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Doxycycline-Induced Acute Pancreatitis: A Likely Source Rarely Seen, Paul Hoffman Do, Wilco Civil Sr, Jung Yoon Do, Gurjeet Kang Do, Christopher Lozano Orpiano Do, Michael Quinn Do, Joseph Staffetti Md, Dilip Ghanekar Md, Lakshminarasimhan Venu Md, Lily N. Jones Do, Ji Kwon Do, Shaival Thakore Md

Gastroenterology

No abstract provided.

Oral Fungal Microbiota: To Thrush And Beyond, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The oral microbiota is complex, multikingdom, interactive, and involves extensive biofilm formation. While dominated by bacteria, Candida is a frequent member of this microbiota; however, several other potentially pathogenic fungi (among around 100 identified species) appear to reside in some individuals, including Cryptococcus, Aspergillus, and Fusarium. Oral candidiasis may manifest as a variety of disease entities in normal hosts and in the immunocompromised. These include pseudomembranous candidiasis (thrush), hyperplastic or atrophic (denture) candidiasis, linear gingival erythema, median rhomboid glossitis, and angular cheilitis. The purpose of this review is to describe the oral fungal microbiota (ie, oral mycobiota), …

Spontaneous Fungal Peritonitis: A Rare Complication Of Ascites Secondary To Right Heart Failure: A Case Report, Saaah Siddiqui Md, Dharti R. Patel Md, Arshad M. Iqbal Md, Ateeq Mubarik Md, Salman Muddassir Md, Fahad Zafar Md

Internal Medicine

•Spontaneous fungal peritonitis (SFP) is an infection defined as a neutrophil count (> 250 cells/mL) in the ascitic fluid with the evidence of positive fungal culture (1) while excluding other intra-abdominal infections. SFP is not as common as spontaneous bacterial peritonitis and has higher mortality rates due to late recognition and difficulty in differentiation between SFP and SBP. (1,2). The common risk factors that have shown to increase the mortality for SFP include hepatorenal syndrome, patient on SBP prophylaxis, elevated APACHE II scores on admission, and elevated lactate levels (2,3). Candida albicans and Candida glabrata are the two …

Cavitary Lesion In An Immunocompromised Adult, Syed Talha Qasmi, Turuvekere Jayaram, Enrique Rincon

Internal Medicine

No abstract provided.

Sterile Compounding: Regulations Addressed After The Meningitis Outbreak Of 2012, Kelly M. Dye, Tara M. Tokar, Halle M. Orlinski, Heather Helsel, Marcia M. Worley

Pharmacy and Wellness Review

No abstract provided.

Antimicrobial Stewardship Programs, Kevin Stack, Eric Stack, Stelios Theophanous, Anne Gentry, Jason M. Pogue

Pharmacy and Wellness Review

Antimicrobial Stewardship Programs (ASPs) are becoming increasingly prevalent in the United States as concerns continue to mount regarding antimicrobial resistance and the lack of new, novel antibiotics being introduced. There are a multitude of factors that have contributed to the escalation in antimicrobial resistance, with some of the more common concerns being overly broad antimicrobial coverage and prolonged antimicrobial treatment amongst others. While antimicrobial resistance is a problem of international proportion, each health care institution remains responsible for assessing its own protocols pertinent to antimicrobial usage. ASPs have had unparalleled success in achieving their goals due to the collaboration of …

Antibiotic Stewardship And Overcoming Antibiotic Resistance In Upper Respiratory Tract Infections, Katherine Elsass, Austin Hilverding, Steve Blake, Brendan Rasor, Steven N. Leonard

Pharmacy and Wellness Review

Antibiotic resistance has rapidly become one of the most significant challenges facing modern health care. Despite widespread public education efforts by the national government and health organizations worldwide, there remains a significant lack of public understanding of antibiotic resistance, how to prevent it and the implications if the science and health care communities fail to find a solution. The Centers for Disease Control and Prevention (CDC) and the American College of Physicians (ACP) recently published updated guidelines for appropriate antibiotic use in upper respiratory tract infections. These guidelines include several key recommendations for acute bronchitis, pharyngitis and acute rhinosinusitis (including …

