Pulmonary-Gastrointestinal

 

Gregory Schilero, M.D.
Director, Sleep Laboratory
Director, Medical/Surgical Intensive Care Unit
James J. Peters VA Medical Center
Associate Professor of Medicine
Mount Sinai School of Medicine
(718) 584-9000 ext 6701
gregory.schilero@va.gov

In 1984, Dr. Schilero received a M.S. degree from Tufts University, and, in 1988, his M.D. from Hahnemann University. Dr. Schilero performed his medical residency and fellowship at the Mount Sinai School of Medicine. He is board certified in Internal Medicine, with subspecialty boards in Pulmonary Disease, Critical Care Medicine, and Sleep Medicine. After completing his fellowship in Pulmonary Medicine, Dr. Schilero remained at the Mount Sinai School of Medicine for four years as the Associate Director for the Lung and Heart/Lung Transplantation program and the Sleep Center at Mount Sinai. When the James J. Peters Veterans Affairs Medical Center offered Dr. Schilero a position as a Pulmonary, Critical Care, and Sleep Medicine specialist, he graciously accepted.

With an interest in the etiology of pulmonary dysfunction and sleep disorders in persons with spinal cord injury, Dr. Schilero joined the Spinal Cord Damage Research Center under Dr. Marvin Lesser in 2005. When Dr. Lesser retired one year later, Dr. Schilero was appointed as the Director of the Pulmonary and Sleep Medicine Program and continued to perform research addressing airway pathophysiology and respiratory symptoms in persons with spinal cord injury. With the assistance of the Co-Director of the Pulmonary Program, Dr. Radulovic, the respiratory studies expanded to include respiratory muscle function, airway inflammation, sleep disordered breathing, and the possible relationship between gastroesophageal reflux and reactive airway disease in patients with a spinal cord injury.

Dr. Schilero is an intensive care attending physician and also directs the Sleep Diagnostic and Treatment Center at the James J. Peters Veterans Affairs Medical Center.

Dr. Schilero has served as a committee member for The International Autonomic Standards for the Neurological Classification of Spinal Cord Injury (Bronchopulmonary Section).  Over the years, Dr. Schilero has greatly appreciated the collaborative effort and multidisciplinary approach to research that the Spinal Cord Damage Research Center has offered, and the opportunity to improve the pulmonary health of persons with spinal cord injury.

Program goals (Lay)
Spinal cord injury causes weakness in the muscles used for breathing, limiting how deeply one can breathe and preventing breathing out forcefully or coughing. The lack of an ability to effectively cough leaves unwanted material in the airway that can result in lung infections and sleep disorders. An asthma-like condition that was first identified by investigators of the SCDRC may also occur.

Dr. Schilero and colleagues have used medications and mechanical devices to improve the ability to breath and to cough, or exhale, forcefully. His findings will assist in the prevention of lung complications. Another goal of his work is to better identify, treat and prevent acid reflux and its potentially damaging effects to the lungs and esophagus in persons with spinal cord injury.

Program goals (Scientific)
Research in the Pulmonary and Sleep Medicine Program has centered upon altered respiratory mechanics and sleep pathophysiology in individuals with spinal cord injury.  Areas of interest include mechanisms underlying non-specific airway hyper-reactivity, bronchodilator responsiveness, and the role of the autonomic nervous system in governing airway tone among persons with tetraplegia.  More recently, investigation has focused upon the presence and impact of the airway inflammatory response, and on methods to accurately measure and potentially augment respiratory muscle strength in persons with tetraplegia and high paraplegia.  Another area of interest involves identification and analysis of sleep disordered breathing, a condition that is highly prevalent among persons with tetraplegia. Other studies are investigating the prevalence and significance of gastroesophageal reflux (“acid indigestion”) in persons with SCI, a problem that may precipitate an asthma-like condition by causing irritation and inflammation in the lining of the lungs.


 

Research

Relevant Publications

  1. Schilero GJ, Spungen AM, Bauman WA, Radulovic M, Lesser M.  Pulmonary function and spinal cord injury.  Respir Physiol Neurobiol. 2009; 166:129-141.

http://www.ncbi.nlm.nih.gov/pubmed/19442929

  1. Radulovic M, Schilero GJ, Wecht JM, LaFountaine M, Rosado-Rivera D, Bauman WA. Exhaled nitric oxide levels are elevated in persons with tetraplegia and comparable to that in mild asthmatics.  Lung. 2010; 188(3):259-262.

http://www.ncbi.nlm.nih.gov/pubmed/20012982

  1. Radulovic M, Spungen AM, Wecht JM, Korsten MA, Schilero GJ, Bauman WA, Lesser M.  Effects of neostigmine and glycopyrrolate on pulmonary resistance in spinal cord injury.  J Rehabil Res Dev. 2004; 41:53-58.

http://www.ncbi.nlm.nih.gov/pubmed/15273897

  1. Grimm DR, Schilero GJ, Spungen AM, Bauman WA, Lesser M.  Salmeterol improves pulmonary function in persons with tetraplegia.  Lung. 2006; 184:335-339.

http://www.ncbi.nlm.nih.gov/pubmed/17096182

  1. Radulovic M, Schilero GJ, Wecht JM, Weir JP, Spungen AM, Bauman WA, Lesser M.  Airflow obstruction and reversibility in spinal cord injury: evidence for functional sympathetic innervation.  Arch Phys Med Rehabil. 2008; 89:2349-2353.

http://www.ncbi.nlm.nih.gov/pubmed/19061747

  1. Radulovic M, Bauman WA, Wecht JM, La Fountaine M, Kahn N, Hobson J, Singh K, Renzi C, Yen C, Schilero GJ.  Biomarkers of inflammation in persons with chronic tetraplegia. J Breath Res. 2015; May 9(3):036001.

http://www.ncbi.nlm.nih.gov/pubmed/25971935