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Association Of Hypercapnia On Admission With Increased Length Of Hospital Stay And Severity In Patients Admitted With Community-Acquired Pneumonia: A Prospective Observational Study From Pakistan., Nousheen Iqbal, Muhammad Irfan, Ali Bin Sarwar Zubairi, Safia Awan, Javaid Khan 2017 Aga Khan University

Association Of Hypercapnia On Admission With Increased Length Of Hospital Stay And Severity In Patients Admitted With Community-Acquired Pneumonia: A Prospective Observational Study From Pakistan., Nousheen Iqbal, Muhammad Irfan, Ali Bin Sarwar Zubairi, Safia Awan, Javaid Khan

Department of Medicine

Objectives: To determine whether the presence of hypercapnia on admission in adult patients admitted to a university-based hospital in Karachi, Pakistan with community-acquired pneumonia (CAP) correlates with an increased length of hospital stay and severity compared with no hypercapnia on admission.

Study Design: A prospective observational study.

Settings: Tertiary care hospital in Karachi, Pakistan.

Methods: Patients who met the inclusion criteria were enrolled in the study. The severity of pneumonia was assessed by CURB-65 and PSI scores. An arterial blood gas analysis was obtained within 24 hours of admission. Based on arterial PaCO2 levels, patients were divided into three ...


Seroprevalence Of Antibodies Against Kaposi's Sarcoma-Associated Herpesvirus Among Hiv-Negative People In China, Tiejun Zhang, Zhenqiu Liu, Jun Wang, Veenu Minhas, Charles Wood, Gary M. Clifford, Na He, Silvia Franceschi 2017 Fudan University

Seroprevalence Of Antibodies Against Kaposi's Sarcoma-Associated Herpesvirus Among Hiv-Negative People In China, Tiejun Zhang, Zhenqiu Liu, Jun Wang, Veenu Minhas, Charles Wood, Gary M. Clifford, Na He, Silvia Franceschi

Virology Papers

Background: Little information on the prevalence of Kaposi’s sarcoma associated herpesvirus (KSHV) among HIV-negative individuals is available from Asia.

Methods: In the present study, we report findings from a new survey of KSHV in 983 HIV-negative male migrants from Shanghai and their combination with previous similar surveys of 600 female migrants, 600 female sex-workers (FSW), 1336 sexually transmitted infection (STI) clinic male patients, 439 intravenous drug-users (IVDU), and 226 men having sex with men (MSM) from China. KSHV-specific antibodies against latent and lytic antigens were assessed using Sf9 and BC3 monoclonal immunofluorescence assay. Age-adjusted prevalence ratios (PR) and 95 ...


Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender 2017 CUNY School of Public Health

Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender

Publications and Research

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38 ...


Balb/C Mice Immunized With A Combination Of Virus-Like Particles Incorporating Kaposi Sarcoma-Associated Herpesvirus (Kshv) Envelope Glycoproteins Gpk8.1, Gb, And Gh/Gl Induced Comparable Serum Neutralizing Antibody Activity To Uv-Inactivated Kshv, Anne K. Barasa, Peng Ye, Meredith Phelps, Ganapathiram T. Arivudainambi, Timelia Tison, Javier Gordon Ogembo 2017 Beckman Research Institute of City of Hope, CA

Balb/C Mice Immunized With A Combination Of Virus-Like Particles Incorporating Kaposi Sarcoma-Associated Herpesvirus (Kshv) Envelope Glycoproteins Gpk8.1, Gb, And Gh/Gl Induced Comparable Serum Neutralizing Antibody Activity To Uv-Inactivated Kshv, Anne K. Barasa, Peng Ye, Meredith Phelps, Ganapathiram T. Arivudainambi, Timelia Tison, Javier Gordon Ogembo

Open Access Articles

Infection with Kaposi sarcoma-associated herpesvirus (KSHV) is estimated to account for over 44,000 new cases of Kaposi sarcoma annually, with 84% occurring in Africa, where the virus is endemic. To date, there is no prophylactic vaccine against KSHV. KSHV gpK8.1, gB, and gH/gL glycoproteins, implicated in the virus entry into host cells, are attractive vaccine targets for eliciting potent neutralizing antibodies (nAbs) against virus infection. We incorporated gpK8.1, gB, or gH/gL on the surface of virus-like particles (VLPs) and characterized these VLPs for their composition, size, and functionality. To determine which viral glycoprotein(s) elicit ...


