Pulmonology Commons^™

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.

Role Of Oxides Of Nitrogen In The Ozone-Cardiorespiratory Visit Association, Xerxes Seposo, Kayo Ueda, Chris Fook Sheng Ng, Lina Madaniyazi, Seiji Sugata, Ayako Yoshino, Akinori Takami

Ateneo School of Medicine and Public Health Publications

Ozone (O3)-induced health effects vary in terms of severity, from deterioration of lung function and hospitalization to death. Several studies have reported a linear increase in health risks after O3 exposure. However, current evidence suggests a non-linear U- and J-shaped concentration-response (C-R) function. The potential increasing risks with decreasing O3 concentrations may seem counterintuitive from the traditional standpoint that decreasing exposure should lead to decreasing health risks. Tus, the question of whether the increasing risks with decreasing concentrations are truly O3-induced or might be from other C-R mechanisms. If these potential risks were not accounted for, this may have contributed …

Appendix 4: Search Strategies, Larry Mellick, Paul Walsh, Clista Clanton, Sarathi Kalra, Shane Mckinney

University Research Data and Datasets

OBJECTIVE: To systematically review all meta-analyses that included outpatient sub-analyses or network meta-analyses with medications treatment comparisons in order to study the clinical benefits of these deimplemented medications in the outpatient setting.

Correlation Between Ct , Mri Of The Chest And Medical Thoracoscopic Findings In Primary Pleural Tumors, Mohamed Tarik Abd Al-Fattah Al-Jammal, Mohamed Ahmed Haroun, Fawzy Mohamed Omar, Mahmoud Mohamed Aboumandour Fouda

Al-Azhar International Medical Journal

Objective: Malignant pleural mesothelioma (MPM) routine diagnostic procedures often include computed tomography (CT) and magnetic resonance imaging (MRI). Histological confirmation by pleural biopsy is required for the MPM diagnosis to be finalized.

Aim of our study: to compare among findings of chest CT, MRI and medical thoracoscopy (MT) for MPM identification.

Patients and methods: Fifty patients (30 Males and 20 females) with definitive MPM diagnosis after (MT) biopsy, underwent chest CT and MRI chest.

Results: There was statistically significant parameters for MRI versus CT for pleural thickening, it was 64% versus 44% (p= 0.044). Post contrast enhancement in MRI was …

Studying The Therapeutic Effect Of Umbilical Cord Stem Cell In Pneumonia Caused By Covid-19, Salama M. El- Shennawy, Abdalla Abo Hassen, Talal Ibrahim Hagag, Asherf I Zahra, Reham Salama, Mariam A. Fouad

Journal of Medicine in Scientific Research

Context: Coronavirus disease (COVID-19) with severe respiratory morbidity and mortality , rapidly spread all over the world, caused by an sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varying from mild symptoms to pulmonary fibrosis( Li Z et al.,2020). Mesenchymal stem cells (MSCs) can have a critical role, by promoting the pulmonary parenchyma regeneration and subsequently decreasing the symptoms of COVID-19 and help immune system to act against the virus (WHO, 2020).Aim: to evaluate the efficacy and safety of using stem cell in the treatment of COVID-19patients.Setting and design: We performed this case control study during the period from November 2020 …

Early Diagnostic Value Of Lung Ultrasound Compared To Chest Computed Tomography For Pleural Effusion And Pneumonia In Critically Ill Patients, Mohamed Osman Abdel Hamid Ibrahim, Mostafa Abdel Hamid Abo-Elainin, Khalid Mohamed Halima, Mohamed Abdelgawad Aboelsuod

Al-Azhar International Medical Journal

Background: Recently, lung ultrasound has been touted as a modality that can diagnose pneumonia in a variety of settings while overcoming many of the shortcomings of other tools. Aim: The aim of the study to compare between diagnostic value of lung ultrasound and CT- chest in evaluating pneumonia and pleural effusion in ICU patients. The primary study outcomes were the sensitivity and specificity of lung ultrasound and CT-chest in pneumonia and pleural effusion. The Secondary study outcomes were the satisfaction of the patient. Patients and Methods: This was observational study included 40 patients admitted to ICU Al-Azhar university hospitals. Results: …

Use Of Lung Ultrasound Instead Of Ct Chest In Follow Up Of Patients With Covid-19 In Icu, Mahmoud Ahmed Ibrahim Elshafey, Imam Abd El-Kader El-Sherief, Emad Hamdi Tayel

Al-Azhar International Medical Journal

Background: The new Coronavirus (Covid-19) struck the central area of China in late December 2019 and quickly spread to several nations across the world. This virus's pandemic breakout, with fast human-to-human transmission, has caused significant devastation in many parts of life as well as a significant loss of human material and financial resources.

Aim of The work: The purpose of this study is to assess the use of lung ultrasonography instead of CT chest in the ICU follow-up of patients with Covid-19.

Patient and method: From February 2022 to May 2023, 50 patients were hospitalized in the intensive care unit …

A Spontaneous Subcutaneous Emphysema As A Life Threatening Complication Of Rheumatoid Arthritis Associated Interstitial Lung Disease, Austin Makadia, Vishesh Persaud, Saiara Choudhury, Asad Chohan, Abhay Vakil

Gulf Coast Division Research Day 2023

No abstract provided.

An Interesting Case Of Diffuse Alveolar Hemorrhage With An Elusive Etiology, Austin Makadia, Vishesh Persaud, Saiara Choudhury, Asad Chohan, Abhay Vakil

Gulf Coast Division Research Day 2023

No abstract provided.

Treatment Options For World Health Organization Hroups 2 And 3 Pulmonary Hypertension: Using Pulmonary Arterial Hypertension Medication, Austin Makadia, Jorge Garza, Arjun Kamath, Ahsan Syed, Vishesh Persaud

Gulf Coast Division Research Day 2023

No abstract provided.

Endobronchial Ultrasound Diagnosis Of A Malignant Superior Vena Cava Tumor Thrombus Extending Into The Right Atrium: An Unusual Cause Of Recurrent Syncope., Larissa Check, Ariba Naz, Richard Duff

South Atlantic Division Research Day 2023

No abstract provided.

Diagnostic Accuracy Of Different Cut-Off Values Of Adenosine Deaminase Levels In Tuberculous Pleural Effusion, Kiran Iqbal Masood, Shayan Shahid, Kauser Jabeen, Joveria Farooqi, Sabeika Raza Kerawala, Muhammad Irfan

Department of Pathology and Laboratory Medicine

Objective: To assess the diagnostic accuracy of different cut-off values of pleural fluid adenosine deaminase levels as a diagnostic method for tuberculous pleural effusion.
Method: The prospective study was conducted from 2014 to 2016 at the Aga Khan University Hospital, Karachi, and comprised pleural fluid samples of adult patients with and without tuberculosis which were tested for adenosine deaminase levels, and divided into tuberculosis group A and non-tuberculosis group B. Sensitivity, specificity, negative predictive value and positive predictive value were calculated using different cut-offs. Data was analysed using IBM SPSS (Statistical Package for Social Sciences) version 21.0 (IBM Corp., Armonk, …

Organizing Pneumonia From Inhalational Injury, Asad Chohan, Rene Franco, Abhay Vakil

Gulf Coast Division Research Day 2023

No abstract provided.

A Curious Case Of Biopsy Proven Usual Interstitial Pneumonia, Austin Makadia, Vishesh Persaud, Saiara Choudhury, Asad Chohan, Abhay Vakil

Gulf Coast Division Research Day 2023

No abstract provided.