with early stage breast cancer.Within six healthcare delivery systems, we identified 1080 women 65 years with stage I-IIb breast cancer diagnosed from 1990 to 1994 with ER-positive or indeterminate tumors who had been prescribed tamoxifen. We then followed them for five years post initial tamoxifen prescription. Data sources included tumor registries, administrative data, and medical records. We used automated pharmacy records to validate tamoxifen prescription information collected from medical records. The primary endpoint was tamoxifen discontinuance, operationalized as ever discontinuing tamoxifen during follow-up. We excluded women who discontinued tamoxifen due to recurrence, death or disenrollment from this definition. Independent variables included demographic characteristics, comorbidity, tumor characteristics, and primary therapy. We used Cox proportional hazards to determine predictors of tamoxifen discontinuance.Of the 1080 women who were prescribed tamoxifen, 974 women did not have a recurrence, die or disenroll during follow-up. Of these 974 women, 489 (50%) stopped taking tamoxifen during the five years of follow-up. Discontinuers were more likely to be women aged 80 years and older (versus aged 65-69, hazard ratio (HR)= 1.96, 95% confidence interval (CI)=1.51-2.56); have a Charlson Comorbidity Index of 1 (versus a Charlson Comorbidity Index of 0, HR=1.31, CI=1.07-1.61); have indeterminate receptor status (versus ER-positive, HR=1.49, CI=1.12-2.00); and to have not received breast-conserving surgery with radiation therapy or mastectomy (HR=1.37, CI=1.10-1.71).Attention to non-adherence among women at risk of discontinuance, particularly not receiving guideline care, might improve breast cancer outcomes for these women. No significant financial relationships to disclose.

PubMed | Boston Medical Group
Type: | Journal: Cornea | Year: 2017

This study evaluates the correlation between corneal densitometry and epithelial ingrowth (EI) after laser in situ keratomileusis (LASIK).Corneal densitometry of 3 patients who developed EI after LASIK was measured with the Oculus Pentacam. Corneal densitometry readings of each patient were obtained preoperatively and postoperatively after ingrowth was discovered. Densitometry was recorded at the central nest of opacity and at the leading edges of EI.For all patients, the most severe stages of EI observed on slit-lamp photographs correlated with the highest densitometry readings, with peak densitometry ranging from 73.3 to 95.1. These values were much higher than preoperative densitometry readings, which ranged from 21.8 to 27.2. In 2 cases, the Pentacam densitometry map revealed progression of EI toward the visual axis that was only faintly detectable or not detectable at all on the corresponding slit-lamp photographs.Corneal densitometry seems to be an objective measure of the severity and progression of EI after LASIK.

PubMed | Boston Medical Group
Type: Journal Article | Journal: The Journal of bone and joint surgery. American volume | Year: 2016

In recent years, the number of total ankle arthroplasty procedures performed has increased dramatically. We sought to report the clinical results of the largest cohort of patients treated with a modern fixed-bearing total ankle arthroplasty by a single surgeon.We retrospectively reviewed the charts of 78 consecutive patients (81 ankles) who underwent total ankle arthroplasty with a minimum clinical follow-up of 2 years. Sixty-three patients completed standardized questionnaires including the Foot and Ankle Disability Index (FADI), the Short Musculoskeletal Function Assessment (SMFA), the Short Form (SF)-36v2, and a visual analog scale (VAS) for pain. In addition, each patient underwent serial range-of-motion examination and radiographic implant evaluation at each follow-up appointment.Implant survival was 97.5% at a mean follow-up time of 5.2 years. There was 1 revision of a tibial component and 1 revision of a talar component. Thirty-six patients underwent a concurrent procedure at the time of the index surgery, with the most common being removal of previous hardware. Seventeen patients underwent additional procedures following the index surgery, with the most common being gutter debridement. Total range of motion averaged 35.5 preoperatively and 39.9 postoperatively (p = 0.02). Fifty-seven ankles (70%) had >2 years of radiographic follow-up, and 25 ankles (31%) displayed evidence of lucency around a metallic component at the final radiographic follow-up. Outcome scores at a mean of 5.2 years revealed promising results for the cohort, with a mean VAS pain score of 17.7 and a mean FADI score of 79.1.Modern fixed-bearing total ankle arthroplasty had excellent implant survival, improved plantar flexion and total range of motion, and had good-to-excellent functional outcome at a mean follow-up of 5.2 years.Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

News Article | November 22, 2010

rsities in Boston. There are actually a number of great universities in the area to attend. You may be missing out on the best education in the world by only considering the Ivy League schools.In addition to the arts programs at the various Boston universities and colleges, there are two excellent art schools you can attend. You can take your courses at the Massachusetts College of Art or the School of the Museum of Fine Arts. Both of these universities are located right in Boston. You can also apply for various forms of financial aid. Get your arts degree while enjoying Boston life.Enjoy full or part time studies at Suffolk University. You can earn an AACSB accredited MBA here. This university also offers online MBA programs. This is great for those who want to further their educations but are unable to attend regular classes. You can also get your specialized degree in international business.You have many choices if you want to study law in Boston and the surrounding area. In Newton, you can attend the Boston College Law School. Cambridge offers the Harvard University Law School. If you prefer to study right in the city, you can attend the New England School of Law, the Northeastern University School of Law, the Boston University School of Law and the Suffolk University School of Law. Graduate and undergraduate programs are available.You can study medicine and dentistry at the best universities in Boston. At Harvard, you have the option of the Harvard Medical School or the Harvard School of Dental Medicine. Tufts also offers these programs. There is the Tufts University School of Dental Medicine and the Tufts University School of Medicine. If you want something a bit different but still in the medical field there is the Tufts University School of Veterinary Medicine, the Massachusetts College of Pharmacy and Applied Health Sciences and the New England College of Optometry.There are many opportunities to study music in Boston. The Berklee College of Music is particularly popular. Of course, there is the Boston Conservatory, as well as the New England Conservatory of Music. You can also study at the Longy School of Music and the New School of Music. Each of these schools offers a variety of music and arts programs.Getting an education in Boston can be very exciting. There is so much to see and do in this bustling city. Housing is important, and most of the universities offer on-campus housing for students. There are also a number of apartments available. Renting can be expensive, so it is best to try and find a group of people to share expenses with. First year students may want to opt for dormatory living until they get used to the city.Continuing education can be quite expensive. Luckily, there are many programs available for students to receive financial aid. In addition to student loan programs, there are other options available to many students. Scholarships are available from all of the Boston universities. You can also apply for grants and bursaries from schools, businesses, etc.If you are a student who is applying to Boston universities from outside the country, there are different types of protocol to follow. Make sure that you have the proper applications. You will also need to have a valid student visa so you can study in the US. You may be required to learn English as a second language before being accepted to some programs. Talk to your teachers and guidance counselors about the best way to go about being an international student in Boston.There are many other colleges in and around Boston that have a variety of excellent programs. If you want to study and live in this area, take your time when deciding which university you want to attend. You have a choice of some of the best universities in Boston. You can learn more about all of the Boston area and other universities by talking to your school?s guidance counselor.The sooner you apply to any Boston universities the better. The popular programs fill up fast. Make sure that you get your application in on time to be considered for the course of study you wish to embark on. New England has long been recognized for its amazing colleges and universities. The first that come to mine are Harvard and Cambridge, which many consider to be the best unive

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