Digital Commons Network^™

Use Of N-Acetylcysteine In Children With Fulminant Hepatic Failure Caused By Acute Viral Hepatitis, Ali Faisal Saleem, Qalab Abbas, Anwarul Haque

Department of Paediatrics and Child Health

Objective: To determine the efficacy of N-acetylcysteine (NAC) in children aged > 1 month to 16 years admitted with Fulminant Hepatic Failure (FHF) secondary to Acute Viral Hepatitis (AVH) in a tertiary care center of a developing country.

Study Design: Analytical study.

Place and Duration of Study: Department of Paediatrics, The Aga Khan University Hospital, Karachi, Pakistan, from January 2007 to December 2011.

Methodology: Medical records of children (> 1 month - 16 years) with FHF admitted with AVH of known etiology who received NAC were reviewed retrospectively. Liver function tests (mean ± SD) at baseline, 24 hours after NAC and …

A Translational Study Determining The Impact Of Timing And Duration Of Aerobic Walking On Metabolic Control And Personal Preferences Among Adults Recently Diagnosed With Type 2 Diabetes, Cory Cox

Graduate Theses

Type 2 diabetes (T2D) is a potentially life threatening metabolic disease characterized by insulin resistance and inability to metabolize glucose (Meneilly & Elliott 1999). According to the American Diabetes Association (ADA, 2013), diabetes played a contributing role in 231,404 deaths in 2007 alone. Because of this, researchers strive to develop the best methods of managing diabetes. Physical activity has been shown to improve glucose control by reducing insulin resistance and reducing body fat (Bacchi et al., 2012). Recent data from DiPietro et al. (2013) indicated that multiple bouts of exercise may be favorable over one continuous bout in managing blood …

Immune Reconstitution But Persistent Activation After 48 Weeks Of Antiretroviral Therapy In Youth With Pre-Therapy Cd4 >350 In Atn 061., Bret J. Rudy, Bill G. Kapogiannis, Carol Worrell, Kathleen E. Squires, James Bethel, Su Li, Craig M. Wilson, Allison Agwu, Patricia Emmanuel, Georgine Price, Stephanie Hudey, Maureen M. Goodenow, John W. Sleasman

Department of Medicine Faculty Papers

BACKGROUND: Measures of immune outcomes in youth who initiate combination antiretroviral therapy (cART) early in HIV infection are limited.

DESIGN: Adolescent Trials Network 061 examined changes over 48 weeks of cART in T-cell subsets and markers of T-cell and macrophage activation in subjects with pre-therapy CD4 > 350 cells/mm. All subjects had optimal viral suppression from weeks 24 through 48.

METHODS: Subjects (n = 48) initiated cART with tenofovir/emtricitabine plus ritonavir-boosted atazanavir. Data were collected at baseline and weeks 12, 24, and 48. Trends were compared to uninfected controls.

RESULTS: Significant increases over 48 weeks were noted in all CD4 populations, …

Sexual Relationships Outside Primary Partnerships And Abstinence Are Associated With Lower Adherence And Adherence Gaps: Data From The Partners Prep Ancillary Adherence Study, Alexander Kintu, Susan E. Hankinson, Raji Balasubramanian, Karen Ertel, Elioda Tumwesigye, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis (PrEP) against HIV.

Methods—We enrolled 1,147 HIV-negative individuals in long-term serodiscordant relationships at three sites in Uganda from the Partners PrEP Study- a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (

Results—Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with

Conclusions—Risk of low overall adherence …

Super Learner Analysis Of Electronic Adherence Data Improves Viral Prediction And May Provide Strategies For Selective Hiv Rna Monitoring, Maya L. Petersen, Erin Ledell, Joshua Schwab, Varada Sarovar, Robert Gross, Nancy Reynolds, Jessica E. Haberer, Kathy Goggin, Carol E. Golin, Julia Arnsten, Marc Rosen, Robert H. Remien, David Etoori, Ira B. Wilson, Jane M. Simoni, Judith A. Erlen, Mark J. Van Der Laan, Honghu Liu, David Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective—Regular HIV RNA testing for all HIV positive patients on antiretroviral therapy (ART) is expensive and has low yield since most tests are undetectable. Selective testing of those at higher risk of failure may improve efficiency. We investigated whether a novel analysis of adherence data could correctly classify virological failure and potentially inform a selective testing strategy.

