A5090775043- Sepsis Diagnosis and Treatment
- Lipoproteins and Cardiovascular Health
- Emergency and Acute Care Studies
- Hemodynamic Monitoring and Therapy
- Clinical Reasoning and Diagnostic Skills
- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Vitamin C and Antioxidants Research
- Electrolyte and hormonal disorders
- Intensive Care Unit Cognitive Disorders
- Trauma and Emergency Care Studies
- Patient-Provider Communication in Healthcare
- Patient Satisfaction in Healthcare
- COVID-19 Clinical Research Studies
- Fatty Acid Research and Health
- Clusterin in disease pathology
- CRISPR and Genetic Engineering
- Injury Epidemiology and Prevention
- Nosocomial Infections in ICU
- Supply Chain Resilience and Risk Management
- Sexual Assault and Victimization Studies
- Vitamin K Research Studies
- Paraoxonase enzyme and polymorphisms
- Metabolomics and Mass Spectrometry Studies
Northwestern University
2023-2024
Florida College
2012-2024
University of Florida
2012-2024
Massachusetts General Hospital
2018-2023
Jacksonville College
2023
WinnMed
2023
University of Florida Health
2017-2023
Charles River Laboratories (United States)
2023
Jacksonville University
2021
Harvard University
2018-2020
We treated a 27-year-old patient with Duchenne's muscular dystrophy (DMD) recombinant adeno-associated virus (rAAV) serotype 9 containing d
SARS-CoV-2 viral entry may disrupt angiotensin II (AII) homeostasis, contributing to COVID-19 induced lung injury. AII type 1 receptor blockade mitigates injury in preclinical models, although data humans with remain mixed.To test the efficacy of losartan reduce hospitalized patients COVID-19.This blinded, placebo-controlled randomized clinical trial was conducted 13 hospitals United States from April 2020 February 2021. Hospitalized and a respiratory sequential organ failure assessment...
An N-of-1 trial was developed to deliver a dCas9-VP64 transgene designed upregulate the cortical dystrophin as custom therapy for Duchenne muscular dystrophy (DMD) patient. After showing signs of mild cardiac dysfunction and pericardial effusion, patient acutely decompensated sustained arrest six-days after dosing succumbed two-days later. Post-mortem examination revealed severe acute-respiratory distress syndrome with diffuse alveolar damage. Vector biodistribution data obtained minimal...
We sought to estimate the effectiveness of a limited course antibiotics in treating patients with chorioamnionitis.We conducted retrospective review treated for chorioamnionitis at our medical center from 2005 2009. Patients received ampicillin plus gentamicin as soon diagnosis was made. Postpartum they only next scheduled dose each antibiotic. who underwent cesarean delivery either metronidazole or clindamycin immediately after cord clamping. The primary outcome treatment failure, defined...
Importance Sepsis is associated with long-term cognitive impairment and worse psychological functional outcomes. Potential mechanisms include intracerebral oxidative stress inflammation, yet little known about the effects of early antioxidant anti-inflammatory therapy on cognitive, psychological, outcomes in sepsis survivors. Objective To describe observed differences vitamin C, thiamine, hydrocortisone between intervention control groups Vitamin Thiamine, Steroids (VICTAS) randomized...
The purpose of this study was to investigate changes in the lipidome patients with sepsis identify signaling lipids associated poor outcomes that could be linked future therapies. Adult were enrolled within 24h recognition. Patients meeting Sepsis-3 criteria from emergency department or intensive care unit and blood samples obtained. Clinical data collected rapid recovery, chronic critical illness (CCI), early death adjudicated by clinicians. Lipidomic analysis performed on two platforms,...
Approximately one-third of sepsis patients experience poor outcomes including chronic critical illness (CCI, intensive care unit (ICU) stay > 14 days) or early death (in-hospital within days). We sought to characterize lipoprotein predictive ability for and contribution heterogeneity.Prospective cohort study with independent replication cohort.Emergency department surgical ICU at two hospitals.Sepsis presenting 24 h.Measures included cholesterol levels (total cholesterol, high density...
