Medicine and Health Sciences Commons^™

Case Report: Post-Obstructive Pneumonia Secondary To Foreign Body Aspiration, Aashna Chaudhry, Andrew Vasta

Rowan-Virtua Research Day

Post-obstructive pneumonia is described as a pulmonary infiltrate that occurs proximal to the site of an obstructed bronchus. Studies show that post-obstructive pneumonia most commonly secondary to obstruction caused by neoplasms. According to a study done on post obstructive pneumonia in lung cancer, most cases of post obstructive pneumonias are associated with advanced neoplasms with up to 50% of those with advanced cancer getting endobronchial compromise. While neoplasms are the most common cause of post obstructive pneumonia, research is scarce on other potential causes of post obstructive pneumonia. This case reports presents a unique clinical case in which an adult …

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Hiding In Plain Sight; Dermatologic Manifestation Of A Systemic Disease, Christopher Ignatz, David Young Do, Brian Chwiecko Md

Tower Health Research Day

No abstract provided.

A Rare Case Of Anti-Mda5 Associated Progressive Interstitial Lung Diseases Without Classical Features Of Dermatomyositis., Nimesh Khanal Md, Ayushma Acharya Md, Bharosha Bhattarai Mbbs, Devi Parvathy Jyothi Ramachandran Nair Md, Peter Daniel Nicholas Iii Do

Tower Health Research Day

No abstract provided.

Understanding Patient-Reported Outcome Measures Used In Adult Survivors Experiencing Long-Term Effects After Covid-19 Infection: A Rapid Review, Egle Barilaite, Harry Watson, Mevhibe B. Hocaoglu

Journal of Patient-Centered Research and Reviews

Purpose

Patient-reported outcome measures (PROMs) are used in individuals experiencing long-term effects from COVID-19 infection, or Long COVID, to evaluate the quality of life and functional status of these individuals. However, little is known about which PROMs are being utilised and the psychometric properties of these PROMs. Our purpose was thus to explore which PROMs are used in Long COVID patients and to discuss the psychometric properties of the PROMs.

Methods

For this rapid review, a systematic literature search was performed in the PubMed, Embase, and CINAHL databases. The found studies were screened using the PRISMA flowchart. We then performed …

Gambaran Klinis Pasien Terduga Tuberkulosis Paru Resisten Obat (Tb-Ro) Dengan Kolonisasi Candida Sp. Di Rumah Sakit Hasan Sadikin Bandung, Hasna Rafifah Zahira Zalfa, Iceu Dimas Kulsum, Hendarsyah Suryadinata, Chrysanti Chrysanti, Intan Mauli Warma Dewi

Jurnal Penyakit Dalam Indonesia

Introduction. Candida sp. is a fungus that lives as a commensal in human body, but may cause infection upon immune suppression. The decrease in immunity due to TB infection and long-term use of antibiotics in TB patients may increase the risk of the Candida sp. colonization in patient. Data regarding the prevalence of Candida sp. colonization in TB patients and its impact has not been widely reported. This study was conducted to determine the prevalence and clinical characteristics of presumptive drug-resistance TB patients with Candida sp. colonization.

Methods. A cross-sectional study was conducted using secondary data from a …

Pulmonary Alveolar Proteinosis Following Severe Covid - 19 Infection: A Case Report, Samina Martin Md, Shivu Kaushik Md, Bharat Bajantri Md

Internal Medicine Residency

A 67-year-old male, with a history of severe COVID-19 infection and exposure to talc was seen for worsening shortness of breath for months, requiring supplemental oxygen. He was treated for COVID-19 infection and suspected pneumonia with no improvement. His pulmonary function test (PFT) worsened and computed tomography (CT) showing bilateral airspace opacities with ground-glass opacities (GGO), also worsened over time. He underwent bronchoscopy, bronchoalveolar lavage and pathology revealed pulmonary alveolar proteinosis (PAP). He subsequently underwent whole lung lavage (WLL) which significantly improved his crazy paving pattern on CT and was successfully weaned off supplemental oxygen.

