Respiratory Tract Diseases Commons^™

No Difference In Clinical Outcomes For African American And White Patients Hospitalized With Sars-Cov-2 Pneumonia In Louisville, Kentucky, Julio A. Ramirez, Stephen P. Furmanek, Thomas Chandler, Stephen S. Hanson, Dawn Balcom, Subathra Marimuthu, Sathya Krishnasamy, Jose Bordon, Rodrigo Cavallazzi, Amr Aboelnasr, Mahder A. Tella, William A. Mattingly, Ashley M. Wilde, Daisy Sangroula, Demetra Antimisiaris, Donghoon Chung, Guillermo Cabral, Gabino R Fernandez-Botran, Jiapeng Huang, Martin Gnoni, Ozan Akca, Paul Schulz, Phillip F. Bressoud, Priya Krishnan, Sally Suliman, William P. Mckinney, Bryan Moffett, Leslie A Wolf, Mark Burns, Alex Glynn, Ruth Carrico, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Introduction: Current literature indicates that African American individuals are at increased risk of becoming infected with the SARS-CoV-2 virus and suffer higher SARS-CoV-2-related mortality rates. However, there is a lack of consensus as to how the clinical outcomes of African American patients differ from those of other groups. The objective of this study was to define the clinical outcomes of African American and White hospitalized patients with SARS-CoV-2 community-acquired pneumonia (CAP) in Louisville, Kentucky.

Methods: This was a retrospective cohort study of hospitalized patients with SARS-CoV-2 CAP at eight hospitals in Louisville, Kentucky. Severity of CAP at time of hospitalization …

Asthma Pathophysiology, Tyler Wolpert

Nursing Student Class Projects (Formerly MSN)

This poster will examine the pathophysiology of Asthma, explore signs and symptoms of the disease, and review different treatment modalities. The Doctorate of Nursing (DNP) prepared nurse should be able to identify signs and symptoms of the disease and be prepared to manage the disease from a medical standpoint, as well as with behavior modification. The economic burden of asthma on healthcare yearly is over $82 billion. It is pertinent that continued research is done in the field of asthma to reduce the economic impacts of the disease, as well as to help improve patient outcomes on people living with …

Gender, Age And Staff Preparedness To Adopt Internet Tools For Research Sharing During Covid-19 In African Varsities, Valentine Joseph Owan, Michael Ekpenyong Asuquo Phd., Samuel Okpon Ekaette Ph.D., Sana Aslam, Moses Eteng Obla, Daniel Clement Agurokpon, Mercy Valentine Owan

Library Philosophy and Practice (e-journal)

This study assessed the partial as well as the collaborative impact of age and gender on academic staff preparedness to adopt Internet tools for research sharing in African universities during Covid-19. Although evidence abounds in the literature on gender and age as they affect relatively, scholars’ utilisation of digital tools for research communication, such studies did not examine scholars’ preparedness to adopt from a broad perspective of Africa. This study was conducted based on the argument that the preparedness of scholars may affect their future interest to utilize digital tools for research sharing. A quantitative method, based on the descriptive …

Post Tuberculosis Radiological Sequelae In Patients Treated For Pulmonary And Pleural Tuberculosis At A Tertiary Center In Pakistan, Syed Muhammad Zubair, Mariyam Gohar Ali, Muhammad Irfan

Section of Pulmonary & Critical Care

Treating tuberculosis (TB) is not the end of the disease because of the wide spectrum of post TB sequelae associated with the disease. There is insufficient data on post TB radiological sequelae. The aim of this study is to evaluate the post TB radiological sequelae on chest x-rays in patients who had completed the treatment for pulmonary and pleural TB at a tertiary care hospital of a high TB burden country. This is a retrospective cross-sectional study conducted on patients treated for pulmonary and pleural TB. Adult patients (18 years or above) with a clinical or microbiological diagnosis of pulmonary …

Griffithsin And Carrageenan Combination Results In Antiviral Synergy Against Sars-Cov-1 And 2 In A Pseudoviral Model, Sahar Alsaidi, Nadjet Cornejal, Oneil Mahoney, Claudia Melo, Neeharika Verma, Thierry Bonnaire, Theresa Chang, Barry R. O'Keefe, James Sailer, Thomas M. Zydowsky, Natalia Teleshova, José A. Fernández Romero

