Pulmonology Commons^™

A Covid-19 Risk Score Combining Chest Ct Radiomics And Clinical Characteristics To Differentiate Covid-19 Pneumonia From Other Viral Pneumonias, Zuhua Chen, Xiadong Li, Jiawei Li, Shirong Zhang, Pengfei Zhou, Xin Yu, Yao Ren, Jiahao Wang, Lidan Zhang, Yunjiang Li, Baoliang Wu, Yanchun Hou, Ke Zhang, Rongjun Tang, Yongguang Liu, Zhongxian Ding, Bin Yang, Qinghua Deng, Qin Lin, Ke Nie, Zhaobin Cai, Shenglin Ma, Yu Kuang

Health Physics and Diagnostic Sciences Faculty Research

With the continued transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout the world, identification of highly suspected COVID-19 patients remains an urgent priority. In this study, we developed and validated COVID-19 risk scores to identify patients with COVID-19. In this study, for patient-wise analysis, three signatures, including the risk score using radiomic features only, the risk score using clinical factors only, and the risk score combining radiomic features and clinical variables, show an excellent performance in differentiating COVID-19 from other viral-induced pneumonias in the validation set. For lesion-wise analysis, the risk score using three radiomic features only also …

Feasibility, Usability And Acceptability Of Paediatric Lung Ultrasound Among Healthcare Providers And Caregivers For The Diagnosis Of Childhood Pneumonia In Resource-Constrained Settings: A Qualitative Study, Atif Riaz, Olga Cambaco, Laura Elizabeth Ellington, Jennifer L. Lenahan, Khatia Munguambe, Usma Mehmood, Sana Qaisar, Benazir Baloch, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Objectives: Paediatric pneumonia burden and mortality are highest in low-income and middle-income countries (LMIC). Paediatric lung ultrasound (LUS) has emerged as a promising diagnostic tool for pneumonia in LMIC. Despite a growing evidence base for LUS use in paediatric pneumonia diagnosis, little is known about its potential for successful implementation in LMIC. Our objectives were to evaluate the feasibility, usability and acceptability of LUS in the diagnosis of paediatric pneumonia.
Design: Prospective qualitative study using semistructured interviews SETTING: Two referral hospitals in Mozambique and Pakistan PARTICIPANTS: A total of 21 healthcare providers (HCPs) and 20 caregivers were enrolled.
Results: HCPs …

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 …

Evaluation Of Serum Ferritin For Prediction Of Severity And Mortality In Covid-19- A Cross Sectional Study, Sibtain Ahmed, Zeeshan Ansar Ahmed, Imran Siddiqui, Naveed Haroon Rashid, Maheen Mansoor, Lena Jafri

Department of Pathology and Laboratory Medicine

Background: Ferritin even though widely recognized as a representative of total body iron stores, its prognostic utility is linked with COVID-19. This study was aimed at evaluation of the association of ferritin with severity in Coronavirus disease 2019 (COVID-19), hospitalized patients and to test the hypothesis that it is an independent predictor of mortality.
Material and methods: This study was conducted at Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University (AKU), Karachi. Medical records of all in-patients including both genders, and all age groups with documented COVID-19 from 1st March to 10^th August 2020 were reviewed. …

Transfusion-Associated Circulatory Overload (Taco): Significance Of Appropriate Pre-Transfusion Risk Assessment To Prevent Fatal Health Outcomes, Nazish Sana, Muhammad Shariq Shaikh

Department of Pathology and Laboratory Medicine

No abstract provided.

Coronary Vasospasm: Not Gone But Often Forgotten, Michael Savage, Tabitha Moe

Division of Cardiology Faculty Papers

No abstract provided.

