A5008282544- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- CAR-T cell therapy research
- Intensive Care Unit Cognitive Disorders
- Inflammasome and immune disorders
- Palliative Care and End-of-Life Issues
- Ethics in medical practice
- Respiratory Support and Mechanisms
- COVID-19 and healthcare impacts
- Cancer Treatment and Pharmacology
- Mechanical Circulatory Support Devices
- Myasthenia Gravis and Thymoma
- Disaster Response and Management
- Glioma Diagnosis and Treatment
- Ethics and Legal Issues in Pediatric Healthcare
- Sepsis Diagnosis and Treatment
- Safe Handling of Antineoplastic Drugs
- Nosocomial Infections in ICU
- Vitamin C and Antioxidants Research
- Cancer, Stress, Anesthesia, and Immune Response
- Chemotherapy-induced cardiotoxicity and mitigation
- Chromatin Remodeling and Cancer
- Patient Dignity and Privacy
- Frailty in Older Adults
- Antibiotic Resistance in Bacteria
Memorial Sloan Kettering Cancer Center
2012-2025
Cleveland Clinic
2017-2023
University of Alabama at Birmingham
2022
New York Proton Center
2022
Society of Critical Care Medicine
2021
Cleveland Clinic Lerner College of Medicine
2020-2021
Case Western Reserve University
2021
Moral distress is the psychological that experienced in relation to a morally challenging situation or event. Although it was first observed within nursing, caregivers across all disciplines-including physicians, respiratory therapists, social workers and chaplains-experience moral distress. In this consult, we discuss 5 types of using examples changes clinical practice have occurred due COVID-19. We also provide suggestions for responding outline resources available at Cleveland Clinic.
In patients with COVID-19, granulocyte-macrophage colony stimulating factor (GM-CSF) might be a mediator of the hyperactive inflammatory response associated respiratory failure and death. We aimed to evaluate whether mavrilimumab, monoclonal antibody GM-CSF receptor, would improve outcomes in COVID-19 pneumonia systemic hyperinflammation.This investigator-initiated, multicentre, double-blind, randomised trial was done at seven hospitals USA. Inclusion required hospitalisation, pneumonia,...
In patients with Covid-19, myocardial injury and increased inflammation are associated morbidity mortality. We designed a proof-of-concept randomized controlled trial to evaluate whether treatment canakinumab prevents progressive respiratory failure worsening cardiac dysfunction in SARS-CoV2 infection, injury, high levels of inflammation.The primary hypothesis is that canakiumab will shorten time recovery.The three C study (canakinumab Covid-19 Cardiac Injury, NCT04365153) double-blind,...
To evaluate the frequency, characteristics, and outcomes of ethics consultations in critically ill patients with cancer.This is a retrospective analysis all adult cancer who were admitted to intensive care unit (ICU) comprehensive center had an consultation between September 2007 December 2011. Demographic clinical variables abstracted along details contexts consultations.Ethics obtained on 53 (representing 1% ICU admissions). The majority (90%) advanced-stage malignancies, received...
Interleukin 6 (IL-6) took center stage as a therapeutic target, given its role in the cytokine storm phase of COVID-19. While IL-6 inhibitors have been widely used to treat variety immune-mediated disease states, they not often intensive care setting, and new data question their efficacy. This brief review provides practical information on administration safety.
There are emerging data depicting the clinical presentation of coronavirus disease 19 (COVID-19) in solid organ transplant recipients but negligible data-driven guidance on management. A biphasic course has been described some infected with severe acute respiratory syndrome 2 (SARS-CoV-2), beginning a flu-like illness followed by an intense inflammatory response characterized elevated c-reactive protein (CRP), interleukin 6 (IL-6), and distress (ARDS) associated high mortality. The exuberant...
The neutrophil-lymphocyte ratio is an inexpensive and simple inflammatory marker. A higher ratio, indicative of acute hyperinflammatory response or diminished overall physiologic health status, has been associated with poor prognoses. This study aimed to evaluate the prognostic potential admission in patients admitted medical ICU coronavirus disease 2019.Retrospective review prospectively collected data.Medical from a large center.2,071 consecutive laboratory-confirmed severe respiratory...
Since the introduction of immunotherapy and targeted therapies, patients not only have adequate tumoral response to these treatments, but their quality life has improved due milder toxicities. However, wide mechanisms action, toxicity profile for therapies is broad, can an insidious onset, recognition be challenging. Rarely, some toxicities cause significant morbidity if diagnosed early lead intensive care unit (ICU) admission death. Anesthesiologists are likely encounter a spectrum also...
The primary objective was to evaluate ICU mortality at 28 days in patients with severe hypoxemic respiratory failure due coronavirus disease 2019 infection who received tocilizumab. secondary objectives were ICU-, hospital-, mechanical ventilation-, and vasopressor-free day development of infections.Retrospective, observational, multicenter, cohort study between March 15, 2020, May 31, 2020. Using propensity score matching based on admission source, C-reactive protein, Sequential Organ...
The care of patients during the COVID-19 pandemic has added many layers complexity to ethical issues. Our response emphasizes importance having an ethically sound framework inform our decisions, requiring caregivers consider what is optimal and feasible for patient. It increasingly important understand principles appropriately apply them both patient management decisions guide scarce resource allocation. If we are be prepared face challenges this pandemic, must prioritize demands treatment concerns.
Background: Patients with cancer who require cardiopulmonary resuscitation (CPR) historically have had low survival to hospital discharge; however, overall CPR outcomes and improved. Identifying patients are unlikely survive could guide improve end-of-life discussions prior cardiac arrest. Methods: Demographics, clinical variables, including immediate for aged ≥18 years required in-hospital from 2012 2015 were collected. Indicators capturing the declining oncologic trajectory (ie, no further...
Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population.To investigate feasibility of early and describe rehabilitation interventions discharge outcomes a cohort patients with cancer.Retrospective review.A retrospective analysis cancer who participated occupational physical therapy while mechanical ventilation utilizing an institutional protocol from June 2010 - July 2011, was...
Many hospitals were unprepared for the surge of patients associated with spread coronavirus disease 2019 (COVID-19) pandemic. We describe processes to develop and implement a plan framework resource allocation, staffing, standardized management in response COVID-19 pandemic across large integrated regional healthcare system.A academic medical center Cleveland metropolitan area, network 10 throughout Northeastern Ohio daily capacity more than 500 intensive care unit (ICU) beds.At beginning...
OBJECTIVES: To report the epidemiology, treatments, and outcomes of adult patients admitted to ICU after cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome. DESIGN: Retrospective cohort study SETTING: Nine centers across U.S. part chimeric antigen receptor-ICU initiative. PATIENTS: Adult treated with receptor T-cell therapy who required admission between November 2017 May 2019. INTERVENTIONS: Demographics, toxicities, specific interventions, were collected....
At outset of the coronavirus disease 2019 (COVID-19) pandemic, significance bacterial and fungal coinfections in individuals with COVID-19 was unknown. Initial reports indicated that prevalence coinfection general population low, but there uncertainty regarding risk critically ill patients.Nine hundred adult patients infection were enrolled this observational case-control study. Patients a (case) without (control) compared using univariate multivariable analyses. A subgroup analysis...
Up to 50 000 intensive care unit interhospital transfers occur annually in the United States.To determine prevalence, characteristics, and outcomes of cancer patients transferred from an one hospital another at oncological center evaluate whether interventions planned before transfer were performed.Data on for January 2008 through December 2012 identified retrospectively. Demographic clinical variables, receipt interventions, outcome data analyzed.Of 4625 admissions center, 143 (3%) units...