Digital Commons Network^™

Peanut Allergen Threshold Study (Pats): Novel Single-Dose Oral Food Challenge Study To Validate Eliciting Doses In Children With Peanut Allergy, Jonathan O'B. Hourihane, Katrina J. Allen, Wayne G. Shreffler, Gillian Dunngalvin, Julie A. Nordlee, Giovanni A. Zurzolo, Audrey Dunngalvin, Lyle C. Gurrin, Joseph L. Baumert, Steve L. Taylor

Department of Food Science and Technology: Faculty Publications

Background: Eliciting doses (EDs) of allergenic foods can be defined by the distribution of threshold doses for subjects within a specific population. The ED₀₅ is the dose that elicits a reaction in 5% of allergic subjects. The predicted ED₀₅ for peanut is 1.5 mg of peanut protein (6 mg of whole peanut).

Objective: We sought to validate the predicted peanut ED05 (1.5 mg) with a novel single-dose challenge.

Methods: Consecutive eligible children with peanut allergy in 3 centers were prospectively invited to participate, irrespective of previous reaction severity. Predetermined criteria for objective reactions were used …

Implementing A Patient Hand-Hygiene Protocol To Decrease Clostridium Difficile Infections In The Acute Care Setting, Lydia S. Mendez

DNP Projects

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 …

Risk Factors For Hypoxia And Tachypnea Among Adolescents With Vertically-Acquired Hiv In Nairobi, Engi F. Attia, Noel S. Weiss, Elizabeth Maleche Obimbo, Christine J. Mcgrath, Anthony Cagle, Eoin T. West, El Antouny G. Neveen, Attwa Mena, Crothers Kristina, Michael Chung

Internal Medicine, East Africa

Background: Chronic lung diseases are increasingly recognized complications of vertically-acquired HIV among adolescents in sub-Saharan Africa and may manifest with hypoxia or tachypnea. We sought to determine the prevalence of and risk factors for hypoxia and tachypnea among adolescents with vertically-acquired HIV in Nairobi, Kenya.

Methods: We performed a cross-sectional analysis of 258 adolescents with vertically-acquired HIV who were initiating care at the Coptic Hope Center for Infectious Diseases. Adolescents with documented pneumonia were excluded. Hypoxia was defined as resting oxygen saturation ≤92%, and tachypnea was based on the 99th percentile of age-appropriate respiratory rates. Logistic regression models adjusted for …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …

Preoperative Chlorhexidine Skin Preparation For Patients Undergoing Vascular Surgery, Janine Lee-Anne Duquette

Walden Dissertations and Doctoral Studies

In response to improving quality patient care, combined with the growing rates of surgical site infections (SSIs) in vascular patients, the need to explore current practice trends with current evidence has been identified. SSIs affect quality patient care and compromise patient safety. Empirical evidence has recommended the use of a chlorhexidine wash preoperatively to reduce SSIs. Despite this recommended practice, vascular patients were not receiving it in their routine plan of care within a hospital organization in southern Ontario. Guided by Lewin's theory of planned change, this project explored how the planning of a chlorhexidine preoperative surgical skin preparation protocol …

A Behavioral And Neuroimmune System Model Of The Effects Of Chronic Low-Level Lead Exposure In Young Male C57bl/6j Mice, Mayra Gisel Flores-Montoya

Open Access Theses & Dissertations

Chronic low-level lead exposure reduces memory in children however the brain mechanisms mediating these effects are not known. In previous studies we showed that early lead exposure reduced olfactory memory and exploratory behavior in young mice, and reduced microglia cell density in hippocampus/dentate gyrus. The present studies aimed to identify additional behavioral tests that were sensitive to early low-level lead exposure in young mice; and to examine whether microglia upregulated factors known to promote cell migration. Seventy-two C57BL/6J male mice were exposed to 0 ppm (controls), 30 ppm (low-dose), or 430 ppm (high-dose) of lead acetate via dams' milk from …

