A5040587603- Research on Leishmaniasis Studies
- Antibiotic Resistance in Bacteria
- HIV/AIDS Research and Interventions
- Trypanosoma species research and implications
- COVID-19 Clinical Research Studies
- SARS-CoV-2 and COVID-19 Research
- HIV/AIDS drug development and treatment
- Antibiotics Pharmacokinetics and Efficacy
- Bacillus and Francisella bacterial research
- Vibrio bacteria research studies
- Long-Term Effects of COVID-19
- HIV Research and Treatment
- Urinary Tract Infections Management
- Antibiotic Use and Resistance
- Trauma and Emergency Care Studies
- Viral Infections and Vectors
- Disaster Response and Management
- Clostridium difficile and Clostridium perfringens research
- Hepatitis B Virus Studies
- HIV-related health complications and treatments
- Vector-borne infectious diseases
- Surgical site infection prevention
- HIV, Drug Use, Sexual Risk
- Antifungal resistance and susceptibility
- Mosquito-borne diseases and control
MedStar Washington Hospital Center
2016-2025
Association Clinique et Thérapeutique Infantile du Val de Marne
2023-2024
Walter Reed Army Institute of Research
2004-2024
Health and Education Research Management and Epidemiologic Services (United States)
2023
MedStar Georgetown University Hospital
2019-2023
Georgetown University
2015-2023
MedStar Health
2019-2022
Washington Hospital
2020-2021
University of Calgary
2018
Foothills Medical Centre
2018
The incidence of acute renal failure, defined by the risk, injury, or failure criteria RIFLE (risk, loss, and end-stage kidney disease), in 66 patients who received colistimethate sodium was 45%, 21% stopped therapy because nephrotoxicity. should be used future to allow for comparison nephrotoxicity among studies.
The poor outcome of the coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, is associated with systemic hyperinflammatory response and immunopathology. Although inflammasome oxidative stress have independently been implicated in COVID-19, it poorly understood whether these two pathways cooperatively contribute to disease severity. Herein, we found an enrichment CD14highCD16- monocytes displaying activation evidenced caspase-1/ASC-speck formation severe COVID-19 patients when compared...
Importance Immune dysregulation contributes to poorer outcomes in COVID-19. Objective To investigate whether abatacept, cenicriviroc, or infliximab provides benefit when added standard care for COVID-19 pneumonia. Design, Setting, and Participants Randomized, double-masked, placebo-controlled clinical trial using a master protocol immunomodulators treatment of participants hospitalized with The results 3 substudies are reported from 95 hospitals at 85 research sites the US Latin America....
The malaria sporozoite vaccine candidate RTS,S, formulated with an oil-in-water emulsion plus the immunostimulants monophosphoryl lipid A and saponin derivative QS21 (vaccine 3), recently showed superior efficacy over two other experimental formulations. Immunized volunteers were followed to determine duration of protective immune responses. Antibody levels decreased between one-third one-half peak values 6 months after last dose vaccine. T cell proliferation interferon-γ production in vitro...
Major advances in combat casualty care have led to increased survival of patients with complex extremity trauma. Invasive fungal wound infections (IFIs) are an uncommon, but increasingly recognized, complication following trauma that require greater understanding risk factors and clinical findings reduce morbidity.The patient population includes US military personnel injured during from June 2009 through December 2010. Case definition required necrosis on successive debridements IFI evidence...
Background. Colistin resistance is of concern since it increasingly needed to treat infections caused by bacteria resistant all other antibiotics and has been associated with poorer outcomes. Longitudinal data from in vivo series are sparse. Methods. Under a quality-improvement directive intensify infection-control measures, extremely drug-resistant (XDR) undergo phenotypic molecular analysis. Results. Twenty-eight XDR Acinetobacter baumannii isolates were longitudinally recovered during...
Treatment options for cutaneous leishmaniasis in the United States are problematic because available products either investigational, toxic, and/or of questionable effectiveness. A retrospective review patients receiving liposomal amphotericin B through Walter Reed Army Medical Center treatment during 2007-2009 was conducted. Twenty who acquired disease five countries and with different strains Leishmania were treated, whom 19 received a full course treatment. Sixteen (84%) experienced cure...
Background. Understanding the impact of hepatitis B virus (HBV) in human immunodeficiency (HIV) coinfection has been limited by heterogeneity HIV disease. We evaluated HBV and HIV-related disease progression a cohort seroconverters.
Uncomplicated Delivery in a Patient with Covid-19 The peripartum care of woman at 39 weeks gestation is described. and the neonate were discharged home on hospital day ...
We evaluated saliva (SAL) specimens for SARS-CoV-2 reverse transcriptase PCR (RT-PCR) testing by comparison of 459 prospectively paired nasopharyngeal (NP) or midturbinate (MT) swabs from 449 individuals with the aim using asymptomatic screening. Samples were collected in a drive-through car line symptomatic ( n = 380) and emergency department (ED) 69).
