A5025601376- Opioid Use Disorder Treatment
- Substance Abuse Treatment and Outcomes
- Emergency and Acute Care Studies
- Cardiac Health and Mental Health
- Acute Myocardial Infarction Research
- Homelessness and Social Issues
- Poisoning and overdose treatments
- Prenatal Substance Exposure Effects
- Health Policy Implementation Science
- Alcohol Consumption and Health Effects
- Cardiac Arrest and Resuscitation
- Heart Failure Treatment and Management
- HIV, Drug Use, Sexual Risk
- Alcoholism and Thiamine Deficiency
- Cardiac Imaging and Diagnostics
- Cardiovascular Health and Risk Factors
- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Pharmaceutical Practices and Patient Outcomes
- Pain Management and Opioid Use
- Sex and Gender in Healthcare
- Health disparities and outcomes
- Elder Abuse and Neglect
- Cardiovascular Issues in Pregnancy
- Suicide and Self-Harm Studies
Yale University
2016-2025
University College London
2025
Athinoula A. Martinos Center for Biomedical Imaging
2025
Harvard University
2002-2025
Massachusetts General Hospital
2025
Massachusetts Institute of Technology
2025
Yale New Haven Hospital
2006-2023
Yale New Haven Health System
2020-2023
Icahn School of Medicine at Mount Sinai
2021-2022
Friends Research Institute
2022
<h3>Importance</h3> Opioid-dependent patients often use the emergency department (ED) for medical care. <h3>Objective</h3> To test efficacy of 3 interventions opioid dependence: (1) screening and referral to treatment (referral); (2) screening, brief intervention, facilitated community-based services (brief intervention); (3) ED-initiated with buprenorphine/naloxone, primary care 10-week follow-up (buprenorphine). <h3>Design, Setting, Participants</h3> A randomized clinical trial involving...
As coronavirus disease 2019 (COVID-19) spread throughout the US in early months of 2020, acute care delivery changed to accommodate an influx patients with a highly contagious infection about which little was known.To examine trends emergency department (ED) visits and that led hospitalizations covering 4-month period leading up during COVID-19 outbreak US.This retrospective, observational, cross-sectional study 24 EDs 5 large health systems Colorado (n = 4), Connecticut 5), Massachusetts...
Background We compared the clinical characteristics and outcomes of young patients with myocardial infarction nonobstructive coronary arteries ( MINOCA ) versus obstructive disease (myocardial due to artery [ MI ‐ CAD ]) among by sex subtype. Methods Results Between 2008 2012, VIRGO (Variation in Recovery: Role Gender on Outcomes Young AMI Patients) prospectively enrolled acute aged 18 55 years 103 hospitals at a 2:1 ratio women men. Using an angiographically driven taxonomy, we defined as...
Background: Some studies report that women are less likely to present with chest pain for acute myocardial infarction (AMI). Information on symptom presentation, perception of symptoms, and care-seeking behaviors is limited young patients AMI. Methods: We interviewed 2009 976 men aged 18 55 years hospitalized AMI at 103 US hospitals participating in the VIRGO study (Variation Recovery: Role Gender Outcomes Young Patients). Structured patient interviews during index hospitalization were used...
Background: The relative prevalence and clinical importance of monogenic mutations related to familial hypercholesterolemia high polygenic score (cumulative impact many common variants) pathways for early-onset myocardial infarction remain uncertain. Whole-genome sequencing enables simultaneous ascertainment both each individual. Methods: We performed deep-coverage whole-genome 2081 patients from 4 racial subgroups hospitalized in the United States with (age ≤55 years) recruited a 2:1...
Sex disparities in reperfusion therapy for patients with acute ST-segment-elevation myocardial infarction have been documented. However, little is known about whether these patterns exist the comparison of young women men.We examined sex differences rates, types therapy, and proportion exceeding American Heart Association time guidelines a prospective observational cohort study (2008-2012) 1465 18 to 55 years age, as part US Variations Recovery: Role Gender on Outcomes Young AMI Patients...
<h3>Importance</h3> Treatment of opioid use disorder (OUD) with buprenorphine decreases and prevents morbidity mortality. Emergency departments (EDs) are an important setting for initiation patients untreated OUD; however, readiness varies among ED clinicians. <h3>Objective</h3> To characterize barriers facilitators to initiate the treatment OUD in identify opportunities promote across multiple clinician types. <h3>Design, Setting, Participants</h3> Using data collected from April 1, 2018,...
Study objectivePeople with opioid use disorder are vulnerable to disruptions in access addiction treatment and social support during the COVID-19 pandemic. Our study objective was understand changes emergency department (ED) utilization following a nonfatal overdose compared historical controls 6 healthcare systems across United States.MethodsOpioid overdoses were retrospectively identified among adult visits 25 EDs Alabama, Colorado, Connecticut, North Carolina, Massachusetts, Rhode Island...
<h3>Importance</h3> Emergency departments (EDs) sporadically use a high-dose buprenorphine induction strategy for the treatment of opioid disorder (OUD) in response to increasing potency illicit drug supply and commonly encountered delays access follow-up care. <h3>Objective</h3> To examine safety tolerability (>12 mg) patients with OUD presenting an ED. <h3>Design, Setting, Participants</h3> In this case series ED encounters, data were manually abstracted from electronic health records...
This cohort study examines the incidence of precipitated withdrawal comparing traditional sublingual buprenorphine with a 7-day extended-release injectable initiated in emergency department (ED).
To determine whether simulation training of ultrasound (US)-guided central venous catheter (CVC) insertion skills on a partial task trainer improves cannulation and success rates in clinical practice.This prospective, randomized, controlled, single-blind study first- second-year residents occurred at tertiary care teaching hospital from January 2007 to September 2008. The intervention group (n = 90) received didactic hands-on, competency-based course US-guided CVC insertion, whereas the...
<h3>Importance</h3>Current efforts to improve health care focus on hospital readmission rates as a marker of quality and the effectiveness transitions in during period after acute is received. Emergency department (ED) visits are also hospital-based following discharge but little known about ED use this period.<h3>Objectives</h3>To determine degree which readmissions contribute overall services within 30 days from hospitals, describe reasons patients return for visits, these patterns among...
Objective Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff screen, perform brief intervention refer treatment (SBIRT). We describe here implementation at 14 Academic EDs a structured SBIRT curriculum determine if this learning experience improves provider beliefs practices. Methods ED faculty, residents, nurses, physician extenders, social workers, Medical Technicians (EMTs) were surveyed prior...
Young women with acute myocardial infarction (AMI) have a higher risk of adverse outcomes than men. However, it is unclear how young AMI are different from men across spectrum characteristics. We sought to compare and at the time on six domains demographic clinical factors in order determine whether they distinct profiles. Using data Variation Recovery: Role Gender Outcomes Patients (VIRGO), prospective cohort study aged ⩽55 years hospitalized for (n = 3501) United States Spain, we evaluated...
Objective A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection drug intoxication suicides in the United States. We evaluated relative importance suicide notes history classification by versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods. Methods This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled undetermined...
Background— Younger age and female sex are both associated with greater mental stress in the general population, but limited data exist on status of perceived young middle-aged patients presenting acute myocardial infarction. Methods Results— We examined difference stress, contributing factors to this difference, whether helps explain sex-based disparities 1-month recovery using from 3572 infarction (2397 women 1175 men) 18 55 years age. The average score 14-item Perceived Stress Scale at...