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 …

Libman-Sacks Endocarditis “A Wolf In Sheep’S Skin”, Philip Dunn Do, Ryan Rogers Do, James Ross Md

Department of Medicine

No abstract provided.

Coculture Of Staphylococcus Aureus With Pseudomonas Aeruginosa Drives S. Aureus Towards Fermentative Metabolism And Reduced Viability In A Cystic Fibrosis Model, Laura M. Filkins, Jyoti A. Graber, Daniel G. Olson, Emily L. Dolben, Lee Lynd, Sabin Bhuju, George A. O'Toole

Dartmouth Scholarship

The airways of patients with cystic fibrosis are colonized with diverse bacterial communities that change dynamically during pediatric years and early adulthood. Staphylococcus aureus is the most prevalent pathogen during early childhood, but during late teens and early adulthood, a shift in microbial composition occurs leading to Pseudomonas aeruginosa community predominance in ∼50% of adults. We developed a robust dual-bacterial in vitro coculture system of P. aeruginosa and S. aureus on monolayers of human bronchial epithelial cells homozygous for the ΔF508 cystic fibrosis transmembrane conductance regulator (CFTR) mutation to better model the mechanisms of this interaction. We show that P. …

Antiviral Activity Of The Human Cathelicidin, Ll-37, And Derived Peptides On Seasonal And Pandemic Influenza A Viruses., Shweta Tripathi, Guangshun Wang, Mitchell White, Li Qi, Jeffery Taubenberger, Kevan L. Hartshorn

Journal Articles: Pathology and Microbiology

Human LL-37, a cationic antimicrobial peptide, was recently shown to have antiviral activity against influenza A virus (IAV) strains in vitro and in vivo. In this study we compared the anti-influenza activity of LL-37 with that of several fragments derived from LL-37. We first tested the peptides against a seasonal H3N2 strain and the mouse adapted H1N1 strain, PR-8. The N-terminal fragment, LL-23, had slight neutralizing activity against these strains. In LL-23V9 serine 9 is substituted by valine creating a continuous hydrophobic surface. LL-23V9 has been shown to have increased anti-bacterial activity compared to LL-23 and we now show slightly …

Hepatitis C Virus Infection Screening Test Compliance At Primary Care Clinic, Talal Alzahrani, Brandon Rieders, Mohammed Fadlalla, Jason Gendell, Anne Cioletti

GW Research Days 2015

Introduction:

Hepatitis C Virus (HCV) is the most common cause of liver cirrhosis and hepatocellular carcinoma, and is the leading cause of liver transplantation in the US. About 3.2 million individuals are chronically infected with HCV. Most of these patients are unaware of their infection because they are largely asymptomatic. Approximately three-fourths of them were born between 1945-1965. Furthermore, with the advances in HCV treatment, it is imperative to identify chronically infected individuals in order to avert the long-term, costly, sequelae of the virus. The U.S. Preventive Services Task Force recently recommended a one-time screening test for HCV for those …

Blood, Brain And Now Bone – Learning More About An Often Overlooked Pathogen, Linda Lesky, Julianne Camba, Sarah De Los Santos, Alexander Fortenko, Talal Alzahrani

GW Research Days 2015

INTRODUCTION:

Arcanobacterium haemolyticum (previously Corynebacterium haemolyticum), a facultative anaerobe, Gram positive rod was first isolated from United States servicemen and indigenous populations of the South Pacific in 1946. Early reported cases detailed A. haemolyticum as a causative pathogen for exudative pharyngitis (most commonly in adolescents) and cutaneous infections. Osteomyelitis caused by A. haemolyticum has been described in less than five cases in the literature. Here, we describe our experience in diagnosing patient with osteomyelitis caused by A. haemolyticum.

CASE REPORT:

A 30-year-old man with a history of peripheral neuropathy, diabetic foot ulcers, methicillin-resistant S. aureus osteomyelitis and amputation of the …

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.

Vivax Malaria And Chloroquine Resistance: A Neglected Disease As An Emerging Threat, Anam A. Waheed,, Najia Karim Ghanchi, Karim A. Rehman,, Afsheen Raza, Syed Faisal Mahmood, Syed Faisal Mahmood, Mohammad A. Beg

Department of Medicine

In Pakistan, Plasmodium vivax contributes to major malaria burden. In this case, a pregnant woman presented with P. vivax infection and which was not cleared by chloroquine, despite adequate treatment. This is probably the first confirmed case of chloroquine-resistant vivax from Pakistan, where severe malaria due to P. vivax is already an emerging problem.

