Pulmonary-Gastrointestinal

 

Miroslav Radulovic, M.D.
Associate Program Director,
Internal Medicine Residency Program
Staff Physician
Health Science Specialist
James J. Peters VA Medical Center
Assistant Professor of Medicine
Mt. Sinai School of Medicine(718) 584-9000 ext 5472
miroslav.radulovic@va.gov

Dr. Radulovic received his doctorate in medicine from the International College of Medicine, University of Nis, Serbia, in 1998. With an interest in the etiology of pulmonary dysfunction, in 2001, he had the opportunity to work as a Research Health Science Specialist in the Pulmonary Program of the Spinal Cord Damage Research Center. Subsequently, Dr. Radulovic completed a residency in Internal Medicine and, in 2006, became board certified in Internal Medicine. After completing his residency training, he returned to the Spinal Cord Damage Research Center and is Co-Director of the Pulmonary and Sleep Medicine Program, with Dr. Gregory Schilero, the Director of the Pulmonary Program. Dr. Radulovic is Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai, and the Associate Program Director of the Icahn School of Medicine at Mount Sinai (Bronx) Residency Training Program in Internal Medicine.

Program goals (Lay)
Spinal cord injury weakens the muscles of breathing and reduces the ability to cough or exhale forcefully, an action that is necessary to clear the lung of secretions, This reduced or absent ability to effectively clear secretions from the airways may result in infections,  as well as contribute to the occurrence of sleep disorders. An asthma-like condition may also occur in those with higher cord lesions.

Dr. Radulovic collaborates with Dr. Schilero and his team to explore the use of medications and mechanical devices to improve the respiratory discomfort and health risks associated with spinal cord injury. The findings of Drs. Radulovic and Schilero would be anticipated to assist in the prevention of disorders of breathing, lung infections, and disordered sleeping patterns.

Another aspect of this work is to better understand the role of acid reflux in the etiology of the asthma-like condition observed after spinal cord injury. Acid reflux may also cause damage to the esophagus.

Program goals (Scientific)
Research in the Pulmonary and Sleep Medicine Program has concentrated on altered respiratory mechanics and sleep pathophysiology in persons 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 in 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. Further work is ongoing to investigate the prevalence and significance of gastroesophageal reflux in persons with SCI, a problem that may precipitate an asthma-like condition by causing irritation and inflammation in the lining of the airways of the lung.


 

Research

Relevant Publications

  1. Radulovic M, Bauman WA, Wecht JM, LaFountaine 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 14;9(3): PMID:25971935

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

  1. Korsten MA, Spungen AM, Radulovic M, Rosman AS, Hunt K, Galea MD, Kornfeld SD, Lyons BL, Yen C, Bauman WA. Neostigmine Administered With MoviPrep Improves Bowel Preparation for Elective Colonoscopy in Patients With Spinal Cord Injury: A Randomized Study. J Clin Gastroenterol. 2015 Oct;49(9):751-6. PMID:25599220

http://www.ncbi.nlm.nih.gov/pubmed/25599220

  1. Radulovic M, Schilero GJ, Yen C, Bauman WA, Wecht JM, Ivan A, La Fountaine MF, Korsten MA. Greatly increased prevalence of esophageal dysmotility observed in persons with spinal cord injury. Dis Esophagus. 2014 Sep 16. [Epub ahead of print]  PMID:25224683

http://www.ncbi.nlm.nih.gov/pubmed/25224683

  1. Lyons BL, Korsten MA, Spungen AM, Radulovic M, Rosman AS, Hunt K, Galea MD, Kornfeld SD, Yen C, Bauman WA. Comparison between pulsed irrigation enhanced evacuation and polyethylene glycol-electrolyte lavage solution for bowel preparation prior to elective colonoscopy in veterans with spinal cord injury. J Spinal Cord Med. 2014 Aug 6. [Epub ahead of print] PMID:25096918

http://www.ncbi.nlm.nih.gov/pubmed/25096918

  1. Schilero GJ, Radulovic M, Wecht JM, Spungen AM, Bauman WA, Lesser M. A center's experience: pulmonary function in spinal cord injury. Lung. 2014 Jun;192(3):339-46. PMID: 24723067

http://www.ncbi.nlm.nih.gov/pubmed/24723067