Saturday, August 06, 2022

Houston Practice Seeks Outpatient Only

Sleep / Pediatric Neurology NP or PA 

- Make a Difference Every Day!-


Houston Specialty Clinic - Neurology & Sleep Specialists, a regional leader in specialty care has experienced great demand. We offer academic quality care and personal attention. We take care of people experiencing illness or seeking answers to specialty-level concerns.

Our practice seeks a PT or FT extender to offer enhanced access to advanced specialty care in sleep disorders and neurologic illness in children. 

Job Summary: Under general direction, provides care in collaboration with the neurologist in the evaluation and treatment of pediatric neurologic illness and sleep disorders; serves as a resource person for staff; provides direct clinical service to patients and families including psychosocial assessment, crisis intervention, counseling, complex care management, and patient education.

While focusing on outpatient care, duties may include any and/or all of the following:

  1. Participates in delivering direct patient care; provides instructions and teaching to patients and families; assists in outpatient clinics with examinations and assessments; follows up on lab, test, and procedure results and prescriptions; informs patients of medication changes; informs physicians of patients' questions; evaluates patients' qualifications for clinical research studies; provides initial contact with patient's primary physician; establishes referral database; communicates with referring physicians for follow-up care and referrals.
  2. Collaborates with health care team members in planning, implementing, and evaluating comprehensive patient care; provides direct clinical service to patients and families inclduing biopsychosocial assessment,  behavior modification, care management, and patient education; researches improvements in patient management, including coordination between services and conservation of resources; facilitates and participates in meetings and projects.
  3. Collaborates with established primary care providers as a specialty consulting service
  4. Serves as a resource person and a nurse consultant for staff; develops an annual plan for professional development; attends conferences; maintains and improves current knowledge and competency as a PA or N.P.
  5. Perform other duties as assigned.


  • Knowledge and experience in Clinical Practice Nursing or as a Physician Assistant
  • Verbal/written communication skills
  • Interpersonal/human relations skills
  • Patient assessment skills
  • Public speaking skills
  • Research skills
  • Ability to respond to questions in a tactful and professional manner
  • Ability to instruct/teach/tutor
  • Ability to maintain confidentiality


Education and experience equivalent to:

Master's degree in nursing and certification in a specialty area of a Clinical Nurse Specialist or Nurse Practitioner; supplemented with two (2) years of related experience. Texas RN License and certification as an Advanced Practice Nurse required.


TX PA licensure supplemented with two (2) years of related experience

Physical Requirements – Typical for an outpatient clinic. 
May require some driving to satellite clinics. 
Duties include telemedicine visits.

Must be comfortable with children and adults with neurologic and developmental disorders

Competitive Salary & Productivity Bonus Commensurate with Experience

We welcome applicants for Part-Time and Full Time Work

HSC offers eligible employees a broad package of benefits such as health care, dental plan, vision plan, 401K.

Contact Dr. Joshua Rotenberg
Fax 713-465-4522

Sunday, April 18, 2021

Neuromodulation for appetite control in Prader Willi

More literature how TDCS can modify food craving in Prader Willi. 

Call our office for an appointment to see if your child is a candidate. 


Prader–Willi syndrome (PWS) is a neurodevelopmental genetic disorder characterized by multiple system involvement with hypotonia, poor suck with feeding difficulties, growth and other hormone deficiencies, intellectual disability, and behavioral problems with childhood onset of hyperphagia resulting in obesity, if not externally controlled. Transcranial direct current stimulation (tDCS) has been increasingly shown to modulate cognitive and behavioral processes in children and adults, including food-intake behaviors in patients with PWS. This study further reports the positive effects of brief tDCS sessions on Go/NoGo task performance involving food and non-food stimuli images, alterations in N2 brain amplitude, and genetic subgroup differences (maternal disomy 15, UPD; 15q11-q13 deletion, DEL) before and after tDCS as assessed by event-related potentials (ERPs) in 10 adults with PWS. The results indicate a group effect on baseline NoGo N2 amplitude in PWS patients with DEL vs UPD (p =0.046) and a decrease in NoGo N2 amplitude following tDCS (p = 0.031). Our tDCS approach also demonstrated a trend towards decreased response time. Collectively, these results replicate and expand prior work highlighting neurophysiological differences in patients with PWS according to genetic subtype and demonstrate the feasibility in examining neuromodulatory effects of tDCS on information processing in this patient population to stimulate additional research and treatment.

