Pulmonology Commons^™

Health Literacy Screening To Increase Antihypertensive Medication Adherence, Boyann Bonjean

Evidence-Based Practice Project Reports

Hypertension contributes to the risk of developing cardiovascular disease (CVD), stroke, heart attack, and chronic kidney disease (CKD) (Abegaz et al., 2016; Weir, 2014; Whelton et al., 2017). Evidence indicates that 30 to 50% of people who are prescribed antihypertensive medication therapy are nonadherent (Hedna et al., 2015). Non-adherence to antihypertensive medications is a major contributor to hypertension treatment failure (Al Ghurair et al., 2012; Hu, 2016; Whelton et al., 2017). Evidence has shown that low health literacy may impact antihypertensive therapy (Slade, 2017). The purpose of this EBP project was to provide an organizational change by implementing a health …

A Refractory Case Of Severely Uncontrolled Eosinophilic Asthma On Maximal Therapy, William Ueng Mph, Jaimin Patel Do, Nathan Brewster Do, Swetangini Patel P3, Andres Zirlinger Md

Department of Medicine

No abstract provided.

Propofol Infusion Syndrome: A Serious Complication With A Commonly Used Drug In The Icu, Hernando Castillo Ms, Jaimin Patel Do, Nathan Brewster Do, Swetangini Patel P3, Brian Civic Md

Department of Medicine

No abstract provided.

The In Vivo Effects Of Alcohol In Lung And Liver Are At Least Partially Mediated Through The Alpha 4 Nicotinic Acetylcholine Receptor, J. Ritzenthaler, E. Torres-Gonzalez, G. E. Arteel, J. Roman

Division of Pulmonary, Allergy, and Critical Care Medicine Posters

Rational: Chronic alcohol abuse is a major risk factor for the development of acute lung injury, with 40% of annual cases in the U.S. linked to this disorder. Alcohol is not only associated with increased incidence of acute lung injury in at-risk individuals, but also increased mortality. The exact mechanisms by which alcohol abuse renders the host susceptible to acute lung injury remain poorly defined. We have reported that α4 nicotinic acetylcholine receptors (α4 nAChRs) may serve as potential sensors for alcohol in lung fibroblasts; however, we have not tested their role in vivo.

Methods: To test the role of …

Congenital Abnormalities Of The Lower Airways And Lungs, Christopher M. Oermann

Presentations

Participants will be able to: Describe the 5 stages of fetal lung development. Summarize the prenatal identification and management of congenital abnormalities of the lower airways and lung (CALA). Explain the classification of CALAL. Compare the clinical characteristics, pathology, and management of common CALAL. Discuss the long term prognosis of CALAL.

Dehydrated Hereditary Stomatocytosis Causing Sever Ascites Leading To Pulmonary Hypoplasia And Respiratory Insufficiency In A Neonate, Michael D. Mcdowell Jr, Christopher M. Oermann

Posters

Care Presentation: EM is a 32.5-week EGA infant who was born with sever congenital ascites (following repeated prenatal paracentesis) identified on prenatal ultrasound. Initial chest-abdomen imaging is shown in Figure 1. He required CPAP at delivery but was weaned of high flow nasal cannula with intermittent episodes of prolonged intubation during repeat paracentesis. Paracentesis demonstrated simple ascites rather than chylous fluid. Lymphangiograms demonstrated transient lymphatic leakage with resolution. Genetic evaluation revealed a pathogenic mutation in the PIEZO 1 gene for autosomal dominant DHS. This disorder had reduced penetrance and variable expressivity and symptoms range for absence of clinical features to …

The Fibrosis Across Organs Symposium: A Roadmap For Future Research Priorities., Jesse Roman, Teresa R. Barnes, Dolly J. Kervitsky, Gregory P. Cosgrove, Dennis E. Doherty, Andrew M. Tager, Luca Richeldi, Eric S. White, David A. Brenner, Lynn M. Schnapp, Timothy D. Hewitson, Bodh I. Jugdutt, Timothy A. Mckinsey, John D. Tosi, Stephen Crane, Kevin K. Brown

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

Massive Hemoptysis In The Setting Of Acute Mitral Regurgitation, Joseph Moran Do, George Prousi Md, Ross Biggs Do, Nirupama Kakumanu Md, Fccp

Department of Medicine

No abstract provided.

Neurocardiac Risk Stratification 6 Hours After Resuscitation From Cardiac Arrest, A Bilkanovic, Z Haxhija, L Lucas, J Dziodzio, R R. Riker, T May, H Friberg, D B. Seder

MaineHealth Maine Medical Center

Introduction:

• An increasing number of patients are resuscitated from out-ofhospital cardiac arrest. Triage to optimal treatment pathways could improve and increase the efficacy of post-resuscition care.

• Despite great variability in etiology, duration, and patterns of injury from cardiac arrest, post-resuscitation treatment guidelines emphasize standard treatments. We hypothesize that by categorizing competing risks very early after resuscitation, it may be possible to improve the efficacy and efficiency of care.

