Digital Commons Network^™

Immunotherapies For Covid-19: Lessons Learned From Sepsis, Ke Remy, Sc Brakenridge, B Francois, T Daix, Cs Deutschman, G Monneret, R Jeannet, Pf Laterre, Rs Hotchkiss, Ll Moldawer

Journal Articles

No abstract provided.

Scientific And Standardization Committee Communication: Clinical Guidance On The Diagnosis, Prevention And Treatment Of Venous Thromboembolism In Hospitalized Patients With Covid-19., Ac Spyropoulos, Jh Levy, W Ageno, Jm Connors, Bj Hunt, T Iba, M Levi, Cm Samama, D Giannis, Jd Douketis, +1 Additional Author

Journal Articles

No abstract provided.

Cerebral Venous Thrombosis: A Typical Presentation Of Covid-19 In The Young, De Klein, R Libman, C Kirsch, R Arora

Journal Articles

No abstract provided.

Perivascular Macrophages In The Neonatal Macaque Brain Undergo Massive Necroptosis After Simian Immunodeficiency Virus Infection, Diana G. Bohannon, Yueying Wang, Colin H. Reinhart, Julian B. Hattler, Jiangtao Luo, Hamid R. Okhravi, Jianshui Zhang, Qingsheng Li, Marcelo J. Kuroda, Woong-Ki Kim

Nebraska Center for Virology: Faculty Publications

We previously showed that rhesus macaques neonatally infected with simian immunodeficiency virus (SIV) do not develop SIV encephalitis (SIVE) and maintain low brain viral loads despite having similar plasma viral loads compared to SIV-infected adults. We hypothesize that differences in myeloid cell populations that are the known target of SIV and HIV in the brain contribute to the lack of neonatal susceptibility to lentivirus-induced encephalitis. Using immunohistochemistry and immunofluorescence microscopy, we examined the frontal cortices from uninfected and SIV-infected infant and adult macaques (n = 8/ea) as well as adults with SIVE (n = 4) to determine differences in myeloid …

The Validity Of Infrared Coagulator, And Bioglue With Antibiotics To Assist Surgical Treatment Of Infective Endocarditis?, G. Pettersson, S. Unai, S. Gordon, S. T. Hussain, E. Eriksson

Journal Articles

No abstract provided.

Pneumatosis Intestinalis In Covid-19: Case Series., K. Wong, D. H. Kim, S. Khanijo, A. Melamud, G. Zaidi

Journal Articles

OBJECTIVE:To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) who developed pneumatosis intestinalis (PI). METHODS:This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in New York State. Patients were included if they were identified as having confirmed COVID-19 as well as pneumatosis intestinalis from March 16, 2020 to July 31, 2020. Patient demographics, clinical characteristics, vasopressor use, anticoagulation use, opiate use, paralytic use, COVID-19 treatment regimen, serum lactate, arterial pH, serum bicarbonate, subsequent intervention, and outcomes during hospitalization were collected. Results: A total …

Acute Seizures Occurring In Association With Sars-Cov-2, S. T. Hwang, A. A. Ballout, U. Mirza, A. N. Sonti, A. Husain, C. Kirsch, R. Kuzniecky, S. Najjar

Journal Articles

© Copyright © 2020 Hwang, Ballout, Mirza, Sonti, Husain, Kirsch, Kuzniecky and Najjar. Seizures are an infrequent and serious neurological complication of SARS-CoV-2 infection, with limited data describing the etiology and the clinical context in which these occur or the associated electrographic and imaging findings. This series details four cases of seizures occurring in patients with COVID-19 with distinct time points, underlying pathology, and proposed physiological mechanisms. An enhanced understanding of seizure manifestations in COVID-19 and their clinical course may allow for earlier detection and improved patient management.

Management Of Pediatric Systemic Lupus Erythematosus: Focus On Belimumab, M. Guzman, J. S. Hui-Yuen

Journal Articles

No abstract provided.

