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Molecular Evolution Of Dengue Type 2 Virus In Thailand, Rebeca Rico-Hesse, Lisa M. Harrison, Ananda Nisalak, David W. Vaughn, Siripen Kalayanarooj, Sharone Green, Alan L. Rothman, Francis A. Ennis 2017 Yale University School of Medicine

Molecular Evolution Of Dengue Type 2 Virus In Thailand, Rebeca Rico-Hesse, Lisa M. Harrison, Ananda Nisalak, David W. Vaughn, Siripen Kalayanarooj, Sharone Green, Alan L. Rothman, Francis A. Ennis

Sharone Green

Dengue is a mosquito-borne viral infection that in recent years has become a major international public health concern. Dengue hemorrhagic fever (DHF), first recognized in Southeast Asia in the 1950s, is today a leading cause of childhood death in many countries. The pathogenesis of this illness is poorly understood, mainly because there are no laboratory or animal models of disease. We have studied the genetic relationships of dengue viruses of serotype 2, one of four antigenically distinct dengue virus groups, to determine if viruses obtained from cases of less severe dengue fever (DF) have distinct evolutionary origins from those obtained ...


Rapid Diagnosis Of Dengue Viremia By Reverse Transcriptase-Polymerase Chain Reaction Using 3'-Noncoding Region Universal Primers, T. Mirawati Sudiro, Hiroaki Ishiko, Sharone Green, Ananda Nisalak, David W. Vaughn, Siripen Kalayanarooj, Alan L. Rothman, Boonyos Raengsakulrach, Jurand Janus, Ichiro Kurane, Francis A. Ennis 2017 University of Massachusetts Medical School

Rapid Diagnosis Of Dengue Viremia By Reverse Transcriptase-Polymerase Chain Reaction Using 3'-Noncoding Region Universal Primers, T. Mirawati Sudiro, Hiroaki Ishiko, Sharone Green, Ananda Nisalak, David W. Vaughn, Siripen Kalayanarooj, Alan L. Rothman, Boonyos Raengsakulrach, Jurand Janus, Ichiro Kurane, Francis A. Ennis

Sharone Green

A reverse transcriptase-polymerase chain reaction (RT-PCR) method was developed as a rapid diagnostic test of dengue viremia. To detect dengue viruses in serum or plasma specimens, a pair of universal primers was designed for use in the RT-PCR. Using these primers, the 3'-noncoding region of dengue virus types 1, 2, 3, and 4 could be amplified, but not those of other flaviviruses, such as West Nile virus, Japanese encephalitis virus, and yellow fever virus, or the alphavirus Sindbis virus. The sensitivity of the RT-PCR assay was similar to that of a quantitative fluorescent focus assay of dengue viruses in ...


Six-Year Experience Of Influenza Vaccination As A Condition Of Employment For A Large Regional Health Care System, John R. Brill, Mark Hermanoff, Angela Tonozzi, Mary Jo Capodice, Jennifer Farrar, Zarina Dawoodbhai 2017 Population Health, Aurora Health Care

Six-Year Experience Of Influenza Vaccination As A Condition Of Employment For A Large Regional Health Care System, John R. Brill, Mark Hermanoff, Angela Tonozzi, Mary Jo Capodice, Jennifer Farrar, Zarina Dawoodbhai

Journal of Patient-Centered Research and Reviews

Background: Influenza remains a significant contributor to morbidity and mortality in the United States. Health care workers (HCW) can be both victims and vectors of influenza. Influenza vaccination of HCW is protective for both caregivers and patients, but voluntary programs generally fail to achieve rates recommended by the Centers for Disease Control and Prevention. Despite a complex, multifaceted influenza program initiated in 1996 that included significant education and promotion as well as free on-site vaccination, annual Aurora Health Care caregiver immunization rates remained in the mid-70s until adoption of a “condition of employment” strategy in 2011.

Purpose: Discuss the annual ...


Fmt Placed By Colonoscopy: Systematic Review And Meta-Analysis, Nadia Huq, Veena Kumaravel, Aboud Affi, Maharaj Singh 2017 Department of Internal Medicine, Aurora Sinai Medical Center

Fmt Placed By Colonoscopy: Systematic Review And Meta-Analysis, Nadia Huq, Veena Kumaravel, Aboud Affi, Maharaj Singh

Journal of Patient-Centered Research and Reviews

Background: Fecal transplants are successful in the treatment of recurrent or refractory Clostridium difficile infections (CDI), but there is no consensus on the best method of instillation. Studies have shown greater success with lower gastrointestinal tract placement, but technical aspects of placement are not validated.