A Prospective Surveillance Study On The Kinetics Of The Humoral Immune Response To The Respiratory Syncytial Virus Fusion Protein In Adults In Houston, Texas, Brittani N Blunck, Letisha Aideyan, Xunyan Ye, Vasanthi Avadhanula, Laura Ferlic-Stark, Lynn Zechiedrich, Brian E Gilbert, Pedro A Piedra

Faculty, Staff and Students Publications

Respiratory syncytial virus (RSV)-specific serum antibody has been correlated to protection of infection and reduction of severe disease, but reinfection is still frequent. In this study, we evaluated RSV-specific serum antibody activity following natural RSV re-infection to examine the longevity of the humoral immune response in adults. Nineteen healthy adult volunteers under sixty-five years of age were enrolled during the 2018-2019 RSV season in Houston, TX. Blood was collected at three study visits. The kinetics of RSV-neutralizing, RSV F site-specific competitive, and RSV-binding antibodies in serum samples were measured by microneutralization and enzyme-linked immunosorbent assays. Three distinct profiles of RSV-specific …

Sarcoidosis Presenting As Fatigue And Weakness, Syed Muhammad Zubair, Naveed Haroon Rashid

Section of Pulmonary & Critical Care

Sarcoidosis is a systemic granulomatous disorder of unknown cause that occurs in both men and women of all races. It typically presents in patients after 20 years of age. Sarcoidosis most frequently involves the lung, but up to 30 percent of patients present with extra-thoracic manifestations. It can involve multiple organs to a variable extent and degree. In areas, where tuberculosis is endemic, the diagnosis of sarcoidosis may be overlooked and misdiagnosed because of clinical and radiographic resemblance. Herein, we present a case of a middle-aged man who visited multiple physicians with constitutional symptoms and was treated symptomatically but did …

Epidemiology And Outcomes Of Hospitalized Adults With Sars-Cov-2 Community-Acquired Pneumonia In Louisville, Kentucky, Julio A. Ramirez, T'Shura Ali, Thomas Chandler, Stephen P. Furmanek, Daniya Sheikh, Vidyulata Salunkhe, Steven Gootee, Mohammad Tahboub, William A. Mattingly, Demetra Antimisiaris, Jiapeng Huang, Jose Bordon, Rodrigo Cavallazzi, Paul Schulz, William P. Mckinney, Dawn Balcom, Mark Burns, Ruth Carrico, Forest W. Arnold, Cerid Covid-19 Study Group

The University of Louisville Journal of Respiratory Infections

Background: During the ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 community-acquired pneumonia (CAP) has been the primary cause of hospitalization. The objective of this study was to evaluate the clinical characteristics and outcomes of 1,013 patients hospitalized with SARS-CoV-2 CAP from September 2020 through March 2021 in Louisville, Kentucky.

Methods: This was a retrospective observational study of 1,013 patients hospitalized with SARS-CoV-2 CAP at eight of the adult hospitals in the city of Louisville from September 2020 through March 2021. Patients with 1) a positive reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, 2) fever, cough, or …

Effect Of Trazodone On Upper Airway Resistance In Chronic Spinal Cord Injury, Geoffrey M. Ginter, Sean Carroll, Abdulghani Sankari, Safwan Badr

Medical Student Research Symposium

Background:

Spinal cord injury (SCI) is a known risk factor for sleep-disordered breathing. While device-based therapies such as CPAP are beneficial in these individuals, adherence to these treatments is often low; consequently, pharmacotherapies for sleep-disordered breathing in patients with SCI are in high demand. Trazodone is an atypical antidepressant with a complex mechanism of action, including alpha adrenergic agonist activity and inhibition of serotonin reuptake. Serotonin (5-HT) is a known modulator of respiratory circuitry, which has been shown to influence the ventilatory drive. Trazodone is commonly prescribed as a sleep aid, but its impact on breathing during sleep is still …

Subcutaneous Emphysema And Pneumomediastinum In Patients With Covid-19 Disease; Case Series From A Tertiary Care Hospital In Pakistan, Sher Sethi, Amber Sabeen Ahmed, Sadaf Hanif, Masooma Aqeel, Ali Bin Sarwar Zubairi

Section of Internal Medicine

Since December 2019, the clinical symptoms of coronavirus disease 2019 (COVID-19) and its complications are evolving. As the number of COVID patients requiring positive pressure ventilation is increasing, so is the incidence of subcutaneous emphysema (SE). We report 10 patients of COVID-19, with SE and pneumomediastinum. The mean age of the patients was 59 ± 8 years (range, 23-75). Majority of them were men (80%), and common symptoms were dyspnoea (100%), fever (80%) and cough (80%). None of them had any underlying lung disorder. All patients had acute respiratory distress syndrome on admission, with a median PaO2/FiO2 ratio of 122.5. …

