Division of Pulmonary and Critical Care Medicine

Rashmi Nisha Aurora, MD, MHS is Associate Professor of Medicine.  A sleep clinician and researcher with an interest in sleep apnea and its association with cardiovascular and metabolic health. In particular, she has an interest in the effect of sleep apnea in women and how the symptoms and effects of sleep apnea may be different in women versus men. Additionally, she is collaborating with scientists across the institution to examine the association between sleep and addiction.  She is currently a member of the Board of Directors of the American Academy of Sleep Medicine and an Associate Editor to the Journal of Clinical Sleep Medicine. Her clinical practice is devoted to patients with sleep disorders.

Ilya Berim, MD is Associate Professor of Medicine. He specializes in Interventional Pulmonology, including advanced bronchoscopy and pleural procedures. His clinical practice is devoted to patients with lung cancer, pleural diseases and interstitial lung disease with a special focus on diagnostic and therapeutic intervention and care of patients in the medical intensive care unit. 

Ibrahim El Husseini, MD is Assistant Professor of Medicine. His areas of interest are physiology in the critically ill patient and point of care ultrasound. His clinical practice is devoted to the care of the patients admitted to the Medical Intensive Care Unit and in the education of residents and fellows on Critical Care Ultrasonography. 

Sabiha Hussain, MD is Associate Professor of Medicine. She is the program director for the pulmonary and critical care fellowship, and Director of the Adult Cystic Fibrosis program.  She has an interest in innovation in teaching methods and has a focus on global health research as well as development of global Health initiatives for the pulmonary and critical care fellowship. Her research interest is in the social determinants of health for patients in the intensive care unit. Her clinical practice is devoted to patients with general pulmonary diseases as well as in the care of patients admitted to the Medical Intensive Care Unit. 

Sugeet Jagpal, MD is Assistant Professor of Medicine.  She is the Co-Director of 4^th year medical student critical care rotation and is the associate program director of the pulmonary critical care fellowship as well as the Adult Cystic Fibrosis program.  

Her clinical practice is devoted to patients with general pulmonary diseases as well as to the care of patients admitted to the Medical Intensive Care unit. Her special focus is on patients with bronchiectasis and cystic fibrosis. 

Aesha Jobanputra, MD is Assistant Professor of Medicine.  Her research interest is in sleep disordered breathing in patients with advanced heart failure and in cystic fibrosis patients.  She is currently also researching sleep disturbances in commercial vehicle operators and on obstructive sleep apnea as a risk factor for developing diabetes in South Asian population.  Her clinical practice is devoted to patients with sleep disorders and to the care of patients admitted to the medical intensive care unit.

Deborah Kim, MD is Assistant Professor of Medicine.  She is interested in education and curriculum development for students and house staff. She is also the M3 Medicine Clerkship site director at RWJUH.  Her clinical interests include advanced COPD and post-Intensive Care unit care.  Her clinical practice is devoted to patients with general pulmonary diseases as well as care of the patients admitted to the medical intensive care unit. 

Judith A. Neubauer, PhD. Is Professor Medicine. She is Associate Editor for the Journal of Applied Physiology. She has had a longstanding interest in research on the neurobiology of respiratory control particularly as it relates to Sleep Apnea Syndrome. Her work has focused on understanding how hypoxia modulates the central respiratory and sympathetic pattern generators at the integrative, as well as cellular and molecular level. Her laboratory discovered that the pacemaker region of the respiratory network, the pre-Bötzinger Complex, serves as a central oxygen sensor and, together with the C1 sympathoexcitory region, may coordinate the sympathetic and sigh responses to both acute and chronic exposure to hypoxia.  Her studies are directed at understanding the mechanism of hypoxic transduction of these medullary regions with a particular focus on heme oxygenase as the critical oxygen sensor in these neurons. 

