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How I Do It: High Flow, Non-Invasive Ventilation And Awake (Non-Intubation) Proning In Covid-19 Patients With Respiratory Failure., S Raoof, S Nava, C Carpati, Ns Hill Jan 2020

How I Do It: High Flow, Non-Invasive Ventilation And Awake (Non-Intubation) Proning In Covid-19 Patients With Respiratory Failure., S Raoof, S Nava, C Carpati, Ns Hill

Journal Articles

No abstract provided.


Powerless In The Icu: Perspectives From Icus In The Face Of Covid-19., P Ramachandran, L Swamy, V Kaul, A Agrawal, M Narasimhan Jan 2020

Powerless In The Icu: Perspectives From Icus In The Face Of Covid-19., P Ramachandran, L Swamy, V Kaul, A Agrawal, M Narasimhan

Journal Articles

No abstract provided.


When Predictions Are Used To Allocate Scarce Health Care Resources: Three Considerations For Models In The Era Of Covid-19., Dm Kent, Jk Paulus, Rr Sharp, N Hajizadeh Jan 2020

When Predictions Are Used To Allocate Scarce Health Care Resources: Three Considerations For Models In The Era Of Covid-19., Dm Kent, Jk Paulus, Rr Sharp, N Hajizadeh

Journal Articles

No abstract provided.


Locked-In With Covid-19, A. Avula, A. Gill, R. Nassar, K. Nalleballe, S. Siddamreddy, M. Chalhoub Jan 2020

Locked-In With Covid-19, A. Avula, A. Gill, R. Nassar, K. Nalleballe, S. Siddamreddy, M. Chalhoub

Journal Articles

© 2020 Elsevier Ltd Coronavirus Disease 2019 (COVID-19) can be associated with various neurological manifestations including acute strokes. Hyper acute diagnosis and treatment are key factors which decrease mortality and morbidity in stroke patients. The COVID-19 pandemic has introduced a great strain on the healthcare system, and as a result clinicians are facing several barriers in diagnosing and treating strokes. Delayed presentation of strokes is a problem as some in the general population defer the decision to seek immediate medical attention fearing contracting the virus. Also playing a role is the paucity of healthcare professionals available during a pandemic. Recent …


Major Thrombotic Event Despite Anticoagulation In A Patient With Covid-19., B. Ataallah, A. Sharma, S. Tamanna, J. Ng, G. Haggerty Jan 2020

Major Thrombotic Event Despite Anticoagulation In A Patient With Covid-19., B. Ataallah, A. Sharma, S. Tamanna, J. Ng, G. Haggerty

Journal Articles

The outbreak of coronavirus disease 2019 (known as COVID-19), which started in Wuhan, China in December 2019, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been associated with both venous and arterial thromboembolism likely secondary to significant cytokine activation and inflammation. Reports on the incidence of thrombotic complications, however, are not well documented. Our case will examine a young man diagnosed with COVID-19 who developed an acute, severe bilateral saddle pulmonary embolism while on prophylactic dose anticoagulation after being admitted to the hospital and treated for two weeks with significant improvement.


Pulmonary Embolism In Patients Hospitalized With Covid-19 (From A New York Health System), H. Xu, A. Martin, A. Singh, M. Narasimhan, J. Lau, M. Weinberg, R. Jauhar, G. Rao Jan 2020

Pulmonary Embolism In Patients Hospitalized With Covid-19 (From A New York Health System), H. Xu, A. Martin, A. Singh, M. Narasimhan, J. Lau, M. Weinberg, R. Jauhar, G. Rao

Journal Articles

© 2020 Elsevier Inc. Pulmonary embolisms (PEs) in coronavirus disease 2019 (COVID-19) have increasingly been reported in observational studies. However, limited information describing their clinical characteristics and outcomes exists. Our study aims to describe clinical features and risk stratification strategies of hospitalized COVID-19 patients with PE. We retrospectively analyzed 101 hospitalized patients with COVID-19 infection and acute PE. Clinical outcomes measured were intensive care unit admission, mechanical ventilation, bleeding and transfusion events, acute kidney injury (AKI) and mortality. Pulmonary severity index (PESI) scores were used for risk stratification. The most common comorbidities were hypertension (50%), obesity (27%) and hyperlipidemia (32%) …