Publications and Research

Over 182 million confirmed cases of COVID-19 and more than 4 million deaths have been reported to date around the world. It is essential to identify broad-spectrum antiviral agents that may prevent or treat infections by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but also by other coronaviruses that may jump the species barrier in the future. We evaluated the antiviral selectivity of griffithsin and sulfated and non-sulfated polysaccharides against SARS-CoV-1 and SARS-CoV-2 using a cytotoxicity assay and a cell-based pseudoviral model. The half-maximal cytotoxic concentration (CC50) and half-maximal effective concentration (EC50) were determined for each compound, using a dose-response-inhibition …

Factors Motivating Smoking Cessation: A Cross-Sectional Study In A Lower-Middle-Income Country, Russell S. Martins, Muhammad Umer Junaid, Muhammad Sharjeel Khan, Namrah Aziz, Zoha Zahid Fazal, Mariam Umoodi, Fatima Shah, Javaid Ahmed Khan

Medical College Documents

Introduction: Only one-quarter of smokers in Pakistan attempt to quit smoking, and less than 3% are successful. In the absence of any literature from the country, this study aimed to explore factors motivating and strategies employed in successful smoking cessation attempts in Pakistan, a lower-middle-income country.
Methods: A survey was carried out in Karachi, Pakistan, amongst adult (≥ 18 years) former smokers (individuals who had smoked ≥100 cigarettes in their lifetime but who had successfully quit smoking for > 1 month at the time of survey). Multivariable logistic regression, with number of quit attempts (single vs. multiple) as the dependent variable, …

Vitamin D Status And Pulmonary Exacerbations In Children And Adolescents With Cystic Fibrosis: Experience From A Tertiary Care Center, Danish Abdul Aziz, Syeda Khadija Fatima, Haissan Iftikhar, Fatima Mir

Department of Paediatrics and Child Health

Background: The function of Vitamin D in preventing inflammation and infection has been studied previously for different pathologies in different populations globally. Relationships between serum Vitamin D levels and its effect on pulmonary exacerbations in the cystic fibrosis (CF) population are not well studied in our part of the world. Therefore, we aimed to ascertain the Vitamin D status in pediatric and adolescent CF patients and its association with pulmonary exacerbations.
Materials and methods: A retrospective study was conducted at The Aga Khan University Hospital from 2015 to 2018. Patients of CF with sweat chloride value >60 mmol/l and who …

Comparison Of Clinical Characteristics And Outcomes Between Covid-19 Pneumonia And H1n1 Influenza, Nosheen Nasir, Iffat Khanum, Kiren Habib, Rimsha Ahmed, Mujahid Hussain, Zahra Hasan, Muhammad Irfan

Department of Medicine

Introduction: The COVID-19 pandemic has been likened to the 2009 H1N1 influenza pandemic. We aim to study the similarities and differences between patients hospitalized with COVID-19 and H1N1 influenza in order to provide better care to patients, particularly during the co-circulation of Influenza A Subtype H1N1 and SARS-CoV-2.
Material and methods: A retrospective cohort study was conducted in order to compare clinical characteristics, complications, and outcomes of hospitalized patients with PCR-confirmed H1N1 influenza pneumonia and COVID-19 at a tertiary care center in Karachi, Pakistan.
Results: A total of 115 patients hospitalized with COVID-19 were compared with 55 patients with H1N1 …

Personalized Digital Phenotype Score, Healthcare Management And Intervention Strategies Using Knowledge Enabled Digital Health Framework For Pediatric Asthma, Utkarshani Jaimini, Amit Sheth

Publications

Asthma is a personalized, and multi-trigger respiratory condition which requires continuous monitoring and management of symptoms and medication adherence. We developed kHealth: Knowledge-enabled Digital Healthcare Framework to monitor and manage the asthma symptoms, medication adherence, lung function, daily activity, sleep quality, indoor, and outdoor environmental triggers of pediatric asthma patients. The kHealth framework collects up to 1852 data points per patient per day. It is practically impossible for the clinicians, parents, and the patient to analyze this vast amount of multimodal data collected from the kHealth framework. In this chapter, we describe the personalized scores, clinically relevant asthma categorization using …

