PULMONARY DISEASE - CRITICAL CARE FELLOWSHIP PROGRAM

 

STATE UNIVERSITY OF NEW YORK AT BUFFALO

 

The Fellowship Program in Pulmonary Disease and Critical Care at the State University of New York at Buffalo (SUNYAB) is designed to provide thorough clinical training as well as research experience in Pulmonary Medicine and Critical Care. Brydon J .B. Grant, M.D., is Head of the Division of Pulmonary and Critical Care Medicine. M. Jeffery Mador, M.D. serves as Program Director for the Pulmonary Disease/Critical Care Fellowship. The program is accredited by the ACGME.

 

The program utilizes the four major teaching hospitals affiliated with SUNYAB School of Medicine. These are the Erie County Medical Center (ECMC), the Buffalo Veterans Affairs Medical Center (VAMC), and the Buffalo General Hospital (BGH).  The SUNYAB Internal Medicine Residency Training Program utilizes these hospitals, and all housestaff at these institutions are part of SUNYAB training programs. All full time faculty at the hospitals have University appointments. There are a total of eleven full time pulmonary faculty. In addition, three part time pulmonary faculty participate in teaching. At all three institutions, the Pulmonary Laboratories, Respiratory Therapy Departments and Medical Intensive Care Units are under the direction of the Pulmonary Disease Division. Both pulmonary function and ICU monitoring equipment have been updated at each hospital, ensuring state of the art facilities at all training program sites.

 

A maximum of two fellowship positions is available for each year of the three-year training program. Ample time for clinical training in all areas of pulmonary medicine and critical care is scheduled. A dedicated research experience is scheduled and, if desired, limited elective time may also be available. Flexibility is maintained in scheduling fellow assignments in order to meet individual needs. The fellow's schedule is divided into 13 four-week modules each year. During the three-year training program, approximately half of the time is spent on clinical service. In addition, there are 3 modules (one/year) for vacation, and the first two initial modules of the first year are spent in an introduction to the principals of pulmonary disease and critical care medicine. The remaining time is dedicated to research. A general description of fellow responsibilities during the various

rotations is listed below.

 

Summary of the Unique Features of the Fellowship Program

 

1.         The fellows are exposed to a diverse population of patients. Buffalo General Hospital is a private institution, Erie County Medical Center is a county owned facility, The Veterans Affairs Medical Center is a federally owned facility and Roswell Park Cancer Institute is state owned facility. Because of the wide variation of funding each facility attracts different populations of patients.

 

2.         There is diversity amongst the faculty. While most are trained in the United States, others are trained in Canada, Lebanon, India, Philippines, and the United Kingdom which provides an array of approaches to clinical problems that is valuable for the fellows to compare and useful for international medical graduates.

 

3.         The fellowship program provides interactions with pulmonary and critical care physicians in the community through our volunteer faculty program that operates at Buffalo General Hospital and Veterans Affairs Medical Center and also through monthly meetings of the Western New York Pulmonary and Critical Care Physicians Society. This Society meets on a monthly basis during the semester and fellows are made members free of charge.

 

4.         There is a wide range of research experience available to fellows in our program.  The disciplines include molecular biology (Dr. Sanjay Sethi), cellular mechanisms and community medicine (Dr. Lwebuga-Mukasa), research in respiratory muscles and pulmonary rehabilitation (Drs. William Gibbons, Thomas Kufel and Jeffery Mador), sleep physiology and clinical epidemiology (Drs. Ali El-Solh, Brydon Grant and Archana Mishra).

 

5.                A core curriculum has been developed for all fellows in internal medicine that covers subjects of mutual interest such as health care economics, medical statistics, medical decision making, clinical epidemiology, ethics, and an introduction to molecular biology.

 

6.                A special interest of the Division is to develop the use of computers in medicine and to introduce their use to the fellows.  The Division has its own web page on the internet (http://www.smbs.buffalo.edu/pccm) an intranet page for the medical school and an intranet page especially for faculty and fellows.

 

7.                The fellowship is fortunate to be able to provide fellows experience in a variety of special clinical services such as interventional bronchoscopy at Roswell Park Cancer Institute, sleep laboratories at Millard Fillmore (Gates) Hospital and Veterans Affairs Medical Center, pulmonary rehabilitation at Veterans Affairs Medical Center.

 

8.                The Division of Pulmonary and Critical Care Medicine has a long standing relationship with the University Departments of Physiology and Biophysics, Microbiology and Social and Preventive Medicine. 

 

9.                The Center for Sleep Disorders Research provides associations with not only the Department of Physiology and Biophysics but also with the Departments of Neurology, Pediatrics, Psychology, Physical Therapy and Exercise Science, Social and Preventive Medicine.


 

Introduction

 

During the first year of fellowship, the initial two modules are spent introducing the basis and basics of both pulmonary disease and critical care. One module is dedicated to each of these general areas, and instruction takes place at each of the three institutions. During this time, the fellow receives extensive training in the performance and interpretation of pulmonary function tests. Didactic sessions with various faculty members are held daily. Pertinent physiologic and clinical literature related to pulmonary function and critical care is reviewed.  In addition, an introduction to techniques of pulmonary flotation catheter insertion and bronchoscopy is also presented at this time. Respiratory Therapy techniques and ventilator management are presented. In the latter part of the lab time, stress is placed on specialized testing such as body plethysmography, exercise and sleep studies. Also included is an introduction to pulmonary pathology.

 

ECMC - Clinical Service

 

During this rotation the fellow's major responsibility is directed towards the Medical Intensive Care Unit. The fellow supervises the two medical residents assigned to the 10 bed MICU Service, making work rounds and directing the care of all patients. Daily attending rounds are held to review all aspects of patient care. The fellow also performs procedures on these ICU patients such as pulmonary flotation catheter and bronchoscopy. In addition, about 25% of the time is spent performing pulmonary consultations at the ECMC.

 

On average there are about 20 cases per module. Medical residents and fourth year students may also be assigned to the consult service. All consults are presented to the Attending Physician during consultation rounds. The fellow under the supervision of the attending physician performs all procedures such as bronchoscopy, transthoracic needle biopsies and other diagnostic tests. In addition, the fellow, in conjunction with an attending physician, interprets all pulmonary lab studies.