Seizure And Covid-19: Association And Review Of Potential Mechanism., R. Joseph, N. Narula, A. Daouk, N. Katyal, S. Acharya, A. Avula, R. Maroun Jan 2020

Seizure And Covid-19: Association And Review Of Potential Mechanism., R. Joseph, N. Narula, A. Daouk, N. Katyal, S. Acharya, A. Avula, R. Maroun

Journal Articles

Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, this highly transmissible virus has since spread rapidly around the world. Though respiratory complication is the primarily reported manifestation though rare, yet serious neurological complications are being frequently reported in the literature. In selected coronavirus disease-2019 (COVID-19) cases neurologic complications may manifest as seizures. In this paper, we have reviewed current literature on seizures linked with SARS- COV 2 infection including published or pre-print original articles, review articles, and case reports. We have discussed the electroencephalogram (EEG), imaging, and Cerebrospinal fluid (CSF) findings in COVID-19 patients …


Study Of Alteplase For Respiratory Failure In Sars-Cov2/Covid-19: Study Design Of The Phase Iia Stars Trial., H. B. Moore, C. D. Barrett, E. E. Moore, R. Jhunjhnuwala, R. C. Mcintyre, P. K. Moore, J. Wang, N. Hajizadeh, A. Sauaia, M. B. Yaffe, +1 Additional Author Jan 2020

Study Of Alteplase For Respiratory Failure In Sars-Cov2/Covid-19: Study Design Of The Phase Iia Stars Trial., H. B. Moore, C. D. Barrett, E. E. Moore, R. Jhunjhnuwala, R. C. Mcintyre, P. K. Moore, J. Wang, N. Hajizadeh, A. Sauaia, M. B. Yaffe, +1 Additional Author

Journal Articles

Background:The COVID-19 pandemic has caused a large surge of acute respiratory distress syndrome (ARDS). Prior phase I trials (non COVID-19) demonstrated improvement in pulmonary function in ARDS patients using fibrinolytic therapy. A follow-up trial using the widely available tissue-plasminogen activator (alteplase) is now needed to assess optimal dosing and safety in this critically ill patient population. Objective:To describe the design and rationale of a Phase IIa trial to evaluate the safety and efficacy of alteplase treatment for moderate/severe COVID-19-induced ARDS. Patients/Methods:A rapidly adaptive, pragmatic, open label, randomized, controlled, phase IIa clinical trial will be conducted with three groups: intravenous(IV) alteplase …


Repurposing Orthopaedic Residents Amid Covid-19: Critical Care Prone Positioning Team., O. F. Rahman, D. P. Murray, R. M. Zbeda, A. D. Volpi, A. Z. Mo, N. A. Wessling, B. A. Mina, M. S. Mendez-Zfass, C. Carpati Jan 2020

Repurposing Orthopaedic Residents Amid Covid-19: Critical Care Prone Positioning Team., O. F. Rahman, D. P. Murray, R. M. Zbeda, A. D. Volpi, A. Z. Mo, N. A. Wessling, B. A. Mina, M. S. Mendez-Zfass, C. Carpati

Journal Articles

No abstract provided.


Cytokine Storm Of A Different Flavor: The Different Cytokine Signature Of Sars-Cov2 The Cause Of Covid-19 From The Original Sars Outbreak., D. O. Griffin, A. Jensen, M. Khan, J. Chin, K. Chin, J. Saad, R. Parnell, C. Awwad, D. Patel Jan 2020

Cytokine Storm Of A Different Flavor: The Different Cytokine Signature Of Sars-Cov2 The Cause Of Covid-19 From The Original Sars Outbreak., D. O. Griffin, A. Jensen, M. Khan, J. Chin, K. Chin, J. Saad, R. Parnell, C. Awwad, D. Patel

Journal Articles

We present a case series of three patients with COVID-19 who had a cytokine panel which revealed elevation of interleukin-6 (IL-6), but normal levels of interleukin-10 (IL-10), interferon-gamma (INF-γ) and interleukin-8 (IL-8) in contrast to the cytokine signature described in Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS). We also documented evidence of a compromised T-cell IFN-gamma response in two of these patients.