The Presence Of Copd Does Not Influence Clinical Outcomes In Hospitalized Patients With Community-Acquired Pneumonia, Rosemeri Maurici, Alessandra Morello Gearhart, Vanessa Viríssimo Maciel, Forest Arnold, Francisco Fernandez, Annuradha K. Persaud, Stephen Furmanek, Timothy Wiemken, Julio Ramirez, Rodrigo Cavallazzi 2017 Postgraduate Program in Medical Sciences / Universidade Federal de Santa Catarina, Florianopolis, SC, Brazil

The Presence Of Copd Does Not Influence Clinical Outcomes In Hospitalized Patients With Community-Acquired Pneumonia, Rosemeri Maurici, Alessandra Morello Gearhart, Vanessa Viríssimo Maciel, Forest Arnold, Francisco Fernandez, Annuradha K. Persaud, Stephen Furmanek, Timothy Wiemken, Julio Ramirez, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

Introduction

Community-acquired pneumonia (CAP) is a leading cause of death worldwide. Chronic obstructive pulmonary disease (COPD) is a well-established risk factor for development of CAP. What is not as clear is the impact of COPD in the outcomes of patients with CAP. In this study, we compared the outcomes of CAP in COPD and non-COPD patients.

Methods

This was a retrospective cohort study. We conducted a secondary analysis of the Community-Acquired Pneumonia Organization (CAPO) international cohort study database, which includes patients with CAP admitted to several hospitals throughout the world. Outcomes were time to clinical stability, length of hospital stay ...


Analysis Of The Local And Systemic Cytokine Response Profiles In Patients With Community-Acquired Pneumonia. Relationship With Disease Severity And Outcomes., Rafael Fernandez-Botran, Timothy Lee Wiemken, Robert R. Kelley, Paula Peyrani, Jose Bordon, Rodrigo Cavallazzi, Julio A. Ramirez 2017 University of Louisville

Analysis Of The Local And Systemic Cytokine Response Profiles In Patients With Community-Acquired Pneumonia. Relationship With Disease Severity And Outcomes., Rafael Fernandez-Botran, Timothy Lee Wiemken, Robert R. Kelley, Paula Peyrani, Jose Bordon, Rodrigo Cavallazzi, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

The goals of this study were to investigate the relationship of systemic and local cytokine responses with time to clinical stability (TCS) in patients with community-acquired pneumonia (CAP) and to develop a model to integrate multiple cytokine data into “cytokine response profiles” based on local vs. systemic and pro- vs. anti-inflammatory cytokine patterns in order to better understand their relationships with measures of CAP severity and outcomes. Forty hospitalized patients enrolled through the Community Acquired Pneumonia Inflammatory Study Group (CAPISG) were analyzed. Based on the ranked distribution of the levels of eight different pro-inflammatory cytokines and chemokines (IL-1b, IL-6, IL-8 ...


Sepsis In Patients With Ventilator Associated Pneumonia Due To Methicillin- Resistant Staphylococcus Aureus: Incidence And Impact On Clinical Outcomes, Anupama Raghuram, Martin Gnoni, Timothy Lee Wiemken, Leslie Beavin, Julio A. Ramirez, Forest W. Arnold, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary Stein, Kimbal D. Ford, Paula Peyrani, the IMPACT-HAP Investigators 2017 University of Louisville, Louisville, KY

Sepsis In Patients With Ventilator Associated Pneumonia Due To Methicillin- Resistant Staphylococcus Aureus: Incidence And Impact On Clinical Outcomes, Anupama Raghuram, Martin Gnoni, Timothy Lee Wiemken, Leslie Beavin, Julio A. Ramirez, Forest W. Arnold, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary Stein, Kimbal D. Ford, Paula Peyrani, The Impact-Hap Investigators

The University of Louisville Journal of Respiratory Infections

Background: Sepsis is a clinical syndrome associated with organ dysfunction due to a dysregulated host response to infection. Methicillin-resistant Staphylococcus aureus (MRSA) Ventilator-associated pneumonia (VAP) is a serious infection frequently associated with sepsis. The objectives of this study were to define the incidence of sepsis and clinical failure in patients with MRSA VAP.

