Carson T. Moss

All Publications

• Allergic Bronchopulmonary Aspergillosis (ABPA) in the Era of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Modulators. Journal of fungi (Basel, Switzerland) Chatterjee, P., Moss, C. T., Omar, S., Dhillon, E., Hernandez Borges, C. D., Tang, A. C., Stevens, D. A., Hsu, J. L. 2024; 10 (9)

  Abstract

  Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity disease caused by Aspergillus fumigatus (Af), prevalent in persons with cystic fibrosis (CF) or asthma. In ABPA, Af proteases drive a T-helper cell-2 (Th2)-mediated allergic immune response leading to inflammation that contributes to permanent lung damage. Corticosteroids and antifungals are the mainstays of therapies for ABPA. However, their long-term use has negative sequelae. The treatment of patients with CF (pwCF) has been revolutionized by the efficacy of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy. Pharmacological improvement in CFTR function with highly effective elexacaftor/tezacaftor/ivacaftor (ETI) provides unprecedented improvements in lung function and other clinical outcomes of pwCF. The mechanism behind the improvement in patient outcomes is a continued topic of investigation as our understanding of the role of CFTR function evolves. As ETI therapy gains traction in CF management, understanding its potential impact on ABPA, especially on the allergic immune response pathways and Af infection becomes increasingly crucial for optimizing patient outcomes. This literature review aims to examine the extent of these findings and expand our understanding of the already published research focusing on the intersection between ABPA therapeutic approaches in CF and the rapid impact of the evolving CFTR modulator landscape. While our literature search yielded limited reports specifically focusing on the role of CFTR modulator therapy on CF-ABPA, findings from epidemiologic and retrospective studies suggest the potential for CFTR modulator therapies to positively influence pulmonary outcomes by addressing the underlying pathophysiology of CF-ABPA, especially by decreasing inflammatory response and Af colonization. Thus, this review highlights the promising scope of CFTR modulator therapy in decreasing the overall prevalence and incidence of CF-ABPA.

  View details for DOI 10.3390/jof10090656

  View details for PubMedID 39330416

• Home Hospital Outcomes for Acute Decompensated Heart Failure and Factors Associated With Escalation of Care. Circulation. Cardiovascular quality and outcomes Achanta, A., Wasfy, J. H., Moss, C. T., Cherukara, A., Ho, D., Boxer, R., Schmieding, M., Phadke, N. A., Thompson, R., Levine, D. M., Weiner, R. B. 2023: e010031

  Abstract

  BACKGROUND: Overall outcomes and the escalation rate for home hospital admissions for heart failure (HF) are not known. We report overall outcomes, predict escalation, and describe care provided after escalation among patients admitted to home hospital for HF.METHODS: Our retrospective analysis included all patients admitted for HF to 2 home hospital programs in Massachusetts between February 2020 and October 2022. Escalation of care was defined as transfer to an inpatient hospital setting (emergency department, inpatient medical unit) for at least 1 overnight stay. Unexpected mortality was defined as mortality excluding those who desired to pass away at home on admission or transitioned to hospice. We performed the least absolute shrinkage and selection operator logistic regression to predict escalation.RESULTS: We included 437 hospitalizations; patients had a median age of 80 (interquartile range, 69-89) years, 58.1% were women, and 64.8% were White. Of the cohort, 29.2% had reduced ejection fraction, 50.9% had chronic kidney disease, and 60.6% had atrial fibrillation. Median admission Get With The Guidelines HF score was 39 (interquartile range, 35-45; 1%-5% predicted inpatient mortality). Escalation occurred in 10.3% of hospitalizations. Thirty-day readmission occurred in 15.1%, 90-day readmission occurred in 33.8%, and 6-month mortality occurred in 11.5%. There was no unexpected mortality during home hospitalization. Patients who experienced escalation had significantly longer median length of stays (19 versus 7.5 days, P<0.001). The most common reason for escalation was progressive renal dysfunction (36.2%). A low mean arterial pressure at the time of admission to home hospital was the most significant predictor of escalation in the least absolute shrinkage and selection operator regression.CONCLUSIONS: About 1 in 10 home hospital patients with HF required escalation; none had unexpected mortality. Patients requiring escalation had longer length of stays. A low mean arterial pressure at the time of admission to home hospital was the most important predictor of escalation of care in the least absolute shrinkage and selection operator logistic regression model.

  View details for DOI 10.1161/CIRCOUTCOMES.123.010031

  View details for PubMedID 38054286

• Caregiver burden in a home hospital versus traditional hospital: A secondary analysis of a randomized controlled trial. Journal of the American Geriatrics Society Moss, C. T., Schnipper, J. L., Levine, D. M. 2023

  View details for DOI 10.1111/jgs.18603

  View details for PubMedID 37789659

• The Reply. The American journal of medicine Barkoudah, E., Moss, C., Connell, N. T. 2023; 136 (3): e56

  View details for DOI 10.1016/j.amjmed.2022.11.011

  View details for PubMedID 36796962

• Occam's Razor for Severe B12 Deficiency. The American journal of medicine Moss, C., Patil, D. T., Connell, N. T., Zon, R. L., Barkoudah, E. 2022; 135 (7): 844-847

  View details for DOI 10.1016/j.amjmed.2022.01.039

  View details for PubMedID 35139322