Engineering And Characterization Of Human Β-Defensin-3 And Its Analogues And Microcin J25 Peptides Against Mannheimia Haemolytica And Bovine Neutrophils, Harpreet Dhingra, Kamaljit Kaur, Baljit Singh

Pharmacy Faculty Articles and Research

Mannheimia haemolytica-induced bovine respiratory disease causes loss of millions of dollars to Canadian cattle industry. Current antimicrobials are proving to be ineffective and leave residues in meat. Antimicrobial peptides (AMPs) may be effective against M. haemolytica while minimizing the risk of drug residues. Cationic AMPs can kill bacteria through interactions with the anionic bacterial membrane. Human β-Defensin 3 (HBD3) and microcin J25 (MccJ25) are AMPs with potent activity against many Gram-negative bacteria. We tested the microbicidal activity of wild-type HBD3, three HBD3 peptide analogues (28 amino acid, 20AA, and 10AA) derived from the sequence of natural HBD3, and MccJ25 …

Transient Leukopenia, Thrombocytopenia, And Severe Neutropenia Associated With Acute Sars-Cov-2 Infection, Austin Schatzman, Julia Vandenheuvel Md, Tibisay Villalobos Md, Kris Rooney Md

Department of Pediatrics

No abstract provided.

Weak Evidence, Supplemented With Common Sense For Reduction In Postoperative Pulmonary Complications, Natalie M. Wiseman

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Kaminski PN, Forgiarini LA, Jr., Andrade CF. Early respiratory therapy reduces postoperative atelectasis in children undergoing lung resection. Respir Care. 2013;58(5):805-809. https://doi.org/10.4187/respcare.01870

for prevention of postoperative pulmonary complications following thoracic surgery for a patient who is not able to participate in incentive spirometry.

Predictors Of Mortality In Hospitalized Covid-19 Patients: A Mexican Population-Based Cohort Study., Fernando Mesta Dr., Ángel Mario Coll Dr., Miguel Ángel Ramírez M.Sc., Livan Delgado-Roche Dr.

BioMedicine

Objectives. COVID-19 outbreak brings a challenge to healthcare systems. The sex, age, and cardiometabolic comorbidities have been considered risk factors for disease severity. To evaluate the association between risk factors with death as well the risk of death in hospitalized COVID-19 patients.

Methods. The present cross-sectional cohort study, includes hospitalized SARS‑CoV‑2 confirmed cases. Data analysis was performed using the National COVID‑19 Cases Report Database. Pearson´s χ² test and odds ratios (95% CI) were calculated to determine the association between variables. Thereafter, risk of death was evaluated by Cox proportional hazards model.

Results. A total of 67 …

Financial Outcomes Of High Flow Nasal Cannula Use For Bronchiolitis On The General Pediatric Floor Across Children's Hospitals, Jonathan Hartley

Research Days

Background: Bronchiolitis is a leading cause of hospitalization for infants and results in over 1.7 billion dollars in yearly hospital charges (Hasegawa). The use of high flow nasal cannula (HFNC) on a general pediatrics floor may reduce hospital costs and length of stay (LOS, Kalburgi). However, the financial impact of HFNC use is not welldescribed.

Objective: The primary objective are the financial outcomes of HFNC utilization on the general pediatric floor. The secondary objective included financial outcomes stratified by All Patients Refined Diagnosis Related Groups (APRDRG) severity of illness (SOI) and payor type. We hypothesize that costs outweigh reimbursement for …

Impact Of High Flow Nasal Cannula On Resource Utilization In Bronchiolitis, Scott Biggerstaff

Research Days

Background: Bronchiolitis is one of the most common diseases requiring hospitalization in children 1-24 months of age, but presently treatment is primarily supportive. High flow nasal cannula is a newer method of oxygen delivery pediatric hospitals have been rapidly adopting to treat respiratory insufficiency caused by viral bronchiolitis.

