Joseph Varon

Joseph Varon
University of Texas Health Science Center at Houston

MD, FACP, FCCP, FCCM, FRSM

About

747
Publications
208,636
Reads
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11,125
Citations
Citations since 2017
152 Research Items
4043 Citations
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20172018201920202021202220230200400600800
20172018201920202021202220230200400600800
Additional affiliations
January 2016 - present
Foundation Surgical Hospital of Houston
Position
  • Chief of Critical Care Services
June 2010 - January 2016
University General Hospital
University General Hospital
Position
  • Chief of Critical Care Services
March 2002 - September 2016
University of Texas Medical Branch at Galveston
Position
  • Clinical Professor of Medicine

Publications

Publications (747)
Article
Full-text available
The emergence of SARS-CoV-2 in late December 2019 has taken the world by storm. In March 2020, the World Health Organization (WHO) named this virus COVID-19. To date, it has infected approximately 186 million people worldwide and is attributed as the cause of death of more than 5 million people (and this number is only increasing.) The global effor...
Article
Full-text available
In December 2019, coronavirus disease 2019 (COVID-19), a severe respiratory illness caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The greatest impact that COVID-19 had was on intensive care units (ICUs), given that approximately 20% of hospitalized cases developed acute respirato...
Article
Full-text available
Background The relationship between computed tomography (CT) and prognosis of patients with COVID-19 pneumonia remains unclear. We hypothesized that the Ichikado CT score, obtained in the first 24 h of hospital admission, is an independent predictor for all-cause mortality during hospitalization in patients with COVID-19 pneumonia. Methods Single-...
Conference Paper
Thyroid hormones are known to have a significant effect on the cardiovascular system through cellular effects on cardiac myocytes and myocardial and vascular smooth muscle cells. It has also been stated cardiovascular complications, such as arrhythmias, ischemia, and cardiomyopathy, are due to hyperdynamic status and decreased systemic vascular res...
Article
Rene Laennec came up with the idea of a stethoscope in 1816 to avoid the embarrassment of performing immediate auscultation on women. Soon many doctors around the world started using this tool because of its increased accuracy and ease of use. Stethoscopes hold great significance in the medical community. However, is the importance placed on stetho...
Article
Full-text available
The aeromedical transport of critically ill patients has become an integral part of practicing medicine on a global scale. The development of reliable portable medical equipment allows physicians, emergency medical technicians, and nurses to transport wounded and diseased patients under constant critical care attention. Air transportation involves...
Article
Full-text available
Novel coronavirus 2019 (COVID-19) has been one of the largest and most devastating global pandemics of our time. There have been several complications of this disease that have also proven to be debilitating and deadly. While primarily affecting the respiratory system, some cases presented with uncommon complications such as pneumopericardium and s...
Article
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Background: After COVID-19 emerged on U.S shores, providers began reviewing the emerging basic science, translational, and clinical data to identify potentially effective treatment options. In addition, a multitude of both novel and repurposed therapeutic agents were used empirically and studied within clinical trials. Areas of uncertainty: The...
Article
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Introduction: COVID-19 has several overlapping phases. Treatment has focused on the late stage of the disease in hospital. Yet, the continuation of the pandemic is by propagation of the disease in outpatients. The current public health strategy relies solely on vaccines to prevent disease. Areas Covered: We searched the major national registries, p...
Article
Full-text available
COVID-19, caused by SARS-CoV-2, continues to be a major health problem since its first description in Wuhan, China, in December 2019. Multiple drugs have been tried to date in the treatment of COVID-19. Critical to treatment of COVID-19 and advancing therapeutics is an appreciation of the multiple stages of this disease and the importance of timing...
Article
The latest edition of this handbook is a concise yet comprehensive guide for attending physicians, fellows, residents, and students who cover the ICU. The chapters follow an outline format and are divided by organ system, including neurologic disorders and cardiovascular disorders, and special topics, such as environmental disorders, trauma, and to...
Article
Full-text available
COVID-19 is a highly heterogeneous and complex medical disorder; indeed, severe COVID-19 is probably amongst the most complex of medical conditions known to medical science. While enormous strides have been made in understanding the molecular pathways involved in patients infected with coronaviruses an overarching and comprehensive understanding of...
Article
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Introduction Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent and progressive airflow limitation generally caused by prolonged cigarette smoking. Ethnic differences have been reported regarding COPD risk from smoking. The purpose of this study was to compare COPD prevalence in Hispanic and Caucasian smokers in a real-worl...
Article
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Background Prolonged Mechanical Ventilation (PMV) is associated with a higher cost of care and increased morbidity and mortality. Patients requiring PMV are referred mostly to Long-Term Acute Care (LTAC) facilities. Objective To determine if protocol-driven weaning from mechanical ventilator by Respiratory Therapist (RT) would result in quicker we...
Article
Full-text available
In December 2019, COVID-19, a severe respiratory illness caused by the new coronavirus SARS-CoV-2 (COVID-19) emerged in Wuhan, China. The greatest impact that COVID-19 had was on intensive care units (ICUs), given that approximately 20% of hospitalized cases developed acute respiratory failure (ARF) requiring ICU admission. Based on the assumption...
