Cryptococcal Empyema: A Rare Manifestation Of Disease, 2017 Western Michigan University Homer Stryker M.D. School of Medicine
Cryptococcal Empyema: A Rare Manifestation Of Disease, Mohamed Mortagy, Larry Lutwick, Stephen Breisach
Introduction: Cryptococcus neoformans is a pathogenic yeast that is generally acquired by man from the environment via the respiratory route. Despite this route of acquisition, overt pulmonary infection is uncommonly diagnosed and the disease is usually manifest as a subacute meningitis which is mostly manifest in individuals who are celluarly immunoincompetent such as those on cancer chemotherapy, receiving anti-solid organ rejection medications and those with HIV/AIDS. Infection of the pleural space with C. neoformans is quite uncommon. We report a non-immunosuppressed man who was found to have infection of the pleural in the wake of bacterial empyema who was ...
Infection-Associated Mycobacterium Fortuitum Infection, 2017 Western Michigan University Homer Stryker M.D. School of Medicine
Infection-Associated Mycobacterium Fortuitum Infection, Dennis T. Huang, Larry Lutwick
Introduction: Mycobacterial species are unusual causes of skin and soft tissue infections and can be difficult to diagnose in the absence of consideration as they often require specific culture media and longer incubation times. We report a Mycobacterium fortuitum subcutaneous abscess in a diabetic related to medication injection that was initially diagnosed without specialized media or prolonged incubation times. Case Report: A 48 year old diabetic female developed a progressive subcutaneous swelling in the tissues of the right lower abdominal wall where she had been injecting liraglutide. Because of continued enlargement "to almost egg size" with pain, she was empirically ...
Retention In Continuous Care And Sustained Viral Suppression: Examining The Association Among Individuals Living With Hiv, 2017 University of Louisville
Retention In Continuous Care And Sustained Viral Suppression: Examining The Association Among Individuals Living With Hiv, Timothy N. Crawford, Alice C. Thornton
Internal Medicine Faculty Publications
Objectives: To examine the relationship between retention in continuous care and sustained viral suppression.
Methods: The authors retrospectively followed 653 persons who were virally suppressed and seeking care at an infectious disease clinic in Kentucky for an average of 6 years to determine the rates of retention in medical care (≥2 visits separated by ≥3 months within a 12-month period) and sustained viral suppression (<400 copies/mL). A generalized linear mixed model was used to determine an association between retention and suppression over time.
Results: Approximately 61% of the study population were retained in continuous care and 75% had sustained viral suppression for all patient-years. Persons retained in care were 3 times the odds of sustaining viral suppression over time ...400>
Distinct Transcriptome Profiles Of Gag-Specific Cd8+ T Cells Temporally Correlated With The Protection Elicited By Sivδnef Live Attenuated Vaccine, 2017 University of Nebraska-Lincoln
Distinct Transcriptome Profiles Of Gag-Specific Cd8+ T Cells Temporally Correlated With The Protection Elicited By Sivδnef Live Attenuated Vaccine, Wuxun Lu, Yanmin Wu, Fangrui Ma, R. Paul Johnson, Qingsheng Li
The live attenuated vaccine (LAV) SIVmac239Δnef (SIVΔnef) confers the best protection among all the vaccine modalities tested in rhesus macaque model of HIV-1 infection. This vaccine has a unique feature of time-dependent protection: macaques are not protected at 3±5 weeks post vaccination (WPV), whereas immune protection emerges between 15 and 20 WPV. Although the exact mechanisms of the time-dependent protection remain incompletely understood, studies suggested that both cellular and humoral immunities contribute to this time-dependent protection. To further elucidate the mechanisms of protection induced by SIVΔnef, we longitudinally compared the global gene expression profiles of SIV Gag-CM9+ CD8+ (Gag-specific ...
Implementing A Patient Hand-Hygiene Protocol To Decrease Clostridium Difficile Infections In The Acute Care Setting, 2017 University of Kentucky
Implementing A Patient Hand-Hygiene Protocol To Decrease Clostridium Difficile Infections In The Acute Care Setting, Lydia Mendez
PURPOSE: The purpose of this study was to develop and implement a patient hand hygiene protocol (PHHP) to improve patient outcomes, specifically to decrease the rates of clostridium difficile infections (CDI) at Norton Hospital (NH) and Norton Audubon Hospital (NAH) in Louisville, Kentucky.
METHODS: This was a multi-center, quasi-experimental study that implemented a PHHP on three units at two hospitals in the Norton Healthcare system. The sample consisted of 159 patients in the pre-intervention period and 18 patients in the intervention period. A retrospective records review was performed to analyze specific demographic variables.
RESULTS: No differences in age and gender ...
