Mora S.,Brigham and Women's Hospital |
Pedersen T.R.,University of Oslo |
LaRosa J.C.,New York University |
Nestel P.J.,Baker Heart and Diabetes Research Institute |
And 11 more authors.
JAMA - Journal of the American Medical Association | Year: 2012
Context: The associations of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB) levels with the risk of cardiovascular events among patients treated with statin therapy have not been reliably documented. Objective: To evaluate the relative strength of the associations of LDL-C, non-HDL-C, and apoB with cardiovascular risk among patients treated with statin therapy. Design: Meta-analysis of individual patient data from randomized controlled statin trials in which conventional lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up. Data Sources: Relevant trials were identified by a literature search updated through December 31, 2011. Investigators were contacted and individual patient data were requested and obtained for 62154 patients enrolled in 8 trials published between 1994 and 2008. Data Extraction: Hazard ratios (HRs) and corresponding 95% CIs for risk of major cardiovascular events adjusted for established risk factors by 1-SD increase in LDL-C, non-HDL-C, and apoB. Results: Among 38 153 patients allocated to statin therapy, 158 fatal myocardial infarctions, 1678 nonfatal myocardial infarctions, 615 fatal events from other coronary artery disease, 2806 hospitalizations for unstable angina, and 1029 fatal or nonfatal strokes occurred during follow-up. The adjusted HRs for major cardiovascular events per 1-SD increase were 1.13 (95% CI, 1.10-1.17) for LDL-C, 1.16 (95% CI, 1.12-1.19) for non-HDL-C, and 1.14 (95% CI, 1.11-1.18) for apoB. These HRs were significantly higher for non-HDL-C than LDL-C (P=.002) and apoB (P=.02). There was no significant difference between apoB and LDL-C (P=.21). Conclusion: Among statin-treated patients, on-treatment levels of LDL-C, non-HDL-C, and apoB were each associated with risk of future major cardiovascular events, but the strength of this association was greater for non-HDL-C than for LDL-C and apoB. ©2012 American Medical Association. All rights reserved.
Mora S.,Brigham and Women's Hospital |
Amarenco P.,Bichat University Hospital |
Pedersen T.R.,University of Oslo |
Larosa J.C.,New York University |
And 14 more authors.
Journal of the American College of Cardiology | Year: 2014
Background Levels of atherogenic lipoproteins achieved with statin therapy are highly variable, but the consequence of this variability for cardiovascular disease risk is not well-documented. Objectives The aim of this meta-analysis was to evaluate: 1) the interindividual variability of reductions in low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), or apolipoprotein B (apoB) levels achieved with statin therapy; 2) the proportion of patients not reaching guideline-recommended lipid levels on high-dose statin therapy; and 3) the association between very low levels of atherogenic lipoproteins achieved with statin therapy and cardiovascular disease risk. Methods This meta-analysis used individual patient data from 8 randomized controlled statin trials, in which conventional lipids and apolipoproteins were determined in all study participants at baseline and at 1-year follow-up. Results Among 38,153 patients allocated to statin therapy, a total of 6,286 major cardiovascular events occurred in 5,387 study participants during follow-up. There was large interindividual variability in the reductions of LDL-C, non-HDL-C, and apoB achieved with a fixed statin dose. More than 40% of trial participants assigned to high-dose statin therapy did not reach an LDL-C target <70 mg/dl. Compared with patients who achieved an LDL-C >175 mg/dl, those who reached an LDL-C 75 to <100 mg/dl, 50 to <75 mg/dl, and <50 mg/dl had adjusted hazard ratios for major cardiovascular events of 0.56 (95% confidence interval [CI]: 0.46 to 0.67), 0.51 (95% CI: 0.42 to 0.62), and 0.44 (95% CI: 0.35 to 0.55), respectively. Similar associations were observed for non-HDL-C and apoB. Conclusions The reductions of LDL-C, non-HDL-C, and apoB levels achieved with statin therapy displayed large interindividual variation. Among trial participants treated with high-dose statin therapy, >40% did not reach an LDL-C target <70 mg/dl. Patients who achieve very low LDL-C levels have a lower risk for major cardiovascular events than do those achieving moderately low levels. © 2014 by the American College of Cardiology Foundation.
