Respiratory Tract Diseases Commons^™

Empiric Antibiotic And Corticosteroid Prescribing For Hospitalized Acute Exacerbations Of Copd: Associations With Length Of Stay And Readmissions In A Large Multicenter U.S. Cohort, Kumar Abhishek, Pratyush Kumar, Archana Machavarapu, Munaf Siyamwala, Michael Waxman, Jeffrey Durbin, Kari Nilsen

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Z Variant Heterozygosity In Alpha-1 Antitrypsin Deficiency: Disease Risk And Treatment Implications, Craig P. Hersh, Jeffrey H. Teckman, Pavel Strnad, Aaron Hakim, Tomás P. Carroll, Ian P. Hall, Auyon J. Ghosh, Igor Barjaktarevic, Noel G. Mcelvaney, Joseph E. Kaserman, David A. Lomas, Charlie Strange, M Bradley Drummond, Stephen I. Rennard, Kathi E. Hanna, Virginia C. Clark, Monica P. Goldklang, Peg Iverson, Andrew A. Wilson

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Individuals heterozygous for alpha-1 antitrypsin deficiency (AATD) have one copy of the normal "M" allele and one copy of an abnormal allele ("Z", "S", or another variant) in the SERPINA1 gene. Historically, evidence has been lacking to support the concept that heterozygotes are at increased risk for liver and/or lung complications compared to individuals homozygous for the M allele. However, growing evidence suggests that inheritance of a single Z allele increases the risk of disease in some individuals. The Alpha-1 Foundation convened a workshop on October 27, 2023, in Bethesda, Maryland that included stakeholders from the research, pharmaceutical, and …

Drug-Induced Ild Requiring Ecmo, Arjun Kamath, Jose Garza, Matthew Wagner, Deekshita Valiveti, Percy Thomas, Christopher Ganson, Abhay Vakil, Zuhair Ali

Gulf Coast Division GME Research Day 2026

No abstract provided.

Ivig As Salvage Therapy In Refractory Antisynthetase Syndrome-Associated Ild: A Three-Case Series, Shine Vazhappilly, Julio Paoli-Gonzalez, Jose Herazo-Maya

West Florida Division GME Research Day 2026

No abstract provided.

Bayesian Reanalysis Of Early Remdesivir For The Treatment Of Covid-19 In Outpatients With High Risk Of Progression To Severe Disease, Mazin Abdelghany, Fang Yu, Stephen I. Rennard, Yeongjin Gwon

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Though Bayesian methods are flexible, intuitive, and readily incorporated into clinical decision-making, with particular utility when prior information is available, they remain underutilized in the analysis of clinical trials.

METHODS: In PINETREE, a Phase 3 randomized controlled trial (RCT) of remdesivir (RDV) for the treatment of outpatients with COVID-19 at high risk of severe disease, the primary outcome of COVID-19-related hospitalization or all-cause death was reanalyzed using a range of reference and data-driven priors. Posterior probability distributions were used to calculate the probability that the estimated hazard ratio (HR) was below a range of clinically meaningful specified thresholds and …

Invasive Pulmonary Aspergillosis: A Two-Year Journey, Jason Woods, Padmaditya Sureddi, Nga Van, Danielle Ford

North Texas GME Research Forum 2026

BACKGROUND: Highly active anti-retroviral therapy (HAART) has decreased the incidence of opportunistic infections among persons with HIV. Invasive aspergillosis specifically is uncommon among individuals with clusters of differentiation 4 (CD4) count >100 cells/mm3. Furthermore, treatment of aspergillosis in the HIV-infected population has not been examined systematically. We report a patient with CD4 count >200 cells/mm3, compliant with HAART therapy who developed invasive pulmonary aspergillosis (IPA) over the course of two years that was successfully treated through a combination of bronchial artery embolization and liposomal amphotericin.

