Pulmonology Commons^™

Exploring The Effectiveness Of Asthma Action Plans In Long-Term Asthma Management, Pankhuri Jha, Jessica Most, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

• Determine the efficacy of AAP in helping patients feel more confident in their self-management
• Improve asthma control by at least 10% after receiving an Asthma Action Plan

Incidental Findings On Ldct For Lung Cancer Screening: Prevalence And Clinical Management, Chris Mcgrath, Md, Mrinalini Venkata-Subramani, Md, Brandon Menachem, Md, Amry Majeed, Brooke Ruane, Crnp, Christine Shusted, Mph, Julie Barta, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Objectives

• To define the frequency of incidental findings on low-dose CT (LDCT) scans among patients undergoing lung cancer screening.
• To determine the current reporting methods for incidental findings and measure the frequency of clinical follow-up.

A Multidisciplinary Chronic Lung Disease Team In A Neonatal Intensive Care Unit Is Associated With Increased Survival To Discharge Of Infants With Tracheostomy, Taylor Hansen

Research Days

No abstract provided.

A Positive Framed Message To Improve Cpap Compliance For Patients With Osa, Frances Clark

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) affects 24% of the US population (DiNapoli, 2014). Untreated OSA causes many diseases, affects one’s quality of life, and increases mortality (Pengo et al., 2018). Continuous positive airway pressure (CPAP) is the lifelong treatment for OSA; yet 30%-80% of OSA patients are CPAP noncompliant within one year. The purpose of this EBP project was to determine if implementing a positive frame message intervention would improve CPAP compliance for newly diagnosed OSA patients. Based on the evidence, implementation of behavioral interventions, such as a positive framed message, was effective in improving CPAP compliance (Pengo et ...

When Treating Sick Joints Harms Lungs, Ixekizumab Induced Pleural Effusion, Rami Batarseh, Kyle Smith, Mohammed Al-Ourani, Amro K. Al-Astal

Marshall Journal of Medicine

Immunological therapies have provided a multitude of new and effective treatment strategies for various disease states. While monoclonal antibody therapy benefits many patients, side effects are widely variable. here we present a case of pleural effusion complicating psoriatic arthritis treatment.

Evaluation Of Serial Biomarkers In Intermediate Risk Acute Pulmonary Embolism Patients, Hilamber Subba, Ariel Mckenna, Joel Wirth

Costas T. Lambrew Research Retreat 2020

Purpose/Background Pulmonary embolism (PE) is a major cause of morbidity and mortality. The rate of hospitalization for PE has doubled in the past decade, and it is now the third most common cause of cardiovascular disease after MI and stroke. Early, accurate risk stratification can guide appropriate management and has the potential to improve clinical outcomes. Patients with PE are stratified as being low, intermediate, or high risk for early mortality based on the European classification system which takes into account clinical, imaging, and laboratory parameters. This strategy is recommended to reduce use of potentially harmful therapies, such as ...

Effect Of 3d Lung Nodule Educational Tool On Patient Distress Following Ldct Incidental Finding Of Lung Nodule, Theresa Roelke, Ivette Emery

Costas T. Lambrew Research Retreat 2020

Summary: Annually, thousands of Americans learn they have pulmonary nodules found on low dose computed tomography (LDCT) within the context of lung cancer screening. These patients experience distress regarding these nodule findings, in part, due to a limited understanding of what a lung nodule is and misconceptions about the risk of cancer that they pose. This study is designed to explore the utility of a 3D printed nodule educational tool to support providers in educating patients during the lung screening shared-decision making (SDM)conversation about this commonly reported lung lesion.

Specific aims: The aim of this study is to assess ...

How Immune T-Cell Augmentation Can Help Prevent Covid-19: A Possible Nutritional Solution Using Ketogenic Lifestyle, Ravi K. Kamepalli Md,Fidsa,Cwsp

The University of Louisville Journal of Respiratory Infections

No abstract provided.

When Rationing Becomes Part Of Clinical Decision-Making, Christopher A. Hopper, Mitra Bahaee

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical practice-based reflection on Noack DP, Newton G. Compared to maximal current management standards, oscillating positive expiratory pressure devices have not been shown to improve clinically relevant outcomes in COPD patients with acute exacerbation. Clin. Res. Prac. 2017;3(2):eP1516. doi: 10.22237/crp/149886732.

