Internists, Critical Care Specialist, Pulmonologist (lungs)
26 years of experience
Video profile
Accepting new patients
Center City East
834 Walnut St
Suite 650
Philadelphia, PA 19107
215-955-5161
Locations and availability (3)

Education ?

Medical School Score Rankings
UMDNJ (1984)
  • Currently 3 of 4 apples
Top 50%

Awards & Distinctions ?

Associations
American Board of Internal Medicine

Affiliations ?

Dr. Sexauer is affiliated with 17 hospitals.

Hospital Affilations

Score

Rankings

  • Ocean Medical Center
    Pulmonary Disease
    425 Jack Martin Blvd, Brick, NJ 08724
    • Currently 4 of 4 crosses
    Top 25%
  • Thomas Jefferson University Hospital
    Pulmonary Disease
    111 S 11th St, Philadelphia, PA 19107
    • Currently 4 of 4 crosses
    Top 25%
  • Somerset Medical Center
    Pulmonary Disease
    110 Rehill Ave, Somerville, NJ 08876
    • Currently 3 of 4 crosses
    Top 50%
  • Robert Wood Johnson Univ Hosp
    Pulmonary Disease
    1 Robert Wood Johnson Pl, New Brunswick, NJ 08901
    • Currently 3 of 4 crosses
    Top 50%
  • University Medical Center At Princeton
    Pulmonary Disease
    253 Witherspoon St, Princeton, NJ 08540
    • Currently 3 of 4 crosses
    Top 50%
  • Virtua Memorial Hospital Of Burlington County
    Pulmonary Disease
    175 Madison Ave, Mount Holly, NJ 08060
    • Currently 3 of 4 crosses
    Top 50%
  • Methodist Hospital
  • Robert Wood Johnsonuniversityhospital
  • Tenet HealthSystem Hahnemann LLC
  • Hahnemann University Hospital
  • Methodist Hospital Division of Thomas Jefferson University Hospital
  • Medical College/Pennsylvania H
  • Rwjuh at Rahway
  • Medical Center of Ocean County
  • Medical CollegePennsylvania H
  • Princeton House Behavorial Healthcare
    905 Herrontown Rd, Princeton, NJ 08540
  • Rwj University Hospital
  • Publications & Research

    Dr. Sexauer has contributed to 9 publications.
    Title Aerosolized Antibiotics in Cystic Fibrosis.
    Date October 2005
    Journal Seminars in Respiratory and Critical Care Medicine
    Excerpt

    Inhaled antibiotics offer an attractive alternative to systemic administration in cystic fibrosis (CF) for several reasons. Antibiotics can be administered directly to the site of infection with little systemic absorption, thereby minimizing toxicity. Aerosolization will permit chronic administration of antipseudomonal antibiotics while avoiding the risks and inconvenience of intravenous access. Modern aerosolized drug delivery systems enable endobronchial delivery of very high antibiotic concentrations, resulting in clinical improvement even in patients with bacterial organisms that traditionally would have been considered resistant. This article summarizes basic concepts of aerosol drug administration and reviews available data on the administration of a variety of drug classes for both suppressive therapy and acute exacerbations of cystic fibrosis, including toxicity and safety data. The aminoglycosides have been by far the most extensively studied class of antibiotics, culminating in U.S. Food and Drug Administration (FDA) approval of a specifically formulated tobramycin solution for inhalation. The available data on the development of antibiotic resistance and emergence of other organisms with long-term use of this agent are reviewed. Finally, a brief guideline for initiating and monitoring patients on antibiotic aerosols is provided for the clinician caring for CF patients.

    Title Utility of the Breathing Reserve Index at the Anaerobic Threshold in Determining Ventilatory-limited Exercise in Adult Cystic Fibrosis Patients.
    Date November 2003
    Journal Chest
    Excerpt

    OBJECTIVES: Cardiopulmonary exercise testing in cystic fibrosis (CF) patients is useful to assess functional status and prognosis. Using the current interpretation guidelines, the utility of this testing will be limited in those patients who cannot exercise to a near-maximal level. This study investigates the utility of the breathing reserve index at the anaerobic threshold (BRIAT), which is defined as minute ventilation at the anaerobic threshold (AT)/maximum voluntary ventilation (MVV), to distinguish ventilatory-limited (VL) CF patients from nonventilatory-limited (NVL) CF patients. DESIGN: Exercise studies on 53 adult CF patients at baseline clinical status performed from 1993 to 1999 were reviewed, of which 40 met the inclusion criteria. The studies were performed via ramp protocol to the symptom-limited maximum on a cycle ergometer with breath-by-breath expired gas analysis. AT was determined noninvasively via the V-Slope method. The patients were classified as VL if they had abnormal spirometry findings, reduced exercise capacity, and a breathing reserve index at maximum exercise (BRImax) of > or = 0.7. NVL patients had a normal BRImax and met the criteria for a maximal study. RESULTS: VL patients (21 patients) had significantly lower FVC, FEV(1), MVV, and body mass index than NVL patients (19 patients). The BRIAT for the VL group was significantly higher than that for the NVL group (p < 0.001). Logistic regression analysis revealed that BRIAT discriminated VL patients from NVL patients better than a variety of nonexercise variables tested. The BRIAT correlated extremely well with BRImax (r = 0.89; p < 0.01), FVC (r = -0.67; p < 0.001), FEV(1) (r = -0.76; p < 0.001), and FEV(1)/FVC ratio (r = -0.683; p < 0.001). A BRIAT value of 0.29 distinguished VL CF patients from NVL CF patients with 95.2% sensitivity and 84.2% specificity. CONCLUSIONS: The BRIAT assessed noninvasively correlates well with commonly used measurements of pulmonary function and accurately distinguishes CF patients with and without a ventilatory limitation to exercise. The BRIAT may have utility in the interpretation of exercise studies in CF patients who are unable to exercise to a maximal level.