Methods: This was a secondary analysis of the Improving Medicine through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. We used the ...


Characterization Of Severe Malaria In Liberian Children 5 Years Old And Younger, Patricia A. McQuilkin 2017 University of Massachusetts Medical School

Characterization Of Severe Malaria In Liberian Children 5 Years Old And Younger, Patricia A. Mcquilkin

GSBS Dissertations and Theses

Malaria continues to be a challenging problem in the developing world, and the burden of this life threatening disease continues to be borne by young children living in Sub Saharan Africa. One of the biggest challenges to the prevention and control of this problem lies in accurately diagnosing malaria, and distinguishing it from the many other febrile illnesses which present in children in this age group.

Liberia is a West African country with a high burden of malaria. Very little is known about the presentation of severe malaria in children aged 5 years old and younger in Liberia. We undertook ...


Identification And Characterization Of Human Monoclonal Antibodies For Immunoprophylaxis Against Enterotoxigenic Escherichia Coli, Serena Giuntini, Matteo Stoppato, Monir Ejemel, Danielle Wisheart, Mark S. Klempner, Yan Wang 2017 University of Massachusetts Medical School

Identification And Characterization Of Human Monoclonal Antibodies For Immunoprophylaxis Against Enterotoxigenic Escherichia Coli, Serena Giuntini, Matteo Stoppato, Monir Ejemel, Danielle Wisheart, Mark S. Klempner, Yan Wang

UMass Center for Clinical and Translational Science Research Retreat

Background. Enterotoxigenic Escherichia coli (ETEC) infections are the major cause of diarrheal morbidity among children living in developing countries. ETEC mediates small intestine adherence through bacterial adhesion followed by production of enterotoxins that induce diarrhea. Currently there is no vaccine available for ETEC. One of the most predominant adhesin of pathogenic ETEC strains is colonization factor antigen I (CFA/I). The CFA/I adhesion tip, CfaE, is required for ETEC binding to human intestinal cells and colonization. Human antibodies against CfaE have potential to block colonization of ETEC and serve as a potent immunoprophylactic against ETEC-related diarrhea.

Methods. A panel ...


Using Hospital Discharge Data To Assess Trends Of Carbapenem-Resistant Enterobacteriaceae In Rhode Island, Seth Peters, Sarah Hart Shuford 2017 Rhode Island Department of Health

Using Hospital Discharge Data To Assess Trends Of Carbapenem-Resistant Enterobacteriaceae In Rhode Island, Seth Peters, Sarah Hart Shuford

UMass Center for Clinical and Translational Science Research Retreat

In 2017, Carbapenem-resistant Enterobacteriaceae (CRE) will become a reportable infectious disease in Rhode Island. To prepare for this updated regulation, the Center for Acute Infectious Disease Epidemiology (CAIDE) analyzed Rhode Island Hospital Discharge Data (HDD), internal epidemiologic line lists, as well as antibiograms from local laboratories to gauge past incidence of CRE in Rhode Island healthcare facilities.

CAIDE used the HDD for a retrospective assessment of statewide CRE incidence in acute care hospitals from 2011-2015 using SAS 9.3 (SAS Institute, Cary, NC). Epidemiologists compiled lists of ICD-9/ICD-10 diagnosis codes that when combined indicate CRE. Codes included specific infections ...


Male Patient Experience Receiving Pre-Exposure Prophylaxis For The Prevention Of Hiv Through Primary Care, Nathaniel L. Currie 2017 University of Pennsylvania

Male Patient Experience Receiving Pre-Exposure Prophylaxis For The Prevention Of Hiv Through Primary Care, Nathaniel L. Currie

Doctorate in Social Work (DSW) Dissertations

Abstract

Objective: The purpose of this study was to examine the experiences of men who seek pre-exposure prophylaxis prevention intervention through their primary care physician, in order to assess access, engagement, effectiveness, and overall satisfaction.

