A5017011735- Trauma and Emergency Care Studies
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Cardiac Arrest and Resuscitation
- Nutrition and Health in Aging
- Trauma Management and Diagnosis
- Cardiac, Anesthesia and Surgical Outcomes
- Abdominal Trauma and Injuries
- Abdominal Surgery and Complications
- Parathyroid Disorders and Treatments
- Clinical Nutrition and Gastroenterology
- Ultrasound in Clinical Applications
- Pelvic and Acetabular Injuries
- Frailty in Older Adults
- Blood transfusion and management
- Traumatic Brain Injury and Neurovascular Disturbances
- Surgical site infection prevention
- Hip and Femur Fractures
- Lipid metabolism and disorders
- Congenital Diaphragmatic Hernia Studies
- Hernia repair and management
- Eosinophilic Esophagitis
- Anesthesia and Pain Management
- Esophageal and GI Pathology
- Gastric Cancer Management and Outcomes
- Mechanical Circulatory Support Devices
University of Alabama at Birmingham
2016-2024
University of Alabama at Birmingham Hospital
2023
Birmingham VA Medical Center
2023
Sewickley Valley Hospital
2022
University of Pittsburgh
2022
University of Phoenix
2019
University of Arizona
2019
University of Missouri Hospital
2016-2018
University of Missouri
2013-2015
Columbia College - South Carolina
2014
Sarcopenia is strongly associated with poor outcomes and mortality following injury among the geriatric population. Diagnosis using psoas area most common but may be unavailable given limited radiographic evaluation low-impact injuries. Masseter has recently been identified as an available alternative 2-year injury. We sought to validate this measure its association early severe traumatic brain (sTBI) a retrospective analysis of all trauma patients sTBI admitted from 2011-2016 our center....
Damage control surgery has revolutionized trauma surgery. Use of damage allows for resuscitation and reversal coagulopathy at the risk loss abdominal domain intra-abdominal complications. Temporary closure is possible with multiple techniques, choice which may affect ability to achieve primary fascial further complication. A retrospective analysis all patients requiring laparotomy upon admission an ACS-verified level one center from 2011 2016 was performed. Demographic clinical data...
Traumatic hemorrhage is the leading cause of preventable death. Early in resuscitation, only RhD-positive red blood cells are likely to be available, which poses a small risk causing harm future fetus if transfused an RhD-negative females childbearing age (CBA), that is, 15 49 years old. We sought characterize how population, particular CBA, felt about emergency administration vis-a-vis potential fetal harm.
Introduction Medical readiness is of paramount concern for active-duty military providers. Low volumes complex trauma in treatment facilities has driven the armed forces to embed surgeons high-volume civilian centers maintain clinical readiness. It unclear what impact this strategy may have on patient outcomes these centers. We sought compare emergent laparotomy (ETL) between Air Force Special Operations Surgical Team (SOST) general and faculty at an American College Surgeons verified level...
Angiopoietin-1 (Agpt-1) and Agpt-2 are cytokine regulators of vascular endothelial integrity. Elevated plasma levels ratios Agpt-2:Agpt-1 associated with adverse outcomes in adult trauma pediatric sepsis populations. However, the behavior angiopoietins after has not been characterized, their relationship to glycocalyx damage, indicated by syndecan-1 (Syn-1) levels, established.We performed a secondary analysis prospectively collected data from 52 patients 12 control at level one center 2013...
Traumatic brain injury (TBI) represents a global pandemic and is currently leading cause of related death worldwide. Unfortunately, those who survive initial often suffer devastating functional, social, economic consequences. Among most affected by the sequelae TBI geriatric population, mortality at significantly higher rates than other population cohorts. Furthermore, this particularly unfortunate given increased incidence head trauma among elderly when compared to their younger peers...
Abstract Background The use of blood products early in the resuscitation bleeding trauma patients is widely accepted, but made difficult by limited supplies D− red cell (RBC)‐containing products. Use D+ RBC‐containing would alleviate this issue, could lead to alloimmunization. Risk associated with transfusing RBC emergency situations being reconsidered. level concern surrounding transfusion as it relates future fetal harm was surveyed among surgeons and nurses. Methods Faculty staff...
The relative effectiveness of live tissue (LT)- and inanimate simulation (SIM)-based training combat medics is the subject intense debate. A structured interview was utilized to determine modality preferences perceived value LT- SIM-based casualty care 25 senior special operations medics. Participant demographics experience, Likert scale-based assessment value, selection preferred for 11 procedures, 12 open-ended questions probing opinions limitations benefits were collected from this...