Objectives/Goal: We sought to compare resource utilization, including cost, length of stay (LOS), and readmission among children who were treated with HFNC versus those who were not.

Methods/Design: In this cross-sectional, multicenter study, we obtained clinical and resource utilization data from the Pediatric Health Information System (PHIS) database for otherwise healthy children …

Outcomes Of Infants With Severe Rop At Risk Of Treatment With Avastin Compared To Laser Surgery, Stephen Doxey

Research Days

Background: Retinopathy of prematurity (ROP) is a well-known complication occurring in the most premature infants leading to visual impairment and in the most severe cases associated with retinal detachment and childhood blindness. Factors contributing the development of ROP include chronic hypoxia and disordered vascular genesis primarily through the vascular endothelial growth factor (VEGF) signaling pathway. Infants at risk of developing ROP are screened with serial eye exam and treated with either laser surgery or intraocular injects of bevacizumab (Avastin) to prevent progression of ROP and preserve vision. Bevacizumab, an inhibitor of VEGF signaling, may have positive effects on preventing ROP …

Sodium Pyruvate Ameliorates Influenza A Virus Infection In Vitro And In Vivo, Jessica M. Reel

Graduate Theses/Dissertations

Pyruvate is produced in duplicate at the end of glycolysis in addition to ATP and NADH. Pyruvate is the metabolite of choice in most cells, whether obtained exogenously or endogenously. Recently we found that the addition of pyruvate’s conjugate base, sodium pyruvate, to cell culture media dampened the immune response to influenza A virus (IAV) infection in cultured innate immune cells. Thus, I decided to investigate the mechanism and potential for treatment of IAV. In vitro using bone marrow derived macrophages that were infected with IAV we found that adding sodium pyruvate to the media decreased immune signaling pathways through …

Efficiency With Covid-19: Home Vs. Dillon’S Rule States, Jason Kolb

Political Science Theses and Capstones

How does a state measure success when dealing with a pandemic like Covid-19? Can Dillon’s Rule keep their citizens happy and protected during a pandemic better then Home Rule? When local governments wait for the state to create policies, is this the best option for the state? Data will show a trend that states with a higher preemption rate have kept the death rate lower when dealing with the Covid-19 pandemic

Violence Against Healthcare Workers During The Covid-19 Pandemic: A Review Of Incidents From A Lower-Middle-Income Country, Omaima Anis Bhatti, Hareem Rauf, Namrah Aziz, Russell S. Martins, Javaid Khan

Medical College Documents

Background: Healthcare workers (HCWs) across the globe have met tremendous challenges during the COVID-19 (coronavirus disease 2019) pandemic, such as shortages of personal protective equipment, extensive work hours, and constant fear of catching the virus or transmitting it to loved ones. Adding on to the already existing burnout, an increase in incidents of violence and aggression against HCWs was seen in Pakistan and globally.
Objectives: Primarily to review cases of violence against HCWs in Pakistan, highlighting and comparing the instigating factors seen within the country and globally. Secondly, to enlist possible interventions to counter workplace violence in healthcare during a …

Animated Videos: The Covid-19 Pandemic, Bailey Alspach

Honors Projects

This project is a resource created to provide information about the Covid-19 pandemic. This pandemic was caused by the SARS-CoV-2 virus (AJMC Staff, 2021). The first reported cases began to appear in December 2019, and the World Health Organization (WHO) declared COVID-19 a pandemic on March 11th, 2020. This pandemic is still active with new cases reported everyday as of April 2021 (AJMC Staff, 2021). This resource consists of four videos ranging from around two and a half to eight minutes long. All videos were created in an animated fashion and were uploaded to YouTube. The first video focuses on …

Improving Antibiotic Prescribing For Acute Respiratory Illnesses, Laurinia Hunter

Student Scholarly Projects

Practice Problem: Unwarranted antibiotic prescribing practices when treating acute respiratory illnesses contribute to the national health threat of antibiotic resistance.

PICOT: In a pediatric outpatient setting for patients ages 6-25 who have no documented uncontrolled comorbidities, presenting with an acute respiratory illness (P), does provider utilization of clinical guidelines, and patient and (caregivers) utilization of educational pamphlets, to collectively develop a plan of care (I), compared to providers and patients who do not utilize such strategies(C) result in a reduction in antibiotics prescribed for acute respiratory illnesses (O) in a 6-week timeframe (T)?