Purpose: This review aims to identify common traits and procedural techniques of successful fecal microbiota transplant (FMT) therapy via colonoscopy.

Methods: An electronic search was conducted using OVID Medline and PubMed for articles published from January 2010 to January 2016. The primary outcome of interest was cure by FMT placed via colonoscopy.

Results: Of the ...


Evaluation Of Mothers And Infants With Presumed Exposure To Zika Virus: A Look Into The Lehigh Valley Experience, Tibisay Villalobos MD, Michelle Maron RN, Jeanette Taveras DO 2017 Lehigh Valley Health Network

Evaluation Of Mothers And Infants With Presumed Exposure To Zika Virus: A Look Into The Lehigh Valley Experience, Tibisay Villalobos Md, Michelle Maron Rn, Jeanette Taveras Do

Department of Pediatrics

No abstract provided.


Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions, Muhammad Shahzad Shamim, Syed Ather Enam, Rushna Pervez Ali, Syed Faizan Ali, Mohammad Wasay 2017 Aga Khan University

Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions, Muhammad Shahzad Shamim, Syed Ather Enam, Rushna Pervez Ali, Syed Faizan Ali, Mohammad Wasay

Ather Enam

No abstract provided.


Outbreak Of Dengue Fever In Karachi 2006: A Clinical Perspective, Muhammad Mehmood Riaz, Khalid Mumtaz, Muhammad Shoaib Khan, Junaid Patel, M. Tariq, Harith Hilal, Shaheryar Ahmed Siddiqui, Farrukh Shezad 2017 Aga Khan University

Outbreak Of Dengue Fever In Karachi 2006: A Clinical Perspective, Muhammad Mehmood Riaz, Khalid Mumtaz, Muhammad Shoaib Khan, Junaid Patel, M. Tariq, Harith Hilal, Shaheryar Ahmed Siddiqui, Farrukh Shezad

Muhammad Tariq

OBJECTIVE: This study reports clinical manifestations and spectrum of severity of dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) in adult patients admitted during 2006 outbreak in Karachi. A rough estimation of cost of care was also calculated. METHODS: A cross-sectional study was done at a tertiary care hospital in Karachi from January to December 2006. Patients suspected of having DF with positive dengue IgM antibodies were included and records were reviewed. Patients were divided into DF, DHF and DSS as per WHO classification, and the severity of clinical manifestations was determined. RESULTS: A total of ...


Beta-Hemolytic Streptococcus Group A Endocarditis: A Rare Clinical Presentation, Aysha Almas, M. Tariq 2017 Aga Khan University

Beta-Hemolytic Streptococcus Group A Endocarditis: A Rare Clinical Presentation, Aysha Almas, M. Tariq

Muhammad Tariq

A case report of an elderly gentleman is reported herein, who presented with one week history of fever, drowsiness and left lower limb weakness. Examination revealed left lower limb weakness with power of grade 3/5. His workup showed evidence of infection and multiple cerebral infarcts on the right side. Blood culture grew Streptococcus pyogens. Echocardiogram showed two vegetations on the aortic valve. Fever was the main presenting feature in this case but it was the presentation of patient with multiple cerebral infarcts that lead to the diagnosis of infective endocarditis. The organism causing Infective Endocarditis (IE) in this patient ...


Tuberculous And Cryptococcal Meningitis In A Setting With High Tb And Low Hiv Prevalence, Afrasyab Khan, Bushra Jamil, Rahmat Ali, Sana Sultan 2017 Aga Khan University

Tuberculous And Cryptococcal Meningitis In A Setting With High Tb And Low Hiv Prevalence, Afrasyab Khan, Bushra Jamil, Rahmat Ali, Sana Sultan

Bushra Jamil

OBJECTIVE: To compare the differences in presentation and outcome of patients with tuberculous meningitis (TBM) and cryptococcal meningitis (CCM). STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from December 1995 to December 2005. METHODOLOGY: Patients with a confirmed diagnosis of TBM or CCM were included in this study. The signs and symptoms, laboratory findings and other variables of patients were entered and analyzed by Statistical Package for Social Sciences (SPSS) Software version 14. RESULTS: We compared 16 patients of TBM with 11 of CCM. None of the patients with TBM were Human Immunodeficiency ...


