Pulmonology Commons^™

Protocol For Ground Glass Opacity, Elissa Goldman

Phase 1

Rationale: Pure ground glass opacities (GGO), identified incidentally or on lung cancer screening, may indicate pre-invasive subtypes of lung adenocarcinoma. These neoplasms typically demonstrate indolent patterns of growth, and Fleischner Society guidelines recommend up to five years of serial imaging. Our aim was to determine the frequency of diagnosed lung adenocarcinoma arising from GGO detected beyond 5 years of CT surveillance.

Methods: We reviewed all pathologic diagnoses of lung adenocarcinoma (n=442) between 2016 and 2018 of a tertiary academic hospital and National Cancer Institute-designated cancer center to identify all cancers that arose from ground glass opacities detected on CT scan. …

Retrospective Review Of Fluoroscopic Swallowing Studies And Outcomes At An Academic Health Center, Rachel Strock, Priyha Mahesh, Baskaran Sundaram, Md, Gregory C. Kane, Md

Phase 1

Introduction: Aspiration is often associated with underlying medical conditions and can cause pneumonia or death. Aspiration risk can be assessed via video fluoroscopic swallowing study (VFSS) or barium swallow (BaSw). We aimed to assess the diagnoses and clinical course of patients who were evaluated for potential aspiration through VFSS or BaSw to determine if there is a degree of aspiration that increases the risk of developing pneumonia and/or death.

Methods: We conducted a retrospective chart review of 374 patients in TJUH who were evaluated via VFSS or BaSw from January 1 to June 30, 2017. We recorded the degree and …

Treatment Of Persistent Air Leaks Using Endobronchial Valves, Michael Zimmerman, Cole Zingas, Achala Donuru, Scott W. Cowan, Nathaniel Evans Iii, Boyd Hehn

Phase 1

Introduction: Persistent air leaks (PAL) are from bronchopleural fistula resulting from communication between the bronchial tree and pleural space. Endobronchial valves (EBVs) are unidirectional valves placed bronchoscopically preventing airflow to the diseased lung lobe. For non-operable patients with PALs, EBVs offer a potential non-invasive treatment approach to stop air leak and allow lung healing. The purpose of this study is to retrospectively analyze EBV placement to treat non-operable adult patients with PALs.

Methods: We retrospectively analyzed all adult patients that underwent EBV placement for PAL treatment at our institution from January 2016 to June 2019. All patients failed conservative …

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 …

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 …