Evaluating Adherence To The Sepsis Bundle And The Effectiveness Of Best Practice Alerts, 2017 University of Kentucky
Evaluating Adherence To The Sepsis Bundle And The Effectiveness Of Best Practice Alerts, Kate Burnett
PURPOSE: To evaluate the adherence to the CMS sepsis recommendations and sepsis bundle used by the study health system before and after the implementation of Best Practice Alerts (BPAs) and assessing the effect of these alerts on patient outcomes.
METHODS: The study was a single-center, process evaluation through a retrospective chart review within a southwest healthcare system. The sample consisted of 73 patients for the pre-implementation period (May 1, 2016-September 7, 2016) and 75 patients for the post-implementation period (September 8, 2016-April 30, 2017).
RESULTS: No major differences were found between the two groups with regard to patient age, ethnicity ...
Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight In Nepal., 2017 George Washington University
Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight In Nepal., Erin K Philpott, Janet A Englund, Joanne Katz, James Tielsch, Subarna Khatry, Stephen C Leclerq, Laxman Shrestha, Jane Kuypers, Amalia S Magaret, Mark C Steinhoff, Helen Y Chu
Global Health Faculty Publications
BACKGROUND: Adverse birth outcomes, including low birth weight (LBW), defined as <2500 >grams, small-for-gestational-age (SGA), and prematurity, contribute to 60%-80% of infant mortality worldwide and may be related to infections during pregnancy. The aim of this study was to assess whether febrile human rhinovirus (HRV) illness is associated with adverse birth outcomes.
METHODS: Active household-based weekly surveillance was performed for respiratory illness episodes in pregnant women as part of a community-based, prospective, randomized trial of maternal influenza immunization in rural Nepal. Rhinovirus (HRV) febrile illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia with ...
Understanding Zoonotic Enteric Disease In Minnesota: A Spatio Temporal Analysis And Causal Theory Approach, 2017 Minnesota State University, Mankato
Understanding Zoonotic Enteric Disease In Minnesota: A Spatio Temporal Analysis And Causal Theory Approach, Suchismita Swain
All Theses, Dissertations, and Other Capstone Projects
With 75 percent of diseases in humans having origin in animals or animal products, zoonotic diseases have an enormous impact on the global disease burden. A significant portion of this can be attributed to bacterial zoonotic enteric pathogens. This study was designed to locate clusters of bacterial zoonotic enteric outbreaks in the State of Minnesota and study the seasonality of these outbreaks. In addition to identifying hot spots for zoonotic enteric outbreaks in Minnesota, the study also aimed to design a causal model to improve understanding of risk factors. This thesis considered only the bacterial zoonotic pathogens with significant disease ...
Reactivation Of Hiv-1 Proviruses In Immune-Compromised Mice Engrafted With Human Voa-Negative Cd4+ T Cells, 2017 University of Nebraska-Lincoln
Reactivation Of Hiv-1 Proviruses In Immune-Compromised Mice Engrafted With Human Voa-Negative Cd4+ T Cells, Zhe Yuan, Guobin Kang, Wuxun Lu, Qingsheng Li
Background: HIV-1 infection remains incurable on antiretroviral therapy (ART) due to virus latency. To date, enhanced co-culture assays, including viral outgrowth assays (VOA), are commonly used to measure HIV-1 latent reservoirs and evaluate latency-reversing agents (LRAs). However, VOA can only reactivate a small fraction of intact proviruses.
Methods: To explore the utility of NOD scid gamma (NSG) mice as an in vivo model to reactivate HIV-1 proviruses from VOA-negative CD4+ T cells, resting CD4+ T cells from an HIV-1 latently infected individual were isolated and the human CD4+ T cells corresponding to VOA-positive and VOA-negative CD4+ T cells were engrafted ...
Tryptophan 375 Stabilizes The Outer-Domain Core Of Gp120 For Hiv Vaccine Immunogen Design, 2017 University of Nebraska-Lincoln
Tryptophan 375 Stabilizes The Outer-Domain Core Of Gp120 For Hiv Vaccine Immunogen Design, Duoyi Hu, Dane Bowder, Wenzhong Wei, Jesse Thompson, Mark A. Wilson, Shi-Hua Xiang
The outer-domain core of gp120 may serve as a better HIV vaccine immunogen than the full-length gp120 because of its greater stability and immunogenicity. In our previous report, we introduced two disulfide bonds to the outer-domain core of gp120 to fix its conformation into a CD4-bound state, which resulted in a significant increase in its immunogenicity when compared to the wild-type outer-domain core. In this report, to further improve the immunogenicity of the outer-domain core based immunogen, we have introduced a Tryptophan residue at gp120 amino acid sequence position 375 (375S/W). Our data from immunized guinea pigs indeed shows ...
