Full Text Journal Articles by
Author Julio A Ramirez

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The Burden of Community-Acquired Pneumonia Requiring Admission to an ICU in the United States.

Rodrigo Cavallazzi, Stephen Furmanek, Forest W Arnold, Leslie A Beavin, Richard G Wunderink, Michael S Niederman, Julio A Ramirez,

BACKGROUND:A paucity of studies have assessed the epidemiology of community-acquired pneumonia (CAP) that require ICU admission. We conducted a study on this group of patients with the primary objective of defining the incidence, epidemiology, and mortality rate of CAP in the ICUs in Louisville, KY. The secondary objective was to ... Read more >>

Chest (Chest)
[2020, :]

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Socioeconomic Position and the Incidence, Severity, and Clinical Outcomes of Hospitalized Patients With Community-Acquired Pneumonia.

Timothy L Wiemken, Ruth M Carrico, Stephen P Furmanek, Brian E Guinn, William A Mattingly, Paula Peyrani, Julio A Ramirez,

OBJECTIVES:The influence of socioeconomic disparities on adults with pneumonia is not well understood. The objective of our study was to evaluate the relationship between community-level socioeconomic position, as measured by an area deprivation index, and the incidence, severity, and outcomes among adults with community-acquired pneumonia (CAP). METHODS:This was an ancillary ... Read more >>

Public Health Rep (Public health reports (Washington, D.C. : 1974))
[2020, 135(3):364-371]

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Older Adults Hospitalized for Pneumonia in the United States: Incidence, Epidemiology, and Outcomes.

Forest W Arnold, Andrea M Reyes Vega, Vidyulata Salunkhe, Stephen Furmanek, Christian Furman, Laura Morton, Anna Faul, Pam Yankeelov, Julio A Ramirez,

OBJECTIVES:To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN:This was a secondary ... Read more >>

J Am Geriatr Soc (Journal of the American Geriatrics Society)
[2020, 68(5):1007-1014]

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The elevated systemic cytokine levels in HIV patients are not associated with an elevated pulmonary cytokine environment.

Rafael Fernandez-Botran, Andrea Reyes Vega, Yasmany García, Chanakya Charan Tirumala, Praneet Srisailam, Anupama Raghuram, Paula Peyrani, Stephen Furmanek, Mahder Alem Tella, Jeffrey D Ritzhentaler, Jesse Roman, Julio A Ramírez,

BACKGROUND:HIV-positive patients on anti-retroviral therapy (ART) are at higher risk of developing many non-AIDS related chronic diseases, including chronic obstructive pulmonary disease (COPD), compared to HIV-negative individuals. While the mechanisms are not clear, a persistent pro-inflammatory state appears to be a key contributing factor. The aims of this study were ... Read more >>

Cytokine (Cytokine)
[2020, 126:154874]

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Early Clinical Response in Community-acquired Bacterial Pneumonia: From Clinical Endpoint to Clinical Practice.

Julio A Ramirez, Evan Tzanis, Marla Curran, Robert Noble, Surya Chitra, Amy Manley, Courtney Kirsch, Paul C McGovern,

BACKGROUND:Early clinical response (ECR) is a new endpoint to determine whether a drug should be approved for community-acquired bacterial pneumonia in the United States. The Omadacycline for Pneumonia Treatment In the Community (OPTIC) phase III study demonstrated noninferiority of omadacycline to moxifloxacin using this endpoint. This study describes the performance ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2019, 69(Suppl 1):S33-S39]

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Plasma cysteine/cystine and glutathione/glutathione disulfide redox potentials in HIV and COPD patients.

Walter H Watson, Jeffrey D Ritzenthaler, Paula Peyrani, Timothy L Wiemken, Stephen Furmanek, Andrea M Reyes Vega, Tom J Burke, Yuxuan Zheng, Julio A Ramirez, Jesse Roman,

Chronic obstructive pulmonary disease (COPD) is prevalent in patients infected with HIV. The purpose of this study was to test the hypothesis that systemic oxidation correlates with loss of lung function in subjects with COPD, and that HIV infection can contribute to creating such an environment. Subjects were recruited at ... Read more >>

Free Radic. Biol. Med. (Free radical biology & medicine)
[2019, 143:55-61]

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Influenza and Viral Pneumonia.