Association Of Anticoagulation Dose And Survival In Hospitalized Covid-19 Patients: A Retrospective Propensity Score-Weighted Analysis, F. Ionescu, I. Jaiyesimi, I. Petrescu, P. R. Lawler, E. Castillo, Y. Munoz-Maldonado, Z. Imam, M. Narasimhan, A. E. Abbas, G. B. Nair, +1 Additional Author Jan 2020

Association Of Anticoagulation Dose And Survival In Hospitalized Covid-19 Patients: A Retrospective Propensity Score-Weighted Analysis, F. Ionescu, I. Jaiyesimi, I. Petrescu, P. R. Lawler, E. Castillo, Y. Munoz-Maldonado, Z. Imam, M. Narasimhan, A. E. Abbas, G. B. Nair, +1 Additional Author

Journal Articles

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Background: Hypercoagulability may contribute to COVID-19 pathogenicity. The role of anticoagulation (AC) at therapeutic (tAC) or prophylactic doses (pAC) is unclear. Objectives: We evaluated the impact on survival of different AC doses in COVID-19 patients. Methods: Retrospective, multi-center cohort study of consecutive COVID-19 patients hospitalized between March 13 and May 5, 2020. Results: A total of 3480 patients were included (mean age, 64.5 years [17.0]; 51.5% female; 52.1% black and 40.6% white). 18.5% (n = 642) required intensive care unit (ICU) stay. 60.9% received pAC (n …


Recommendations For Core Critical Care Ultrasound Competencies As A Part Of Specialist Training In Multidisciplinary Intensive Care: A Framework Proposed By The European Society Of Intensive Care Medicine (Esicm), A. Wong, L. Galarza, L. Forni, D. De Backer, M. Slama, B. Cholley, P. Mayo, A. Mclean, F. Duška, +17 Additional Authors Jan 2020

Recommendations For Core Critical Care Ultrasound Competencies As A Part Of Specialist Training In Multidisciplinary Intensive Care: A Framework Proposed By The European Society Of Intensive Care Medicine (Esicm), A. Wong, L. Galarza, L. Forni, D. De Backer, M. Slama, B. Cholley, P. Mayo, A. Mclean, F. Duška, +17 Additional Authors

Journal Articles

© 2020 The Author(s). Critical care ultrasound (CCUS) is an essential component of intensive care practice. Although existing international guidelines have focused on training principles and determining competency in CCUS, few countries have managed to operationalize this guidance into an accessible, well-structured programme for clinicians training in multidisciplinary intensive care. We seek to update and reaffirm appropriate CCUS scope so that it may be integrated into the international Competency-based Training in Intensive Care Medicine. The resulting recommendations offer the most contemporary and evolved set of core CCUS competencies for an intensive care clinician yet described. Importantly, we discuss the rationale …


Lung Ultrasonography As An Alternative To Chest Computed Tomography In Covid-19 Pneumonia?, A. Vieillard-Baron, A. Goffi, P. Mayo Jan 2020

Lung Ultrasonography As An Alternative To Chest Computed Tomography In Covid-19 Pneumonia?, A. Vieillard-Baron, A. Goffi, P. Mayo

Journal Articles

No abstract provided.


General And Intensive Care Outcomes For Hospitalized Patients With Solid Organ Transplants With Covid-19, F. Mastroianni, D. E. Leisman, G. Fisler, M. Narasimhan Jan 2020

General And Intensive Care Outcomes For Hospitalized Patients With Solid Organ Transplants With Covid-19, F. Mastroianni, D. E. Leisman, G. Fisler, M. Narasimhan