Legionnaires' Disease, A Rising Occurrence In The United States, Jennifer Harklerode, Olivia Henton, Myranda Smith, Rebecca Worden, Andrew Roecker

Pharmacy and Wellness Review

Legionella pneumophila, a microscopic bacterium usually responsible for a number of illnesses and fatalities, can eliminate a local population, a region or even a nation. In 1976, L. pneumophila was first discovered due to a number of cases presenting with pneumonia-like symptoms. These cases occurred in an isolated population attending an American Legion convention in Philadelphia, Pennsylvania, therefore lending to the name Legionella. Usually found in aquatic environments such as lakes, streams, cooling towers, air conditioning systems and hot tubs, its ability to thrive in artificial and natural environments makes it an ideal bacterium. L. pneumophila can be transmitted via …

Zika Virus Induced Neurological Disorders And Impacts On Public Health, Alexandra Herman, Martha Zimmerman, Olivia Vanscoy, Olivia Henton, Lindsey Peters

Pharmacy and Wellness Review

Zika virus is a public health emergency of international concern. Zika virus (ZIKV) is a mosquito-borne pathogen that is carried by the Aedes genus. Zika is spread through direct bite and nonvector transmission. Most individuals infected with Zika will be asymptomatic, but some may present nonspecific viral symptoms. A rising number of neurological disorders in newborns whose mothers were infected with ZIKV during pregnancy have been reported due to recent outbreaks. Neurological disorders affect both the central and peripheral nervous systems and can result from bacterial, viral, fungal or parasitic infections of the nervous system or from the immune response …

Zika Virus: Infectious Process And Public Health Response, Morgan Homan, Julia Dickman, Jenna Deininger, Austin Hopkins, Olivia Henton, Steven N. Leonard

Pharmacy and Wellness Review

The Zika virus has become a growing concern as a global pandemic. Since being identified in Uganda in 1947, the virus has spread around the world, recently emerging in South America with a great impact on Brazil. As of 2016, Zika has made its appearance in the United States and is now actively being transmitted in Florida. The virus is a mosquito-vectored flavivirus primarily transmitted by the Aedes mosquito which infects a human through biting. Transmission through sexual intercourse is also possible as well as transmission from a pregnant woman to her fetus. This latter form of transmission presents the …

Combating Antibiotic Resistance In The 21st Century, Kevin Krivanek, Brian Heilbronner, Brendan Rasor, Kelsey Lindsley, Andrew Roecker

Pharmacy and Wellness Review

Antibiotic resistance is one of the most significant challenges facing the medical community today. In response, the Centers for Disease Control and Prevention (CDC) created a list of the greatest antibiotic resistance threats, a number of which are gram-positive bacteria. The cell wall of these organisms has long been a favored target of antibiotic therapies, but the development of numerous resistance mechanisms has led to widespread resistance against nearly all major antibiotic compounds on the market. The medical community is faced with the task of developing better antibiotic compounds that preclude the spread of bacterial resistance and also increasing the …

Whooping Cough: A Pharmacist's Role In An Emerging Endemic, Haley Armstrong, Lydia Suchecki, Sarah Lipperman, Taylor Roberson, Andrew M. Roecker

Pharmacy and Wellness Review

Pertussis is an acute infectious disease caused by the organism Bordetella pertussis and characterized by a "whooping cough." Incidence of the disease had declined since the development of a vaccine, but is now increasing in reported cases. This increase has been attributed to both an increased awareness but also surmised to be related to a decrease in vaccinations. The pertussis vaccine is given in conjunction with tetanus and diphtheria vaccines to children before the age of 6 in five separate injections over the course of four to six years. A booster is now recommended for the older child and adults …

A Comparison Of Mipomersen (Kynamro®) And Lomitapide (Juxtapid®): Medications For The Treatment Of Homozygous Familial Hypercholesterolemia, Ann Marie Ruhe, Austin Brown, Ginny Daniels, Kelsey Fink, David Bright

