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Article ; Online: Chimeric Antigen Receptor T Cells: Toxicity and Management Considerations.

Owusu, Kent A / Schiffer, Molly / Perreault, Sarah

2022 Volume 33, Issue 4, Page(s) 301–307

MeSH term(s)	Humans ; Receptors, Chimeric Antigen ; T-Lymphocytes
Chemical Substances	Receptors, Chimeric Antigen
Language	English
Publishing date	2022-12-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2239949-5
ISSN	1559-7776 ; 1559-7768
ISSN (online)	1559-7776
ISSN	1559-7768
DOI	10.4037/aacnacc2022936
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Article ; Online: Evaluation and Management of Seizures and Status Epilepticus.

Ameli, Pouya Alexander / Ammar, Abdalla A / Owusu, Kent A / Maciel, Carolina B

Neurologic clinics

2021 Volume 39, Issue 2, Page(s) 513–544

Abstract: Seizures are frequently triggered by an inciting event and result from uninhibited excitation and/or decreased inhibition of a pool of neurons. If physiologic seizure abortive mechanisms fail, the ensuing unrestrained synchronization of neurons-status ... ...

Abstract	Seizures are frequently triggered by an inciting event and result from uninhibited excitation and/or decreased inhibition of a pool of neurons. If physiologic seizure abortive mechanisms fail, the ensuing unrestrained synchronization of neurons-status epilepticus-can be life-threatening and is associated with the potential for marked morbidity in survivors and high medical care costs. Prognosis is intimately related to etiology and its response to therapeutic measures. Timely implementation of pharmacologic therapy while concurrently performing a stepwise workup for etiology are paramount. Neurodiagnostic testing should guide titration of pharmacologic therapies, and help determine if there is a role for immune modulation.
MeSH term(s)	Humans ; Seizures/diagnosis ; Seizures/therapy ; Status Epilepticus/diagnosis ; Status Epilepticus/therapy
Language	English
Publishing date	2021-03-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1013148-6
ISSN	1557-9875 ; 0733-8619
ISSN (online)	1557-9875
ISSN	0733-8619
DOI	10.1016/j.ncl.2021.01.009
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Article ; Online: Improving Post-procedure Outcomes With Clinical Care Pathway for Enteral Access.

Miller, Samuel M / Abou-Azar, Sara / Owusu, Kent A / Judson, Benjamin L / Rhodes, Deborah / Morton, John M

The American surgeon

2023 Volume 89, Issue 12, Page(s) 6362–6365

Abstract: Our health system introduced an enteral access clinical pathway (EACP) hoping to increase nutritionist consults and decrease presentation to the Emergency Department, readmission to the hospital, and overall hospital length of stay. We followed patients ... ...

Abstract	Our health system introduced an enteral access clinical pathway (EACP) hoping to increase nutritionist consults and decrease presentation to the Emergency Department, readmission to the hospital, and overall hospital length of stay. We followed patients with short-term access (STA), longterm access (LTA), and short-long-term conversions (SLT) seen in the six months prior to the EACP launch (baseline group) and the six months after (performance group). The baseline cohort consisted of 2,553 patients and the performance cohort of 2,419 patients. Those in the performance group were more likely to receive a nutrition consult (52.4% vs 48.0%, P < .01), less likely to re-present to the ED (31.9% vs 42.6%, P < .001), and less likely to be readmitted to the hospital (31.0% vs 41.6%, P < .001. These findings suggest that the EACP may increase the likelihood of both expert-driven nutritional support and effective discharge planning for hospitalized patients.
MeSH term(s)	Humans ; Length of Stay ; Critical Pathways ; Nutritional Status ; Nutritional Support ; Patient Discharge ; Emergency Service, Hospital ; Patient Readmission ; Retrospective Studies
Language	English
Publishing date	2023-05-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348231177914
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Article ; Online: Alcohol Withdrawal Syndrome in Neurocritical Care Unit: Nicotine Replacement Therapy and Thiamine Deficiency.

Farrokh, Salia / Roels, Christina / Owusu, Kent A / Nelson, Sarah E / Cook, Aaron M

Neurocritical care

2021 Volume 34, Issue 2, Page(s) 707–708

MeSH term(s)	Humans ; Smoking Cessation ; Substance Withdrawal Syndrome/etiology ; Thiamine Deficiency/drug therapy ; Tobacco Use Cessation Devices
Language	English
Publishing date	2021-01-05
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2381896-7
ISSN	1556-0961 ; 1541-6933
ISSN (online)	1556-0961
ISSN	1541-6933
DOI	10.1007/s12028-020-01168-y
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Article: Narrative Review: Addressing Covid-19 Vaccine Concerns in Special and Vulnerable Populations.

