Urologists
17 years of experience

Accepting new patients
Central
Henry Ford Hospital
2799 W Grand Blvd
Detroit, MI 48202
313-916-2436
Locations and availability (2)

Education ?

Medical School Score Rankings
University of Michigan Medical School (1993)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Awards  
Castle Connolly's Top Doctors™ (2012 - 2013)
Associations
American Urological Association
American Board of Urology

Affiliations ?

Dr. Rivers is affiliated with 6 hospitals.

Hospital Affilations

Score

Rankings

  • Henry Ford Wyandotte Hospital
    2333 Biddle Ave, Wyandotte, MI 48192
    • Currently 4 of 4 crosses
    Top 25%
  • Henry Ford Macomb Hospitals
  • Henry Ford Health Systems
  • Henry Ford Medical Center at Maplegrove
  • Henry Ford Hospital
  • John D. Dingell Veterans Affairs Medical Center
    4646 John R St, Detroit, MI 48201
  • Publications & Research

    Dr. Rivers has contributed to 2 publications.
    Title Early and Innovative Interventions for Severe Sepsis and Septic Shock: Taking Advantage of a Window of Opportunity.
    Date November 2005
    Journal Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne
    Excerpt

    The pathogenic, diagnostic and therapeutic landscape of sepsis is no longer confined to the intensive care unit: many patients from other portals of entry to care, both outside and within the hospital, progress to severe disease. Approaches that have led to improved outcomes with other diseases (e.g., acute myocardial infarction, stroke and trauma) can now be similarly applied to sepsis. Improved understanding of the pathogenesis of severe sepsis and septic shock has led to the development of new therapies that place importance on early identification and aggressive management. This review emphasizes approaches to the early recognition, diagnosis and therapeutic management of sepsis, giving the clinician the most contemporary and practical approaches with which to treat these patients.

    Title The Clinical Utility of Serologic Markers in the Evaluation of the Acute Scrotum.
    Date November 2000
    Journal Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
    Excerpt

    OBJECTIVE: To examine the presence of interleukin-1 (IL-1), interleukin-6 (IL-6), and creatine phosphokinase-MM (CPK-MM) in patients with acute scrotal pain and assess their clinical utility in the diagnosis of testicular torsion (TT) and epididymitis. METHODS: Twenty-five patients with acute scrotal pain were prospectively enrolled over a two-year period. History, physical examination, complete blood count, urinalysis, and scrotal ultrasound were performed. Testicular torsion was confirmed by surgical exploration. Epididymitis was diagnosed using physical examination, scrotal ultrasound, and positive urinalysis. Venous blood was assayed for IL-1, IL-6, and CPK-MM in triplicate during the routine drawing of blood in the emergency department. The data are reported as medians +/- interquartile ranges (IQRs). RESULTS: Twenty-five patients with acute scrotal pain were evaluated; 11 with TT, three with torsion of the appendix testis (TAT), ten with epididymitis, and one with varicocele. One patient had both TT and epididymitis. Interleukin-1 was not detectable in either group. The CPK-MM values between TT and epididymitis were virtually identical at 99.8 and 100 IU/L, respectively. The median value for IL-6 was 1. 03 (IQR = 0.19 to 2.86) vs 20.86 (IQR = 2.14 to 65.50) pg/mL in the torsion and epididymitis groups, respectively. The 97.5% CI for the difference of medians of 19.9 was 0.4 to 65.1, p = 0.02. Using receiver operating characteristic (ROC) curve analysis for IL-6, the area under the curve was 0.82 for torsion and 0.67 for epididymitis. Using a cutoff value of IL-6 >/= 1.41 pg/mL, the positive predictive value of IL-6 in diagnosing epididymitis was 78.6%, with a negative predictive value of 100% for TT. There were no cases of missed TT on follow-up. CONCLUSIONS: This preliminary investigation of serologic markers demonstrates that IL-6 is significantly elevated in epididymitis as compared with TT. Creatine phosphokinase-MM and IL-1 were not found to be of diagnostic utility. The small sample size of this study precludes a definitive conclusion as to the utility of these markers in the emergency department. However, IL-6 may be clinically useful as an additional element in differentiating the causes of acute scrotal pain, and further study is warranted.

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