Design Of The Strive-Ipf Trial-Study Of Therapeutic Plasma Exchange, Rituximab, And Intravenous Immunoglobulin For Acute Exacerbations Of Idiopathic Pulmonary Fibrosis, Tejaswini Kulkarni, Gerard Criner, Daniel Kass, Ivan Rosas, Mary Beth Scholand, Daniel Dilling, Ross Summer, Steven Duncan

Division of Pulmonary and Critical Care Medicine Faculty Papers

BACKGROUND: Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) affect a significant proportion of patients with IPF. There are limited data to inform therapeutic strategies for AE-IPF, despite its high mortality. We discuss the rationale and design of STRIVE-IPF, a randomized, multi-center, open-label Phase IIb clinical trial to determine the efficacy of combined therapeutic plasma exchange (TPE), rituximab, and intravenous immunoglobulin (IVIG), in comparison to treatment as usual (TAU), among patients with acute IPF exacerbations.

METHODS: The STRIVE-IPF trial will randomize 51 patients among five sites in the United States. The inclusion criteria have been designed to select a study population …

Simplifying Treatment From Double-Inhaler To Single-Inhaler Triple Therapy In Patients With Chronic Obstructive Pulmonary Disease, Kelly Yang, Leah Warren

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Ferguson GT, Brown N, Compton C, et al. Once-daily single-inhaler versus twice-daily multiple-inhaler triple therapy in patients with COPD: lung function and health status results from two replicate randomized controlled trials. Respir Res. 2020;21(1):131. https://doi.org/10.1186/s12931-020-01360-w

for a patient requesting a simplified therapeutic regimen with equal efficacy for chronic obstructive pulmonary disease (COPD) management.

Issue 7: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls, Srinivasan Devanathan Md, Manuel Martinez Md

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 7

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health. The content resides within critical care and pulmonary related topics and this information is compiled into four main formats.

1. Original Study Summaries: New research publications are read, reviewed, then concisely summarized for clinical interpretation with professional …

Heated Tobacco Product Iqos Induces Unique Metabolic Signatures In Human Bronchial Epithelial Cells, Erin O. Curley, Omran Abu Aboud, Kenneth J. Chmiel, Ajay P. Nayak, Oliver Fiehn, Amir A. Zeki, Pawan Sharma

Center for Translational Medicine Faculty Papers

Metabolic signatures are lacking for heated tobacco products, making it crucial to identify new biosignatures of lung damage. This will enable the establishment of product-specific guidelines and an understanding of associated toxicity.

Validation Of A Novel, Rapid Sepsis Diagnostic For Emergency Department Use, Hollis R. O'Neal, Roya Sheybani, David R. Janz, Robert Scoggins, Tonya Jagneaux, James E. Walker, Daniel J. Henning, Elizabeth Rosenman, Simon A. Mahler, Hariharan Regunath, Christopher S. Sampson, D. Clark Files, Richard D. Fremont, Michael J. Noto, Erica E. Schneider, Wesley R. Shealey, Matthew S. Berlinger, Thomas C. Carver, Morgan K. Walker, Nathan A. Ledeboer, Ajay M. Shah, Henry T.K. Tse, Dino Dicarlo, Todd W. Rice, Christopher B. Thomas

School of Medicine Faculty Publications

OBJECTIVES: To assess the in vitro IntelliSep test, a microfluidic assay that quantifies the state of immune activation by evaluating the biophysical properties of leukocytes, as a rapid diagnostic for sepsis. DESIGN: Prospective cohort study. SETTING: Five emergency departments (EDs) in Louisiana, Missouri, North Carolina, and Washington. PATIENTS: Adult patients presenting to the ED with signs (two of four Systemic Inflammatory Response Syndrome criteria, where one must be temperature or WBC count) or suspicion (provider-ordered culture) of infection. INTERVENTIONS: All patients underwent testing with the IntelliSep using ethylene diamine tetraacetic acid-anticoagulated whole blood followed by retrospective adjudication for sepsis by …

