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Article ; Online: Novel Use of EBUS-guided Forceps Biopsy to Diagnose Solitary Fibrous Tumors of the Pleura.

Obata, Reiichiro / D'Souza, Kenneth / Perwaiz, Muhammad

Journal of bronchology & interventional pulmonology

2023 Volume 30, Issue 1, Page(s) 79–83

MeSH term(s)	Humans ; Pleura/diagnostic imaging ; Biopsy ; Solitary Fibrous Tumors
Language	English
Publishing date	2023-01-01
Publishing country	United States
Document type	Letter
ZDB-ID	2478320-1
ISSN	1948-8270 ; 1944-6586
ISSN (online)	1948-8270
ISSN	1944-6586
DOI	10.1097/LBR.0000000000000845
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Article ; Online: Mycobacterium avium Complex-associated Pleural Effusion in an Immunocompetent Host : A Rare Case Report and Literature Review.

Perwaiz, Muhammad / Obata, Reiichiro / Bradley, Ellen C

Journal of bronchology & interventional pulmonology

2023 Volume 30, Issue 2, Page(s) 171–174

MeSH term(s)	Humans ; Mycobacterium avium Complex ; Mycobacterium avium-intracellulare Infection/complications ; Mycobacterium avium-intracellulare Infection/diagnosis ; Pleural Effusion/diagnostic imaging ; Pleural Effusion/etiology ; Exudates and Transudates
Language	English
Publishing date	2023-04-01
Publishing country	United States
Document type	Review ; Case Reports ; Letter
ZDB-ID	2478320-1
ISSN	1948-8270 ; 1944-6586
ISSN (online)	1948-8270
ISSN	1944-6586
DOI	10.1097/LBR.0000000000000858
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Article ; Online: Aphasia and confusion - influenza encephalopathy: atypical presentation of influenza.

Obata, Reiichiro / Ernst, Kristina

BMJ case reports

2020 Volume 13, Issue 10

Abstract: Influenza encephalopathy, a rare manifestation of influenza infection in the adult population which is not widely recognised, can present with confusion and focal neurological symptoms, including aphasia. The aim of this report is to illustrate the ... ...

Abstract	Influenza encephalopathy, a rare manifestation of influenza infection in the adult population which is not widely recognised, can present with confusion and focal neurological symptoms, including aphasia. The aim of this report is to illustrate the unique presentation of influenza encephalopathy and discuss the need for close attention to and monitoring of this rare but highly fatal disease.A 28-year-old woman was admitted with acute-onset confusion and incoherent speech. CT of the head was unremarkable. Cerebrospinal fluid analysis showed elevation of protein, but was otherwise unremarkable. A detailed history revealed recent upper respiratory symptoms which prompted a rapid influenza test which was positive and oseltamivir was started. The patient's confusion and aphasia gradually improved and her speech was back to her baseline by the next day.
MeSH term(s)	Adult ; Aphasia/drug therapy ; Aphasia/etiology ; Confusion/drug therapy ; Confusion/etiology ; Diagnosis, Differential ; Encephalitis, Viral/complications ; Encephalitis, Viral/diagnosis ; Encephalitis, Viral/drug therapy ; Encephalitis, Viral/virology ; Female ; Humans ; Influenza A Virus, H1N1 Subtype/isolation & purification ; Influenza, Human/complications ; Influenza, Human/diagnosis ; Influenza, Human/drug therapy ; Influenza, Human/virology ; Oseltamivir/therapeutic use ; Treatment Outcome
Chemical Substances	Oseltamivir (20O93L6F9H)
Language	English
Publishing date	2020-10-10
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2020-235559
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Article: Benign inoperable tracheal stenosis in COVID versus non-COVID patients at the pandemic epicenter: a case series.

Perwaiz, Muhammad / Durrance, Richard / Bogart, Michael / Obata, Reiichiro / Bradley, Ellen C

Annals of medicine and surgery (2012)

2023 Volume 85, Issue 9, Page(s) 4201–4205

Abstract: Background: The COVID-19 pandemic has exponentially expanded the number of patients requiring treatment for chronic respiratory failure. One consequence is an increase in the number of patients requiring intubation and mechanical ventilation. Benign ... ...