Erysipelothrix Rhusiopathiae Endocarditis, T. Wang, D. Khan, N. Mobarakai

Journal Articles

© 2020 Erysipelothrix rhusiopathiae is a zoonotic gram positive coccobacillus. It is rarely found in humans as an occupational pathogen that mainly infects animal handlers. There are three forms of human infection: localized erysipeloid, diffuse cutaneous form and lastly, bacteremia that could progress to infective endocarditis. We present a case of a 59-year-old male who was found to have E. rhusiopathiae bacteremia that was diagnosed as aortic valve endocarditis with severe aortic regurgitation. The patient was treated with ampicillin-sulbactam then transitioned to six weeks of intravenous ampicillin. This report summarizes a rare organism that causes a serious human infection and …

Pneumothorax In Covid-19 Acute Respiratory Distress Syndrome: Case Series., K. Wong, D. H. Kim, A. Iakovou, S. Khanijo, A. Tsegaye, S. Hahn, M. Narasimhan, G. Zaidi

Journal Articles

Objective The study aims to describe the clinical characteristics and outcomes of patients with COVID-19 related acute respiratory distress syndrome (ARDS) who developed pneumothorax. Design and setting A retrospective chart review was performed of the electronic medical record. Patients were included if they were identified as having confirmed COVID-19 as well as pneumothorax from March 16, 2020 to May 31, 2020. Patients' demographic and clinical characteristics, mechanical ventilator parameters, lung compliance measurements and outcomes during hospitalization were collected. This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in …

Secondary Encephalocele In An Adult Leading To Subdural Empyema, T. Wang, A. Uddin, N. Mobarakai, R. Gilad, M. Raden, S. Motivala

Journal Articles

© 2020 The Author(s) Brain abscesses are an uncommon but potentially fatal infection. They can spread directly from an adjacent source or hematogenously from a distant source. Encephaloceles represent a rare form of neural tube defects that can potentially be complicated by the development of meningitis or brain abscess. We report a case of a 63-year-old female who presented with bilateral lower extremity weakness and was ultimately found to have a Streptococcus pneumoniae subdural empyema and an associated frontal lobe encephalocele extending through the left frontal sinus. She was treated with surgical drainage, intravenous antimicrobials, and ultimately surgical repair of …

Pathophysiology And Pathology Of Acute Kidney Injury In Patients With Covid-19, J. H. Ng, V. Bijol, M. A. Sparks, M. E. Sise, H. Izzedine, K. D. Jhaveri

Journal Articles

© 2020 National Kidney Foundation, Inc. Acute kidney injury (AKI) is common among hospitalized patients with Coronavirus Infectious Disease 2019 (COVID-19), with the occurrence of AKI ranging from 0.5% to 80%. The variability in the occurrence of AKI has been attributed to the difference in geographic locations, race/ethnicity, and severity of illness. AKI among hospitalized patients is associated with increased length of stay and in-hospital deaths. Even patients with AKI who survive to hospital discharge are at risk of developing chronic kidney disease or end-stage kidney disease. An improved knowledge of the pathophysiology of AKI in COVID-19 is crucial to …

Estimating The Predictive Value Of Negative Sars-Cov-2 Results: A Prospective Study, D. Hirschwerk, M. Foley, M. Lesser, B. Farber, J. M. Crawford, K. W. Davidson, G. J. Berry, E. Smith, C. Kast, T. Mcginn, +1 Additional Author

Journal Articles

© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved. We performed a prospective study of 501 patients, regardless of symptoms, admitted to the hospital, to estimate the predictive value of a negative Nasopharyngeal swab for SARS-CoV-2. At a positivity rate of 10.2%, the estimated Negative Predictive Value (NPV) was 97.2% and NPV rose as prevalence decreased during the study.

Morphea (Localized Scleroderma) Presenting With Recurrent Skin And Soft Tissue Infections: A Diagnostic Dilemma., A. M. Khatri, M. Mclemore, P. Malhotra

Journal Articles

Morphea or localized scleroderma is reported to be triggered through diverse stimuli. We present a case of morphea that presented as a non-healing wound with superimposed methicillin-sensitive Staphylococcus aureus (MSSA) infection. In our case, morphea was thought to have been potentially triggered by a post-surgical infection. We discuss the potential infectious triggers and common infections that may confound the diagnosis.

Isolated Pulmonary Valve Endocarditis., S. Acharya, S. Anwar, M. Iannuzzi, V. Anugu, F. Ghavami

Journal Articles

Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks. Because of the persistent bacteremia, a transesophageal echocardiogram was performed and it revealed a thickened pulmonary valve with 1.8 cm vegetation in the …

Carbapenemase Producing Klebsiella Pneumoniae (Kpc) Meningitis From Chronic Otitis Media, S. Anwar, S. Acharya, S. Thapa, J. Rabadi, N. Mobarakai

Journal Articles

© 2020 The Authors Meningitis and brain abscess caused by carbapenemase-producing Klebsiella pneumoniae (KPC) is rarely described in the medical literature. Such infections have been described after neurosurgical medium or post-trauma. We describe an unusual case of KPC meningitis originating from with long term intravenous antibiotics.

