A5071486730- Respiratory viral infections research
- Neonatal Respiratory Health Research
- Ultrasound in Clinical Applications
- Respiratory Support and Mechanisms
- Emergency and Acute Care Studies
- Pneumonia and Respiratory Infections
- Viral gastroenteritis research and epidemiology
- Neuroscience of respiration and sleep
- Education Systems and Policy
- Adolescent and Pediatric Healthcare
- Phonocardiography and Auscultation Techniques
- Microbial infections and disease research
- Bacterial Infections and Vaccines
- Diverse Education Studies and Reforms
- Asthma and respiratory diseases
- Restraint-Related Deaths
- Healthcare Policy and Management
- Congenital Diaphragmatic Hernia Studies
- Parvovirus B19 Infection Studies
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Animal Disease Management and Epidemiology
- Diverse Educational Innovations Studies
- AI-based Problem Solving and Planning
- Obstructive Sleep Apnea Research
- Hospital Admissions and Outcomes
Sutter Medical Center
2016-2025
Association Clinique et Thérapeutique Infantile du Val de Marne
2024
Guy's and St Thomas' NHS Foundation Trust
2023
University of California, Davis
2013-2020
Sutter Institute for Medical Research
2020
Kern Medical Center
2004-2015
National University of Ireland
2014
University of California Davis Medical Center
2013-2014
University of California, Los Angeles
2008-2011
Instituto Nacional de Salud Pública
2008-2010
A nylon flocked swab/universal transport medium collection method developed for bacterial sexually transmitted infections was adapted to detect respiratory viruses in infants and toddlers. This significantly outperformed the traditional use of nasal aspirates terms PCR-based virus detection (P = 0.016), samples were easier clinicians evaluate, store, transport.
To develop and validate a logistic regression model to predict need for admission length of hospital stay in children presenting the Emergency Department with bronchiolitis.Two children's hospitals Dublin, Ireland.We reviewed 118 episodes bronchiolitis 99 admitted from Department. Those discharged within 24 h by consultant/attending paediatrician were retrospectively categorized as suitable discharge. We then validated using cohort 182 affected infants another paediatric season 2 years...
Abstract Objectives: To compare the effect of nebulized racemic epinephrine to albuterol on successful discharge from emergency department (ED). Methods: Children up their 18th month life presenting two teaching hospital EDs with a clinical diagnosis bronchiolitis who were ill enough warrant treatment but did not need immediate intubation eligible for this double‐blind randomized controlled trial (RCT). Patients received either three doses or one dose plus saline nebulizers. Disposition was...
Objective: Clinical experience and patient-level physiological studies indicate that albuterol transiently reduces oxygen saturation, irrespective of the underlying respiratory condition causing wheezing. Three revisions Cochrane review, Bronchodilators for Bronchiolitis (Review), have found temporarily increases saturation. Rarely, these findings were even statistically significant, but direction effect is consistently opposite from studies. In this study, we attempted to resolve apparent...
Bovine respiratory syncytial virus (BRSV) infection is a part of the bovine disease complex. This one most significant problems in both dairy and beef production sector, inflicting severe economic damage to industry. BRSV manifests clinically as syndrome, affecting upper lower tract, including bronchiolitis with dyspnea wheezing. It has been shown previously that these symptoms caused by IL-4/IL-13 domination immune response are associated an antibody isotype switch IgE. Prostaglandin...
Objectives. To measure inter-rater agreement of overall clinical appearance febrile children aged less than 24 months and to compare methods for doing so.Study Design Setting. We performed an observational study reliability the assessment in a county hospital emergency department serving mixed urban rural population. Two medicine healthcare providers independently evaluated age who had presented fever. They recorded initial ‘gestalt’ whether or not child was ill appearing if they were...
Background Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and hospital admission in infants. An analogous disease occurs cattle costs US agriculture a billion dollars year. RSV causes much its morbidity indirectly via adverse effects host response to virus. accompanied by elevated prostaglandin E2 (PGE2) which followed neutrophil led inflammation lung. Ibuprofen prototypical non-steroidal anti-inflammatory drug that decreases PGE2 levels inhibiting...
