A5005967890- Sepsis Diagnosis and Treatment
- Blood transfusion and management
- Immune Response and Inflammation
- Trauma and Emergency Care Studies
- Respiratory Support and Mechanisms
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Neonatal Respiratory Health Research
- Intensive Care Unit Cognitive Disorders
- Cardiac, Anesthesia and Surgical Outcomes
- Erythropoietin and Anemia Treatment
- Immune cells in cancer
- Gut microbiota and health
- Cardiac Arrest and Resuscitation
- Mesenchymal stem cell research
- Traumatic Brain Injury and Neurovascular Disturbances
- Hemoglobinopathies and Related Disorders
- Appendicitis Diagnosis and Management
- Thermal Regulation in Medicine
- Erythrocyte Function and Pathophysiology
- Abdominal Surgery and Complications
- Clostridium difficile and Clostridium perfringens research
- Abdominal Trauma and Injuries
- Hematological disorders and diagnostics
- Inflammation biomarkers and pathways
- Nosocomial Infections in ICU
Florida College
2015-2024
University of Florida
2015-2024
American College of Surgeons
2011-2024
Gainesville Obstetrics & Gynecology
2017-2024
National Institute of General Medical Sciences
2024
National Institutes of Health
2018-2024
University of Florida Health
2015-2023
Tallahassee Orthopedic Clinic
2022
Maine Farmland Trust
2022
University of Washington
2021
To provide an appraisal of the evolving paradigms in pathophysiology sepsis and propose evolution a new phenotype critically ill patients, its potential underlying mechanism, implications for future management research.Literature search using PubMed, MEDLINE, EMBASE, Google Scholar.Sepsis remains one most debilitating expensive illnesses, prevalence is not declining. What changing our definition(s), clinical course, how we manage septic patient. Once thought to be predominantly syndrome over...
We hypothesized that after sepsis in humans, MDSCs will be persistently increased, functionally immunosuppressive, and associated with adverse clinical outcomes.Cancer have surprisingly similar immunologic responses equally dismal long term consequences. In cancer, increased myeloid-derived suppressor cells (MDSCs) induce detrimental immunosuppression, but little is known about the role of sepsis.Blood was obtained from 74 patients within 12 hours severe sepsis/septic shock (SS/SS), at set...
Angiographic embolization (AE) is a safe and effective method for controlling hemorrhage in both blunt penetrating liver injuries. Improved survival after hepatic injuries has been documented using multimodality approach; however, patients still have significant long-term morbidity. This study examines further the role of AE outcomes its use.The medical records 37 consecutive admitted from 1995 to 2002 Level I trauma center who underwent angiography with intent embolize were reviewed....
Many sepsis survivors develop chronic critical illness (CCI) and are assumed to be immunosuppressed, but there is limited clinical evidence support this. We sought determine whether the incidence of secondary infections immunosuppressive biomarker profiles patients with CCI differ from those rapid recovery (RAP) after sepsis.This prospective observational study evaluated 88 critically ill 20 healthy controls. Cohorts were defined based on trajectory (early death, RAP, or CCI), whereas...
A growing number of patients survive sepsis but remain chronically critically ill. We sought to define clinical outcomes and incidence chronic critical illness (CCI) after determine whether selected biomarkers inflammation, immunosuppression, catabolism differ between these those that rapidly recover (RAP).This 3-year prospective observational cohort study (NCT02276417) evaluated 145 surgical intensive care unit with for the development CCI (≥14 days resource utilization persistent organ...
Abstract Background Sepsis is an increasingly significant challenge throughout the world as one of major causes patient morbidity and mortality. Central to host immunologic response sepsis increase in circulating myeloid-derived suppressor cells (MDSCs), which have been demonstrated be present independently associated with poor long-term clinical outcomes. MDSCs are plastic potentially modifiable, particularly through epigenetic interventions. The objective this study was determine how...
