Clinical Focus


  • Critical Care Medicine

Academic Appointments


Professional Education


  • Medical Education: St George's University School of Medicine Grenada West Indies (2012) NY West Indies
  • Board Certification: American Board of Internal Medicine, Sleep Medicine (2021)
  • Fellowship: Stanford School of Medicine (2020) CA
  • Board Certification: American Board of Internal Medicine, Critical Care Medicine (2019)
  • Fellowship: UCSF Fresno Medical Education Programs (2019) CA
  • Board Certification: American Board of Internal Medicine, Pulmonary Disease (2018)
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2017)
  • Residency: St Joseph Hospital and Medical Center Internal Medicine Residency (2016) AZ

All Publications


  • International consensus statement on obstructive sleep apnea. International forum of allergy & rhinology Chang, J. L., Goldberg, A. N., Alt, J. A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., Billings, M. E., Boon, M. S., Bosschieter, P., Braverman, I., Brodie, K., Cabrera-Muffly, C., Caesar, R., Cahali, M. B., Cai, Y., Cao, M., Capasso, R., Caples, S. M., Chahine, L. M., Chang, C. P., Chang, K. W., Chaudhary, N., Cheong, C. S., Chowdhuri, S., Cistulli, P. A., Claman, D., Collen, J., Coughlin, K., Creamer, J., Davis, E. M., Dupuy-McCauley, K. L., Durr, M. L., Dutt, M., Ali, M. E., Elkassabany, N. M., Epstein, L. J., Fiala, J. A., Freedman, N., Gill, K., Gillespie, M. B., Golisch, L., Gooneratne, N., Gottlieb, D. J., Green, K. K., Gulati, A., Gurubhagavatula, I., Hayward, N., Hoff, P. T., Hoffmann, O. M., Holfinger, S. J., Hsia, J., Huntley, C., Huoh, K. C., Huyett, P., Inala, S., Ishman, S., Jella, T. K., Jobanputra, A. M., Johnson, A. P., Junna, M. R., Kado, J. T., Kaffenberger, T. M., Kapur, V. K., Kezirian, E. J., Khan, M., Kirsch, D. B., Kominsky, A., Kryger, M., Krystal, A. D., Kushida, C. A., Kuzniar, T. J., Lam, D. J., Lettieri, C. J., Lim, D. C., Lin, H., Liu, S. Y., MacKay, S. G., Magalang, U. J., Malhotra, A., Maurer, J. T., May, A. M., Mitchell, R. B., Mokhlesi, B., Mullins, A. E., Nada, E. M., Naik, S., Nokes, B., Olson, M. D., Pack, A. I., Pang, E. B., Pang, K. P., Patil, S. P., de Perck, E. V., Piccirillo, J. F., Pien, G. W., Piper, A. J., Plawecki, A., Quigg, M., Ravesloot, M. J., Redline, S., Rotenberg, B. W., Ryden, A., Sarmiento, K. F., Sbeih, F., Schell, A. E., Schmickl, C. N., Schotland, H. M., Schwab, R. J., Seo, J., Shah, N., Shelgikar, A. V., Shochat, I., Soose, R. J., Steele, T. O., Stephens, E., Stepnowsky, C., Strohl, K. P., Sutherland, K., Suurna, M. V., Thaler, E., Thapa, S., Vanderveken, O. M., de Vries, N., Weaver, E. M., Weir, I. D., Wolfe, L. F., Woodson, B. T., Won, C. H., Xu, J., Yalamanchi, P., Yaremchuk, K., Yeghiazarians, Y., Yu, J. L., Zeidler, M., Rosen, I. M. 2022

    Abstract

    BACKGROUND: Evaluation and interpretation of the literature on obstructive sleep apnea is needed to consolidate and summarize key factors important for clinical management of the OSA adult patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).METHODS: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus.RESULTS: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA and treatment on the multiple comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated.CONCLUSION: This review of the literature in OSA consolidates the available knowledge and identifies the limitations of the current evidence. This effort aims to highlight the basis of OSA evidence-based practice and identify future research needs. Knowledge gaps and opportunities for improvement include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy. This article is protected by copyright. All rights reserved.

    View details for DOI 10.1002/alr.23079

    View details for PubMedID 36068685

  • Hepatitis C virus as a systemic disease: reaching beyond the liver HEPATOLOGY INTERNATIONAL Gill, K., Ghazinian, H., Manch, R., Gish, R. 2016; 10 (3): 415-423

    Abstract

    Chronic hepatitis C (CHC) is associated with multiple extrahepatic manifestations that may impact infected patients. The mechanisms through which these develop include those which are immunological, in which the chronic persistence of virus leads to the circulation of immune complexes (mixed cryoglobulinemia) and other autoimmune phenomena, and those which are virological and related to the extrahepatic tropism of the virus to other tissues. It is estimated that 40-74 % of patients with CHC may develop at least one extrahepatic manifestation during the course of the disease. Extrahepatic syndromes may represent the first signal of hepatitis C infection in some patients. CHC is associated with a four-fold increased risk of insulin resistance and type 2 diabetes mellitus; with cardiovascular disease in 17-37 % of patients; and with increased risk for cerebrovascular deaths, with a biological gradient of cerebrovascular mortality correlating with an increasing serum viral load. CHC is also associated with lymphoproliferative disorders, particularly non-Hodgkin B-cell lymphoma. The kidney is involved in 35-60 % of patients with CHC-associated mixed cryoglobulinemia. The prevalent type of glomerulonephritis associated with mixed cryoglobulinemia is membranoproliferative glomerulonephritis. In 30 % of cases, renal involvement begins with a nephritis syndrome and acute renal failure, while in 55 % there is only mild hematuria, microalbuminuria, proteinuria and renal insufficiency. CHC is also associated with cognitive impairment, especially in memory and concentration. Thus, extrahepatic CHC manifestations involve multiple organ systems outside the liver linked to a variety of comorbidities which may lead to significantly increased mortality from non-liver-related events.

    View details for DOI 10.1007/s12072-015-9684-3

    View details for Web of Science ID 000373595200005

    View details for PubMedID 26660706

    View details for PubMedCentralID PMC4819925