Methods: Data was collected through semi-structured, qualitative, electronic, telephone, and face-to-face interviews. Participants were adult males (n =20) (18 years of age or older), currently residing in the continental United States, and who are currently receiving pre-exposure prophylaxis (PrEP) through their primary care physician (PCP).

Results: The experiences of the subjects in this study indicated variable confidence in primary care providers in both knowledge of ...


Safety And Immunogenicity Of An Inactivated Whole Cell Tuberculosis Vaccine Booster In Adults Primed With Bcg: A Randomized, Controlled Trial Of Dar-901, C. Fordham von Reyn, Timothy Lahey, Robert D. Arbeit, Bernard Landry, Leway Kailani, Lisa Adams, Brenda Haynes, Todd Mackenzie, Wendy Wieland-Alter, Ruth Connor, Sue Tvaroha, David Hokey, Ann Ginsberg, Richard Waddell 2017 Dartmouth College

Safety And Immunogenicity Of An Inactivated Whole Cell Tuberculosis Vaccine Booster In Adults Primed With Bcg: A Randomized, Controlled Trial Of Dar-901, C. Fordham Von Reyn, Timothy Lahey, Robert D. Arbeit, Bernard Landry, Leway Kailani, Lisa Adams, Brenda Haynes, Todd Mackenzie, Wendy Wieland-Alter, Ruth Connor, Sue Tvaroha, David Hokey, Ann Ginsberg, Richard Waddell

Open Dartmouth: Faculty Open Access Articles

Development of a tuberculosis vaccine to boost BCG is a major international health priority. SRL172, an inactivated whole cell booster derived from a non-tuberculous mycobacterium, is the only new vaccine against tuberculosis to have demonstrated efficacy in a Phase 3 trial. In the present study we sought to determine if a three-dose series of DAR-901 manufactured from the SRL172 master cell bank by a new, scalable method was safe and immunogenic.


A Comparative Analysis Of The West African Hemorrhagic Fevers Caused By The Lassa And Ebola Viruses, Emiene E. Amali-Adekwu 2017 Southeastern University - Lakeland

A Comparative Analysis Of The West African Hemorrhagic Fevers Caused By The Lassa And Ebola Viruses, Emiene E. Amali-Adekwu

Selected Honors Theses

Lassa fever (LF) and Ebola Hemorrhagic Fever (EHF) are viral diseases endemic to West Africa.The etiological agent of Lassa fever is an enveloped virus from the Arenaviridae family and was first discovered in 1969 when two missionary nurses died of a mysterious illness in the town of Lassa in Borno state, Nigeria.1 This virus is animal-borne (zoonotic) and is carried by the animal vector Mastomys natalensis (multimammate rat). The Ebola virus is also zoonotic originating from fruit bats belonging to the Pteropodidae family.2 The first reported case of Ebola Virus Disease (EVD) was a principal who was ...


Opinion: Inhibition Of Blood-Brain Barrier Repair As A Mechanism In Hiv-1 Disease., Monique E. Maubert, Brian Wigdahl, Michael R. Nonnemacher 2017 Drexel University College of Medicine

Opinion: Inhibition Of Blood-Brain Barrier Repair As A Mechanism In Hiv-1 Disease., Monique E. Maubert, Brian Wigdahl, Michael R. Nonnemacher

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

No abstract provided.


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

Journal of Patient-Centered Research and Reviews

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.