Covid-19 Hospital Mortality Among Patients With Invasive Mechanical Ventilation: A Comparison Between Public And Private Healthcare Services In San Luis Potosí 2020–2022, María E. Torres-Acosta, Rocío M. Cubos-Moncada, Alan Y. Martínez-Castellanos

The University of Louisville Journal of Respiratory Infections

Background: During 2019, México’s total public spending on health was 5.43% of the national gross domestic product, making it one of the countries of the Organisation for Economic Co-operation and Development that invested the least in developing public health systems. This study analyzes hospital mortality among intubated patients with laboratory-confirmed COVID-19 according to type of institution in San Luis Potosí, México, from March 18, 2020, to April 7, 2022.

Methods: This is a secondary data analysis of publicly available information about mortality among intubated patients with a laboratory-confirmed diagnosis of COVID-19 with respect to the type of hospitalization institution.

Results: …

Vitamin D Oral Replacement In Children With Obesity Related Asthma: Vdora1 Randomized Clinical Trial., Brian O'Sullivan, Song Ounpraseuth, Laura James, Marc Majure, Jason Lang, Zhuopei Hu, Alan Simon, Scott Bickel, Brian Ely, L E Faricy, Maryam Garza, Melody Greer, Daniel Hsia, Akilah Jefferson, Lisa Knight, Jeannette Lee, Deborah Liptzin, Mehtap Haktanir Abul, Tamara T. Perry, Fred Prior, Christine Sangiovanni, Jade B. Tam-Williams, Brian Wu, Jessica Snowden, Echo Idea States Pediatric Clinical Trial Network

Manuscripts, Articles, Book Chapters and Other Papers

Children with asthma and obesity are more likely to have lower vitamin D levels, but the optimal replacement dose is unknown in this population. The objective of this study is identifying a vitamin D dose in children with obesity-related asthma that safely achieves serum vitamin D levels of ≥ 40 ng/mL. This prospective multisite randomized controlled trial recruited children/adolescents with asthma and body mass index ≥ 85% for age/sex. Part 1 (dose finding), evaluated 4 oral vitamin D regimens for 16 weeks to identify a replacement dose that achieved serum vitamin D levels ≥ 40 ng/mL. Part 2 compared the …

Utilizing Primary Human Airway Mucociliary Tissue Cultures To Model Ramifications Of Chronic E-Cigarette Usage., Vincent J Manna, Shannon Dwyer, Vanessa Pizutelli, Salvatore J Caradonna

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Electronic cigarettes are battery powered devices that use a vape-liquid to produce a vapor that is inhaled. A consequence of the rise in e-cigarette usage was the 2019 emergence of a vaping-induced respiratory disease denoted as 'e-cigarette or vaping use-associated lung injury' (EVALI). One of the suspected causes of EVALI is Vitamin E Acetate (VEA), which was found to be a diluent in certain illicit vape-pens, whereas nicotine is commonly diluted in equal parts propylene glycol and vegetable glycerin (PG:VG). The prevalent use of e-cigarettes and the emergence of a novel illness has made understanding how e-cigarette vapors affect our …

Issue 6: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 6

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The goal of this newsletter is to give a brief summary of the most pertinent articles to everyday practice and an attempt to keep up with literature as best as possible. Newsletters go out every 1-2 months.