Using Tcr Transgenic, Gp100 Reactive T Cells And Checkpoint Inhibition To Target Lymphangioleimyomatosis, Christian Ankney

Master's Theses

Lymphangioleiomyomatosis (LAM) is a low-grade neoplastic disease affecting primarily women. It is characterized by cystic lung disease as well as renal and retroperitoneal tumors called angiomyolipomas and lymphangiomas. Tumor cells have smooth muscle features as well as neuroendocrine cell surface markers, and the disease can be diagnosed by HMB45 staining of tumor cells. We questioned whether expression of melanocytic antigens, specifically gp100, creates an opportunity to treat LAM by adoptive T cell transfer. LAM lung lesions demonstrate poor immune surveillance, therefore adoptive T cell transfer could offer benefits in this disease.

A link was made between melanoma and depigmenting vitiligo …

High Resolution Melting: A Useful Field-Deployable Method To Measure Dhfr And Dhps Drug Resistance In Both Highly And Lowly Endemic Plasmodium Populations, Yaye Dié Ndiaye, Cyrille K. Diédhiou, Amy K. Bei, Baba Dieye, Aminata Mbaye, Nasserdine Papa Mze, Rachel F. Daniels, Ibrahima M. Ndiaye, Awa B. Déme, Amy Gaye, Mouhamad Sy, Tolla Ndiaye, Aida S. Badiane, Mouhamadou Ndiaye, Zul Premji, Dyann F. Wirth, Souleymane Mboup, Donald Krogstad, Sarah K. Volkman, Ambroise D. Ahouidi, Daouda Ndiaye

Pathology, East Africa

Background: Emergence and spread of drug resistance to every anti-malarial used to date, creates an urgent need for development of sensitive, specifc and feld-deployable molecular tools for detection and surveillance of validated drug resistance markers. Such tools would allow early detection of mutations in resistance loci. The aim of this study was to compare common population signatures and drug resistance marker frequencies between two populations with diferent levels of malaria endemicity and history of anti-malarial drug use: Tanzania and Sénégal. This was accomplished by implementing a high resolution melting assay to study molecular markers of drug resistance as compared to …

Reference Intervals For Thyroid Stimulating Hormone And Free Thyroxine Derived From Neonates Undergoing Routine Screening For Congenital Hypothyroidism At A University Teaching Hospital In Nairobi, Kenya: A Cross Sectional Study, Geoffrey Omuse, Ali Kassim, Francis Kiigu, Ra'ana Hussain, Mary Limbe

Pathology, East Africa

Background: In order to accurately interpret neonatal thyroid function tests (TFTs), it is necessary to have population specific reference intervals (RIs) as there is significant variation across different populations possibly due to genetic, environmental or analytical issues. Despite the importance of RIs, globally there are very few publications on RIs for neonatal TFTs primarily due to ethical and technical issues surrounding recruitment of neonates for a prospective study. To the best of our knowledge, this is the first report from Africa on neonatal RIs for TFTs.

Methods: We used hospital based data largely derived from neonates attending the wellness clinic …

Patient Predictors Of Poor Drug Sensitive Tuberculosis Treatment Outcomes In Kyiv Oblast, Ukraine, Omowunmi Aibana, Andrej Slavuckij, Mariya Bachmaha, Viatcheslav Krasiuk, Natasha Rybak, Timothy P Flanigan, Vasyl Petrenko, Megan B Murray

Faculty, Staff and Student Publications

Background: Ukraine has high rates of poor treatment outcomes among drug sensitive tuberculosis (DSTB) patients, while global treatment success rates for DSTB remain high.

We evaluated baseline patient factors as predictors of poor DSTB treatment outcomes.