Chloroviruses Have A Sweet Tooth, 2017 University of Nebraska - Lincoln
Chloroviruses Have A Sweet Tooth, James L. Van Etten, Irina V. Agarkova, David D. Dunigan Ph. D., Michela Tonetti, Cristina De Castro, Garry A. Duncan
Chloroviruses are large double-stranded DNA (dsDNA) viruses that infect certain isolates of chlorella-like green algae. They contain up to approximately 400 protein-encoding genes and 16 transfer RNA (tRNA) genes. This review summarizes the unexpected finding that many of the chlorovirus genes encode proteins involved in manipulating carbohydrates. These include enzymes involved in making extracellular polysaccharides, such as hyaluronan and chitin, enzymes that make nucleotide sugars, such as GDP-L-fucose and GDP-D-rhamnose and enzymes involved in the synthesis of glycans attached to the virus major capsid proteins. This latter process differs from that of all other glycoprotein containing viruses that traditionally use ...
Regulatory T Cells In Endemic Burkitt Lymphoma Patients Are Associated With Poor Outcomes: A Prospective, Longitudinal Study, 2016 Uniformed Services University of the Health Sciences
Regulatory T Cells In Endemic Burkitt Lymphoma Patients Are Associated With Poor Outcomes: A Prospective, Longitudinal Study, Emily Parsons, Juliana A. Otieno, John Michael Ong'echa, Christina E. Nixon, John Vulule, Christian Munz, V. Ann Stewart, Ann M. Moormann
Open Access Articles
Deficiencies in Epstein-Barr virus (EBV)-specific T cell immunosurveillance appear to precede the development of endemic Burkitt lymphoma (eBL), a malaria-associated pediatric cancer common in sub-Saharan Africa. However, T cell contributions to eBL disease progression and survival have not been characterized. Our objective was to investigate regulatory and inflammatory T cell responses in eBL patients associated with clinical outcomes. By multi-parameter flow cytometry, we examined peripheral blood mononuclear cells from 38 eBL patients enrolled in a prospective cohort study in Kisumu, Kenya from 2008-2010, and 14 healthy age-matched Kenyan controls. Children diagnosed with eBL were prospectively followed and outcomes categorized ...
Performance Of The G4 Xpert(R) Mtb/Rif Assay For The Detection Of Mycobacterium Tuberculosis And Rifampin Resistance: A Retrospective Case-Control Study Of Analytical And Clinical Samples From High- And Low-Tuberculosis Prevalence Settings, 2016 The State University of New Jersey
Performance Of The G4 Xpert(R) Mtb/Rif Assay For The Detection Of Mycobacterium Tuberculosis And Rifampin Resistance: A Retrospective Case-Control Study Of Analytical And Clinical Samples From High- And Low-Tuberculosis Prevalence Settings, Nila J. Dharan, Robert Blakemore, Alexander Sloutsky, Devinder Kaur, Richard C. Alexander, Minoo Ghajar, Kimberlee A. Musser, Vincent E. Escuyer, Marie-Claire Rowlinson, Susanne Crowe, Rafael Laniado-Laborin, Eloise Valli, Pamela Nabeta, Pamela Johnson, David Alland
Open Access Articles
BACKGROUND: The Xpert(R) MTB/RIF (Xpert) assay is a rapid PCR-based assay for the detection of Mycobacterium tuberculosis complex DNA (MTBc) and mutations associated with rifampin resistance (RIF). An updated version introduced in 2011, the G4 Xpert, included modifications to probe B and updated analytic software.
METHODS: An analytical study was performed to assess Xpert detection of mutations associated with rifampin resistance in rifampin-susceptible and -resistant isolates. A clinical study was performed in which specimens from US and non-US persons suspected of tuberculosis (TB) were tested to determine Xpert performance characteristics. All specimens underwent smear microscopy, mycobacterial culture, conventional ...
Immunogenicity And Protective Efficacy Of The Dar-901 Booster Vaccine In A Murine Model Of Tuberculosis, Timothy Lahey, Dominick Laddy, Krystal Hill, Jacqueline Schaeffer
Open Dartmouth: Faculty Open Access Articles
The development of a novel tuberculosis vaccine is a leading global health priority. SRL172, an inactivated, whole-cell mycobacterial vaccine, was safe, immunogenic and reduced the incidence of culture-confirmed tuberculosis in a phase III trial in HIV-infected and BCG immunized adults in Tanzania. Here we describe the immunogenicity and protective efficacy of DAR-901, a booster vaccine against tuberculosis manufactured from the same seed strain using a new scalable method.
Properdin Levels In Individuals With Chemotherapy-Induced Neutropenia, 2016 University of Massachusetts Medical School
Properdin Levels In Individuals With Chemotherapy-Induced Neutropenia, Artsiom Tsyrkunou, Sarika Agarwal, Bibek Koirala, Robert W. Finberg, Rajneesh Nath, Bruce A. Barton, Stuart M. Levitz, Jennifer P. Wang, Sanjay Ram
Open Access Articles
BACKGROUND: Neutrophils produce and carry key components of the alternative pathway (AP) of complement, including properdin (P). The effect of chemotherapy-induced absolute neutropenia on circulating P levels and AP function has not been previously established.