 

VA - Clinical Service

 

During this rotation the fellow's main responsibility involves evaluating inpatient consults at the VAMC. Approximately 40 to 50 consults will be seen during the four-week period. Medical residents and fourth year students are also assigned to the Consultation Service. All cases are presented to an attending physician during daily consultation rounds. The fellow under supervision of the attending physician performs all procedures such as bronchoscopy, transthoracic needle biopsies and other diagnostic tests.

 

In addition, the fellow oversees the care, on a consultative basis, of respiratory patients in a fourteen-bed ICU. The fellow will work directly with the housestaff in formulating plans for care of these patients. A pulmonary attending is also assigned to the Critical Care Service and advises and supervises the fellow. In addition, the fellow, in conjunction with an attending physician, interprets all pulmonary lab studies and cardiopulmonary exercise tests.

 

BGH - Clinical Service

 

During this rotation the fellow will be involved in the evaluation of 40 to 50 inpatient consults per month. All cases are presented to an attending physician during daily consultation rounds. The fellow and the attending perform consultations and daily work rounds in the 10 bed Medical Intensive Care Unit. The fellow, under supervision of the attending, performs invasive procedures such as pulmonary arterial flotation catheter insertion, pleural biopsy and thoracentesis. The fellows can also gain experience in evaluation and management of patients with sleep apnea syndrome and in lung transplantation. The fellow presents and discusses cases at the weekly management conference held jointly with the Thoracic Surgery Department and the twice weekly morning report to housestaff on the Medicine service which is supervised by the Pulmonary Division. The fellow supervises medical residents and fourth year medical students rotating on the pulmonary service. The fellow under supervision of the attending physician performs procedures such as bronchoscopy and other diagnostic tests.

 

Critical Care

 

The clinical critical care experience is derived from rotations of ECMC, BGH and the VA. One additional rotation of clinical critical care experience is also included. Towards the end of the third year of fellowship, one rotation is spent in the Surgical ICU as part of the care delivery team. Fellows may choose from a wide range of experiences, including coronary critical care, burn unit, trauma ICU, cardiac surgery ICU, neurology-neurosurgery ICU and others. Specific experience with medical ethics is also provided.

 

Research

 

The program is designed to provide an intensive research experience. Research activities take place at all hospitals as well as the basic science departments of the School of Medicine. Current areas of interest include pulmonary gas exchange, asthma, infections in chronic obstructive pulmonary disease, respiratory muscle fatigue, control of breathing, sleep neurophysiology and a variety of clinical research projects, particularly in sleep medicine, pulmonary rehabilitation and clinical epidemiology.  A number of diagnostic tools are being developed with classification and progress in drugs and with artificial neural networks. A new program in lung biology has been established, which focuses on the cellular and molecular mechanics involved in lung injury and repair, with particular emphasis on the role of the extracellular matrix in lung remodeling, type II pneumocyte differentiation, and growth. Research activities are supported through grants from federal funding and other sources. Potential areas for research participation are discussed in detail with each fellow and arranged on an individual basis. Research opportunities are not limited to the Division of Pulmonary, Critical Care and Sleep Medicine, but can be arranged with other Divisions or Departments in the university, if appropriate and mutually acceptable. A list of recent publications produced by the Division of Pulmonary, Critical Care and Sleep Medicine is attached. An asterisk indicates Work performed by fellows during their training.

 

Elective Time

 

Elective time, if requested, reduces the number of modules available for research, and is therefore limited.  Limited time may be available, and is arranged on an individual basis through the Directors of the training program.

 

Vacation

 

One module (four weeks of vacation time) is available each year. It is taken either as a block or split into several periods. This is usually done in conjunction with elective or research time.

 

Clinic

 

In addition to the other responsibilities listed above each fellow has one weekly pulmonary clinic. This is either a morning or afternoon clinic at the ECMC or VA. Pulmonary attendings are also present in clinic, and are available to discuss findings and review plans.

 

Conferences

 

Conferences are held during one weekly conference block lasting from 8:00 - 10:00 on Wednesday mornings:

Fellow's Conference, Pulmonary Case Conference, Sleep Case Conference, Basic Science Conference alternating with Sleep Medicine Lectures, Pulmonary Medicine Review Series, Critical Care Medicine Review Series. In addition, Research Conference is held on the first Monday of the month and Journal Club is held on the third Thursday of the month.

 

Conferences rotate between four teaching hospitals: Buffalo General Hospital, Erie County Medical Center, Millard Fillmore Hospital (Gates) and Veterans Affairs Medical Center. A variety of formats are used, including lecture, small group discussion and case presentations. In addition to these conferences, the Department of Medicine runs a full complement of teaching sessions at all hospitals as well as a City-Wide Grand Rounds.

 

For details of our conferences, visit our web site: http://www.smbs.buffalo.edu/pccm/regconf.html

 

Stipend

 

Fellowship applicants are normally required to have three years of postgraduate training in an accredited Internal Medicine Program. Fellows are paid at a salary level of fourth, fifth and sixth year graduate trainees.  Since non-federal funds are utilized for most salary support, acceptance of the Fellowship does not commit the individual to specific career goals, such as academic medicine or hospital based teaching positions.

                                       

FACULTY

 

The division is comprised of thirteen full time faculty (Drs A.T. Aquilina, L.A. Campbell, A. A. El-Solh, W.J. Gibbons, B.J.B.Grant, T.J. Kufel, G. M. Loewen, J.S. Lwebuga-Mukasa, M.J. Mador, A. Mishra, L. Pineda, S. Sethi, E Ten Brock), three faculty with substantial commitments outside the division (Drs R.A. Klocke, S.H. Schwartz, H.J. Schünemann and A.R. Saltzman) and three volunteer faculty ( Drs. H. Boepple, N. H. Rabadi and S. M. Sherif).

