Pulmonology Commons^™

A Postmortem Analysis Of Embalmed Lungs, A Human Cadaver Study, Frederick S. Merdian, Matthew Peterman, Odinaka Osigwe, Vikash Patel, Savita Arya

Research Day

OBJECTIVE: The human cadaveric study is vital to fully understanding lung pathologies and the prevalence of potentially cancerous neoplasms upon death in the general population. Developing an accurate knowledge of human respiratory neoplastic pathology is vital in furthering the field of respiratory medicine. This study aims to analyze a cohort of lung sets belonging to human cadavers for visible potentially pathogenic neoplasms and contrast this with epidemiological data available for representative populations.

METHODS: Cadaveric lungs (n= 20 pairs; 38 individual lungs) were isolated, and gross observations were performed of the parietal surface of both lungs. These samples were part of …

Gold 2023 Update: Implications For Clinical Practice, Diana R. Tamondong-Lachica, Neil Skolnik, John R. Hurst, Nathaniel Marchetti, Adrian Paul J. Rabe, Maria Montes De Oca, Bartolome R. Celli

Abington Jefferson Health Papers

In 2022, over 3 million people died of chronic obstructive pulmonary disease (COPD) and the global burden of the disease is expected to increase over the coming decades. Recommendations for the treatment and management of patients with COPD are published by the Global Initiative for Chronic Obstructive Lung Disease, and updated annually with scientific evidence-based recommendations. The 2023 updates, published in November 2022, contain key changes to recommendations for diagnosis and treatment of COPD that are anticipated to have a significant impact on clinical practice for patients with COPD. Updates to how COPD is defined and diagnosed, including the expansion …

Case Report: Cavitary Pneumonia In A 28 Year Old Male, Dan Zaayenga, Katelyn Courtney

Rowan-Virtua Research Day

Cavitary pneumonia can be caused by several different mechanisms. Such causes include suppurative necrosis (pyogenic lung abscess), caseous necrosis (tuberculosis), ischemic necrosis (pulmonary infarction) cystic dilatation of lung structures (ball value obstruction and Pneumocystis pneumonia) as well as malignant processes. Causes are subject to both environmental factors and host susceptibility. The most common cause of infectious process is tuberculosis with its propensity to cause extensive caseous necrosis. The potential for secondary infection after an individual develops a cavitary pneumonia is also great as it provides a shelter for various pathogens the flourish in an environment otherwise usually well-guarded by host …

Evaluating The Accuracy And Quality Of The Information On Pulmonary Rehabilitation Videos Shared On Youtube Amidst The Covid-19 Pandemic, Payaum Fotovat-Ahmadi, Bilal M. Ali, Bhavinkumar Dalal

Posters

YouTube is a visual library that is growing at incredible pace, especially with the rise of COVID-19 pandemic. Pulmonary rehabilitation refers to the rehabilitation treatment of patients with chronic pulmonary diseases. YouTube has made it possible to practice remote rehabilitation, the effectiveness of which have been proven non-inferior to traditional approaches.

Evaluation Of Phenobarbital In The Treatment Of Alcohol Withdrawal In The Intensive Care Unit, Sienna J. Ringgenberg, Vishal K. Patel

Posters

Alcohol withdrawal syndrome (AWS) is typically managed using the Clinical Institute Withdrawal Assessment (CIWA) protocol which includes benzodiazepines, supportive care, and close clinical monitoring. Alternatives to benzodiazepines such as phenobarbital provide several advantages including less frequent dosing, longer tapering off of doses, and additional glutamate inhibition. The purpose of this study is to evaluate the effectiveness and potential benefit to using phenobarbital in addition to CIWA protocol in the treatment of AWS at Beaumont, Royal Oak.

Impact Of Structured Reporting Template On The Quality Of Hrct Radiology Reports For Interstitial Lung Disease, Han G. Ngo, Girish B. Nair, Sayf Al-Katib

Posters

This QI study compared the completeness of HRCT radiology reports before and after the implementation of a disease-specific structured reporting template for suspected cases of interstitial lung disease (ILD).