METHODS: We prospectively measured free P levels in serum from 27 individuals expected to develop neutropenia after administration of chemotherapy for hematological malignancies in preparation for hematopoietic stem cell transplantation and here describe the relationship between serum P levels and the neutrophil count over time.
RESULTS: When the absolute neutrophil count (ANC) was > 500 cells/mm3 pre-chemotherapy, P levels were significantly higher than P levels ...
Applying Multiple Data Collection Tools To Quantify Human Papillomavirus Vaccine Communication On Twitter., Philip M. Massey, Amy Leader, Elad Yom-Tov, Alexandra Budenz, Kara Fisher, Ann C. Klassen
Department of Medical Oncology Faculty Papers
BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. There are several vaccines that protect against strains of HPV most associated with cervical and other cancers. Thus, HPV vaccination has become an important component of adolescent preventive health care. As media evolves, more information about HPV vaccination is shifting to social media platforms such as Twitter. Health information consumed on social media may be especially influential for segments of society such as younger populations, as well as ethnic and racial minorities.
OBJECTIVE: The objectives of our study were to quantify HPV vaccine communication on ...
Highlights From The 6th International Meeting On Emerging Diseases And Surveillance (Imed 2016) Vienna, Austria From Nov 3 To 7, 2016, 2016 International Society for Infectious Diseases
Highlights From The 6th International Meeting On Emerging Diseases And Surveillance (Imed 2016) Vienna, Austria From Nov 3 To 7, 2016, Britta Lassmann, Lawrence C. Madoff
Open Access Articles
Emerging infectious diseases remain at the center of the world's attention. The current threats posed by Zika, Yellow Fever, MERS-CoV, and pandemic influenza, the recent Ebola outbreak that devastated West Africa, and the realization that new infectious diseases may be recognized at any time, in any place, has dramatically increased public awareness of infectious diseases and underscored the need to understand emerging pathogens. As with each prior iteration, IMED 2016 fully embodied the “One Health” model of emerging diseases, recognizing the commonality of human, environmental and animal health by bringing together human and veterinary health clinicians, scientists, and policy ...
Bilateral Moyamoya Disease In A 2-Year-Old Pakistani Male Treated With Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome., 2016 Baqai Medical University, Karachi
Bilateral Moyamoya Disease In A 2-Year-Old Pakistani Male Treated With Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome., Shahvaiz Magsi, Adeel Khoja, Mansoor Ali Merchant Rameez, Ariba Khan, Noman Ishaque
Department of Medicine
Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS), in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness) at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA ...
Whole Genome Sequencing As A Tool For Identifying Phenotypic Properties And Underlying Genetic Mechanisms In Staphylococcus Pseudintermedius, 2016 University of Tennessee, Knoxville
Whole Genome Sequencing As A Tool For Identifying Phenotypic Properties And Underlying Genetic Mechanisms In Staphylococcus Pseudintermedius, Matthew C. Riley
Staphylococcus pseudintermedius is a Gram-positive bacterial opportunistic pathogen commonly associated with dermal infections in canines, but capable of causing serious disease in other species. Reports of human infections caused by S. pseudintermedius along with an increase in resistance to multiple antibiotics highlights the importance of this organism. Whole genome sequencing can allow large scale investigation of genetic mechanisms underlying phenotypic properties that contribute to the expansion of successful S. pseudintermedius clonal lineages.
The increase in multidrug and methicillin-resistant S. pseudintermedius (MRSP) may result from horizontal transfer of genetic material between bacterial isolates, yet is thought to be rare in Staphylococci ...
Path To Resistance: Risk Factors Associated With Carbapenem-Resistant Pseudomonas Aeruginosa, 2016 Department of Internal Medicine, Aurora Sinai Medical Center
Path To Resistance: Risk Factors Associated With Carbapenem-Resistant Pseudomonas Aeruginosa, Kushal Patel, Jessica J.F. Kram, Dennis J. Baumgardner
Journal of Patient-Centered Research and Reviews
Background: An estimated 51,000 health care-associated Pseudomonas aeruginosa infections occur in the United States annually. More than 13% are secondary to non-carbapenem multidrug-resistant strains, which result in 400 yearly deaths. Traditional risk factors for resistance include ICU stay, mechanical ventilation, previous hospitalization and major comorbidities. As microbes evolve, risk factors also may evolve.
Purpose: To determine if traditional and/or new risk factors for P. aeruginosa resistance are valid and predictive of infection with carbapenem-resistant P. aeruginosa.
Methods: We retrospectively studied inpatients and outpatients ≥ 18 years old who presented to an Aurora Health Care facility with a positive P ...