News Article | November 29, 2016
Californians can expect an increase of over 13% on health plans purchased through Covered California in 2017. With the rise in pricing and a decrease in plan options caused by insurers pulling back from the marketplace, many patients have begun searching for alternatives to traditional insurance-led healthcare plans. Huntington Beach, CA direct primary care (DPC) practice, Elevated Health, is currently accepting new patients to their small, personalized practice. DPC through Elevated Health offers a unique dynamic where patients have unlimited, direct access to a board-certified physician, Dr. Matthew Abinante, free or discounted in-office services, and steep negotiated discounts on medications and off-site services. Unlike traditional healthcare plans, DPC membership pricing is a flat rate determined by age. Direct primary care does not currently qualify as insurance, according to the Affordable Care Act (ACA), however, patients can remain compliant to ACA regulations and still save up to 30% on insurance costs by selecting a high-deductible plan and an HSA that can be used to pay for DPC, or by joining a health share plan which may subsidize a DPC membership (such as http://www.libertydirect.org) Dr. Matthew Abinante is board certified in Family Medicine. He received his DO and MPH degrees from Touro University in California. “Direct primary care allows us to really care for our patients individually and personally, without involving insurance in treatment decisions,” Explained Dr. Abinante, founder of Elevated Health. “We are committed to offering the best, most personal care available in Southern California.” To learn more about direct primary care through Elevated Health, visit http://www.elevatedhealth.md or contact the office by phone at 714-916-5210.
News Article | December 9, 2016
ROSEVILLE, CA, December 09, 2016-- TMS Health Solutions has opened their newest clinic, in Roseville at 1731 E. Roseville Parkway. "Our team is excited to be bringing compassionate, comprehensive psychiatric care for treatment-resistant depression, including advanced therapies like Transcranial Magnetic Stimulation (TMS), to the north Sacramento area," said Dr. Marsha Snyder. "We're inviting clinicians to our Grand Opening event on January 24, 2017 to learn about our consultation and therapy services, gain insight into our TMS program, and tour our state- of-the-art treatment rooms. They'll also meet our practitioners, including Dr. Richard Bermudes, TMS Health Solutions' CMO and supervising clinician, a nationally recognized authority on depression therapy, and current president of the Clinical TMS Society." TMS Health Solutions provides comprehensive psychiatric services and is Northern California's leading provider of TMS therapy, a highly effective, FDA-cleared treatment for those who do not respond to treatment and/or medication. TMS uses non-invasive, utilizing magnetic pulses to precisely stimulate areas of the brain known to cause depression and mood disorders, without the systemic side effects of anti-depressant medication. TMS sessions are administered in a comfortable outpatient setting, and patients can resume normal activity immediately afterward."Many of our referring providers and patients live around Roseville and will now be able to access quality psychiatric care, including TMS therapy, right where they live and work," said Brad Hummel, CEO of TMS Health Partners, the business management company for TMS Health Solutions . "With our clinics in west Sacramento and El Dorado Hills, we now provide comprehensive psychiatric services across the region."Dr. Lanocha is a neuropsychiatrist, Board Certified in Adult Psychiatry and Sleep Medicine, with over 30 years' experience caring for patients with treatment-resistant depression. Dr. Lanocha was trained in TMS at the Berenson-Allen Center for Noninvasive Brain Stimulation at Harvard Beth Israel Deaconess Medical Center in Boston and was the first physicians in the country to offer outpatient TMS therapy. He has become a nationally recognized expert in the field and serves as the Head of TMS Education. Dr. Lanocha has lectured widely about TMS, taught professional seminars, provided hands-on training to clinicians, and coauthored several pioneering papers on the therapy's clinical application and long-term