A5000339189- Anesthesia and Pain Management
- Pain Management and Opioid Use
- Cardiac, Anesthesia and Surgical Outcomes
- Opioid Use Disorder Treatment
- Diversity and Career in Medicine
- Blood transfusion and management
- Hospital Admissions and Outcomes
- Anesthesia and Sedative Agents
- Nausea and vomiting management
- Healthcare professionals’ stress and burnout
- Hemodynamic Monitoring and Therapy
- Enhanced Recovery After Surgery
- Bone health and treatments
- Pituitary Gland Disorders and Treatments
- TGF-β signaling in diseases
- Intensive Care Unit Cognitive Disorders
- Medical Education and Admissions
- Traumatic Brain Injury and Neurovascular Disturbances
- Bone Metabolism and Diseases
- Total Knee Arthroplasty Outcomes
- Sleep and Work-Related Fatigue
- Acne and Rosacea Treatments and Effects
- Psoriasis: Treatment and Pathogenesis
- Blood Pressure and Hypertension Studies
- Cardiac Arrest and Resuscitation
University of Virginia Health System
2012-2025
Neurological Surgery
2019-2024
University of Virginia
2015-2024
West Virginia University
2023
Johns Hopkins Medicine
2023
Johns Hopkins University
2023
Duke University
2022
Sussex Partnership NHS Foundation Trust
2021
Committee on Publication Ethics
2020
Barro Colorado Island
2017-2019
Melanoma often metastasizes to bone where it is exposed high concentrations of TGF-β. Constitutive Smad signaling occurs in human melanoma. Because TGF-β promotes metastases by several types solid tumors including breast cancer, we hypothesized that pharmacologic blockade the pathway may interfere with capacity melanoma cells metastasize bone. In this study, tested effect a small molecule inhibitor receptor I kinase (TβRI), SD-208, on various parameters affecting development and progression...
Most patients with advanced breast cancer develop bone metastases, which cause pain, hypercalcemia, fractures, nerve compression and paralysis. Chemotherapy causes further loss, bone-specific treatments are only palliative. Multiple tumor-secreted factors act on the microenvironment to drive a feed-forward cycle of tumor growth. Effective treatment requires inhibiting upstream regulators groups prometastatic factors. Two central hypoxia transforming growth factor (TGF)- beta. We asked...
Acne is a significant adolescent problem and may precipitate emotional psychological effects. The impact of acne on parameters implications for treatment are not fully understood.We performed MEDLINE search using the terms "acne" "adolescent" along with "psychological," "depression," or "psychiatric," which yielded 16 reviewed studies.Qualitative review selected articles revealed that presence has self-esteem quality life. Depression other disorders more prevalent in patients improve...
OBJECTIVE Perception of perioperative pain is influenced by various psychological factors. The aim this study was to determine the impact catastrophizing, anxiety, and depression on in-hospital opioid consumption, scores, quality recovery in adults who underwent spine surgery. METHODS Patients undergoing surgery were enrolled study, preoperatively completed questionnaires included verbal rating scale (VRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety Depression (HADS), Oswestry...
Chronic opioid use is a significant public health concern. Surgery risk factor for developing chronic use. Patients undergoing major spine surgery frequently are prescribed opioids preoperatively and may be at postoperatively. The aim of this study was to investigate the incidence perioperative factors associated with after surgery.The records patients who underwent elective University Virginia between March 2011 February 2016 were retrospectively reviewed. primary outcome through 12 months...
Enhanced recovery after surgery (ERAS) protocols are standardized and designed to provide superior analgesia, reduce opioid consumption, improve patient recovery, hospital length of stay. Yet, moderate-to-severe postsurgical pain continues afflict over 40% patients remains a major priority for anesthesia research. Methadone administration in the perioperative setting may postoperative scores have opioid-sparing effects, which be beneficial enhanced recovery. possesses multimodal profile...
