Respiratory Tract Diseases Commons^™

Variation In Systemic Corticosteroid Prescribing During Asthma-Related Hospitalizations Across Children's Hospitals, Sian Best, Kathryn Kyler, Matt Hall, Jessica L. Bettenhausen, Shelby Chesbro, Nicholas Clark, Adrienne Deporre, Jonathan Ermer, Leah Jones, Jessica Markham, Maria Newmaster, Laura Plencner, Henry T. Puls, Smit Shah, Bridgette Jones, Megan Collins, Elisha Mccoy

Research Days

This abstract describes the variability and trends in inpatient systemic corticosteroid prescribing practices for acute asthma exacerbations in children's hospitals, and aims to determine associations between the prescribed steroid and hospitalization outcomes.

The Calcineurin-Nfatc Pathway Modulates The Lipid Mediators In Bal Fluid Extracellular Vesicles, Thereby Regulating Microvascular Endothelial Cell Barrier Function, Manjula Karpurapu, Yunjuan Nie, Sangwoon Chung, Jiasheng Yan, Patrick Dougherty, Sonal Pannu, Jon Wisler, Ryan Harkless, Narasimham Parinandi, Evgeny Berdyshev, Dehua Pei, John W Christman

Faculty, Staff and Student Publications

Extracellular vesicles mediate intercellular communication by transporting biologically active macromolecules. Our prior studies have demonstrated that the nuclear factor of activated T cell cytoplasmic member 3 (NFATc3) is activated in mouse pulmonary macrophages in response to lipopolysaccharide (LPS). Inhibition of NFATc3 activation by a novel cell-permeable calcineurin peptide inhibitor CNI103 mitigated the development of acute lung injury (ALI) in LPS-treated mice. Although pro-inflammatory lipid mediators are known contributors to lung inflammation and injury, it remains unclear whether the calcineurin-NFATc pathway regulates extracellular vesicle (EV) lipid content and if this content contributes to ALI pathogenesis. In this study, EVs from mouse …

High All-Cause Mortality And Increasing Proportion Of Older Adults With Tuberculosis In Texas, 2008–2020, Belinda A Medrano, Miryoung Lee, Gretchen Gemeinhardt, Lana Yamba, Blanca I Restrepo

Faculty, Staff and Student Publications

Pulmonary tuberculosis (PTB) elimination efforts must consider the global growth of the ageing population. Here we used TB surveillance data from Texas, United States (2008-2020; total n = 10656) to identify unique characteristics and outcomes in older adults (OA, ≥65 years) with PTB, compared to young adults (YA, 18-39 years) or middle-aged adults (40-64 years). We found that the proportion of OA with PTB increased from 15% in 2008 to 24% in 2020 (trend p < 0.05). Diabetes was highly prevalent in OA (32%) but not associated with adverse outcomes. Death was 13-fold higher in OA compared to YA and was 7% at the time of diagnosis which suggests diagnostic delays. However, once TB was suspected, we found no differences in culture, smear, or nucleic acid detection of mycobacteria (although less lung cavitations) in OA. During treatment, OA had less drug-resistant TB, few adverse reactions and adhered with TB treatment. We recommend training healthcare workers to 'think TB' in OA, for prompt treatment initiation to diminish deaths. Furthermore, OA should be added as a priority group to the latent TB treatment guidelines by the World Health Organization, to prevent TB disease in this highly vulnerable group.

Unraveling The Role Of Gjb3 In Lung Adenocarcinoma, Swathi M. Priyanka

Theses & Dissertations

Lung cancer stands as a leading cause of cancer-related mortality worldwide, with small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) comprising its primary categories. NSCLC, representing nearly 85% of cases, exhibits a 5-year survival rate of less than 21%. Among NSCLC subtypes, lung adenocarcinoma (LUAD) prevails as the most common, followed by squamous cell carcinoma and large cell carcinoma. Gap junctions are crucial for intercellular communication and cellular homeostasis maintenance, demonstrate altered expression patterns in various diseases, including cancer. Gap junction beta 3 (GJB3 or Connexin31) exhibits significant expression in both preclinical and clinical LUAD samples, prompting investigation into …

Case Report: Post-Obstructive Pneumonia Secondary To Foreign Body Aspiration, Aashna Chaudhry, Andrew Vasta

Rowan-Virtua Research Day

Post-obstructive pneumonia is described as a pulmonary infiltrate that occurs proximal to the site of an obstructed bronchus. Studies show that post-obstructive pneumonia most commonly secondary to obstruction caused by neoplasms. According to a study done on post obstructive pneumonia in lung cancer, most cases of post obstructive pneumonias are associated with advanced neoplasms with up to 50% of those with advanced cancer getting endobronchial compromise. While neoplasms are the most common cause of post obstructive pneumonia, research is scarce on other potential causes of post obstructive pneumonia. This case reports presents a unique clinical case in which an adult …