Methods: We conducted a retrospective analysis of new drug sensitive pulmonary TB patients treated in Kyiv Oblast, Ukraine between November 2012 and October 2014. We defined good treatment outcomes as cure or completion and poor outcomes as death, default (lost to follow up) or treatment failure. We performed logistic regression analyses, using routine program data, to identify baseline patient factors associated with poor outcomes. …

Erratum To: Scaling Up Strategies Of The Chronic Respiratory Disease Programme Of The European Innovation Partnership On Active And Healthy Ageing (Action Plan B3: Area 5)., J Bousquet, J Farrell, G Crooks, P Hellings, E H. Bel, M Bewick, N H. Chavannes, J Correia De Sousa, A A. Cruz, T Haahtela, G Joos, N Khaltaev, J Malva, A Muraro, M Nogues, S Palkonen, S Pedersen, C Robalo-Cordeiro, B Samolinski, T Strandberg, A Valiulis, A Yorgancioglu, T Zuberbier, A Bedbrook, W Aberer, M Adachi, A Agusti, C A Akdis, M Akdis, J Ankri, A Alonso, I Annesi-Maesano, I J. Ansotegui, J M. Anto, S Arnavielhe, H Arshad, C Bai, I Baiardini, C Bachert, A K. Baigenzhin, C Barbara, E D. Bateman, B Beghé, A Ben Kheder, K S. Bennoor, M Benson, K C. Bergmann, T Bieber, C Bindslev-Jensen, L Bjermer, H Blain, F Blasi, A L. Boner, M Bonini, S Bonini, S Bosnic-Anticevitch, L P. Boulet, R Bourret, P J. Bousquet, F Braido, A H. Briggs, C E. Brightling, J Brozek, R Buhl, P G. Burney, A Bush, F Caballero-Fonseca, D Caimmi, M A. Calderon, P M. Calverley, P A M Camargos, G W. Canonica, T Camuzat, K H. Carlsen, W Carr, A Carriazo, T Casale, A M. Cepeda Sarabia, L Chatzi, Y Z. Chen, R Chiron, E Chkhartishvili, A G. Chuchalin, K F. Chung, G Ciprandi, I Cirule, L Cox, D J. Costa, A Custovic, R Dahl, S E. Dahlen, U Darsow, G De Carlo, F De Blay, T Dedeu, D Deleanu, E De Manuel Keenoy, P Demoly, J A. Denburg, P Devillier, A Didier, A T. Dinh-Xuan, R Djukanovic, D Dokic, H Douagui, G Dray, R Dubakiene, S R. Durham, M S. Dykewicz, Y El-Gamal, R Emuzyte, L M. Fabbri, M Fletcher, A Fiocchi, A Fink Wagner, J Fonseca, W J. Fokkens, F Forastiere, P Frith, M Gaga, A Gamkrelidze, J Garces, J Garcia-Aymerich, B Gemicioğlu, J E. Gereda, S González Diaz, M Gotua, I Grisle, L Grouse, Z Gutter, M A. Guzmán, L G. Heaney, B Hellquist-Dahl, D Henderson, A Hendry, J Heinrich, D Heve, F Horak, J O' B Hourihane, P Howarth, M Humbert, M E. Hyland, M Illario, J C. Ivancevich, J R. Jardim, E J. Jares, C Jeandel, C Jenkins, S L. Johnston, O Jonquet, K Julge, K S. Jung, J Just, I Kaidashev, M R. Khaitov, O Kalayci, A F. Kalyoncu, T Keil, P K. Keith, L Klimek, B Koffi N'Goran, V Kolek, G H. Koppelman, M L. Kowalski, I Kull, P Kuna, V Kvedariene, B Lambrecht, S Lau, D Larenas-Linnemann, D Laune, L T T Le, P Lieberman, B Lipworth, J Li, K Lodrup Carlsen, R Louis, W Macnee, Y Magard, A Magnan, B Mahboub, A Mair, I Majer, M J. Makela, P Manning, S Mara, G D. Marshall, M R. Masjedi, P Matignon, M Maurer, S Mavale-Manuel, E Melén, E Melo-Gomes, E O. Meltzer, A Menzies-Gow, H Merk, J P. Michel, N Miculinic, F Mihaltan, B Milenkovic, G M Y Mohammad, M Molimard, I Momas, A Montilla-Santana, M Morais-Almeida, M Morgan, R Mösges, J Mullol, S Nafti, L Namazova-Baranova, R Naclerio, A Neou, H Neffen, K Nekam, B Niggemann, G Ninot, T D. Nyembue, R E. O'Hehir, K Ohta, Y Okamoto, K Okubo, S Ouedraogo, P Paggiaro, I Pali-Schöll, P Panzner, N Papadopoulos, A Papi, H S. Park, G Passalacqua, I Pavord, R Pawankar, R Pengelly, O Pfaar, R Picard, B Pigearias, I Pin, D Plavec, D Poethig, W Pohl, T A. Popov, F Portejoie, P Potter, D Postma, D Price, K F. Rabe, F Raciborski, F Radier Pontal, S Repka-Ramirez, S Reitamo, S Rennard, F Rodenas, J Roberts, J Roca, L Rodriguez Mañas, C Rolland, M Roman Rodriguez, A Romano, J Rosado-Pinto, N Rosario, L Rosenwasser, M Rottem, D Ryan, M Sanchez-Borges, G K. Scadding, H J. Schunemann, E Serrano, P Schmid-Grendelmeier, H Schulz, A Sheikh, M Shields, N Siafakas, Y Sibille, T Similowski, F E R Simons, J C. Sisul, I Skrindo, H A. Smit, D Solé, T Sooronbaev, O Spranger, R Stelmach, P J. Sterk, J Sunyer, C Thijs, T To, A Todo-Bom, M Triggiani, R Valenta, A L. Valero, E Valia, E Valovirta, E Van Ganse, M Van Hage, O Vandenplas, T Vasankari, B Vellas, J Vestbo, G Vezzani, P Vichyanond, G Viegi, C Vogelmeier, T Vontetsianos, M Wagenmann, B Wallaert, S Walker, D Y. Wang, U Wahn, M Wickman, D M. Williams, S Williams, J Wright, B P. Yawn, P K. Yiallouros, O M. Yusuf, A Zaidi, H J. Zar, M E. Zernotti, L Zhang, N Zhong, M Zidarn, J Mercier