Sepsis Management: An Evidence-Based Approach., Muhammad Akbar Baig, Hira Shahzad, Bushra Jamil, Erfan Hussain 2017 Aga Khan University

Sepsis Management: An Evidence-Based Approach., Muhammad Akbar Baig, Hira Shahzad, Bushra Jamil, Erfan Hussain

Bushra Jamil

The Surviving Sepsis Campaign (SSC) guidelines have outlined an early goal directed therapy (EGDT) which demonstrates a standardized approach to ensure prompt and effective management of sepsis. Having said that, there are barriers associated with the application of evidence-based practice, which often lead to an overall poorer adherence to guidelines. Considering the global burden of disease, data from low- to middle-income countries is scarce. Asia is the largest continent but most Asian countries do not have a well-developed healthcare system and compliance rates to resuscitation and management bundles are as low as 7.6% and 3.5%, respectively. Intensive care ...


Mortality In Sepsis And Its Relationship With Gender., Nosheen Nasir, Bushra Jamil, Shahla Siddiqui, Fauzia A. Khan, Rabia Hussain 2017 Aga Khan University

Mortality In Sepsis And Its Relationship With Gender., Nosheen Nasir, Bushra Jamil, Shahla Siddiqui, Fauzia A. Khan, Rabia Hussain

Bushra Jamil

BACKGROUND AND OBJECTIVE:

Sepsis remains a leading cause of death across the world, carrying a mortality rate of 20-50%. Women have been reported to be less likely to suffer from sepsis and to have a lower risk of mortality from sepsis compared to men. The objective of this study was to determine the relationship between gender and mortality in sepsis, and compare cytokine profiles of male and female patients.

METHODS:

This was a prospective case series on 97 patients admitted with sepsis. Clinical and microbiological data was gathered, blood samples were collected for cytokine (IL-10, IL-6 and TNFα) levels and ...


Guidelines For The Initial Management Of Adults With Sepsis/Severe Sepsis/Septic Shock: 2015, Erfan Hussain, Bushra Jamil, Naseem Salahuddin 2017 Aga Khan University

Guidelines For The Initial Management Of Adults With Sepsis/Severe Sepsis/Septic Shock: 2015, Erfan Hussain, Bushra Jamil, Naseem Salahuddin

Bushra Jamil

No abstract provided.


An Unusual Pathogen Causing Native Valve Endocarditis., Aneela Hussain, Nosheen Nasir, Bushra Jamil 2017 Aga Khan University

An Unusual Pathogen Causing Native Valve Endocarditis., Aneela Hussain, Nosheen Nasir, Bushra Jamil

Bushra Jamil

No abstract provided.


Child Contact Management In High Tuberculosis Burden Countries: A Mixed-Methods Systematic Review, Daria Szkwarko, Yael Hirsch-Moverman, Lienki Du Plessis, Karen Du Preez, Catherine W. Carr, Anna M. Mandalakas 2017 University of Massachusetts Medical School

Child Contact Management In High Tuberculosis Burden Countries: A Mixed-Methods Systematic Review, Daria Szkwarko, Yael Hirsch-Moverman, Lienki Du Plessis, Karen Du Preez, Catherine W. Carr, Anna M. Mandalakas

Library Publications and Presentations

Tuberculosis (TB) remains a leading cause of morbidity and mortality worldwide. Considering the World Health Organization recommendation to implement child contact management (CCM) for TB, we conducted a mixed-methods systematic review to summarize CCM implementation, challenges, predictors, and recommendations. We searched the electronic databases of PubMed/MEDLINE, Scopus, and Web of Science for studies published between 1996-2017 that reported CCM data from high TB-burden countries. Protocol details for this systematic review were registered on PROSPERO: International prospective register of systematic reviews (#CRD42016038105). We formulated a search strategy to identify all available studies, published in English that specifically targeted a) population ...


A Systematic Review And Meta-Analysis On Herpes Zoster And The Risk Of Cardiac And Cerebrovascular Events, Nathaniel Erskine, Hoang Tran, Len L. Levin, Christine M. Ulbricht, Joyce D. Fingeroth, Catarina I. Kiefe, Robert J. Goldberg, Sonal Singh 2017 University of Massachusetts Medical School

A Systematic Review And Meta-Analysis On Herpes Zoster And The Risk Of Cardiac And Cerebrovascular Events, Nathaniel Erskine, Hoang Tran, Len L. Levin, Christine M. Ulbricht, Joyce D. Fingeroth, Catarina I. Kiefe, Robert J. Goldberg, Sonal Singh

Library Publications and Presentations

BACKGROUND: Patients who develop herpes zoster or herpes zoster ophthalmicus may be at risk for cerebrovascular and cardiac complications. We systematically reviewed the published literature to determine the association between herpes zoster and its subtypes with the occurrence of cerebrovascular and cardiac events.

