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  1. Article ; Online: Adjunctive Therapies in Acute Respiratory Distress Syndrome.

    Trieu, Megan / Qadir, Nida

    Critical care clinics

    2023  Volume 40, Issue 2, Page(s) 329–351

    Abstract: Despite significant advances in understanding acute respiratory distress syndrome (ARDS), mortality rates remain high. The appropriate use of adjunctive therapies can improve outcomes, particularly for patients with moderate to severe hypoxia. In this ... ...

    Abstract Despite significant advances in understanding acute respiratory distress syndrome (ARDS), mortality rates remain high. The appropriate use of adjunctive therapies can improve outcomes, particularly for patients with moderate to severe hypoxia. In this review, the authors discuss the evidence basis behind prone positioning, recruitment maneuvers, neuromuscular blocking agents, corticosteroids, pulmonary vasodilators, and extracorporeal membrane oxygenation and considerations for their use in individual patients and specific clinical scenarios. Because the heterogeneity of ARDS poses challenges in finding universally effective treatments, an individualized approach and continued research efforts are crucial for optimizing the utilization of adjunctive therapies and improving patient outcomes.
    MeSH term(s) Humans ; Respiratory Distress Syndrome/therapy ; Extracorporeal Membrane Oxygenation
    Language English
    Publishing date 2023-12-23
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2023.12.004
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  2. Article ; Online: Pharmacologic Treatments for Acute Respiratory Distress Syndrome.

    Qadir, Nida / Chang, Steven Y

    Critical care clinics

    2021  Volume 37, Issue 4, Page(s) 877–893

    Abstract: Acute respiratory distress syndrome is a heterogenous syndrome with many etiologies for which there are no definitive pharmacologic treatments, despite decades of research. We explore some adjunctive pharmacologic therapies, including neuromuscular ... ...

    Abstract Acute respiratory distress syndrome is a heterogenous syndrome with many etiologies for which there are no definitive pharmacologic treatments, despite decades of research. We explore some adjunctive pharmacologic therapies, including neuromuscular blockade, corticosteroids, and inhaled pulmonary vasodilators. Additionally, we explore some investigative therapies, including Vitamin C, beta-agonists, statins, mesenchymal stromal cells, and granulocyte-macrophage colony stimulating factor. We do discuss the potential role of steroids in acute respiratory distress syndrome with severe acute respiratory syndrome coronavirus 2 as a trigger. The standard of care, however, remains supportive care.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; COVID-19 ; Humans ; Respiration, Artificial ; Respiratory Distress Syndrome/drug therapy ; SARS-CoV-2
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2021-05-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2021.05.009
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  3. Article ; Online: Postacute Sequelae of COVID-19 Critical Illness.

    Schwab, Kristin / Schwitzer, Emily / Qadir, Nida

    Critical care clinics

    2022  Volume 38, Issue 3, Page(s) 455–472

    Abstract: With an ever-increasing number of COVID-19 survivors, providers are tasked with addressing the longer lasting symptoms of COVID-19, or postacute sequelae of SARS-CoV-2 infection (PASC). For critically ill patients, existing knowledge about postintensive ... ...

    Abstract With an ever-increasing number of COVID-19 survivors, providers are tasked with addressing the longer lasting symptoms of COVID-19, or postacute sequelae of SARS-CoV-2 infection (PASC). For critically ill patients, existing knowledge about postintensive care syndrome (PICS) represents a useful structure for understanding PASC. Post-ICU clinics leverage a multidisciplinary team to evaluate and treat the physical, cognitive, and psychological sequelae central to both PICS and PASC in critically ill patients. While management through both pharmacologic and nonpharmacologic modalities can be used, further research into both the optimal treatment and prevention of PASC represents a key public health imperative.
    MeSH term(s) COVID-19/complications ; COVID-19/therapy ; Critical Illness/therapy ; Disease Progression ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2022-01-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2022.01.001
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  4. Article ; Online: Adjunctive Therapies in ARDS: The Disconnect Between Clinical Trials and Clinical Practice.

    Qadir, Nida / Chen, Jen-Ting

    Chest

    2020  Volume 157, Issue 6, Page(s) 1405–1406

    MeSH term(s) Combined Modality Therapy ; Humans ; Lung ; Respiration, Artificial ; Respiratory Distress Syndrome/therapy
    Keywords covid19
    Language English
    Publishing date 2020-06-05
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2020.03.022
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  5. Article ; Online: Disseminated Fungal Infection On Bone Marrow Trephine In An Asplenic Patient.