benefitsDr. Marsha Snyder is Board Certified in Adult and Geriatric Psychiatry, with over 30 years' experience treating depression and anxiety, providing organizational leadership, working to improve the quality of the modern medical experience, and seeking advanced treatments for her patients.Dr. Snyder earned her Doctor of Medicine, Masters in Applied Positive Psychology, and Bachelor of Science in Nursing degrees from the University of Pennsylvania. She served as the Chairman of the Department of Psychiatry and Medical Director of the Behavioral Medicine Service Line at St Luke's Health Network in Bethlehem, PA. She is the author of textbooks on positive psychology and self-care for physicians, has developed programs to improve patient care, and currently serves as Adjunct Clinical Professor at Touro University's Department of Psychiatry.Dr. Carolina Bonilla is Board Certified in Adult and Geriatric Psychiatry. Her areas of expertise include late-life depression, grief, and treatment-resistant depression. A native of Colombia, Dr. Bonilla is fluent in Spanish and particularly knowledgeable about women's issues and Latin America. She has also a deep appreciation and respect for other cultures, and has worked successfully with patients from many other ethnic, religious and cultural backgrounds.She obtained her medical degree from the Pontificia Universidad Javeriana School of Medicine, Bogota, Colombia in 1999. She completed a General Psychiatry Residency at the University of Texas Health Science Center at San Antonio, in August 2007, and a Geriatric Psychiatry Fellowship at the University of Pittsburgh Medical Center, Western Psychiatric Institute, Pittsburgh, Pennsylvania in 2008.Cleared by the FDA in 2008, TMS is a drug-free, non-invasive therapy for patients who suffer from treatment-resistant depression. It is administered in a physician's office in an outpatient setting. By using an MRI-strength magnetic field to stimulate the prefrontal cortex of the brain, the core symptoms of major depression can be relieved. Unlike antidepressants or Electroconvulsive Therapy (ECT), patients undergoing TMS therapy experience minimal side effects.Headquartered in San Francisco, California, TMS Health Solutions clinics specialize in the delivery of TMS therapy for patients suffering from treatment-resistant depression. Additionally, the clinics provide traditional treatment for mood disorders. TMS Health Solutions is led by Dr. Richard Bermudes and Dr. Karl Lanocha, two of the nation's leading experts on using TMS therapy as an innovative treatment for depression.
Jordan D.N.,University of California at Los Angeles |
Jordan D.N.,California State University, Fullerton |
Jordan J.L.,Touro University
Journal of Diabetes and its Complications | Year: 2010
Aim: To examine the diabetes self-care behaviors of Filipino-American (FA) adults with type 2 diabetes mellitus (DM). Method: The Summary of Diabetes Self Care Activities-Revised and Expanded measure was administered to 192 (74 males and 118 females) FA adult immigrants with type 2 DM. Results: Older FAs (≥65 years), females, those who were older when they immigrated, and participants diagnosed with type 2 DM longer were more likely to follow recommended medication regimens. Younger FAs (<65 years) and participants diagnosed with type 2 DM for shorter duration of time were less likely to perform blood glucose testing. Most FAs reported following their eating plans; however, those who lived in the United States (US) longer followed healthful eating plans. Likewise, females reported eating five or more servings of fruits and/or vegetables daily. Moreover, older FAs reported evenly spacing carbohydrate intake everyday. Furthermore, older participants, those with less education, participants who were older when they immigrated, and those older when diagnosed with type 2 DM ate fewer foods high in fats. As to physical activity, FA males and participants with higher education exercised more frequently. Conclusion: Younger FAs were less likely to perform optimum type 2 DM self-care behaviors pertaining to diet, medication taking, and blood glucose testing compared to their older counterparts. This finding suggests an increased risk for type 2 DM comorbidities and/or complications in younger FAs, which may require more intensive treatments in later years. © 2010.