Design—Multisite prospective cohort consortium.

Methods—We evaluated longitudinal data on 1478 adult patients treated with ART and monitored using the Medication Event Monitoring System (MEMS) in 16 United States cohorts contributing to the MACH14 consortium. Since the relationship between adherence and virological failure is …

My Time With E, Alyssa Mohorek

Journal of Patient-Centered Research and Reviews

Poignant encounters with a dying patient and her family are described. These reflections explore one aspect of the maturation process of a medical intern.

Optimization Of Fluorescent Detection Of Rotavirus Protein Nsp4 And A Cellular Receptor In Two Cell Lines, Katelyn D. Defrates, Rebecca Walker, Ron Havenar, Rebecca D. Parr

Bright Ideas Conference

Rotavirus (RV) infections are the most common cause of severe diarrhea in infants and young children worldwide. The two licensed vaccines for RV protect children from common strains of RV, but they are less effective against new emerging RV strains. Therefore, new therapeutics to treat RV infections need to be developed. Recently, we have shown stilbenoids, trans-arachidin-1 (t-A1) and trans-arachidin-3 (t-A3), decrease progeny virus particles by one hundred fold. Likewise, western blot assays show a decrease in the amount of the viral protein NSP4 with the addition of the stilbenoids during a RV infection. This indicates an effect on viral …

Estrogen, Bisphenol A, And Bisphenol S: Regulation Of Cathepsin L Activity And Its Relation To Systemic Lupus Erythematosis, Regina M. Powers

Biology Honors Papers

Systemic Lupus Erythematosis (SLE) is an autoimmune disease that causes the immune system to self-destruct. SLE is nine times more frequent in women than in men, and it has been shown that there is a correlation between high estrogen levels and an increased severity of the disease. This raises a concern about environmental estrogens, including Bisphenol A (BPA) which is found in many plastic products in the United States. BPA can be absorbed by the foods and liquids that are held in the plastic containers and then can enter into the human body. Because of its structural similarity to estrogen, …

Site-Specific Immunomodulator: A Novel Treatment For Crohn's Disease, Brian Bressler, Kevin P. Bethel, Ralf Kleef, Sophie L. Reynolds, Simon Sutcliffe, David W. Mullins, Hal Gunn

Dartmouth Scholarship

We investigated the mechanism of action, safety, and efficacy of the Site-Specific Immunomodulator (SSI) QBECO, a novel immunotherapy for Crohn’s disease (CD). Using human monocytic THP-1 cells, we demonstrate that SSI QBECO (derived from the common colon bacteria E. coli) activates macrophages to an M1 phenotype (associated with enhanced capacity to eliminate bacteria and activate innate immune responses). We assessed SSI QBECO in a compassionate use protocol of ten adult patients with active CD. Patients with moderate to severe clinical symptoms receiving conventional CD treatments and/or complementary therapies were included, except patients receiving anti-TNF medications. SSI QBECO was self-administered subcutaneously …

A Microrna Profile Associated With Opisthorchis Viverrini-Induced Cholangiocarcinoma In Tissue And Plasma., Jordan Plieskatt, Gabriel Rinaldi, Yanjun Feng, Jin Peng, Samantha Easley, Xinying Jia, Jeremy Potriquet, Chawalit Pairojkul, Vajarabhongsa Bhudhisawasdi, Banchob Sripa, Paul J Brindley, Jeffrey Bethony, Jason Mulvenna

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive tumor of the bile duct, and a significant public health problem in East Asia, where it is associated with infection by the parasiteOpisthorchis viverrini. ICC is often detected at an advanced stage and with a poor prognosis, making a biomarker for early detection a priority.

Methods

We have comprehensively profiled miRNA expression levels in ICC tumor tissue using small RNA-Seq and validated these profiles using quantitative PCR on matched plasma samples.

Results

Distinct miRNA profiles were associated with increasing histological differentiation of ICC tumor tissue. We also observed that histologically …

Gestational Diabetes, David D. Monin

Biology Undergraduate

No abstract provided.