Access To Pediatric Type 1 Diabetes Care In Montana, James C. Bohnhoff, Michael Kohut Phd, Chelsea Bodnar, Elizabeth A. Jacobs

Costas T. Lambrew Research Retreat 2023

Introduction: Management of Type 1 Diabetes (T1D) requires significant family effort and specialty support. We aimed to understand how living in a rural state impacts families’ experiences during and after diagnosis.

Food Insecurity Screening In People With Cystic Fibrosis, Rebecca Edwards, Lauren Tate, Ana Cairns, Cheryl Coyne, Kathleen Walker, Kim Violette, Ann Ladner, Jessica D'Amico

Costas T. Lambrew Research Retreat 2023

Background: Adequate nutrition is a cornerstone in the management of cystic fibrosis (CF). Malabsorption secondary to pancreatic insufficiency and increased energy demands related to lung disease can increase energy requirements over twofold for a person with CF. Food insecurity (FI) affects approximately 10% of Mainers (1). Per the Cystic Fibrosis Foundation, there may be up to a threefold increase in the prevalence of FI in the CF population (2). To address this issue, we implemented FI screening in the adult and pediatric CF programs to identify the prevalence of FI within our population and to offer immediate interventions.

Identification Of Molecular Markers Associated With Copd In Non-Smokers And Smokers: A Bioinformatics Analysis, Agede O. Ayodele, Isa M. Wasagu, Ademola E. Fawibe, Alakija K. Salami

The University of Louisville Journal of Respiratory Infections

Background

Even though the proportional burden of COPD among never-smokers is significant in both developing and developed nations, accounting for around 30% of all COPD in the community, there is little awareness of the prevalence of COPD in this population. Understanding the molecular processes that underlie COPD in nonsmokers is essential.

Methods

Dataset (GSE146560) was acquired from the Gene Expression Omnibus (GEO). The limma and clusterProfiler software tools were used to identify differentially expressed genes (DEGs) and conduct a functional enrichment analysis respectively.

Results

In all, 10,583 DEGs were found, of which 1,065 were up-regulated and 9,518 were down-regulated. The …

Preventable Tacrolimus Toxicity, Brooke Parker, Jessica Sterner, John Mele, Laura Dewald, Cassidy Johnston

Articles, Abstracts, and Reports

No abstract provided.

Gender Disparities In The Diagnosis Of Sleep Disordered Breathing, Kenna Haile, Nesrine Ibrahim, Safwan Badr, Apala Vaishnav

Medical Student Research Symposium

Introduction: Current diagnostic guidelines for sleep disordered breathing (SDB) require that apneas and hypopneas be accompanied by a 4% desaturation for it to constitute a respiratory event (AHI-Accepted). However, the American Academy of Sleep Medicine recommends expanding the diagnostic criteria to include apneas and hypopneas accompanied by a 3% desaturation or a cortical arousal for diagnosis (AHI-Recommended). We hypothesized that a clinical sample of both men and women would demonstrate that women are more likely to be misdiagnosed using the accepted criteria compared to the recommended criteria.

Methods: The clinical sample consisted of all patients receiving a PSG at the …

Moving Senolytics Closer To The Clinic In Ipf, Daniel Kramer, Gautam George, Ross Summer

Division of Pulmonary and Critical Care Medicine Faculty Papers

No abstract provided.

Change In Basic Pulmonary Function With Change In Altitude, Jaden Arnold, Mindy Cook, Bivash Neupane, Erika Noonan Md, Rex Ripplinger Md

Annual Research Symposium

No abstract provided.