Reynold A. Panettieri, Jr., MD is Professor of Medicine, Vice Chancellor for Translational Medicine and Science, Director of the Rutgers Institute for Translational Medicine and Science, and the PI of New Jersey’s only CTSA Hub, NJ ACTS.  He is an accomplished cell and molecular biologist focused on the role of airway smooth muscle function in complex severe airways diseases such as asthma and COPD.  His laboratory pioneered human cell and tissue models to identify novel therapeutic targets to promote bronchodilation and to ameliorate airway inflammation.  Additionally, his lab studies the manner in which toxicants mediate airway hyper-responsiveness and steroid insensitivity in lung disease.  His clinical practice is devoted to patients with severe airways disease.

Jared Radbel, MD is Assistant Professor of Medicine. His research interests include inflammatory mechanisms of air pollution-induced ARDS, World Trade Center dust-induced lung disease, and COVID-19. He has received multiple career development awards from the Society of Toxicology and the NIH NIEHS CEED Pilot Program and has recently been awarded an NIH K08 award. His clinical interests include acute and chronic interstitial lung diseases and methods of mechanical ventilation. His clinical practice is in the care of patients admitted to the medical intensive care unit.

Matthew Scharf, MD, PHD is Assistant Professor of Medicine and Neurology. He is currently Medical Director, Robert Wood Johnson Sleep Laboratory.   His research interests include the impact of sleep and sleep disorders on patients with epilepsy.  He is also interested in the biological consequences of sleep disorders including the significance of sleepiness and sleep disruption.  Dr. Scharf is committed to the education of medical students, residents and fellows on the importance of sleep and sleep disorders. His clinical practice is devoted to patients with sleep disorders.

Jag Sunderram, MD is Professor of Medicine. He is currently the Interim Division Chief of the Pulmonary and Critical Care Division and is the Medical Director of the Medical ICU of Robert Wood Johnson University Hospital. His research interest is the pathogenesis, epidemiology and consequences of Obstructive Sleep Apnea. He is currently the Co-Principal Investigator of a NIOSH funded grant examining the mechanism of Obstructive Sleep Apnea in World Trade Center Responders. His clinical practice is devoted to patients with general pulmonary diseases as well as sleep disorders and care of patients in the medical intensive care unit. 

The Division of Pulmonary and Critical Care Medicine offers diagnosis and second-opinion outpatient and inpatient consultations for various adult lung diseases, sleep disorders and illnesses that require intensive care unit admissions. The division includes highly trained and skilled specialists who are board certified in the fields of pulmonary medicine, critical care medicine and sleep medicine. Division faculty members serve as attending physicians at Robert Wood Johnson University Hospital (RWJUH). They are responsible for the administration and direction of RWJUH's Medical Intensive Care Unit, Pulmonary Function Laboratory, Respiratory Therapy, Bronchology Service and Comprehensive Sleep Disorders Center. In addition to providing clinical care, our physicians also participate in the teaching and training of new physicians and conduct research in critical care medicine and all types of lung disease and sleep problems. These physicians attend national and international meetings to present and review the latest findings in the care of patients with lung disease, sleep disorders and critical care problems.

Adult Cystic Fibrosis Center

The Adult Cystic Fibrosis Center at Robert Wood Johnson Medical School is fully accredited by the Cystic Fibrosis Foundation to serve the needs of cystic fibrosis patients in New Jersey and surrounding states. The primary function of the center is to provide excellent clinical care, resources and advocacy for adult CF patients and their families. Comprehensive care is provided by a multidisciplinary team led by Dr. Sabiha Hussain, who has more than 15 years' experience in CF-related care, education and research. Experienced team members in the fields of nursing, nutrition, social work and respiratory therapy are available to meet the varied needs of the maturing CF patient. A primary function of the CF team is to assist the adult CF patient and family in navigating today's increasingly complex health care and insurance systems to ensure provision of optimal care. In concert with our pediatric colleagues, the Robert Wood Johnson Cystic Fibrosis Center is a leader in CF-related education and research in New Jersey.

The Comprehensive Sleep Disorders Center

The Comprehensive Sleep Disorders Center is a joint program of Rutgers Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital and is a fully accredited center by the American Sleep Disorders Association.

