Samir Sultan - Academia.edu (original) (raw)
Papers by Samir Sultan
The Annals of Thoracic Surgery, 2021
Critical Care Explorations, 2020
Translational Lung Cancer Research, 2021
Journal of the American College of Cardiology
Respiratory Medicine Case Reports
Patients under consideration for lung transplantation as treatment for end-stage lung diseases su... more Patients under consideration for lung transplantation as treatment for end-stage lung diseases such as idiopathic pulmonary fibrosis (IPF) often have risk factors such as a history of smoking or concomitant emphysema, both of which can predispose the patient to lung cancer. In fact, IPF itself increases the risk of lung cancer development by 6.8% to 20%. Solid organ malignancy (non-skin) is an established contraindication for lung transplantation. We encountered a clinical dilemma in a patient who presented with an IPF flare-up and underwent urgent evaluation for lung transplantation. After transplant, the patient's explanted lungs showed extensive adenocarcinoma , with the foci of invasion and metastatic adenocarcinoma in N1-level lymph nodes, as well as usual interstitial pneumonia. Retrospectively, we saw no evidence to suggest malignancy in addition to the IPF flare-up. Clinical diagnostic dilemmas such as this emphasize the need for new noninvasive testing that would facilitate malignancy diagnosis in patients too sick to undergo invasive tissue biopsy for diagnosis. Careful pathological examination of explanted lungs in patients with IPF is critical, as it can majorly influence immunosuppressive regimens, surveillance imaging, and overall prognosis after lung transplant.
Heart failure clinics, 2018
Diffuse pulmonary lung disease and chronic obstructive pulmonary disease is a heterogeneous popul... more Diffuse pulmonary lung disease and chronic obstructive pulmonary disease is a heterogeneous population that can manifest pulmonary hypertension. These subgroups are classified as primarily World Health Organization group 3. Available data suggest that the impact of pulmonary hypertension targeted therapy in diffuse pulmonary lung disease and chronic obstructive pulmonary disease is limited and survival is poor despite attempted treatment.
Southwest Journal of Pulmonary and Critical Care
Journal of the American College of Cardiology, 2017
Southwest Journal of Pulmonary and Critical Care, 2016
Southwest Journal of Pulmonary and Critical Care, 2016
Southwest Journal of Pulmonary and Critical Care, 2015
Southwest Journal of Pulmonary and Critical Care, 2015
Journal of thoracic disease, 2013
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction ... more Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that can lead to lung destruction and dyspnea. Although there has been a slight reduction in mortality in recent decades, COPD is still a serious health problem that has enormous costs and utilizes significant medical resources. There have been a number of pharmacologic interventions that have been developed for the treatment of COPD. Current guidelines recommend the use of long-acting bronchodilators for the treatment of moderate and severe stage COPD, since they have been shown to improve lung function, respiratory symptoms, and quality of life. Indacaterol is a once-daily beta2-agonist (β2-agonist) delivered by a single-dose dry powder inhaler used for the treatment of COPD. It is currently approved at a dose of 75 μg in the United States and a dose of 150 μg with a maximal dose of 300 μg in Europe and other countries. Several studies show that indacaterol was statistically superior t...
Southwest Journal of Pulmonary and Critical Care, 2015
CHEST Journal, 2014
ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON:... more ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Falciparum Malaria is associated with transient immunosuppression resulting in disseminated fungal infections like aspergillosis. Ineffective phagocyotosis by alveolar macrophages was implicated as the pathogenetic mechanism leading to disseminated fungal infections. So far 4 cases were reported in the literature of severe falciparum malaria associated with disseminated aspergillosis. We present the first documented case of malaria observed in different stages on bronchoalveolar lavage with underlying disseminated aspergillosis. 55 years old Sudanese male admitted to our hospital ICU intubated and in shock state. Patient returned from Sudan three weeks ago prior to his presentation. The past medical/surgical history was notable for splenectomy for hypersplenism, but no history of an immunocompromised state. Diagnosis at the time of admission was severe falciparum malaria with multi organ failure. Aggressive supportive care along with malaria specific therapy was initiated. The parasite load decreased from 19.6% on admission to 1% after implementation of exchange transfusion. Patient then developed profuse endobronchial hemorrhage with clots needing therapeutic bronchoscope and dislodgement of the clots. Broncho alveolar lavage done was sent for analysis. After initiation of malaria treatment, patient showed clinical