Background: Artificial neural networks apply complex non-linear functions to pattern recognition problems. An ensemble is a ‘committee’ of that usually outperforms single networks. Bronchiolitis common manifestation viral lower respiratory tract infection in infants and toddlers. Objective: To train artificial network ensembles predict the disposition length stay children presenting Emergency Department with bronchiolitis. Methods: A specifically constructed database 119 episodes...
<h3>Background:</h3> The use of rapid antigen tests to triage specimens for polymerase chain reaction (PCR) testing from emergency department patients with influenza-like illness during surveillance novel influenza viruses has been suggested. <h3>Objective:</h3> To measure the observed sensitivity and specificity a widely used test (Binax) using PCR-based assay (Medical Diagnostic Laboratories). <h3>Methods:</h3> Nasopharyngeal samples were taken flocked swabs (Copan Diagnostics) presenting...
We hypothesized (1) that gastrointestinal (GI) and renal adverse events (AE) would occur more often in infants first prescribed ibuprofen before rather than after six months of age (2) be associated with effects acetaminophen younger months.We created two partly overlapping retrospective cohorts aged less when California Medicaid paid for or between 2004 2010. In the cohort we compared incidence rate ratio (RR) GI AE those age. second RR (+/-acetaminophen) only acetaminophen.We identified...
Importance Fostamatinib, a spleen tyrosine kinase inhibitor, has been reported to improve outcomes of COVID-19. Objective To evaluate the efficacy and safety fostamatinib in adults hospitalized with COVID-19 hypoxemia. Design, Setting, Participants This multicenter, phase 3, placebo-controlled, double-blinded randomized clinical trial was conducted at 41 US sites 21 international between November 17, 2021, September 27, 2023; last follow-up visit December 31, 2023. were aged 18 years or...
The research presented here explores the hypothesis that deployment and acceptance of decision support systems in medicine will be enhanced if basis for recommendation produced by system is apparent. We describe a advising on patients suffering from bronchiolitis. This supports its recommendations with precedent cases selected to along justification text highlights aspects these relevant query case. It also presents an estimate confidence recommendation. main contribution this paper...
Background: We previously constructed and tested a bronchiolitis severity assessment tool in 2 independent hospitals. The model uses age, work of breathing, dehydration tachycardia to successfully predict disease severity. Objective: To prospectively measure the interrater reliability its component variables. Design: Prospective observational survey. Setting: A county teaching hospital emergency department serving mixed urban rural population with an medicine residency program 2-3-4 format....
Bovine respiratory syncytial virus (RSV) is a valid model for human RSV and an important bovine pathogen. Very early administration of ibuprofen GS-561937, fusion protein inhibitor (FPI), have separately been shown to decrease the severity RSV. Our aims were determine how long after inoculation GS-561937 can be administered with clinical benefit whether using both was better than monotherapy.
Introduction: Coronavirus disease 2019 (COVID-19) can be a life-threatening lung or trivial upper respiratory infection depending on whether the alveoli are involved. Emergency department (ED) evaluation of symptomatic patients with normal vital signs is frequently limited to chest auscultation and oro-nasopharyngeal swabs. We tested null hypothesis that being screened for COVID-19 in ED without hypoxia would have point-of-care ultrasound (LUS) consistent less than 2% time.Methods: performed...
Objective To measure the performance characteristics of an immunochromatographic rapid antigen test for respiratory syncytial virus (RSV) and determine how its interpretation should be contextualised in patients presenting to emergency department (ED) with bronchiolitis. Design Diagnostic accuracy study a RSV test. Setting County hospital ED. Intervention We took paired nasal samples from consecutively enrolled infants bronchiolitis tested them reverse transcriptase PCR gold standard....
Background Bronchiolitis sometimes triggers the development of subsequent recurrent wheezing. Treatment with either acetaminophen or ibuprofen during initial episode may affect occurrence Materials and methods We did a retrospective study comparing effect prescribing acetaminophen, ibuprofen, neither for first bronchiolitis on medical attendances wheezing in infants younger than 12 months. created our cohorts using California Medicaid data from 2003 to 2010. used propensity score derived...