CASE PRESENTATION: A 56-year-old man from southern Africa with four-year history of HIV-1 on HAART …

Reducing Respiratory Viral Testing In A Pediatric Emergency Department: A Quality Improvement Initiative, Anna Suessman

North Texas GME Research Forum 2026

Background: Respiratory viral testing in pediatric emergency departments (EDs) is frequently performed despite limited impact on clinical management for many low-risk presentations. Unnecessary testing increases cost and operational burden may delay patient throughput and can provide false reassurance to caregivers. Additionally, pediatric emergency department nurses agreed with overburden and impact to throughput based on overuse of viral testing (qualitative nursing survey conducted on September 4, 2024 showed >98% felt testing was unnecessary). We hypothesized that reducing testing through standardized team education and discharge processes would not negatively affect patient experience. This initiative aimed to decrease unnecessary respiratory viral testing during …

Impact Of Mips Measure 66 On The Incidence Of Pta's, Sydney Finch, Christopher Houston

North Texas GME Research Forum 2026

INTRO

A number of randomized controlled trials indicate that using point-of-care group A strep (POC GAS) testing decreases antibiotic utilization without compromising health outcomes. In 2018, the Merit-based Incentive Payment System (MIPS) measure 66 went into effect requiring the testing for GAS when treating pharyngitis. The intent was to decrease the unnecessary use of antibiotics in the treatment of pharyngitis, given that most cases are viral. Anecdotally, some physicians have noticed the increased incidence of peritonsillar abscesses (PTA). Our research group aims to investigate if there has been a significant increase in incidence of PTAs after the implementation of MIPS …

Initiation, Timing, And Duration Of Prone Positioning In Icu Ards Patients: An Integrative Research Review (Irr), Amanda Everard Thomas

Covenant Nurses Week 2026

No abstract provided.

Type 2 Myocardial Infarction In Adults Admitted For Severe Persistent Asthma With Status Asthmaticus: Evaluating Predictors And Mortality Burden, Kanwar Bir Dhaliwal, Rahul Pawa, Naresh Kodwani

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Baseline Right Ventricular-Pulmonary Arterial Coupling As A Predictor Of Clinical Outcomes In Endobronchial Valve Therapy For Advanced Emphysema, Syed Ali Raza Abidi, Prithvi Basu Roy, Munaf Siyamwala, Amelia Goslin

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Beyond Drainage: Can Pleural Effusion Serve As A Natural Tamponade Against Tumor Hemorrhage? A Case Report And Mechanistic Hypothesis, Pratyush Kumar, Kumar Abhishek, Pankti Shah, Amelia Goslin, Archana Machavarapu, Catherine Joyce, Michael Waxman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Shaping The Future Of Respiratory Care: A Look Into The Next Decade And Strategic Recommendations By The European Forum For Research And Education In Allergy And Airways Diseases, Xander Bertels, Glenis K. Scadding, Vibeke Backer, Susanne Lou, Wytske J. Fokkens, Peter J. Barnes, Manuel Bernal Sprekelsen, Leif Bjermer, Michael Blaiss, Elena Borzova, Marie-Charlotte Brüggen, Guy G. Brusselle, Lars Olaf Cardell, Diego M. Conti, Marjolein Cornet, Eugenio De Corso, Bernard De Groeve, Ratko Djukanovic, Adam T. Fox, Mina Gaga, Philippe Gevaert, Peter Gibson, Claudia L. Gray, Joseph Han, Liam Heaney, Enrico Heffler, Hans Jürgen Hoffmann, Claire Hopkins, Daniel Jackson, Outi Jauhola, Milos Jesenak, Pål Johansen, Ekaterina Khaleva, Basile Landis, Stella Lee, Valerie Lund, Mika Mäkelä, Marinda Mcdonald, Erik Melén, Joaquim Mullol, Antonio Nieto-García, Ian Pavord, Anju Peters, David Price, Santiago Quirce, Dermot Ryan, Pernilla Sahlstrand-Johnson, Sophie Scheire, Peter Schmid-Grendelmeier, Sven Schneider, Brent A. Senior, Catherine M.E. Shire, Peter K. Smith, Zsolt Szépfalusi, M. Thijs A. Teeling, Michael E. Wechsler, Philippe Houssiau, Klaus F. Rabe, Peter W. Hellings, José Luis Castro

