A5027624570- Intensive Care Unit Cognitive Disorders
- Hemoglobinopathies and Related Disorders
- Research on Leishmaniasis Studies
- Anesthesia and Sedative Agents
- Trypanosoma species research and implications
- Anesthesia and Neurotoxicity Research
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Healthcare Policy and Management
- Organ Donation and Transplantation
- Palliative Care and End-of-Life Issues
- Neonatal Respiratory Health Research
- Emergency and Acute Care Studies
- Venous Thromboembolism Diagnosis and Management
- Infant Development and Preterm Care
- Parasites and Host Interactions
- Family and Patient Care in Intensive Care Units
- Cardiac, Anesthesia and Surgical Outcomes
- Airway Management and Intubation Techniques
- Congenital Diaphragmatic Hernia Studies
- Craniofacial Disorders and Treatments
- Animal Nutrition and Physiology
- Central Venous Catheters and Hemodialysis
- Cellular transport and secretion
- Moyamoya disease diagnosis and treatment
- Pediatric Pain Management Techniques
Children's Healthcare of Atlanta
2024
Texas Children's Hospital
2018-2023
Baylor College of Medicine
2016-2023
Vanderbilt University Medical Center
2013-2015
Vanderbilt University
2015
University of Iowa
2007-2012
Iowa City VA Medical Center
2012
Iowa City Public Library
2009
OBJECTIVES: To inform workforce planning for pediatric critical care (PCC) physicians, it is important to understand current staffing models and the spectrum of clinical responsibilities physicians. Our objective was describe expected workload associated with a full-time equivalent (cFTE) in PICUs across U.S. Pediatric Critical Care Chiefs Network (PC3N). DESIGN: Cross-sectional survey. SETTING: participating PC3N. SUBJECTS: PICU division chiefs or designees PC3N from 2020 2022....
Visceral leishmaniasis (VL) caused by Leishmania chagasi is endemic to northeast Brazil. A positive delayed-type hypersensitivity skin test response (DTH+) a marker for acquired resistance disease, clusters in families and may be genetically controlled. Twenty-three single nucleotide polymorphisms (SNPs) were genotyped the cytokine 5q23.3-q31.1 region IRF1-IL5-IL13-IL4-IL9-LECT2-TGFBI 102 (323 DTH+; 190 DTH-; 123 VL individuals) from Data 20 SNPs analyzed association with DTH+/- status using...
The protozoan Leishmania chagasi can cause disseminated, fatal visceral leishmaniasis (VL) or asymptomatic infection in humans. We hypothesized that host genetic factors contribute to this variable response infection. A family study was performed neighborhoods of endemicity for L. near Natal northeastern Brazil. Study subjects were assessed the presence VL infection, which defined by a positive delayed-type hypersensitivity (DTH) skin test antigen without disease symptoms. genomewide panel...
Visceral leishmaniasis is a potentially fatal infectious disease caused by the protozoan parasite Leishmania infantum/chagasi in New World, or L. donovani Old World. Infection leads to variety of outcomes ranging from asymptomatic infection active disease, characterized fevers, cachexia, hepatosplenomegaly and suppressed immune responses. We reasoned that events occurring during initial few hours when encounters cells innate adaptive systems are likely influence eventual response develops....
Background Previous findings indicate that susceptibility to Leishmania (Viannia) panamensis infection of monocyte-derived macrophages from patients and asymptomatically infected individuals were associated with the adaptive immune response clinical outcome. Methodology/Principal Findings To understand basis for this difference we examined differential gene expression human following exposure L. (V.) panamensis. Gene activation profiles determined using healthy volunteers cultured or without...
This policy statement aims to enhance comfort and increase knowledge of pediatric organ donation transplantation the general community, specifically focusing on health care professional medical home. The will for neonates, infants, children, adolescents who may become donors or transplant recipients and, thus, is a crucial member patient's team. Understanding donation, transplantation, follow-up are important primary engagement. Furthermore, play role in shaping public policies related...
The purpose of this policy statement is to update the 2004 American Academy Pediatrics clinical report and provide enhanced guidance for institutions, administrators, providers in development operation a pediatric intermediate care unit (IMCU). Since 2004, there have been significant advances medical, surgical, critical that resulted an evolution acuity complexity children potentially requiring IMCU admission. A group 9 experts care, hospital medicine, surgery developed consensus on priority...
Summary Visceral leishmaniasis (VL) in northeast Brazil is a disease caused by infection with the protozoan Leishmania chagasi . Infection leads to variable clinical outcomes ranging from asymptomatic potentially fatal disease. Prior studies suggest genetic background of host contributes development different after infection, although it not known if ancestral itself influences outcomes. VL endemic peri‐urban areas around city Natal Brazil. The population mixture distinct racial and ethnic...