Article
Full-text available
Background: Several prediction models have been proposed to assess the short outcomes and in-hospital mortality among patients with heart failure (HF). Several variables were used in common among those models. We sought to focus on other, yet important risk factors that can predict outcomes. We also sought to stratify patients based on ejection fra...
Article
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Case presentation An 86-year-old Hispanic lady was brought to the emergency department in acute respiratory distress. She had tested COVID-19 positive a week prior to her presentation. She had a past medical history of chronic hypertension, gastric ulcer, abdominal hernia , anxiety, and arthritis. On arrival blood pressure was 130/72 mmHg, heart ra...
Article
Full-text available
Delivering bad news to patients is a challenging yet impactful everyday task in clinical practice. Ideally, healthcare practitioners should receive formal training in implementing these protocols, practice in simulation environments, and real-time supervision with feedback. We aimed to investigate whether healthcare providers involved in delivering...
Preprint
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In March 2020, an expert panel called the Front Line COVID-19 Critical Care Alliance (FLCCC) was created and led by Professor Paul E. Marik, with the goal of continuously reviewing the rapidly emerging basic science, translational, and clinical data in order to gain insight into and to develop a treatment protocol for COVID-19. At the same time, ma...
Article
The newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has impacted the world dramatically, forcing the medical community to quickly and effectively find ways to manage coronavirus disease 2019 (COVID-19). The COVID-19 pandemic has shown many similarities to the human immunodeficiency virus pandemic in 1981, from the fear...
Article
Full-text available
Lazarus phenomenon refers to autoresuscitation of a patient declared dead after cessation of cardiopulmonary resuscitation (CPR). The Lazarus phenomenon is rarely encountered and pathophysiology is not very well understood, but physicians need to be aware of this phenomenon. It is prudent that a physician leading a CPR effort waits for some time an...
Chapter
Therapeutic hypothermia has been used for millennia, but more recently, targeted temperature management has caught physician’s interest as the main neuroprotective strategy for cardiac arrest patients who remain comatose after return of spontaneous circulation. Randomized clinical trials have shown benefits in neurologic and mortality outcomes when...
Article
Full-text available
Introduction COVID-19 disease progresses through a number of distinct phases. The management of each phase is unique and specific. The pulmonary phase of COVID-19 is characterized by an organizing pneumonia with profound immune dysregulation, activation of clotting, and a severe microvascular injury culminating in severe hypoxemia. The core treatme...
Article
Objective Inhalation of noble and other gases after cardiac arrest (CA) might improve neurological and cardiac outcomes. This article discusses up-to-date information on this novel therapeutic intervention. Data sources CENTRAL, MEDLINE, online published abstracts from conference proceedings, clinical trial registry clinicaltrials.gov, and referen...
Article
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Background: A diverse country like India may have variable intensive care units (ICUs) practices at state and city levels. Aim: To gain insight into clinical services and processes of care in ICUs in India, this would help plan for potential educational and quality improvement interventions. Methods: The Indian ICU needs assessment research gr...
Preprint
Full-text available
Background. The spread of COVID-19 from Wuhan in China throughout the world has been alamingly rapid. Epidemiologic techniques succeeded in containing the disease in China, but efforts were not as successful in the rest of the world, particularly the United States where there have been 1,592, 599 cases with 95,863 deaths as of May 25, 2020. Project...
Article
Tranexamic acid (TXA) is labeled as an antifibrinolytic agent that decreases mortality, reduces blood loss after trauma or surgery, and lowers transfusion requirements in trauma patients with bleeding. This review of the literature is related to TXA use in a variety of settings, with a specific focus on trauma patients, to assess therapeutic effica...
Article
By the end of December 2019, a single stranded ribonucleic acid (RNA) virus, Coronavirus, was said to be responsible for an outbreak of respiratory infections of unknown origin in Wuhan, China. Globally, this virus has caused over 160,000 deaths and is expected to increase as the pandemic continues. The majority of patients with the coronavirus dis...
Article
Full-text available
A fifty-seven-year-old woman, with a large myometrial tumor who underwent a mechanical mitral valve replacement with a left ventricular ejection fraction (EF) estimated at 63% prior to surgery and post operation ranging at 17%. Following surgery, cardiogenic shock (CS) was diagnosed after an electrocardiogram (ECG) monitor that revealed a narrow pa...
Article
Heyde syndrome is characterized by an association between gastrointestinal (GI) bleeding and calcific aortic stenosis (AS). Although the course of disease progression that links AS and GI bleeding has not been determined, overlaps among AS, intestinal dysplasia, and acquired von Willebrand's syndrome are thought to result in GI bleeding. Aortic val...
Article
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Sepsis and septic shock remain a major cause of morbidity and mortality among patients admitted in the intensive care unit. Diabetes is a major risk factor for the development of sepsis. The global mortality of sepsis remains high, despite significant interventions and guidelines. It has been known for decades that patients with sepsis have reduced...
Article
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We hereby present a case of iatrogenic dissection of the superior mesenteric artery dissection in a 63-year-old female undergoing a lumbar puncture (LP). She presented with severe diffused abdominal pain accompanied by lower back pain, nausea and vomiting a few hours after undergoing an LP due to ongoing headaches. Abdominal CT showed evidence of h...