Hlhs Is Caused By The Up Regulation Of Hif1Α Due To Hypoxia Caused By A Polymorphism In Enos, Tyler J. Bruinsma, Kevin T. Curwick, Leah Ellman, Jared M. Grootwassink, Thomas M. O'Toole

Celebrating Scholarship & Creativity Day (2011-2017)

Hypoplastic left heart syndrome (HLHS) is a rare congenital heart defect occurring in fewer than 0.5% of live births in the United States (Fruitman, 2000). It is characterized by a critically underdeveloped left ventricle with accompanying imperfections including septal defects, under-sized aorta, and underdeveloped bicuspid and aortic semilunar valves (Mayo Clinic Staff, 2012; CDC, 2013). HLHS is detectable on ultrasound at the end of the first trimester of pregnancy allowing for early diagnosis and potential treatment in utero. While a protocol involving three surgeries exists to treat the condition, there is no cure for HLHS. Even with treatment, many …

Translation Initiation Complex Eif4f Is A Therapeutic Target For Dual Mtor Kinase Inhibitors In Non-Hodgkin Lymphoma., Christos Demosthenous, Jing Jing Han, Mary J Stenson, Matthew J Maurer, Linda E Wellik, Brian Link, Kristen Hege, Ahmet Dogan, Eduardo Sotomayor, Thomas Witzig, Mamta Gupta

Medicine Faculty Publications

Deregulated mRNA translation has been implicated in disease development and in part is controlled by a eukaryotic initiation complex eIF4F (composed of eIF4E, eIF4G and eIF4A). We demonstrate here that the cap bound fraction from lymphoma cells was enriched with eIF4G and eIF4E indicating that lymphoma cells exist in an activated translational state. Moreover, 77% (110/142) of diffuse large B cell lymphoma tumors expressed eIF4E and this was associated with an inferior event free survival. Over-expression of wild-type eIF4E (eIF4E(WT)) but not cap-mutant eIF4E (eIF4E(cap mutant)) increased the activation of the eIF4F complex. Treatment with the active-site dual mTOR inhibitor …

Barriers To Music Therapy In The Care Of Those With Alzheimer's/Dementia, Karin E. Kvam

Honors College Theses

This pilot study examines the barriers caregivers encounter when implementing music therapy in the care of those with Alzheimer’s/dementia. An 8-question survey was distributed at two long-term care facilities and an Alzheimer’s support group to understand how often and in what ways music therapy is utilized, as well as what barriers caregivers face when using the therapy. Results indicated that, although the majority of caregivers report using music therapy, it is not implemented as frequently as it could or should be. Caregivers report a knowledge deficit as the main reason for not implementing music therapy. The data suggests that an …

The Plight Of The Lucluc: Examining The Deadly Mystery Of Nodding Syndrome, Ethan K. Mcgann

Senior Honors Theses

Nodding syndrome (NS) is an emerging epidemic neurological disease that is shrouded in mystery. It is currently only found in the post-conflict regions of South Sudan, northern Uganda, and Tanzania. NS occurs in children from the ages of five to fifteen and is characterized by a loss of motor control in the neck muscles. Seizure episodes can range in intensity from atonic to tonic-clonic, and the onset of the first episode generally marks the beginning of a decline in the child’s physical and mental health. NS is a progressive disease that generally results in physical wasting, stunted growth, behavioral difficulties, …

The Huntington’S Disease Community Can’T Afford To Lose Momentum, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

I'Ve Been Diagnosed: A Champion! Crohn's & Colitis Family Day, Samantha M. Goldberg

Honors College Theses

This Honors thesis outlines the creation of “I’ve Been Diagnosed: A Champion! Crohn’s & Colitis Family Day”—an experience designed to provide Southeast Georgia children and families affected by inflammatory bowel disease (IBD) an opportunity to enhance community involvement and build a support network through therapeutic recreation, team-based activities, education, and a positive family-centered environment. Following the nursing process focusing on the community as the patient, this paper is organized by assessment, diagnosis, planning, intervention, and evaluation. A literature review was conducted and interviews with a medical professional and a patient were completed. Specific interventions were planned using the nursing process …

Identification Guide To Larval Stages Of Ticks Of Medical Importance In The Usa, Kymbreana Coley