    Qadir, Hira / Qadir, Nida / Nasir, Nadia / Qadir, Areesha / Tanzeem, Hammad

    Journal of Ayub Medical College, Abbottabad : JAMC

    2022  Volume 33, Issue 4, Page(s) 690–691

    Abstract: hyposplenism increases the risk of life-threatening infection with encapsulated bacteria. however, literature review revealed that hyposplenism is also a risk factor for disseminated fungal infection. here, we report a case of individual who presented ... ...

    Abstract hyposplenism increases the risk of life-threatening infection with encapsulated bacteria. however, literature review revealed that hyposplenism is also a risk factor for disseminated fungal infection. here, we report a case of individual who presented with pyrexia of unknown origin and had splenectomy for hemolytic anemia and later he found to have disseminated fungal infection on bone marrow examination. this case emphasized the likelihood of disseminated fungal infection in an asplenic patient and also importance of bone marrow trephine in prompt diagnosis and management of patient.
    MeSH term(s) Bone Marrow ; Bone Marrow Examination ; Humans ; Invasive Fungal Infections ; Male ; Splenectomy ; Splenic Diseases/surgery
    Language English
    Publishing date 2022-05-24
    Publishing country Pakistan
    Document type Case Reports
    ZDB-ID 2192473-9
    ISSN 1819-2718 ; 1025-9589
    ISSN (online) 1819-2718
    ISSN 1025-9589
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  6. Article ; Online: Shining a Light on Diversity in Team Science.

    Chen, Jen-Ting / Qadir, Nida / Hope, Aluko A / Gershengorn, Hayley Beth

    Critical care medicine

    2022  Volume 50, Issue 4, Page(s) 685–687

    MeSH term(s) Interdisciplinary Research
    Language English
    Publishing date 2022-03-19
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005292
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  7. Article ; Online: Improved Clinical Competence and Patients Satisfaction: Comparison of Patient-centered, Interdisciplinary Collaborative Round versus Traditional Post-partum Round.

    Javed, Arshia / Sohaila, Arjumand / Sheikh, Irfan / Qadir, Nida

    Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

    2021  Volume 31, Issue 7, Page(s) 868–870

    Abstract: The origin of the patient-centered interdisciplinary collaborative round, which involves health care members of all levels at a time, is an effective and emerging approach to offer inpatient healthcare. Traditionally, post-partum rounds at teaching ... ...

    Abstract The origin of the patient-centered interdisciplinary collaborative round, which involves health care members of all levels at a time, is an effective and emerging approach to offer inpatient healthcare. Traditionally, post-partum rounds at teaching hospitals consisted of separate visits from all members of the obstetric team that resulted in patient inconvenience, care insufficiencies, and communication gaps. The main objective of this study was to assess the patient's satisfaction level from the traditional post-partum round versus the patient-centered collaborative care (PCCC) round. This study showed that in the traditional round, the patient's satisfaction with the treatment was 95.1%; whereas, in PCCC rounds it was 96.9%. Patients were more satisfied with the treatment options discussed with them and the results of the medical tests explained to them. In conclusion, the survey showed that the implementation of the PCCC round improved patient satisfaction. Key Words: Interdisciplinary collaborative  round, Traditional postpartum round, Patients satisfaction, Clinical competence.
    MeSH term(s) Clinical Competence ; Female ; Humans ; Patient Care Team ; Patient Satisfaction ; Patient-Centered Care ; Postpartum Period ; Pregnancy ; Teaching Rounds
    Language English
    Publishing date 2021-07-21
    Publishing country Pakistan
    Document type Journal Article
    ZDB-ID 2276646-7
    ISSN 1681-7168 ; 1022-386X
    ISSN (online) 1681-7168
    ISSN 1022-386X
    DOI 10.29271/jcpsp.2021.07.868
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  8. Article ; Online: How trustworthy guidelines can impact outcomes.

    Rochwerg, Bram / Kawano-Dourado, Leticia / Qadir, Nida

    Current opinion in critical care

    2021  Volume 27, Issue 5, Page(s) 544–550

    Abstract: Purpose of review: If developed using rigorous methods and produced in a timely manner, clinical practice guidelines have the potential to improve patient outcomes. Although the COVID-19 pandemic has highlighted the challenges involved in generating ... ...

