A5041158101- Sepsis Diagnosis and Treatment
- Heart Rate Variability and Autonomic Control
- Hemodynamic Monitoring and Therapy
- Clinical Reasoning and Diagnostic Skills
- Non-Invasive Vital Sign Monitoring
- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Emergency and Acute Care Studies
- Healthcare Policy and Management
- Trauma and Emergency Care Studies
- Healthcare cost, quality, practices
- COVID-19 Clinical Research Studies
- Intensive Care Unit Cognitive Disorders
- Patient Satisfaction in Healthcare
- Vagus Nerve Stimulation Research
- Radiology practices and education
- Venous Thromboembolism Diagnosis and Management
- Pediatric Pain Management Techniques
- Meta-analysis and systematic reviews
- Anesthesia and Pain Management
- Nicotinic Acetylcholine Receptors Study
- scientometrics and bibliometrics research
- COVID-19 and healthcare impacts
- Electronic Health Records Systems
- EEG and Brain-Computer Interfaces
Albert Einstein College of Medicine
1998-2024
Feinstein Institute for Medical Research
2020-2024
Northwell Health
2020-2024
Hofstra University
2019-2024
North Shore Diabetes and Endocrine Associates
2023
Donald & Barbara Zucker School of Medicine at Hofstra/Northwell
2019-2021
Health Innovations (United States)
2020
University of Ottawa
2017-2018
Montefiore Medical Center
2017
Icahn School of Medicine at Mount Sinai
2002
There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).To describe clinical with COVID-19 hospitalized in a health care system.Case series admitted to 12 hospitals New York City, Long Island, Westchester County, York, within Northwell Health system. The study included all sequentially between March 1, 2020, April 4, inclusive these dates.Confirmed severe acute respiratory syndrome 2...
<h3>Importance</h3> The choice of analgesic to treat acute pain in the emergency department (ED) lacks a clear evidence base. combination ibuprofen and acetaminophen (paracetamol) may represent viable nonopioid alternative. <h3>Objectives</h3> To compare efficacy 4 oral analgesics. <h3>Design, Settings, Participants</h3> Randomized clinical trial conducted at 2 urban EDs Bronx, New York, that included 416 patients aged 21 64 years with moderate severe extremity enrolled from July 2015 August...
Predicting early respiratory failure due to COVID-19 can help triage patients higher levels of care, allocate scarce resources, and reduce morbidity mortality by appropriately monitoring treating the at greatest risk for deterioration. Given complexity COVID-19, machine learning approaches may support clinical decision making with this disease.
The number of cases from the coronavirus disease 2019 (COVID-19) global pandemic has overwhelmed existing medical facilities and forced clinicians, patients, families to make pivotal decisions with limited time information.
To test the hypothesis that heart rate variability (HRV) can provide an early indication of illness severity among patients presenting to emergency department (ED) with sepsis.The authors enrolled a convenience sample 15 ED meeting American College Chest Physicians/Society Critical Care Medicine criteria for sepsis. Each patient had continuous Holter monitoring performed in ED. Acute Physiology and Chronic Health II (APACHE II) Sequential Organ Failure (SOFA) scores were calculated day...
BACKGROUND. Metabolic syndrome (MetS) is an obesity-driven condition of pandemic proportions that increases the risk type 2 diabetes and cardiovascular disease. Pathophysiological mechanisms are poorly understood, though inflammation has been implicated in MetS pathogenesis. The aim this study was to assess effects galantamine, a centrally acting acetylcholinesterase inhibitor with antiinflammatory properties, on markers insulin resistance risk, other metabolic indices subjects MetS.
Abstract Objective Our primary objective was to use initial data available clinicians characterize and predict survival for hospitalized coronavirus disease 2019 (COVID-19) patients. While clinical characteristics mortality risk factors of COVID-19 patients have been reported, a practical calculator based on from diverse group U.S. has not yet introduced. Such tool would provide timely valuable guidance in decision-making during this global pandemic. Design We extracted demographic,...
Background: The metabolic syndrome (MetS) is an obesity-associated disorder of pandemic proportions and limited treatment options. Oxidative stress, low-grade inflammation altered neural autonomic regulation, are important components drivers pathogenesis. Galantamine, acetylcholinesterase inhibitor a cholinergic drug that clinically-approved (for Alzheimer's disease) has been implicated in regulation several conditions characterized with immune derangements. Here we examined the effects...