Evidence: The evidence reviewed reported the utilization …

Implementation Of A Postdischarge Virtual Visit And Nurse Follow-Up Protocol To Decrease 30-Day Readmission Rates For Patients With Pulmonary Arterial Hypertension, Kimberly Thompson

The Eleanor Mann School of Nursing DNP Capstone Projects

Pulmonary arterial hypertension (PAH) is a rare, chronic disease with no cure. Patients with this disease have high mortality and morbidity, experience frequent hospitalizations, readmissions, and psychosocial burdens, and require a high degree of self-care management skills (Doyle-Cox et al., 2016; Lattimer et al., 2016; McDevitt & Walter, 2019). More than half of PAH patients are hospitalized within the first year following diagnosis, and about 20% are readmitted to the hospital within thirty days of discharge (Bhattacharya et al., 2019: Tonelli, 2020). These patients also have a high symptom burden, and these symptoms significantly affect their physical and mental quality …

Post Covid-19 Tuberculosis: An Emerging Threat Of Pandemic, Aqusa Zahid, Nousheen Iqbal, Sarosh Moeen, Muhammad Irfan

Section of Pulmonary & Critical Care

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic has hit the world hard. Millions of people have died due to the infection and several have suffered with what are now known as post COVID-19 squeal. Among these squeals one is immunosuppression which leaves patients prone to severe opportunistic infection. We here report a case of young female who was infected by COVID-19 and later developed cavitary pneumonia which upon investigation turned out to be due to mycobacterium tuberculosis. Through this report we aim to highlight the importance of high index of suspicion for infection like Mycobacterium tuberculosis after …

Serious Adverse Events And 30-Day Hospital Readmission Rate Following Elective Total Knee Arthroplasty: A Systematic Review And Meta-Analysis., Costas Papakostidis, Peter V Giannoudis, J. Tracy Watson, Robert Zura, R. Grant Steen

School of Medicine Faculty Publications

Background: Elective total knee arthroplasty (TKA) is a common surgery which has evolved rapidly. However, there are no recent large systematic reviews of serious adverse event (SAE) rate and 30-day readmission rate (30-dRR) or an indication of whether surgical methods have improved. Methods: To obtain a pooled estimate of SAE rate and 30-dRR following TKA, we searched Medline, Web of Science, Cochrane Library, and Google Scholar databases. Data were extracted by two authors following PRISMA guidelines. Eligibility criteria were defined prior to a comprehensive search. Studies were eligible if they were published in 2007 or later, described sequelae of TKA …

Facial Mask Use And Covid-19 Protection Measures In Jefferson County, Kentucky: Results From An Observational Survey, November 5−11, 2020, Seyed M. Karimi, Sonali S. Salunkhe, Kelsey B. White, Sahal A. Alzahrani, Bert Little, William P. Mckinney, Natalie Dupre, Riten Mitra, Yuting Chen, Martha M Popescu, Emily R. Adkins, Julia A. Barclay, Emmanuel Ezekekwu, Caleb.He X. He, Dylan M Hurst, Aravindreddy Kothagadi, Shaminul H. Shakib, Devin N. Swinney, David A. Johnson, Rebecca Hollenbach, Sarah Moyer

The University of Louisville Journal of Respiratory Infections

Introduction: The transmission of respiratory infectious diseases such as COVID-19 can significantly decrease by mask-wearing. However, accurate information about the extent and proper use of the facial mask is scarce. This study’s main objective was to observe and analyze mask-wearing behavior and the level of COVID-19 protection measures in indoor public areas (PAs) of Jefferson County, Kentucky.