Manuscripts, Articles, Book Chapters and Other Papers

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Importance Of Physical Activity In Women, Minaz Mawani

Department of Medicine

No abstract provided.

Slc11a1 Polymorphisms And Host Susceptibility To Cutaneous Leishmaniasis In Pakistan., Mariam Sophie,, Abdul L Hameed Institute Of Biomedical And Genetic Engineering (Ibge), 24-Mauve Area, G- 9/1, Islamabad, Pakistan., Akhtar Muneer, Azam J. Samdani, Saima Saleem, Abid Azhar

Department of Medicine

Background:The vector-borne cutaneous leishmaniasis (CL) is endemic in several regions of Pakistan mainly affecting poor populations. Host genetic factors, particularly SLC11A1 (solute carrier transmembrane protein) within macrophages, play a crucial role in disease pathology and susceptibility. Association of SLC11A1 with cutaneous leishmaniasis, a neglected tropical disease, is not well established. Inconsistencies have been observed within different populations worldwide with respect to genetic susceptibility. This study was designed to investigate genetic variation(s) in SLC11A1 and to assess possible association with cutaneous leishmaniasis in Pakistan.

Results: Eight polymorphisms (rs2276631, rs3731864, rs2290708, rs2695342, rs201565523, rs17215556, rs17235409, rs17235416) were genotyped across SLC11A1 in …

Patient Characteristics Of The Accident And Emergency Department Of Kenyatta National Hospital, Nairobi, Kenya: A Cross-Sectional, Prospective Analysis, Justin Guy Myers, Katherine M. Hunold, Karen Ekernas, Ali Wangara, Alice Maingi, Vincent Mutiso, Stephen Dunlop, Ian B K Martin

Faculty & Staff Scholarship

Background Resource-limited settings are increasingly experiencing a ‘triple burden’ of disease, composed of trauma, non-communicable diseases (NCDs) and known communicable disease patterns. However, the epidemiology of acute and emergency care is not well characterised and this limits efforts to further develop emergency care capacity.