Pharmacy and Wellness Review

Homozygous familial hypercholesterolemia (HoFH) is a rare disease that involves mutations in the genes coding for low density lipoprotein (LDL) receptors, preventing the uptake of LDL cholesterol from the serum and resulting in extremely high cholesterol levels.1 Between December 2012, and January 2013, two orphan drugs were approved by the U.S. Food and Drug Administration (FDA) for the treatment of HoFH. Mipomersen (Kynamro®) is a subcutaneous injection that functions as an antisense oligonucleotide inhibitor and ultimately prevents the translation of mRNA coding for apolipoprotein B (apoB)-100 which binds to LDL and very low density lipoprotein (vLDL) cholesterol.7 Lomitapide (Juxtapid®) is …

Fda Approves New Tuberculosis Drug: Bedaquiline (Sirturo®), Megan Ruffner, Kent Wilin, Charles Hay, Zachary Crawford, Andrew Roecker

Pharmacy and Wellness Review

Tuberculosis (TB), caused by the acid-fast bacilli (AFB) Mycobacterium tuberculosis, is an infectious disease that continues to greatly impact morbidity and mortality worldwide; in 2011 it caused 1.4 million deaths. Some strains of the bacteria have become resistant to current treatment regimens, resulting in multidrug-resistant (MOR) and extensively drugresistant (XOR) TB. The emergence of these resistant strains of bacteria calls for new treatment regimens that can quickly and effectively eradicate the organism. The U.S. Food and Drug Administration (FDA) recently approved Sirturo® (bedaquiline) with the indication of MDR pulmonary TB. Bedaquiline introduces a novel mechanism of action via the inhibition …

Laboratory Mutations Of H5n1 Confer Efficient Transmission In Animal Models And Generate International Debate Regarding Publication Of Dual Use Research, Morgan A. Belling, Kelly Dye, Joshua Ilenin, Jamie Amero, Andrew M. Roecker

Pharmacy and Wellness Review

H5N1, a subtype of influenza A virus that originated in Hong Kong in 1997 and has since spread across Asia and Africa, features a reported case fatality rate of nearly 60 percent in humans. Although naturally-occurring H5N1 has not developed the ability to be efficiently transmitted from human to human, two independent research teams have recently mutated strains of the virus, resulting in facile transmission among laboratory ferrets, which are considered the most accurate models for humans in viral studies. As a consequence of the security and public health risks of such information, the U.S. National Science Advisory Board for …

Fidaxomicin (Dificid®): New Antibiotic Approved For The Treatment Of Clostridium Difficile Infections, Sara M. Mcallister, Zachary Crawford, Joshua Ilenin, Ellen Hazelet, Andrew M. Roecker

Pharmacy and Wellness Review

Clostridium difficile is a gram-positive, spore forming bacteria normally transmitted by the fecal-oral route. Infection develops in patients with decreased normal gut flora and is typically associated with recent antibiotic use. Other risk factors include bowel surgery, compromised immune system function, extended hospital stays, and other underlying diseases. C. difficile bacteria produce two toxins, which cause increased intestinal fluid secretion and inflammation. Patients commonly present with diarrhea, abdominal discomfort, loss of appetite, and nausea. Current treatment guidelines are to discontinue antimicrobial agents and increase hydration. Less severe C. difficile associated diarrhea (CDAD) cases are treated with metronidazole 500 mg three …

Nocardia Beijingensis: A Rare And Unusual Cause Of Intracranial Abscess, Lakshpaul Chauhan Md, Nirali Vassa Md, Elizabeth Henderson Md, Ateeq Mubarik Md, Danish M. Siddiq Md, Abdulmagid Eddib Md

Infectious Disease

Background : Nocardia species are thin, aerobic, filamentous, gram-positive bacilli that are ubiquitous in soil worldwide. Nocardia infections are divided into three main categories: pulmonary nocardiosis, disseminated nocardiosis, and cutaneous nocardiosis.

Methods : We present a case of cerebral nocardiosis in an immunocompetent patient caused by Nocardia beijingensis (NB).