Article
A fecalith is a mass of an accumulation of hardened fecal matter that is seen in patients with Chagas disease, Hirschsprung's disease, and inflammatory bowel disease. In this article, we report a case of a 53-year-old female with chronic abdominal pain who was admitted with progressive weight loss, near syncope episode, and serum potassium of 2.6 m...
Article
Full-text available
The coronavirus (CoV), thus named because its virion is spherical with spiky projections similar to solar corona, is an enveloped, non-segmented positive-sense RNA virus belonging to the Coronaviridae family in the Nidovirales order. This family is further divided into alpha, beta, gamma, and delta coronaviruses, based on serology. CoVs contain a 5...
Article
Introduction Television medical dramas (TVMDs) use cardiopulmonary resuscitation (CPR) as a mean of achieving higher viewing rates. TVMDs portrayal of CPR can be used to teach laypersons attempting to perform CPR and to form a shared professional and layperson mental model for CPR decisions. We studied the portrayal of CPR across a wide range of TV...
Article
Introduction Helicopter medical transport of prisoner patients has unique logistical and medical challenges, as well as potential risks to healthcare providers. Prisoners have specific requirements for safe transport, and it is of paramount importance to know the variables related to transport related mortality since most prisoners that need air ev...
Article
Full-text available
In December 2019, a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak of respiratory disease in Wuhan, China, that quickly spread to other countries causing a global pandemic. Although the reverse transcriptase polymerase chain reaction (RT-PCR) test for SARS-CoV-2 infection has become the standard method of diag...
Article
Full-text available
Background: The ethical principle of justice demands that resources be distributed equally and based on evidence. Guidelines regarding forgoing of CPR are unavailable and there is large variance in the reported rates of attempted CPR in in-hospital cardiac arrest. The main objective of this work was to study whether local culture and physician pre...
Article
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Mycobacterium terrae infection can cause progressive debilitating disease. A case of a 63-year-old man with localized pulmonary infection characterized by extensive, thick-walled cavitary lesions is presented. A pneumonectomy was considered as definitive treatment, but the patient would not have tolerated the procedure given his severe deconditioni...
Article
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The association between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD) is well-established in children. However, there is a paucity of literature regarding this association in adults. The aim of this study was to determine if ADHD is more common in adult patients with OSA. All patients referred to a sleep center f...
Article
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Carbon monoxide (CO) is a gas product of combustion, considered highly poisonous. Prolonged CO exposure is responsible for more than half of fatal poisonings and is also one of the leading causes of poisoning in Western countries. We aimed to compare the effectiveness of therapy with hyperbaric oxygen (HBO) versus normobaric oxygen (NBO) in the set...
Article
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Factor V (FV) deficiency (F5D) is a rare hematological disorder with a variable spectrum ofbleeding manifestations. Until now, no specific protocols for the management of these patientshave been established. However, available literature suggests that perioperative infusion offresh frozen plasma (FFP) may help maintain FV levels to prevent bleeding...
Article
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The Brockenbrough-Braunwald-Morrow phenomenon provides objective evidence of the existence and degree of left ventricular outflow tract (LVOT) obstruction, which can be improved with pharmacological therapy, surgical myectomy, or interventional alcohol septal ablation (ASA). This article incorporates contemporary research findings that are useful f...
Article
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Blood glucose control, including hyperglycemia correction, maintaining glucose at optimal level and avoiding hypoglycemia, is a challenge clinicians face every day in intensive care units (ICUs). If managed inadequately, its related mortality can increase. Prior to 2001, no relevant data from randomized, controlled studies assessing glucose control...
Article
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We present the case of a 59-year-old gentleman with a history of nonmetastatic tonsillar malignancy and radiation chondronecrosis, who underwent targeted temperature management (TTM) in a sequential manner. The first time the patient underwent therapeutic cooling occurred after he developed a respiratory arrest followed by a cardiac arrest and prol...
Article
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Alpha-1 antitrypsin deficiency (AATD) or alpha-1 antitrypsin proteinase inhibitor (α1-Pi) deficiency, is a genetic disorder leading to a higher risk of pulmonary, hepatic and other organ-related diseases. The spectrum of diseases associated with AATD is large and includes pulmonary conditions (COPD, asthma, asthma-COPD overlap syndrome, bronchiecta...
Article
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Purpose: Hypertension remains a common cause of morbidity and mortality worldwide, and proper management can prevent death. Over the last few decades, several changes in definitions, clinical manifestations, and management have occurred. We aimed to investigate the extent of knowledge about these changes, as the pertain to acute elevations of blood...
Article
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Hiatal hernia is a condition involving herniation of abdominal cavity contents through the diaphragm into the mediastinum. These hernias may compromise mediastinal structures and can be life-threating for which emergent treatment may be required. We recently had such one case of a 56-year old gentleman with a large transverse left posterior diaphra...