A5026083168- Anesthesia and Pain Management
- Cardiac, Anesthesia and Surgical Outcomes
- Pain Management and Opioid Use
- Intensive Care Unit Cognitive Disorders
- Neural dynamics and brain function
- Anesthesia and Sedative Agents
- Anesthesia and Neurotoxicity Research
- Traumatic Brain Injury and Neurovascular Disturbances
- Pediatric Pain Management Techniques
- Neurosurgical Procedures and Complications
- Neuroscience of respiration and sleep
- Pain Management and Placebo Effect
- Pain Mechanisms and Treatments
- Airway Management and Intubation Techniques
- Spine and Intervertebral Disc Pathology
- Color Science and Applications
- Respiratory Support and Mechanisms
- Visual perception and processing mechanisms
- Cardiovascular Health and Disease Prevention
- Non-Invasive Vital Sign Monitoring
- Neuroscience and Neuropharmacology Research
- Intracranial Aneurysms: Treatment and Complications
- Liver Disease and Transplantation
- Circadian rhythm and melatonin
- Simulation-Based Education in Healthcare
Johns Hopkins Medicine
2015-2024
Johns Hopkins University
2015-2024
Northwestern University
2020-2021
Johns Hopkins Hospital
2003-2020
Bloomberg (United States)
2019
Children's Center
2019
Marianjoy Rehabilitation Hospital
2014
Johns Hopkins Bayview Medical Center
2011
Marymount University
1994-2009
Center for Pain and the Brain
2008
Preemptive analgesia can decrease the sensitization of central nervous system that would ordinarily amplify subsequent nociceptive input, but a clear demonstration its clinical efficacy is necessary for it to become routine component acute pain therapy.To determine impact preemptive epidural on postoperative and other clinically important outcome variables after radical retropubic prostatectomy.A block randomized double-blind trial lasting 20 months at single academic medical center.A total...
To elucidate the mechanisms that lead to sleep-disordered breathing, we have developed a mathematical model allows for dynamic interactions among chemical control of respiration, changes in sleep-waking state, and upper airway patency. The increase steady-state arterial PCO2 accompanying sleep is shown be inversely related ventilatory response CO2. Chemical respiration becomes less stable during light stage sleep, despite reduction chemoresponsiveness, due concomitant "plant gain" (i.e.,...
Background Pain following thoracotomy can persist for years with an undetermined impact on quality of life. Factors hypothesized to modulate this painful experience include analgesic regimen, gender, and type incision. Methods A total 157 generally healthy patients both genders scheduled segmentectomy, lobectomy, or bilobectomy through a posterolateral muscle-sparing incision were randomly assigned receive thoracic epidural analgesia initiated prior at the time rib approximation. activity...
Object Opioid administration after major intracranial surgery is often limited by a presumed lack of need and concern that opioids will adversely affect the postoperative neurological examination. The authors conducted prospective study to evaluate incidence, severity, treatment pain in patients who underwent surgery. Methods One hundred eighty-seven (77 men 110 women, mean age 52 ± 15 years, weight 78.1 19.9 kg) either supratentorial (129 patients) or infratentorial (58 procedures....
Objectives Based on a multifactorial model of delirium, to compare the types and magnitude pre‐ intraoperative predisposing factors for incident delirium in stratified sample individuals with without preoperative dementia undergoing acute hip fracture repair. Design Prospective cohort study. Setting Academic medical center. Participants Four hundred twenty‐five (mean age 80.2 ± 6.8, 73.2% female, 33.1% probable dementia) admitted multidisciplinary repair service. Measurements A research...
<h3>Importance</h3> Postoperative delirium is the most common complication following major surgery in older patients. Intraoperative sedation levels are a possible modifiable risk factor for postoperative delirium. <h3>Objective</h3> To determine whether limiting during spinal anesthesia reduces incident overall. <h3>Design, Setting, and Participants</h3> This double-blind randomized clinical trial (A Strategy to Reduce Incidence of Delirum Elderly Patients [STRIDE]) was conducted from...
Recent attempts at high-resolution sensory-stimulated fMRI performed 1.5 T have had very limited success demonstrating a somatotopic organization for individual digits. Our purpose was to determine if functional MRI 4 can demonstrate the sensory map of human hand. Sensory in five normal volunteers using low-frequency vibratory stimulus on pad each finger left A simple motor control task also performed. The data were normalized standard atlas, and group statistical parametric maps (SPMs)...
Objectives To determine the relationship between opioid consumption and cognitive impairment after hip fracture repair. Design Prospective study of consecutive patients. Setting Johns Hopkins Bayview Medical Center, Baltimore, Maryland. Participants Two hundred thirty‐six participants aged 65 older undergoing Measurements Older adults without preoperative delirium who underwent repair April 2005 July 2009 were followed for pain, consumption, postoperative delirium. tested using Confusion...
Low intraoperative Bispectral Index (BIS) values may be associated with increased mortality. In a previously reported trial to prevent delirium, we randomized patients undergoing hip fracture repair under spinal anesthesia light (BIS >80) or deep approximately 50) sedation. We analyzed survival of in the original trial. Among all patients, mortality was equivalent across sedation groups. However, among serious comorbidities (Charlson score >4), 1-year reduced (22.2%) vs (43.6%) group (hazard...
BACKGROUND: Cardiac anesthetics rely heavily on opioids, with the standard patient receiving between 70 and 105 morphine sulfate equivalents (MSE; 10–15 µg/kg of fentanyl). A central tenet Enhanced Recovery Programs (ERP) is use multimodal analgesia. This study was performed to assess association nonopioid interventions employed as part an ERP for cardiac surgery intraoperative opioid administration. METHODS: represents a post hoc secondary analysis data obtained from institutional surgery....
A mathematical model of the three-phase respiratory network proposed by Richter et al. (News Physiol. Sci. 1: 109-112, 1986) is developed and its properties are examined. The reproduces experimentally determined trajectories membrane potential for five physiologically distinct types neurons included. Stepwise parameter changes can produce a rhythm with only two separate electrophysiological phases, result in apnea, or more complex patterns firing. phase-resetting behavior was obtained...
In Brief BACKGROUND: The impact of delirium on survival elderly patients remains undetermined with conflicting results from clinical studies and meta-analysis. this study, we assessed the relationship between long-term mortality incident postoperative in undergoing hip fracture repair. METHODS: Patients ≥65 years old who were not delirious before repair included a database maintained prospectively March 1999 to July 2009. All participating underwent assessment second day by using confusion...
Objectives The characteristics and etiology of long-term pain after major thoracotomy methods for its prevention have yet to be established. Methods One hundred twenty patients who had completed the hospital-based portion a prior study evaluate efficacy intraoperative epidural use during thoracotomy, all whom received patient-controlled thoracic analgesia until at least thoracostomy tube removal, were followed 48 weeks surgery provided data this study. Results Although preoperative was...