The center, which evaluates and treats approximately 1,500 patients annually, provides a full range of diagnostic and treatment services for disorders of sleep and wakefulness. These issues include hypersomnias, sleep apnea, narcolepsy, periodic limb movements in sleep, insomnias, parasomnias (sleep walking, night terrors) and disorders of the sleep-wake schedule. The staff of the center includes specialists in medicine, pediatrics, psychiatry, neurology, otolaryngology and dentistry who provide a multidisciplinary team approach to patient care.

Diagnostic services of the center include an outpatient clinic and sleep laboratory where polysomnography and multiple sleep latency testing are performed. Patients with sleep apnea receive nasal CPAP/BiPAP evaluation and treatment when indicated. Other treatment services include pharmacological therapy, behavioral therapy, sleep hygiene training, dental appliances and upper airway surgery in selected cases. Long-term follow-up is provided for all treatment cases.

Interventional Bronchology Services

We provide interventional bronchology services for the diagnosis and treatment of malignant and non-malignant airway and mediastinal diseases. Therapeutic bronchoscopy is indicated for relief of symptoms in patients who have central airway obstruction from either malignant or non-malignant central airway obstruction or asthma. Several modalities allow us to tailor therapy for each patient. These modalities include:

• Endobronchial ultrasound (EBUS)
• Thermal techniques, including argon plasma coagulation (APC), electrocautery, laser and cryotherapy
• Endobronchial brachytherapy
• Silicone, metallic and hybrid airway stents
• Bronchial thermoplasty

Medical Critical Care Services

Medical Critical Care Services are provided by the division in the Medical Intensive Care Unit at Robert Wood Johnson University Hospital.

The Medical Intensive Care Unit is a Leapfrog-compliant ICU that provides care for critically ill patients who have complex, multisystem, life-threatening diseases and is a tertiary referral center for patients with complex medical critical care issues.

Diseases diagnosed and managed include, but are not limited to, acute respiratory failure due to COPD, asthma, pneumonia and ARDS, severe sepsis, life-threatening infections, hypovolemic and distributive shock, acute gastrointestinal hemorrhage, severe pancreatitis, acute liver and kidney failure, strokes, intracranial hemorrhage, status epilepticus and endocrine emergencies.

The MICU at Robert Wood Johnson University Hospital is a 16-bed, state-of-the-art unit with individual patient rooms, one pod for two patient rooms, and a nurse-to-patient ratio of 1:2. The nursing staff are all registered nurses and more than 80 percent are critical care registered nurses. The MICU also possesses a specially trained and dedicated staff of pharmacists, nutritionists and respiratory therapists with the expertise to care for critically ill patients.

Patients admitted under the care of Robert Wood Johnson Medical Group physicians are cared for by a board-certified critical care academic physician, a critical care fellow and a team of internal medicine residents. Subspecialty faculty covering all fields are available for consultations.

All patients admitted to the MICU at Robert Wood Johnson University Hospital are also cared for by a group of in-house board-certified intensivists during the hours of 7 p.m. to 9 a.m.

Pulmonary Consultation Service

The Pulmonary Consultation Service provides help in the diagnosis and state-of-the-art clinical care of patients with various adult respiratory disease, including interstitial lung diseases, lung cancer, obstructive lung diseases, pulmonary hypertension and sarcoidosis. We provide consultations to establish or review a treatment plan, as well as longitudinal care of patients, if requested. The service will assess for disease severity, design a personalized treatment plan and arrange for pulmonary rehabilitation, home oxygen, smoking cessation, dietary counseling or other therapies as deemed appropriate.

Diagnoses of lung diseases are made with the help of investigative procedures such as imaging studies, pulmonary function tests, cardiopulmonary exercise studies and fiberoptic bronchoscopy. Pulmonary imaging studies such as chest X-ray and CT scan are performed at Robert Wood Johnson University Hospital and are read by expert chest radiologists. High-quality pulmonary function testing and cardiopulmonary exercise studies are performed at Robert Wood Johnson University Hospital by a group of highly trained pulmonary technologists, several of whom are also certified respiratory therapists. Fiberoptic bronchoscopy is performed to obtain specimens from the lung and is performed by board-certified pulmonologists from the division of pulmonary and critical care medicine.