Hair Dye Poisoning And Rhabdomyolysis., Munira Bokutz, Nosheen Nasir, Syed Faisal Mahmood, Sara Sajid

Department of Medicine

Hair dye ingestion is a rare cause of toxicity in Pakistan. We are presenting the case report of a 55 year old male who presented with accidental hair dye ingestion and developed laryngeal oedema requiring emergent tracheostomy. He had also developed aspiration pneumonitis and chemical oesophagitis. However, the most alarming manifestation was rhabdomyolysis. Hair dye toxicity can be fatal if not recognized early. There is no antidote available. Rhabdomyolysis is a complication and needs to be managed aggressively in order to prevent long term morbidity.

Babies First: Ensuring Proper Infant Nutrition During Emergencies, Abigail M. Alonso

Independent Study Project (ISP) Collection

Background: Breastfeeding is the best source of nutrition for an infant, living in all regions and cultures. Recommendations apply across the board, from developed nations to refugee camps, from women with HIV to those with time constraints regarding feeding. There also exists a complex relationship between corporations that provide BMS and the NGOs working to promote breastfeeding in emergency situations amongst vulnerable populations.

Objective: The objective of this paper is to expose breastfeeding promotion, using the Dadaab camps in Northeastern Kenya as a case study of IYCF programs and support of breastfeeding among low-literacy populations with an emphasis on women …

Isoniazid Induced Acute Pancreatitis In A Young Girl, Ali Faisal Saleem Dr, Saba Arbab, Farah Qamar Naz

Department of Paediatrics and Child Health

Isoniazid (INH) is the mainstay of management against Mycobacterium tuberculosis. INH-induced acute pancreatitis is an uncommon association and with dearth of literature on it. We are reporting a case of an 11 years old girl who developed acute pancreatitis after 2 weeks of antituberculous therapy. An INH free regimen was started. She was discharged and followed without complications.

Prolonged-Acting, Multi-Targeting Gallium Nanoparticles Potently Inhibit Growth Of Both Hiv And Mycobacteria In Co-Infected Human Macrophages., Prabagaran Narayanasamy, Barbara L. Switzer, Bradley E. Britigan

Journal Articles: Pathology and Microbiology

Human immunodeficiency virus (HIV) infection and Mycobacterium tuberculosis (TB) are responsible for two of the major global human infectious diseases that result in significant morbidity, mortality and socioeconomic impact. Furthermore, severity and disease prevention of both infections is enhanced by co-infection. Parallel limitations also exist in access to effective drug therapy and the emergence of resistance. Furthermore, drug-drug interactions have proven problematic during treatment of co-incident HIV and TB infections. Thus, improvements in drug access and simplified treatment regimens are needed immediately. One of the key host cells infected by both HIV and TB is the mononuclear phagocyte (MP; monocyte, …

Re-Recurrent Dermatofibrosarcomaprotuberans Of The Chest Wall., Niaz Hussain, Mujtaba Zaki Naveed, Ghulam H

Section of Pulmonary & Critical Care

Dermatofibrosarcomaprotuberans is a rare, soft tissue tumour with high rate of recurrence. It is locally aggressive, with a low rate of metastasis. We describe the case of a 42 year old man who presented with a re-recurrent, large tumour situated on the anterior chest wall in the sternal region. We did a wide local excision and covered the resulting defect by using bilateral, pectoralis major myocutaneous flaps. Histopathology and immunohistochemical staining findings were consistent with the diagnosis of Dermatofibrosarcoma Protuberance. Post operatively the patient was treated with chemotherapy and radiotherapy.

Labrad : Vol 41, Issue 1 - March 2015, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• An Overview of Proficiency Testing
• Sources of Pre-analytical Variations
• Five Q-Framework for Implementing Total Quality Management in Laboratory
• Delta Check in Clinical Laboratory
• Indicators of Quality Improvement in Surgical Pathology
• Types of Analytical Errors
• Method Validation for Quantitative Tests: CAP Recommendations
• Levey Jenning Chart and a Guide to Use Westgard Rules
• Quality Control of Vitek-2 System
• Establishing Quality Control Values for Haematology Parameters

Digest Of The Philadelphia College Of Osteopathic Medicine (Spring 2015), Philadelphia College Of Osteopathic Medicine