Following emergency department (ED) assessment, patients with infection may be directly admitted to the intensive care unit (ICU) or alternatively hospital wards sent home. Those home experience future deterioration necessitating ICU admission.We used a prospectively collected registry from two hospitals within single tertiary network between 2011 and 2014. Patient information, outcomes, costs were stored in data warehouse. Patients categorized into three groups: (1) ED ICU; (2) initially...
Abstract Objective: To test the hypothesis that heart rate variability (HRV) can provide an early indication of illness severity among patients presenting to emergency department (ED) with sepsis. Methods: The authors enrolled a convenience sample 15 ED meeting American College Chest Physicians/Society Critical Care Medicine criteria for Each patient had continuous Holter monitoring performed in ED. Acute Physiology and Chronic Health II (APACHE II) Sequential Organ Failure (SOFA) scores...
Risk stratification of patients presenting to the emergency department (ED) with sepsis can be challenging. We derived and evaluated performance a predictive model containing clinical, laboratory, heart rate variability (HRV) measures quantify risk deterioration in this population.ED aged 21 older satisfying 1992 consensus conference criteria for able consent (directly or through surrogate) were enrolled (n = 1,247). Patients had HRV data recorded within 1 h ED presentation, followed...
The autonomic nervous system (ANS) maintains physiological homeostasis in various organ systems via parasympathetic and sympathetic branches. ANS function is altered common diffuse focal conditions heralds the beginning of environmental disease stresses. Reliable, sensitive, quantitative biomarkers, first defined healthy participants, could discriminate among clinically useful changes function. This framework combines controlled testing with feature extraction during responses.Twenty-one...
Rationale: During the first wave of coronavirus disease (COVID-19) pandemic in New York City, number mechanically ventilated COVID-19 patients rapidly surpassed capacity traditional intensive care units (ICUs), resulting health systems utilizing other areas as expanded ICUs to provide critical care. Objectives: To evaluate mortality admitted compared with those ICUs. Methods: Multicenter, retrospective, cohort study at 11 Northwell Health hospitals greater City area between March 1, 2020 and...
Abstract Patients with coronavirus disease 2019 (COVID-19) can have increased risk of mortality shortly after intubation. The aim this study is to develop a model using predictors early intubation from COVID-19. A retrospective 1945 intubated patients COVID-19 admitted 12 Northwell hospitals in the greater New York City area was performed. Logistic regression backward selection applied. This evaluated 14-day for patients. within 14 days included older age, history chronic kidney disease,...
Abstract Impaired sleep for hospital patients is an all too common reality. Sleep disruptions due to unnecessary overnight vital sign monitoring are associated with delirium, cognitive impairment, weakened immunity, hypertension, increased stress, and mortality. It also one of the most complaints while imposing additional burdens on healthcare providers. Previous efforts forgo measurements improve patient used providers’ subjective stability assessment or utilized expanded, thus harder...
Abstract Clinical prognostic models can assist patient care decisions. However, their performance drift over time and location, necessitating model monitoring updating. Despite rapid significant changes during the pandemic, for COVID-19 patients do not currently account these drifts. We develop a framework continuously updating apply it to predict 28-day survival in patients. use demographic, laboratory, clinical data from electronic health records of 34912 hospitalized March 2020 until May...
Background Clinicians often disregard potentially beneficial clinical decision support (CDS). Objective In this study, we sought to explore the psychological and behavioral barriers use of a CDS tool. Methods We conducted qualitative study involving emergency medicine physicians physician assistants. A semistructured interview guide was created based on Capability, Opportunity, Motivation-Behavior model. Interviews focused tool built Wells’ criteria for pulmonary embolism assist clinicians...
Objective To examine the ability of low-frequency/high-frequency (LF/HF) ratio heart rate variability (HRV) analysis to identify patients with sepsis at risk early deterioration. Methods This is a prospective observational cohort study presenting Montefiore Medical Center ED from December 2014 through September 2015. On presentation, single ECG Holter recording was obtained and analysed obtain LF/HF HRV. Initial Sequential Organ Failure Assessment (SOFA) scores were computed. Patients...
The objective was to test the hypothesis that exclusive use of butterfly needles for phlebotomy, compared with sample collection via intravenous (IV) catheter, will reduce rates hemolysis.This an observational study hemolysis before and after implementation a "butterfly-only" phlebotomy protocol. Weekly rates, generated by central laboratory, were collected proportion hemolyzed specimens protocol compared.Prior institution butterfly-only protocol, 11.3% sent from emergency department...