Department of Otolaryngology (ENT) Faculty Publications

Chronic respiratory diseases (CRDs) remain 1 of the leading causes of preventable morbidity and disability worldwide, affecting up to one-third of the total Western population in 2025. Recognizing the substantial burden of inflammatory airway diseases such as asthma, COPD, chronic rhinosinusitis, and respiratory allergy, the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) organized the symposium “Shaping the Future of Respiratory Care” in April 2025 in Brussels, Belgium, at the occasion of the 10-year jubilee. Featuring keynote speakers from the World Health Organization and EUFOREA, this initiative had the following aims: (1) promoting dialogue on translating …

Dupilumab For Patients With Allergic Fungal Rhinosinusitis, Amber U. Luong, Joshua M. Levy, Sarah K. Wise, Joseph K. Han, Mamoru Yoshikawa, Luo Zhang, Rodney Schlosser, Prerna Ranganathan, Paula Dakin, Jennifer Maloney, George D. Yancopoulos, Andrew P. Fontenot, Neelam A. Phadke, Lacey R. Robinson

Department of Otolaryngology (ENT) Faculty Publications

Background

Allergic fungal rhinosinusitis (AFRS) is a severe subtype of chronic rhinosinusitis characterized by fungal hypersensitivity and accentuated type 2 inflammation. Dupilumab-a fully human monoclonal antibody blocking interleukin-4/13, approved for type 2 inflammatory diseases, including chronic rhinosinusitis with nasal polyps-may benefit patients with AFRS.

Objective

We sought to understand the effect of dupilumab in AFRS

Methods

In this phase 3 trial, patients with AFRS aged ≥6 years were randomized to dupilumab or matched placebo for 52 weeks. The primary end point was Lund-Mackay computed tomography (LMK-CT) score, quantifying sinus opacification, at 52 weeks. Secondary end points were multiplicity-controlled and hierarchically …

Investigating The Role Of Traditional Chinese Herbal Medicine For Cancer Symptom Management In Older Adults: A Rapid Review, Isabelle C. Karshner

Honors Undergraduate Theses

Background: Patients with cancer often experience symptoms related to disease, complications, and treatment. One potential method of alleviating these symptoms is traditional Chinese herbal medications (TCHM). This rapid review explores the role of traditional Chinese herbal medications in treating cancer-related symptoms in older adults.

Purpose: The purpose of this rapid review is to gain and provide a better understanding of the effects of TCHM on cancer-symptom management in the older adult population. This review explores the association between TCHM and effects on cancer symptoms in older adults, including interactions, toxicity, and signs/symptoms of TCHM use that may be useful information …

Synthesis And Characterization Of Succinate Dehydrogenase Inhibitors H2/Z14 And C6/Z96 In Order To Combat Small Cell Lung Cancer, Lauren M. Graves

Honors Undergraduate Theses

The use of ubiquinone inhibitors to combat cancer is a recent development in medicinal science and procedures to efficiently synthesize these drugs remain limited. C6/Z96 and H2/Z14, two succinate dehydrogenase inhibitors, have been previously tested in vitro against NSCLC with positive results. Their similarity to ubiquinone is what makes them a strong candidate for a succinate dehydrogenase inhibitor at the ubiquinone binding site. The heterocyclic scaffolds and substituents are proposed to bind strongly through a combination of electronics, hydrogen-bonding, and fit, allowing them to bind well and prove to be more favorable than ubiquinone when competing for the Q-site. By …

Use Of Ultrasound In The Pre-Hospital Setting To Differentiate Acute Dyspnea, Kenith D'Souza, Michael Cabebe, Taryn Hoffman, Martin Wegman, Justin Deaton, Christopher Carney

South Atlantic Division GME Research Days 2026

No abstract provided.