Carbapenem-resistant Acinetobacter baumannii (CRAb) is 1 of the most problematic antimicrobial-resistant bacteria. We sought to elucidate international epidemiology and clinical impact CRAb. In a prospective observational cohort study, 842 hospitalized patients with CRAb culture were enrolled at 46 hospitals in five global regions between 2017 2019. The primary outcome was all-cause mortality 30 days from index culture. strains underwent whole-genome analysis. Of cases, 536 (64%) represented...
Background: War-trauma, especially due to blast injury, can be associated with long bone fracture. Immediate external fixation of fractures, followed by internal when the patient is medically stabilized (damage control orthopedics [DCO]), U.S. Army policy for war-related fractures. Data on infectious outcomes DCO used war-trauma fractures are scant. Methods: A retrospective review patients from 2003 2007 femoral or tibial treated was conducted. Fisher's Exact and Mann-Whitney tests were...
To determine the anatomic sites and natural history of colonization with gram-negative multidrug-resistant organisms (MDROs).Prospective, longitudinal cohort study.Walter Reed Army Medical Center, a 236-bed tertiary care center in Washington, DC.Deployed subjects (ie, inpatients medically evacuated from Iraq or Afghanistan) nondeployed admitted to same hospital.Consenting patients had 6 cultured every 3 days for 2 weeks then weekly. Gram-negative resistant more classes antibiotics were...
Background Cutaneous Leishmania major has affected many travelers including military personnel in Iraq and Afghanistan. Optimal treatment for this localized infection not been defined, but interestingly the parasite is thermosensitive. Methodology/Principal Findings Participants with parasitologically confirmed L. were randomized to receive intravenous sodium stibogluconate (SSG) 20mg/kg/day ten doses or ThermoMed (TM) device heat (applied at 50°C 30 seconds) one session. Those facial...
The efficacy and toxicity of sodium stibogluconate (SSG) at a dosage 20 mg/(kg.d) for either days (for cutaneous disease) or 28 visceral, mucosal, viscerotropic in the treatment leishmaniasis is reported. Ninety-six U.S. Department Defense health care beneficiaries with parasitologically confirmed were prospectively followed 1 year. One patient was infected human immunodeficiency virus; otherwise, comorbidity absent. Clinical cure occurred 91% 83 cases disease 93% 13 visceral/viscerotropic...
A fluorescent DNA probe (LEIS.P1) specific for a conserved region of the small-subunit ribosomal RNA gene Leishmania and pair flanking primers (LEIS.U1 LEIS.L1) were designed use in fluorogenic polymerase chain reaction. Optimal assay conditions with zero background established to detect low levels from clinical samples. By this assay, we amplified 27 strains cultured (both Old New World strains) selectively 12 paraffin-embedded human biopsy samples 3 fresh skin specimens. For tissue...
A real-time PCR assay for the detection of four Leishmania complexes (L. Viannia, L. mexicana, donovani/infantum, and major) was developed evaluated. The to detect glucosephosphate isomerase gene capitalizes on DNA sequence variability within that complex identification. Primer/probe sets were created tested against a panel 21 known negative controls extracted from cultured promastigotes or tissue biopsies patients with cutaneous leishmaniasis. highly specific, as no amplification products...
The recommended treatment for cutaneous leishmaniasis is pentavalent antimony at a dosage of 20 mg/kg/day days. Some studies conducted in locales which Leishmania endemic have suggested that shorter courses may be as efficacious. We randomized, double-blind, placebo-controlled study 10 versus days sodium stibogluconate (SSG) United States military personnel who contracted while serving overseas; 19 patients received SSG (and placebo days), and Cure rates were 100% (19 patients) the 10-day...
Management of combat-related trauma is derived from skills and data collected in past conflicts civilian trauma, information experience obtained during ongoing conflicts. The best methods to prevent infections associated with injuries observed military combat are not fully established. Current these types primarily controlled trials elective surgery as well retrospective studies interventions. following guidelines integrate available evidence expert opinion, within outside the US medical...
To examine the outcomes of highly-active antiretroviral therapy (HAART) for individuals with free access to healthcare, we evaluated 2327 patients in a cohort study composed military personnel and beneficiaries HIV infection who initiated HAART from 1996 end 2007. Outcomes analyzed were virologic suppression (VS) failure (VF), CD4 count changes, AIDS death. VF was defined as never suppressing or having at least one rebound event. Multivariate (MV) analyses stratified by initiation year...
Multidrug-resistant organism (MDRO) infections, including those secondary to Acinetobacter (ACB) and extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (Escherichia coli Klebsiella species) have complicated the care of combat-injured personnel during Operations Iraqi Freedom Enduring Freedom. Data suggest that source these bacterial infections includes nosocomial transmission in both deployed hospitals receiving military medical centers (MEDCENs). Admission screening for MDRO...
Abstract Background Intramuscular cabotegravir-rilpivirine (CAB-RPV) is a long-acting antiretroviral for the treatment of HIV which can be administered every 1-2 months. Registration trials demonstrated non-inferiority CAB-RPV versus oral therapy, but data on ‘real world’ performance sparse. In addition, these required virologic suppression (viral load (VL) < 50 copies/mL) with medications before transitioning to CAB-RPV. Small studies have reported success when was started in...