Declines In Lung Function After Antiretroviral Therapy Initiation In Adults With Human Immunodeficiency Virus And Tuberculosis: A Potential Manifestation Of Respiratory Immune Reconstitution Inflammatory Syndrome, Sara C. Auld, Pholo Maenetje, Shruthi Ravimohan, Drew Weissman, Itai Ncube, Mandla Mlotshwa, Nelly Ratsela, William Chase, Mboyo-Di-Tamba Vangu, Robert Wallis, Gavin Churchyard, Hardy Kornfeld, Gregory P. Bisson

Open Access Articles

End-organ impairment has received relatively little research attention as a possible manifestation of tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS). In this prospective cohort study, one-half of adults with human immunodeficiency virus and pulmonary tuberculosis experienced meaningful declines in lung function on antiretroviral therapy, suggesting a role for lung function in TB-IRIS definitions.

Imatinib-Induced Interstitial Pneumonitis – A Literature Review And Case Report, Olga Hilda Orasan, Andreea Maria Stefan, Iulia Minciuna, Adela Sitar-Taut, George Ciulei, Simina Tarmure, Ioana Para, Flaviu Muresan, Ovidiu Fabian, Sorina Cezara Coste, Vasile Negrean, Angela Cozma, Laura Urian

Journal of Mind and Medical Sciences

Imatinib is generally well tolerated, with mild common side effects such as nausea and vomiting, diarrhea, muscle cramps, fatigue, skin rash and edema; however, pulmonary complications are uncommon. A 73-year-old woman undergoing one month treatment with Imatinib for chronic myeloid neoplasm associated with eosinophilia was admitted for sudden alteration of her performance status, dyspnea at rest and productive cough. On clinical examination, the patient was hypoxic (oxygen saturation on room air was 87%), and auscultation of her lungs revealed diffuse bilateral fine crackles. Computed tomography showed bilateral pulmonary interstitial syndrome. Imatinib was discontinued and the patient received systemic corticosteroid therapy ...

Covid-19 In Critically Ill Patients In The Seattle Region - Case Series., Pavan K Bhatraju, Bijan J Ghassemieh, Michelle Nichols, Richard Kim, Keith R Jerome, Arun K Nalla, Alexander L Greninger, Sudhakar Pipavath, Mark M Wurfel, Laura Evans, Patricia A Kritek, T Eoin West, Andrew Luks, Anthony Gerbino, Chris Dale, Jason D Goldman, D Shane O'Mahony, Carmen Mikacenic

Articles, Abstracts, and Reports

BACKGROUND: Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020.

METHODS: We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up.

RESULTS: We identified 24 patients with confirmed Covid-19. The mean (±SD) age of the patients was 64±18 years, 63% were men, and symptoms began 7±4 ...

Galcanezumab-Induced Anaphylaxis: A Case Report, Erick Perez Sifontes, Sonja Knittel-Hliddal, Zhao Han, Rahimullah Asad, Aya Marachi, Uma Iyer

Pulmonary Disease

Introduction: Case Report: Galcanezumab is a monoclonal antibody recently approved by the FDA for migraine prevention. Common side effects include injection site reactions, nasopharyngitis, and nausea. However, there have been no reported cases of anaphylaxis.

Description: We describe the first case of galcanezumab-induced anaphylaxis in a 47-year-old female with history of asthma and a prior episode of topiramate-induced anaphylaxis requiring intubation. The patient presented to the emergency department (ED) complaining of sudden onset shortness of breath, generalized pruritus, flushing, throat and mouth swelling 20 minutes after self- administration of two 120 mg doses of galcanezumab IM. Prior to ED presentation ...