Catheter Directed Therapy In Acute Pulmonary Embolism: Patient Characteristics And Variability, Kalyan Mantha, W Angelo Kantrales, Brooke Mcmurtie, Caroline Mills, Martin Wegman

South Atlantic Division GME Research Days 2026

No abstract provided.

Association Between Emergency Medicine Residency Program And Diagnostic Efficiency For Pulmonary Embolism, Kerolos Abadeer, Kalyan Mantha, W Angelo Kantrales, Pranav Bommineni, Martin Wegman

South Atlantic Division GME Research Days 2026

No abstract provided.

Impact Of Sputum Collection Within 24 Hours Of Admission For Patients Hospitalized With Pneumonia, Sally Baker, Madelaine Duarte, Lauren Kirk, Mohamed Faris

South Atlantic Division GME Research Days 2026

No abstract provided.

Spontaneous Hemidiaphragm Elevation, A Subtle, Early Sign Of Malignancy, Michael Lee Phillips, Caitlyn Brown, Rena Phillips, John Ashby, Chad Martins

South Atlantic Division GME Research Days 2026

No abstract provided.

Senescent Fibroblasts In Aging And Pulmonary Fibrosis, Sara B. Palega, Aiwei Y. Borengasser, Yan Y. Sanders

Department of Biomedical and Translational Sciences Faculty Publications

Aging is a major risk factor for many chronic lung diseases, including Idiopathic Pulmonary Fibrosis (IPF), a fatal and incurable disease characterized by progressive fibrotic remodeling. Age-associated structural alterations, impaired regenerative capacity, and dysregulated cellular signaling collectively create a pro-fibrotic microenvironment. A central driver of this pathological shift is the accumulation of senescent cells, which undergo irreversible growth arrest and develop a robust pro-inflammatory senescence-associated secretory phenotype (SASP). Emerging evidence identifies senescent lung fibroblasts as critical mediators of IPF pathogenesis. These cells promote excessive extracellular matrix deposition, myofibroblast differentiation, and tissue stiffening, while simultaneously impairing epithelial regeneration. Together, these effects …

Systemic Sclerosis-Associated Interstitial Lung Disease: Improved Understanding And Advances In Management, Amit Syal, Chris T. Derk

Student Papers, Posters & Projects

Interstitial lung disease (ILD), a common manifestation of systemic sclerosis (SSc), has the highest organ-specific morbidity and mortality, particularly in patients with diffuse cutaneous SSc (dcSSc). Recent advances in diagnostics-including artificial intelligence (AI)-enhanced high-resolution computed tomography (HRCT) and biomarkers such as Krebs van den Lungen (KL)-6-have enabled earlier detection and monitoring of disease progression. Therapeutically, the approval of antifibrotics like nintedanib (NINT) and immunomodulators such as tocilizumab (Toci) has significantly expanded treatment options. Updated international guidelines from the American College of Rheumatology (ACR), American College of Chest Physicians (CHEST), American Thoracic Society (ATS), and European league against Rheumatism (EULAR) now …

Urinothorax And Empyema: Presentation Of An Unusual Complication Of A Rare Condition, Nolan Fox, Nicholas Fox, Shourjo Chakravorty, Neeraj Sinha

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

A 68-year-old male with a history of metastatic bladder cancer and urinary obstruction presented with intractable hiccups and chest pain is presented in this case. He was found to have a unilateral pleural effusion in addition to ipsilateral renal metastasis abutting the diaphragm. Imaging revealed empyema. Thoracentesis revealed positive cultures and a lack of malignant cells on cytology. Comorbid urinary obstruction and urinary tract infection suggested the rare diagnosis of an infected urinothorax. Thoracentesis also revealed pleural fluid creatinine greater than serum creatinine, meeting the most specific diagnostic criteria for urinothorax and establishing the diagnosis. Treatment aimed at evacuating the …

Dermal Lymphatic Carcinomatosis As A Cutaneous Metastasis From Epidermal Growth Factor Receptor-Positive Lung Adenocarcinoma: A Case Report, Sarah A. Hemelt, Jonathan M. Joseph, Nicholas Culotta