Optimizing Telehealth Experience Design Through Usability Testing In Hispanic American And African American Patient Populations: Observational Study., D. King, S. Khan, J. Polo, J. Solomon, R. Pekmezaris, N. Hajizadeh

Journal Articles

BACKGROUND:Telehealth-delivered pulmonary rehabilitation (telePR) has been shown to be as effective as standard pulmonary rehabilitation (PR) at improving the quality of life in patients living with chronic obstructive pulmonary disease (COPD). However, it is not known how effective telePR may prove to be among low-income, urban Hispanic American and African American patient populations. To address this question, a collaborative team at Northwell Health developed a telePR intervention and assessed its efficacy among low-income Hispanic American and African American patient populations. The telePR intervention system components included an ergonomic recumbent bike, a tablet with a built-in camera, and wireless monitoring devices. …

Color-Changing Device To Improve Adherence To Foley Catheter Replacement Protocols And Reduce Urinary Tract Infection Frequency, Alexander Straus, Ms, Kurt Hill, Bryn Cross, Jason M. Fields, Md

Phase 1

Background: Catheter associated urinary tract infections (CAUTI) are a major source of patient morbidity and mortality in healthcare settings and have a significant financial impact on the healthcare system. Many hospitals have clinical protocols in place to continually reassess the necessity of indwelling foley catheters and remove them if their use is no longer warranted. However, it is still common for indwelling foley catheters to be overlooked and remain in place, even after meeting criteria for removal. A design project was conducted that sought to improve adherence to clinical protocols, and reduce frequency of CAUTIs, by creating a color-changing device …

Stochastic Expression Of Sae-Dependent Virulence Genes During Staphylococcus Aureus Biofilm Development Is Dependent On Saes, Elizabeth A. Delmain, Derek E. Moormeier, Jennifer L. Endres, Rebecca E. Hodges, Marat R. Sadykov, Alexander R. Horswill, Kenneth W. Bayles

Journal Articles: Pathology and Microbiology

The intricate process of biofilm formation in the human pathogen Staphylococcus aureus involves distinct stages during which a complex mixture of matrix molecules is produced and modified throughout the developmental cycle. Early in biofilm development, a subpopulation of cells detaches from its substrate in an event termed “exodus” that is mediated by SaePQRS-dependent stochastic expression of a secreted staphylococcal nuclease, which degrades extracellular DNA within the matrix, causing the release of cells and subsequently allowing for the formation of metabolically heterogenous microcolonies. Since the SaePQRS regulatory system is involved in the transcriptional control of multiple S. aureus virulence factors, the …

Fluorescent Sensor Arrays Can Predict And Quantify The Composition Of Multicomponent Bacterial Samples, Denis Svechkarev, Marat Sadykov, Lucas J. Houser, Kenneth W. Bayles, Aaron M. Mohs

Journal Articles: Pathology and Microbiology

Fast and reliable identification of infectious disease agents is among the most important challenges for the healthcare system. The discrimination of individual components of mixed infections represents a particularly difficult task. In the current study we further expand the functionality of a ratiometric sensor array technology based on small-molecule environmentally-sensitive organic dyes, which can be successfully applied for the analysis of mixed bacterial samples. Using pattern recognition methods and data from pure bacterial species, we demonstrate that this approach can be used to quantify the composition of mixtures, as well as to predict their components with the accuracy of ~80% …

Graduate Medical Education Annual Report 2019-2020, Children's Mercy Hospital

GME Annual Reports

Annual report of the Children's Mercy Hospital Graduate Medical Education department, including pediatric residency, internal medicine/pediatrics residency, fellowship programs, medical students, continuing medical education, and library services.

Endothelial Injury And Glycocalyx Degradation In Critically Ill Coronavirus Disease 2019 Patients: Implications For Microvascular Platelet Aggregation, Douglas Fraser

Data and Test Instruments

No abstract provided.

Inflammation Profiling Of Critically Ill Coronavirus Disease 2019 Patients, Douglas Fraser

Data and Test Instruments

No abstract provided.

Novel Outcome Biomarkers Identified With Targeted Proteomic Analyses Of Plasma From Critically Ill Coronavirus Disease 2019 Patients, Douglas Fraser

Data and Test Instruments

No abstract provided.

Covid-19, Serendipity, And Strange Interlude: Gloria In Absurdicum With An Apology To Ovid, Lawrence Charles Parish, W Clark Lambert

Department of Dermatology and Cutaneous Biology Faculty Papers

The absurd edicts initially issued by several governors, including those of Michigan and New York, prohibiting physicians from ordering hydroxychloroquine for patients suspected of or diagnosed with COV-19 are reprehensible. Their reasoning is beyond the pale.