Watson T.S.,Desert Orthopaedic Center |
Shurnas P.S.,Columbia Orthopaedic Group |
Denker J.,Touro University
Journal of the American Academy of Orthopaedic Surgeons | Year: 2010
Injuries to the tarsometatarsal joint complex, also known as the Lisfranc joint, are relatively uncommon. However, the importance of an accurate diagnosis cannot be overstated. These injuries, especially when missed, may result in considerable long-term disability as the result of posttraumatic arthritis. A high level of suspicion, recognition of the clinical signs of injury, and appropriate radiographic studies are needed for correct diagnosis. When surgery is indicated, closed reduction with percutaneous screw fixation should be attempted. If reduction is questionable, open reduction should be performed. Screw fixation remains the traditional fixation technique. Copyright 2010 by the American Academy of Orthopaedic Surgeons.
News Article | February 15, 2017
Provides discounted military tuition rate & 100% scholarship (free tuition) for up to 3 courses based on degree & credits completed at TUW. - Touro University Worldwide (TUW), a nonprofit online university accredited by the WASC Senior Commission of Universities and Colleges, is pleased to announce a special military scholarship program. This scholarship program follows the long tradition of Touro’s appreciation of and unique relationship with service members, veterans, and their families. TUW focuses on quality education, affordability, a military friendly environment, and exemplary student services. “As an appreciation to military members for their service and sacrifice, we created a military scholarship program, making TUW the most affordable online university,” says Dr. Yoram Neumann, Chief Executive Officer of Touro University Worldwide. “Active duty personnel, veterans, and their families can now earn a high-quality undergraduate or graduate degree at the fraction of the cost that other online universities charge.” This military tuition program is offered for active duty and reservist military members from all service branches including those in the Coast Guard and National Guard. Retirees and veterans with an honorable discharge and Department of Defense employees are also eligible. This program is also extended for spouses and children of the aforementioned. Eligible military students will receive the special military tuition rate. Bachelor’s programs have a tuition rate of $250 per credit hour, master’s program at $300 per credit hour, and doctorate program at $560 per credit hour. In addition, military students will be awarded 100 percent scholarship (free tuition) for up three courses, depending on their degree program and the number of credits that they have completed at TUW. As a military friendly university, there is no limitation on the time to complete course credits to be eligible for the military tuition rate and scholarship. The university is also waiving the application fee. A complete online library and resources are included in the tuition so there are no extra expenses on textbooks for students. Courses are offered six times a year, resulting in a clear and supportive path to the successful completion of degree programs. To learn more about TUW’s commitment to the military and their scholarship program, visit TUW.edu/military. Touro University Worldwide (TUW) is a non-profit university, accredited by the WASC Senior College and University Commission, and is part of the Touro College and University System. TUW Offers degrees that range from AA degree to Doctorate level. For more information, visit TUW.edu.
Thairu L.,Touro University |
Wirth M.,Maternova |
Lunze K.,Boston University
Tropical Medicine and International Health | Year: 2013
Objectives: To review medical devices addressing newborn health in resource-poor settings, and to identify existing and potential barriers to their actual and efficient use in these settings. Methods: We searched Pubmed as our principal electronic reference library and dedicated databases such as Maternova and the Maternal and Neonatal Directed Assessment of Technology. We also researched standard public search engines. Studies and grey literature reports describing devices for use in a low- or middle-income country context were eligible for inclusion. Results: Few devices are currently described in the peer-reviewed medical or public health literature. The majority of newborn-specific devices were found in the grey literature. Most sources described infant warmers, neonatal resuscitators, and phototherapy devices. Other devices address the diagnosis of infectious diseases, monitoring of oxygen saturation, assisted ventilation, prevention of mother-to-child transmission of HIV, assisted childbirth, weight or temperature assessment, and others. Conclusion: Many medical devices designed for newborns in the developing world are under development or in the early stages of production, but the vast majority of them are not available when and where they are needed. Making them available to mothers, newborns, and birth attendants in resource-limited countries at the time and place of birth will require innovative and creative production, distribution, and implementation approaches. © 2012 Blackwell Publishing Ltd.