Objective To define the burden of disease by describing the patient population presenting to the Accident and Emergency Department (A&E) at Kenyatta National Hospital (KNH) in Kenya.

Methods We completed a prospective descriptive assessment of patients in KNH’s A&E obtained via systematic sampling over 3 months. Research assistants collected data directly from patients and their charts. …

Community Engagement And Integrated Health And Polio Immunisation Campaigns In Conflict-Affected Areas Of Pakistan: A Cluster Randomised Controlled Trial, Atif Habib, Sajid Soofi, Simon Cousens, Saeed Anwar, Najib Ulhaque, Imran Ahmed, Noshad Ali, Rehman Tahir, Zulfiqar A Bhutta

Department of Paediatrics and Child Health

Background: Pakistan faces huge challenges in eradicating polio due to widespread poliovirus transmission and security challenges. Innovative interventions are urgently needed to strengthen community buy-in, to increase the coverage of oral polio vaccine (OPV) and other routine immunisations, and to enhance immunity through the introduction of inactivated polio vaccine (IPV) in combination with OPV. We aimed to evaluate the acceptability and effect on immunisation coverage of an integrated strategy for community engagement and maternal and child health immunisation campaigns in insecure and conflict-affected polio-endemic districts of Pakistan.
Methods: We did a community-based three-arm cluster randomised trial in healthy children …

Use Of Antibiotics In Children Younger Than Two Years In Eight Countries: A Prospective Cohort Study, Elizabeth T. Rogawski, James A. Platts-Mills, Jessica C. Seidman, Sushil John, Mustafa Mahfuz, Manjeswori Ulak, Sanjaya K. Shrestha, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Objective: To describe the frequency and factors associated with antibiotic use in early childhood, and estimate the proportion of diarrhoea and respiratory illnesses episodes treated with antibiotics.
Methods: Between 2009 and 2014, we followed 2134 children from eight sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa and the United Republic of Tanzania, enrolled in the MAL-ED birth cohort study. We documented all antibiotic use from mothers’ reports at twice-weekly visits over the children’s first two years of life. We estimated the incidence of antibiotic use and the associations of antibiotic use with child and household characteristics. We described …

Predictors Of Pneumococcal Carriage And The Effect Of The 13-Valent Pneumococcal Conjugate Vaccination In The Western Australian Aboriginal Population, Deirdre A. Collins, Anke Hoskins, Thomas Snelling, Kalpani Senasinghe, Jacinta Bowman, Natalie A. Stemberger, Amanda J. Leach, Deborah Lehmann

Research outputs 2014 to 2021

Background

The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced to prevent invasive pneumococcal disease (IPD) in Western Australian (WA) Aboriginal people in 2001. PCV13 replaced PCV7 in July 2011, covering six additional pneumococcal serotypes; however, IPD rates remained high in Aboriginal people in WA. Upper respiratory tract pneumococcal carriage can precede IPD, and PCVs alter serotype distribution.

Methods

To assess the impact of PCV13 introduction, identify emerging serotypes, and assess risk factors for carriage, nasopharyngeal swabs and information on demographic characteristics, health, medication and living conditions from Aboriginal children and adults across WA from August 2008 to November 2014 were …

Readiness For Antimicrobial Resistance (Amr) Surveillance In Pakistan; A Model For Laboratory Strengthening, Dania Khalid Saeed, Rumina Hasan, Mahwish Naim, Afia Zafar, Erum Khan, Kauser Jabeen, Seema Irfan, Imran Ahmed Haq, Mohammad Zeeshan, Zabin Wajidali, Joveria Farooqi, Sadia Shakoor, Abdul Chagla, Jason Roy