Results : A 60-year-old Caucasian lady from Florida with type 2 diabetes mellitus, hypertension, hyperlipidemia, presented to the emergency room with complaints of altered mentation. Per husband, she was having episodes of emesis and diarrhea three days prior to admission that resolved however, her mentation significantly deteriorated to where she was …

Ecthyma Gangrenosum In An Immunocompromised Patient Without Detectable Bacteremia, Jonathan Miles, Alex Mari, Matthew Crabtree, Vinod Nambudiri, Jilian Sansbury

Dermatology

Ecthyma gangrenosum (EG) is typically pathognomonic of Pseudomonas aeruginosa bacteremia among immunocompromised patients, particularly with underlying malignancy. Recently, other pathogens and clinical histories have been implicated, challenging the classic picture of patients with EG. The cutaneous findings in patients follow a pattern of lesion progression from indurated pustules and hemorrhagic vesicles evolving to necrotic ulcers with central black eschar and surrounding erythema. While lesions typically occur on the perineum or lower extremities, their presence has also been described elsewhere. Herein, we describe a case of an immunocompromised man with chronic lymphocytic leukemia and multiple myeloma actively undergoing chemotherapy presenting with …

The Kentucky Cabinet For Health And Family Services’ Response To The Hepatitis A Virus Outbreak In Kentucky: An Idea Model Analysis, Rachel Leigh Cato

Masters Theses & Specialist Projects

The hepatitis A crisis in Kentucky is unprecedented compared to other states. With thousands of hospitalizations and over 60 deaths in the state of Kentucky alone, there is a need to evaluate the government’s response to the hepatitis A virus (HAV) epidemic. Therefore, the instructional risk communication messages that are being conveyed by the Kentucky Cabinet for Health and Family Services (KCHFS) are instrumental in the education and action plans of Kentuckians who are at risk of contracting HAV.

This study utilizes the IDEA Model Thematic Analysis Codebook as a guide to analyze the KCHFS’ risk communication regarding the hepatitis …

Improving Pneumococcal Vaccination Rates In High Risk Patients Across Multiple Specialty Divisions, Rachel Moran, Julia G. Harris, Claire Olsen, Rana El Feghaly, Liset Olarte, Douglas Blowey, Luke A. Harris

Posters

Pediatric patients with deficient immune systems or certain chronic medical conditions have an increased risk of acquiring invasive pneumococcal disease.

The 23-valent pneumococcal (PPSV23) vaccine provides protection against 23 pneumococcal serotypes and is recommended for patients aged 2 years or older who are high-risk for invasive pneumococcal disease.

Unfortunately, many high-risk patients are not properly vaccinated due to lack of provider knowledge or understanding of accountability between primary care and specialty providers.

The goal of this project was to improve PPSV23 vaccination rates by 10-20% across multiple Children's Mercy Kansas City specialty divisions.

Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang

Independent Study Project (ISP) Collection

Background: Schistosomiasis is considered one of the most prevalent neglected tropical diseases in the world. According to the World Health Organization (WHO), the most effective strategy for schistosomiasis control is through preventive chemotherapy with praziquantel (PZQ). In order to successfully control morbidity rates, the WHO recommends mass treatment targeting high risk groups, such as school-age children and adults considered to be at risk.

Methods: This cross-sectional study examined the effects of the National School-Based Deworming Programme (NSBDP) on knowledge of schistosomiasis and subsequent prevalence rates and intensity. A total of 43 residents in Luanda K’Otieno were interviewed, and 34 of …

An Analysis Of The Rajasthan Public Health System’S Response To The 2019 Dengue Insurgence, Luke Bryan

Independent Study Project (ISP) Collection

Dengue virus is in a pandemic status and is a major public health issue in the modern world. The mosquito-borne disease is largely prevalent in Asia and specifically India, where more than half of the states are considered to have complete presence of the dengue virus. The intricate infrastructure of the Indian public health system looks for dengue cases at all levels and reports to the integrated disease surveillance programme (IDSP).