It Is Not Pneumocystis Jiroveci (Pcp), It Is Cyclophosphamide-Induced Pneumonitis, Mery Bartl, Yilen Karen Ng-Wong, Blesset Alexander, Jose Gomez Casanovas, Josenny L. Rodriguez-Paez, Andres Suarez, Christine Loftis

School of Medicine Publications and Presentations

Cyclophosphamide (CYC) is an immunosuppressive medication used to treat life-threatening complications of various rheumatic diseases like vasculitis and systemic lupus erythematosus. A rare side effect of this medication is pneumonitis, which occurs in less than 1% of patients. We describe a case of an 83-year-old woman with a past medical history of microscopic polyangiitis, who presented with progressive dyspnea at rest, exacerbated on exertion, and associated with orthopnea that was attributed to CYC-induced pneumonitis. Three months before this presentation, the patient was diagnosed with antineutrophil cytoplasmic antibodies (ANCA)-positive pauci-immune crescentic and necrotizing glomerulonephritis and started on CYC. On admission, a …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

What? Now A Respiratory Syncytial Virus Epidemic, Aya Allam, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Pulse Oximetry: Why Oxygen Saturation Is Still Not A Part Of Standard Pediatric Guidelines In Low-And-Middle-Income Countries (Lmics), Maheen Sheikh, Huzaifa Ahmad, Romesa Ibrahim, Muhammad Imran Nisar, Fyezah Jehan

Department of Paediatrics and Child Health

Background: With the high frequency of acute respiratory infections in children worldwide, particularly so in low-resource countries, the development of effective diagnostic support is crucial. While pulse oximetry has been found to be an acceptable method of hypoxemia detection, improving clinical decision making and efficient referral, many healthcare set ups in low- and middle-income countries have not been able to implement pulse oximetry into their practice.
Main body: A review of past pulse oximetry implementation attempts in low- and middle-income countries proposes the barriers and potential solutions for complete integration in the healthcare systems. The addition of pulse oximetry into …

Spontaneous Large Volume Hemothorax Managed With A Small-Bore Chest Tube, Moiz Salahuddin, Samia Ayub

Department of Medicine

A 67-year-old male with metastatic lung cancer presented with acute shortness of breath and increasing oxygen requirements. He had a decreasing hemoglobin for which he required red blood cell transfusions. His chest x-ray showed near complete white-out of the left lung. Bedside ultrasound (Handheld Sonostar C4PL) showed a large pleural effusion with swirling echogenic material suggestive of plankton sign. The pleural effusion was aspirated and showed frank blood, after which a small-bore chest tube (SBCT) was inserted. A total of 3200ml of blood was drained with the SBCT. There was complete clearance of the pleural space, and no further blood …

Acute Outcomes For The Full Us Cohort Of The Flash Mechanical Thrombectomy Registry In Pulmonary Embolism, Caitlin Toma, Wissam A. Jaber, Mitchell D. Weinberg, Matthew C. Bunte, Sameer Khandhar, Brian Stegman

Articles

Background

Evidence supporting interventional pulmonary embolism (PE) treatment is needed.

Aims

We aimed to evaluate the acute safety and effectiveness of mechanical thrombectomy for intermediate- and high-risk PE in a large real-world population.

Methods

FLASH is a multicentre, prospective registry enrolling up to 1,000 US and European PE patients treated with mechanical thrombectomy using the FlowTriever System. The primary safety endpoint is a major adverse event composite including device-related death and major bleeding at 48 hours, and intraprocedural adverse events. Acute mortality and 48-hour outcomes are reported. Multivariate regression analysed characteristics associated with pulmonary artery pressure and dyspnoea improvement.

Results …

Recurrent Cyanotic Spells In An Octogenarian, Chin Tong Kwok, Chun Kit Wong

Journal of the Hong Kong College of Cardiology

We report rare case of an octogenarian who, after years of diagnostic delay, was found to have a patent foramen ovale, and due to an ascending aortic aneurysm that anatomically facilitated right-to-left shunt, presenting with life-threatening cyanotic attacks. The characteristic orthodeoxia-platypnea syndrome and high alveolar arterial gradient hint to the diagnosis. She was eventually treated successfully with urgent percutaneous PFO closure. Routine ordering of a transthoracic echocardiogram, without agitated saline injection under provocation maneuvers, may not be sufficient to rule out shunts.