Journal Articles

© The Author(s) 2020. Purpose: COVID-19 has been associated with a dysregulated inflammatory response. Patients who have received solid-organ transplants are more susceptible to infections in general due to the use of immunosuppressants. We investigated factors associated with mechanical ventilation and outcomes in solid-organ transplant recipients with COVID-19. Materials and Methods: We conducted a retrospective cohort study of all solid-organ transplant recipients admitted with a diagnosis of COVID-19 in our 23-hospital health system over a 1-month period. Descriptive statistics were used to describe hospital course and laboratory results and bivariate comparisons were performed on variables to determine differences. Results: Twenty-two …


Physician Agreement On The Diagnosis Of Sepsis In The Intensive Care Unit: Estimation Of Concordance And Analysis Of Underlying Factors In A Multicenter Cohort, B. K. Lopansri, R. R. Miller, J. P. Burke, M. Levy, S. Opal, M. Narasimhan, A. Tsegaye, S. Hahn, P. Mayo, R. B. Brandon, +19 Additional Authors Jan 2019

Physician Agreement On The Diagnosis Of Sepsis In The Intensive Care Unit: Estimation Of Concordance And Analysis Of Underlying Factors In A Multicenter Cohort, B. K. Lopansri, R. R. Miller, J. P. Burke, M. Levy, S. Opal, M. Narasimhan, A. Tsegaye, S. Hahn, P. Mayo, R. B. Brandon, +19 Additional Authors

Journal Articles

© 2019 The Author(s). Background: Differentiating sepsis from the systemic inflammatory response syndrome (SIRS) in critical care patients is challenging, especially before serious organ damage is evident, and with variable clinical presentations of patients and variable training and experience of attending physicians. Our objective was to describe and quantify physician agreement in diagnosing SIRS or sepsis in critical care patients as a function of available clinical information, infection site, and hospital setting. Methods: We conducted a post hoc analysis of previously collected data from a prospective, observational trial (N = 249 subjects) in intensive care units at seven US hospitals, …


Humanizing The Intensive Care Unit, M. E. Wilson, S. Beesley, A. Grow, E. Rubin, R. O. Hopkins, N. Hajizadeh, S. M. Brown Jan 2019

Humanizing The Intensive Care Unit, M. E. Wilson, S. Beesley, A. Grow, E. Rubin, R. O. Hopkins, N. Hajizadeh, S. M. Brown

Journal Articles

No abstract provided.


Septic Emboli Of The Lung Due To Fusobacterium Necrophorum, A Case Of Lemierre's Syndrome, S. Habib, K. Rajdev, A. H. Siddiqui, M. Azam, A. Memon, M. Chalhoub Jan 2019

Septic Emboli Of The Lung Due To Fusobacterium Necrophorum, A Case Of Lemierre's Syndrome, S. Habib, K. Rajdev, A. H. Siddiqui, M. Azam, A. Memon, M. Chalhoub

Journal Articles

© 2019 The Authors Fusobacterium necrophorum plays a causal role in a rare and life-threatening condition, Lemierre's syndrome. It is characterized by infection involving the posterior compartment of the lateral pharyngeal space complicated by septic suppurative thrombophlebitis of the internal jugular vein with F. necrophorum bacteremia and metastatic abscesses, primarily to the lung and pulmonary septic emboli. Herein, we present a very rare case of oropharyngeal infection complicated by Lemierre's syndrome with characteristic septic emboli to the lungs presenting as sore throat in a previously healthy patient. A 23-year-old woman presented with sore throat and was found to be in …


Placental Transmogrification Of The Lung Associated With Unilateral Pleural Effusion: A Case Report With A Comprehensive Review Of The Literature, N. Narula, S. Ngu, D. Sharma, F. Siddiqui, M. Chalhoub Jan 2019

Placental Transmogrification Of The Lung Associated With Unilateral Pleural Effusion: A Case Report With A Comprehensive Review Of The Literature, N. Narula, S. Ngu, D. Sharma, F. Siddiqui, M. Chalhoub