• When measured very early after resuscitation, suppression ratio (SR, the percentage of suppressed EEG), correlates with severity of brain injury and the likelihood of poor neurological outcome.

• The …

Outpatient Treatment Of Pulmonary Embolism: A Single-Center Case Series, Annie Huyler, Casey Z. Macvane, Andrew Perron, Tania D Strout

MaineHealth Maine Medical Center

Background: Pulmonary embolus (PE) is associated with significant utilization of health care resources and financial burden Several additions that have allowed us to look at safely treating patients with PEs as outpatients:

• Simplified Pulmonary Embolism Severity Index (sPESI) -Risk stratifies patients based on their age, vital signs, and past medical history

• Novel oral anticoagulants

Primary Objective: To describe the population, treatment strategies, short-term complications and outcomes associated with outpatient management of PE following treatment in the ED.

Seerratus Anterior Plane Block (Sapb) Improves Paine Control In Rib Fractures, Randy Kring, Peter Croft, David Mackenzie, Christina Wilson, Joseph Rappold, Tania D. Strout

MaineHealth Maine Medical Center

Background:

•Trauma is a major cause of morbidity and mortality worldwide. Rib fractures are identified in at least 10% of all injured patients.

•Rib fractures can lead to significant respiratory complications, with pneumonia and respiratory failure occurring in up to 31% of patients with rib fractures. Early initiation of aggressive pain control and pulmonary hygiene with incentive spirometry are standard of care to prevent complications from developing.

•In the Emergency Department, patients with rib fractures typically receive systemic analgesia that is largely narcotic-based. This pain control strategy puts patients at risk for the side effects of narcotics such as constipation, …

Recent Progress In The Theranostics Application Of Nanomedicine In Lung Cancer., Anubhab Mukherjee, Manash Paul, Sudip Mukherjee

Articles, Abstracts, and Reports

Lung cancer is one of the leading causes of cancer-related death worldwide. Non-small cell lung cancer (NSCLC) causes around 80% to 90% of deaths. The lack of an early diagnosis and inefficiency in conventional therapies causes poor prognosis and overall survival of lung cancer patients. Recent progress in nanomedicine has encouraged the development of an alternative theranostics strategy using nanotechnology. The interesting physico-chemical properties in the nanoscale have generated immense advantages for nanoparticulate systems for the early detection and active delivery of drugs for a better theranostics strategy for lung cancer. This present review provides a detailed overview of the …

Physical Exercise – The Friend Or The Enemy Of The Patient With Pulmonary Tuberculosis?, Victoria Maria Ruta, Teodora Gabriela Alexescu, Simina Tarmure, Vasile Negrean, Monica Carmen Pop, Nicoleta Motoc, Iulia Olimpia Pfingstgraf, Mirela Georgiana Perne, Lorena Ciumarnean, Simona Valeria Clichici, Adina Milena Man

Journal of Mind and Medical Sciences

Introduction. Tuberculosis, a major cause of morbidity and mortality, is the second cause of death from an infectious disease, after HIV/AIDS. Each second, a new infection occurs around the globe. Pulmonary tuberculosis can equally affect a performance athlete as well as an aspiring athlete. Physical exercise must be individualized and customized. Pulmonary rehabilitation guides 3 recommend types of exercises for patients with obstructive pathology: stretching, cardiovascular exercise or aerobics. Exercises must be started under medical supervision and must be interrupted if: the ventricular altitude increases above the maximum estimated level for the age, oxygen saturation (SaO2). Aim. The current review …

The Effects Of Implementing A Smartphone Application To Improve Asthma Self-Management In Adults, Lindsay J. Humpfer

Evidence-Based Practice Project Reports

Asthma is one of the most common chronic diseases, affecting 20.4 million adults in the United States (CDC, 2018). While asthma can generally be controlled, patients having an exacerbation may experience missed days of work and school, limitations in daily activities, decreased enjoyment of life, and decreased productivity at home, work, and school (MarcanoBelisario et al., 2013). Therefore, the purpose of this project was to improve patients’ overall asthma control and asthma-related quality of life by encouraging self-management through patient education and the implementation of a mobile smartphone application. A total of 26 adult primary care patients with asthma participated …

An Uncommon Complication Of A Common Medication: Diffuse Alveolar Hemorrhage Secondary To Supratherapeutic Inr, Nathan Brewster Do, Christopher Lenivy Do, Kareem Godil Md, Andres Zirlinger Md

Department of Medicine

No abstract provided.