Owusu, Kent A / Effendi, Muhammad K / Thompson Bastin, Melissa L / Tirmizi, Samad / Lat, Ishaq / Ammar, Mahmoud A

Hospital pharmacy

2022 Volume 57, Issue 4, Page(s) 575–587

Abstract: Public health advocates and healthcare professionals (HCPs) have been challenged with vaccine hesitancy and addressing misinformation. In order for HCPs and pharmacists, in particular, to serve as effective stewards of COVID-19 vaccine science in the ... ...

Abstract	Public health advocates and healthcare professionals (HCPs) have been challenged with vaccine hesitancy and addressing misinformation. In order for HCPs and pharmacists, in particular, to serve as effective stewards of COVID-19 vaccine science in the interest of the public good, it is imperative for HCPs to appreciate the various factors contributing to vaccine hesitancy and vaccine distrust. A PubMed search was performed and relevant articles on COVID-19 vaccine in populations of interest were included. Information from health agencies, such as the Centers for Disease Control and Prevention (CDC) as well as established professional health societies was incorporated for guidance. This review focuses on COVID-19 vaccine concerns in the populations of children, pregnancy and lactation, immunocompromised, and religious and ethnic disparities. We also discuss post emergency use authorization experience with respect to vaccine safety including annotations on Guillain-Barré Syndrome, myocarditis and pericarditis, and thrombosis with thrombocytopenia syndrome.
Language	English
Publishing date	2022-01-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1468893-1
ISSN	0018-5787
ISSN	0018-5787
DOI	10.1177/00185787211066463
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Article ; Online: Application of Cannabinoids in Neurosciences: Considerations and Implications.

Owusu, Kent A / Saliba, Lina / Ammar, Abdalla A / Ammar, Mahmoud A / Mucksavage, Jeffrey

Critical care nursing quarterly

2020 Volume 43, Issue 2, Page(s) 216–231

Abstract: Medicinal cannabinoid use continues to evolve across the United States, although legitimate federal recognition for medicinal purpose is lacking. Variability exists across states within the United States with respect to legislation, and health care ... ...

Abstract	Medicinal cannabinoid use continues to evolve across the United States, although legitimate federal recognition for medicinal purpose is lacking. Variability exists across states within the United States with respect to legislation, and health care institutions encounter challenges when patients present with a history of medicinal cannabinoid use. Emerging evidence in the field of neurosciences suggests a role of cannabinoids for neurologic medical conditions such as Parkinson disease, multiple sclerosis, and epilepsy. We aim to provide an overview of cannabinoids including a historical perspective, pharmacology, applications in neurosciences, and challenges in health care and academia. Knowledge of the appropriate role of cannabinoids in the clinical setting is essential for all health care practitioners including nursing.
MeSH term(s)	Cannabinoids/history ; Cannabinoids/pharmacology ; Cannabinoids/therapeutic use ; Epilepsy/therapy ; History, 19th Century ; History, 20th Century ; History, 21st Century ; History, Ancient ; Humans ; Medical Marijuana/therapeutic use ; Multiple Sclerosis/therapy ; Neurosciences ; Parkinson Disease/therapy ; United States
Chemical Substances	Cannabinoids ; Medical Marijuana
Language	English
Publishing date	2020-02-21
Publishing country	United States
Document type	Historical Article ; Journal Article
ZDB-ID	639095-x
ISSN	1550-5111 ; 0887-9303
ISSN (online)	1550-5111
ISSN	0887-9303
DOI	10.1097/CNQ.0000000000000303
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Article ; Online: Alcohol Withdrawal Syndrome in Neurocritical Care Unit: Assessment and Treatment Challenges.

Farrokh, Salia / Roels, Christina / Owusu, Kent A / Nelson, Sarah E / Cook, Aaron M

Neurocritical care

2020 Volume 34, Issue 2, Page(s) 593–607

Abstract: Alcohol withdrawal syndrome (AWS) can range from mild jittery movements, nausea, sweating to more severe symptoms such as seizure and death. Severe AWS can worsen cognitive function, increase hospital length of stay, and in-hospital mortality and ... ...