Journal Articles

© 2018 The Authors Placental transmogrification of the lung (PTL) is a rare benign pulmonary lesion resembling chorionic villi. With fewer than 40 cases reported in literature, associations have thus far been made with bullous emphysema, pulmonary fibrochondromatous hamartomas and adenocarcinoma of the lung. Typically presenting as unilateral solitary cystic or bullous lesion, we report the first case of PTL presenting with unilateral pleural effusion. A 70-year-old male presented with recurrent unilateral pleural effusion that failed to resolve with multiple thoracenteses. He underwent thoracoscopic excision and biopsy of a cystic mass identified on computed tomography (CT) scan which revealed characteristic …


Hepatocellular Carcinoma After Successful Treatment Of Hepatitis C Virus With Ledipasvir/Sofosbuvir Presenting As Acute Pulmonary Tumor Embolism., S. Habib, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub Jan 2019

Hepatocellular Carcinoma After Successful Treatment Of Hepatitis C Virus With Ledipasvir/Sofosbuvir Presenting As Acute Pulmonary Tumor Embolism., S. Habib, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub

Journal Articles

Hepatitis C virus (HCV)-induced cirrhosis is a major cause of hepatocellular carcinoma (HCC) worldwide. HCC is an aggressive malignancy in which tumor thrombus can invade portal vein, hepatic veins and inferior vena cava (IVC) in the later stages. Our case brings to attention, HCV patient population who might need long-term follow-up to ensure HCV clearance. Physicians should ensure appropriate follow-up after treatment of HCV and should emphasize on the ongoing screening for HCC in patients with cirrhosis or advanced fibrosis, regardless of antiviral treatment outcome.


Achromobacter Xylosoxidans/Denitrificans Bacteremia And Subsequent Fatal Escherichia Coli/Streptococcus Anginosus Pleural Empyema, S. Habib, N. Fuca, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub Jan 2018

Achromobacter Xylosoxidans/Denitrificans Bacteremia And Subsequent Fatal Escherichia Coli/Streptococcus Anginosus Pleural Empyema, S. Habib, N. Fuca, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub

Journal Articles

© 2018 The Authors Achromobacter xylosoxidans, a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR Achromobacter xylosoxidans/denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal pleural empyema due to MDR Escherichia coli and Streptococcus anginosus. A 44-year-old male presented to the hospital with chief complaints of chest tightness associated with a productive cough. He was found to have pleural empyema secondary to MDR E. coli and S. anginous. Three months prior to current presentation, he had a history of MDR A. xylosoxidans originating from …


Giant Cell Carcinoma Of The Lung Successfully Treated With Surgical Resection And Adjuvant Vinorelbine And Cisplatin, S. Habib, L. E. Leifer, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub Jan 2018

Giant Cell Carcinoma Of The Lung Successfully Treated With Surgical Resection And Adjuvant Vinorelbine And Cisplatin, S. Habib, L. E. Leifer, M. Azam, A. H. Siddiqui, K. Rajdev, M. Chalhoub

Journal Articles

© 2018 Giant Cell Carcinoma of the lung, a subtype of Sarcomatoid lung cancer is a poorly differentiated Non-Small-Cell Lung Cancer. GCCL has exceptionally aggressive characteristics, and its prognosis is much poorer than any other NSCLCs. Herein, we present a rare case of Giant Cell Carcinoma of lung treated successfully with surgical resection and adjuvant vinorelbine and cisplatin. A 48-year-old African American man with a history of smoking and chronic obstructive pulmonary disease was admitted to the hospital for chief complaints of shortness of breath. He was found to have a 3.5 cm × 3.3 cm x 2.8 cm cavitary …


Pulmonary Arterial Hypertension: A Current Review Of Pharmacological Management, S. Sahni, M. Ojrzanowski, S. Majewski, A. Talwar Jan 2016

Pulmonary Arterial Hypertension: A Current Review Of Pharmacological Management, S. Sahni, M. Ojrzanowski, S. Majewski, A. Talwar

Journal Articles

Pulmonary hypertension (PHTN) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventricular failure and death. At present there is no cure for pulmonary arterial hypertension (PAH); however over the past decade targeted pharmaceutical options have become available for the treatment of PAH. Prior to evaluation for therapeutic options a definitive diagnosis of pulmonary arterial hypertension must be made via comprehensive physical exam and definitive diagnostic testing. Screening test of choice remains echocardiography and gold standard for definitive diagnosis is right heart catheterization. Once the establishment …