 

Division Head:

Brydon J.B. Grant, M.D. Professor of Medicine, Physiology & Biophysics, and of Social & Preventive Medicine, Adjunct Professor of Biostatistics. Special interests: clinical epidemiology, sleep, pulmonary gas exchange and pulmonary hemodynamics. (email: grant@buffalo.edu)

 

Alan T. Aquilina, M.D. Professor of Clinical Medicine.  Special interests: asthma, and sleep disorders.  (email: aquilina@buffalo.edu)

 

Lucy A. Campbell, M.D. Associate Professor of Clinical Medicine. Special interests: lung transplantation, pulmonary hypertension and medical education. (email: LCampbell@KaleidaHealth.org)

 

Ali A. El-Solh, M.D., M.P.H. Assistant Professor of Medicine. Special interests: cellular mechanisms of disease, clinical epidemiology. (email: solh@buffalo.edu)

 

William J. Gibbons, M.D. Assistant Professor of Medicine. Special interests: lung transplantation, pulmonary rehabilitation and muscle pathophysiology. (email: WGibbons@KaleidaHealth.org)

 

Robert A. Klocke, M.D. Professor of Medicine and Physiology. Special interests: pulmonary gas exchange and pulmonary circulation. (email: rklocke@adelphia.net)

 

Thomas J. Kufel, M.D. Assistant Professor of Clinical Medicine. Special interests: respiratory muscles, exercise. (email: Thomas.Kufel@med.va.gov )

 

Gregory M. Loewen, D.O. Associate Professor of Clinical Medicine. Special interests: pulmonary oncology and clinical exercise testing. (email: loewen@sc3101.med.buffalo.edu)

 

Jamson S. Lwebuga-Mukasa, M.D., Ph.D. Associate Professor of Medicine. Special interests: lung growth, epidemiology of asthma (email: jlwebuga@buffalo.edu)

 

Pulmonary and Critical Care Fellowship Program Director:

M. Jeffery Mador, M.D. Associate Professor of Medicine. Special interests: respiratory muscles and mechanical ventilation. (email: mador@acsu.buffalo.edu)

 

 

Archana Mishra, M.D., M.S. Research Assistant Professor of Medicine. Special interests: asthma and clinical epidemiology. (email: amishra@ams.ecmc.edu)

 

Lillibeth Pineda, M.D., Assistant Professor of Medicine.  Special interests: COPD. (email: lpineda@buffalo.edu)

 

Alan R. Saltzman, M.D., M.B.A. Professor of Clinical Medicine. Special interests: pulmonary function, lung mechanics, and medical economics. (email: asaltzma@buffalo.edu)

 

Susan H. Schwartz, M.D. Professor of Clinical Medicine. Special interests:

critical care medicine, asthma. (email: SSchwartz@KaleidaHealth.org)

 

Holger J. Schünemann M.D., Ph.D., M.S. Assistant Professor of Medicine. Special interests: respiratory epidemiology, clinical epidemiology, guidelines and recommendations. (email: hjs@buffalo.edu)

 

Sanjay Sethi, M.D. Associate Professor of Medicine. Special interests: pulmonary infection, chronic bronchitis. (email: ssethi@buffalo.edu)

 

Sleep Fellowship Program Director:

Eric Ten Brock, M.D. Professor of Clinical Medicine and Neurology. Special interests: Critical care medicine, sleep disorders, ethics, clinical exercise testing. (email: ETenbrock@KaleidaHealth.org)

 

 

RECENT PUBLICATIONS

 

RECENT PUBLICATIONS

 

NOTE: All publications are articles, editorials or chapters published since January 1, 1994. Abstracts have not been included.

 

An asterisk next to names indicates that the work was done by fellows during their SUNYAB Pulmonary Disease - Critical Care Fellowship Program.

 

1994

 

Grant BJB. Noninvasive tests for acute venous thromboembolism. Am J Resp Crit Care Med., 149:1044-1047, 1994.

 

Kumar NM, Rabadi NH*, Nair MPN, Schwartz SA, Lwebuga-Mukasa JS. HIV-1 derived peptides regulate proliferative response of A549 cells, a human lung carcinoma cell line. Proceedings of the International Cancer Congress. Moduzzi Editore, Bologna, Italy. 1 994.XVI: 1097-1101, 1994.

 

Lieber BB, Li Z and Grant BJB. Beat by beat changes of the viscoelastic and inertial properties of the pulmonary arteries. J. Appl. Physiol. 76:2348-2355, 1994.

 

Lwebuga-Mukasa JS. Mn++ enhanced, RGD dependent adhesion technique for isolation of adult rat type II alveolar epithelial cells for immediate functional studies. Am J Respir Cell Mol Biol; 10: 347-354, 1994.

 

Lwebuga-Mukasa JS. (1994). Mechanisms of Lung Injury and Repair. In "Internal Medicine.” Jay H. Stein, Editor; 4th Edition, Mosby-Year Book, Inc., St. Louis, MO, 1995.

 

Mador MJ. Assist-control ventilation. In: Principles and practice of mechanical ventilation. MJ Tobin, editor. McGraw-Hill, New York. p. 207- 219, 1994.

 

Mador MJ, Magalang UJ, Kufel TJ. Twitch potentiation following voluntary diaphragmatic contraction. Am J Respir Crit Care Med. 149:739-743, 1994.

 

Sigurdson SL, Lwebuga-Mukasa JS. Divalent cation-dependent regulation of rat alveolar epithelial cell adhesion and spreading. Exp Cell Res; 213(1):71-79, 1994.

 

Szczepkowski M, Shalin V, Bertram D, Drury C, Aquilina AT, Ten Brock E. Observable measures of physician mental workload in medical intensive care Communications General 6:229-231, 1994.

 

1995

 

El-Solh AA*, Ameen K* and Sherif S. Endobronchial non-Hodgkin's lymphoma in an AIDS patient. Resp Med 89:697-699, 1995.

 

Gibson KF, Aguayo SM, Flowers JC, Ford JG, Jackson JH, Lwebuga-Mukasa JS, Roman J, Samet JM, Thomas Jr., AV, Young RC, Ram JS and Hurd SS. Respiratory Disease Disproportionately Affecting Minorities. Chest; 108:1380-1392, 1995.

 

Grant BJB and El-Solh AA*. Thromboembolic disease: optimizing recognition. Hospital Medicine, 31: 14-24, 1995.

 

Grant BJB and El-Solh AA*. Venous thromboembolic disease: decisions in treatment and prophylaxis. Hospital Medicine, 31:33-37, 1995.

 

Grant BJB. Lower extremity noninvasive testing for assessing venous thromboembolic disease. UPTODATE in Pulmonary and Critical Care Medicine, American Thoracic Society CD-ROM, Falling LJ and Weinberger SE, Eds. 1995.