Frequent Mutation Of Hypoxia-Related Genes In Persistent Pulmonary Hypertension Of The Newborn, Mingbang Wang, Deyi Zhuang, Mei Mei, Haiyan Ma, Zixiu Li, Fusheng He, Guoqiang Cheng, Guang Lin, Wenhao Zhou

Open Access Articles

AIMS: Persistent pulmonary hypertension of the newborn (PPHN) is characterized by sustained high levels of pulmonary vascular resistance after birth with etiology unclear; Arterial blood oxygen saturation of Tibetan newborns at high latitudes is higher than that of Han newborns at low latitudes, suggesting that genetic adaptation may allow sufficient oxygen to confer Tibetan populations with resistance to pulmonary hypertension; We have previously identified genetic factors related to PPHN through candidate gene sequencing; In this study, we first performed whole exome sequencing in PPHN patients to screen for genetic-related factors.

METHODS AND RESULTS: In this two-phase genetic study, we first ...

Linkage Between Poverty And Smoking In Philadelphia And Its Impact On Future Directions For Tobacco Control In The City., Christine S. Shusted, Gregory C. Kane

Department of Medicine Faculty Papers

Poverty is linked to negative health consequences and harmful health behaviors such as smoking. Despite this established correlation, few comparative studies have investigated the relationship between local poverty rates and smoking in urban settings through a Social Ecological Model framework. The authors sought to examine the linkage between local poverty rates in Philadelphia, Pennsylvania and adult smoking rates by scrutinizing existing patterns and potential mediating factors via publicly accessible data in established planning districts. The authors determined several individual, interpersonal, organizational, community, and environmental factors, varying across these districts, that impact smoking in Philadelphia. Poverty rates influence the resources, demographic ...

Modern Ventilator Management In Surgical/Trauma Patients, Errington C. Thompson Md, Facs, Fccm

Marshall Journal of Medicine

Physicians have a lot to consider when they place a patient on the ventilator. This article reviews the literature and provides the physician with a clear guide to managing the ventilator in the ICU. This manuscript is meant to be a practical guide to managing the ventilator at the patient's bedside.

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these ...

Terminological Usage Related To Dyspnea By Nursing Staff: A Cross-Sectional Questionnaire Survey, Yuko Nemoto, Sayuri Suzuki, Shinichiro Okauchi, Katsunori Kagohashi, Hiroaki Satoh

Asian / Pacific Island Nursing Journal

In recent years, additional expressions such as ‘sensation of breathing discomfort’ and ‘discomfort of dyspnea’ are being used in daily nursing care in Japan. To better understand the current status of the use of these terms by nurses, and to ascertain what the term ‘dyspnea’ may not express, we designed an original questionnaire and conducted a study with all nurses at our hospital. The questionnaire included questions to determine if nurses used these terms, and in what context. Of the 279 nurses in our hospital, 225 (80.6%) responded. Three-quarters of nurses indicated that they use these terms in clinical ...

Mitochondrial Quality Control In Age-Related Pulmonary Fibrosis., Willy Roque, Karina Cuevas-Mora, Freddy Romero

Center for Translational Medicine Faculty Papers

Idiopathic pulmonary fibrosis (IPF) is age-related interstitial lung disease of unknown etiology. About 100,000 people in the U.S have IPF, with a 3-year median life expectancy post-diagnosis. The development of an effective treatment for pulmonary fibrosis will require an improved understanding of its molecular pathogenesis and the "normal" and "pathological' hallmarks of the aging lung. An important characteristic of the aging organism is its lowered capacity to adapt quickly to, and counteract, disturbances. While it is likely that DNA damage, chronic endoplasmic reticulum (ER) stress, and accumulation of heat shock proteins are capable of initiating tissue repair, recent ...

Perspectives On Lung Cancer Screening In The Philadelphia Lgbtq Community, Kaitlin Demarest, Kristine Pham, Mph, Rickie Brawer, Phd

Phase 1

Introduction: Lung cancer is the leading cause of cancer deaths in the United States, but there are low screening rates across the country. While the prevalence of smoking in the LGBTQ population is disproportionately high, the LGBTQ community may have decreased access to screening, since they are reported to be less likely to have health insurance, more likely to receive inferior care or be denied care. The objective of this project was to better understand the knowledge, beliefs, and attitudes toward lung cancer screening in the LGBTQ community in Philadelphia in order to develop appropriate, community-focused educational materials to increase ...