METHODS/RESULTS: Systematic searches of PubMed (MEDLINE), SCOPUS (Embase) and Google Scholar were performed in December 2016. Eligible studies were cohort, case-control, and self-controlled case-series examining the association between herpes zoster or subtypes of herpes zoster with the occurrence of cerebrovascular and cardiac events including stroke, transient ischemic attack, coronary heart disease, and myocardial infarction. Data on ...


Recurrent Clostridium Difficile Infection Among Medicare Patients In Nursing Homes: A Population-Based Cohort Study, Marya D. Zilberberg, Andrew F. Shorr, William M. Jesdale, Jennifer Tjia, Kate L. Lapane 2017 University of Massachusetts Amherst

Recurrent Clostridium Difficile Infection Among Medicare Patients In Nursing Homes: A Population-Based Cohort Study, Marya D. Zilberberg, Andrew F. Shorr, William M. Jesdale, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

We explored the epidemiology and outcomes of Clostridium difficile infection (CDI) recurrence among Medicare patients in a nursing home (NH) whose CDI originated in acute care hospitals. We conducted a retrospective, population-based matched cohort combining Medicare claims with Minimum Data Set 3.0, including all hospitalized patients age > /=65 years transferred to an NH after hospitalization with CDI 1/2011-11/2012. Incident CDI was defined as ICD-9-CM code 008.45 with no others in prior 60 days. CDI recurrence was defined as (within 60 days of last day of CDI treatment): oral metronidazole, oral vancomycin, or fidaxomicin for > /=3 days ...


Risk Factors For Bk Virus Infection After Kidney Transplantation, London, Ontario 2016, Seyed M Hosseini-Moghaddam 2017 The University of Western Ontario

Risk Factors For Bk Virus Infection After Kidney Transplantation, London, Ontario 2016, Seyed M Hosseini-Moghaddam

Electronic Thesis and Dissertation Repository

Our objective was to determine the risk factors for BK virus infection in renal allograft recipients in the first year after transplantation. In this cohort, we included all patients who received renal allograft at London Health Sciences Centre (LHSC) between 2012 and 2014. We continued post-transplantation follow-up for one year. Of 175 patients (37% female) with median age (range) of 53 (14-82) years, 40 (22.9%) developed BK viremia (median interval:100 days, range: 35-264). Recipient age, recipient gender, hemodialysis (HD) vs peritoneal dialysis (PD), Human Leukocyte Antigens A1, B35 and Cw4 increased the risk of post-transplant BKV infection. However ...


Fungal Infections From Human And Animal Contact, Dennis J. Baumgardner 2017 Aurora UW Medical Group, Aurora Health Care; University of Wisconsin School of Medicine and Public Health; Center for Urban Population Health

Fungal Infections From Human And Animal Contact, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America. Other human-acquired and zoonotic fungal infections also are discussed in brief.


Freshwater Fungal Infections, Dennis J. Baumgardner 2017 Aurora UW Medical Group, Aurora Health Care

Freshwater Fungal Infections, Dennis J. Baumgardner

Dennis J. Baumgardner. MD

Fungal infections as a result of freshwater exposure or trauma are fortunately rare. Etiologic agents are varied, but commonly include filamentous fungi and Candida. This narrative review describes various sources of potential freshwater fungal exposure and the diseases that may result, including fungal keratitis, acute otitis externa and tinea pedis, as well as rare deep soft tissue or bone infections and pulmonary or central nervous system infections following traumatic freshwater exposure during natural disasters or near-drowning episodes. Fungal etiology should be suspected in appropriate scenarios when bacterial cultures or molecular tests are normal or when the infection worsens or fails ...


Strategic Approach Of An Urban 900-Bed Academic Medical Center To Combat Clostridium Difficile Infection Transmission Using Staff Engagement, Courtney Mitchell, MPH, Kelly Zabriskie, CIC 2017 Thomas Jefferson University

Strategic Approach Of An Urban 900-Bed Academic Medical Center To Combat Clostridium Difficile Infection Transmission Using Staff Engagement, Courtney Mitchell, Mph, Kelly Zabriskie, Cic

Department of Medicine Posters

BACKGROUND

  • Clostridium difficile infection (CDI) caused nearly 500,000 illnesses with 29,000 deaths in the United States
  • Preventing hospital-associated Clostridium difficile infection (HA-CDI) is crucial to modern healthcare systems for reducing mortality, healthcare costs and length of stay
  • There are multiple risk factors for CDI transmission in healthcare settings:
    • Failure to comply with hand hygiene
    • Ineffective equipment and surface cleaning
    • Diagnosis delays

Poster presented at: APIC 2017 in Portland Oregon, United States.


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