Methods: For conducting the observational survey study, targets were indoor PAs, and zip codes were defined as surveying clusters. The number of selected PAs in each zip code was proportional to the population and the total number of PAs in that zip code. …

H1n1 Influenza Virus (Swine Flu): A Comprehensive Insight Into Escalating Catch-22 Scenarios, Muhammad Shahzaib, Ehsan Ul Haq

The University of Louisville Journal of Respiratory Infections

Introduction: Viruses have always been a major cause of various disastrous pandemics in mankind’s history. H1N1 became a threat when its original strain was first discovered back in the swine flu pandemic of 2009. It became highly catastrophic on a large scale because none of the therapeutic interventions and methodologies that were already present at the time were effective against the virus.

Methods: A vast amount of literature and research is available regarding H1N1 influenza from different reputable sources online. The data were gathered with the contrasting and relative situations of 1918 and 2009 pandemics in mind. The overall extracted …

Role Of Awake Prone Positioning In Patients With Moderate-To-Severe Covid-19: An Experience From A Developing Country, Iffat Khanum, Fatima Samar, Fatimah Yousuf, Safia Awan, Adil Aziz, Kiren Habib, Nosheen Nasir, Syed Faisal Mahmood, Bushra Jamil

Department of Medicine

There is limited evidence on the efficacy of awake prone positioning (PP) in non-ventilated patients with COVID-19 who have hypoxemia. We, therefore, aim to describe our experience with the use of early proning in awake, non-intubated patients with confirmed COVID-19. In our retrospective observational study, 23 patients with confirmed positive PCR test results for Severe Acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and hypoxemia that required oxygen therapy with or without non-invasive ventilation were treated with PP. Patients were classified into mild, moderate and severe COVID-19 disease. There were no targeted number of hours for proning per day and patients were kept …

Pancoast Syndrome Due To High Grade Anaplastic Tumor, Christian Almanzar, Seth Maxwell, Mauricio Gomez, Omar Ansari, Luis Silva

HCA Healthcare Journal of Medicine

The Pancoast tumor is an uncommon type of lung cancer that arises from within the superior sulcus. With most clinical manifestations occurring due to mass effect, Pancoast syndrome is a known complication that includes shoulder and arm musculoskeletal pain, Horner’s syndrome and neurological complications of the upper extremities, including weakness and atrophy. Even though adenocarcinoma is the most common cause of Pancoast syndrome among lung cancers, other malignancies can be responsible as well. Treatment is similar to that of other standard NSCLC treatments that include chemotherapy, radiation, immunotherapy and surgery. Here we report a patient with Pancoast syndrome secondary to …

Esophageal Cancer Complicated By A Distal Acquired Esophagopulmonary Fistula, Alexander D. Lake, Yousef Almuzaini, Aaron Jaffe, Joseph Staffetti, Mukesh Patel

HCA Healthcare Journal of Medicine

Esophageal respiratory fistulas, commonly found as a tracheoesophageal fistula (TEF), are abnormal connections between the esophagus and trachea. These can be congenital (infants) or acquired (malignancy). A more rare form of an esophageal respiratory fistula is an abnormal connection between the esophagus and the lung parenchyma—also known as an esophagopulmonary fistula. In our case, we present a middle-aged male with a history of esophageal cancer undergoing chemotherapy and radiation presenting into the intensive care unit for increasing shortness of breath and vomiting after eating found to have a rare form of a TEF causing his symptoms.

Analysis Of Covid-19 Prevention And Treatment In Taiwan (Review), Yu-Jen Chiu, Jo‑Hua Chiang, Chih-Wei Fu, Mann-Jen Hour, Hai-Anh Ha, Sheng-Chu Kuo, Jen-Jyh Lin, Ching-Chang Cheng, Shih‑Chang Tsai, Yu‑Shiang Lo, Yu‑Ning Juan, Yih-Dih Cheng, Jai-Sing Yang, Fuu‑Jen Tsai

BioMedicine

Coronavirus disease 2019 (COVID‐19) has been spreading worldwide with a mind-boggling speed. According to a statement from World Health Organization (WHO), COVID-19 has infected more than six billions people and caused more than one and half million passing in the world. Based on previous experience with SARS, the Taiwanese government had decided to block viral transmission during its early stages. This review sums up the clinical characteristics, Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) viral infection process, diagnostic methods, preventive strategy, and the executive proportions of COVID-19, as well as the name-based mask distribution system (NBMDS) in Taiwan. We …