Medicine and Health Sciences Commons^™

Imaging Algorithm For Covid-19: A Practical Approach, S. Ghosh, H. Deshwal, M. B. Saeedan, V. K. Khanna, S. Raoof, A. C. Mehta

Journal Articles

© 2020 Elsevier Inc. The global pandemic of COVID-19 pneumonia caused by the novel coronavirus (SARS-CoV-2) has strained healthcare resources across the world with emerging challenges of mass testing, resource allocation and management. While reverse transcriptase-polymerase chain reaction (RT-PCR) test is the most commonly utilized test and considered the current gold standard for diagnosis, the role of chest imaging has been highlighted by several studies demonstrating high sensitivity of computed tomography (CT). Many have suggested using CT chest as a first-line screening tool for the diagnosis of COVID-19. However, with advancement of laboratory testing and challenges in obtaining a CT …

A Case-Control Study Of Prone Positioning In Awake And Nonintubated Hospitalized Coronavirus Disease 2019 Patients., P. C. Nauka, S. Chekuri, M. Aboodi, A. A. Hope, M. N. Gong, J.T. Chen

Journal Articles

To determine the association between prone positioning in nonintubated patients with coronavirus disease 2019 and frequency of invasive mechanical ventilation or inhospital mortality.

Design

A nested case-matched control analysis.

Setting

Three hospital sites in Bronx, NY.

Patients

Adult coronavirus disease 2019 patients admitted between March 1, 2020, and April 1, 2020. We excluded patients with do-not-intubate orders. Cases were defined by invasive mechanical ventilation or inhospital mortality. Each case was matched with two controls based on age, gender, admission date, and hospital length of stay greater than index time of matched case via risk-set sampling. The presence of nonintubated proning …

Utilization Of Extracorporeal Membrane Oxygenation During The Covid-19 Pandemic., A. Kichloo, A. Kumar, R. Amir, M. Aljadah, N. Farooqi, M. Albosta, J. Singh, S. Jamal, Z. El-Amir, N. Lone, +1 Additional Author

Journal Articles

The ongoing outbreak of severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2, or coronavirus disease 2019 (COVID-19)] was declared a pandemic by the World Health Organization on March 11, 2020. Worldwide, more than 65 million people have been infected with this SARS-CoV-2 virus, and over 1.5 million people have died due to the viral illness. Although a tremendous amount of medical progress has been made since its inception, there continues to be ongoing research regarding the pathophysiology, treatments, and vaccines. While a vast majority of those infected develop only mild to moderate symptoms, about 5% of people have severe forms of infection …

The Use Of Oxygen Hoods In Patients Failing On Conventional High-Flow Oxygen Delivery Systems, The Effects On Oxygenation, Mechanical Ventilation And Mortality Rates In Hypoxic Patients With Covid-19. A Prospective Controlled Cohort Study, D. Dayya, O. J. O'Neill, T. D. Feiertag, R. Tuazon-Boer, J. Sullivan, L. Perez, S. Gurash, M. Eaton, T. Bodley, T. Hall, +2 Additional Authors

Journal Articles

© 2021 Introduction: Efforts to meet increased oxygen demands in COVID-19 patients are a priority in averting mechanical ventilation (MV), associated with high mortality approaching 76.4–97.2%. Novel methods of oxygen delivery could mitigate that risk. Oxygen hoods/helmets may improve: O2-saturation (SaO2), reduce in-hospital mechanical ventilation and mortality rates, and reduce length of hospitalization in hypoxic Covid-19 patients failing on conventional high-flow oxygen delivery systems. Methods: DesignProspective Controlled Cohort Study. SettingSingle Center. ParticipantsAll patients admitted with a diagnosis of COVID-19 were reviewed and 136/347 patients met inclusion criteria. Study period3/6/2020 to 5/1/2020. 136 participants completed the study with known status for …

Pulmonary Artery Aneurysm: A Review, M. Gupta, A. Agrawal, A. Iakovou, S. Cohen, R. Shah, A. Talwar

Journal Articles

No abstract provided.

Pulmonary Artery Dilatation And Obstructive Sleep Apnea, J. Simonson, H. Greenberg, A. Talwar

Journal Articles

No abstract provided.