Rodrigo Cavallazzi, Julio A Ramirez,

Influenza and other respiratory viruses are commonly identified in patients with community-acquired pneumonia, hospital-acquired pneumonia, and in immunocompromised patients with pneumonia. Clinically, it is difficult to differentiate viral from bacterial pneumonia. Similarly, the radiological findings of viral infection are nonspecific. The advent of polymerase chain reaction testing has enormously facilitated ... Read more >>

Clin. Chest Med. (Clinics in chest medicine)
[2018, 39(4):703-721]

Cited: 1 time

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Effectiveness of 13-Valent Pneumococcal Conjugate Vaccine Against Hospitalization for Community-Acquired Pneumonia in Older US Adults: A Test-Negative Design.

John M McLaughlin, Qin Jiang, Raul E Isturiz, Heather L Sings, David L Swerdlow, Bradford D Gessner, Ruth M Carrico, Paula Peyrani, Timothy L Wiemken, William A Mattingly, Julio A Ramirez, Luis Jodar,

Background:Following universal recommendation for use of 13-valent pneumococcal conjugate vaccine (PCV13) in US adults aged ≥65 years in September 2014, we conducted the first real-world evaluation of PCV13 vaccine effectiveness (VE) against hospitalized vaccine-type community-acquired pneumonia (CAP) in this population. Methods:Using a test-negative design, we identified cases and controls from ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2018, 67(10):1498-1506]

Cited: 10 times

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How can we improve clinical research in pneumonia?

Julio A Ramirez,

PURPOSE OF REVIEW:The primary challenges in the field of clinical research include a lack of support within existing infrastructure, insufficient number of clinical research training programs and a paucity of qualified mentors. Most medical centers offer infrastructure support for investigators working with industry sponsors or government-funded clinical trials, yet there ... Read more >>

Curr Opin Pulm Med (Current opinion in pulmonary medicine)
[2018, 24(3):220-226]

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Macrolide therapy is associated with lower mortality in community-acquired bacteraemic pneumonia.

Forest W Arnold, Gustavo Lopardo, Timothy L Wiemken, Robert Kelley, Paula Peyrani, William A Mattingly, Charles Feldman, Martin Gnoni, Rosemeri Maurici, Julio A Ramirez, ,

BACKGROUND:Community-acquired pneumonia (CAP) has a potential complication of bacteremia. The objective of this study was to define the clinical outcomes of patients with CAP and bacteremia treated with and without a macrolide. MATERIALS AND METHODS:Secondary analysis of the Community-Acquired Pneumonia Organization database of hospitalized patients with CAP. Patients with a ... Read more >>

Respir Med (Respiratory medicine)
[2018, 140:115-121]

Cited: 2 times

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Googling your hand hygiene data: Using Google Forms, Google Sheets, and R to collect and automate analysis of hand hygiene compliance monitoring.

Timothy L Wiemken, Stephen P Furmanek, William A Mattingly, Janet Haas, Julio A Ramirez, Ruth M Carrico,

BACKGROUND:Hand hygiene is one of the most important interventions in the quest to eliminate healthcare-associated infections, and rates in healthcare facilities are markedly low. Since hand hygiene observation and feedback are critical to improve adherence, we created an easy-to-use, platform-independent hand hygiene data collection process and an automated, on-demand reporting ... Read more >>

Am J Infect Control (American journal of infection control)
[2018, 46(6):617-619]

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Adults Hospitalized With Pneumonia in the United States: Incidence, Epidemiology, and Mortality.

Julio A Ramirez, Timothy L Wiemken, Paula Peyrani, Forest W Arnold, Robert Kelley, William A Mattingly, Raul Nakamatsu, Senen Pena, Brian E Guinn, Stephen P Furmanek, Annuradha K Persaud, Anupama Raghuram, Francisco Fernandez, Leslie Beavin, Rahel Bosson, Rafael Fernandez-Botran, Rodrigo Cavallazzi, Jose Bordon, Claudia Valdivieso, Joann Schulte, Ruth M Carrico, ,

Understanding the burden of community-acquired pneumonia (CAP) is critical to allocate resources for prevention, management, and research. The objectives of this study were to define incidence, epidemiology, and mortality of adult patients hospitalized with CAP in the city of Louisville, and to estimate burden of CAP in the US adult ... Read more >>

Clin. Infect. Dis. (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2017, 65(11):1806-1812]

Cited: 32 times

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The order of administration of macrolides and beta-lactams may impact the outcomes of hospitalized patients with community-acquired pneumonia: results from the community-acquired pneumonia organization.