improvement, but continued to have hemoptysis needing repeated bronchoscopies and bronchial artery embolization. His clinical condition worsened necessitating escalation of antimicrobial regimen. At that point, serological studies were sent for Aspergillus Fumigatus. On day 10 of his arrival to the hospital he passed away despite aggressive treatments. Autopsy revealed disseminated Aspergillus Fumigatus to multiple organs which included lung, heart, liver, small bowel. This case presents a unique challenge to health care providers as his presentation was life threatening malaria but his eventual cause of death seemed to be disseminated Aspergillosis. As with other previously reported cases, his underlying disseminated aspergillosis became clinically apparent after the treatment of malaria. Severe malaria infections can lead to other life threatening fungal infections leading to fatality. High index of clinical suspicion with broad anti microbial coverage should be the treatment approach in dealing with cases of severe malaria.Reference #1: Isabella Eckerlie, Damaris Ebinger, Gotthardt, R.Eberhardt et all.Invasive Aspergillosis fumigatus infection after plasmodium Falciparum malaria in an Immuno competent host: Case report and review of literature. Malaria Journal 2009, 8:167.Reference #2: Hocqueloux L, Bruneel F, Pages CL, Vachon F. Fatal Invasive Aspergillosis complicating Severe Plasmodium Falciparum Malaria.Clinical infectious disease 200 Jun: 30(6): 940-2.Reference #3: Ruhnke M, Eichenauer E, Searle J, Lippek F. Fulminant tracheo bronchial and pulmonary aspergillosis complicating imported plasmodium malaria in an apparently immunocompetent woman. Clinical infectious disease Jun: 30(6) 938-40. The following authors have nothing to disclose: Suresh UppalapuNo Product/Research Disclosure Information.
CHEST Journal, 2014
ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON:... more ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Falciparum Malaria is associated with transient immunosuppression resulting in disseminated fungal infections like aspergillosis. Ineffective phagocyotosis by alveolar macrophages was implicated as the pathogenetic mechanism leading to disseminated fungal infections. So far 4 cases were reported in the literature of severe falciparum malaria associated with disseminated aspergillosis. We present the first documented case of malaria observed in different stages on bronchoalveolar lavage with underlying disseminated aspergillosis. 55 years old Sudanese male admitted to our hospital ICU intubated and in shock state. Patient returned from Sudan three weeks ago prior to his presentation. The past medical/surgical history was notable for splenectomy for hypersplenism, but no history of an immunocompromised state. Diagnosis at the time of admission was severe falciparum malaria with multi organ failure. Aggressive supportive care along with malaria specific therapy was initiated. The parasite load decreased from 19.6% on admission to 1% after implementation of exchange transfusion. Patient then developed profuse endobronchial hemorrhage with clots needing therapeutic bronchoscope and dislodgement of the clots. Broncho alveolar lavage done was sent for analysis. After initiation of malaria treatment, patient showed clinical improvement, but continued to have hemoptysis needing repeated bronchoscopies and bronchial artery embolization. His clinical condition worsened necessitating escalation of antimicrobial regimen. At that point, serological studies were sent for Aspergillus Fumigatus. On day 10 of his arrival to the hospital he passed away despite aggressive treatments. Autopsy revealed disseminated Aspergillus Fumigatus to multiple organs which included lung, heart, liver, small bowel. This case presents a unique challenge to health care providers as his presentation was life threatening malaria but his eventual cause of death seemed to be disseminated Aspergillosis. As with other previously reported cases, his underlying disseminated aspergillosis became clinically apparent after the treatment of malaria. Severe malaria infections can lead to other life threatening fungal infections leading to fatality. High index of clinical suspicion with broad anti microbial coverage should be the treatment approach in dealing with cases of severe malaria.Reference #1: Isabella Eckerlie, Damaris Ebinger, Gotthardt, R.Eberhardt et all.Invasive Aspergillosis fumigatus infection after plasmodium Falciparum malaria in an Immuno competent host: Case report and review of literature. Malaria Journal 2009, 8:167.Reference #2: Hocqueloux L, Bruneel F, Pages CL, Vachon F. Fatal Invasive Aspergillosis complicating Severe Plasmodium Falciparum Malaria.Clinical infectious disease 200 Jun: 30(6): 940-2.Reference #3: Ruhnke M, Eichenauer E, Searle J, Lippek F. Fulminant tracheo bronchial and pulmonary aspergillosis complicating imported plasmodium malaria in an apparently immunocompetent woman. Clinical infectious disease Jun: 30(6) 938-40. The following authors have nothing to disclose: Suresh UppalapuNo Product/Research Disclosure Information.