Transcranial stimulation may reduce appetite in Prader Willi

Sunday, February 07, 2021

Concussion Mild Brain Injury in Children Lasts Longer than a Few Weeks


Hate to spoil the Super Bowl ...

But, so many kids suffer from brain injury that is unrecognized. It’s true in Houston Texas and elsewhere. 


Post Here

Friday, February 05, 2021

Autism and Maternal Antibodies

 This is an interesting article about association without a clinical application at this time. 


Risk assessment analysis for maternal autoantibody-related autism (MAR-ASD): a subtype of autism


The incidence of autism spectrum disorder (ASD) has been rising, however ASD-risk biomarkers remain lacking. We previously identified the presence of maternal autoantibodies to fetal brain proteins specific to ASD, now termed maternal autoantibody-related (MAR) ASD. 

The current study aimed to create and validate a serological assay to identify ASD-specific maternal autoantibody patterns of reactivity against eight previously identified proteins (CRMP1, CRMP2, GDA, NSE, LDHA, LDHB, STIP1, and YBOX) that are highly expressed in developing brain, and determine the relationship of these reactivity patterns with ASD outcome severity. We used plasma from mothers of children diagnosed with ASD (n = 450) and from typically developing children (TD, n = 342) to develop an ELISA test for each of the protein antigens. 

We then determined patterns of reactivity a highly significant association with ASD, and discovered several patterns that were ASD-specific (18% in the training set and 10% in the validation set vs. 0% TD). 

The three main patterns associated with MAR ASD are

  • CRMP1 + GDA (ASD% = 4.2 vs. TD% = 0, OR 31.04, p = <0.0001), 
  • CRMP1 + CRMP2 (ASD% = 3.6 vs. TD% = 0, OR 26.08, p = 0.0005) 
  • NSE + STIP1 (ASD% = 3.1 vs. TD% = 0, OR 22.82, p = 0.0001). 

Additionally, we found that maternal autoantibody reactivity to CRMP1 significantly increases the odds of a child having a higher Autism Diagnostic Observation Schedule (ADOS) severity score (OR 2.3; 95% CI: 1.358–3.987, p = 0.0021). 

This is the first report that uses machine learning subgroup discovery to identify with 100% accuracy MAR ASD-specific patterns as potential biomarkers of risk for a subset of up to 18% of ASD cases in this study population.

Monday, November 23, 2020

Cannabis Epilepsy Trivia

Cannabis Trivia  

CBD has been in the news as a treatment for many conditions epilepsy. It was widely used for millennia by Indian "Arabian" and Persian medical traditions.

Q: When was cannabis first described in WESTERN medical literature as a TETANUS treatment?

A: 1839

Saturday, September 19, 2020

Medication Use ADD ADHD and Risk of Motor Vehicle Crashes

 Is there a relationship between medication use and a LOWER risk of accidents? 


Short term? Yes.

Long-term? Yes.

Men? Yes.

Women? Yes. 

Please take your medicines. 

Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes


Is the use of attention-deficit/hyperactivity disorder medication associated with a reduced risk of motor vehicle crashes in patients with the disorder?


In a national cohort study of 2 319 450 patients with attention-deficit/hyperactivity disorder, the use of medication for the disorder was associated with a significant reduction in the risk of motor vehicle crashes in male and female patients.


Attention-deficit/hyperactivity disorder medication use may lower the risk of motor vehicle crashes, a prevalent and preventable cause of mortality and morbidity among patients with the disorder.