Respiratory Tract Diseases Commons^™

Us Guided Management Of Undifferentiated Dyspneic Patient In The Ed, Kaleigh Miller

Longitudinal Scholar's Project

Intro: Undifferentiated dyspnea can be a complicated presentation muddled by patient comorbidities and similar symptomology shared among etiologies. Some studies have shown increased mortality and length of stay in the hospital when incorrectly initially diagnosed in the ED. US has been shown more effective at differentiating these causes and improves diagnostic accuracy. This study will implement US exam upon initial exam of patient and chart time to diagnosis/treatment, length of stay in ED, length of stay in hospital admissions versus discharge rates, and 30 day mortality. ADHF and COPD/asthma patient differentiation will be the focus.

Methods: Prospective cohort study of …

How Deep Is Too Deep?, Dietrich Schlueter Md, Asma Jamil Md, Ibrahim Talab, Samia Faiz, Scott Kubomoto Md

Internal Medicine

No abstract provided.

Relationship Of Patient Self-Administered Copd Assessment Test To Physician Standard Assessment Of Chronic Obstructive Pulmonary Disease In A Family Medicine Residency Training Program, Jessica E. Burchette, Ivy A. Click, Leigh Johnson, S. Alicia Williams, Brett Tyler Morgan

Journal of Patient-Centered Research and Reviews

Assessing the global impact of chronic obstructive pulmonary disease (COPD) on a patient’s life can be difficult to perform in the clinical setting due to time constraints and workflow challenges. The primary objective of this study was to compare disease impact ratings between patient self-administered COPD Assessment Test (CAT) and physician standard office assessment. This prospective study was conducted at a family medicine residency clinic in northeast Tennessee. The study included two study groups: 1) adult patients seen at the clinic during the 3-month study period with an active diagnosis of COPD, and 2) their physicians. Physicians’ assessment of the …

The Wet Bridge Transfer System: An Novel In Vitro Tool For Assessing Exogenous Surfactant As A Pulmonary Drug Delivery Vehicle, Brandon J. Baer

Western Research Forum

Background:

Due to its complex branching structure, direct drug delivery to the remote areas of the lung is a major challenge. Consequently, most therapies, such as those treating pulmonary infection and inflammation, must utilize large systemic dosing, with the potential for adverse side effects. A novel alternative strategy is to use exogenous surfactant, a material capable of distributing throughout the lung, as a pulmonary drug delivery vehicle.

Objective:

Utilize an in vitro transferring system to assess exogenous surfactant (BLES) as a pulmonary delivery vehicle for different therapeutics.

Methods:

An in vitro technique was developed to simultaneously study surfactant delivery and …

Provider Education And Rapid Antigen Detection Test Use In An Academic Pediatric Clinic, Steven Dahl

Research Days

No abstract provided.

Simulating Alternative Tuberculosis Diagnosis Methods In Underdeveloped Countries, Luke Turner

Industrial Engineering Undergraduate Honors Theses

Tuberculosis is the deadliest infectious disease in the world; it is especially rampant in underdeveloped countries because they do not have the infrastructure, technology, or funding to properly combat the infection. However, the development of portable point-of-care diagnosis machines can reverse this epidemic as they far surpass conventional laboratory identification. The question now is where to place these machines, which is a difficult decision with a lack of data. Therefore, a flexible simulation model is created to test the implementation of these machines with different countries and configurations. The simulation tests the baseline model and three proposed implementations of the …

Data Visualization Of Treatment Outcomes For Tuberculosis Patients, Joy Jenkins

Industrial Engineering Undergraduate Honors Theses

Tuberculosis is an infectious disease, and different treatments have been discovered over the years. However, patients may develop various drug resistance levels that affect the likelihood of becoming cured or dying. In this study, we sought to employ data visualization to explore the relationship between treatment trajectory, as indicated by smear and culture results in the follow-up tests and patient outcomes. A large sample of patients have been broken down by demographics including age, gender, and drug resistance status. Sankey diagrams were used to visualize the pathway progression of the patients over time split between two time periods- months 0-6 …

Successful Extracorporeal Membrane Oxygenation In The Management Of Acute Respiratory Distress Syndrome And Cardiopulmonary Collapse Secondary To Amniotic Fluid Embolism, Sumon Roy, Nishit A. Biniwale, Venkata S. Pendela, Patricia Oates, Katrina Wojciechowski, Scott C. Feitell