The Annals of Thoracic Surgery, 2021
Critical Care Explorations, 2020
Translational Lung Cancer Research, 2021
Journal of the American College of Cardiology
Respiratory Medicine Case Reports
Patients under consideration for lung transplantation as treatment for end-stage lung diseases su... more Patients under consideration for lung transplantation as treatment for end-stage lung diseases such as idiopathic pulmonary fibrosis (IPF) often have risk factors such as a history of smoking or concomitant emphysema, both of which can predispose the patient to lung cancer. In fact, IPF itself increases the risk of lung cancer development by 6.8% to 20%. Solid organ malignancy (non-skin) is an established contraindication for lung transplantation. We encountered a clinical dilemma in a patient who presented with an IPF flare-up and underwent urgent evaluation for lung transplantation. After transplant, the patient's explanted lungs showed extensive adenocarcinoma , with the foci of invasion and metastatic adenocarcinoma in N1-level lymph nodes, as well as usual interstitial pneumonia. Retrospectively, we saw no evidence to suggest malignancy in addition to the IPF flare-up. Clinical diagnostic dilemmas such as this emphasize the need for new noninvasive testing that would facilitate malignancy diagnosis in patients too sick to undergo invasive tissue biopsy for diagnosis. Careful pathological examination of explanted lungs in patients with IPF is critical, as it can majorly influence immunosuppressive regimens, surveillance imaging, and overall prognosis after lung transplant.
Heart failure clinics, 2018
Diffuse pulmonary lung disease and chronic obstructive pulmonary disease is a heterogeneous popul... more Diffuse pulmonary lung disease and chronic obstructive pulmonary disease is a heterogeneous population that can manifest pulmonary hypertension. These subgroups are classified as primarily World Health Organization group 3. Available data suggest that the impact of pulmonary hypertension targeted therapy in diffuse pulmonary lung disease and chronic obstructive pulmonary disease is limited and survival is poor despite attempted treatment.
Southwest Journal of Pulmonary and Critical Care
Journal of the American College of Cardiology, 2017
Southwest Journal of Pulmonary and Critical Care, 2016
Southwest Journal of Pulmonary and Critical Care, 2016
Southwest Journal of Pulmonary and Critical Care, 2015
Southwest Journal of Pulmonary and Critical Care, 2015
Journal of thoracic disease, 2013
Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction ... more Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction that can lead to lung destruction and dyspnea. Although there has been a slight reduction in mortality in recent decades, COPD is still a serious health problem that has enormous costs and utilizes significant medical resources. There have been a number of pharmacologic interventions that have been developed for the treatment of COPD. Current guidelines recommend the use of long-acting bronchodilators for the treatment of moderate and severe stage COPD, since they have been shown to improve lung function, respiratory symptoms, and quality of life. Indacaterol is a once-daily beta2-agonist (β2-agonist) delivered by a single-dose dry powder inhaler used for the treatment of COPD. It is currently approved at a dose of 75 μg in the United States and a dose of 150 μg with a maximal dose of 300 μg in Europe and other countries. Several studies show that indacaterol was statistically superior t...
Southwest Journal of Pulmonary and Critical Care, 2015
CHEST Journal, 2014
ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON:... more ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Falciparum Malaria is associated with transient immunosuppression resulting in disseminated fungal infections like aspergillosis. Ineffective phagocyotosis by alveolar macrophages was implicated as the pathogenetic mechanism leading to disseminated fungal infections. So far 4 cases were reported in the literature of severe falciparum malaria associated with disseminated aspergillosis. We present the first documented case of malaria observed in different stages on bronchoalveolar lavage with underlying disseminated aspergillosis. 55 years old Sudanese male admitted to our hospital ICU intubated and in shock state. Patient returned from Sudan three weeks ago prior to his presentation. The past medical/surgical history was notable for splenectomy for hypersplenism, but no history of an immunocompromised state. Diagnosis at the time of admission was severe falciparum malaria with multi organ failure. Aggressive supportive care along with malaria specific therapy was initiated. The parasite load decreased from 19.6% on admission to 1% after implementation of exchange transfusion. Patient then developed profuse endobronchial hemorrhage with clots needing therapeutic bronchoscope and dislodgement of the clots. Broncho alveolar lavage done was sent for analysis. After initiation of malaria treatment, patient showed clinical improvement, but continued to have hemoptysis needing repeated bronchoscopies and