Honors College Theses

Scanning Electron Micrographs were prepared of four morphologically diagnostic regions (dorsal capitulum, ventral capitulum, scutum, leg coxae) for the larval stage of the 16 species of ixodid (hard) ticks known to parasitize humans in the USA. These species are: Amblyomma americanum, A. maculatum, A. mixtum, A. tuberculatum, Dermacentor albipictus, D. andersoni, D. occidentalis, D. variabilis, Haemaphysalis leporispalustris, Ixodes angustus, I. cookei, I. pacificus, I. scapularis, I. spinipalpis, I. texanus, and Rhipicephalus sanguineus. Based on the morphological characters observed, a dichotomous identification key to ixodid larvae that parasitize humans in the USA was prepared. Common names, hosts and geographical distributions are …

The Role Of Occupational Therapy In The Prevention Of Infant Torticollis & Plagiocephaly, Anne H. Zachry

Faculty Presentations

AOTA includes health promotion as an Intervention approach in the Occupational Therapy Practice Framework: Domain and Process. As health care professionals, occupational therapy practitioners are responsible for promoting public health and wellness. Occupational therapists need to educate parents and caregivers about the importance of varying infant positions, providing tummy time, and limiting infant time spent in baby gear.

Engaging A ‘Scared Population’ Of Huntington’S Disease Families By Respecting Their Journeys, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Targeted Single Molecule Sequencing Methodology For Ovarian Hyperstimulation Syndrome., Funda Orkunoglu-Suer, Arthur F. Harralson, David Frankfurter, Paul Gindoff, Travis J. O'Brien

Genomics and Precision Medicine Faculty Publications

BACKGROUND: One of the most significant issues surrounding next generation sequencing is the cost and the difficulty assembling short read lengths. Targeted capture enrichment of longer fragments using single molecule sequencing (SMS) is expected to improve both sequence assembly and base-call accuracy but, at present, there are very few examples of successful application of these technologic advances in translational research and clinical testing. We developed a targeted single molecule sequencing (T-SMS) panel for genes implicated in ovarian response to controlled ovarian hyperstimulation (COH) for infertility.

RESULTS: Target enrichment was carried out using droplet-base multiplex polymerase chain reaction (PCR) technology (RainDance®) …

Impact Of Social And Cultural Factors On Teenage Pregnancy, Devi Akella, Melissa Jordan

Journal of Health Disparities Research and Practice

United States has the highest level of teenage pregnancy amongst the industrialized nations. Further, the level of teenage pregnancy is highest amongst the minority population. This research study examines the reasons behind high rates of early childbirth amongst African American teenagers. This study uses Bandura’s (1977) Social Learning Theory to deconstruct the factors, which influence and manipulate the overall behavior of the teenagers and initiates them to choose early motherhood over education and career. To ensure better quality of empirical data, the authors collaborated with the pregnant teenagers and a local non-profit community agency using a phenomenological analysis.

Opisthorchiasis: An Overlooked Danger, Ludmila M. Ogorodova, Olga S. Fedorova, Banchob Sripa, Viatcheslav A. Mordvinov, Aleksei V. Katokhin, Paul J. Brindley, The Topic Consortium

Microbiology, Immunology, and Tropical Medicine Faculty Publications

No abstract provided.

Opisthorchiasis: An Overlooked Danger., Ludmila M Ogorodova, Olga S Fedorova, Banchob Sripa, Viatcheslav A Mordvinov, Aleksei V Katokhin, Jennifer Keiser, Peter Odermatt, Paul J. Brindley, Oleg A Mayboroda, Thirumalaisamy P Velavan, Maxim B Freidin, Alexey E Sazonov, Irina V Saltykova, Mariya Y Pakharukova, Yulia V Kovshirina, Kostas Kaloulis, Olga Y Krylova, Maria Yazdanbakhsh

Microbiology, Immunology, and Tropical Medicine Faculty Publications

No abstract provided.

