A5009647347- Liver Disease Diagnosis and Treatment
- Pancreatic and Hepatic Oncology Research
- Mechanical Circulatory Support Devices
- Cancer Genomics and Diagnostics
- Cardiac Structural Anomalies and Repair
- Hepatocellular Carcinoma Treatment and Prognosis
- Liver Disease and Transplantation
- Hepatitis C virus research
- Heart Failure Treatment and Management
- Genetic factors in colorectal cancer
- Colorectal Cancer Screening and Detection
- Alcohol Consumption and Health Effects
- Cardiac pacing and defibrillation studies
- Epigenetics and DNA Methylation
- Gastrointestinal Bleeding Diagnosis and Treatment
- Global Cancer Incidence and Screening
- Esophageal and GI Pathology
- Healthcare Systems and Reforms
- Hepatitis B Virus Studies
- Global Maternal and Child Health
- Cardiac Arrest and Resuscitation
- Gastrointestinal disorders and treatments
- Drug-Induced Hepatotoxicity and Protection
- Diabetes Management and Research
- Artificial Intelligence in Healthcare
Yale University
2019-2025
VA Connecticut Healthcare System
2023-2025
United States Department of Veterans Affairs
2024
Partners In Health
2013-2014
Brigham and Women's Hospital
2013-2014
<h3>Objective</h3> Integrated Management of Childhood Illness (IMCI) is the leading clinical protocol designed to decrease under-five mortality globally. However, impact threatened by gaps in IMCI quality care (QOC). In 2010, Partners Health and Rwanda Ministry implemented a nurse mentorship intervention Mentoring Enhanced Supervision at Centres (MESH) two rural districts. This study measures change QOC following addition MESH didactic training. <h3>Design</h3> Prepost after 12 months...
<h3>Importance</h3> Left ventricular assist devices (LVADs) improve outcomes in patients with advanced heart failure, but little is known about the role of neurohormonal blockade (NHB) treating these patients. <h3>Objective</h3> To analyze association between NHB and LVADs. <h3>Design, Setting, Participants</h3> This retrospective cohort analysis Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) included from more than 170 centers across United States Canada...
Metabolic dysfunction-associated steatotic liver disease (MASLD) has a global prevalence of 25%. Studies on incident and cardiovascular outcomes in lean (Body mass index: BMI < 25 kg/m2, or 23 kg/m2 for Asians) vs. non-lean individuals with MASLD have reported mixed results. We aimed to compare clinical mortality between compensated cirrhosis large national cohort. This was retrospective cohort study patients newly diagnosed the Veterans Health Administration 01/2008 05/2021. The primary...
INTRODUCTION: Although metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with increased alcohol intake (MetALD) are identified as clinical entities; tools to identify patients from electronic health records (EHRs) perform large outcome studies lacking. METHODS: In this retrospective study of participants the Veterans Analysis Liver Disease cohort assembled 1/1/2013 12/31/2022, a rule-based natural language processing (NLP) algorithm searched EHRs for imaging evidence...
The risk of hepatocellular carcinoma (HCC) declines over time after hepatitis C virus (HCV) cure by direct-acting antiviral (DAA) therapies. Liver society guidelines recommend continuing HCC screening for these patients, but data on outcomes are lacking.
As resource-limited health systems evolve to address complex diseases, attention must be returned basic primary care delivery. Limited data exists detailing the quality of general adult and adolescent delivered at front-line facilities in these regions. Here we describe baseline for adults adolescents rural Rwanda. Patients aged 13 older presenting eight center outpatient departments one district southeastern Rwanda between February March 2011 were included. Routine nurse-delivered was...
Background: Diabetes is associated with HCC; however, the impact of longitudinal blood glucose (BG) control on HCC risk in cirrhosis not well known. We investigated this knowledge gap a cohort United States Veterans from 2015 to 2021. Methods: used repeated hemoglobin A1c measurements categorize follow-up time according BG (defined as < 7%) state over time: uncontrolled, nonsustained (≤2 y), or sustained (>2 y). performed sensitivity analysis using 8% define control. Fine and Gray Cox...
Abstract Background: Alterations to DNA methylation have been identified in both hepatocellular carcinoma (HCC) tumor and circulating from affected individuals. These markers potential utility HCC screening. Adherence screening is poor acceptable tests are needed. Methods: A feasibility study was performed on a subset of case patients control subjects prior risk factors for HCC. Case (n=12) included adults aged 47–85 years with first diagnosis between 2011 2016 without viral hepatitis....
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The impact of respiratory failure on patients undergoing left ventricular assist device (LVAD) implantation is not well understood, especially since these were excluded from landmark clinical trials. We sought to evaluate the associations between immediate preimplant and postimplant outcomes in advanced heart LVAD implantation.We included all Interagency Registry for Mechanically Assisted Circulatory Support who implanted with continuous-flow LVADs 2008 2016. Of 16 362 underwent placement,...
Importance Patient outcomes in heart failure clinical trials are generally better than those observed real-world settings. This may be related to stricter inclusion and exclusion criteria trials. Objective We study sought characterize the implications of differences between patients a registry receiving left ventricular assist devices (LVADs). Design, setting, participants retrospective cohort included all INTERMACS (the Interagency Registry for Mechanically Assisted Circulatory Support) who...
Abstract Background: Hepatocellular carcinoma (HCC) incidence and outcomes vary across populations in the United States, but few studies evaluate local drivers of observed disparities. We measured HCC at community level assessed community-level risk factors with goal informing resource allocation to improve early case detection, which is associated improved outcomes. Methods: Clinical demographic data including census tract residence for all adults diagnosed Connecticut Tumor Registry...
Background Guidelines recommend universal mismatch repair (MMR) tumour testing of colorectal adenocarcinomas (CRCs) to screen for Lynch syndrome (LS). However, its implementation remains disjointed and referral genetic dismal, particularly among minorities. We aimed increase referral, cancer eventually LS diagnosis by developing the CLEAR (Closed Loop Enhanced Assessment Referral Syndrome) intervention, a systems approach which in second phase was automated. Methods This is cohort study all...
Background: Hepatocellular carcinoma (HCC) is a heterogeneous disease that typically arises in the setting of chronic liver disease, making treatment selection complex. Multidisciplinary tumor boards (MDLTB) have been shown to improve outcomes patients with HCC. However, many cases, evaluated by MDLTBs ultimately do not receive board's recommended treatment. Purpose: This study aims assess adherence MDLTB recommendations for HCC, reasons non-adherence, and survival Barcelona Clinic Liver...
<p>Supplementary Figure S8: Correlation between average annual cases of HCC (y-axis) and proportion adults living in poverty (x-axis).</p>