Resident Endothelial Cells And Endothelial Progenitor Cells Restore Endothelial Barrier Function After Inflammatory Lung Injury, S. Z. Mao, X. B. Ye, G. Liu, D. M. Song, S. F. Liu Jan 2015

Resident Endothelial Cells And Endothelial Progenitor Cells Restore Endothelial Barrier Function After Inflammatory Lung Injury, S. Z. Mao, X. B. Ye, G. Liu, D. M. Song, S. F. Liu

Journal Articles

Objective Disruption of endothelial barrier integrity is a characteristic of many inflammatory conditions. However, the origin and function of endothelial cells (ECs) restoring endothelial barrier function remain unknown. This study defined the roles of resident ECs (RECs) and bone marrow-derived endothelial progenitor cells (BMDEPCs) in endothelial barrier restoration after endotoxemic lung injury. Approach and Results We generated mice that enable to quantify proliferating RECs or BMDEPCs and also to study the causal link between REC or BMDEPC proliferation and endothelial barrier restoration. Using these mouse models, we showed that endothelial barrier restoration was associated with increased REC and BMDEPC proliferation. …


"Saw-Tooth Sign" In Upper Airway Disorders - A Case Report, S. Sahni, A. Blood, S. Paulus, A. Talwar Jan 2015

"Saw-Tooth Sign" In Upper Airway Disorders - A Case Report, S. Sahni, A. Blood, S. Paulus, A. Talwar

Journal Articles

Spirometry flow-volume loop measurement is the screening test of choice to rule out obstructive lung diseases. Flow oscillations occasionally seen on flow volume loops, referred to as a "saw-tooth" sign, are thought to be due to an upper airway obstructive processes associated with upper airway collapsibility. Widely described in obstructive sleep apnea syndrome, flow oscillations have also been linked to many other upper airway pathologies. The mechanism by which flow oscillations occur is centered on the inspiratory and expiratory flow of air. It has been theorized that the mechanism of flow oscillations result from rapid intermittent changes in driving pressure …


Non-Small-Cell Lung Cancer Clinicopathologic Features And Survival Outcomes In Asian Pacific Islanders Residing In The United States: A Seer Analysis, M. S. Hamid, R. Shameem, K. Gafoor, J. George, B. Mina, K. Sullivan Jan 2015

Non-Small-Cell Lung Cancer Clinicopathologic Features And Survival Outcomes In Asian Pacific Islanders Residing In The United States: A Seer Analysis, M. S. Hamid, R. Shameem, K. Gafoor, J. George, B. Mina, K. Sullivan

Journal Articles

Background. The objective of our study was to ascertain racial/ethnic disparities in Asian/Pacific Islanders (API) for non-small-cell lung cancer (NSCLC) clinicopathologic features and survival outcomes based on various tumor characteristics and treatment modalities. Method. SEER database identified invasive NSCLC cases from 2004 to 2010. Variables included American Joint Committee on Cancer (AJCC) stage 7, tumor grade, tumor size, histology, age, marital status, radiation, surgery, and reason for no surgery. The Kruskall-Wallis test and the Z test were used to examine differences between races/ethnicities and the referent, non-Hispanic white (NHW). Multivariate Cox proportional analyses were used to establish the weight of …


Dyspnea, Depression And Health Related Quality Of Life In Pulmonary Arterial Hypertension Patients, A. Talwar, S. Sahni, E. J. Kim, S. Verma, N. Kohn Jan 2015

Dyspnea, Depression And Health Related Quality Of Life In Pulmonary Arterial Hypertension Patients, A. Talwar, S. Sahni, E. J. Kim, S. Verma, N. Kohn

Journal Articles

No abstract provided.