 

Hsiao CB, Sethi S* and Murphy TF. Outer membrane protein CD of Branhamella catarrhalis: sequence conservation in strains recovered from the human respiratory tract. Microbial Pathogenesis 19: 215-225, 1995.

 

Klocke RA (editor) Lung Disease: State of the Art. New York: Amer. Lung Assoc 1995.

 

Klocke RA, Schünemann HJ and Grant BJB. Distribution of pulmonary capillary transit times. Am J Resp Crit Care Med, 152:2014-2020, 1995.

 

Kumar NM, Sigurdson SL, Sheppard D, Lwebuga-Mukasa JS. Differential modulation of integrin receptors and extracellular matrix laminin by transforming growth factor b1 in rat alveolar epithelial cells. Expt Cell Res; 221:385-394, 1995.

 

Li Z, Grant BJB and Lieber BB. Pulmonary arterial input impedance via wavelet decomposition. J. Appl. Physiol., 78: 2309-2319, 1995.

 

Loewen GM, Stomper P, Mercurio J, Wilkes J, Takita H, Raghavan D. Bronchioalveolar cell carcinoma: A retrospective clinical and radiographic review. Am J Respir Crit Care Med. 151:4,A846, 1995.

 

Mador MJ, Tobin MJ. Acute respiratory failure. In: Chronic obstructive pulmonary diseases. PMA Calverley, NB Pride, editors. Chapman & Hall: London, Chapter 19, p. 461-494, 1995.

 

Mador MJ. Work of breathing measurements. Can they help identify patients who can be successfully extubated. Chest. 108:893-894, 1995.

 

Mador MJ, Rodis A*, Magalang, UJ*. Reproducibility of Borg scale measurements of dyspnea in patients with chronic obstructive pulmonary disease during exercise. Chest. 107:1590-1597, 1995.

 

Magalang UJ* and Grant BJB. Determination of gas exchange threshold by nonparametric regression. Am J Resp Crit Care Med, 151:98-106, 1995.

 

Sethi S*, Hill SL and Murphy TF. Serum Antibodies to Outer Membrane Proteins of Moraxella (Branhamella) catarrhalis in patients with Bronchiectasis: Identification of OMP B1 as an important antigen. Infection and Immunity 63: 1516-1520, 1995.

 

Zhang S, Saltzman AR, Klocke RA. Influence of cardiac action gas mixing in closed-chest dogs. J Appl Physiol.

79(1):113-120, 1995.

 

1996

 

El-Solh AA*, Stubeusz DL, Grant GB, Grant BJB. Outcome of patients with AIDS requiring mechanical ventilation predicted by recursive partitioning. Chest, 109:1584-1590, 1996.

 

El-Solh AA* and Grant BJB. A comparison of severity of illness scoring systems for critically ill obstetric patients. Chest, 110:1299-1304, 1996.

 

Grant BJB and Lieber BB. Clinical significance of pulmonary arterial input impedance. (editorial) European Respiratory Journal, 9: 2196-99, 1996.

 

Grant BJB. Lower extremity noninvasive testing for assessing venous thromboembolic disease. UPTODATE in Pulmonary and Critical Care Medicine, American Thoracic Society CD-ROM, Falling LJ and Weinberger SE, Eds. 1996.

 

Kumar NM, Rabadi NH*, Sigurdson LS, Schünemann HJ, Lwebuga-Mukasa JS. Induction of interleukin-1 and interleukin-8 mRNAs and proteins by TGF b1 in rat lung alveolar epithelial cells. J Cellular Physiol 169: 186-199, 1996.

 

Mador MJ, Rodis A*, Diaz J*. Diaphragmatic fatigue following voluntary hyperpnea. Am J Respir Crit Care Med. 154:63-67, 1996.

 

Mador MJ, Rodis A*, Magalang UJ*, Ameen K*. Comparison of cervical magnetic and transcutaneous magnetic nerve stimulation before and after threshold loading. Am J Respir Crit Care Med. 154:448-453, 1996.

 

Mador MJ, Dahuja M. Mechanisms for diaphragmatic fatigue following high intensity leg exercise. Am J Respir Crit Care Med. 154:1484-1489, 1996.

 

Mensah EA, Kumar NM, Nielsen L, Lwebuga-Mukasa JS. Distribution of alveolar type II cells in neonatal and adult rat lung revealed by RT-PCR-In- situ. Am J Physiol 271 (Lung Cell & Mol Physiol 15): L178 -L185, 1996.

 

Moxey-Mims MM, Nielsen L, Noble B, Lwebuga-Mukasa JS. Monocyte chemoattractant protein-1 in chronic proliferative immune complex nephritis. Clin Immunol Immunopath 80:123-128, 1996.

 

Nair MPN, Kumar NM, Monaco G, Tang Y, Lwebuga-Mukasa JS, Schwartz SA. Alcohol inhibits lipopolysaccharide (LPS)-induced tumor necrosis factor alpha (TNFa) gene expression by peripheral blood mononuclear cells as measured by RT-PCR in situ hybridization. Clin Diag Lab Immunol 3: 392-398, 1996.

 

Sethi S, Murphy TF and Klingman KL. Diagnosis, Epidemiology and Pathogenesis of Bacterial Infections in the Molecular Era. Journal of Clinical Pathology: Molecular Pathology 49: M1-M7, 1996.

 

1997

 

Bhushan R, Kirkham C, Sethi S, and Murphy TF. Antigenic characterization and analysis of the human immune response to outer membrane protein E of Branhamella catarrhalis. Infection and Immunity 65: 2668-2675, 1997.

 

El-Solh A*, Kumar NM, Nair MPN, Schwartz SA, Lwebuga-Mukasa. An RGD containing peptide from HIV-1 Tat-(65-80) modulates protooncogene expression in human bronchoalveolar carcinoma cell line, A549. Immunol Invest. 26(3): 351-370, 1997.

 

El-Solh A*, Mylotte J, Sherif SM, Serghani J and Grant BJB. Validity of a decision tree for predicting active pulmonary tuberculosis from clinical and radiographic data. Amer J Resp Crit Care Med, 155:1711-1716, 1997.

