A5086941370- Chronic Obstructive Pulmonary Disease (COPD) Research
- Asthma and respiratory diseases
- Lung Cancer Diagnosis and Treatment
- Inhalation and Respiratory Drug Delivery
- Radiomics and Machine Learning in Medical Imaging
- Gut microbiota and health
- Esophageal Cancer Research and Treatment
- Respiratory viral infections research
- Respiratory and Cough-Related Research
- Pediatric health and respiratory diseases
- Respiratory Support and Mechanisms
- Tracheal and airway disorders
- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- Lung Cancer Treatments and Mutations
- Mycobacterium research and diagnosis
- Obstructive Sleep Apnea Research
- Neonatal Respiratory Health Research
- Cystic Fibrosis Research Advances
- Transplantation: Methods and Outcomes
- Airway Management and Intubation Techniques
- Phonocardiography and Auscultation Techniques
- Cancer Immunotherapy and Biomarkers
- Pleural and Pulmonary Diseases
- Medical Imaging and Pathology Studies
Beaumont Hospital
2016-2025
Royal College of Surgeons in Ireland
2014-2025
New York University
2018-2025
NYU Langone Health
2020-2025
University College London
2024
Pulmonary and Critical Care Associates
2018-2024
SleepMed
2020-2024
Botsford Hospital
2016-2023
Beaumont Hospital, Dearborn
2016-2023
Trinity College Dublin
2016
Rationale: Coronavirus disease (COVID-19) is a global threat to health. Its inflammatory characteristics are incompletely understood.Objectives: To define the cytokine profile of COVID-19 and identify evidence immunometabolic alterations in those with severe illness.Methods: Levels IL-1β, IL-6, IL-8, IL-10, sTNFR1 (soluble tumor necrosis factor receptor 1) were assessed plasma from healthy volunteers, hospitalized but stable patients (COVIDstable patients), requiring ICU admission (COVIDICU...
In lung cancer, upregulation of the PI3K (phosphoinositide 3-kinase) pathway is an early event that contributes to cell proliferation, survival, and tissue invasion. Upregulation this was recently described as associated with enrichment lower airways bacteria identified oral commensals.
Objective adherence to inhaled therapy by patients with chronic obstructive pulmonary disease (COPD) has not been reported.To objectively quantify preventer Diskus inhaler COPD an electronic audio recording device (INCA).This was a prospective observational study. On discharge from hospital were given salmeterol/fluticasone INCA attached. Analysis of this quantified the frequency and proficiency use.Patients (n = 244) recruited. The mean age 71 years, FEV1 1.3 L, 59% had evidence...
In severe asthma, poor control could reflect issues of medication adherence or inhaler technique, that the condition is refractory. This study aimed to determine if an intervention with (bio)feedback on features use would identify refractory asthma and enhance technique adherence.Patients uncontrolled were subjected a stratified-by-site random block design. The intensive education group received repeated training in use, disease management. same intervention, enhanced by (bio)feedback-guided...
Respiratory failure is associated with increased mortality in COVID-19 patients. There are no validated lower airway biomarkers to predict clinical outcome. We investigated whether bacterial respiratory infections were poor outcome of a prospective, observational cohort 589 critically ill adults, all whom required mechanical ventilation. For subset 142 patients who underwent bronchoscopy, we quantified SARS-CoV-2 viral load, analysed the tract microbiome using metagenomics and...
In lung cancer, enrichment of the lower airway microbiota with oral commensals commonly occurs, and
We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID.This was an analysis within a multicenter, prospective cohort study confirmed diagnosis COVID-19 and persistent symptoms >4 weeks onset acute symptoms. performed multiple correspondence (MCA) on most common self-reported hierarchical clustering results MCA identify symptom clusters.Two hundred thirty-three were included in analysis;...
Aspiration is associated with nontuberculous mycobacterial (NTM) pulmonary disease and airway dysbiosis increased inflammation. We examined whether NTM was a distinct microbiota immune profile. 297 oral wash induced sputum samples were collected from 106 participants respiratory symptoms imaging abnormalities compatible NTM. Lower obtained in 20 undergoing bronchoscopy. 16S rRNA gene nested mycobacteriome sequencing approaches characterised composition. In addition, inflammatory profiles of...
