Pulmonology Commons^™

Fluoroquinolone Use And Risk Of Pneumothorax In Adults Hospitalized With Community Acquired Pneumonia: A Retrospective Cohort Study, Steven Yi B. S., Saurav Sumughan B.S., Jessica Cobb M. D., Erika J. Yoo

Department of Medicine Faculty Papers

Objectives: The objective of this study is to examine the relationship between fluoroquinolone exposure and pneumothorax risk in patients hospitalized with pneumonia.

Methods: This retrospective cohort study used the TriNetX US Collaborative Network. We defined two mutually exclusive cohorts of hospitalized adults based on exposure to antibiotic classes commonly used to treat community acquired pneumonia: fluoroquinolone (ciprofloxacin, moxifloxacin, levofloxacin, and ofloxacin) versus nonfluoroquinolone (amoxicillin, azithromycin, ceftriaxone, and doxycycline). Patients with connective tissue disorders were excluded. The primary outcome was the occurrence of pneumothorax within 60 days. We used Cox proportional hazards regression to estimate hazard ratios (HRs) adjusted for demographics, …

Annual Adherence Of Asian American Individuals In A Lung Cancer Screening Program Compared With Other Racial Groups, Benjamin Tasevac, Christine S. Shusted, Brooke Ruane, Emily Muse, Olugbenga Okusanya, Tyler Grenda, Nathaniel R. Evans, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie Barta

Department of Medicine Faculty Papers

Racial differences in lung cancer screening (LCS) eligibility and outcomes persist despite recent expansion of the US Preventive Services Task Force criteria and greater recognition of screening disparities. Research Question: What is the annual screening adherence rate for US Preventive Services Task Force-eligible Asian American individuals receiving LCS through a centralized screening program? Study Design and Methods: Individuals screened through a centralized LCS program were identified retrospectively using the Jefferson LCS Program Registry. Sociodemographic and clinical data were extracted from the prospectively maintained registry. Frequency statistics were compared by race including among Asian American subgroups, and multivariate logistic regression was …

Perspectives From Patients With Chronic Lung Disease On A Telehealth-Facilitated Integrated Palliative Care Model: A Qualitative Content Analysis Study, Jeannette Kates, Carrie Tompkins Stricker, Kristin L. Rising, Alexzandra Gentsch, Ellen Solomon, Victoria Powers, Venise J. Salcedo, Brooke Worster

Department of Medicine Faculty Papers

BACKGROUND: Chronic lung disease affects nearly 37 million Americans and often results in significant quality of life impairment and healthcare burden. Despite guidelines calling for palliative care (PC) integration into pulmonary care as a vital part of chronic lung disease management, existing PC models have limited access and lack scalability. Use of telehealth to provide PC offers a potential solution to these barriers. This study explored perceptions of patients with chronic lung disease regarding a telehealth integrated palliative care (TIPC) model, with plans to use findings to inform development of an intervention protocol for future testing.

METHODS: For this qualitative …

Which Sample Type Is Better For Xpert Mtb/Rif To Diagnose Adult And Pediatric Pulmonary Tuberculosis?, Mengyuan Lyu, Jian Zhou, Yuhui Cheng, Weelic Chong, Kang Wu, Teng Fang, Tianbo Fu, Binwu Ying

Department of Medicine Faculty Papers

OBJECTIVE: This review aimed to identify proper respiratory-related sample types for adult and pediatric pulmonary tuberculosis (PTB), respectively, by comparing performance of Xpert MTB/RIF when using bronchoalveolar lavage (BAL), induced sputum (IS), expectorated sputum (ES), nasopharyngeal aspirates (NPAs), and gastric aspiration (GA) as sample.

METHODS: Articles were searched in Web of Science, PubMed, and Ovid from inception up to 29 June 2020. Pooled sensitivity and specificity were calculated, each with a 95% confidence interval (CI). Quality assessment and heterogeneity evaluation across included studies were performed.

RESULTS: A total of 50 articles were included. The respective sensitivity and specificity were 87% …

Anticoagulation And Bleeding Risk In Patients With Covid-19, Nancy Musoke, Kevin Bryan Lo, Jeri Albano, Eric Peterson, Ruchika Bhargav, Fahad Gul, Robert Dejoy, Grace Salacup, Jerald Pelayo, Padmavathi Tipparaju, Zurab Azmaiparashvili, Gabriel Patarroyo-Aponte, Janani Rangaswami

Department of Medicine Faculty Papers

BACKGROUND: There is no current standardized approach to anticoagulation in patients with Coronavirus Disease 2019 (COVID-19) while potential bleeding risks remain. Our study characterizes the patterns of anticoagulation use in COVID-19 patients and the risk of related bleeding.

METHODS: This is a single center retrospective analysis of 355 adult patients with confirmed diagnosis of COVID-19 from March 1 to May 31, 2020. Chi-square was used to analyze the relationship between degree of anticoagulant dose and bleeding events by site. Multivariable logistic regression was used to look at factors associated with inpatient death.

RESULTS: 61% of patients were being treated with …

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 …

Acute Exacerbations Of Progressive-Fibrosing Interstitial Lung Diseases., Martin Kolb, Benjamin Bondue, Alberto Pesci, Yasunari Miyazaki, Jin Woo Song, Nitin Y. Bhatt, John T. Huggins, Justin M. Oldham, Maria L. Padilla, Jesse Roman, Md, Shane Shapera

Department of Medicine Faculty Papers

Acute exacerbation of interstitial lung disease (ILD) is associated with a poor prognosis and high mortality. Numerous studies have documented acute exacerbation in idiopathic pulmonary fibrosis (IPF), but less is known about these events in other ILDs that may present a progressive-fibrosing phenotype. We propose defining acute exacerbation as an acute, clinically significant respiratory deterioration, typically less than 1 month in duration, together with computerised tomography imaging showing new bilateral glass opacity and/or consolidation superimposed on a background pattern consistent with fibrosing ILDs. Drawing on observations in IPF, it is suspected that epithelial injury or proliferation and autoimmunity are risk …

A 22-Year-Old Man With Pleural Tuberculosis Associated Hydropneumothorax: Case Report And Literature Review., Lauren A Sharan, Thea Price, Md, Boyd Hehn, David Manoff, Md, Scott W. Cowan, Md

Department of Medicine Faculty Papers

A 22-year-old Asian male presented with fever, non-productive cough, right-sided pleuritic chest pain and was found to have a large right hydropneumothorax. A chest tube was placed. Pleural fluid analysis revealed a lymphocytic predominant exudate and he was subsequently started on four-drug daily anti-tuberculosis therapy (isoniazid, ethambutol, rifampin, pyrazinamide). Pleural biopsy revealed acid-fast bacilli. Given his persistent pleural effusion, he was given four doses of intrapleural tissue plasminogen activator (tPA) and dornase alpha (DNase) via his chest tube over a period of 6 days resulting in clinical and radiologic improvement. Pleural biopsy and pleural fluid culture specimens later revealed Mycobacterium …