The VAD Journal

Amniotic fluid embolism (AFE) is one of the most devastating complications of pregnancy that typically manifests as acute cardiopulmonary collapse during delivery or in the postpartum period. The potential role of extracorporeal membrane oxygenation (ECMO) as a management technique in severe cases of AFE remains largely unknown given the limited literature available. In this report, we present the first case, to our knowledge, of successful implementation of ECMO as a life-saving measure in a case of hemorrhagic shock due to postpartum bleeding complicated by severe AFE leading to acute respiratory distress syndrome (ARDS) ultimately requiring tracheostomy. Hemodynamic decompensation is often …

Management Of Patients With Brain Metastases From Non-Small Cell Lung Cancer And Adverse Prognostic Features: Multi-National Radiation Treatment Recommendations Are Heterogeneous, Minesh Mehta

All Publications

No abstract provided.

Transforming Growth Factor-Β1 Decreases Β2-Agonist–Induced Relaxation In Human Airway Smooth Muscle, Christie A. Ojiaku, Elena Chung, Vishal Parikh, Jazmean K. Williams, Anthony Schwab, Ana Lucia Fuentes, Maia L. Corpuz, Victoria Lui, Sam Paek, Natalia M. Bexiga, Shreya Narayan, Francisco J. Nunez, Kwangmi An, Rennolds S. Ostrom, Steven S. An, Reynold A. Pannettieri Jr.

Pharmacy Faculty Articles and Research

Helper T effector cytokines implicated in asthma modulate the contractility of human airway smooth muscle (HASM) cells. We have reported recently that a profibrotic cytokine, transforming growth factor (TGF)-β1, induces HASM cell shortening and airway hyperresponsiveness. Here, we assessed whether TGF-β1 affects the ability of HASM cells to relax in response to β₂-agonists, a mainstay treatment for airway hyperresponsiveness in asthma. Overnight TGF-β1 treatment significantly impaired isoproterenol (ISO)-induced relaxation of carbachol-stimulated, isolated HASM cells. This single-cell mechanical hyporesponsiveness to ISO was corroborated by sustained increases in myosin light chain phosphorylation. In TGF-β1–treated HASM cells, ISO evoked markedly lower …

Rethinking Intravenous Catheter Size And Location For Computed Tomography Pulmonary Angiography, Travis Marshall, Nae Meng Chen, Eric Nguyen, David E. Slattery, Tony Zitek

School of Medicine Faculty Research

Introduction: Computed tomography pulmonary angiography (CTPA) is the test of choice for diagnosis of pulmonary embolism (PE) in the emergency department (ED), but this test may be indeterminate for technical reasons such as inadequate contrast filling of the pulmonary arteries. Many hospitals have requirements for intravenous (IV) catheter size or location for CTPAs to reduce the chances of inadequate filling, but there is a lack of clinical data to support these requirements. The objective of this study was to determine if a certain size or location of IV catheter used for contrast for CTPA is associated with an increased chance …

Effect Of Neoadjuvant Chemoradiation On Preoperative Pulmonary Physiology, Postoperative Respiratory Complications And Quality Of Life In Patients With Oesophageal Cancer, J. A. Elliott, L. O'Byrne, G. Foley, C. F. Murphy, Suzanne Doyle, S. King, E. M. Guinan, N. Ravi, V. Reynolds

Articles

Background: It remains controversial whether neoadjuvant chemoradiation (nCRT) for oesophageal cancer influences operative morbidity, in particular pulmonary, and quality of life. This study combined clinical outcome data with systematic evaluation of pulmonary physiology to determine the impact of nCRT on pulmonary physiology and clinical outcomes in locally advanced oesophageal cancer.

Methods: Consecutive patients treated between 2010 and 2016 were included. Three-dimensional conformal radiation was standard, with a lung dose–volume histogram of V20 less than 25 per cent, and total radiation between 40 and 41⋅4Gy. Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and diffusion capacity …

Community-Acquired Pneumonia In Adults: Diagnostic Reliability Of Physical Examination Techniques And Their Teaching In Academia, Amber Tordoff, Lauren A. Williams

Physician Assistant Capstones, 2016 to 2019

Background: Chest physical examination techniques are taught in academia, but their usefulness in the evaluation and diagnosis of patients in the clinical setting is controversial. Objective: To investigate the accuracy of physical examination techniques and their reliability in diagnosing community acquired pneumonia (CAP) and suggest a modified teaching approach to be used in academia. Design: Systematic Literature Review. Methods: Database search of PubMed and Google Scholar using the search terms “prediction of pneumonia in adults” and “prediction rule for pulmonary infiltrates.” Filters were implemented to include articles that only dealt with human subjects and were full text. Articles …