Summaries/Topics in this issue:

Wasted Blood in Hospital Setting

Blood Transfusions

MINT Trial

Epinephrine related death

Non-invasive Airway Management of Comatose Poisoned Emergency Patients

Angiotensin II (AT2) and Vasopressors

Angiotensin II for the Treatment …

Comparison Of Risk Factors Of Mortality During The Two Coronavirus Disease 2019 Waves In Delhi, India, Neena Katoch, Ajay K. Gupta, Rachna Gulati, Ketan Garg, Vikas Kumar

Journal of Medicine in Scientific Research

Objective To determine the risk factors of mortality (in terms of age, sex, and comorbidities) among hospitalized patients in an Indian tertiary care hospital during the first and second waves. Patients and methods A retrospective observational study was conducted, where the patients’ mortality data were collected over two coronavirus disease 2019 (COVID-19) periods, and their characteristics were compared. The first phase was from May 2020 to January 2021 and the second wave was from March 2021 to August 2021. Results A mortality rate of 23.84% (874 deaths among 3666 patients) and 1.36% (232 deaths among 17 000 patients) was noted …

Standardizing The Discharge Process To Reduce Copd Readmission Rates, Kristine Doligosa

Doctor of Nursing Practice Scholarly Projects

Background: Frequent acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can lead to unfavorable patient outcomes and costly readmissions. Inadequate patient support during discharge and an inconsistent discharge process are factors contributing to high readmissions in this population.

Purpose: This quality improvement project aimed to reduce COPD-related hospital readmissions by standardizing the discharge process for patients admitted with AECOPD and identify patient risk factors for readmission.

Methods: Following a quantitative and quasi-experimental design, this project standardized the discharge process for patients admitted with AECOPD using the Re-Engineered Discharge Toolkit components and a discharge care bundle. The project was …

Parasympathetic Activity And Bronchial Hyperresponsiveness In Athletes, Audrey Badza

The Downtown Review

Bronchial hyperresponsiveness (BHR) is a term used to describe the bronchial constriction response to environmental stimuli. BHR is increasingly common in endurance athletes due to increased exposure to some stimuli. The purpose of this review is to evaluate Stang et al.'s (2016) article, "Parasympathetic Activity and Bronchial Hyperresponsiveness in Athletes" and discuss the significance of their results. The results concluded that BHR is related to the parasympathetic activity of the heart rather than the pupils. The study concluded that there is an association between BHR and parasympathetic activity of the heart, methacholine is associated with BHR and cardiac vagal activity, …

Early Surgical Stabilization Of Rib Fractures (Ssrf) Is Better, But Delayed Ssrf Is Not Worse, Stephen J. Bordes, Patrick Greiffenstein

School of Medicine Faculty Publications

Comment on; Belaroussi Y, Drevet G, Soldea V, et al. When to proceed to surgical rib fixation?-A single-institution clinical experience. J Thorac Dis 2023;15;323-34.

Allergic Bronchopulmonary Aspergillosis: Radiological And Microbiological Profile Of Patients Presented In An Outpatient Pulmonary Clinic In A Developing Country, Nousheen Iqbal, Muhammad Irfan, Mustafa Bin Ali Zubairi, Maaha Ayub, Safia Awan, Kauser Jabeen, Ali Bin Sarwar Zubairi

Section of Pulmonary & Critical Care

There is limited data available about allergic bronchopulmonary aspergillosis (ABPA) in Pakistan. The aim of the study was to describe the radiological and microbiological profile of ABPA patients presenting to the outpatient pulmonary clinic of a tertiary care hospital in Karachi, Pakistan. A retrospective study was conducted on ABPA patients who presented to the pulmonary outpatient clinic at Aga Khan University Hospital, Karachi, Pakistan, from January 2017 to December 2019. Data was collected on microbiology and radiology features on predesigned proforma. A total of 7759 asthmatic patients presented at the outpatient pulmonology clinic during the study period. Of the 245 …

Pulmonary & Critical Care Insider: Issue 4, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 4

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The goal of this newsletter is to give a brief summary of the most pertinent articles to everyday practice and an attempt to keep up with literature as best as possible. Newsletters go out every 1-2 months.

