A5085557916- Global Maternal and Child Health
- Fatty Acid Research and Health
- Cardiovascular Disease and Adiposity
- Trauma and Emergency Care Studies
- Childhood Cancer Survivors' Quality of Life
- Cancer, Lipids, and Metabolism
- Cancer survivorship and care
- Cancer Risks and Factors
- Palliative Care and End-of-Life Issues
- Abdominal Trauma and Injuries
- Child Nutrition and Water Access
- Maternal and Perinatal Health Interventions
- Pelvic and Acetabular Injuries
- Emergency and Acute Care Studies
- Global Health and Epidemiology
- Adipokines, Inflammation, and Metabolic Diseases
- European and International Law Studies
- Patient-Provider Communication in Healthcare
- Bone health and treatments
- Prostate Cancer Treatment and Research
- Frailty in Older Adults
- Family Support in Illness
- Eicosanoids and Hypertension Pharmacology
- Trauma Management and Diagnosis
- Adipose Tissue and Metabolism
Johns Hopkins Hospital
2022-2024
Harvard University
2018-2024
Johns Hopkins Medicine
2020-2024
Johns Hopkins University
2020-2024
Ariadne Diagnostics (United States)
2019-2020
Memorial Sloan Kettering Cancer Center
2014-2018
Lancaster General Hospital
2012
Rogers (United States)
2012
Fundación Juan March
2012
Scripps Mercy Hospital
2012
Chronic inflammation is recognized as a risk factor for the development of several malignancies. Local white adipose tissue (WAT) inflammation, defined by presence dead or dying adipocytes encircled macrophages that form crown-like structures (CLS), occurs in breasts (CLS-B) most overweight and obese women. Previously, we showed CLS-B associated with elevated levels proinflammatory mediators aromatase, rate-limiting enzyme estrogen biosynthesis. The increased aromatase breast provide...
The geriatric trauma patient poses unique challenges to the surgeon due occult injuries and hypoperfusion. We hypothesized that those elderly patients with significant injuries, who were not initially evaluated via activation, would suffer worse outcomes. All cases of (age ≥ 65) admitted service from years 2000 2010 included. Our activation system encompasses anatomic, physiologic, mechanism injury criteria. defined as undertriaged (UT) if they had an ISS > 15 did undergo a team but...
This study aimed to determine the relative "weight" of risk factors known be associated with venous thromboembolism (VTE) for patients trauma based on injuries and comorbidities.A retrospective review 16,608 consecutive admissions a center was performed. Patients were separated into those who developed VTE (n = 141) versus did not (16,467). Univariate analysis performed each factor reported in literature. Risk that shown significant (p < 0.05) by univariate underwent multivariate develop...
Injured geriatric patients pose unique challenges to the trauma team because of their abnormal responses shock and injury. We have developed high-risk protocol (GP) that seeks identify patients. hypothesized a GP would improve outcome in this select group patients.Patients from 2000 2010 were included. Patients 65 years or older who met based on comorbidities and/or physiologic parameters compared with those had not received before its implementation as well other non-GP This includes...
The Trauma and Injury Severity Score (TRISS) has been the approach to trauma outcome prediction during past 20 years adopted by many commercial registries. Unfortunately, its survival predictions are based upon coefficients that were derived from a data set collected in 1980s updated only once using early 1990s. We hypothesized improvements care would lead improved large database, thus making TRISS biased.The TRISSs Pennsylvania statewide registry (Collector, Digital Innovations) for 1990...
Abstract Obesity, a cause of subclinical inflammation, is risk factor for the development postmenopausal breast cancer and associated with poorer outcomes. Docosahexaenoic acid (DHA), an omega-3 fatty acid, possesses anti-inflammatory properties. We hypothesized that treatment DHA would reduce expression proinflammatory genes aromatase, rate-limiting enzyme estrogen biosynthesis, in benign tissue overweight/obese women. A randomized, placebo-controlled, double-blind phase II study given 12...
Background Evidence-based practices that reduce childbirth-related morbidity and mortality are core processes to quality of care. In the BetterBirth trial, a matched-pair, cluster-randomised controlled trial coaching-based implementation WHO Safe Childbirth Checklist (SCC) in Uttar Pradesh, India, we observed significant increase adherence practices, but no reduction perinatal mortality. Methods Within birth attendants subset study sites providing care labouring women assess individual...
Rationale: Early identification of intensive care unit (ICU) patients likely to benefit from specialist palliative could reduce the time such spend in ICU receiving inconsistent with their goals. Objectives: To evaluate real-world effects early screening for criteria a medical ICU. Methods: We performed retrospective cohort study adults admitted using causal inference approach instrumental variable analysis. The intervention consisted admissions trigger conditions and, if present, offering...