Leishmania braziliensis is an intracellular parasite that resides mostly in macrophages. Both the genome and clinical disease manifestations show considerable polymorphism. Clinical syndromes caused by L. include localized cutaneous (CL), mucosal (ML) disseminated leishmaniasis (DL). Our prior studies showed genetically distinct clades associate with different types. Herein we hypothesized that: (1) induces changes macrophage gene expression facilitates infection; (2) infection of...
We report here a newborn female infant with striking features consistent severe Pfeiffer syndrome (PS). is rare craniofacial disorder that has an autosomal dominant mode of inheritance (OMIM 101600). Our patient had unexpected differences between her clinical and those predicted from genetic tests. The following were noted: exophthalmos, syndactyly, upper extremity contractures, relative macroglossia. A head computed tomography three-dimensional reconstruction showed she did not have...
In this report, the authors describe case of a teenage boy who presented with hypertensive emergency, posterior reversible encephalopathy syndrome, and hydrocephalus due to fourth ventricle outlet obstruction. Posterior syndrome is well-characterized but uncommon in children that generally triggered by severe hypertension. The unusual clinical picture patient, had isolated cerebellar edema leading obstructive hydrocephalus, has been rarely described children.
Arginine is a conditionally essential amino acid, the precursor for nitric oxide and key factor in cell proliferation, protein synthesis, energy metabolism. When there increased demand setting of inflammation, ischemia-reperfusion injury, organ dysfunction, endogenous arginine production falls short, external supplementation may be necessary. The goal this study was to assess changes concentrations plasma arginine, citrulline, ornithine, glutamine, arginase infants children undergoing...
Abstract Background/aim Low-cost commercial bCPAP devices have been deployed in resource-limited settings to treat neonatal respiratory failure. The use of these has increased access pediatric support for infants. However, constrained resources may result substitution recommended consumables and/or older age groups. We hypothesized that commercially available devices, the standard WHO-style device and various improvised adaptations would all generate effective, safe positive pressure at...
Abstract Data on outcomes and interventions for children with sickle cell disease (SCD) admitted to a pediatric intensive care units (PICU) are unknown. We provide the first comprehensive multi-center report PICU associated death, need invasive respiratory support or stroke among critically ill SCD. collected retrospective cohort data from January 1, 2012 December 31, 2019 utilizing Virtual Pediatric Systems, LLC database. identified 3388 unique SCD, accounting total of 5264 admissions 138...
The aim of this study was to evaluate single-stage laryngotracheal reconstruction (ssLTR) outcomes before and after the implementation a postoperative care protocol in pediatric patients.A case-control with chart review conducted at 2 tertiary academic centers from 2010 2016. Pediatric patients who underwent ssLTR were compared those did not receive under protocol. Data regarding perioperative management collected using χ2 Wilcoxon rank tests. Planned extubation, length intubation intensive...
L eucine‐ R ich epeat‐ C ontaining 8 (LRRC8) family members are essential components of ICl swell , the evolutionarily‐conserved anion conductance that modulates cytoplasmic volume in response to cell swelling. Our previous work has demonstrated 2Cl ‐ /H + anti‐porter ClC‐3 is required for TNFα‐induced endosomal superoxide (O 2 • ) production by Nox1, as well subsequent activation and NF‐κB both HEK293 vascular smooth muscle cells (VSMC). We hypothesized TNFα a step signaling. Immunostaining...
Cytokines such as TNFα drive inflammation via transcription factors including NF‐κB. Biologic agents targeting modulate disease, but require I.V. administration and cause immune suppression. Thus there is a need to develop oral, titratable therapies. In smooth muscle cells, NF‐κB activation by depends upon intracellular, endosomal ROS production Nox1 deficiency of ClC‐3 disrupts at this site. also activates I Cl swell ROS. We hypothesized that activity required for TNFα. used...
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ClC‐3 is required for NADPH Oxidase (Nox)‐dependent endosomal superoxide (O 2 ‐ ) production and NF‐kB activation in response to cytokines. We co‐localized ClC‐3, Rab‐GTPases O following TNFa treatment of HEK293 cells. Rab5(A, B, C), Rab7 (GFP, mCherry, RFP tags) (ClC‐3‐HyPer fusion protein) were visualized by confocal microscopy. Expressed ClC‐3‐GFP was precipitated using bead‐immobilized GFP‐binding protein under detergent‐free conditions Western analysis assessed ClC‐3‐Rab associations....
Introduction: Chloral hydrate (CH) has long been utilized as a pediatric procedural sedation agent. However, very little is published describing CH use in intensive care unit (PICU) setting. The aim of this retrospective observational cohort study was to investigate and describe the mechanically-ventilated, critically ill children at large tertiary referral hospital. Methods: Data were extracted from hospital electronic medical record locally maintained registry all admitted PICU between...