Tissue Plasminogen Activator (Tpa) Treatment For Covid-19 Associated Acute Respiratory Distress Syndrome (Ards): A Case Series, J. Wang, N. Hajizadeh, E. E. Moore, R. C. Mcintyre, P. K. Moore, L. A. Veress, M. B. Yaffe, H. B. Moore, C. D. Barrett

Journal Articles

This article is protected by copyright. All rights reserved. A hallmark of severe COVID-19 is coagulopathy, with 71.4% of patients who die of COVID-19 meeting ISTH criteria for disseminated intravascular coagulation (DIC) while only 0.6% of patients who survive meet these criteria (1). Additionally, it has become clear that this is not a bleeding diathesis but rather a predominantly pro-thrombotic DIC with high venous thromboembolism rates, elevated D-dimer levels, high fibrinogen levels in concert with low anti-thrombin levels, and pulmonary congestion with microvascular thrombosis and occlusion on pathology in addition to mounting experience with high rates of central line thrombosis …

Management Of Lung Nodules And Lung Cancer Screening During The Covid-19 Pandemic: Chest Expert Panel Report, Pj Mazzone, Mk Gould, Da Arenberg, Ac Chen, Hk Choi, Fc Detterbeck, F Farjah, Km Fong, S Raoof, Ga Silvestri, +14 Additional Authors

Journal Articles

No abstract provided.

Tissue Plasminogen Activator (Tpa) Treatment For Covid-19 Associated Acute Respiratory Distress Syndrome (Ards): A Case Series, J Wang, N Hajizadeh, Ee Moore, Rc Mcintyre, Pk Moore, La Veress, Mb Yaffe, Hb Moore, Cd Barrett

Journal Articles

No abstract provided.

Critical Care Transesophageal Echocardiography In Patients During The Covid-19 Pandemic, F Teran, Km Burns, M Narasimhan, A Goffi, P Mohabir, Jm Horowitz, E Yuriditsky, A Nagdev, S Koenig, R Arntfield, +3 Additional Authors

Journal Articles

No abstract provided.

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.

Bilateral Pneumothorax As Possible Atypical Presentation Of Coronavirus Disease 2019 (Covid-19), A. S. Ahluwalia, T. Qarni, N. Narula, W. Sadiq, M. N. Chalhoub

Journal Articles

© 2020 The Authors Coronavirus disease 2019 (COVID-19) is most frequently associated with a mild presentation of fever, cough, and shortness of breath. Typical radiographic findings of COVID-19 are bilateral ground-glass opacities on computed tomography (CT) scans. However, there have been instances of pneumothorax, giant bulla, and pneumomediastinum, mainly in elderly COVID-19 patients and predominately occurring at least one week after symptom onset. Here, we report a case where a healthy, young Hispanic man presented with three days of fever, cough, and dyspnea. On admission to the emergency department, he was found to have bilateral pneumothoraces, pneumomediastinum, and pneumopericardium requiring …

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.

Nebulized In-Line Endotracheal Dornase Alfa And Albuterol Administered To Mechanically Ventilated Covid-19 Patients: A Case Series, A. G. Weber, A. S. Chau, M. Egeblad, B. J. Barnes, T. Janowitz

Journal Articles

© 2020 The Author(s). Background: Mechanically ventilated patients with COVID-19 have a mortality of 24-53%, in part due to distal mucopurulent secretions interfering with ventilation. DNA from neutrophil extracellular traps (NETs) contribute to the viscosity of mucopurulent secretions and NETs are found in the serum of COVID-19 patients. Dornase alfa is recombinant human DNase 1 and is used to digest DNA in mucoid sputum. Here, we report a single-center case series where dornase alfa was co-administered with albuterol through an in-line nebulizer system. Methods: Demographic and clinical data were collected from the electronic medical records of five mechanically ventilated patients …

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%) …

Pulmonary Embolism And Increased Levels Of D-Dimer In Patients With Coronavirus Disease, D. O. Griffin, A. Jensen, M. Khan, J. Chin, K. Chin, J. Saad, R. Parnell, C. Awwad, D. Patel

Journal Articles

No abstract provided.