Abstract	Background: The COVID-19 pandemic has exponentially expanded the number of patients requiring treatment for chronic respiratory failure. One consequence is an increase in the number of patients requiring intubation and mechanical ventilation. Benign inoperable tracheal stenosis presents a challenge, especially in COVID-19 patients. Methods: We describe a case series of 15 patients with Benign inoperable tracheal stenosis treated with interventional bronchoscopy over a 15-month period. These patients were divided into two groups, COVID and non-COVID. We used an electrocautery snare as an electrocautery knife to cut the stenotic segment followed by four injections of 1 mg submucosal Decadron via a Wang needle. Patients were subsequently followed by the pulmonary clinic. Institutional review board approval was not required as per our institutional policy for a retrospective case series. Results: There was a high degree of success with this intervention, with a low rate of recurrence. We also noticed the following differences between the two subgroups. COVID tracheal stenosis was longer in length, had a higher percentage of cartilage involvement, and was located more distal to cords than the non-COVID group. The median age was younger in the COVID group. Conclusions: COVID pandemic an enormous number of intubations and tracheotomies have been performed. As a result, there will be an increased prevalence of tracheal stenosis. Most of these cases can be effectively treated with surgery. Dealing with complex inoperable cases remains a dilemma. Our case series/research article is an attempt to provide an easy technique with a high cure rate.
Language	English
Publishing date	2023-04-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000000588
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Article: Endobronchial blood-patch: A novel technique for a persistent pleural air leak.

Durrance, Richard J / D'Souza, Kenneth G / Obata, Reiichiro / Bradley, Ellen C / Perwaiz, Muhammad K

Respiratory medicine case reports

2022 Volume 38, Page(s) 101670

Abstract: Introduction: Patients with severe COVID-19 Pneumonia requiring prolonged mechanical ventilation have an increased incidence of pneumothorax. Mechanically ventilated patients who are critically ill and develop a persistent air leak from pneumothorax are ...

Abstract	Introduction: Patients with severe COVID-19 Pneumonia requiring prolonged mechanical ventilation have an increased incidence of pneumothorax. Mechanically ventilated patients who are critically ill and develop a persistent air leak from pneumothorax are poor candidates for surgical repair. As the persistent air leak can be a significant barrier to vent-weaning and clinical stability, these patients present a unique clinical challenge. Clinical case: A 65-year-old male intubated and on prolonged mechanical ventilation for severe COVID-19 Pneumonia developed a pneumothorax complicated by a persistent alveolar-pleural fistula with a persistent air-leak. Given his critical state with ongoing pressor requirements and elevated vent requirements, surgical repair was not an option. A bedside bronchoscopy occlusion study with isolation of the air leak, and subsequent autologous endobronchial blood-patch repair with thrombin was performed with rapid and definitive resolution of the air leak. The patient progressed favorably, ultimately being weaned from the ventilator, decannulated, and walking out of the hospital. Conclusion: In critically ill ventilated patients with pneumothorax complicated by a persistent air-leak, bedside endobronchial evaluation and blood-patch repair is a feasible approach to management.
Language	English
Publishing date	2022-05-28
Publishing country	England
Document type	Case Reports
ZDB-ID	2666110-X
ISSN	2213-0071
ISSN	2213-0071
DOI	10.1016/j.rmcr.2022.101670
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Article ; Online: Palliative Care Team Involvement in Patients With COVID-19 in New York City.

Obata, Reiichiro / Maeda, Tetsuro / Rizk, Dahlia / Kuno, Toshiki

The American journal of hospice & palliative care

2020 Volume 37, Issue 10, Page(s) 869–872

Abstract: Background: With the highest number of cases in the world as of April 13, 2020, New York City (NYC) became the epicenter of the global coronavirus disease 2019 (COVID-19) pandemic. The data regarding palliative team involvement in patients with COVID-19, ...

Abstract	Background: With the highest number of cases in the world as of April 13, 2020, New York City (NYC) became the epicenter of the global coronavirus disease 2019 (COVID-19) pandemic. The data regarding palliative team involvement in patients with COVID-19, however, remains scarce. We aimed to investigate outcomes of palliative team involvement for the patients with COVID-19 in NYC. Methods: Consecutive 225 patients with confirmed COVID-19 requiring hospitalization in our urban academic medical center in NYC were analyzed. Patients were divided into 2 groups, those with a palliative care consult (palliative group: 14.2% [n = 32]) versus those with no palliative care consult (no palliative group: 85.8% [n = 193]). Results: The palliative group was older and had more comorbidities. During the hospital course, the palliative group had more intensive care unit stays, rapid response team activations, and more use of vasopressors ( Conclusions: Critically ill patients hospitalized for COVID-19 benefit from palliative team consults by helping to clarify advanced directives and minimize futile resuscitative efforts.
MeSH term(s)	Advance Directives ; Aged ; Aged, 80 and over ; COVID-19 ; Cardiopulmonary Resuscitation/statistics & numerical data ; Coronavirus Infections/therapy ; Female ; Humans ; Male ; Middle Aged ; New York City ; Palliative Care/methods ; Pandemics ; Patient Care Team ; Pneumonia, Viral/therapy ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-07-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1074344-3
ISSN	1938-2715 ; 1049-9091
ISSN (online)	1938-2715
ISSN	1049-9091
DOI	10.1177/1049909120940986
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Article ; Online: Increased Secondary Infection in COVID-19 Patients Treated with Steroids in New York City.