Loop-Mediated Isothermal Amplification Methods For Diagnosis Of Bacterial Meningitis, Mitsuko Seki, Paul E. Kilgore, Eun Jin Kim, Makoto Ohnishi, Satoshi Hayakawa, Dong Wook Kim

Department of Pharmacy Practice

The rapid, accurate, and efficient identification of an infectious disease is critical to ensure timely clinical treatment and prevention in public health settings. In 2015, meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis was responsible for 379,200 (range: 322,700–444,700) deaths. Clinical features alone cannot determine whether bacterial meningitis is present; an analysis of cerebrospinal fluid (CSF) is essential. Loop-mediated isothermal amplification (LAMP) is a nucleic acid amplification method offering an alternative to polymerase chain reaction (PCR). LAMP-based assays for detection of three leading bacteria in CSF for diagnosis of meningitis have been established. The typing assays …

Diffuse Pulmonary Infiltrates: A Guise Of Adenocarcinoma, Mourad Ismail, Raminderjit Sekhon

NYMC Faculty Publications

Small and non-small cell lung cancer present in a variety of radiologic and clinical patterns, and have been linked to smoking. Primary adenocarcinoma of the lung has been increasingly recognized in females and nonsmokers, often presenting a diagnostic challenge. In the absence of smoking history, these radiographic patterns may be initially misdiagnosed as an infectious or inflammatory condition, often delaying the diagnosis of malignancy. We report two cases of female patients with relatively short or no smoking history presenting with diffuse pulmonary infiltrates not typically seen in primary lung cancer, which created a diagnostic challenge, ultimately diagnosed as primary lung …

Analysis Of The Local And Systemic Cytokine Response Profiles In Patients With Community-Acquired Pneumonia. Relationship With Disease Severity And Outcomes., Rafael Fernandez-Botran, Timothy Lee Wiemken, Robert R. Kelley, Paula Peyrani, Jose Bordon, Rodrigo Cavallazzi, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

The goals of this study were to investigate the relationship of systemic and local cytokine responses with time to clinical stability (TCS) in patients with community-acquired pneumonia (CAP) and to develop a model to integrate multiple cytokine data into “cytokine response profiles” based on local vs. systemic and pro- vs. anti-inflammatory cytokine patterns in order to better understand their relationships with measures of CAP severity and outcomes. Forty hospitalized patients enrolled through the Community Acquired Pneumonia Inflammatory Study Group (CAPISG) were analyzed. Based on the ranked distribution of the levels of eight different pro-inflammatory cytokines and chemokines (IL-1b, IL-6, IL-8, …

The Role Of Nicotine, A7 Nicotinic Acetylcholine Receptors And Extracellular Matrix Remodeling In Pulmonary Fibrosis., Glenn Ward Vicary

Electronic Theses and Dissertations

The median survival for idiopathic pulmonary fibrosis (IPF) patients from diagnosis is a dismal 3 years. This condition is characterized by pulmonary fibroproliferation and excess production and disordered deposition of extracellular matrix (ECM) proteins resulting in obliteration of the original tissue architecture, loss of lung function and eventual death due to respiratory failure. The main hindrance to the development of effective treatments against pulmonary fibrosis is the late detection of its progression and is often of unknown cause. Tobacco smoke represents the most important environmental factor linked to the development of pulmonary fibrosis, with over 60% of IPF patients current …

Discriminant Validity Of The Hospital Anxiety And Depression Scale, Beck Depression Inventory (Ii) And Beck Anxiety Inventory To Confirmed Clinical Diagnosis Of Depression And Anxiety In Patients With Chronic Obstructive Pulmonary Disease, Tina Phan, Owen Carter, Claire Adams, Grant Waterer, Li Ping Chung, Maxine Hawkins, Cobie Rudd, Mel R. Ziman, Natalie Strobel

Research outputs 2014 to 2021

The objective of this study was to investigate the discriminant validity of commonly used depresson and anxiety screening tools in order to determine the most suitable tool for patients with chronic obstructive pulmonary disease (COPD). COPD patients (n = 56) completed the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). These scores were compared to confirmed clinical diagnosis of depression and anxiety using the Mini Neuropsychiatric Interview. HADS depression subscale (HADS-D) sensitivity/specificity was 78/81 %; BDI-II 89/77 %; HADS anxiety subscale (HADS-A) 71/81 %; and BAI 89/62 %. HADS-D sensitivity/specificity was improved …