 

Gowda MS, Klocke RA. Variability of indices of hypoxemia in ARDS. Crit Care Med. 1997.

 

Grant BJB. Lower extremity noninvasive testing for assessing venous thromboembolic disease. UPTODATE in Pulmonary and Critical Care Medicine, American Thoracic Society CD-ROM, Falling LJ and Weinberger SE, Eds. 1997.

 

Klocke RA. CO2 Transport. In: The Lung: Scientific Foundation, 2nd ed., vol. 2 edited by R.G. Crystal and JB West. New York: Raven Press. p193-202, 1997.

 

Klocke RA. Diffusion, chemical reactions involving respiratory gases, and diffusing capacity. In: Pulmonary Diseases and  Disorders, 3rd ed., edited by AP Fishman, JA Elise, JA Fishman, MA Grippe, LR Kaiser and RM Senior. New York: McGraw-Hill. p193-202, 1997.

 

Kufel TJ and Grant BJB. Arterial blood gas monitoring: respiratory assessment. In: Principles and Practice of Intensive Care Monitoring, MJ Tobin, ed. McGraw-Hill, New York, p197-215, 1997.

 

Jubran A, Grant BJB and Tobin MJ. Effect of hyperoxic hypercapnia on variational activity of breathing. Amer J Resp Crit Care Med, 156:1129-39, 1997.

 

Lwebuga-Mukasa JS. Preparation of type II pneumocytes. In "Methods in Pulmonary Research." Eds S. Uhlig and A.E. Taylor, Birkhäuser Verlag AG, Basel, Switzerland, 1997.

 

Mador MJ, Wendel T, Kufel TJ. Effect of acute hypercapnia on diaphragmatic and limb muscle contractility. Am J Respir Crit Care Med. 155:1590-1595, 1997.

 

Schünemann HJ, Muti P, Freudenheim JL, Armstrong D, Browne R, Klocke RA, Trevisan M. Oxidative stress and lung function. American Journal of Epidemiology. 146(11):939-48, 1997.

 

Sethi S, Surface JM and Murphy TF. Antigenic heterogeneity and molecular analysis of CopB of Branhamella (Moraxella) catarrhalis. Infection and Immunity 65:3666-3671, 1997.

 

Yi K, Sethi S and Murphy TF. Human immune response to nontypeable Haemophilus influenzae in chronic bronchitis. Journal of Infectious Disease 176:1247-1252, 1997.

 

1998

 

Cook RD, Fradet G, Casu C, Gibbons WJ, Ostrow DN, Partovi N, Levy RD. Influence of lung functional exercise capacity following lung transplantation. J Heart Lung Transplant. 115: 410-7, 1998.

 

El-Solh AA, Abul-Khoudoud M*, Sherif SM, Aquilina AT, Grant BJB. Clinical and radiographic features of uncommon pulmonary nontuberculous mycobacterial disease. Chest, 114:138-145, 1998.

 

Hicks W, Hall L III, Sigurdson SL, Stewart C, Hard R, Winston J,

Lwebuga-Mukasa JS. Isolation and characterization of basal cells from

human upper respiratory epithelium. Exp Cell Res. 237: 357-363, 1998

 

Mador MJ Weaning from mechanical ventilation: what have we learned and what do we still need to know? Chest 114(3):672-4, 1998.

 

Schünemann HJ, Dillon D, Nielsen LC, Lwebuga-Mukasa JS. Modulation of laminin integrin receptors in the postnatal and adult rat lung. Differentiation. 63(4):181-91, 1998.

 

Sethi S. Is chronic bronchitis an infectious disease? Mediguide to Pulmonary Medicine. 5: Issue1, 1998.

 

Sethi S. The etiology of AECB. What role does infection play? Postgraduate Medicine, S8-S13, 1998.

 

Sethi S. Management of exacerbations of chronic bronchitis. Infectious Diseases in Clinical Practice. 7: S300-8, 1998.

 

Sigurdson SL, Lwebuga-Mukasa JS. Adhesive characteristics of type II pneumocyte subpopulations from saline- and silica-treated rats. Experimental Lung Research. 24(3):307-20, 1998.

 

 

1999

 

El-Solh A, Mador J, Ten-Brock E, Schucard D, Grant BJB. Validity of an artificial neural network in predicting sleep apnea. Sleep 22:105-111, 1999.

 

El-Solh A, Hsiao CB, Goodnough S, Serghani J, Grant BJB.  Predicting active pulmonary tuberculosis using an artificial neural network.  Chest 116:968-73, 1999.

 

Hicks W Jr, Sigurdson L, Gabalski E, Hard R, Hall L 3rd, Gardella J, Powers C, Kumar N, Lwebuga-Mukasa J.  Does cartilage down-regulate growth factor expression in tracheal epithelium? Arch Otol Head Neck Surg, 125(11):1239-43, 1999.

 

Murphy TF, Sethi S, Klingman KL, Brueggemann AB and GV Doern.  Simultaneous respiratory tract colonization by multiple strains of nontypeable Haemophilus influenzae in chronic obstructive pulmonary disease: implications for antibiotic therapy. Journal of Infectious Diseases, 180:404-9, 1999.

 

Murphy TF, Kirkham C, DeNardin E, Sethi S.  Analysis of the antigenic structure and human immune response to outer membrane protein CD of Moraxella catarrhalis. Infection and Immunity. 67:4578-85, 1999.

 

Patel PA and Grant BJB. Application of prediction systems to individual intensive care units. Intensive Care Medicine 25:977-82, 1999

 

Ramos-Barbon D, Fitchett D, Gibbons WJ, Latter DA, Levy RD.  Maximal exercise testing for the selection of heart transplantation candidates: limitation of peak oxygen consumption.  Chest; 115(2):410-417, 1999.

 

Sethi S. Infectious exacerbations of chronic bronchitis: diagnosis and management. J Antimicrobial Chemotherapy 43: SA 97-105, 1999.

 

Sethi S.  Etiology and management of infection in COPD.  Clinical Pulmonary Medicine.  6:327-32, 1999.

 

2000

 

El-Solh A, Saltzman S, Ramadan F, Naughton B. Validity of artificial neural network in predicting discharge destination from a post acute geriatric rehabilitation unit. Archives of Physical Medicine and Rehabilitation 81:1388-93, 2000.