To evaluate whether integration of the Opportunity-Ability-Motivation plus Supplies (OAMS) framework into coaching improved delivery essential birth practices in a low-resource setting.This prospective mixed-methods study used routine visit data obtained from first eight intervention facilities BetterBirth trial Uttar Pradesh, India, between December 19, 2014, and October 21, 2015. The 8-month was peer that integrated OAMS to support uptake WHO Safe Childbirth Checklist. Descriptive...
Patient satisfaction surveys are increasingly being used as a measure of physician performance in hospital setting. We sought to determine what role the clinical condition is treating has on overall patient scores. scores were calculated for elective and emergent general surgery trauma patients eight surgeons taking care all three types patients. Both (PP) (GP) calculated. Mean (± standard deviation) between groups compared with P < 0.05 significance. Of 1521 3779 patients, there was 14.8...
40 Background: Chronic inflammation predisposes to several malignancies. We previously demonstrated an obesity → aromatase axis in breast tissue. As is a risk factor for postmenopausal (PoM) but not premenopausal (PreM) cancer (BC), we examined whether menopause and body mass index (BMI) independently impact white adipose tissue (WAT) inflammation. Methods: WAT was prospectively collected from patients (pts) 04/10 08/13. inflammation, detected by CD68 immunohistochemistry, defined the...
Although cancer care is often contextualized in terms of survival, there are other important outcomes, such as quality life and cost care. The ASCO Value Framework assesses the value therapies not only survival but also with consideration financial cost. Early palliative for patients advanced associated improved life, mood, symptoms, overall patients, well savings. While has been shown to have numerous benefits, impact real-world implementation outpatient embedded on value-based metrics...
1126 Background: TNBC is recognized to be heterogeneous based on gene expression profiling. An AR+, androgen-dependent subset of benefits from antiAR drugs. FOXA1, a nuclear mediator steroid receptor signaling involved in the regulation ER and AR. FOXA1 ER+ BC correlates with better prognosis; significance not established. We report rates relationship AR, basal markers outcome retrospective cohort pts TNBC. Methods: identified 1,032 resectable, (ER/PR<1%; HER2 0-2+/FISH <2) who had surgery...
Although cancer care is often contextualized in terms of survival, there are other important outcomes, such as quality life and cost care. The ASCO Value Framework assesses the value therapies not only survival but with consideration financial cost. Early palliative for patients advanced associated improved life, mood, symptoms, overall savings. While has been shown to have numerous benefits, impact real-world implementation outpatient embedded on value-based metrics fully understood. We...
512 Background: Chronic inflammation predisposes to several malignancies. We previously demonstrated an obesity → aromatase axis in breast tissue. As is a risk factor for postmenopausal (PoM) but not premenopausal (PreM) cancer (BC), we examined whether menopause and body mass index (BMI) independently impact white adipose tissue (WAT) inflammation. Methods: WAT was prospectively collected from patients (pts) 04/10 – 08/13. inflammation, detected by CD68 immunohistochemistry, defined the...
63 Background: Obesity, a common cause of chronic inflammation, is associated with an increased risk high grade, lethal prostate cancer (PC) and poor outcomes. The existence or clinical importance periprostatic white adipose tissue inflammation (WATi) in patients (pts) PC has not been previously described. We examined the relationships among WATi 1) tumor clinicopathologic features, 2) host factors including age, body mass index (BMI), circulating metabolic factors. Methods: Periprostatic...
<div>Abstract<p>Obesity, a cause of subclinical inflammation, is risk factor for the development postmenopausal breast cancer and associated with poorer outcomes. Docosahexaenoic acid (DHA), an omega-3 fatty acid, possesses anti-inflammatory properties. We hypothesized that treatment DHA would reduce expression proinflammatory genes aromatase, rate-limiting enzyme estrogen biosynthesis, in benign tissue overweight/obese women. A randomized, placebo-controlled, double-blind phase...
<div>Abstract<p>Obesity, a cause of subclinical inflammation, is risk factor for the development postmenopausal breast cancer and associated with poorer outcomes. Docosahexaenoic acid (DHA), an omega-3 fatty acid, possesses anti-inflammatory properties. We hypothesized that treatment DHA would reduce expression proinflammatory genes aromatase, rate-limiting enzyme estrogen biosynthesis, in benign tissue overweight/obese women. A randomized, placebo-controlled, double-blind phase...