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Advanced Lung Disease

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David A. Leiman – One of the best experts on this subject based on the ideXlab platform.

  • Correction to: Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher, David A. Leiman
    Abstract:

    The original version of this article unfortunately contained a mistake. The shared first authorship information was missing in the published article. It has been given below. The first authorship is shared between Dr. Shai Posner and Kurren Mehta.

  • Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher, David A. Leiman
    Abstract:

    Gastroesophageal reflux Disease and esophageal dysmotility are common in patients with Advanced Lung Disease (ALD) and are associated with worse outcomes. Assessing esophageal function in these patients is relevant for determining pulmonary transplant eligibility and prognosticating post-transplant outcomes. Barium Swallow (BaS) is a non-invasive testing modality often performed as a complement to formal esophageal function tests (EFTs), but its role and clinical utility in this context is unknown. Therefore, we aimed to determine the relationship between BaS and EFTs with high-resolution manometry (HRM) and 24-h ambulatory pH-metry in patients with ALD. We performed a retrospective study of 226 consecutive patients undergoing evaluation for Lung transplantation at a single center. All patients underwent EFTs and BaS independent of clinical history or symptoms per institutional protocol. Appropriate statistical tests were performed to evaluate the relationship between EFTs and BaS. Mucosal, reflux and motility findings were categorized. Abnormal motility was reported in 133 (59%) patients by BaS and 99 (44%) by HRM, with a significant difference in the proportions of patients with abnormal studies ( p  

  • esophageal function tests are not associated with barium swallow findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, David A. Leiman, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher
    Abstract:

    Gastroesophageal reflux Disease and esophageal dysmotility are common in patients with Advanced Lung Disease (ALD) and are associated with worse outcomes. Assessing esophageal function in these patients is relevant for determining pulmonary transplant eligibility and prognosticating post-transplant outcomes. Barium Swallow (BaS) is a non-invasive testing modality often performed as a complement to formal esophageal function tests (EFTs), but its role and clinical utility in this context is unknown. Therefore, we aimed to determine the relationship between BaS and EFTs with high-resolution manometry (HRM) and 24-h ambulatory pH-metry in patients with ALD. We performed a retrospective study of 226 consecutive patients undergoing evaluation for Lung transplantation at a single center. All patients underwent EFTs and BaS independent of clinical history or symptoms per institutional protocol. Appropriate statistical tests were performed to evaluate the relationship between EFTs and BaS. Mucosal, reflux and motility findings were categorized. Abnormal motility was reported in 133 (59%) patients by BaS and 99 (44%) by HRM, with a significant difference in the proportions of patients with abnormal studies (p < 0.01). There were 7 (26%) patients with abnormal barium tablet passage who had normal HRM. The sensitivity (35%) and specificity (77%) for detecting pathologic reflux with BaS was poor. Inducibility of reflux and barium column height were not associated with pH-metry results. No clinically significant luminal irregularities were identified. In conclusion, while BaS can non-invasively assess esophageal mucosa, its findings are not associated with EFTs in patients with ALD.

Steven D. Nathan – One of the best experts on this subject based on the ideXlab platform.

  • Lung transplantation in IIP: A review.
    Respirology (Carlton Vic.), 2015
    Co-Authors: A. Whitney Brown, Hatice Kaya, Steven D. Nathan
    Abstract:

    The idiopathic interstitial pneumonias (IIP) encompass a large and diverse subtype of interstitial Lung Disease (ILD) with idiopathic pulmpulmonary fibrfibrosis (IPF) and non-specific interstitial pneumonia (NSIP) being the most common types. Although pharmacologic treatments are available for most types of IIP, many patients progress to Advanced Lung Disease and require Lung transplantation. Close monitoring with serial functional and radiographic tests for Disease progression coupled with early referral for Lung transplantation are of great importance in the management of patients with IIP. Both single and bilateral Lung transplantation are acceptable procedures for IIP. Procedure selection is a complex decision influenced by multiple factors related to patient, donor and transplant centre. While single Lung transplant may reduce waitlist time and mortality, the long-term outcomes after bilateral Lung transplantation may be slightly superior. There are numerous complications following Lung transplantation including primary graft dysfunction, chronic Lung allograft dysfunction (CLAD), infections, gastroesophageal reflux Disease (GERD) and airway Disease that limit post-transplant longevity. The median survival after Lung transplantation is 4.7 years in patients with ILD, which is less than in patients with other underlying Lung Diseases. Although long-term survival is limited, this intervention still conveys a survival benefit and improved quality of life in suitable IIP patients with Advanced Lung Disease and chronic hypoxemic respiratory failure.