Analyses of the IDSP and trends of dengue cases was done in response to dengue outbreaks throughout the state. Geographic information system (GIS) maps were created to evaluate a …

Treatment Of Podoconiosis With Complicating Polyinfections Within Rural African Villages: A Case Study, Amanda R. Beering, Abigail R. Florence, Soon Bahrami Md

Journal of Refugee & Global Health

This case study aims to provide a treatment plan for the treatment of podoconiosis with complicating polyinfections in a resource poor setting. A second objective is to help healthcare providers teach preventive measures to villagers in affected regions.

Coccidioidomycosis: Medical And Spatio-Temporal Perspectives, Nikias Sarafoglou, Rafael Laniado-Laborin, Menas Kafatos

Mathematics, Physics, and Computer Science Faculty Articles and Research

Coccidioidomycosis (CM) is a disease of major public health importance due to the challenges in its diagnosis and treatment. To understand CM requires the attributes of a multidisciplinary network analysis to appreciate the complexity of the medical, the environmental and the social issues involved: public health, public policy, geology, atmospheric science, agronomy, social sciences and finally humanities, all which provide insight into this population transformation.

In section 1 of this paper, we describe the CM-epidemiology, the clinical features, the diagnosis and finally the treatment.

In section 2, we highlight the most important contributions and controversies in the history of the …

West Nile Virus: An Old Tale, New Mystery, Seetha Venkateswaran, Patricia Gilford

Family Medicine

• West Nile Virus (WNV), belongs to the Flavivirus family, is considered an endemic disease in many states including Florida.
• In the last decade, the virus has been prominently reported in the Southern and Midwest States.
• The disease is most prevalent during the summer to fall month periods due to elevated temperatures leading to enhanced vector transmission.
• WNV is acquired via the bite of an infected mosquito particularly the Culex species, and is considered as the vector for the disease.
• Equines and humans are incidental hosts of WNV and disease transmission from these sources are rare. There are various human risk …

Cutaneous Leishmaniasis In A Traveler: A Case Report, Sarah Al-Obaydi Md, Nemer Dabage Md, James Demaio Md

Internal Medicine

Leishmaniasis, a vector-borne infection transmitted by sandflies, is endemic throughout the Mediterranean basin and the tropics. We present a case diagnosed in Florida after overseas travel.

Nitrofurantoin Induced Lung Toxicity: A Rare Adverse Effect, Farrah Chilet Md, Nour Tlimat Md, Salman Muddassir Md

Internal Medicine

No abstract provided.

Seaweeds As Nutraceuticals For Health And Nutrition, Emer Shannon, Nissreen Abu-Ghannam

Articles

Throughout human history, seaweeds have been used as food, folk remedies, dyes, and as mineral-rich fertilisers. Seaweeds as nutraceuticals or functional foods with dietary benefits beyond their fundamental macronutrient content are now a major research and industrial development concept. The occurrence of dietary and lifestyle related diseases, notably type 2 diabetes, obesity, cancer, and metabolic syndrome has become a health epidemic in developed countries. Global epidemiological studies have shown that countries where seaweed is consumed on a regular basis have significantly fewer instances of obesity and dietary-related disease. This review outlines recent developments in seaweed applications for human health from …

Occupied, Judy Diamond, Tom Floyd, Rebecca Smith, Ann Downer-Hazell, Martin Powell, Nick Poliwko, Angie Fox, Amy Spiegel, Patricia Wonch Hill, Julia Mcquillan

Zea E-Books Collection

Our bodies are home to more microbes than human cells. The balance of helpful to harmful microbes in our bodies can make us sick or healthy. The Biology of Human project focuses on helping people understand themselves by exploring scientific principles that underlie modern research in human biology. Biology of Human is an alliance of science educators, artists, science writers, and biomedical researchers working to increase public understanding about viruses and infectious disease. In this comic, Daniel and Miguel find themselves in the world of the microbes, where they meet the Roid (Bacteroides), Longo biffi (Bifidobacterium longum), E. …

Our Envirome, Spring/Summer 2019, Issue 40

Sustain Magazine

No abstract provided.