Investigation Of Dual Stage Acridones As A Potent Malaria Treatment, Stephanie Huezo

Dissertations, Masters Theses, Capstones, and Culminating Projects

The need for potent antimalarials to prevent the emergence of drug resistant Plasmodium falciparum is urgent. Discovery of novel acridone chemotypes have shown promise for a new antimalarial drug treatment. Presently, two acridone chemotypes have intrinsic antimalarial potency against chloroquine sensitive and multidrug resistant parasites. Acridones lacking an N10 side chain are known as chemotype I acridones, whereas, chemotype II acridones are defined as having an alkyl side chain at the same position. The N10 substitution of chemotype II acridones is thought to target heme and inhibit hemozoin formation within the parasite’s digestive vacuole, and is known to provide synergistic …

Permanence And Picnic Tables Perceptions Of Maji Safi Group’S Disease Prevention Center At Shirati Kmt District Designated Hospital, Sarah Muskin

Independent Study Project (ISP) Collection

This study conducted in Shirati village in the Rorya District of the Mara Region of Tanzania analyzed perspectives on the effectiveness of Maji Safi Group’s Disease Prevention Center at Shirati KMT District Designated Hospital. It took place from April 9th- 24th 2015. The sample frame was those affiliated with or using the Disease Prevention Centers resources. The sample populations were medical professional employed at Shirati Hospital (n = 15), Community Health Workers (n = 11) (CHWs) working for Maji Safi Group, and visitors (n = 113) to the Disease Prevention Center. This study utilized three main methods for data collection: …

Diabetes Distress: Transforming A Practice, Goff M. Jeannie

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus affects millions of people in the United States, placing them at risk for other disease related complications. This makes the management of diabetes and the prevention of complications an important challenge. The psychological aspect of diabetes care may present a barrier to patients that inhibit them from achieving optimal self-care.

Diabetes distress (DD) is the psychological aspect of diabetes that is specific to the emotional distress caused from living a chronic disease. DD has been linked to poorer self-management behaviors which makes it a significant problem that should be taken into consideration for effective management of the diabetic …

Barriers To Prevention And Treatment Of Type 2 Diabetes Mellitus: A Qualitative Analysis Of Women In East Sikkim, India, Emily Applewhite

Independent Study Project (ISP) Collection

Diabetes Mellitus is a metabolic disorder that affects more people in India than anywhere else in the world (Ramachandran et. al., 2010). A recent national study concluded that Sikkim, a small northeastern state in the Himalayas, has the highest prevalence of Diabetes Mellitus compared to any other state in India. In order to determine why this is so, this study looks at the barriers women face when attempting to prevent and treat Type 2 Diabetes Mellitus (T2DM) in East Sikkim. Fieldwork for this study was facilitated by The Volunteer Health Association of Sikkim, and took place in Gangtok and a …

The Therapeutic Role Of Turmeric In Treatment And Prevention Of Alzheimer’S Disease, Rylan M. Mcquade

Selected Honors Theses

As a devastating neurological condition that expends millions of lives each year, Alzheimer’s disease (AD) is a subject of intense investigation.¹ Although AD has been known for over a century, the precise mechanisms that underlie AD pathogenesis and development are still poorly understood. The Alzheimer phenotype is typified by extracellular amyloid-beta (Aβ) plaques and intracellular neurofibrillary tangles (NFTs), causing researchers to notice several key enzymes implicated in this process.¹ Most notable are β and γ secretases (which drive Aβ plaque production) and phospholipase

A₂ (which stimulates major cascade activation through the specific cleavage of fatty acyl esters). …

True Durability: Hiv Virologic Suppression In An Urban Clinic And Implications For Timing Of Intensive Adherence Efforts And Viral Load Monitoring, Debra A. Benator, Angelo Elmi, Manuel D. Rodriguez, Howard B. Gale, Virginia L. Kan, Heather J. Hoffman, Susan Tramazzo, Karen Hall, Angela Mcknight, Leah Squires

Medicine Faculty Publications

Although the majority of HIV-infected patients who begin potent antiretroviral therapy should expect long-term virologic suppression, the realities in practice are less certain. Durability of viral suppression was examined to define the best timing of targeted adherence strategies and intensive viral load monitoring in an urban clinic population with multiple challenges to ART adherence. We examined the risk of viral rebound for patients who achieved two consecutive viral loads lower than the lower limit of quantification (LLOQ) within 390 days. For 791 patients with two viral loads below the LLOQ, viral rebound >LLOQ from the first viral load was 36.9 …