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience: Master of Public Health

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Pulmonary Endobronchial Hamartoma Presenting With Post-Obstructive Pneumonia, Diane S Habib, Pushan Jani, Bihong Zhao, Elakiya Anjali Jayaraman, Ramesh Kesavan

Faculty, Staff and Student Publications

Pulmonary hamartomas (PH) are rare but are the most common benign tumors found in the lungs. They are slow-growing and are usually found incidentally on chest imaging during the sixth decade of life. Approximately 10% of pulmonary hamartomas are endobronchial. Rarely, pulmonary hamartomas can cause a spectrum of pulmonary symptoms depending on their size and location. We present a case of endobronchial hamartoma causing airway obstruction and recurrent post-obstructive pneumonia.

Identifying Barriers To Healthcare Access And Utilization Experienced By Lgbtq+ Adults With Chronic Diseases Through The Lens Of The Social Ecological Model, Devin Mottier

Capstone Experience: Master of Public Health

The purpose of this literature review is to comprehensively examine and synthesize existing research on present barriers to health access and utilization that contribute to the disparities in chronic disease prevalence within the adult LGBTQ+ population. In the context of this review, the social-ecological model (SEM) was used to describe the nuanced and multifaceted nature of healthcare access and utilization. This literature review was based upon the following question: ‘Using the social-ecological model, what are the barriers to health access and utilization that contribute to high rates of chronic disease in LGBTQ+ adults?’ Outcome measures of interest included the following …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Sickle-Cell Trait As A Risk Factor For Unprovoked Venous Thromboembolism: A Case Report, James Cross, Brendan Mackey, Umme Yasmin

Tower Health Research Day

No abstract provided.

Interstitial Lung Disease Associated With Certolizumab Pegol Monotherapy In Psoriatic Arthritis, Tan T. Tran, Raesham Bukhari, Mahmood Danishwar, Mohammad Abu Tineh, Syed Jaleel

Tower Health Research Day

No abstract provided.

Vaccine Effectiveness Against Influenza A-Associated Hospitalization, Organ Failure, And Death: United States, 2022-2023, Nathaniel M Lewis, Yuwei Zhu, Ithan D Peltan, Manjusha Gaglani, Tresa Mcneal, Shekhar Ghamande, Jay S Steingrub, Nathan I Shapiro, Abhijit Duggal, William S Bender, Leyla Taghizadeh, Samuel M Brown, David N Hager, Michelle N Gong, Amira Mohamed, Matthew C Exline, Akram Khan, Jennifer G Wilson, Nida Qadir, Steven Y Chang, Adit A Ginde, Nicholas M Mohr, Christopher Mallow, Adam S Lauring, Nicholas J Johnson, Kevin W Gibbs, Jennie H Kwon, Cristie Columbus, Robert L Gottlieb, Catherine Raver, Ivana A Vaughn, Mayur Ramesh, Cassandra Johnson, Lois Lamerato, Basmah Safdar, Jonathan D Casey, Todd W Rice, Natasha Halasa, James D Chappell, Carlos G Grijalva, H Keipp Talbot, Adrienne Baughman, Kelsey N Womack, Sydney A Swan, Elizabeth Harker, Ashley Price, Jennifer Decuir, Diya Surie, Sascha Ellington, Wesley H Self, Investigating Respiratory Viruses In The Acutely Ill (Ivy) Network

Faculty, Staff and Students Publications

BACKGROUND: Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.2a, a close antigenic match to the vaccine strain.

METHODS: To understand effectiveness of the 2022-2023 influenza vaccine against influenza-associated hospitalization, organ failure, and death, a multicenter sentinel surveillance network in the United States prospectively enrolled adults hospitalized with acute respiratory illness between 1 October 2022, and 28 February 2023. Using the test-negative design, vaccine effectiveness (VE) estimates against influenza-associated hospitalization, organ failures, and death were measured by …

Sub-Saharan Africa’S Handling Of Covid-19 Pandemic: Rwanda Versus Tanzania, Luke D. Baumel

Honors Undergraduate Conference

How has the Covid-19 outbreak in early 2020 and the pandemic that followed been handled in Sub-Saharan Africa? What was done well and what was done poorly and why? What are the implications of the way it was handled? These questions and more are answered throughout this paper, using Rwanda as an example of a Sub-Saharan African country who handled it relatively well and neighboring Tanzania as an example of a Sub-Saharan African country that mishandled the outbreak and pandemic. In early 2021, most Sub-Saharan African countries had been afflicted by Covid-19 at a relatively lower rate than many Western …