Pulmonary Rehabilitation And Exercise In Pulmonary Arterial Hypertension: An Underutilized Intervention, S. Sahni, B. Capozzi, A. Iftikhar, V. Sgouras, M. Ojrzanowski, A. Talwar Jan 2015

Pulmonary Rehabilitation And Exercise In Pulmonary Arterial Hypertension: An Underutilized Intervention, S. Sahni, B. Capozzi, A. Iftikhar, V. Sgouras, M. Ojrzanowski, A. Talwar

Journal Articles

Pulmonary arterial hypertension (PAH) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance which eventually leads to right ventricular failure and death. Early thought process was that exercise and increased physical activity may be detrimental to PAH patients however many small cohort trials have proven otherwise. In addition to the many pharmaceutical options, exercise and pulmonary rehabilitation have also been shown to increase exercise capacity as well as various aspects of psychosomatic health. As pulmonary and exercise rehabilitation become more widely used as an adjuvant therapy patient outcomes improve and physicians …


Case Report: Pulmonary Kaposi Sarcoma In A Non-Hiv Patient, A. Kodra, M. Walczyszyn, C. Grossman, D. Zapata, T. Rambhatla, B. Mina Jan 2015

Case Report: Pulmonary Kaposi Sarcoma In A Non-Hiv Patient, A. Kodra, M. Walczyszyn, C. Grossman, D. Zapata, T. Rambhatla, B. Mina

Journal Articles

Kaposi Sarcoma (KS) is an angioproliferative tumor associated with human herpes virus 8 (HHV-8). Often known as one of the acquired immunodeficiency syndrome (AIDS)-defining skin diseases, pulmonary involvement in KS has only been discussed in a handful of case reports, rarely in a non-HIV patient. Herein we report the case of a 77 year-old- male who presented with a 6-week history of progressive dyspnea on exertion accompanied by productive cough of yellow sputum and intermittent hemoptysis. His past medical history was significant for Non-Hodgkin's Follicular B-Cell Lymphoma (NHL). Patient also had biopsy-confirmed cutaneous KS. His physical exam was notable for …


Ultrasound In The Diagnosis And Management Of Pleural Effusions, N. J. Soni, R. Franco, M. I. Velez, D. Schnobrich, R. Dancel, M. I. Restrepo, P. H. Mayo Jan 2015

Ultrasound In The Diagnosis And Management Of Pleural Effusions, N. J. Soni, R. Franco, M. I. Velez, D. Schnobrich, R. Dancel, M. I. Restrepo, P. H. Mayo

Journal Articles

We review the literature on the use of point-of-care ultrasound to evaluate and manage pleural effusions. Point-of-care ultrasound is more sensitive than physical exam and chest radiography to detect pleural effusions, and avoids many negative aspects of computerized tomography. Additionally, point-of-care ultrasound can assess pleural fluid volume and character, revealing possible underlying pathologies and guiding management. Thoracentesis performed with ultrasound guidance has lower risk of pneumothorax and bleeding complications. Future research should focus on the clinical effectiveness of point-of-care ultrasound in the routine management of pleural effusions and how new technologies may expand its clinical utility. Journal of Hospital Medicine …


Lps Down-Regulates Specificity Protein 1 Activity By Activating Nf-Kappab Pathway In Endotoxemic Mice, X. Ye, H. Liu, Y. S. Gong, S. F. Liu Jan 2015

Lps Down-Regulates Specificity Protein 1 Activity By Activating Nf-Kappab Pathway In Endotoxemic Mice, X. Ye, H. Liu, Y. S. Gong, S. F. Liu

Journal Articles

BACKGROUND: Specificity protein (Sp) 1 mediates the transcription of a large number of constitutive genes encoding physiological mediators. NF-kappaB mediates the expression of hundreds of inducible genes encoding pathological mediators. Crosstalk between Sp1 and NF-kappaB pathways could be pathophysiologically significant, but has not been studied. This study examined the crosstalk between the two pathways and defined the role of NF-kappaB signaling in LPS-induced down-regulation of Sp1 activity. METHODS AND MAIN FINDINGS: Challenge of wild type mice with samonelia enteritidis LPS (10 mg/kg, i.p.) down-regulated Sp1 binding activity in lungs in a time-dependent manner, which was concomitantly associated with an increased …