Steven J. Palazzo
Seattle University
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Featured researches published by Steven J. Palazzo.
Respiratory Care | 2012
Steven J. Palazzo; Terri Simpson; Jillian Simmons; Lynn M. Schnapp
OBJECTIVE: To determine the utility of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels in bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC) samples from patients who underwent bronchoscopy for a clinical suspicion of ventilator-associated pneumonia (VAP), to categorize patients as VAP positive and VAP negative, when compared to quantitative culture results of BALF. METHODS: Observational study conducted on admitted patients in the trauma-surgical, medical-cardiac, burn, and neurosurgical ICUs of Harborview Medical Center between March 2009 and May 2010. BALF and EBC samples were obtained from 45 patients with clinically suspected VAP. Bronchoscopy was performed on the day of clinically suspected VAP. sTREM-1 levels in EBC and BAL fluid were measured using quantikine human TREM-1 immunoassay. VAP was diagnosed by quantitative cultures of BALF. RESULTS: The concentrations of sTREM-1 in BALF and EBC did not correlate with VAP status. sTREM-1 levels did not discriminate VAP positive from VAP negative patients, when compared to quantitative cultures of BALF as the gold standard. Using a cutoff value of 204 pg/mL for BALF sTREM-1 levels resulted in a sensitivity of 79% and a specificity of 23%. A cutoff value of 10 pg/mL for EBC sTREM-1 levels resulted in a sensitivity of 42% and a specificity of 50%. CONCLUSIONS: EBC and BALF sTREM-1 levels did not effectively categorize patients as VAP positive or VAP negative when using direct bronchoscopic quantitative culture samples as the comparison standard.
PLOS ONE | 2013
Elizabeth V. Nguyen; Sina A. Gharib; Steven J. Palazzo; Yu Hua Chow; David R. Goodlett; Lynn M. Schnapp
Rationale Ventilator-associated pneumonia (VAP) is a common complication in patients with acute lung injury (ALI) and can lead to increased morbidity and mortality. Identifying protein profiles specific to VAP in bronchoalveolar lavage fluid (BALF) may aid in earlier diagnosis, elucidate mechanisms of disease, and identify putative targets for therapeutic intervention. Methods BALF was obtained from 5 normal subjects and 30 ALI patients: 14 with VAP (VAP+) and 16 without VAP (VAP–). Each sample underwent shotgun proteomic analysis based on tandem mass spectrometry. Differentially expressed proteins between the groups were identified using statistical methods based on spectral counting. Mechanisms of disease were explored using functional annotation and protein interaction network analysis. Supervised classification algorithms were implemented to discover a proteomic classifier for identifying critically ill patients with VAP. Results ALI patients had distinct BALF proteomic profiles compared to normal controls. Within the ALI group, we identified 76 differentially expressed proteins between VAP+ and VAP–. Functional analysis of these proteins suggested activation of pro-inflammatory pathways during VAP. We identified and validated a limited proteomic signature that discriminated VAP+ from VAP– patients comprised of three proteins: S100A8, lactotransferrin (LTF), and actinin 1 (ACTN1). Conclusions Combining proteomic with computational analyses is a powerful approach to study the BALF proteome during lung injury and development of VAP. This integrative methodology is a promising strategy to differentiate clinically relevant subsets of ALI patients, including those suffering from VAP.
Dimensions of Critical Care Nursing | 2012
Steven J. Palazzo; Terri Simpson; Lynn M. Schnapp
Excessive and unregulated inflammation contributes to multiorgan failure and death in sepsis. Triggering receptor expressed on myeloid cells type 1(TREM-1) is expressed on neutrophils and monocytes and is upregulated in the presence of bacterial pathogens. Engagement of TREM-1 results in increased expression of proinflammatory chemokines and cytokines and amplifies the inflammatory response. In this article, we will review the structure and signaling pathway of TREM-1 and review the role of TREM-1 and soluble TREM-1 in the inflammatory response during sepsis. Based on these studies, modulation of the TREM-1 signaling pathway has been suggested as a potential therapeutic strategy for the treatment of sepsis, to dampen the inflammatory response without interrupting the ability of the host to clear pathogens. This basic science research may someday lead to other treatments for sepsis and other diseases.
Public Health Nursing | 2017
Gail Salvatierra; Steven J. Palazzo; Allison Emery
Objective: Describe the rates of CPR/AED training in high schools in the state of Washington after passage of legislation mandating CPR/AED training. Design and Sample: A web‐based survey was sent to administrators at 660 public and private high schools in the state of Washington. Results and Conclusions: The survey was completed by 148 schools (22%); 64% reported providing CPR training and 54% provided AED training. Reported barriers to implementation included instructor availability, cost, and a lack of equipment. Descriptive statistics were used to describe the sample characteristics and implementation rates. Mandates without resources and support do not ensure implementation of CPR/AED training in high schools. Full public health benefits of a CPR mandate will not be realized until barriers to implementation are identified and eliminated through use of available, accessible public health resources.
Nursing Outlook | 2017
Abraham A. Brody; Jason E. Farley; Gordon Lee Gillespie; Ronald L. Hickman; Eric A. Hodges; Courtney Lyder; Steven J. Palazzo; Todd M. Ruppar; Martin Schiavenato; Daniel J. Pesut
BACKGROUND Managing diversity dynamics in academic or clinical settings for men in nursing has unique challenges resulting from their minority status within the profession. PURPOSE The purpose of this study was to share challenges and lessons learned identified by male scholars in the Robert Wood Johnson Foundation Nurse Faculty Scholars program and suggest strategies for creating positive organizations promoting inclusive excellence. METHODS Multiple strategies including informal mentored discussions and peer-to-peer dialogue throughout the program, formal online surveys of scholars and National Advisory Committee members, and review of scholar progress reports were analyzed as part of the comprehensive evaluation plan of the program. DISCUSSION Diversity dynamic issues include concerns with negative stereotyping, microaggression, gender intelligence, and differences in communication and leadership styles. CONCLUSION Male nurse faculty scholars report experiencing both opportunities and challenges residing in a predominately female profession. This article attempts to raise awareness and suggest strategies to manage diversity dynamics in service of promoting the development of a culture of health that values diversity and inclusive excellence for both men and women in academic, research, and practice contexts.
Heart & Lung | 2011
Steven J. Palazzo; Terri Simpson; Lynn M. Schnapp
Nursing education perspectives | 2016
Steven J. Palazzo; Carrie Westmoreland Miller; Gail Salvatierra
Archive | 2017
Omar Ali; Steven J. Palazzo; Jeffrey A. Willey
Journal of Adolescent Health | 2017
Steven J. Palazzo
44th Biennial Convention (28 October - 01 November 2017) | 2017
Steven J. Palazzo; Nancy C. Sharts-Hopko; Lynnette Leeseberg Stamler