Covid-19 Vaccination In Patients With Inborn Errors Of Immunity Reduces Hospitalization And Critical Care Needs Related To Covid-19: A Usidnet Report, John Mcdonnell, Kimberley Cousins, M. Elizabeth M. Younger, Adam Lane, Hassan Abolhassani, Roshini S. Abraham, Salem Al-Tamemi, Juan Carlos Aldave-Becerra, Eman Hesham Al-Faris, Alberto Alfaro-Murillo, Suzan A. Alkhater, Nouf Alsaati, Alexa Michelle Altman Doss, Melissa Anderson, Ernestina Angarola, Barbara Ariue, Danielle E. Arnold, Amal H. Assa'ad, Caner Aytekin, Meaghan Bank, Jenna R.E. Bergerson, Jack Bleesing, John Boesing, Carolina Bouso, Nicholas Brodszki, Diana Cabanillas, Carol Cady, Meghan A. Callahan, Luke Wall, Et Al

School of Medicine Faculty Publications

BACKGROUND: The CDC and ACIP recommend COVID-19 vaccination for patients with inborn errors of immunity (IEI). Not much is known about vaccine safety in IEI, and whether vaccination attenuates infection severity in IEI. OBJECTIVE: To estimate COVID-19 vaccination safety and examine effect on outcomes in patients with IEI. METHODS: We built a secure registry database in conjunction with the US Immunodeficiency Network to examine vaccination frequency and indicators of safety and effectiveness in IEI patients. The registry opened on January 1, 2022, and closed on August 19, 2022. RESULTS: Physicians entered data on 1245 patients from 24 countries. The most …

Education Of Ventilator-Associated Pneumonia Prevention In Adult Intensive Care Patients, Carlin Morgan

Scholars Week

The purpose of this project was to improve knowledge related to evidence-based ventilator-associated pneumonia (VAP) preventative measures that decrease the prevalence of VAP in adult patients in the intensive care unit (ICU). An educational presentation was provided to twelve critical care nurses at a 349-bed hospital in western Kentucky. A pretest was obtained to measure the nurse’s knowledge prior to the presentation. A PowerPoint and pamphlet containing VAP prevention techniques were presented to the twelve critical care nurses during each meeting. A posttest was then administered after the presentation to measure the efficacy of the educational presentation. The mean of …

Sleep Apnea And Ischemic Stroke- A Perspective For Translational Preclinical Modelling, Ifechukwude J. Biose, A B. Bakare, H Wang, T E. Gressett, G J. Bix

School of Medicine Faculty Publications

Obstructive sleep apnea (OSA) is associated with ischemic stroke. There is, however, a lack of knowledge on the exact cause-effect relationship, and preclinical models of OSA for experimental ischemic stroke investigations are not well characterized. In this review, we discuss sleep apnea and its relationship with stroke risk factors. We consider how OSA may lead to ischemic stroke and how OSA-induced metabolic syndrome and hypothalamic-pituitary axis (HPA) dysfunction could serve as therapeutic targets to prevent ischemic stroke. Further, we examine the translational potential of established preclinical models of OSA. We conclude that metabolic syndrome and HPA dysfunction, which are often …

Diffuse Alveolar Haemorrhage Due To Atypical Hemolytic Uremic Syndrome (Ahus) Associated With Covid-19, Atif Siddiqui, Amanda Tchakarov

Faculty, Staff and Student Publications

Delayed presentation of atypical HUS after COVID‐19 with diffuse alveolar haemorrhage is uncommon and can be life threatening.

Outcomes Of Extracorporeal Cardiopulmonary Resuscitation For In-Hospital Cardiac Arrest Among Children With Noncardiac Illness Categories, Morgann Loaec, Adam S Himebauch, Ron Reeder, Jessica S Alvey, Jonathan A Race, Lillian Su, Javier J Lasa, Julia C Slovis, Tia T Raymond, Ryan Coleman, Bradley J Barney, Todd J Kilbaugh, Alexis A Topjian, Robert M Sutton, Ryan W Morgan

Faculty, Staff and Students Publications

Objectives: The objective of this study was to determine the association of the use of extracorporeal cardiopulmonary resuscitation (ECPR) with survival to hospital discharge in pediatric patients with a noncardiac illness category. A secondary objective was to report on trends in ECPR usage in this population for 20 years.

Design: Retrospective multicenter cohort study.

Setting: Hospitals contributing data to the American Heart Association's Get With The Guidelines-Resuscitation registry between 2000 and 2021.

Patients: Children (< 18 yr) with noncardiac illness category who received greater than or equal to 30 minutes of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest.

Interventions: None.

Measurements and main results: Propensity score weighting balanced ECPR and conventional CPR (CCPR) groups on hospital and patient characteristics. Multivariable logistic regression incorporating …