Abstract Background Sepsis and trauma are known to disrupt gut bacterial microbiome communities, but the impacts perturbations in fungal (mycobiome) community after severe infection or injury, particularly patients experiencing chronic critical illness (CCI), remain unstudied. Methods We assess persistence of mycobiome perturbation (dysbiosis) CCI following sepsis for up two-to-three weeks intensive care unit hospitalization. Results show that dysbiotic arrays shift toward a pathobiome...
Patients with minimal head injury (MHI) and intracranial bleed (ICB) detected on cranial computed tomography (CT) scan routinely undergo a repeat CT within 24 hours after to assess for progression of injuries. While this is clearly beneficial in patients deteriorating neurologic status, it questionable value normal examination. The goal study was prospectively the MHI an ICB who have examination.A prospective analysis all adult admitted Level I trauma center blunt causing (defined as loss...
We sought to compare traditional inpatient outcomes long-term functional and mortality of surgical intensive care unit (SICU) patients with sepsis.As sepsis declines, an increasing number initial survivors now progress into a state chronic critical illness (CCI) their post-discharge are unclear.We performed prospective, longitudinal cohort study SICU sepsis.Among this recent 301 septic patients, 30-day was 9.6%. Only 13 (4%) died within 14 days, primarily refractory multiple organ failure...
Differentiating between partial adhesive small bowel obstruction (aSBO) likely to resolve with medical management and complete requiring operative intervention remains elusive. We implemented a standardized protocol for the of aSBO reviewed our experience retrospectively.Patients symptoms were admitted intravenous fluid resuscitation, rest, nasogastric tube decompression, abdominal examinations every 4 hours. Laboratory values computed tomography scan abdomen pelvis contrast obtained....
Sepsis is a common, costly and morbid cause of critical illness in trauma surgical patients. Ongoing advances sepsis resuscitation care support strategies have led to improved in-hospital mortality. However, these patients now survive enter state chronic (CCI), persistent low-grade organ dysfunction poor long-term outcomes driven by the inflammation, immunosuppression catabolism syndrome (PICS). The Critical Illness Research Center (SCIRC) was created provide platform which prevalence...
As nonoperative management of appendicitis gains popularity, vigilance for appendiceal tumors becomes increasingly important. We hypothesized that, among patients presenting with acute appendicitis, those advanced age, multiple comorbidities, atypical presentation, and complicated would be more likely to have underlying tumors.We performed a 4-year retrospective cohort analysis 677 consecutive adult who underwent appendectomy at our tertiary care center. Patients an tumor on their final...
Abstract The elderly are particularly susceptible to trauma, and their outcomes frequently dismal. Such patients often have complicated clinical courses ultimately die of infection sepsis. Recent research has revealed that although subjects increased baseline inflammation as compared with younger counterparts, the do not respond severe or injury an exaggerated inflammatory response. Initial retrospective analysis data from Glue Grant trauma database demonstrated despite a similar frequency,...
Objectives Sepsis has been called a “disease of the elderly,” and as in‐hospital mortality decreased, more sepsis survivors are progressing into poorly characterized long‐term outcomes. The purpose this study was to describe current epidemiology in older adults compared with middle‐aged young adults. Design Prospective longitudinal (≤45 years), (46‐64 (≥65 years) patient groups. Setting University tertiary medical center. Participants A total 328 adult surgical intensive care unit (ICU)...
In Brief Export A review of UF SCIRC's research efforts characterizing CCI, PICS biomarkers, effect site infection, acute kidney injury, effects on older patients, dysfunctional high-density lipoproteins, sarcopenia/cachexia, emergency myelopoiesis, and dysregulated erythropoiesis.
Bone marrow derived cells (BMDC) and mesenchymal stem (MSC) are necessary for healing of injured tissues. Intravenous granulocyte-colony stimulating factor (G-CSF) is known to induce mobilization BMDC peripheral blood the tissue levels stromal cell factor-1 (SDF-1) be key in their homing sites injury. We hypothesized that injection SDF-1 site injury and/or systemic administration G-CSF increases improves traumatic also postulated increased MSC alone would improve healing.Male Sprague-Dawley...