Pneumatosis Intestinalis In Covid-19: Case Series., K. Wong, D. H. Kim, S. Khanijo, A. Melamud, G. Zaidi

Journal Articles

OBJECTIVE:To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) who developed pneumatosis intestinalis (PI). METHODS:This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in New York State. Patients were included if they were identified as having confirmed COVID-19 as well as pneumatosis intestinalis from March 16, 2020 to July 31, 2020. Patient demographics, clinical characteristics, vasopressor use, anticoagulation use, opiate use, paralytic use, COVID-19 treatment regimen, serum lactate, arterial pH, serum bicarbonate, subsequent intervention, and outcomes during hospitalization were collected. Results: A total …

Bevacizumab-Induced Pneumonitis In A Patient With Metastatic Colon Cancer: A Case Report, S. Pervaiz, S. Homsy, N. Narula, S. Ngu, D. Elsayegh

Journal Articles

© The Author(s) 2020. Bevacizumab is a vascular endothelial growth factor–directed humanized monoclonal antibody used to treat many types of cancer and some eye diseases. Due to inhibition of angiogenesis, many adverse reactions such as bowel necrosis, nasal septal perforation, and renal thrombotic microangiopathy have been described. However, its association with interstitial pneumonitis is scarcely reported in the literature. We report a case of a 79-year-old woman with metastatic colon cancer who presented with cough and dyspnea on exertion the day after initiation of bevacizumab. She was found to have bilateral airspace opacities on imaging. Infectious and cardiogenic etiologies of …

Isolated Pulmonary Valve Endocarditis., S. Acharya, S. Anwar, M. Iannuzzi, V. Anugu, F. Ghavami

Journal Articles

Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks. Because of the persistent bacteremia, a transesophageal echocardiogram was performed and it revealed a thickened pulmonary valve with 1.8 cm vegetation in the …

Lung Nodule Management Practice Patterns - A Survey Of Indian Physicians, V. Mehta, P. Makkar, K. Bhatia, S. Mehta, S. Raoof

Journal Articles

No abstract provided.

Life Threatening Haemoptysis In Primary Lung Cancer-Signet Ring Cell Carcinoma, S. Anwar, S. Acharya, D. Elsayegh, A. Sokoloff, M. Rehan

Journal Articles

© 2020 The Author(s) Primary signet ring cell carcinoma of the lung is a rare non-small cell carcinoma of the lung with extremely aggressive features and poor prognosis. The diagnosis mainly required tissue biopsy with immunohistochemical analysis and gene mutation studies. We describe a unique case of primary signet ring cell carcinoma of the lung presenting with life threatening haemoptysis along with literature review of prognosis and management of this rare clinical entity.

La Inhalers For Copd: Perceptions/Reality Of Abcd Gold Tool Use., V. Boryushkina, V. Kumar, M. Barnes, S. Nabeel, T. Le, H. Siddique, G. Haggerty, J. Ng, A. Kaell

Journal Articles

BACKGROUND:The Global Initiative for Chronic Obstructive Lung Disease (GOLD) created an ABCD tool to assess staging and severity of COPD subgroups that respond to LAMA or LABA with improved quality of life and reduced exacerbations. Our study assesses perception of physicians at five community hospitals towards LAMA use for patients admitted with COPD exacerbations according to the GOLD guidelines and describes the experience at our hospital. METHODS:Electronic survey forms regarding LAMA use and the GOLD criteria ABCD for COPD treating physicians were sent to five hospitals. A one-year chart review at our hospital determined prevalent use of a maintenance LAMA …

Pneumothorax In Covid-19 Acute Respiratory Distress Syndrome: Case Series., K. Wong, D. H. Kim, A. Iakovou, S. Khanijo, A. Tsegaye, S. Hahn, M. Narasimhan, G. Zaidi

Journal Articles

Objective The study aims to describe the clinical characteristics and outcomes of patients with COVID-19 related acute respiratory distress syndrome (ARDS) who developed pneumothorax. Design and setting A retrospective chart review was performed of the electronic medical record. Patients were included if they were identified as having confirmed COVID-19 as well as pneumothorax from March 16, 2020 to May 31, 2020. Patients' demographic and clinical characteristics, mechanical ventilator parameters, lung compliance measurements and outcomes during hospitalization were collected. This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in …

Pneumopericardium, Pneumomediastinum And Air Travel: A Case Report In A Patient With Gardner Syndrome, A. El Haj Chehade, G. Debal, W. Mansour, A. Avula, M. Chalhoub

Journal Articles

© 2020 The Author(s) Onboard aircraft medical emergencies are on the rise as commercial air traffic is increasing. However, thoracic injury secondary to air travel is extremely rare and, most reported injuries are cases of pneumothoraces. Spontaneous pneumomediastinum and pneumopericardium have been barely reported in the medical literature as a complication of air travel. We are reporting a case of spontaneous pneumopericardium and pneumomediastinum in a patient with Gardner's Syndrome after a flight from Central America to New York City. The patient presented with chest discomfort. He was managed conservatively with oxygen therapy as he was hemodynamically stable throughout his …

