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  1. Article ; Online: Paxlovid with Caution: Novel Case of Paxlovid-Induced Tacrolimus Toxicity in a Cardiac Transplant Patient.

    Shah, Aaisha / Nasrullah, Adeel / Butt, Muhammad Ali / Young, Meilin

    European journal of case reports in internal medicine

    2022  Volume 9, Issue 9, Page(s) 3528

    Abstract: Tacrolimus is commonly used as a prophylactic against acute rejection in transplant patients. Tacrolimus toxicity has numerous presentations that have been well documented in the literature and can be induced by a wide variety of agents. We present a ... ...

    Abstract Tacrolimus is commonly used as a prophylactic against acute rejection in transplant patients. Tacrolimus toxicity has numerous presentations that have been well documented in the literature and can be induced by a wide variety of agents. We present a novel case of tacrolimus toxicity in a cardiac transplant patient induced by outpatient treatment for COVID-19 pneumonia with ritonavir-nirmatrelvir, which was successfully treated with phenytoin therapy.
    Learning points: Ritonavir-nirmatrelvir is a newly approved antiviral therapy for COVID-19 to prevent hospitalization and is increasingly prescribed in the outpatient setting.Thorough assessment of drug interactions prior to starting ritonavir-nirmatrelvir can prevent tacrolimus toxicity in patients with solid organ transplants.Phenytoin increases the metabolism of tacrolimus and can be safely utilized to treat tacrolimus toxicity.
    Language English
    Publishing date 2022-09-16
    Publishing country Italy
    Document type Journal Article
    ISSN 2284-2594
    ISSN (online) 2284-2594
    DOI 10.12890/2022_003528
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  2. Article ; Online: Effects of pulmonary rehabilitation on functional and psychological parameters in post-acute sequelae of SARS-CoV-2 infection (PASC) patients.

    Nasrullah, Adeel / Virk, Shiza / Javed, Anam / Shah, Aaisha / Ramanujam, Deeksha / Sharma, Alisha / Gutierrez, Laura / Nauer, Kevin / Maggio, Mindy / Yin, Yue / Bajwa, Yousaf / Cheema, Tariq / Disilvio, Briana

    BMC pulmonary medicine

    2024  Volume 24, Issue 1, Page(s) 231

    Abstract: Background: COVID-19 survivors may develop long-term symptoms of fatigue, dyspnea, mental health issues, and functional limitations: a condition termed post-acute sequelae of COVID-19 (PASC). Pulmonary rehabilitation (PR) is a recommended treatment for ... ...