 

El-Solh A, Sikka P*, Draw A*. Pulmonary and Critical Pearls: A 58 year-old woman with recurrent productive cough and diarrhea. Chest 118:1194-1197, 2000.

 

Gibbons WJ: Idiopathic pulmonary fibrosis. In: Thoracic Surgery Secrets. Edited by HL Karamanoukian, PR Soltoski & TA Salerno. Hanley & Belfus, Inc., Philadelphia, pp. 100-105, 2000.

 

Lwebuga-Mukasa, JS, Dunn-Georgiou E. 2000. The prevalence of asthma in elementary school children in Western New York. J. Urban Health. 77(4): 745-761, 2000.

 

Mador MJ, Kufel TJ, Pineda L*, Sharma GK.  Diaphragmatic fatigue and high intensity exercise in patients with COPD.  Am J Respir Crit Care Med. 161:118-123, 2000.

 

Mador MJ, Kufel TK, Pineda L*.  Quadriceps fatigue following cycle exercise in patients with COPD. Am J Respir Crit Care Med.  161:447-453, 2000.

 

Mador, MJ, Kufel TK, Pineda LA*.  Quadriceps and diaphragmatic function after exhaustive cycle exercise in the healthy elderly.  Am J Respir Crit Care Med.  162:1760-1766, 2000.

 

Murphy TF, Sethi S and Neiderman M.  The role of bacteria in exacerbations of COPD: A constructive view. Chest. 118:204-209, 2000.

 

Schünemann HJ, Dorn J, Grant BJB, Winkelstein, Jr. W, Trevisan M. Pulmonary function is a long-term predictor of mortality in the general population: 29 years follow-up of the Buffalo Health Study. Chest, 118:656-664, 2000.

 

Sethi S, Muscarella KA, Evans N, Klingman KL, Grant BJB and TF Murphy.  Acute bacterial exacerbations of COPD are associated with greater airway inflammation than non-bacterial exacerbations. Chest.  118:1557-65, 2000.

 

Sikka P*, Jaafar W, Bozkanat E, El-Solh A. A comparison of severity of illness scoring systems for elderly patients with severe pneumonia. Intensive Care Med, 26: 1803-1810, 2000.

 

 

2001

 

Almeida JP, Lwebuga-Mukasa JS. Geographic variations in asthma mortality in Erie and Niagara Counties, Western New York, 1991-1996. American Journal of Public Health. 91(9):1394-1395, 2001.

 

Campbell LA, Klocke RA. Implications for the pregnant patient. American Journal of Respiratory & Critical Care Medicine. 163(5):1051-4, 2001.

 

El-Solh A, Sikka P*, Ramadan F, Davies J. Etiology of severe pneumonia in the very elderly.  American Journal of Respiratory and Critical Care Medicine 163:645-651, 2001.

 

El-Solh A, Sikka P*, Jaafar W, Bozkanat E. Outcome of critically obese patients admitted to the medical intensive care unit. Chest 120(6):1989-97, 2001.

 

El-Solh A, Sikka P*, Ramadan F. Outcome of severe pneumonia in the elderly predicted by recursive partitioning. Journal of American Geriatric Society 49(12):1614-21, 2001.

 

Gibbons WJ, Fruchter N, Sloan S, Levy RD. Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil.  21:87-93, 2001.

 

Kufel TJ, Pineda LA*, Mador MJ. Comparison of potentiated and unpotentiated twitches as an index of muscle fatigue. Muscle and Nerve, 21:87-93, 2001.

 

Lee SD, Magalang UJ, Krasney JA, Farkas GA. Opiodergic modulation of ventilatory response to sustained hypoxia in obese Zucker rats. Obes Res. 9: 407-13, 2001.

 

Lwebuga-Mukasa JS, Pszonak R. Patterns of inpatient and outpatient  

care for asthma in Erie and Niagara Counties, Western New York State.  J of

Asthma; 38(2):155 -160, 2001.

 

Mador MJ, Kufel TJ, Pineda LA*, Steinwald A, Aggarwal A*, Upadhyay AM., Khan MA*. Effect of pulmonary rehabilitation on quadriceps fatigability during exercise. Am J Respir Crit Care Med. 163: 930-35, 2001.

 

Mador MJ, Bozkanat E. Skeletal muscle dysfunction in COPD. Respir Research 2: 216-24, 2001.

 

Muhammad AA. Sikka P*. Dhillon RS. Gibbons WJ. Ahmed A. Co-existing granular cell tumor and adenocarcinoma of the lung: a case report and review of the literature Respiratory Care. 46(7):702-4, Jul 2001.

 

Nakano H, Magalang UJ, Lee S, Krasney JA, Farkas GA. Serotonergic modulation of ventilation and upper airway stability in obese Zucker rats.  Am J Respir Crit Care Med. 163: 1191-97, 2001.

 

Obaji A* and S Sethi.  Acute exacerbations of chronic bronchitis: what role the new fluoroquinolones. Drugs and aging. 18:1-11, 2001.

 

Pineda LA*, Hathwar VS and Grant BJB. Clinical suspicion in fatal pulmonary embolism. Chest, 120:791-795, 2001.

 

Schünemann HJ, Grant BJB, Freudenheim JL, Muti P, Browne RW, Drake JA, Klocke RA, Trevisan M. The relation of serum levels of antioxidant vitamins C and E, retinol and carotenoids with pulmonary function in the general population. American Journal of Respiratory and Critical Care Medicine, 163:1246-1255, 2001.

 

Schünemann HJ, Freudenheim J and Grant BJB. Epidemiologic evidence linking antioxidant vitamins to pulmonary function and airway obstruction. Epidemiologic Reviews 23:248-64, 2001

 

Schünemann HJ, McCann S, Grant BJB, Muti P, Trevisan M, Freudenheim JL. Lung function in relation to dietary intake of carotenoids and other antioxidant vitamins in a population-based study. European Respiratory Journal 18:S199, 2001.

 

Sethi S and TF Murphy. Bacterial infection in chronic obstructive pulmonary disease in 2000.  A state of the art review.  Clinical Microbiology Reviews.  14:336-363, 2001.

 

Sethi S. Antibiotics and acute exacerbation of COPD. Advance for Managers of Respiratory Care, 10(8):28-31, 2001.

