Respiratory Tract Diseases Commons^™

Extensive Mycobacterium Abscessus Pneumonia In An Immunocompetent Infant With No Underlying Lung Pathology, Morouge M Alramadhan, James R Murphy, Michael L Chang

Faculty, Staff and Student Publications

Pulmonary infection due to Mycobacterium abscessus occurs in patients with cystic fibrosis, but rarely in immunocompetent children without underlying lung pathology. Treatment is complicated by frequent resistance to many antibiotics. We present a case report of a 4-month-old female infant with 2 months of cough, difficulty feeding, and failure to thrive, with extensive culture-confirmed M. abscessus pulmonary infection without identified immunodeficiency or underlying lung pathology following multidisciplinary evaluation. We describe our complete evaluation including immunodeficiency evaluation incorporating whole-exome sequencing, describe our antibiotic selection and treatment duration given complicated susceptibility pattern of the M. abscessus isolate, and review literature for nontuberculous …

An International Study Of Interobserver Variability Of “String Sign” Of Pancreatic Cysts Among Experienced Endosonographers, Wanda Phipatanakul, David T Mauger, Theresa W Guilbert, Leonard B Bacharier, Sandy Durrani, Daniel J Jackson, Fernando D Martinez, Anne M Fitzpatrick, Amparito Cunningham, Susan Kunselman, Lisa M Wheatley, Cindy Bauer, Carla M Davis, Bob Geng, Kirsten M Kloepfer, Craig Lapin, Andrew H Liu, Jacqueline A Pongracic, Stephen J Teach, James Chmiel, Jonathan M Gaffin, Matthew Greenhawt, Meera R Gupta, Peggy S Lai, Robert F Lemanske, Wayne J Morgan, William J Sheehan, Jeffrey Stokes, Peter S Thorne, Hans C Oettgen, Elliot Israel

Faculty, Staff and Students Publications

Asthma remains one of the most important challenges to pediatric public health in the US. A large majority of children with persistent and chronic asthma demonstrate aeroallergen sensitization, which remains a pivotal risk factor associated with the development of persistent, progressive asthma throughout life. In individuals with a tendency toward Type 2 inflammation, sensitization and exposure to high concentrations of offending allergens is associated with increased risk for development of, and impairment from, asthma. The cascade of biological responses to allergens is primarily mediated through IgE antibodies and their production is further stimulated by IgE responses to antigen exposure. In …

Power Washing Pulmonary Alveolar Proteinosis, Tiana R Endicott-Yazdani, Gary S Schwartz, Haiying Zhang, Randall L Rosenblatt, Puneet S Garcha

Faculty, Staff and Students Publications

Pulmonary alveolar proteinosis is an uncommon cause of insidious onset shortness of breath and hypoxemia. It is caused by an accumulation of surfactant within the alveoli. Left untreated, it can be fatal. Standard-of-care treatment is whole-lung lavage; however, in severe cases, the associated hypoxemia can be profound and single-lung ventilation would not be tolerated, potentially preventing a lifesaving treatment. Single cases using veno-venous extracorporeal membrane oxygenation to perform whole-lung lavage have been reported. Here we describe three patients with severe pulmonary alveolar proteinosis who were successfully treated with whole-lung lavage using veno-venous extracorporeal membrane oxygenation for oxygenation support.

Translation Into Spanish, Cultural Adaption And Content Validity Of The Bristol Copd Knowledge Questionnaire, Vilma Gómez

Dissertations and Theses @ UNI

COPD is the major cause of respiratory mortality world-wide. The treatment of COPD includes education and self-management to enable patients to control the symptoms, handle the treatment, manage the physical and psychosocial consequences of the disease, and adopt the necessary lifestyle changes for dealing with a chronic condition. Measurement of results of interventions is necessary to demonstrate their effectiveness. Questionnaires help clinicians measure the level of knowledge before and after treatments. However, there are no questionnaires available in Colombian Spanish to measure knowledge of Chronic Obstructive Pulmonary Disease (COPD). This research resulted in the translation into Spanish, cultural adaptation, and …

High Flow Nasal Cannula Therapy In Children With Acute Respiratory Insufficiency In The Pediatric Intensive Care Unit Of A Resource-Limited Country: A Preliminary Experience, Bushra Saeed, Asim Azim, Anwar Ul Haque, Qalab Abbas

Department of Paediatrics and Child Health

A retrospective study was performed in children (aged one month - 16 years) receiving HFNC to determine the frequency, efficacy and adverse effects of high flow nasal cannula (HFNC) therapy in the pediatric intensive care unit (PICU), from January to December 2017. Treatment failure was defined as clinical deterioration on HFNC therapy such that mechanical ventilation (MV) was required. Clinical parameters before and after HFNC were assessed using repeated measures analysis of variance. A total of 120 patients received HFNC therapy (21% of total admissions). Primary diagnosis were respiratory disease (50%), central nervous system diseases (14.2%), sepsis (10.8%), and postoperative …