Introduction Extracorporeal membrane oxygenation (ECMO) in acute trauma patients is a poorly characterized event. While ECMO most commonly has been deployed for advanced cardiopulmonary or respiratory failure following initial resuscitation, growing levels of evidence out hospital cardiac arrest support early cannulation as part resuscitative efforts. We sought to perform descriptive analysis evaluating traumatically injured patients, who were placed on ECMO, during their resuscitation...
Gunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, furthermore whether with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought determine rates of donation, as well identify factors associated both outcomes in CPR.We performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011...
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic presents a threat to health care systems worldwide. Trauma centers may be uniquely impacted, given the need for rapid invasive interventions in severely injured and growing incidence of community infection. We discuss impact that SARS-CoV-2 has had our trauma center steps limit potential exposures.We performed retrospective evaluation service, from March 16 30, following appearance state. recorded daily number patients...
Abstract Background Multiple thresholds are defined to identify patients at risk of death from hemorrhage, including massive transfusion (MT), critical administration threshold (CAT), and resuscitation intensity (RI). All fail account for the use whole blood (WB). We hypothesized that a definition WB would better predict early mortality following trauma. Methods This is retrospective review all trauma with activation MT protocol December 2018 February 2020. Combinations WB, RBCs, fresh...
Damage control laparotomy allows for resuscitation and reversal of coagulopathy with improved mortality. In-tra-abdominal packing is often used to limit hemorrhage. Temporary abdominal closure associated increased rates subse-quent intra-abdominal infection. The effect duration antibiotics unknown on these infection rates. We sought determine the role in damage surgery.A retrospective analysis all trauma patients requiring admission an ACS verified level one center from 2011 2016 was...
The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial failed to demonstrate a mortality difference for hemorrhaging patients receiving balanced (1:1:1) vs 1:1:2 resuscitation at 24 hours 30 days. Recent guidelines recommend earlier end points hemorrhage-control trials, the use of contemporary statistical methods. aim this post hoc analysis PROPPR was evaluate impact strategy early time using Bayesian analytical framework.Bayesian hierarchical models were created assess...
Missed injury of the diaphragm may result in hernia formation, enteric strangulation, and death. Compounding problem, diaphragmatic injuries are rare difficult to diagnose with standard imaging. As such, for patients high suspicion injury, operative exploration remains gold diagnosis. no current data currently exist, we sought perform a pragmatic evaluation diagnostic ability 256-slice multidetector CT scanners diagnosing after trauma.A retrospective review trauma from 2011 2018 was...
Traumatic injury and hemorrhagic shock result in endothelial cell activation vascular dysfunction that, if not corrected, can propagate multiorgan failure. Angiopoietin-1 angiopoietin-2 are important regulators of function, the ratio plasma angiopoietin-2-to-1 is a useful indicator overall health. We therefore characterized angiopoietin-2/-1 ratios over time after trauma adults an effort to gain insight into pathophysiology that may drive post-traumatic vasculopathy organ injury. performed...
Changes in electrodermal activity (EDA) correlate with arousal and stress during stimulating experiences. We hypothesized that associations exist between short-term performance gains changes EDA. A total of 187 combat medics were randomly assigned to simulation (S), live tissue (L), or video (V) based training the recognition treatment nerve agent casualties. Change EDA from baseline was quantified for tonic phasic responses categorized as positive (>+10%), no change (±10%), negative...
We evaluated patient outcomes after early, small volume red blood cell (RBC) transfusion in the setting of presumed hemorrhagic shock. hypothesized that with even amounts would be associated more complications.Retrospective review trauma patients admitted to a Level 1 center between 2016-2021. Patients predicted require massive who survived ≥72 h were categorized according units RBCs transfused first 24 h. A Cox regression model stratified by dichotomized ISS and adjusted for SBP <90 mm Hg...
Rib fractures are common among trauma patients and may result in significant morbidity mortality. There numerous treatment options, but ideal management is unclear. Delivery of local anesthetic via an analgesia catheter for continuous intercostal nerve blockade offers attractive potential option with rib fractures.We performed a single-center, retrospective case-control analysis multiple from 2016 to 2018, comparing managed standard care. Matching was 2:1 ratio by Injury Severity Score, age,...
Surgical site infection remains a preeminent focus of perioperative care given its huge potential to impact outcomes, length stay, and mortality. Numerous governmental regulatory bodies have developed recommendations limit the incidence surgical infection. These continue evolve at rapid pace, with all aspects sharing ongoing scrutiny. Implementation these strategies should remain providers postoperative infections optimize outcomes. This review contains 4 figures, 14 tables, 109 references....