    Abstract Background: COVID-19 survivors may develop long-term symptoms of fatigue, dyspnea, mental health issues, and functional limitations: a condition termed post-acute sequelae of COVID-19 (PASC). Pulmonary rehabilitation (PR) is a recommended treatment for PASC; however, there is a lack of data regarding PR's effect on multiple health indices and the factors that influence patient outcomes. The aim of our study is to evaluate the impact of pulmonary rehabilitation on functional and psychological parameters in patients diagnosed with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), thereby offering insights into the efficacy of such interventions in improving the quality of life and clinical outcomes for these individuals.
    Methods: We extracted patient demographic, comorbidity, and outcome data from Allegheny Health Network's electronic medical records. Functionality test results were compared before and after PR, including 6-minute walk test (6MWT), chair rise repetitions (CR reps), timed up and go test (TUG), gait speed (Rehab gait), modified medical research council scale (MMRC), shortness of breath questionnaire (SOBQ), hospital anxiety and depression scale (HADS) and chronic obstructive pulmonary disease assessment test (CAT) scores. Multiple regression analysis was done to evaluate the effect of comorbidities and patient factors on patient responses to PR.
    Results: The 55 patients included in this study had a mean time of 4 months between the initial COVID-19 diagnosis and the subsequent PASC diagnosis. Following pulmonary rehabilitation (PR), significant improvements were observed across various metrics. The distance covered in the 6-minute walk test (6MWT) increased markedly from a pre-rehabilitation average of 895 feet (SD 290) to 1,300 feet (SD 335) post-rehabilitation, with a mean change of 405 feet (95% CI [333, 477]). Chair rise repetitions (CR reps) saw an increase from 9 (SD 3) reps to 13 (SD 3) reps, with a change of 4 reps (95% CI [3.7, 4.9]). The timed up and go test (TUG) time decreased significantly from 13 s (SD 5) to 10 s (SD 2), reflecting a mean reduction of 3 s (95% CI [-4.5, -2.5]). Rehabilitation gait speed improved from 1.0 m/s to 1.3 m/s, changing by 0.3 m/s (95% CI [0.2, 0.3]). The Modified Medical Research Council (MMRC) dyspnea scale showed a notable decrease from a mean of 2 (SD 1) to 1 (SD 1), a change of -1 (95% CI [-1.5, -1]). The Shortness of Breath Questionnaire (SOBQ) scores reduced significantly from 51 (SD 21) to 22 (SD 18), with a change of -29 (95% CI [-34, -23]). The Hospital Anxiety and Depression Scale (HADS) scores decreased from 11 (SD 7) to 8 (SD 7), a reduction of -4 (95% CI [-5, -2]). Lastly, the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) scores significantly dropped from 18 (SD 7) to 9 (SD 7), changing by -10 (95% CI [-11, -8]). However, the presence of hypertension, diabetes, chronic lung diseases, outpatient status, and receipt of specific pharmacologic treatments (decadron, decadron + remdesivir, and decadron + remdesivir + tocilizumab) were identified as factors associated with a poor response to PR.
    Conclusion: Our study supports PR as an integrated model of care for PASC patients to improve several physical and mental health indices. The long-term effects of PR on patients' functional status should be investigated in the future.
    MeSH term(s) Humans ; COVID-19/rehabilitation ; COVID-19/psychology ; COVID-19/complications ; Male ; Female ; Middle Aged ; Post-Acute COVID-19 Syndrome ; Quality of Life ; Aged ; SARS-CoV-2 ; Walk Test ; Dyspnea/etiology ; Dyspnea/rehabilitation ; Dyspnea/psychology ; Dyspnea/physiopathology ; Retrospective Studies
    Language English
    Publishing date 2024-05-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059871-3
    ISSN 1471-2466 ; 1471-2466
    ISSN (online) 1471-2466
    ISSN 1471-2466
    DOI 10.1186/s12890-024-03047-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Acute Respiratory Distress Syndrome and the Use of Inhaled Pulmonary Vasodilators in the COVID-19 Era: A Narrative Review.

    Nasrullah, Adeel / Virk, Shiza / Shah, Aaisha / Jacobs, Max / Hamza, Amina / Sheikh, Abu Baker / Javed, Anam / Butt, Muhammad Ali / Sangli, Swathi

    Life (Basel, Switzerland)

    2022  Volume 12, Issue 11

    Abstract: The Coronavirus disease (COVID-19) pandemic of 2019 has resulted in significant morbidity and mortality, especially from severe acute respiratory distress syndrome (ARDS). As of September 2022, more than 6.5 million patients have died globally, and up to ...

    Abstract The Coronavirus disease (COVID-19) pandemic of 2019 has resulted in significant morbidity and mortality, especially from severe acute respiratory distress syndrome (ARDS). As of September 2022, more than 6.5 million patients have died globally, and up to 5% required intensive care unit treatment. COVID-19-associated ARDS (CARDS) differs from the typical ARDS due to distinct pathology involving the pulmonary vasculature endothelium, resulting in diffuse thrombi in the pulmonary circulation and impaired gas exchange. The National Institute of Health and the Society of Critical Care Medicine recommend lung-protective ventilation, prone ventilation, and neuromuscular blockade as needed. Further, a trial of pulmonary vasodilators is suggested for those who develop refractory hypoxemia. A review of the prior literature on inhaled pulmonary vasodilators in ARDS suggests only a transient improvement in oxygenation, with no mortality benefit. This narrative review aims to highlight the fundamental principles in ARDS management, delineate the fundamental differences between CARDS and ARDS, and describe the comprehensive use of inhaled pulmonary vasodilators. In addition, with the differing pathophysiology of CARDS from the typical ARDS, we sought to evaluate the current evidence regarding the use of inhaled pulmonary vasodilators in CARDS.
    Language English
    Publishing date 2022-11-02
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life12111766
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  4. Article ; Online: Comparing Clinical Outcomes of COVID-19 and Influenza-Induced Acute Respiratory Distress Syndrome: A Propensity-Matched Analysis.