Obata, Reiichiro / Maeda, Tetsuro / Rizk, Dahlia / Kuno, Toshiki

Japanese journal of infectious diseases

2020 Volume 74, Issue 4, Page(s) 307–315

Abstract: Steroids are expected to be effective in the treatment of cytokine release syndrome, which is considered to be associated with severe cases of coronavirus disease 2019 (COVID-19). We aimed to investigate the use of steroids and its effects. We conducted ... ...

Abstract	Steroids are expected to be effective in the treatment of cytokine release syndrome, which is considered to be associated with severe cases of coronavirus disease 2019 (COVID-19). We aimed to investigate the use of steroids and its effects. We conducted a retrospective chart review and an analysis of 226 consecutive hospitalized patients with confirmed COVID-19. Patients were divided into those who received steroids (steroid group) and those who did not (no steroid group). Inverse probability weighted analysis was performed to assess the effect of steroids on in-hospital mortality. The steroid group had higher rates of preexisting hypertension and peripheral vascular disease as well as higher lactate dehydrogenase levels, d-dimer levels, and inflammatory markers than the no steroid group (all P <0.05). The steroid group had significantly higher rates of multifocal pneumonia than the no steroid group at admission (75.4% vs. 50.3%, P = 0.001). Notably, the steroid group had higher rates of developing bacterial infection (25% vs. 13.1%, P = 0.041) and fungal infection (12.7% versus 0.7%, P <0.001) during the hospital course than the no steroid group. After adjustment, it was observed that steroids did not decrease or increase in-hospital mortality (odds ratio [95% confidence interval]: 1.02 [0.60-1.73, P = 0.94]). There was an increase in bacterial and fungal infections with steroid use.
MeSH term(s)	Bacterial Infections/mortality ; COVID-19/epidemiology ; COVID-19/mortality ; Coinfection/epidemiology ; Coinfection/mortality ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Inflammation/mortality ; Inflammation/virology ; Male ; Middle Aged ; Mycoses/mortality ; New York City/epidemiology ; Retrospective Studies ; SARS-CoV-2/pathogenicity ; Steroids/therapeutic use
Chemical Substances	Steroids
Language	English
Publishing date	2020-12-25
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1478383-6
ISSN	1884-2836 ; 1344-6304
ISSN (online)	1884-2836
ISSN	1344-6304
DOI	10.7883/yoken.JJID.2020.884
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Article ; Online: Cardiovascular comorbidities, cardiac injury, and prognosis of COVID-19 in New York City.

Kuno, Toshiki / Takahashi, Mai / Obata, Reiichiro / Maeda, Tetsuro

American heart journal

2020 Volume 226, Page(s) 24–25

Abstract: Using Mt. Sinai (New York City) EMR health system data, we retrospectively analyzed a cohort of 8438 COVID-19 patients seen between March 1 and April 22, 2020. Risk of intubation and of death rose as a function of increasing age and as a function of ... ...

Abstract	Using Mt. Sinai (New York City) EMR health system data, we retrospectively analyzed a cohort of 8438 COVID-19 patients seen between March 1 and April 22, 2020. Risk of intubation and of death rose as a function of increasing age and as a function of greater cardiovascular comorbidity. Combining age and specific comorbidity markers showed patterns suggesting that cardiovascular comorbidities increased relative risks for adverse outcomes most substantially in the younger subjects with progressively diminishing relative effects at older ages.
MeSH term(s)	Age Factors ; Aged ; Betacoronavirus ; COVID-19 ; Cardiomyopathies/complications ; Cardiomyopathies/epidemiology ; Cardiomyopathies/mortality ; Cardiovascular Diseases/blood ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/mortality ; Comorbidity ; Coronary Artery Disease/epidemiology ; Coronary Artery Disease/mortality ; Coronavirus Infections/blood ; Coronavirus Infections/epidemiology ; Coronavirus Infections/mortality ; Electronic Health Records/statistics & numerical data ; Female ; Heart Failure/epidemiology ; Heart Failure/mortality ; Humans ; Male ; Middle Aged ; New York City/epidemiology ; Pandemics ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/mortality ; Pneumonia, Viral/blood ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/mortality ; Respiration, Artificial/mortality ; Respiration, Artificial/statistics & numerical data ; Retrospective Studies ; Risk ; SARS-CoV-2 ; Troponin I/blood
Chemical Substances	Troponin I
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	United States
Document type	Letter
ZDB-ID	80026-0
ISSN	1097-6744 ; 0002-8703
ISSN (online)	1097-6744
ISSN	0002-8703
DOI	10.1016/j.ahj.2020.05.005
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Article ; Online: Cardiac Injury and Outcomes of Patients With COVID-19 in New York City.