    Abstract Purpose of review: If developed using rigorous methods and produced in a timely manner, clinical practice guidelines have the potential to improve patient outcomes. Although the COVID-19 pandemic has highlighted the challenges involved in generating reliable clinical guidance, it has also provided an opportunity to address these challenges.
    Recent findings: New research addressing drugs for COVID-19 is being produced at unprecedented rates. Incorporating this new knowledge into patient care can be daunting for the average clinician. In collaboration with the BMJ and MAGIC, the WHO has developed a living guideline initiative with the goal of providing rapid and trustworthy clinical guidance in response to practice-changing evidence. As new evidence becomes available, it is incorporated into a living network meta-analysis that informs these guidelines, which are iteratively updated. Until this point, the group has generated guidelines addressing the use of corticosteroids, remdesivir, hydroxychloroquine, lopinavir/ritonavir, and ivermectin for COVID-19.
    Summary: We provide an example of how rapid and rigorous guidelines can be accomplished, even in the setting of a pandemic, capitalizing on expertise, large and dedicated teams, and focused scope. We highlight the benefits of multifaceted knowledge dissemination through multiple formats to ensure global dissemination and in order to maximize impact.
    MeSH term(s) COVID-19 ; Humans ; Hydroxychloroquine ; Lopinavir ; Pandemics ; SARS-CoV-2
    Chemical Substances Lopinavir (2494G1JF75) ; Hydroxychloroquine (4QWG6N8QKH)
    Language English
    Publishing date 2021-07-07
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000858
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  9. Article ; Online: Machine learning-based modeling of acute respiratory failure following emergency general surgery operations.

    Hadaya, Joseph / Verma, Arjun / Sanaiha, Yas / Ramezani, Ramin / Qadir, Nida / Benharash, Peyman

    PloS one

    2022  Volume 17, Issue 4, Page(s) e0267733

    Abstract: Background: Emergency general surgery (EGS) operations are associated with substantial risk of morbidity including postoperative respiratory failure (PRF). While existing risk models are not widely utilized and rely on traditional statistical methods, ... ...

    Abstract Background: Emergency general surgery (EGS) operations are associated with substantial risk of morbidity including postoperative respiratory failure (PRF). While existing risk models are not widely utilized and rely on traditional statistical methods, application of machine learning (ML) in prediction of PRF following EGS remains unexplored.
    Objective: The present study aimed to develop ML-based prediction models for respiratory failure following EGS and compare their performance to traditional regression models using a nationally-representative cohort.
    Methods: Non-elective hospitalizations for EGS (appendectomy, cholecystectomy, repair of perforated ulcer, large or small bowel resection, lysis of adhesions) were identified in the 2016-18 Nationwide Readmissions Database. Factors associated with PRF were identified using ML techniques and logistic regression. The performance of XGBoost and logistic regression was evaluated using the receiver operating characteristic curve and coefficient of determination (R2). The impact of PRF on mortality, length of stay (LOS) and hospitalization costs was secondarily assessed using generalized linear models.
    Results: Of 1,003,703 hospitalizations, 8.8% developed PRF. The XGBoost model exhibited slightly superior discrimination compared to logistic regression (0.900, 95% CI 0.899-0.901 vs 0.894, 95% CI 0.862-0.896). Compared to logistic regression, XGBoost demonstrated excellent calibration across all risk levels (R2: 0.998 vs 0.962). Congestive heart failure, neurologic disorders, and coagulopathy were significantly associated with increased risk of PRF. After risk-adjustment, PRF was associated with 10-fold greater odds (95% confidence interval (CI) 9.8-11.1) of mortality and incremental increases in LOS by 3.1 days (95% CI 3.0-3.2) and $11,900 (95% CI 11,600-12,300) in costs.
    Conclusions: Logistic regression and XGBoost perform similarly in overall classification of PRF risk. However, due to superior calibration at extremes of risk, ML-based models may prove more useful in the clinical setting, where probabilities rather than classifications are desired.
    MeSH term(s) Humans ; Logistic Models ; Machine Learning ; ROC Curve ; Respiratory Distress Syndrome ; Respiratory Insufficiency
    Language English
    Publishing date 2022-04-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0267733
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  10. Article: Cardiac Conduction Defects in Systemic Lupus Erythematosus.

    Butt, Shayan / Kiran, Simra / Qadir, Nida / Menghani, Divya / Tanzeem, Hammad

    Cureus

    2020  Volume 12, Issue 10, Page(s) e10882

    Abstract: Systemic autoimmune conditions may cause morbidity and mortality. Systemic lupus erythematosus (SLE) is a prominent example of such diseases. It can result in conduction abnormalities due to accelerated atherosclerosis, vasculitis, or autoantibodies- ... ...

    Abstract Systemic autoimmune conditions may cause morbidity and mortality. Systemic lupus erythematosus (SLE) is a prominent example of such diseases. It can result in conduction abnormalities due to accelerated atherosclerosis, vasculitis, or autoantibodies-induced myocarditis. Cardiac conduction abnormalities may produce sinus tachycardia, sinus bradycardia, prolonged QT intervals, atrial fibrillation, or atrioventricular (AV) nodal blocks. Neonatal lupus is sometimes associated with anti-Ro/SSA and anti-La/SSB antibodies, but their role remains a matter of controversy in adults.
    Language English
    Publishing date 2020-10-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.10882
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