 

Sheikh S* and S Sethi. Management of infectious exacerbation of COPD. Home Health Care Consultant 8:21-27, 2001.

 

                                    

2002

Devereaux PJ, Schünemann HJ, Ravindran N, Bhandari M, Garg AX, Choi P T-L, Grant BJB, Haines T, Lacchetti C, Weaver B, Lavis JN, Cook DJ, Haslam DRS, Sullivan T, Guyatt GH. A systematic review and meta-analysis of studies comparing mortality between private for-profit and private not-for-profit hemodialysis units. Journal of the American Medical Association, 288:2449-57, 2002.

Devereaux PJ. Choi PT. Lacchetti C. Weaver B. Schünemann HJ. Haines T., Lavis JN. Grant BJ. Haslam DR. Bhandari M. Sullivan T. Cook DJ. Walter SD., Meade M. Khan H. Bhatnagar N. Guyatt GH. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. Canadian Medical Association Journal. 166(11):1399-406, 2002.

 

El-Solh A, Mador J, Sikka P*, Roth M, Dhillon R, Grant BJB. Adhesion molecules in coronary artery disease patients with sleep apnea. Chest 121(5):1541-7, 2002.

 

El-Solh A, Bozkanat E, Roth M, Mador J, Grant BJB.  Association between plasma endothelin-1 levels and Cheyne-Stokes respiration in patients with congestive heart failure.  Chest 121:1541-1547, 2002.

 

El-Solh AA. Aquilina AT. Dhillon RS. Ramadan F. Nowak P. Davies J. Impact of invasive strategy on management of antimicrobial treatment failure in institutionalized older people with severe pneumonia. American Journal of Respiratory & Critical Care Medicine. 166(8):1038-43, 2002.

 

Haccoun C, Smountas AA, Gibbons WJ, Borbeau J, Lands LC.  Isokinetic muscle function in COPD. Chest; 121 (4): 1079-1084, 2002.

 

Hershey CO. Grant BJ. Controlled trial of a patient-completed history questionnaire: effects on quality of documentation and patient and physician satisfaction. Controlled Clinical Trial. American Journal of Medical Quality. 17(4):126-35, 2002.

 

Kufel TJ. Pineda LA*. Mador MJ. Comparison of potentiated and unpotentiated twitches as an index of muscle fatigue. Muscle & Nerve. 25(3):438-44, 2002.

 

Lwebuga-Mukasa JS., Dunn-Georgiou E, Johnson C.  A school-based asthma intervention program in the Buffalo, New York schools. Journal of School Health 72(1):27-32, 2002.

 

Lwebuga-Mukasa JS, Wojcik  R, Dunn-Georgiou E, Johnson C. Home environmental factors associated with asthma prevalence in two Buffalo inner-city neighborhoods. J of Health Care for Poor and Under-Served; 13 (2): 214-228, 2002.

 

Mador MJ, Khan S*, Kufel TJ. Bilateral anterolateral magnetic stimulation of the phrenic nerves can detect diaphragmatic fatigue. Chest, 121:452-458, 2002.

 

Magalang UJ and Mador MJ.  Behavioral and pharmacologic therapy of obstructive sleep apnea.  In: Sleep Medicine.  TL Lee-Chiong, Carskadon MA, Sateia MJ, editors. Hanley & Belfus, Inc, Philadelphia, Chapter 41, p389-396, 2002.

 

Murphy TF, Sethi S, Hill SL and RA Stockley.  Inflammatory markers in bacterial exacerbations of COPD (letter). American Journal of Respiratory and Critical Care Medicine. 165:132, 2002.

 

Murphy TF and S Sethi.  Chronic obstructive pulmonary disease: Role of bacteria and guide to antibacterial selection in the older patient.  Drugs and Aging. 19:761-775, 2002.

Muti P, Quattrin T, Grant BJB, Krogh V, Micheli A, Schünemann HJ, Ram M, Freudenheim JL, Sieri S, Trevisan M, Berrino F. Fasting glucose, insulin and insulin-like growth factor (IGF)-I pattern in relation to breast cancer risk: a prospective study. Cancer Epidemiology, Biomarkers and Prevention, 11:1361-8, 2002.

Muti P. Quattrin T. Grant BJ. Krogh V. Micheli A. Schünemann HJ. Ram M. Freudenheim JL. Sieri S. Trevisan M. Berrino F. Fasting glucose is a risk factor for breast cancer: a prospective study.  Cancer Epidemiology, Biomarkers & Prevention. 11(11):1361-8, 2002.

 

Neiderman MS, Sethi S and F Martinez.  Acute exacerbations of chronic obstructive pulmonary disease (letter). Annals of Internal Medicine.  136:557, 2002.

 

Schünemann HJ. McCann S. Grant BJ. Trevisan M. Muti P. Freudenheim JL. Lung function in relation to intake of carotenoids and other antioxidant vitamins in a population-based study. American Journal of Epidemiology 155(5):463-71, 2002.

 

Schünemann HJ, Grant BJB, Freudenheim J, Muti P, McCann S, Kudalkar D, Ram M, Nochajski T, Russell M, Trevisan M. Beverage specific alcohol intake in a population-based study: evidence for a positive association between pulmonary function: do lungs prefer red or white wine? BMC Pulmonary Medicine, 2:3, 2002.

 

S Sethi.  Acute exacerbations of COPD: A ‘multi-pronged’ approach.  Journal of Respiratory Diseases.  23:217-225, 2002.

 

Sethi S, Evans N, Grant BJB, Murphy TF.  Acquisition of a new bacterial strain and occurrence of exacerbations of chronic obstructive pulmonary disease.  New England Journal of Medicine, 347(7):465-71, 2002.

                                                                 

 

 

2003

 

El-Solh AA, Magalang UJ, Mador MJ, Dmochowski J, Veeramachaneni S, Saberi A, Draw AM*, Lieber BB and Grant BJB. The utility of a neural network in the diagnosis of Cheyne-Stokes respiration. Journal of Medical Engineering and Technology, 27: 54-58, 2003.

 

El-Solh A, Pietrantoni C*, Bhat A*, Aquilina T, Okada M, Grover V, Gifford N. Microbiology of severe aspiration in the elderly. American Journal of Respiratory and Critical Care Medicine 167:1650-1654, 2003.