Maeda, Tetsuro / Obata, Reiichiro / Rizk, Dahlia / Kuno, Toshiki

Heart, lung & circulation

2020 Volume 30, Issue 6, Page(s) 848–853

Abstract: Background: Prior studies demonstrated that elevated troponin in patients with COVID-19 was associated with increased in-hospital mortality. However, the association of cardiac injury and electrocardiogram (ECG) changes remains unclear. The aim of this ... ...

Abstract	Background: Prior studies demonstrated that elevated troponin in patients with COVID-19 was associated with increased in-hospital mortality. However, the association of cardiac injury and electrocardiogram (ECG) changes remains unclear. The aim of this study was to investigate the association of cardiac injury with ECG abnormality and with in-hospital mortality. Methods: We conducted a retrospective cohort study of patients who were hospitalised with COVID-19 between 13 March and 31 March 2020. Those patients with troponin I measurement were included in the study and divided into those who had elevated troponin I (cardiac injury group) and those who did not (no cardiac injury group). Statistical analyses were performed to compare differences between the groups, and a multivariate logistic regression model was constructed to assess the effect of cardiac injury on in-hospital mortality. Results: One hundred and eight-one (181) patients were included, 54 of whom were in the cardiac injury group and 127 in the no cardiac injury group. The mean age was 64.0±16.6 years and 55.8% were male. The cardiac injury group was more likely to be older, have a history of coronary artery disease, atrial fibrillation and congestive heart failure compared to the no cardiac injury group (all p<0.05); there was no difference in presence of chest pain (cardiac injury group versus no cardiac injury group: 17.0% versus 22.5%, p=0.92); the cardiac injury group had a significantly higher value of brain natriuretic peptide, procalcitonin, interleukin-6 and D-dimer (all p<0.05); they had numerically more frequent ECG abnormalities such as T wave inversion (13.2% versus 7.5%, p=0.23) and ST depression (1.9% versus 0.0%, p=0.13) although statistically not significant; they had significantly higher in-hospital mortality (42.3% versus 12.6%, p<0.001). With a multivariate logistic regression model, age (odds ratio [95% confidence interval]: 1.033 [1.002-1.065], p=0.034) and cardiac injury (3.25 [1.40-7.54], p=0.006) were independent predictors of in-hospital mortality. Conclusions: Patients with COVID-19 with elevated troponin I had a relatively low proportion of chest pain and ECG abnormality. Cardiac injury was independently associated with in-hospital mortality.
MeSH term(s)	Atrial Fibrillation/diagnosis ; Atrial Fibrillation/etiology ; COVID-19/complications ; COVID-19/mortality ; COVID-19/physiopathology ; COVID-19/therapy ; Chest Pain/diagnosis ; Chest Pain/etiology ; Electrocardiography/methods ; Female ; Heart Diseases/blood ; Heart Diseases/diagnosis ; Heart Diseases/virology ; Hospital Mortality ; Humans ; Male ; Middle Aged ; New York City/epidemiology ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Troponin I/blood
Chemical Substances	Troponin I
Language	English
Publishing date	2020-11-23
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2020.10.025
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Article ; Online: THE ASSOCIATION OF RACE, ETHNICITY, AND OUTCOMES OF PATIENTS WITH COVID-19 IN NEW YORK CITY

Maeda, Tetsuro / Obata, Reiichiro / Rizk, Dahlia / Kuno, Toshiki

Chest

2020 Volume 158, Issue 4, Page(s) A1037

Keywords	Critical Care and Intensive Care Medicine ; Pulmonary and Respiratory Medicine ; Cardiology and Cardiovascular Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2020.08.964
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