Is The Neuraminidase Inhibitor Tamiflu Effective In The Treatment Of Influenza?, Eliyakim Hershkop

The Science Journal of the Lander College of Arts and Sciences

Influenza is a disease that has caused the deaths of tens of millions people in the last century alone. The influenza neuraminidase protein is essential in the mechanism infection. It enables the virus to leave the infected cell and proliferate. Antiviral neuraminidase inhibitor drugs can be used for treatment. The drug Tamiflu is the standard of care for both treatment and prophylaxis of influenza. The Cochrane reports of 2009 and 2014 conclude that evidence is lacking to support this. Numerous bodies disagree. Cochrane also question the accuracy and credibility of many studies and agencies in support of Tamiflu. This paper …

The Search For Novel Inhibitors Of The Mycobacterial Enoyl Reductase Inha, Esther Saul

The Science Journal of the Lander College of Arts and Sciences

Isoniazid (INH), one of two first-line drugs used to treat tuberculosis (TB), has been shown to be a potent inhibitor of InhA, the mycobacterial enoyl reductase. However, the increasing resistance to INH makes it imperative to find alternative drugs that are as effective as the first-line drugs, yet active against INH-resistant strains. Since InhA has been validated as an excellent target of TB, there have been attempts to find novel inhibitors of InhA. Through rational drug design, a variety of high affinity InhA inhibitors were synthesized. Triclosan itself was observed to be a suboptimal inhibitor of InhA with a K …

Biomarkers In Nsclc Epidermal Growth Factor Receptor Mutations, Suzanne Freidman

The Science Journal of the Lander College of Arts and Sciences

Lung Cancer is the most common global cause of cancer related deaths in men and women (Markus, Alain, 2013). As standard radiation and chemotherapy have proved ineffective, novel target therapies are in the midst of development. This review will analyze the success of the inhibitor drugs targeting the Epidermal Growth Factor Receptor (EGFR) mutation, commonly found amongst Lung Cancer patients. Numerous studies and reviews are utilized to determine the cause of the 10% success rate currently exhibited for these drugs. The L858R and E746-A750 point mutations and deletions respectively, were found prevalent in responsive patients as well as clinical-pathological features …

Scanned Ion Beam Therapy For Thoracic Tumors, John Gordon Eley

Dissertations and Theses (Open Access)

Although frequently cured of Hodgkin lymphoma, adolescents and young adults can develop radiation induced second cancers. These patients could potentially benefit from scanned ion radiotherapy yet likely would require motion mitigation strategies. In theory, four-dimensional (4D) optimization of ion beam fields for individual motion states of respiration can enable superior sparing of healthy tissue near moving targets, compared to other motion mitigation strategies. Furthermore, carbon-ion therapy can sometimes provide greater relative biological effectiveness (RBE) for cell sterilization in a target but nearly equivalent RBE in tissue upstream of the target, compared to proton therapy. Thus, we expected that for some …

Evaluation Of Smoking Cessation Services In Ireland: Design And Pilot Of A Smoking Cessation Treatment Database, Sheila Keogan

Masters

A reduction in tobacco use is one of the stated aims of the National Health Promotion Strategy
(2000-2005) (Department of Health and Children, 2000a) as well being the core activity of
membership for all health promoting hospitals (HPH).
AIMS OF THE STUDY

1. To develop a database of smoking cessation services in Ireland.

2. Do a census of the smoking cessation services in Ireland and evaluate the range and
availability of them.
3. Develop a database for use in smoking cessation treatment services which would schedule
consultations with patients and gather all relevant demographics, treatments and their outcomes,
(cessation treatment …

Ventilator Associated Pneumonia Prevention In The Traumatically Injured Patient: Beyond The Bundle!, Cindy Umbrell Msn,Rn,Cns,Ccrn, Kenneth Miller Med, Rrt-Nps

Patient Care Services / Nursing

No abstract provided.

Quantitative Sugar Estimations In Pleural Fluid - An Aid To Diagnosis, John E. Peterson

Medical Arts and Sciences: A Scientific Journal of the College of Medical Evangelists

In a study of 33 cases of serous effusion it would appear that determination of the sugar content of the pleural fluid may provide an early clue to the etiologic diagnosis.

Cancer Of The Lungs, H. James Hara

Medical Arts and Sciences: A Scientific Journal of the College of Medical Evangelists

No abstract provided.