School of Medicine Faculty Publications

Cutaneous metastases are an uncommon but clinically significant manifestation of internal malignancies. We present a rare case of dermal lymphatic carcinomatosis arising from epidermal growth factor receptor (EGFR)-positive lung adenocarcinoma, a presentation that may closely mimic inflammatory dermatoses and indicate therapeutic resistance or disease progression. We describe the clinical course of a 65-year-old woman who developed a violaceous cutaneous metastatic lesion beneath the left breast during treatment for metastatic lung adenocarcinoma. This case highlights the importance of recognizing cutaneous signs as indicators of disease progression and emphasizes the diagnostic challenges and prognostic implications of cutaneous metastases in lung cancer.

Endothelial-Derived Extracellular Vesicles During Exercise In Copd Patients, Samuel C Okpechi, Dorota Wyczechowska, Bennett Deboisblanc, Jessica L Johnson, Mohamed A Ghonim, Natalie Bauer, Hamid A Boulares, Matthew R Lammi

School of Medicine Faculty Publications

Introduction: There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development. Methods: We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate–severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost. Results: Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there …

Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md

The Lahey Journal

Development of a Longitudinal, Small-Group POCUS Curriculum for Internal Medicine Residents

Introduction

Point-of-Care Ultrasound (POCUS) is integral for clinicians to enhance their diagnostic and procedural skills. Unlike Emergency Medicine or Anesthesia training programs, Internal Medicine programs often lack a structured and standardized curriculum. We thus developed a longitudinal and multi-pronged POCUS curriculum aimed at building trainee competency when utilizing ultrasound for diagnostic and procedural work-up.

Methods

The curriculum encompasses the following: basics of ultrasound, ultrasound-guided procedures, thoracic ultrasound/Bed Lung Ultrasound in Emergency (BLUE), and cardiac ultrasound/Focus-Assessed Transthoracic Echocardiography (FATE). These modules were integrated into the residents’ clinic blocks. We utilized …

Chronic Rhinosinusitis Is A Risk Factor For Interstitial Lung Disease In Sjogren’S Syndrome, Brian Schonewald, Christopher Xie, Andrew Engel, Ross Summer, Giorgos Loizidis

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

BACKGROUND: Interstitial lung disease (ILD) is a leading cause of morbidity and mortality in Sjögren's syndrome (SS), but its risk factors remain unclear. Although SS affects both the upper and lower respiratory epithelium, it is unknown whether this occurs simultaneously or separately. In other autoimmune conditions-such as eosinophilic granulomatosis with polyangiitis and granulomatosis with polyangiitis-upper airway disease precedes lower lung involvement by months or even years. We hypothesized that chronic rhinosinusitis (CRS), as an upper airway disease, may be a risk factor for ILD in SS.

METHODS: We analyzed the TriNetX Research Network database to compare incident ILD in SS …

Regorafenib Pulmonary Toxicity: A Case Of Cavitary Lung Disease And Ards Treated With Infliximab, Michael Dong, Mackenzie Kramer, Tanmay Gandhi, Gautam George

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Regorafenib-induced pneumonitis and acute respiratory distress syndrome (ARDS) are rare and poorly characterized toxicities. We describe a 43-year-old male with metastatic colorectal cancer who developed hypoxic respiratory failure after two cycles of regorafenib. Imaging revealed cavitary lung lesions and diffuse ground glass opacities. Despite antibiotics and high-dose corticosteroids, his condition deteriorated, requiring ICU admission and mechanical ventilation. Bronchoalveolar lavage revealed bacterial pathogens, and he was treated for pneumonia. After multidisciplinary discussion, he was assessed to have regorafenib-induced pneumonitis as a major driver of his respiratory failure, and after limited steroid response, infliximab was administered with marked respiratory improvement. However, he …

Progress In Progressive Pulmonary Fibrosis, Jesse Roman

Rothman Institute Papers

No abstract provided.