A5071857490- Antibiotics Pharmacokinetics and Efficacy
- Poisoning and overdose treatments
- Pharmacogenetics and Drug Metabolism
- Antibiotic Resistance in Bacteria
- Drug-Induced Hepatotoxicity and Protection
- Malaria Research and Control
- Acute Kidney Injury Research
- Pharmaceutical studies and practices
- Pneumonia and Respiratory Infections
- Hormonal and reproductive studies
- Epilepsy research and treatment
- Computational Drug Discovery Methods
- Pharmacology and Obesity Treatment
- Bacterial Identification and Susceptibility Testing
- Sepsis Diagnosis and Treatment
- Muscle and Compartmental Disorders
- Indoor Air Quality and Microbial Exposure
- Probiotics and Fermented Foods
- Travel-related health issues
- Dermatological diseases and infestations
- Occupational Health and Performance
- Suicide and Self-Harm Studies
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Vibrio bacteria research studies
- Occupational exposure and asthma
Walter Reed Army Institute of Research
2019-2024
Uniformed Services University of the Health Sciences
2019-2021
Walter Reed National Military Medical Center
2018-2019
Temple University
2016
Naval Medical Research Command
2015
Hôpital Civil, Strasbourg
1976
Novel hemoperfusion systems are emerging for the treatment of sepsis. These devices can directly remove pathogens, pathogen-associated molecular patterns, cytokines, and other inflammatory markers from circulation. However, significant safety concerns such as potential antibiotic clearance need to be addressed prior these being used in large clinical studies.
Certain dermatologic conditions are known to show seasonal variations in frequency, the reasons for which unclear but some cases may be attributable changes ambient weather conditions.The current study was conducted determine whether trends might exist including erythema multiforme, guttate psoriasis, dyschromicum perstans (ashy dermatosis), pityriasis lichenoides, and rosea.Data were derived from a 15-year retrospective review of electronic records large dermatopathology laboratory located...
Severe burn injury involves widespread skin and tissue damage leading to systemic inflammation, hypermetabolism multi-organ failure. The hypermetabolic phase of has been associated with increased antibiotic clearance; however, critical illness in the absence may also induce similar physiologic changes. Continuous renal replacement therapy (CRRT) is often implemented critically ill patients affect clearance. Although pharmacokinetics (PK) meropenem described both non-burn populations, direct...
Abstract Introduction Personalized medicine is the right treatment, to patient, at dose. Knowledge of genetic predisposition variable metabolism and distribution drugs within body currently available as pharmacogenomic testing one pillars personalized medicine. Pharmacogenomic growing. It has become part guidelines for dosing on FDA labels been used by health care organizations improve outcomes reduce adverse events. Additionally, it approved direct-to-consumer purchase cause concern patient...
Continuous venovenous hemofiltration (CVVH) is a life-sustaining procedure in patients with severe burns and acute kidney injury. Physiologic changes from burn injury use of CVVH may alter imipenem pharmacokinetics (PK). We aimed to compare clearance (CL) without CVVH, determine the effect on volume distribution (CVVH, n = 12; no 11), combination previously published models. Model qualification was performed standard diagnostics comparing predicted PK parameters/time-concentration profiles...
Critical illness caused by burn and sepsis is associated with pathophysiologic changes that may result in the alteration of pharmacokinetics (PK) antibiotics. However, it unclear if one mechanism critical alters PK more significantly than another. We developed a population model for piperacillin tazobactam (pip-tazo) using data from 19 critically ill patients (14 non-burn trauma 5 burn) treated Military Health System. A two-compartment best described pip-tazo data. There were no significant...
The Seraph® 100 Microbind® Affinity Blood Filter (Seraph 100) is a hemoperfusion device that can remove pathogens from central circulation. However, the effect of Seraph on achieving pharmacodynamic (PD) targets not well described. We sought to determine impact ability achieve PD for commonly used antibiotics.Estimates antibiotic clearance were obtained via literature. For vancomycin and gentamicin, published pharmacokinetic models explore probability target attainment (PTA). meropenem...
The authors present a case of an elderly man with history Waldenstrom macroglobulinaemia in remission who presented progressively worsening gait abnormalities and falls for several months. His examination was notable bilateral lower extremity weakness unsteady gait. Brain spinal MRI showed focal leptomeningeal enhancement the brain column. Lumbar puncture performed cerebrospinal fluid flow cytometry demonstrated monoclonal CD5/CD10-negative, CD20-positive B-cell lymphocyte population...