Lysine Residues Of Interferon Regulatory Factor 7 Affect The Replication And Transcription Activatormediated Lytic Replication Of Kaposi’S Sarcomaassociated Herpesvirus/Human Herpesvirus 8, Tianzheng Zhang, Ying Wang, Li Zhang, Bin Liu, Jinhui Xie, Charles Wood, Jinzhong Wang 2017 Nankai University

Lysine Residues Of Interferon Regulatory Factor 7 Affect The Replication And Transcription Activatormediated Lytic Replication Of Kaposi’S Sarcomaassociated Herpesvirus/Human Herpesvirus 8, Tianzheng Zhang, Ying Wang, Li Zhang, Bin Liu, Jinhui Xie, Charles Wood, Jinzhong Wang

Virology Papers

Kaposi’s sarcoma-associated herpesvirus (KSHV) infection goes through latent and lytic phases, which are controlled by the viral replication and transcription activator (RTA). Upon KSHV infection, the host responds by suppressing RTA-activated lytic gene expression through interferon regulatory factor 7 (IRF-7), a key regulator of host innate immune response. Lysine residues are potential sites for post-translational modification of IRF-7, and were suggested to be critical for its activity. In this study, we analysed the 15 lysine residues for their effects on IRF-7 function by site-directed mutagenesis. We found that some mutations affect the ability of IRF-7 to activate interferon (IFN ...


Herpes Simplex Proctitis Mimicking Inflammatory Bowel Disease In A Teenaged Male, Kristen E Sandgren, Nathan B Price, Warren P Bishop, Patrick J McCarthy 2017 University of Iowa

Herpes Simplex Proctitis Mimicking Inflammatory Bowel Disease In A Teenaged Male, Kristen E Sandgren, Nathan B Price, Warren P Bishop, Patrick J Mccarthy

Stead Family Department of Pediatrics Publications

We report the case of a 17-year-old male who was initially assessed for pain with defecation, bloody rectal discharge, and diarrhea, consistent with proctitis. Though proctitis is most commonly due to inflammatory bowel disease (IBD), infectious etiologies must also be considered, including sexually transmitted causes of infectious proctitis. In discussion of his sexual history, he identified as homosexual and acknowledged engaging in receptive anal intercourse. Rectal biopsies obtained via colonoscopy were culture-positive for herpes simplex virus (HSV), leading to a diagnosis of HSV proctitis and treatment with an appropriate antiviral medication. HSV proctitis is more common in individuals with high-risk ...


Appendicular Mass – A Rare Form Of Tuberculosis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mircea Bratucu, Teodora Vladescu, Cristian Balalau 2017 Carol Davila University, Department of Surgery, Bucharest, Romania

Appendicular Mass – A Rare Form Of Tuberculosis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mircea Bratucu, Teodora Vladescu, Cristian Balalau

Journal of Mind and Medical Sciences

Tuberculosis is in the top 10 causes of death worldwide, being one of the most deadly infectious diseases. It is estimated that one of three people from the entire earth population has a latent infection with M tuberculosis. This aerobic bacterium possesses the ability to persist in host tissues for years and to begin replication once immunity declines.

The lungs are most frequent site of infection as the Mycobacterium tuberculosis is carried by aerosol droplets and is commonly transmitted by respiratory route. The second way of transmission is by contaminated food.

Intestinal contamination coexists with pulmonary tuberculosis and only 10 ...


A New Class Of Inhibitors Of The Arac Family Virulence Regulator Vibrio Cholerae Toxt, Anne K. Woodbrey, Evans O. Onyango, Maria Pellegrini, Gabriela Kovacikova, Ronald Taylor, Gordon Gribble, F. Jon Kull 2017 Dartmouth College

A New Class Of Inhibitors Of The Arac Family Virulence Regulator Vibrio Cholerae Toxt, Anne K. Woodbrey, Evans O. Onyango, Maria Pellegrini, Gabriela Kovacikova, Ronald Taylor, Gordon Gribble, F. Jon Kull

Open Dartmouth: Faculty Open Access Articles

Vibrio cholerae is responsible for the diarrheal disease cholera that infects millions of people worldwide. While vaccines protecting against cholera exist, and oral rehydration therapy is an effective treatment method, the disease will remain a global health threat until long-term solutions such as improved sanitation and access to clean water become widely available. Because of this, there is a pressing need for potent therapeutics that can either mitigate cholera symptoms, or act prophylactically to prevent the virulent effects of a cholera infection. Here we report the design, synthesis, and characterization of a set of compounds that bind and inhibit ToxT ...


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

University of Massachusetts Medical School Faculty Publications

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 ...


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