Knowledge, Attitude And Perception Of Pakistanis Towards Covid-19; A Large Cross-Sectional Survey, Zoya Fatima Rizwan Ladiwala, Rubaid Azhar Dhillon, Ibrahim Zahid, Omar Irfan, Muhammad Sharjeel Khan, Safia Awan, Javaid Ahmad Khan

Medical College Documents

Background: The Novel Coronavirus Disease (COVID-19) has created havoc globally as countries worldwide struggle to combat this pandemic. Since prevention and social isolation are known to be the only ways to prevent the spread of COVID-19, this has created challenges among the lower-middle income countries (LMIC) including Pakistan, as it battles between an under-resourced healthcare, an economic shutdown, and widespread myths and misconceptions. Therefore, a study was conducted to evaluate the knowledge, attitude and perceptions regarding COVID-19 as public understanding is vital to help facilitate the control of this outbreak.
Methods: A pre-validated online questionnaire was distributed among the general …

A Case-Control Study Of Prone Positioning In Awake And Nonintubated Hospitalized Coronavirus Disease 2019 Patients., P. C. Nauka, S. Chekuri, M. Aboodi, A. A. Hope, M. N. Gong, J.T. Chen

Journal Articles

To determine the association between prone positioning in nonintubated patients with coronavirus disease 2019 and frequency of invasive mechanical ventilation or inhospital mortality.

Design

A nested case-matched control analysis.

Setting

Three hospital sites in Bronx, NY.

Patients

Adult coronavirus disease 2019 patients admitted between March 1, 2020, and April 1, 2020. We excluded patients with do-not-intubate orders. Cases were defined by invasive mechanical ventilation or inhospital mortality. Each case was matched with two controls based on age, gender, admission date, and hospital length of stay greater than index time of matched case via risk-set sampling. The presence of nonintubated proning …

Utilization Of Extracorporeal Membrane Oxygenation During The Covid-19 Pandemic., A. Kichloo, A. Kumar, R. Amir, M. Aljadah, N. Farooqi, M. Albosta, J. Singh, S. Jamal, Z. El-Amir, N. Lone, +1 Additional Author

Journal Articles

The ongoing outbreak of severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2, or coronavirus disease 2019 (COVID-19)] was declared a pandemic by the World Health Organization on March 11, 2020. Worldwide, more than 65 million people have been infected with this SARS-CoV-2 virus, and over 1.5 million people have died due to the viral illness. Although a tremendous amount of medical progress has been made since its inception, there continues to be ongoing research regarding the pathophysiology, treatments, and vaccines. While a vast majority of those infected develop only mild to moderate symptoms, about 5% of people have severe forms of infection …

The Use Of Oxygen Hoods In Patients Failing On Conventional High-Flow Oxygen Delivery Systems, The Effects On Oxygenation, Mechanical Ventilation And Mortality Rates In Hypoxic Patients With Covid-19. A Prospective Controlled Cohort Study, D. Dayya, O. J. O'Neill, T. D. Feiertag, R. Tuazon-Boer, J. Sullivan, L. Perez, S. Gurash, M. Eaton, T. Bodley, T. Hall, +2 Additional Authors

Journal Articles

© 2021 Introduction: Efforts to meet increased oxygen demands in COVID-19 patients are a priority in averting mechanical ventilation (MV), associated with high mortality approaching 76.4–97.2%. Novel methods of oxygen delivery could mitigate that risk. Oxygen hoods/helmets may improve: O2-saturation (SaO2), reduce in-hospital mechanical ventilation and mortality rates, and reduce length of hospitalization in hypoxic Covid-19 patients failing on conventional high-flow oxygen delivery systems. Methods: DesignProspective Controlled Cohort Study. SettingSingle Center. ParticipantsAll patients admitted with a diagnosis of COVID-19 were reviewed and 136/347 patients met inclusion criteria. Study period3/6/2020 to 5/1/2020. 136 participants completed the study with known status for …