  • Disease-Specific Considerations for Referral
    , 2015
    Co-Authors: Steven D. Nathan
    Abstract:

    The timing of the referral and listing of patients for Lung transplantation remains a difficult decision. Life expectancy and quality of life with and without transplantation are the pivotal issues that need to be considered by physicians and presented to prospective transplant candidates. The recognition of recent advances in the understanding of the various primary Diseases, other potential therapies, and the latest posttransplant statistics are essential for a balanced discussion or decision about Lung transplantation. This article provides a review of these and other pertinent issues for patients with various forms of Advanced Lung Disease. (CHEST 2005; 127:1006–1016)

  • Pulmonary hypertension due to Lung Disease and/or hypoxia.
    Clinics in chest medicine, 2013
    Co-Authors: Steven D. Nathan, Paul M. Hassoun
    Abstract:

    Pulmonary hypertension may complicate the course of patients with many forms of Advanced Lung Disease. The cause is likely multifactorial with pathogenic pathways both common and unique to the specific Disease entities. The occurrence of pulmonary hypertension is associated with worse outcomes, but whether this is an adaptive or maladaptive phenomenon remains unknown. The treatment of pulmonary hypertension with vasoactive medications in Lung Disease remains unproved. Specific Disease phenotypes that might benefit, and those in which such therapies might be deleterious, remain to be determined.

Don Hayes – One of the best experts on this subject based on the ideXlab platform.

Shai Posner – One of the best experts on this subject based on the ideXlab platform.

  • Correction to: Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher, David A. Leiman
    Abstract:

    The original version of this article unfortunately contained a mistake. The shared first authorship information was missing in the published article. It has been given below. The first authorship is shared between Dr. Shai Posner and Kurren Mehta.

  • Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher, David A. Leiman
    Abstract:

    Gastroesophageal reflux Disease and esophageal dysmotility are common in patients with Advanced Lung Disease (ALD) and are associated with worse outcomes. Assessing esophageal function in these patients is relevant for determining pulmonary transplant eligibility and prognosticating post-transplant outcomes. Barium Swallow (BaS) is a non-invasive testing modality often performed as a complement to formal esophageal function tests (EFTs), but its role and clinical utility in this context is unknown. Therefore, we aimed to determine the relationship between BaS and EFTs with high-resolution manometry (HRM) and 24-h ambulatory pH-metry in patients with ALD. We performed a retrospective study of 226 consecutive patients undergoing evaluation for Lung transplantation at a single center. All patients underwent EFTs and BaS independent of clinical history or symptoms per institutional protocol. Appropriate statistical tests were performed to evaluate the relationship between EFTs and BaS. Mucosal, reflux and motility findings were categorized. Abnormal motility was reported in 133 (59%) patients by BaS and 99 (44%) by HRM, with a significant difference in the proportions of patients with abnormal studies ( p  

  • esophageal function tests are not associated with barium swallow findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, David A. Leiman, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher
    Abstract:

    Gastroesophageal reflux Disease and esophageal dysmotility are common in patients with Advanced Lung Disease (ALD) and are associated with worse outcomes. Assessing esophageal function in these patients is relevant for determining pulmonary transplant eligibility and prognosticating post-transplant outcomes. Barium Swallow (BaS) is a non-invasive testing modality often performed as a complement to formal esophageal function tests (EFTs), but its role and clinical utility in this context is unknown. Therefore, we aimed to determine the relationship between BaS and EFTs with high-resolution manometry (HRM) and 24-h ambulatory pH-metry in patients with ALD. We performed a retrospective study of 226 consecutive patients undergoing evaluation for Lung transplantation at a single center. All patients underwent EFTs and BaS independent of clinical history or symptoms per institutional protocol. Appropriate statistical tests were performed to evaluate the relationship between EFTs and BaS. Mucosal, reflux and motility findings were categorized. Abnormal motility was reported in 133 (59%) patients by BaS and 99 (44%) by HRM, with a significant difference in the proportions of patients with abnormal studies (p < 0.01). There were 7 (26%) patients with abnormal barium tablet passage who had normal HRM. The sensitivity (35%) and specificity (77%) for detecting pathologic reflux with BaS was poor. Inducibility of reflux and barium column height were not associated with pH-metry results. No clinically significant luminal irregularities were identified. In conclusion, while BaS can non-invasively assess esophageal mucosa, its findings are not associated with EFTs in patients with ALD.

Deborah A. Fisher – One of the best experts on this subject based on the ideXlab platform.

  • Correction to: Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher, David A. Leiman
    Abstract:

    The original version of this article unfortunately contained a mistake. The shared first authorship information was missing in the published article. It has been given below. The first authorship is shared between Dr. Shai Posner and Kurren Mehta.

  • Esophageal Function Tests are Not Associated with Barium Swallow Findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher, David A. Leiman
    Abstract:

    Gastroesophageal reflux Disease and esophageal dysmotility are common in patients with Advanced Lung Disease (ALD) and are associated with worse outcomes. Assessing esophageal function in these patients is relevant for determining pulmonary transplant eligibility and prognosticating post-transplant outcomes. Barium Swallow (BaS) is a non-invasive testing modality often performed as a complement to formal esophageal function tests (EFTs), but its role and clinical utility in this context is unknown. Therefore, we aimed to determine the relationship between BaS and EFTs with high-resolution manometry (HRM) and 24-h ambulatory pH-metry in patients with ALD. We performed a retrospective study of 226 consecutive patients undergoing evaluation for Lung transplantation at a single center. All patients underwent EFTs and BaS independent of clinical history or symptoms per institutional protocol. Appropriate statistical tests were performed to evaluate the relationship between EFTs and BaS. Mucosal, reflux and motility findings were categorized. Abnormal motility was reported in 133 (59%) patients by BaS and 99 (44%) by HRM, with a significant difference in the proportions of patients with abnormal studies ( p  

  • esophageal function tests are not associated with barium swallow findings in Advanced Lung Disease
    Dysphagia, 2020
    Co-Authors: Shai Posner, David A. Leiman, Kurren Mehta, Alice Parish, Donna Niedzwiecki, Rajan T. Gupta, Deborah A. Fisher
    Abstract:

    Gastroesophageal reflux Disease and esophageal dysmotility are common in patients with Advanced Lung Disease (ALD) and are associated with worse outcomes. Assessing esophageal function in these patients is relevant for determining pulmonary transplant eligibility and prognosticating post-transplant outcomes. Barium Swallow (BaS) is a non-invasive testing modality often performed as a complement to formal esophageal function tests (EFTs), but its role and clinical utility in this context is unknown. Therefore, we aimed to determine the relationship between BaS and EFTs with high-resolution manometry (HRM) and 24-h ambulatory pH-metry in patients with ALD. We performed a retrospective study of 226 consecutive patients undergoing evaluation for Lung transplantation at a single center. All patients underwent EFTs and BaS independent of clinical history or symptoms per institutional protocol. Appropriate statistical tests were performed to evaluate the relationship between EFTs and BaS. Mucosal, reflux and motility findings were categorized. Abnormal motility was reported in 133 (59%) patients by BaS and 99 (44%) by HRM, with a significant difference in the proportions of patients with abnormal studies (p < 0.01). There were 7 (26%) patients with abnormal barium tablet passage who had normal HRM. The sensitivity (35%) and specificity (77%) for detecting pathologic reflux with BaS was poor. Inducibility of reflux and barium column height were not associated with pH-metry results. No clinically significant luminal irregularities were identified. In conclusion, while BaS can non-invasively assess esophageal mucosa, its findings are not associated with EFTs in patients with ALD.