Abstract Background Cholesterol metabolism is dysregulated in sepsis contributing to patient heterogeneity. Subphenotypes displaying lower lipoprotein levels and higher mortality (HYPO) or (NORMO), were described. We developed a simplified clinical algorithm for bedside subphenotype recognition. Methods analyzed data from four prospective studies (internal dataset), focusing on HYPO NORMO subphenotypes. A 1,000-tree Random Forest classifier logistic regression models built, using features...
Improving door-to-needle times (DNTs) for thrombolysis of acute ischemic stroke patients improves outcomes, but participation in DNT improvement initiatives has been mostly limited to larger, academic medical centers with an existing interest quality improvement. It is not known whether can improve at a population level, including smaller community hospitals. This study aims determine the effect provincial collaborative intervention on and patient outcomes.A pre post cohort was conducted...
Metabolic derangements in sepsis influence phosphate levels, which may predict mortality outcomes. We investigated the association between initial levels and 28-day patients with sepsis.
Low cholesterol levels in early sepsis patients are associated with mortality. We sought to test if IV lipid emulsion administration low would prevent a decline or increase total at 48 hours.
Abstract Objective Research evaluating the relationship between vasopressor initiation timing and clinical outcomes is limited conflicting. We investigated association time to vasopressors, worsening organ failure, mortality in patients with septic shock. Methods This was a retrospective study of shock (2013–2016) within 24 hours emergency department (ED) presentation. The primary outcome defined as an increase Sequential Organ Failure Assessment (SOFA) score ≥2 at 48 compared baseline, or...
Patients with septic shock have the highest risk of death from sepsis, however, racial disparities in mortality outcomes this cohort not been rigorously investigated. Our objective was to describe association between race/ethnicity and patients shock. study is a retrospective adult OneFlorida Data Trust (Florida, United States America) admitted January 2012 July 2018. We identified as having if they received vasopressors during their hospital encounter had either an explicit International...
Introduction Sepsis is a life-threatening, dysregulated response to infection. Both high-density lipoprotein and low-density cholesterol should protect against sepsis by several mechanisms; however, for partially unknown reasons, levels become critically low in patients with early who experience poor outcomes. An anti-inflammatory lipid injectable emulsion containing fish oil approved the Food Drug Administration as parenteral nutrition ill may prevent this decrease serum providing substrate...
The goal of this research was to determine the gender distribution chief residents in emergency medicine (EM) residencies United States explore whether leadership gap is present at resident level EM.
Sepsis is a life-threatening, dysregulated response to infection. Lipid biomarkers including cholesterol are dynamically regulated during sepsis and predict short-term outcomes. In this study, we investigated the predictive ability of lipid for physical function long-term mortality after sepsis.Prospective cohort study patients admitted surgical intensive-care unit (ICU) within 24 h bundle initiation. Samples were obtained at enrollment biomarkers. Multivariate regression models determined...
This is a study of lipid metabolic gene expression patterns to discover precision medicine for sepsis.
Patient-provider communication has been recognized as a critical area of focus for improved health care quality, with mounting body evidence tying patient satisfaction and provider to important outcomes. Despite this, few programs have studied in the emergency department (ED) setting. The authors designed curriculum conducted trainings all ED clinical staff. Although only 72% clinicians believed course would be valuable use their time before taking it, 97% reported that it was after ( P <...
Background: Reduced cholesterol levels are associated with increased organ failure and mortality in sepsis. Cholesterol may vary by infection type (gram negative vs positive), possibly reflecting differences cholesterol-mediated bacterial clearance. Methods: This was a secondary analysis of combined data set 2 prospective cohort studies adult patients meeting Sepsis-3 criteria. Infection types were classified as gram negative, positive, or culture negative. We investigated quantitative...
Abstract Objectives Cholesterol may be protective in sepsis. Patients with early sepsis have critically low cholesterol levels that are associated poor outcomes. The study objective was to test the safety of a fish oil–containing lipid injectable emulsion for stabilizing Methods Phase I Bayesian optimal interval design trial adult patients septic shock (Sequential Organ Failure Assessment score ≥4 or vasopressor dependence). Using sequential dose escalation, participants received 2 doses 1.0...