    Virk, Shiza / Quazi, Mohammed A / Nasrullah, Adeel / Shah, Aaisha / Kudron, Evan / Chourasia, Prabal / Javed, Anam / Jain, Priyanka / Gangu, Karthik / Cheema, Tariq / DiSilvio, Briana / Sheikh, Abu Baker

    Viruses

    2023  Volume 15, Issue 4

    Abstract: Acute respiratory distress syndrome (ARDS) is one the leading causes of mortality and morbidity in patients with COVID-19 and Influenza, with only small number of studies comparing these two viral illnesses in the setting of ARDS. Given the pathogenic ... ...

    Abstract Acute respiratory distress syndrome (ARDS) is one the leading causes of mortality and morbidity in patients with COVID-19 and Influenza, with only small number of studies comparing these two viral illnesses in the setting of ARDS. Given the pathogenic differences in the two viruses, this study shows trends in national hospitalization and outcomes associated with COVID-19- and Influenza-related ARDS. To evaluate and compare the risk factors and rates of the adverse clinical outcomes in patients with COVID-19 associated ARDS (C-ARDS) relative to Influenza-related ARDS (I-ARDS), we utilized the National Inpatient Sample (NIS) database 2020. Our sample includes 106,720 patients hospitalized with either C-ARDS or I-ARDS between January and December 2020, of which 103,845 (97.3%) had C-ARDS and 2875 (2.7%) had I-ARDS. Propensity-matched analysis demonstrated a significantly higher in-hospital mortality (aOR 3.2, 95% CI 2.5-4.2,
    MeSH term(s) Humans ; COVID-19/complications ; COVID-19/therapy ; Influenza, Human/complications ; Influenza, Human/epidemiology ; Influenza, Human/therapy ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/therapy ; Respiration, Artificial ; Morbidity
    Language English
    Publishing date 2023-04-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2516098-9
    ISSN 1999-4915 ; 1999-4915
    ISSN (online) 1999-4915
    ISSN 1999-4915
    DOI 10.3390/v15040922
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  5. Article: Impact of COVID-19 on Pregnancy Outcomes across Trimesters in the United States.

    Virk, Shiza / Gangu, Karthik / Nasrullah, Adeel / Shah, Aaisha / Faiz, Zohaa / Khan, Umair / Jackson, David Bradley / Javed, Anam / Farooq, Asif / DiSilvio, Briana / Cheema, Tariq / Sheikh, Abu Baker

    Biomedicines

    2023  Volume 11, Issue 11

    Abstract: Background: Current knowledge regarding the association between trimester-specific changes during pregnancy and COVID-19 infection is limited. We utilized the National Inpatient Sample (NIS) database to investigate trimester-specific outcomes among ... ...

    Abstract Background: Current knowledge regarding the association between trimester-specific changes during pregnancy and COVID-19 infection is limited. We utilized the National Inpatient Sample (NIS) database to investigate trimester-specific outcomes among hospitalized pregnant women diagnosed with COVID-19.
    Results: Out of 3,447,771 pregnant women identified, those with COVID-19 exhibited higher in-hospital mortality rates in their third trimester compared with those without the virus. Notably, rates of mechanical ventilation, acute kidney injury, renal replacement therapy, and perinatal complications (preeclampsia, HELLP syndrome, and preterm birth) were significantly elevated across all trimesters for COVID-19 patients. COVID-19 was found to be more prevalent among low-income, Hispanic pregnant women.
    Conclusions: Our findings suggest that COVID-19 during pregnancy is associated with increased risk of maternal mortality and complications, particularly in the third trimester. Furthermore, we observed significant racial and socioeconomic disparities in both COVID-19 prevalence and pregnancy outcomes. These findings emphasize the need for equitable healthcare strategies to improve care for diverse and socioeconomically marginalized groups, ultimately aiming to reduce adverse COVID-19-associated maternal and fetal outcomes.
    Language English
    Publishing date 2023-10-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines11112886
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  6. Article ; Online: Hypertension in Women and Pregnancy.