Continuous Positive Airway Pressure (Cpap) In Nonapneic Asthma: A Clinical Review Of Current Evidence, H. M. Karim, A. M. Esquinas, S. Ziatabar, G. Insalaco, S. Skoczyński, I. Šarc, L. Ferini-Strambi, L. P. Özyiğit, T. Hernández-Gilsoul, B. A. Mina, +17 Additional Authors

Journal Articles

© 2020 by Turkish Thoracic Society-. The use of continuous positive airway pressure (CPAP) in asthma has been a point of debate over the past several years. Various studies, including those on animals and humans have attempted to understand the role and pathophysiology of CPAP in patients with either well controlled or poorly controlled asthma. The aim of this manuscript is to review the currently available literature on the physiologic and clinical effects of CPAP in animal models of asthma and on humans with stable asthma.

A Telehealth-Delivered Pulmonary Rehabilitation Intervention In Underserved Hispanic And African American Patients With Chronic Obstructive Pulmonary Disease: A Community-Based Participatory Research Approach., R. Pekmezaris, A. Kozikowski, B. Pascarelli, G. Wolf-Klein, E. Boye-Codjoe, S. Jacome, D. Madera, D. Tsang, J. Polo, N. Hajizadeh, +3 Additional Authors

Journal Articles

BACKGROUND:Although home telemonitoring (TM) is a promising approach for patients managing their chronic disease, rehabilitation using home TM has not been tested for use with individuals living with chronic obstructive pulmonary disease (COPD) residing in underserved communities. OBJECTIVE:This study aimed to analyze qualitative data from focus groups with key stakeholders to ensure the acceptability and usability of the TM COPD intervention. METHODS:We utilized a community-based participatory research (CBPR) approach to adapt a home TM COPD intervention to facilitate acceptability and feasibility in low-income African American and Hispanic patients. The study engaged community stakeholders in the process of modifying the intervention …

Management Of Lung Nodules And Lung Cancer Screening During The Covid-19 Pandemic: Chest Expert Panel Report., P. J. Mazzone, M. K. Gould, D. A. Arenberg, A. C. Chen, H. K. Choi, F. C. Detterbeck, F. Farjah, K. M. Fong, S. Raoof, G. A. Silvestri, +10 Additional Authors

Journal Articles

BACKGROUND:The risks from potential exposure to coronavirus disease 2019 (COVID-19), and resource reallocation that has occurred to combat the pandemic, have altered the balance of benefits and harms that informed current (pre-COVID-19) guideline recommendations for lung cancer screening and lung nodule evaluation. Consensus statements were developed to guide clinicians managing lung cancer screening programs and patients with lung nodules during the COVID-19 pandemic. METHODS:An expert panel of 24 members, including pulmonologists (n = 17), thoracic radiologists (n = 5), and thoracic surgeons (n = 2), was formed. The panel was provided with an overview of current evidence, summarized by recent …

Systematic Review And Literature Appraisal On Methodology Of Conducting And Reporting Critical-Care Echocardiography Studies: A Report From The European Society Of Intensive Care Medicine Prices Expert Panel, S. Huang, F. Sanfilippo, A. Herpain, M. Balik, M. Chew, F. Clau-Terré, C. Corredor, D. De Backer, P. Mayo, A. Vieillard-Baron, +10 Additional Authors

Journal Articles

© 2020, The Author(s). Background: The echocardiography working group of the European Society of Intensive Care Medicine recognized the need to provide structured guidance for future CCE research methodology and reporting based on a systematic appraisal of the current literature. Here is reported this systematic appraisal. Methods: We conducted a systematic review, registered on the Prospero database. A total of 43 items of common interest to all echocardiography studies were initially listed by the experts, and other “topic-specific” items were separated into five main categories of interest (left ventricular systolic function, LVSF n = 15, right ventricular function, RVF n …

A Sleep Medicine Curriculum For Pulmonary And Pulmonary/Critical Care Fellowship Programs A Multisociety Expert Panel Report, D. A. Schulman, C. A. Piquette, M. M. Alikhan, E. Freedman, S. Kumar, J. Mccallister, B. Mokhlesi, J. Santamauro, E. Singas, K. R. Casey, +2 Additional Authors

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

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 …