Direct Lung Sampling Indicates That Established Pathogens Dominate Early Infections In Children With Cystic Fibrosis., Peter Jorth, Zarmina Ehsan Md, Amir Rezayat, Ellen Caldwell, Christopher Pope, John J. Brewington, Christopher H. Goss, Dan Benscoter, John P. Clancy, Pradeep K. Singh

Manuscripts, Articles, Book Chapters and Other Papers

Culture and sequencing have produced divergent hypotheses about cystic fibrosis (CF) lung infections. Culturing suggests that CF lungs are uninfected before colonization by a limited group of CF pathogens. Sequencing suggests diverse communities of mostly oral bacteria inhabit lungs early on and diversity decreases as disease progresses. We studied the lung microbiota of CF children using bronchoscopy and sequencing, with measures to reduce contamination. We found no evidence for oral bacterial communities in lung lavages that lacked CF pathogens. Lavage microbial diversity varied widely, but decreases in diversity appeared to be driven by increased CF pathogen abundance, which reduced the …

Aztreonam Lysine Inhalation Solution In Cystic Fibrosis., Claire Elson, Joel Mermis, Deepika Polineni, Christopher M. Oermann

Manuscripts, Articles, Book Chapters and Other Papers

Patients with cystic fibrosis (CF) develop pulmonary disease secondary to airway infection and dysregulated inflammation. Therapeutic innovations such as nebulized antimicrobial therapy targeting specific pathogens have resulted in improvements in quality of life and life expectancy. Aztreonam lysine for inhalation (AZLI) solution was initially approved to improve respiratory symptoms in CF patients with Pseudomonas aeruginosa (PA) in 2010 by the Food and Drug Administration. Since then, research broadening labeling and clinical application has been developed. In this review, we analyze published and ongoing research regarding AZLI therapy in CF. A search of the Cochrane Database of Systematic Reviews and the …

Cancer And How The Patients See It; Prevalence And Perception Of Risk Factors: A Cross-Sectional Survey From A Tertiary Care Centre Of Karachi, Pakistan, Saira Saeed, Javaid Khan, Nousheen Iqbal, Sana Irfan, Alviya Shafique, Safia Awan

Section of Pulmonary & Critical Care

Background: The incidence of cancer is rising but data available regarding prevalence of cancer and patient perception of the disease in Pakistan is limited. It is difficult to deal with Cancer if the main causes are negligence towards risk factors and bizarre myths. This study was aimed to investigate common cancer presentations at a government sector hospital and to gain insight into patient knowledge of the disease.

Methods: This was a cross-sectional study conducted on cancer patients from Jinnah Postgraduate Medical Centre. A self-made questionnaire was used to assess the norms related to cancer prevalence in our society, associated myths, …

Right Ventricular Outflow Tract Velocity Time Integral-To-Pulmonary Artery Systolic Pressure Ratio: A Non-Invasive Metric Of Pulmonary Arterial Compliance Differs Across The Spectrum Of Pulmonary Hypertension., Priyanka T. Bhattacharya, Gregory S. Troutman, Frances Mao, Arieh L. Fox, Monique S. Tanna, Payman Zamani, E. Wilson Grandin, Jonathan N. Menachem, Edo Y. Birati, Julio A. Chirinos, Sula Mazimba, Kerri Akaya Smith, Steven M. Kawut, Paul R. Forfia, Anjali Vaidya, Jeremy A. Mazurek

Student Papers, Posters & Projects

Pulmonary arterial compliance (PAC), invasively assessed by the ratio of stroke volume to pulmonary arterial (PA) pulse pressure, is a sensitive marker of right ventricular (RV)-PA coupling that differs across the spectrum of pulmonary hypertension (PH) and is predictive of outcomes. We assessed whether the echocardiographically derived ratio of RV outflow tract velocity time integral to PA systolic pressure (RVOT-VTI/PASP) (a) correlates with invasive PAC, (b) discriminates heart failure with preserved ejection-associated PH (HFpEF-PH) from pulmonary arterial hypertension (PAH), and (c) is associated with functional capacity. We performed a retrospective cohort study of patients with PAH (n = 70) and …

Multidisciplinary Care For Adult Hermansky-Pudlak Syndrome Patients In Puerto Rico, Isabel Becerra, Shirley Martinez, Atencio Xavier, Torrens Jonathan, Juan Alemany, Eric Cruz, Felix Rivera Borges, Monica Egozcue, Jesse Roman, Rosa Roman

Division of Pulmonary, Allergy, and Critical Care Medicine Posters

Background: Hermansky-Pudlak syndrome (HPS) is an autosomal recessive rare disease characterized by oculo-cutaneous albinism, bleeding diathesis due to platelet dysfunction, and is sometimes accompanied by immunodeficiency, granulomatous colitis, and/or interstitial lung disease / pulmonary fibrosis. Puerto Rico houses the highest concentration of patients with HPS, especially HPS-1, which is considered quite severe and often associated with pulmonary fibrosis. We believe that the establishment of an HPS Multidisciplinary Clinic in Puerto Rico would improve outcomes.

Methods: A multidisciplinary clinic was started in November 2018 and another was held in February 2019 at the Mayaguez Medical Center located in the Southwest region …