Meghan Marmor
Clinical Assistant Professor, Medicine - Pulmonary, Allergy & Critical Care Medicine
Bio
Dr. Marmor is board certified in pulmonary and critical care medicine. She specializes in the treatment of individuals with chronic airway diseases, bronchiectasis, and chronic lung infections.
Clinical Focus
- Bronchiectasis
- Nontuberculous mycobacterial pulmonary disease
- Critical Care Medicine
- Chronic lung infections
Academic Appointments
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Clinical Assistant Professor, Medicine - Pulmonary, Allergy & Critical Care Medicine
Administrative Appointments
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Director of Quality, Division of Pulmonary Medicine, Department of Medicine (2021 - Present)
Professional Education
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Board Certification: American Board of Internal Medicine, Critical Care Medicine (2019)
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Fellowship: Stanford University Pulmonary and Critical Care Fellowship (2019) CA
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Board Certification: American Board of Internal Medicine, Pulmonary Disease (2018)
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Board Certification: American Board of Internal Medicine, Internal Medicine (2016)
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Residency: Brown University Internal Medicine Residency (2016) RI
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Medical Education: University of Arizona College of Medicine Office of the Registrar (2013) AZ
All Publications
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Mind the gap: challenges to overcome in airway clearance.
The European respiratory journal
2024; 63 (6)
View details for DOI 10.1183/13993003.00687-2024
View details for PubMedID 38843939
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The Impact of Tobacco Smoking in Bronchiectasis: Data from the United States Bronchiectasis and NTM Research Registry.
American journal of respiratory and critical care medicine
2024
View details for DOI 10.1164/rccm.202402-0466RL
View details for PubMedID 38712994
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Variables associated with antibiotic treatment tolerance in patients with Mycobacterium avium complex pulmonary disease.
Respiratory research
2024; 25 (1): 123
Abstract
Treatment of Mycobacterium avium complex pulmonary disease (MAC-PD) involves prolonged courses of multiple antibiotics that are variably tolerated and commonly cause adverse drug reactions (ADR). The purpose of this retrospective, single-center study was to identify demographic and disease-related variables associated with significant ADRs among patients treated with antibiotics against MAC-PD.We reviewed all patients treated with antibiotic therapy for MAC-PD at a single center from 2000 to 2021. Patients were included if they met diagnostic criteria for MAC-PD, were prescribed targeted antibiotic therapy for any length of time and had their treatment course documented in their health record. We compared patients who completed antibiotics as originally prescribed (tolerant) with those whose antibiotic treatment course was modified or terminated secondary to an ADR (intolerant).Over the study period, 235 patients were prescribed antibiotic treatment with their clinical course documented in our center's electronic health record, and 246 treatment courses were analyzed. One hundred forty-three (57%) tolerated therapy versus 108 (43%) experienced ADRs. Among the 108 intolerant courses, 67 (63%) required treatment modification and 49 (46%) required premature treatment termination. Treatment intolerance was associated more frequently with smear positive sputum cultures (34% vs. 20%, p = 0.009), a higher Charlson Comorbidity Index (CCI) (4 vs. 6, p = 0.007), and existing liver disease (7% vs. 1%, p = 0.03). There was no between-group difference in BMI (21 vs. 22), fibrocavitary disease (24 vs. 19%), or macrolide sensitivity (94 vs. 80%). The use of daily therapy was not associated with intolerance (77 vs. 79%). Intolerant patients were more likely to be culture positive after 6 months of treatment (44 vs. 25%).Patients prescribed antibiotic therapy for MAC-PD are more likely to experience ADRs if they have smear positive sputum cultures at diagnosis, a higher CCI, or existing liver disease. Our study's rate of early treatment cessation due to ADR's was similar to that of other studies (20%) but is the first of its kind to evaluate patient and disease factors associated with ADR's. A systematic approach to classifying and addressing ADRs for patients undergoing treatment for MAC-PD is an area for further investigation.
View details for DOI 10.1186/s12931-024-02752-y
View details for PubMedID 38468274
View details for PubMedCentralID 6993793
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Diffuse Panbronchiolitis in a Patient With Ulcerative Colitis Treated With Ustekinumab.