Hydroxychloroquine was first approved by the FDA in 1955 and has a remarkable safety record in its use as a preventative for malaria and in the treatment of several immunologic and/or light induced diseases. Its use came about serendipitously, and its mechanism of action is unclear, but the fact remains that it seems to work.

Evaluation For Association Between Maternal Microbiota And Development Of Necrotizing Enterocolitis Or Gram-Negative Bacteremia In Preterm Infants, Mei Chi Quek

Master of Medicine in Paediatrics and Child Health

Background: Preterm birth is the leading cause of perinatal morbidity and mortality worldwide. There is a need for a better understanding of the correlation of vaginal microbiota with adverse preterm outcomes. Our study aimed to explore how the vaginal microbiota influences the outcome of the preterm infants, determine whether fecal microbiota in premature infants differs from that in term infants, and explore the microbiota pattern in preterm neonates who received multiple antibiotics. Method: A prospective cohort design was used to enroll 33 women admitted in spontaneous labor between 25 to 36 weeks, and 33 controls matched for age and parity …

First-Time Characterization Of Viable But Non-Culturable Proteus Mirabilis: Induction And Resuscitation, Reham Wasfi, G. R. Abdellatif, H. M. Elshishtawy, Hossam M. Ashour

USF St. Petersburg Campus Faculty Publications

Pathogenic bacteria can enter into a viable but non-culturable (VBNC) state under unfavourable conditions. Proteus mirabilis is responsible for dire clinical consequences including septicaemia, urinary tract infections and pneumonia, but is not a species previously known to enter VBNC state. We suggested that stress-induced P. mirabilis can enter a VBNC state in which it retains virulence. P. mirabilis isolates were incubated in extreme osmotic pressure, starvation, low temperature and low pH to induce a VBNC state. Resuscitation was induced by temperature upshift and inoculation in tryptone soy broth with Tween 20 and brain heart infusion broth. Cellular ultrastructure and gene …

Inhibition Of Penicillin-Binding Protein 2: Toward New Therapeutics For Antimicrobial-Resistant Gonorrhea, Jonathan M. Turner

MUSC Theses and Dissertations

Gonorrhea is the second most common sexually transmitted bacterial infection in the United States, with nearly 600,000 cases reported in 2018 by the Centers for Disease Control. Alarmingly, the causative agent Neisseria gonorrhoeae has developed resistance to a number of antimicrobials over the last century. With limited options remaining, the CDC now recommends dual therapy with ceftriaxone and azithromycin to decrease the likelihood of resistance development. However, strains with combined cephalosporin and macrolide resistance have now emerged, raising concerns of a post-antibiotic future in which untreatable gonorrhea would impose enormous human and economic cost. The discovery and development of novel …

Outcomes Of Inpatients Hospitalized With Community Acquired Pneumonia, Jamila Nambafu

Master of Medicine in Internal Medicine

Background: The morbidity from lower respiratory tract infections has varied between age groups and from region to region. In sub-Saharan Africa, pneumonia remains the most frequent reason for adult hospitalization, with approximately 4 million episodes and about 200,000 deaths every year. Some of the attributable factors have been HIV pandemic, pulmonary tuberculosis, and poor socio-economic status. Objective: The main objective was to determine the morbidity of community-acquired pneumonia in patients admitted to a tertiary hospital in Nairobi, Kenya, between May 2019, and March 2020. The results are anticipated to help in informing protocols for the evaluation and treatment of community-acquired …

Unmet Need In Rheumatology: Reports From The Targeted Therapies Meeting 2019., Kevin L Winthrop, Michael E Weinblatt, Joan Bathon, Gerd R Burmester, Philip Mease, Leslie Crofford, Vivian Bykerk, Maxime Dougados, James Todd Rosenbaum, Xavier Mariette, Joachim Sieper, Fritz Melchers, Bruce N Cronstein, Ferry C Breedveld, Joachim Kalden, Josef S Smolen, Daniel Furst

Articles, Abstracts, and Reports

OBJECTIVES: To detail the greatest areas of unmet scientific and clinical needs in rheumatology.

METHODS: The 21st annual international Advances in Targeted Therapies meeting brought together more than 100 leading basic scientists and clinical researchers in rheumatology, immunology, epidemiology, molecular biology and other specialties. During the meeting, breakout sessions were convened, consisting of 5 disease-specific groups with 20-30 experts assigned to each group based on expertise. Specific groups included: rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus and other systemic autoimmune rheumatic diseases. In each group, experts were asked to identify unmet clinical and translational research needs in general …