Abstract	Alcohol withdrawal syndrome (AWS) can range from mild jittery movements, nausea, sweating to more severe symptoms such as seizure and death. Severe AWS can worsen cognitive function, increase hospital length of stay, and in-hospital mortality and morbidity. Due to a lack of reliable history of present illness in many patients with neurological injury as well as similarities in clinical presentation of AWS and some commonly encountered neurological syndromes, the true incidence of AWS in neurocritical care patients remains unknown. This review discusses challenges in the assessment and treatment of AWS in patients with neurological injury, including the utility of different scoring systems such as the Clinical Institute Withdrawal Assessment and the Minnesota Detoxification Scale as well as the reliability of admission alcohol levels in predicting AWS. Treatment strategies such as symptom-based versus fixed dose benzodiazepine therapy and alternative agents such as baclofen, carbamazepine, dexmedetomidine, gabapentin, phenobarbital, ketamine, propofol, and valproic acid are also discussed. Finally, a treatment algorithm considering the neurocritical care patient is proposed to help guide therapy in this setting.
MeSH term(s)	Alcoholism ; Benzodiazepines ; Humans ; Hypnotics and Sedatives/therapeutic use ; Reproducibility of Results ; Retrospective Studies ; Substance Withdrawal Syndrome/drug therapy ; Substance Withdrawal Syndrome/therapy
Chemical Substances	Hypnotics and Sedatives ; Benzodiazepines (12794-10-4)
Language	English
Publishing date	2020-08-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2381896-7
ISSN	1556-0961 ; 1541-6933
ISSN (online)	1556-0961
ISSN	1541-6933
DOI	10.1007/s12028-020-01061-8
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Article ; Online: DEXmedetomidine compared to PROpofol in NEurocritical Care [DEXPRONE]: A multicenter retrospective evaluation of clinical utility and safety.

Owusu, Kent A / Kurczewski, Lisa / Armahizer, Michael J / Zichichi, Albert / Maciel, Carolina B / Heavner, Mojdeh S

Journal of critical care

2020 Volume 60, Page(s) 79–83

Abstract: Purpose: Although guidelines recommend dexmedetomidine (DEX) or propofol (PRO) as preferred sedatives in critically ill adults, comparisons in neurocritical care (NCC) are limited. We aimed to evaluate the clinical utility and safety of DEX compared ... ...

Abstract	Purpose: Although guidelines recommend dexmedetomidine (DEX) or propofol (PRO) as preferred sedatives in critically ill adults, comparisons in neurocritical care (NCC) are limited. We aimed to evaluate the clinical utility and safety of DEX compared with PRO in NCC setting. Materials and methods: This retrospective, multicenter, observational cohort study conducted at three tertiary academic hospitals with Level 1 Trauma Center and Comprehensive Stroke Center designations, compared the clinical indication and safety of DEX vs PRO in patients in NCC setting. Results: 179 patients were included (94 DEX and 85 PRO), median age of 58, 49% were male (DEX) and 58% were male (PRO). PRO was more commonly used to manage agitation. DEX was more commonly used for facilitating extubation, alcohol withdrawal, and sedation during frequent neurologic assessments. Mean Glasgow Coma Scale scores were higher in DEX group (11 vs. 9; p = .04). The duration of either infusions, mechanical ventilation, and lengths of stay were similar. No difference was observed in hypotension or bradycardia rates. Death was significantly higher with PRO (DEX 10% vs. PRO 22%; p = .02). Conclusions: DEX and PRO were used for distinct indications in our cohort. Adverse effect profiles and clinical outcome, in the cohorts are largely similar.
MeSH term(s)	Adult ; Aged ; Bradycardia/chemically induced ; Critical Care/methods ; Critical Illness ; Dexmedetomidine/adverse effects ; Female ; Humans ; Hypnotics and Sedatives/adverse effects ; Hypotension/chemically induced ; Intensive Care Units ; Male ; Middle Aged ; Propofol/adverse effects ; Respiration, Artificial ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Hypnotics and Sedatives ; Dexmedetomidine (67VB76HONO) ; Propofol (YI7VU623SF)
Language	English
Publishing date	2020-07-24
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2020.07.021
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Article ; Online: Andexanet Alfa Versus 4-Factor Prothrombin Complex Concentrate for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage.

Ammar, Abdalla A / Ammar, Mahmoud A / Owusu, Kent A / Brown, Stacy C / Kaddouh, Firas / Elsamadicy, Aladine A / Acosta, Julián N / Falcone, Guido J

Neurocritical care

2021 Volume 35, Issue 1, Page(s) 255–261

Abstract: Background/objective: There are limited data on the risks and benefits of using andexanet alfa (AA) in comparison with four-factor prothrombin complex concentrate (4F-PCC) to reverse factor Xa inhibitors (FXi) associated intracranial hemorrhage (ICH). ... ...