Predictors Of Mortality In Hospitalized Patients With Influenza: A Five-Year Experience From A Tertiary Care Centre In Pakistan, Iffat Khanum, Amber Sabeen Ahmed, Safia Awan, Sabiha Banu, Bushra Jamil

Department of Medicine

Influenza outbreaks are associated with significant morbidity. Our aim was to determine the factors associated with increased mortality in hospitalized patients admitted with diagnosis of influenza, at a tertiary care center in Pakistan. This study included all adult patients with an influenza infection, confirmed by realtime reverse-transcriptase polymerase-chain-reaction (RT-PCR) at Aga Khan University Hospital Pakistan. In our study, 112 patients with laboratory-confirmed influenza virus infection were admittedat our hospital from the 1st of January 2013 to the 31st of December 2018. Eighty-nine patients (79.46%) were managed in ward or special care units and 23 patients (20.5%) received treatment in intensive …

Efficacy Of Pulmonary Ultrasound Compared To N-Terminal Prohormone Brain Natriuretic Peptide As A Diagnostic Tool For Congestive Heart Failure In Patients Presenting With Acute Dyspnea In The Emergency Setting, Leah Krohn, Michael Burns

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of using pulmonary ultrasound as a diagnostic tool in acute dyspnea of undetermined cause compared to the use of serum N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) in the diagnosis of heart failure.

Design: Systematic literature review

Methods: Searches were conducted in PubMed and Scopus using the terms pulmonary ultrasound and congestive heart failure and studies within the last 10 years. Studies that used pulmonary ultrasound compared to BNP as a marker for the diagnosis of heart failure were included.

Results: All three studies found that the use of pulmonary ultrasound was a more specific …

Retrospective Review Of Anticoagulation Regimens Used For The Prevention Of Venous Thromboembolisms In Critically Ill Patients Infected With Sars-Cov-2, Tony Nguyen, Heidi Clarke

All Publications

No abstract provided.

Evaluation Of Incidence Of Thrombosis And Bleeding In Medical Floor Covid-19 Patients At A Community Hospital, Giselle Chahili, Frank C. Moreno Exposito, Heidi Clarke, Erika Dittmar

All Publications

No abstract provided.

An Investigation Into The Response Of The Us And Eu5 To The Covid-19 Disease (Convergence Of Two Pandemics: Covid-19 And Ncds), Omar Hassan

Publications and Research

In late December 2019, a coronavirus disease (COVID-19) was identified in Wuhan China. COVID-19 was a result of the novel severe acute respiratory syndrome coronavirus 2 (SARA-CoV-2), which has resulted in a worldwide sudden and substantial increase in hospitalizations for pneumonia with multiorgan disease. As of October 6, 2020, SARS-CoV-2 has affected more than 200 countries, resulting in more than 35 million identified cases with more than 1 million confirmed deaths.

This is a cross-sectional, non-interventional, observational study in patients infected with the novel coronavirus (SARS-CoV-2) or Covid-19, using John Hopkins University database JHU Coronavirus map. The data collected from …

Assessing The Vulnerability Of Monterey Bay Area Seniors To Covid-19, Ethan A. Quaranta, Gerhard L. Gross

Culture, Society, and Praxis

This paper assesses the vulnerability of seniors residing in the Monterey Bay Tri-County Region to the COVID-19 pandemic. Due to weakened immune systems, seniors are the most at-risk members of our community to COVID-19, and have a death rate that is three times higher than the overall death rate to COVID-19. Using standard ambulance response times from each hospital throughout the area, our objective is to determine what proportion of Tri-County seniors aged 65 and over, including those who are in nursing homes, are living independently, and cannot afford health care, were within an adequate travel time to the hospital. …

A Drive-Thru Anticoagulation Testing Clinic During Covid-19 Pandemic, Tina Hyman, Nohemi Sadule Rios, Robert P. Ramirez

Nursing & Health Sciences Research Journal

As COVID-19 started to spread rapidly in their community, a team of nurses at South Miami Hospital initiated a drive-thru anticoagulation testing process to provide safe access to care for patients on anticoagulation therapy, requiring Internationalized Ratio (INR) testing. This article describes the implementation of a drive-thru anticoagulation testing process and implications for best practices during a pandemic crisis.