Imaging Algorithm For Covid-19: A Practical Approach, S. Ghosh, H. Deshwal, M. B. Saeedan, V. K. Khanna, S. Raoof, A. C. Mehta

Journal Articles

© 2020 Elsevier Inc. The global pandemic of COVID-19 pneumonia caused by the novel coronavirus (SARS-CoV-2) has strained healthcare resources across the world with emerging challenges of mass testing, resource allocation and management. While reverse transcriptase-polymerase chain reaction (RT-PCR) test is the most commonly utilized test and considered the current gold standard for diagnosis, the role of chest imaging has been highlighted by several studies demonstrating high sensitivity of computed tomography (CT). Many have suggested using CT chest as a first-line screening tool for the diagnosis of COVID-19. However, with advancement of laboratory testing and challenges in obtaining a CT …

Prolonged Thunder Before The Storm – Diagnosis Of Aortobronchial Fistula After 28 Months Of Recurrent Hemoptysis, Hilamber Subba, Truc Ta, Edmund Sears

Costas T. Lambrew Research Retreat 2021

Aortobronchial fistula (ABF) should always be considered in patients with hemoptysis and previous thoracic surgery, however the diagnosis is known to be difficult both clinically and radiographically1. We present a case with the longest indolent course of hemoptysis reported to date .

The Maine Lung Cancer Coalition: A Statewide, Multi-Sector Partnership To Improve Evidence-Based Lung Cancer Prevention & Screening, Leo B Waterston, Liz Scharnetzki, Susan Leeds, Jaclyn A. Janis, Lee Lucas, Deborah Deatrick, Rebecca Boulos, Neil Korsen, Paul K.J. Han

Costas T. Lambrew Research Retreat 2021

MLCC has two primary goals:

1. Engage and educate about evidence based lung cancer prevention and screening practices

2. Develop, implement, and evaluate innovative programs to increase access to prevention, screening, and treatment services for all Mainers

Circulating Exosomal Microrna Expression Patterns Distinguish Cardiac Sarcoidosis From Myocardial Ischemia., Elliott D Crouser, Mark W Julian, Sabahattin Bicer, Vikas Ghai, Taek-Kyun Kim, Lisa A Maier, May Gillespie, Nabeel Y Hamzeh, Kai Wang

Articles, Abstracts, and Reports

OBJECTIVE: Cardiac sarcoidosis is difficult to diagnose, often requiring expensive and inconvenient advanced imaging techniques. Circulating exosomes contain genetic material, such as microRNA (miRNA), that are derived from diseased tissues and may serve as potential disease-specific biomarkers. We thus sought to determine whether circulating exosome-derived miRNA expression patterns would distinguish cardiac sarcoidosis (CS) from acute myocardial infarction (AMI).

METHODS: Plasma and serum samples conforming to CS, AMI or disease-free controls were procured from the Biologic Specimen and Data Repository Information Coordinating Center repository and National Jewish Health. Next generation sequencing (NGS) was performed on exosome-derived total RNA (n = 10 …

The Hsp90 Inhibitor, Auy-922, Protects And Repairs Human Lung Microvascular Endothelial Cells From Hydrochloric Acid-Induced Endothelial Barrier Dysfunction, Ruben M.L. Colunga Biancatelli, Pavel Solopov, Betsy Gregory, John D. Catravas

Bioelectrics Publications

Exposure to hydrochloric acid (HCl) leads acutely to asthma-like symptoms, acute respiratory distress syndrome (ARDS), including compromised alveolo-capillary barrier, and respiratory failure. To better understand the direct effects of HCl on pulmonary endothelial function, we studied the characteristics of HCl-induced endothelial barrier dysfunction in primary cultures of human lung microvascular endothelial cells (HLMVEC), defined the involved molecular pathways, and tested the potentially beneficial effects of Heat Shock Protein 90 (HSP90) inhibitors. HCl impaired barrier function in a time- and concentration-dependent manner and was associated with activation of Protein Kinase B (AKT), Ras homolog family member A (RhoA) and myosin light …