We provide interventional bronchology services for the diagnosis and treatment of malignant and non-malignant airway and mediastinal diseases. Therapeutic bronchoscopy is indicated for relief of symptoms in patients who have central airway obstruction from either malignant or non-malignant central airway obstruction or asthma. Several modalities allow us to tailor therapy for each patient. These modalities include:

• Endobronchial ultrasound (EBUS)
• Thermal techniques, including argon plasma coagulation (APC), electrocautery, laser and cryotherapy
• Endobronchial brachytherapy
• Silicone, metallic and hybrid airway stents
• Bronchial thermoplasty

The division’s research activities include clinical trials of drugs (mycophenolate vs. oral cyclophosphamide) in treatment of Scleroderma interstitial lung disease,  developing countermeasures for chemical warfare agents (using various agents to hasten repair of wounds in animal models of chemical weapons injury), determining the effects of environmental exposures in bronchial asthma and COPD and determining the mechanisms behind the central ventilatory response to hypoxia.

Impact of Division Research

Research by Dr. Riley could improve the course and outcomes of Scleroderma interstitial lung disease by showing the greater efficacy of mycophenolate mofetil (as opposed to the current therapy of choice, cyclophosphamide) in scleroderma interstitial lung disease. A second study involves looking into Bosentan in similar conditions. Dr. Neubauer and Sunderram’s studies documenting heme-oxygenase involvement in central hypoxic responses provide a paradigm for further investigations on how the brain responds to and adapts to hypoxia. Dr. Hussain’s studies quantifying specific environmental influences on airway obstruction in COPD and bronchial asthma and their mechanisms should help clinicians better understand the role of the environment in exacerbations of lung disease. Finally, a better understanding of the evolving pulmonary problems of World Trade Center 9/11 first responders is being uncovered by Dr. Sotolongo in collaboration with Dr. Udasin in EOHSI.

Publications

• Sunderram, J, Semmlow J, Thakker-Varia S, Bhaumik M, Hoang-Le O, Neubauer JA. Heme oxygenase-1 dependent central cardiorespiratory adaptations to chronic hypoxia in mice. Am J Physiol Regul Integr Comp Physiol. 297: R300-R312, 2009.
• Chang YC, Sabourin CL, Lu SE, Sasaki T, Svoboda KK, Gordon MK, Riley DJ, Casillas RP, Gerecke DR. Upregulation of gamma-2 laminin-322 in the mouse ear vesicant wound model. J. Biochem. Mol. Toxicol. 23: 172-184, 2009.
• D’Agostino D, Mazza Jr. E, Neubauer JA. Heme oxygenase is necessary for the excitatory response of cultured neonatal rat rostral ventrolateral medulla neurons to hypoxia. Am J Physiol Regul Integr Comp Physiol. 296: R102-R118, 2009.
• Langhammer CG, Garg K, Neubauer JA, Rosenthal S, Kinzy TG. Medical Student Research Exposure via a series of modular research programs. J. Invest. Med. 57: 11-17, 2009.

Abstract Listing

• Shakarjian MP, Vetrano AM, Gray JP, DeSantis AS, Riley DJ, Laskin JD, Chang Y-C, Gerecke DP, Heck DE. Cell adhesion and migration changes in response to alkylation of laminin322. U.S. Army Med. Defense Biosciences Rev. A138, 2008.
• Shakarjian MP, Vetrano AM, Gray JP, DeSantis AS, Riley DJ, Laskin JD, Chang Y-C, Gerecke DR, Heck DE. Disruption of keratinocyte-basement membrane (BM) component interactions by sulfur mustard (SM) analogues. The Toxicologist. A552, 2009

For Appointments: 732-235-7840