Low bone mass and increased fracture risk are recognized complications of cystic fibrosis (CF). CF-related disease (CFBD) is characterized by uncoupled turnover--impaired osteoblastic formation enhanced osteoclastic resorption. Intestinal malabsorption, vitamin D deficiency inflammatory cytokines contribute to CFBD. However, epidemiological investigations animal models also support a direct causal link between inactivation skeletal transmembrane regulator (CFTR), the gene that when mutated...
Objective: To investigate the incidence of perioperative adverse events in patients receiving intravenous methadone for major spine surgery.Design: Retrospective review records from March 2011 and February 2016.Setting: University Virginia Healthsystem.Patients: Adult undergoing elective spinal fusion two or more levels. Main Outcome Measures: Incidence respiratory depression, time to extubation, hypotension, hypoxemia, reintubation, cardiac complications, death.Results: Reviewed 1,478...
Liver transplantation may be complicated by massive intraoperative bleeding, and red blood cell (RBC) transfusions required. The storage duration or age of transfused RBCs has been shown to affect the morbidity mortality critically ill, trauma, cardiac surgery patients. Here we investigate effect RBC on outcomes liver transplant Five hundred thirty-one patients underwent orthotopic between January 1, 2000 August 15, 2010. patient demographics, Model for End-Stage Disease-sodium (MELD-Na)...
Perioperative lidocaine infusion improves analgesia and recovery after some surgical procedures, possibly through systemic antiinflammatory effects. This commentary provides the clinician with evidence for rational use of perioperative in procedures where it is demonstrated benefit.
The relationship between intraoperative physiology and postoperative stroke is incompletely understood. Preliminary data suggest that either hypo- or hypercapnia coupled with reduced cerebrovascular inflow (e.g., due to hypotension) can lead ischemia. This study tested the hypothesis combination of hypotension hypercarbia associated ischemic stroke.We conducted a retrospective, case-control via Multicenter Perioperative Outcomes Group. Noncardiac, nonintracranial, nonmajor vascular surgical...
Abstract Editor’s Perspective What We Already Know about This Topic Article Tells Us That Is New Background Residency programs utilize night float systems to adhere duty hour restrictions; however, the influence of on resident sleep has not been described. The study aim was determine patterns and quality sleep. hypothesized that total time decreases during float, increases as residents acclimate shift work, returns baseline recovery. Methods a single-center observational 30 anesthesia...
Traumatic brain injury (TBI) is associated with increased risk for psychological and substance use disorders. The study aim to determine incidence factors persistent opioid prescription after hospitalization TBI. Electronic medical records of patients age ≥ 18 admitted a neuroscience intensive care unit between January 2013 February 2017 an intracranial were retrospectively reviewed. Primary outcome was through 12 months post-hospital discharge. A total 298 complete data included in the...
Abstract As we move further and into the twentieth century, Western 'global governance' norm of interventionism is being challenged by East Asian non-interference territorial integrity. The two sets norms are historically philosophically rooted have influential backers. Intriguingly, while approaches appear irreconcilable, some countries lent their support to both norms. Asia emerges as a major force in global relations can way be found for contrasting exist side-by-side, perhaps each...
OBJECTIVE Significant blood loss and coagulopathy are often encountered during adult spinal deformity (ASD) surgery, the optimal intraoperative transfusion algorithm is debatable. Rotational thromboelastometry (ROTEM), a functional viscoelastometric method for real-time hemostasis testing, may allow early identification of improve practices. The objective this study was to investigate effect ROTEM-guided product management on perioperative requirements in ASD patients undergoing correction...
Background: Key goals during intracranial surgery are to facilitate rapid emergence and extubation for early neurologic evaluation. Longer-acting opioids often avoided or administered at subtherapeutic doses due their perceived risk of sedation delayed emergence. However, inadequate analgesia increased postoperative pain common after surgery. In this multicenter study, we describe variability in opioid nonopioid administration patterns patients undergoing Methods: This was a multicenter,...