A Collaborative Approach To Reduce The Spread Of Covid-19 In A Large Urban Hospital In South Florida, David Schneider, Roberto L. Roman Laporte

Nursing & Health Sciences Research Journal

The novel Coronavirus has proven challenging for many healthcare organizations. Hospitals are pressed to secure sufficient personal protective equipment to ensure the safety of their healthcare personnel and various strategies have been implemented to stop the spread of the virus. There are still many unknowns about COVID-19 and hospitals are rapidly adapting to new information while trying to maintain the safety and wellbeing of healthcare personnel. Baptist Hospital of Miami developed a collaborative data driven plan to monitor, disseminate vital information, and implement various strategies to protect employees and patients during the pandemic.

A Collaborative Effort To Establish A Convalescent Plasma Program In South Florida, Roberto L. Roman Laporte, Edwina Brathwaite

Nursing & Health Sciences Research Journal

On March 11, 2020, Miami-Dade County had its first diagnosed case of COVID-19 and quickly became the top hotspot of COVID-19 cases in Florida. Hospitals were challenged to find effective treatments to combat the virus. A collaborative effort between Doctors Hospital and Boca Raton Regional Hospital established a robust convalescent plasma program for critically ill patients diagnosed with COVID-19 within Baptist Health South Florida.

The Outstanding Service Of A Nurse Supervisor During Covid-19, Judy Bowling

Nursing & Health Sciences Research Journal

Nurses are heroes but are often hesitant to use this title. Nurses stand at the center of the public health crises with the coronavirus pandemic, demonstrating courage, bravery, knowledge, and commitment, often putting themselves in harms’ way while caring for and guarding their patients. Nurses respond to the call to care at every level, from the direct care nurses in hospitals to board members shaping national policies. One special category of nurses on the front line, administrative nursing supervisors, are experienced and dedicated nurses who exemplify the finest characteristics of nurses. This article relates the exploits of one nursing supervisor …

A Healthcare Organization’S Response To Challenges During A Pandemic, Debora O'Cathey, Judy Bowling

Nursing & Health Sciences Research Journal

The pandemic of 2020 has added many new challenges for healthcare organizations. Front-line nurses have borne the brunt of these challenges and were tested as never before to deliver excellent patient care during such arduous time. This story details the efforts of one hospital to rise above the chaos and overcome the challenges presented during this time.

Supporting Evidence-Based Practices And Standardization Of Care Through Implementation Of Outpatient, Emergency Department, And Hospital Covid-19 Order Sets In A Large Healthcare System, Timothy P. Gauthier, Erika Gonzalez

Nursing & Health Sciences Research Journal

No abstract provided.

Impact Of A Pharmacist-Driven Methicillin-Resistant Staphylococcus Aureus Nasal Swab Protocol On The De-Escalation Of Empiric Vancomycin In The Setting Of Community Acquired Pneumonia, Grether Hernandez Gama, Winifred Pardo, Wilbert Fuerte, James Adefisoye

All Publications

No abstract provided.

The Effect Of Hydroxychloroquine On In-Hospital Mortality In Covid-19, Samar Aboulenain, Nakeya Dewaswala, Fergie Ramos, Pedro Torres, Ahmed Abdallah, Mohamed Abdul Qader, Baher Al-Abbasi, Charles R. Bornmann, Karolina N. Dziadkowiec, Kai Chen, Jesus E. Pino, Robert Chait, Kleper De Almeida

HCA Healthcare Journal of Medicine

Background: Hydroxychloroquine (HCQ) is an antimalarial medication that has been tested against various viral illnesses. The available evidence regarding the role of HCQ in the coronavirus disease 2019 (COVID-19) remains controversial.

Methods: This is a comparative retrospective cohort study that aims to evaluate the efficacy and safety of HCQ in hospitalized patients with COVID-19. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included ICU admission rate, mechanical ventilation, prolonged length of stay (LOS), QTc prolongation and cardiac arrest.

Results: A cohort of 175 hospitalized patients with COVID-19 were included with a median (interquartile range [IQR]) age of 66 [48–79] …

Innovative Conservation Of Inhaled Medication Devices During The Covid-19 Pandemic Through A Canister Reassignment Process, Mandelin K. Cooper, L. Hayley Burgess, Karla Miller, Theresa Baltz, Julia Moody, Elizabeth Wiggins, Jeffrey Guy

HCA Healthcare Journal of Medicine

Background: The ideal practice for patients requiring metered-dose inhalers (MDI) with coronavirus disease 2019 (COVID-19) is to use patient specific MDIs. However, this practice may not be possible during a time of increased usage throughout the country and limited availability of the medication. Nebulized medications are a concern due to the potential for aerosolized virus and increased exposure for health care workers. An alternative program of canister reassignment is proposed to address concerns for infection prevention, cross-contamination of MDI canisters and the shortage of MDI’s due to the COVID-19 pandemic.

Methods: A comprehensive MDI canister reassignment process was developed for …