bronchial artery embolization. His clinical condition worsened necessitating escalation of antimicrobial regimen. At that point, serological studies were sent for Aspergillus Fumigatus. On day 10 of his arrival to the hospital he passed away despite aggressive treatments. Autopsy revealed disseminated Aspergillus Fumigatus to multiple organs which included lung, heart, liver, small bowel. This case presents a unique challenge to health care providers as his presentation was life threatening malaria but his eventual cause of death seemed to be disseminated Aspergillosis. As with other previously reported cases, his underlying disseminated aspergillosis became clinically apparent after the treatment of malaria. Severe malaria infections can lead to other life threatening fungal infections leading to fatality. High index of clinical suspicion with broad anti microbial coverage should be the treatment approach in dealing with cases of severe malaria.Reference #1: Isabella Eckerlie, Damaris Ebinger, Gotthardt, R.Eberhardt et all.Invasive Aspergillosis fumigatus infection after plasmodium Falciparum malaria in an Immuno competent host: Case report and review of literature. Malaria Journal 2009, 8:167.Reference #2: Hocqueloux L, Bruneel F, Pages CL, Vachon F. Fatal Invasive Aspergillosis complicating Severe Plasmodium Falciparum Malaria.Clinical infectious disease 200 Jun: 30(6): 940-2.Reference #3: Ruhnke M, Eichenauer E, Searle J, Lippek F. Fulminant tracheo bronchial and pulmonary aspergillosis complicating imported plasmodium malaria in an apparently immunocompetent woman. Clinical infectious disease Jun: 30(6) 938-40. The following authors have nothing to disclose: Suresh UppalapuNo Product/Research Disclosure Information.
CHEST Journal, 2014
ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON:... more ABSTRACT Infectious Disease Case Reports Posters IIISESSION TYPE: Case Report PosterPRESENTED ON: Sunday, March 23, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Falciparum Malaria is associated with transient immunosuppression resulting in disseminated fungal infections like aspergillosis. Ineffective phagocyotosis by alveolar macrophages was implicated as the pathogenetic mechanism leading to disseminated fungal infections. So far 4 cases were reported in the literature of severe falciparum malaria associated with disseminated aspergillosis. We present the first documented case of malaria observed in different stages on bronchoalveolar lavage with underlying disseminated aspergillosis. 55 years old Sudanese male admitted to our hospital ICU intubated and in shock state. Patient returned from Sudan three weeks ago prior to his presentation. The past medical/surgical history was notable for splenectomy for hypersplenism, but no history of an immunocompromised state. Diagnosis at the time of admission was severe falciparum malaria with multi organ failure. Aggressive supportive care along with malaria specific therapy was initiated. The parasite load decreased from 19.6% on admission to 1% after implementation of exchange transfusion. Patient then developed profuse endobronchial hemorrhage with clots needing therapeutic bronchoscope and dislodgement of the clots. Broncho alveolar lavage done was sent for analysis. After initiation of malaria treatment, patient showed clinical improvement, but continued to have hemoptysis needing repeated bronchoscopies and bronchial artery embolization. His clinical condition worsened necessitating escalation of antimicrobial regimen. At that point, serological studies were sent for Aspergillus Fumigatus. On day 10 of his arrival to the hospital he passed away despite aggressive treatments. Autopsy revealed disseminated Aspergillus Fumigatus to multiple organs which included lung, heart, liver, small bowel. This case presents a unique challenge to health care providers as his presentation was life threatening malaria but his eventual cause of death seemed to be disseminated Aspergillosis. As with other previously reported cases, his underlying disseminated aspergillosis became clinically apparent after the treatment of malaria. Severe malaria infections can lead to other life threatening fungal infections leading to fatality. High index of clinical suspicion with broad anti microbial coverage should be the treatment approach in dealing with cases of severe malaria.Reference #1: Isabella Eckerlie, Damaris Ebinger, Gotthardt, R.Eberhardt et all.Invasive Aspergillosis fumigatus infection after plasmodium Falciparum malaria in an Immuno competent host: Case report and review of literature. Malaria Journal 2009, 8:167.Reference #2: Hocqueloux L, Bruneel F, Pages CL, Vachon F. Fatal Invasive Aspergillosis complicating Severe Plasmodium Falciparum Malaria.Clinical infectious disease 200 Jun: 30(6): 940-2.Reference #3: Ruhnke M, Eichenauer E, Searle J, Lippek F. Fulminant tracheo bronchial and pulmonary aspergillosis complicating imported plasmodium malaria in an apparently immunocompetent woman. Clinical infectious disease Jun: 30(6) 938-40. The following authors have nothing to disclose: Suresh UppalapuNo Product/Research Disclosure Information.