 

El-Solh A, Okada M, Bhat A*, Pietrantoni C*. Swallowing disorders post orotracheal intubation in the elderly. Intensive Care Medicine. 29:1451-1455, 2003.

 

Freudenheim J L, Ram M, Nie J, Muti P, Trevisan M, Shields PG, Bandera EV, Campbell LA, McCann SE, Schünemann HJ, Caraosella AM, Vito D, Russell M, Nochajski TH, Goldman R.  Lung cancer in humans not associated with lifetime total alcohol consumption or with genetic variation in alcohol dehydrogenase 3 (ADH3)1,2.  Journal of Nutrition 133; 3619-3624, 2003.

 

Grant BJB, Kudalkar D, Muti P, McCann S, Trevisan M, Freudenheim JL, Schünemann HS. Relation between lung function and RBC distribution width in a population based study. Chest 124: 494-500, 2003.

 

Haas CE, Magram Y, Mishra A. Rhabdomyolysis and Acute Renal Failure Following an Ethanol and Diphenhydramine Overdose.  Ann Pharmacother.37:538-42, 2003.

 

Hiltke TJ. Schiffmacher AT. Dagonese AJ. Sethi S. Murphy TF. Horizontal transfer of the gene encoding outer membrane protein P2 of nontypeable Haemophilus influenzae, in a patient with chronic obstructive pulmonary disease. Journal of Infectious Diseases. 188(1):114-7, 2003.

 

Lwebuga-Mukasa JS, Ayirookuzhi SA, Hyland A. Traffic volumes and

respiratory health care utilization among residents in close proximity to the Peace Bridge

before and after September 11, 2001. J of Asthma; 40(8): 855–864, 2003.

 

Mador MJ, Bozkanat E, Kufel TJ. Quadriceps fatigue after cycle exercise in patients with COPD compared with healthy control subjects. Chest 123: 1104-1111, 2003.

 

Mador MJ, Deniz O, Kufel TJ. Quadriceps fatigability after single muscle exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 168: 102-108, 2003.

 

Mador MJ, Deniz O, Aggarwal A*, Kufel TJ. Quadriceps fatigability after single muscle exercise in patients with COPD. Am J Respir Crit Care Med.168:425-430, 2003.

 

Mador MJ, Gibbons WB. Invasive ventilation and the intensive care unit. In: Chronic obstructive pulmonary disease, second edition. PMA Calverley, W MacNee, NB Pride, SI Rennard editors. Edward Arnold: London Chapter 28, p415-438, 2003.

 

Magalang U, Mador MJ. Behavioral and pharmacologic therapy of obstructive sleep apnea. Clinics in Chest Medicine. 24:343-353, 2003.

 

Magalang UJ, Dmochowski J, Veeramachaneni S, Draw A*, Mador MJ, El- Solh A, Grant BJB. Prediction of the apnea-hypopnea index from overnight pulse oximetry. Chest 124:1694-1701, 2003.

 

Mishra A., Novak J, Nowak P, Aquilina AT, Grant BJB. Burden of Asthma in the Elderly. Chest. 124(4):142, 2003.

 

Murphy TF. Kirkham C. Liu DF. Sethi S. Human immune response to outer membrane protein CD of Moraxella catarrhalis in adults with chronic obstructive pulmonary disease. Infection & Immunity. 71(3):1288-94, 2003.

 

Pietrantoni C*, El-Solh A.  Respiratory complications of obesity: weighty issues. Advance for Managers of Respiratory Care. 12: 32-36, 2003.

 

Saey D, Debigare R, LeBlanc P, Mador MJ, Cote CH, Jobin J, Maltais F. Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with COPD. Am J Respir Crit Care Med.168:102-108, 2003.

 

Schünemann HS, Dmochowski J, Campbell LA, Grant BJB. A novel approach for quality control of total lung capacity in the clinical pulmonary function laboratory: A study in a veteran population. Respirology 8:365-370, 2003.

 

Sethi S. Gatifloxacin in community-acquired respiratory tract infection.  Expert Opinion on Pharmacotherapy. 4(10):1847-55, 2003.

 

S Sethi.  The role of antibiotics in acute exacerbations of chronic obstructive pulmonary disease.  Current Infectious Disease Reports.  5:9-15, 2003.

Sethi S, File T, Dagan R.  Acute exacerbations of chronic bronchitis: diagnosis and therapy. Journal of Respiratory Diseases.  24(6):257-63, 2003.

 

 

2004

 

El-Solh A, Aquilina A, Gunen H, Ramadan F. Radiographic resolution of community acquired bacterial pneumonia in the elderly. Journal of the American Geriatrics Society. 52:224-229, 2004.

El-Solh A. A clinical approach to the critically ill morbidly obese patient. American Journal of Respiratory and Critical Care Medicine. 169: 557-561, 2004.

El-Solh A, Bhat A*, Gunen H, Pietrantoni C*, Berbary E. Extubation failure in the elderly. Respiratory Medicine. 98(7):661-8, 2004.

El-Solh A, Okada M, Dhillon R, Aquilina A, Berbary E. Hoemostatic activity in inadequately treated ventilator associated pneumonia. Am J Respir Crit Care Med, 169: A373. 2004.

 

Hicks WL, Hall LA, Hard R, Gardella J, Bright F, Parasharma N, Lwebuga-

Mukasa J, Sigurdson L.  Keratinocyte growth factor and autocrine repair of

airway epithelium. Arch Otolaryngol, Head, Neck Surg., 130(4):446-9, 2004.

 

Lwebuga-Mukasa JS, Oyana T, Thenappan A, Ayirookuzhi SJ. Association

between traffic volume and health care use for asthma among residents at a U.S.

Canadian border crossing point. J of Asthma 41(3):289-304, 2004.

 

Lwebuga-Mukasa JS, Oyana TJ, Wydro P.  Risk factors influencing

asthma prevalence and chronic respiratory illnesses among residents of different

neighborhoods in Buffalo, New York.  J. Epidemiology & Community

Health. 58951-957, 2004.

 

Lwebuga-Mukasa JS, Oyana TJ, Johnson C, 2004. Local ecological factors, ultrafine

particulate concentrations, and asthma prevalence rates in Buffalo neighborhoods, New