Abstract	Background/objective: There are limited data on the risks and benefits of using andexanet alfa (AA) in comparison with four-factor prothrombin complex concentrate (4F-PCC) to reverse factor Xa inhibitors (FXi) associated intracranial hemorrhage (ICH). We sought to describe our experience with AA or 4F-PCC in patients with oral FXi-related traumatic and spontaneous ICH. Methods: We conducted a retrospective review of consecutive adult patients with FXi-related ICH who received AA or 4F-PCC. FXi-related ICH cases included traumatic and spontaneous intracranial hemorrhages. Our primary analysis evaluated ICH stability on head computed tomography scan (CT), defined as a similar amount of blood from the initial scan at the onset of ICH to subsequent scans, at 6-h and 24-h post-administration of AA or 4F-PCC. For the subset of spontaneous intraparenchymal hemorrhages, volume was measured at 6-h and 24-h post-reversal. In secondary analyses, we evaluated good functional outcome at discharge, defined as a Modified Rankin Score of less than 3, and the incidence of thrombotic events after AA or 4F-PCC adminstration, during hospitalization. Results: A total of 44 patients (16 traumatic and 28 spontaneous ICH) with median age of 79 years [72-86], 36% females, with a FXi-related ICH, were included in this study. The majority of spontaneous ICHs were intraparenchymal 19 (68%). Twenty-eight patients (64%) received AA and 16 patients (36%) received 4F-PCC. There was no difference between AA and 4F-PCC in terms of CT stability at 6 h (21 [78%] vs 10 [71%], p = 0.71) and 24 h (15 [88%] vs 6 [60%], p = 0.15). In a subgroup of patients with spontaneous intraparenchymal hemorrhage, there was no difference in the degree of achieved hemostasis based on hematoma volume between AA and 4F-PCC at 6 h (9.3 mL [6.9-26.4] vs 10 mL [9.4-22.1], adjusted p = 0. 997) and 24-h (9.2 mL [6.1-18.8] vs 9.9 [9.4-21.1], adjusted p = 1). The number of patients with good outcome based on mRS on discharge were 10 (36%) and 6 (38%) in the AA and 4F-PCC groups, respectively (adjusted p = 0.81). The incidence of thromboembolic events was similar in the AA and 4F-PCC groups (2 [7%] vs 0, p = 0.53). Conclusion: In this limited sample of patients, we found no difference in neuroimaging stability, functional outcome and thrombotic events when comparing AA and 4F-PCC in patients with FXi-related ICH. Since our analysis is likely underpowered, a multi-center collaborative network devoted to this question is warranted.
MeSH term(s)	Adult ; Anticoagulants/adverse effects ; Blood Coagulation Factors/pharmacology ; Factor Xa ; Factor Xa Inhibitors/adverse effects ; Female ; Humans ; Infant, Newborn ; Intracranial Hemorrhages/chemically induced ; Intracranial Hemorrhages/drug therapy ; Male ; Recombinant Proteins ; Retrospective Studies
Chemical Substances	Anticoagulants ; Blood Coagulation Factors ; Factor Xa Inhibitors ; PRT064445 ; Recombinant Proteins ; prothrombin complex concentrates (37224-63-8) ; Factor Xa (EC 3.4.21.6)
Language	English
Publishing date	2021-01-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2381896-7
ISSN	1556-0961 ; 1541-6933
ISSN (online)	1556-0961
ISSN	1541-6933
DOI	10.1007/s12028-020-01161-5
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Article ; Online: Andexanet Alfa: Considerations and Practical Applications.

Owusu, Kent A / Effendi, Muhammad K / DeFilippo, Nicholas A / Reardon, David P / Ian Lee, Alfred

Critical pathways in cardiology

2019 Volume 18, Issue 4, Page(s) 200–206

MeSH term(s)	Blood Coagulation Factors/therapeutic use ; Factor Xa/therapeutic use ; Factor Xa Inhibitors/adverse effects ; Hemorrhage/chemically induced ; Hemorrhage/drug therapy ; Humans ; Pyrazoles/adverse effects ; Pyridones/adverse effects ; Recombinant Proteins/therapeutic use ; Rivaroxaban/adverse effects
Chemical Substances	Blood Coagulation Factors ; Factor Xa Inhibitors ; PRT064445 ; Pyrazoles ; Pyridones ; Recombinant Proteins ; prothrombin complex concentrates (37224-63-8) ; apixaban (3Z9Y7UWC1J) ; Rivaroxaban (9NDF7JZ4M3) ; Factor Xa (EC 3.4.21.6)
Language	English
Publishing date	2019-11-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2079676-6
ISSN	1535-2811 ; 1535-282X
ISSN (online)	1535-2811
ISSN	1535-282X
DOI	10.1097/HPC.0000000000000190
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