    Shah, Aaisha / Kapcin, Kyle / Deicke, Matthew / Pappan, Nikos / Holden, Kyle / Routray, Sujit Kumar / Schmetzer, Amy / DuMont, Tiffany / Nashar, Khaled / Bajwa, Omer / Ivanova, Valentyna

    Critical care nursing quarterly

    2023  Volume 46, Issue 4, Page(s) 377–390

    Abstract: Hypertension has been shown to have long-term cardiovascular effects if left untreated. Hypertension also has been shown to affect women during pregnancy, which can be detrimental not only to the patient but also to the fetus. Early identification and ... ...

    Abstract Hypertension has been shown to have long-term cardiovascular effects if left untreated. Hypertension also has been shown to affect women during pregnancy, which can be detrimental not only to the patient but also to the fetus. Early identification and treatment are paramount to prevent adverse outcomes. This article details the epidemiology, clinical presentation, diagnosis, and treatment of essential hypertension in women, gestational hypertension, preeclampsia, and eclampsia.
    MeSH term(s) Pregnancy ; Female ; Humans ; Hypertension ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/epidemiology ; Pre-Eclampsia/therapy ; Hypertension, Pregnancy-Induced/diagnosis ; Hypertension, Pregnancy-Induced/epidemiology ; Hypertension, Pregnancy-Induced/therapy
    Language English
    Publishing date 2023-09-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639095-x
    ISSN 1550-5111 ; 0887-9303
    ISSN (online) 1550-5111
    ISSN 0887-9303
    DOI 10.1097/CNQ.0000000000000480
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  7. Article ; Online: Gender differences in pulmonology and critical care authorship and editorial boards.

    Nasrullah, Adeel / Sharma, Alisha / Hamza, Amina / Ramanujam, Deeksha / Shah, Sana / Virk, Shiza / Shah, Aaisha / Javed, Anam / Garg, Ishan / Saa, Lisa / Verma, Akanksha / Faturous, Andrew / Assaf, Sara / DiSilvio, Briana / Sheikh, Abu Baker

    Current medical research and opinion

    2023  Volume 39, Issue 3, Page(s) 375–381

    Abstract: Objective: This study aims to characterize the gender distribution of first authors, senior authors, and editorial board members across several high-impact factor journals in PCCM.: Methods: In this cross-sectional study, we analysed gender ... ...

    Abstract Objective: This study aims to characterize the gender distribution of first authors, senior authors, and editorial board members across several high-impact factor journals in PCCM.
    Methods: In this cross-sectional study, we analysed gender disparities in critical care authorship and editorial boards, based on publications from 1 January 2019 to 31 December 2021 from the top 20 high impact journals based on the Journal of Citation Reports.
    Results: Among 20 journals (median impact factor of 6.66), 25% of editors-in-chief and 28.8% of editorial board members were female. From 2019 to 2021, a total of 23,994 articles were published. Female first authors and last authors made up 29.1% and 21.2% of the authorship, respectively (
    Conclusions: Our study demonstrates significant gender disparities in critical care authorship and editorial boards, with males predominantly filling the roles of editors in chief, editorial members, and first and senior authors. Despite this significant difference in gender distribution, there was no statistically significant correlation between authorship and editor gender.
    MeSH term(s) Humans ; Authorship ; Pulmonary Medicine ; Critical Care ; Publishing ; Periodicals as Topic ; Diversity, Equity, Inclusion ; Gender Equity ; Leadership
    Language English
    Publishing date 2023-02-03
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80296-7
    ISSN 1473-4877 ; 0300-7995
    ISSN (online) 1473-4877
    ISSN 0300-7995
    DOI 10.1080/03007995.2023.2174329
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