    Title New Treatment Modalities for Cystic Fibrosis.
    Date December 1997
    Journal Current Opinion in Pulmonary Medicine
    Excerpt

    Refinements in standard therapy for cystic fibrosis have led to dramatic increases in survival and quality of life over the past three decades. Standard therapy has consisted of oral and intravenous antibiotics, chest percussion with postural drainage, and aerosol bronchodilator therapy. The discovery of the cystic fibrosis gene and elucidation of the underlying biochemical defect have broadened our understanding of the pathophysiology of cystic fibrosis and provided a rationale for many new and innovative therapies. Modulation of airway epithelial ion transport may improve mucociliary clearance and delay colonization by infective organisms. Anti-inflammatory therapy may decrease lung injury that results from the host's attempt to limit airway infection. Supplementation of airway antiproteases may limit the destructive effects of unopposed proteases on pulmonary architecture. Genetic biotechnology has already produced agents that preserve pulmonary function and decrease infectious exacerbations by altering the viscoelastic properties of sputum from patients with cystic fibrosis. Both active and passive immunotherapy are currently being investigated as a measure to delay or combat endobronchial infection with Pseudomonas spp. Aerosolized aminoglycoside antibiotics are being increasingly employed to control pulmonary infection while minimizing systemic toxicity. These treatment modalities, combined with the prospects for gene therapy, provide a brighter outlook for the patient with cystic fibrosis than ever before.

    Title Hemoptysis As the Presenting Symptom in Bronchiolitis Obliterans Organizing Pneumonia.
    Date July 1997
    Journal Chest
    Excerpt

    Bronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon but increasingly recognized pulmonary entity that usually presents with symptoms of dyspnea, cough, and fever. The medical literature describes rare cases of hemoptysis in BOOP, with very small quantities of blood expectorated. We describe two cases of BOOP, one idiopathic and one in association with rheumatoid arthritis, in which large-quantity hemoptysis was the primary presenting symptom.

    Title Bronchial Obstruction Secondary to Aortic Pseudoaneurysm: Treatment with an Expandable Metallic Stent.
    Date September 1995
    Journal Ajr. American Journal of Roentgenology
    Title Management Options for Cystic Fibrosis in Adults.
    Date September 1994
    Journal Contemporary Internal Medicine
    Title The Comparative Effects of Elastase-induced Emphysema on Costal and Crural Diaphragm and Parasternal Intercostal Muscle Contractility.
    Date March 1994
    Journal American Journal of Respiratory and Critical Care Medicine
    Excerpt

    Chronically, hyperinflated human subjects with chronic obstructive pulmonary disease and animals with experimentally induced emphysema generate greater than expected levels of transdiaphragmatic pressure at high lung volume because of adaptive changes in the length-tension relationship of the costal diaphragm. The ability to lower intrathoracic pressure during inspiration depends on the mechanical action of all the inspiratory muscles acting in concert. However, the effect of chronic hyperinflation on the mechanical action of inspiratory muscles other than the costal diaphragm remains unknown. This study compares the effect of chronic hyperinflation in the form of elastase-induced emphysema on the contractile properties of the three major inspiratory muscles of the hamster (i.e., the costal and crural diaphragm and parasternal intercostals). Muscles were studied in vitro 6 months after emphysema was induced by intratracheal injection of elastase. Saline-injected animals served as controls. TLC in the elastase-injected hamsters was significantly greater than in controls (12.5 +/- 0.8 ml versus 9.0 +/- 0.3 ml, p < 0.002). Maximal tetanic tension, time to peak tension, maximal velocity of shortening, and the force-velocity relationship differed among the three muscles but for any given muscle were similar in control and emphysematous animals. In contrast, the fiber length optimal for tension generation (Lo) not only differed across muscles but was significantly shorter in the costal diaphragm of emphysematous animals compared with control animals. However, Lo of the parasternal intercostal and crural diaphragm was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

    Title Pleural Effusions in Right-sided Endocarditis: Characteristics and Pathophysiology.
    Date January 1993
    Journal Southern Medical Journal
    Excerpt

    The incidence, characteristics, and pathogenesis of pleural effusions in patients with right-sided endocarditis (RSE) are poorly defined. We have recently observed four patients with a history of intravenous drug abuse and bacteremia due to Staphylococcus aureus who had pleural effusions during an episode of RSE. We report the pleural fluid characteristics of five effusions in these four patients and attempt to define the pathogenesis of each. We found that (1) an exudative, sterile, serosanguineous, or bloody effusion is common in RSE, (2) empyema occurred in only one patient, and (3) transudative effusions due to CHF were not observed. Possible mechanisms of pleural fluid formation in RSE include parapneumonic effusion, septic pulmonary emboli with or without infarction, and empyema. Congestive heart failure does not appear to be a common cause of pleural effusion in pure right-sided endocarditis.

    Title Recurrent Hemoptysis, Chest Pain, and Purulent Sputum in a Young Man.
    Date June 1992
    Journal Chest

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