Department of Pathology and Laboratory Medicine

Background: Limited capacity of laboratories for antimicrobial susceptibility testing (AST) presents a critical diagnostic bottleneck in resource limited countries. This paper aims to identify such gaps and to explore whether laboratory networks could contribute towards improving AST in low resource settings.
Methods: A self-assessment tool to assess antimicrobial susceptibility testing capacity was administered as a pre-workshop activity to participants from 30 microbiology laboratories in 3 cities in Pakistan. Data from public and private laboratories was analyzed and capacity of each scored in percentage terms. Laboratories from Karachi were invited to join a support network. A cohort of five laboratories that …

Factors Related To Diagnosis Of Community-Acquired Pneumonia In The Elderly, Elza Febria Sari, C. Martin Rumende, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Introduction. Diagnosing community-acquired pneumonia (CAP) in the elderly remains a clinical challenge for various reasons. The clinical manifestation in the elderly is not frank and atypical manifestations, e.g. falls, decrease of functional status and food intake or urinary incontinence, may be present. These reasons may be associated with under or over diagnosis, which consequently contribute to the higher observed mortality rate in the elderly population with CAP. Study about factors related to diagnosis of CAP in the elderly was ra rely performed.

Methods. From January to October 2010, 158 elderly patients suspected of having pneumonia at RSCM were registered. Relationship …

Immunogenicity And Protective Efficacy Of The Dar-901 Booster Vaccine In A Murine Model Of Tuberculosis, Timothy Lahey, Dominick Laddy, Krystal Hill, Jacqueline Schaeffer

Dartmouth Scholarship

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.

Simplified Antibiotic Regimens For Treatment Of Clinical Severe Infection In The Outpatient Setting When Referral Is Not Possible For Young Infants In Pakistan (Simplified Antibiotic Therapy Trial [Satt]): A Randomised, Open-Label, Equivalence Trial, Fatima Mir, Imran Nisar, Shiyam S. Tikmani, Benazir Baloch, Sadia Shakoor, Fyezah Jehan, Imran Ahmed, Simon Cousens, Anita K M Zaidi

Department of Paediatrics and Child Health

Background: Parenteral antibiotic therapy for young infants (aged 0–59 days) with suspected sepsis is sometimes not available or feasible in countries with high neonatal mortality. Outpatient treatment could save lives in such settings. We aimed to assess the equivalence of two simplified antibiotic regimens, comprising fewer injections and oral rather than parenteral administration, compared with a reference treatment for young infants with clinical severe infection.
Methods: We undertook the Simplified Antibiotic Therapy Trial (SATT), a three-arm, randomised, open-label, equivalence trial in five communities in Karachi, Pakistan. We enrolled young infants (aged 0–59 days) who either presented at a primary health-care …

E-Learning For Research Capacity Strengthening In Sexual And Reproductive Health: The Experience Of The Geneva Foundation For Medical Education And Research And The Department Of Reproductive Health And Research, World Health Organization, Karim Abawi, Venkatraman Chandra-Mouli, Igor Toskin, Mario Philip Festin, Lynn Gertiser, Raqibat Idris, Hanan Hamamy, Moazzam Ali, Ameyo Masakhwe Bonventure, Marleen Temmerman, Aldo Campana

Obstetrics and Gynaecology, East Africa

Abstract: Technological advancement has resulted in the increasing use of e-learning and online education, initially in high-income countries and increasingly in low- and middle-income countries.

Background: In 2010, the Geneva Foundation for Medical Education and Research, in collaboration with the World Health Organization and partner institutions, developed an online postgraduate course “From Research to Practice: Training Course in Sexual and Reproductive Health Research”. This course takes advantage of the advancing Internet technology to provide training opportunities to health professionals mostly from low- and middle-income countries whose access to quality education is constrained by time, financial resources, or both.