Paula Peyrani, Timothy L Wiemken, Mark L Metersky, Forest W Arnold, William A Mattingly, Charles Feldman, Rodrigo Cavallazzi, Rafael Fernandez-Botran, Jose Bordon, Julio A Ramirez,

The beneficial effect of macrolides for the treatment of community-acquired pneumonia (CAP) in combination with beta-lactams may be due to their anti-inflammatory activity. In patients with pneumococcal meningitis, the use of steroids improves outcomes only if they are administered before beta-lactams. The objective of this study was to compare outcomes ... Read more >>

Infect Dis (Lond) (Infectious diseases (London, England))
[2018, 50(1):13-20]

Cited: 6 times

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Methods for computational disease surveillance in infection prevention and control: Statistical process control versus Twitter's anomaly and breakout detection algorithms.

Timothy L Wiemken, Stephen P Furmanek, William A Mattingly, Marc-Oliver Wright, Annuradha K Persaud, Brian E Guinn, Ruth M Carrico, Forest W Arnold, Julio A Ramirez,

BACKGROUND:Although not all health care-associated infections (HAIs) are preventable, reducing HAIs through targeted intervention is key to a successful infection prevention program. To identify areas in need of targeted intervention, robust statistical methods must be used when analyzing surveillance data. The objective of this study was to compare and contrast ... Read more >>

Am J Infect Control (American journal of infection control)
[2018, 46(2):124-132]

Cited: 0 times

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Infection prevention and control and the refugee population: Experiences from the University of Louisville Global Health Center.

Ruth M Carrico, Linda Goss, Timothy L Wiemken, Rahel S Bosson, Paula Peyrani, William A Mattingly, Allison Pauly, Rebecca A Ford, Stanley Kotey, Julio A Ramirez,

During 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful ... Read more >>

Am J Infect Control (American journal of infection control)
[2017, 45(6):673-676]

Cited: 2 times

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Using cluster analysis of cytokines to identify patterns of inflammation in hospitalized patients with community-acquired pneumonia: a pilot study.

Timothy L Wiemken, Robert R Kelley, Rafael Fernandez-Botran, William A Mattingly, Forest W Arnold, Stephen P Furmanek, Marcos I Restrepo, James D Chalmers, Paula Peyrani, Rodrigo Cavallazzi, Jose Bordon, Stefano Aliberti, Julio A Ramirez,

Patients with severe community-acquired pneumonia (CAP) are believed to have an exaggerated inflammatory response to bacterial infection. Therapies aiming to modulate the inflammatory response have been largely unsuccessful, perhaps reflecting that CAP is a heterogeneous disorder that cannot be modulated by a single anti-inflammatory approach. We hypothesize that the host ... Read more >>

Univ Louisville J Respir Infect (The University of Louisville journal of respiratory infections)
[2017, 1(1):3-11]

Cited: 1 time

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Role of Atypical Pathogens in the Etiology of Community-Acquired Pneumonia.

Forest W Arnold, James T Summersgill, Julio A Ramirez,

Atypical pneumonia has been described for over 100 years, but some of the pathogens attributed to it have been identified only in the past decades. The most common pathogens are Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila. The epidemiology and pathophysiology of these three pathogens have been studied since their ... Read more >>

Semin Respir Crit Care Med (Seminars in respiratory and critical care medicine)
[2016, 37(6):819-828]

Cited: 3 times

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Process control charts in infection prevention: Make it simple to make it happen.

Timothy L Wiemken, Stephen P Furmanek, Ruth M Carrico, William A Mattingly, Annuradha K Persaud, Brian E Guinn, Robert R Kelley, Julio A Ramirez,

Quality improvement is central to Infection Prevention and Control (IPC) programs. Challenges may occur when applying quality improvement methodologies like process control charts, often due to the limited exposure of typical IPs. Because of this, our team created an open-source database with a process control chart generator for IPC programs. ... Read more >>

Am J Infect Control (American journal of infection control)
[2017, 45(3):216-221]

Cited: 0 times

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Comparing posteroanterior with lateral and anteroposterior chest radiography in the initial detection of parapneumonic effusions.