ACG case reports journal
2023; 10 (5): e01062
View details for DOI 10.14309/crj.0000000000001062
View details for PubMedID 37234998
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Primary Ciliary Dyskinesia
CHEST Pulmonary Reviews
2023; 1 (1): 1-12
View details for DOI 10.1016/j.chpulm.2023.100004
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Treatment of NTM Lung Disease Is Complex; Thus, Shared Decision Making Is Critical.
Annals of the American Thoracic Society
2022
View details for DOI 10.1513/AnnalsATS.202201-002VP
View details for PubMedID 35316167
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Prolonged Hospitalization Following Acute Respiratory Failure.
Chest
2020
Abstract
A better understanding of the clinical features associated with prolonged hospitalization in acute respiratory failure may allow for better informed care planning.To assess the incidence, mortality, cost and clinical determinants of prolonged hospitalization among patients with acute respiratory failure (ARF).Using the National Inpatient Sample (NIS) data from 2004 to 2014, we identified adults 18 years and older with International Classification of Disease, 9th Edition (ICD-9), codes for ARF requiring mechanical ventilation for at least two days (ICD-9 518.81 or 518.82, 96.7 or 96.04, and 96.05). Outcomes studied included incidence, in-hospital mortality, cost of hospitalization, and associated patient-level and hospital-level characteristics. Trends were assessed by logistic regression, linear regression and general linear modeling with Poisson distribution.Of the 5,539,567 patients with ARF, 77,665 (1.4%) had a prolonged length of stay, defined as ≥60 days (pLOS). Among pLOS, 52,776 (68%) survived to discharge. Over the study period, incidence of pLOS decreased by 48%, in-patient mortality decreased by 18%, per patient cost-of-care rose, but percent of the total cost of ARF care consumed by patients with pLOS did not significantly decrease (p=0.06). PLOS was more likely to occur in urban teaching hospitals (OR 6.8, CI 4.6-10.2, p<0.001), hospitals located in the Northeastern US (OR 3.6, CI 3.0-4.3, p<0.001), and among patients with Medicaid insurance coverage (OR 2.1, CI 1.9-2.4, p<0.001).From 2004-2014, incidence and mortality decreased among patients with ARF and pLOS, and while per patient costs rose, percent of total cost of care remained stable. There is substantial variation in length-of-stay for patients with ARF by US region, hospital teaching status and patient insurance coverage.
View details for DOI 10.1016/j.chest.2020.11.023
View details for PubMedID 33333057
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Corticosteroids for COVID-19-Associated ARDS
Clinical Pulmonary Medicine
2020; 27 (6): 165-167
View details for DOI 10.1097/CPM.0000000000000381
- How is CF diagnosed? Facing Cystic Fibrosis: A Guide for Patients and Their Families 2019
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Opportunities to Improve Utilization of Palliative Care among Adults with Cystic Fibrosis: A Systematic Review.
Journal of pain and symptom management
2019
Abstract
Individuals with Cystic Fibrosis (CF) frequently survive into adulthood and many have multi-faceted symptoms that impair quality of life.We conducted a systematic review to investigate opportunities to improve utilization of palliative care among adults with CF.We searched PubMed, Embase, Scopus, Web of Science and CINAHL databases from inception until September 27, 2018, and reviewed references manually. Eligible articles were published in English, involved adults age 18 years and older with CF and contained original data regarding patient outcomes related to presence of advanced care planning (ACP), symptom experience, and preferred and/or received end-of-life care.We screened 652 article abstracts and 32 full text articles; 12 studies met inclusion criteria. All studies were published between 2000 and 2018. Pertinent findings include that while 43% to 65% of adults with CF had contemplated completing ACP, the majority only completed ACP during their terminal hospital admission. Patients also reported high prevalence of untreated symptoms, with adequate symptom control reported in 45% among those with dyspnea, 22% among those with pain and 51% among those with anxiety and/or depression. Prevalence of in-hospital death ranged from 62% to 100%, with a third dying in the intensive care unit (ICU). The majority received antibiotics and preventative treatments during their terminal hospitalization. Finally, treatment from a palliative care specialist was associated with a higher prevalence of patient completion of advanced directives, decreased likelihood of in-ICU death and decreased use of mechanical ventilation at end-of-life.Adults with CF often have untreated symptoms and many opportunities exist for palliative care specialists to improve ACP completion and quality of end-of-life care.
View details for DOI 10.1016/j.jpainsymman.2019.08.017
View details for PubMedID 31437475