Case presentation: …

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 …

Population Pharmacokinetics Of Liposomal Amphotericin B In Immunocompromised Children., Jodi M Lestner, Andreas H Groll, Ghaith Aljayyoussi, Nita L Seibel, Aziza Shad, Corina Gonzalez, Lauren V Wood, Paul F Jarosinski, Thomas J Walsh, William W Hope

Pediatrics Faculty Publications

Liposomal amphotericin B (LAmB) is widely used in the treatment of invasive fungal disease (IFD) in adults and children. There are relatively limited pharmacokinetic (PK) data to inform optimal dosing in children that achieves systemic drug exposures comparable to those of adults. Our objective was to describe the pharmacokinetics of LAmB in children aged 1 to 17 years with suspected or documented IFD. Thirty-five children were treated with LAmB at doses of 2.5 to 10 mg kg(-1) daily. Samples were taken at baseline and at 0.5- to 2.0-h intervals for 24 h after receipt of the first dose (n = …

Baylisascaris Procyonis Exposure Case Study, Andrea M. Lauffer M.D., Patricia Lutz M.D., Susan L. Flesher M.D.

Pediatrics

We report a case of exposure to raccoon feces found to be contaminated with baylisascaris procyonis. The exposure was recognized early enough by the family to allow prophylaxis with albendazole. Because of the potential fatal or neurologically catastrophic effects of this disease immediate treatment is indicated. This is started in advance of environmental studies that are done to determine if the feces is indeed contaminated.

In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel

Doctoral Projects

Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus …

A Novel Codon-Optimized Siv Gag-Pol Immunogen For Gene-Based Vaccination, Catherine M. Crosby, Eric A. Weaver, Reeti Khare, Michael A. Barry

Nebraska Center for Virology: Faculty Publications

Simian immunodeficiency virus (SIV) is a robust pathogen used in non-human primates to model HIV vaccines. SIV encodes a number of potential vaccine targets. By far the largest and most conserved protein target in SIV is its gag-pol protein that bears many epitopes to drive multivalent immune T cell responses. While gag-pol is an attractive antigen, it is only translated after a frame shift between gag and pol with the effect that gag and pol are expressed at an approximate 10/1 ratio. The codon bias of native lentiviral genes are also mismatched with the abundance of tRNAs in mammalian cells …

Spectrum Of Acute Flaccid Paralysis In Children, Shaila Ali, M. Zia Ur Rehman, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Acute flaccid paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness in a child aged less than 15 years due to any cause when polio is suspected(1). Exact cause of AFP with its incidence is needed for proper management.

Predictors Of Diarrheal Mortality And Patterns Of Caregiver Health Seeking Behavior In In Karachi, Pakistan, Farah Naz Qamar, Umber Zaman, Farheen Quadri, Asia Khan, Babar Tasneem Shaikh, Iqbal Azam, Dilruba Nasrin, Karen Kotloff, Myron Levine, Nick Brown

Department of Paediatrics and Child Health

Background: Pakistan is unfortunately among the five countries that contributed to the most deaths due to diarrhea and pneumonia in 2010. To explore factors associated with diarrheal deaths we assessed care-seeking behavior and other predictors of diarrhea-related mortality in children in selected low-income peri-urban communities of Karachi, Pakistan.
Methods: A mixed methods study (qualitative and quantitative) using matched case-control design and focus group discussions with parents of children with moderate to severe diarrhea (MSD) was undertaken. Cases were children Demographic, clinical, and care-related behavioral predictors of mortality were assessed. Conditional logistic regression was performed, matched adjusted odds ratios (mOR) are …

Mycobacterial Contamination Of Bronchoscopes: Challenges And Possible Solutions In Low Resource Settings, Dania Khalid Saeed, Sadia Shakoor, Seema Irfan, Rumina Hasan

Department of Pathology and Laboratory Medicine

The use of bronchoscopes has increased in tuberculosis (TB) diagnostics to circumvent the diagnostic challenges that are associated with low sputum volume and smear-negative TB. In healthcare facilities situated in low income countries that have a high burden of TB, adequate decontamination of bronchoscopes is a challenge and often overlooked to save on time and costs. This amplifies the risk of outbreaks and pseudo-outbreaks due to Mycobacterium tuberculosis and nontuberculosis mycobacteria. In this minireview, we review published literature of contaminated bronchoscopes causing pseudo-outbreaks of M. tuberculosis and nontuberculosis mycobacteria in an effort to determine common sources, and possible mitigation strategies …