Rationale: Cross-sectional human data suggest that enrichment of oral anaerobic bacteria in the lung is associated with an increased T-helper cell type 17 (Th17) inflammatory phenotype.Objectives: In this study, we evaluated microbial and host immune-response dynamics after aspiration commensals using a preclinical mouse model.Methods: Aspiration mixture (MOC; Prevotella melaninogenica, Veillonella parvula, Streptococcus mitis) was modeled mice followed by variable time killing. The genetic...
Background Microbiome studies of the lower airways based on bacterial 16S rRNA gene sequencing assess microbial community structure but can only infer functional characteristics. Microbial products, such as short-chain fatty acids (SCFAs), in have significant impact host's immune tone. Thus, approaches to analyses microbiome are necessary. Methods Here we used upper and airway samples from a research bronchoscopy smoker cohort. In addition, validated our results an experimental mouse model....
Rationale Poor adherence to inhaler use can be due poor temporal and/or technique adherence. Up until now there has been no way of reliably tracking both these factors in everyday use. Objectives This paper introduces a device developed create time stamped acoustic recordings an individual's use, which empirical evidence and monitored over time. The correlation between clinical outcomes adherence, as determined by this device, was compared for alone combined Findings technology validated...
False negatives from nasopharyngeal swabs (NPS) using reverse transcriptase PCR (RT-PCR) in SARS-CoV-2 are high. Exhaled breath condensate (EBC) contains lower respiratory droplets that may improve detection. We performed EBC RT-PCR for genes (E, S, N, ORF1ab) on NPS-positive (n=16) and NPS-negative/clinically positive COVID-19 patients (n=15) two commercial assays. detected 93.5% (29/31) the four genes. Pre-SARS-CoV-2 era controls (n=14) were negative. was NPS negative/clinically 66.6%...
Obstructive sleep apnea (OSA) is associated with recurrent obstruction, subepithelial edema, and airway inflammation. The resultant inflammation may influence or be influenced by the nasal microbiome.To evaluate whether composition of microbiota obstructive inflammatory biomarkers.Two large cohorts were used: 1) a discovery cohort 472 subjects from WTCSNORE (Seated, Supine Post-Decongestion Nasal Resistance in World Trade Center Rescue Recovery Workers) cohort, 2) validation 93 rom Zaragoza...
In January 2020, the WHO declared SARS-CoV-2 outbreak a public health emergency; by March 11, pandemic was declared. To date in Ireland, over 3300 patients have been admitted to acute hospitals as result of infection with COVID-19. This article aims describe establishment COVID Recovery Service, multidisciplinary service for comprehensive follow-up hospital diagnosis COVID-19 pneumonia. A hybrid model virtual and in-person clinics established, supported team consisting respiratory, critical...
Introduction Neutrophilic inflammation is a major driver of bronchiectasis pathophysiology, and neutrophil elastase activity the most promising biomarker evaluated in sputum to date. How active correlates with lung microbiome still unexplored. We aimed understand whether associated low microbial diversity distinct characteristics. Methods An observational, cross-sectional study was conducted at programme Policlinico Hospital Milan, Italy, where adults were enrolled between March 2017 2019....
Currently, studies on adherence to inhaled medications report average over time. This measure does not account for variations in the interval between doses, nor errors inhaler use.To investigate whether calculated as a single area under (concentration-time) curve (AUC) measure, incorporating doses and technique, was more reflective of patient outcomes than were current methods assessing adherence.We attached digital audio device (INhaler Compliance Assessment) dry powder inhaler. recorded...
BackgroundThe relationship between tuberculosis (TB), one of the leading infectious causes death worldwide, and microbiome, which is critical for health, poorly understood.MethodsTo identify potential microbiome-host interactions, profiling oral, sputum stool microbiota [n = 58 cases, n 47 culture-negative symptomatic controls (SCs)] whole blood transcriptome were done in pre-treatment presumptive pulmonary TB patients. This was a cross-sectional study. Microbiota also characterised close...
Chronic obstructive pulmonary disease (COPD) is associated with high morbidity, mortality, and healthcare costs. Cigarette smoke a causative factor; however, not all heavy smokers develop COPD. Microbial colonization infections are contributing factors to progression in advanced stages.
Drug delivery from a Dry Powder Inhaler (DPI) is dependent on the peak inspiratory flow rate (PIFR) generated. Currently available methods for estimating PIFR most DPIs are limited and mainly rely subjective assessment. We aim to show that spirometric Diskus™ Inspiratory Vital Capacity (IVC) related underlying respiratory condition can be used assess whether will adequate when using this DPI. Healthy volunteers patients with asthma, COPD, neuromuscular disease non-respiratory disorders were...