Bryan K Moffett, Tanmay S Panchabhai, Raul Nakamatsu, Forest W Arnold, Paula Peyrani, Timothy Wiemken, Juan Guardiola, Julio A Ramirez,

It is unclear whether anteroposterior (AP) or posteroanterior with lateral (PA/Lat) chest radiographs are superior in the early detection of clinically relevant parapneumonic effusions (CR-PPEs). The objective of this study was to identify which technique is preferred for detection of PPEs using chest computed tomography (CCT) as a reference standard.A ... Read more >>

Am J Emerg Med (The American journal of emergency medicine)
[2016, 34(12):2402-2407]

Cited: 2 times

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Disinfectant sprays versus wipes: Applications in behavioral health.

Timothy L Wiemken, Whitney Powell, Ruth M Carrico, William A Mattingly, Robert R Kelley, Stephen P Furmanek, Debra Johnson, Julio A Ramirez,

We evaluated the utility and usability of a spray and a wipe-based cleaner/disinfectant in a behavioral health setting where health care providers institute cleaning and disinfection procedures. The spray-based version resulted in significantly lower adenosine triphosphate readings after use compared with the wipe version. Staff surveys indicated that users preferred ... Read more >>

Am J Infect Control (American journal of infection control)
[2016, 44(12):1698-1699]

Cited: 0 times

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Tuberculosis is always a possibility (even in the intensive care unit).

Rodrigo Cavallazzi, Rosemeri Maurici, Julio A Ramirez,

Rev Bras Ter Intensiva (Revista Brasileira de terapia intensiva)
[2016, 28(2):97-99]

Cited: 0 times

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Cost effectiveness of adherence to IDSA/ATS guidelines in elderly patients hospitalized for Community-Aquired Pneumonia.

Michael E Egger, John A Myers, Forest W Arnold, Leigh Ann Pass, Julio A Ramirez, Guy N Brock,

Adherence to guidelines for the treatment of hospitalized elderly patients with community-acquired pneumonia (CAP) has been associated with improved clinical outcomes. This study evaluated the cost-effectiveness of adherence to guidelines for the treatment of CAP in an elderly hospitalized patient cohort.Data from an international, multicenter observational study for patients age ... Read more >>

BMC Med Inform Decis Mak (BMC medical informatics and decision making)
[2016, 16:34]

Cited: 9 times

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Understanding why low-risk patients accept vaccines: a socio-behavioral approach.

Timothy L Wiemken, Ruth M Carrico, Robert R Kelley, Laura E Binford, Paula Peyrani, Kimbal D Ford, Verna Welch, Julio A Ramirez,

Vaccines are one of the most important public health interventions. Understanding factors associated with vaccine acceptance is critical. The objectives of this study were to evaluate the impact of the three constructs of the Theory of Planned Behavior (TPB) on the intention to be vaccinated among healthy individuals being seen ... Read more >>

BMC Res Notes (BMC research notes)
[2015, 8:813]

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Macrolide Use and Neutrophil Function/Cytokine Levels in Hospitalized Patients with Community-Acquired Pneumonia: A Pilot Study.

Forest W Arnold, Jose Bordon, Rafael Fernandez-Botran, Madhavi J Rane, Silvia M Uriarte, Robert Kelley, Timothy L Wiemken, Paula Peyrani, Julio A Ramirez, ,

The objective of this study was to measure plasma cytokine levels and blood neutrophil functions as well as clinical outcomes in hospitalized patients with community-acquired pneumonia (CAP) treated with or without macrolide use--a known modulator of inflammatory response.Subjects with CAP had peripheral blood analyzed for some neutrophil functions (degranulation of ... Read more >>

Lung (Lung)
[2016, 194(1):155-162]

Cited: 3 times

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The upper respiratory tract microbiome of hospitalised patients with community-acquired pneumonia of unknown aetiology: a pilot study.

Timothy L Wiemken, Venkatakrishna Rao Jala, Robert R Kelley, Paula Peyrani, William A Mattingly, Forest W Arnold, Patricio W Cabral, Rodrigo Cavallazzi, Bodduluri Haribabu, Julio A Ramirez,

The composition of the upper respiratory tract microbiome may play an important role in the development of lower respiratory tract infections. Here, we characterised the microbiome of the nasopharynx and oropharynx of hospitalised patients with community-acquired pneumonia (CAP) with unknown aetiology in an attempt to obtain insight into the aetiology ... Read more >>

Pneumonia (Nathan) (Pneumonia (Nathan Qld.))
[2015, 6:83-89]

Cited: 0 times

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