Salmonella enterica, serovar Typhi (S. Typhi), a causative agent of enteric fever (typhoid fever), predominately affects populations in developing regions with poor access to clean food and water. In addition, travelers these are at risk exposure.We report the epidemiological characteristics S. cases among active duty United States military personnel from 1998 2011 using data obtained Defense Medical Surveillance System. Cases were identified based on International Classification for Disease...
Abstract Purpose To explore patterns of antimuscarinic medication as a risk factor for type 2 diabetes mellitus (T2DM). Methods This is retrospective cohort study females 18 years or older within the Military Health System from 2006 to 2016. Administrative and claims data were used select patients who initiated therapy with tolterodine, fesoterodine, oxybutynin, darifenacin, solifenacin, trospium. Patients no documented history T2DM followed occurrence T2DM, end loss eligibility. Rates...
Abstract Background Malaria remains the top infectious disease threat facing U.S. military in many forward operating environments. Compliance with malaria chemoprophylaxis a critical component preventing deployed Service Member. Studies of previous operations show that compliance is consistently higher weekly versus daily dosing regimens. Current FDA approved options have contraindications can limit prescribing. The combination chloroquine (CQ) azithromycin (AZ) has previously been shown to...
ABSTRACT Introduction Clinical utilization of pharmacogenomics (PGx) testing is highly institutionally dependent, and little information known about provider practices PGx in the Military Health System (MHS). In this study, we aimed to characterize Pharmacogenetics Implementation Consortium (CPIC) actionable prescription (Rx) patterns their temporal relationship with MHS. Methods Using data from Management Analysis Reporting Tool (M2) database, retrospective cohort study included all...
We sought to better understand the utility and role of animal models infection for Food Drug Administration (FDA)-approved antibiotics indications community-, hospital-acquired-, ventilator-associated bacterial pneumonia (CABP, HABP, VABP), complicated urinary tract (cUTI), intra-abdominal (cIAI), acute skin structural infections (ABSSSIs). reviewed relevant documents from new drug applications (NDA) FDA-approved 2014–2019 above indications. Murine neutropenic thigh supported choice a...
Abstract Plerixafor is a CXCR4 antagonist approved in 2008 by the FDA for hematopoietic stem cell collection. Subsequently, plerixafor has shown promise as potential pathogen‐agnostic immunomodulator variety of preclinical animal models. Additionally, investigator‐led studies demonstrated prevents viral and bacterial infections patients with WHIM syndrome, rare immunodeficiency aberrant signaling. Here, we investigated whether could be repurposed to treat sepsis or severe wound infections,...
Probability of target attainment (PTA) analysis using Monte Carlo simulations has become a mainstay dose optimization. We highlight the technical and clinical factors that may affect PTA for beta-lactams.We performed mini review in adults to explore relating cefepime success how researchers incorporate into dosing decisions. In addition, we investigated, via with population pharmacokinetic (PK) model, success.The included 14 articles. results were generally consistent, given differences...
Combat injuries are complex and multimodal. Most to the extremities occur because of explosive devices such as improvised devices. Blast exposure dramatically increases risk infection in combat wounds, there is limited available information on best antibiotic treatments for these injuries. We previously demonstrated that mice exposed blast displayed a delayed clearance cefazolin from plasma liver; further semi-mechanistic modeling determined concentrations skin were reduced. Our objective...
Abstract Background Probiotics are live microbial organisms that provide benefit to the host while co-habitating in gastrointestinal tract. safe, available over counter, and have clinical by reducing number of antibiotic-associated diarrhea days. Prescriptions from providers direct consumer demand probiotics appear be on rise. Several recent animal studies demonstrated may significant effect absorption co-administered drugs. However, date, most probiotic-drug interaction models been limited...
Cefazolin is a first-line antibiotic to treat infection related deployment-associated blast injuries. Prior literature demonstrated 331% increase cefazolin liver area under the curve (AUC) in mice exposed survivable compared with controls. We repeated experiment, validated findings, and established semimechanistic two-compartment pharmacokinetic (PK) model effect compartments representing skin. found that statistically significantly increased pseudo–partition coefficient by 326% (95%...