Summaries/Topics in this issue:

• Inside Medicine- Ozempic

• Inhaled Amikacin for VAP (AMIKINHAL Trial)

• 2023 GOLD Guidelines for COPD

• SAGA of Antibiotics in the ICU

• The MANDALA trial

• The DENALI trial

• RESCUE IHCA – Not …

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Pulmonary & Critical Care Insider: Special Issue 5: 2023 In Review, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 5: Special Issue

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The goal of this newsletter is to give a brief summary of the most pertinent articles to everyday practice and an attempt to keep up with literature as best as possible. Newsletters go out every 1-2 months.

The Effect Of Cotton Dust Exposure As A Longterm Impact On Lung Function Changes: A Short Narrative Review, Naureen Akber Ali, Noshaba Akber, Adeel Khoja

School of Nursing & Midwifery

No abstract provided.

Racial Disparities Among Predicted Bronchopulmonary Dysplasia Risk Outcomes In Premature Infants Born <30 Weeks Gestation, Priyanka Patel, Andrew Ellefson, David A. Paul

Department of Pediatrics Faculty Papers

Background and Objective: There is extensive literature to support eliminating race-based risk stratification. The National Institute of Child Health and Human Development (NICHD) calculator, used to predict risk of bronchopulmonary dysplasia (BPD), includes race as a variable. We sought to investigate how utilizing race in determination of risk for BPD may lead to inequitable care.

Methods: The study included a retrospective cohort of infants born <30 weeks gestation between January 2016 and February 2022. The primary outcome was the difference in predictive risk of BPD for non-Hispanic Black compared to non-Hispanic White infants. The secondary outcome was the disparity in theoretical administration of post-natal corticosteroids when the calculator was applied to the cohort. Analysis included paired T-tests and Chi-Square.

Results: Of the 273 infants studied, 154 were non-Hispanic Black (56%). There was no difference between the groups in gestation or respiratory support on day of life (DOL) 14 or 28. …

Pulmonary Specialist-Supported Health Coaching Delivered By Lay Personnel Improves Receipt Of Quality Care For Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial, Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise Devore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, Doranne Donesky, Stephanie Tsao, David H. Thom, George Su

Journal of Patient-Centered Research and Reviews

Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting.

Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care …

Using Simulation To Assess Knowledge And Attitude Amongst Healthcare Provider Regarding Cardiopulmonary Resuscitation At A Tertiary Care Hospital In Karachi, Pakistan- A Pre And Post Test Qausi Experimental Study, Nausheen Barkat Ali Noorani

Theses & Dissertations

No abstract provided.

Isolated Small Airways Obstruction Predicts Future Chronic Airflow Obstruction: A Multinational Longitudinal Study, Ben Knox Brown, James Potts, Valentina Quintero Santofimio, Cosetta Minelli, Jaymini Patel, Peter Gj Burney, Andre Fs Amaral, Najlaa Mohammed Abass, Dhiraj Agarwal, Asaad A. Nafees

Community Health Sciences

Background: Chronic airflow obstruction is a key characteristic of chronic obstructive pulmonary disease. We investigated whether isolated small airways obstruction is associated with chronic airflow obstruction later in life.
Methods: We used longitudinal data from 3957 participants of the multinational Burden of Obstructive Lung Disease study. We defined isolated small airways obstruction using the prebronchodilator mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FVC) (FEF25-75) if a result was less than the lower limit of normal.
Results: Median follow-up time was 8.3 years. Chronic airflow obstruction was more likely to develop in participants with …

Ten Steps Toward Improving In-Hospital Cardiac Arrest Quality Of Care And Outcomes, Brahmajee K. Nallamothu, Robert Greif, Theresa Anderson, Huba Atiq, Thomaz Bittencourt Couto, Julie Considine, Allan R De Caen, Therese Djärv, Ann Doll, Matthew J. Douma

Department of Anaesthesia

No abstract provided.