Digest

The Spring 2015 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Message from the President
• PCOM Updates
• Development News
• Institutional Announcement: Farewell to Paul W. McGloin, CPA, LLD (Hon.)
• Institutional Heritage: Founders’ Day 2015
• Feature: The Healing Touch – Health Advocacy without Borders
• Bringing Hope and Care to Ukrainians – Zenia Chernyk, DO ’77
• Helping Victims of Human Trafficking in India – Winson T. George, PhD, DO ’09
• Hands-on in Haiti – Shelly Chvotzkin, DO ’02
• Class Notes
• My Turn

Implementation Of Antimicrobial Stewardship Policies In U.S. Hospitals: Findings From A National Survey., Monika Pogorzelska-Maziarz, Carolyn T A Herzig, Elaine L Larson, E Yoko Furuya, Eli N Perencevich, Patricia W Stone

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To describe the use of antimicrobial stewardship policies and to investigate factors associated with implementation in a national sample of acute care hospitals.

DESIGN: Cross-sectional survey.

PARTICIPANTS: Infection Control Directors from acute care hospitals participating in the National Healthcare Safety Network (NHSN).

METHODS: An online survey was conducted in the Fall of 2011. A subset of hospitals also provided access to their 2011 NHSN annual survey data.

RESULTS: Responses were received from 1,015 hospitals (30% response rate). The majority of hospitals (64%) reported the presence of a policy; use of antibiograms and antimicrobial restriction policies were most frequently utilized …

Assessing Usual Care In Clinical Trials, Judith A. Erlen, Lisa K. Tamres, Nancy Reynolds, Carol E. Golin, Marc I. Rosen, Robert H. Remien, Julie W. Banderas, Neil Schneiderman, Glenn Wagner, David Bangsberg, Honghu Liu

OHSU-PSU School of Public Health Faculty Publications and Presentations

Researchers designing clinical trials often specify usual care received by participants as the control condition expecting that all participants receive usual care regardless of group assignment. The assumption is that the groups in the study are affected similarly. We describe the assessment of usual care within the 16 studies in MACH 14, a multi-site collaboration on adherence to antiretroviral therapy. Only five of the studies in MACH 14 assessed usual care. Assessment protocols varied as did the timing and frequency of assessments. All usual care assessments addressed patient education focused on HIV, HIV medications, and medication adherence. Our findings support …

The Role Of Il-27 In Susceptibility To Post-Influenza Staphylococcus Aureus Pneumonia, Keven M. Robinson, Benjamin Lee, Erich V Scheller, Sivanarayana Mandalapu, Richard I. Enelow

Dartmouth Scholarship

Influenza is a common respiratory virus and Staphylococcus aureus frequently causes secondary pneumonia during influenza infection, leading to increased morbidity and mortality. Influenza has been found to attenuate subsequent Type 17 immunity, enhancing susceptibility to secondary bacterial infections. IL-27 is known to inhibit Type 17 immunity, suggesting a potential critical role for IL-27 in viral and bacterial co-infection.

Department Of Surgery Update, February 2015, Wright State University Department Of Surgery

Department of Surgery Updates

A four page newsletter created by the Department of Surgery documenting changes to the department. This issue contains note about Margaret M. Dunn, M.D., being appointed dean of the Boonshoft School of medicine, a message from the chair, a list of important dates, a call for abstracts, scholarly activity and more.

Oncolog, Volume 60, Number 02, February 2015, Sarah Bronson, Bryan Tutt, N. Danckers

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Natural Killer Cell Therapy May Augment Treatment of Hematological Cancers: Tough cancer treatments can severely weaken the body's natural ability to attack cancer cells. To improve immune recovery and function in patients who have undergone these treatments, especially those who may later receive a stem cell transplant, researchers are turning to natural killer cells that have been expanded in the laboratory.
• Concurrent Treatment of HIV and Cancer Improves Survival Outcomes: Concurrent HIV and cancer present special challenges in the clinic, regardless of which disease is diagnosed first. The simultaneous treatment of HIV and cancer is complicated by patients' weakened immune …

Tcr Alpha Lcr And Non-Lcr Cis-Elements Contributing To Tissue Specific Expression Of The Tcr Alpha Gene In Thymic And Peripheral T Cells, Martina Kucerova-Levisohn

Dissertations, Theses, and Capstone Projects

Orchestrated expression of multiple genes residing in the complex TCRα/δ/Dad1 locus requires tight control from multiple cis-acting elements. The TCRα locus control region (LCR), is positioned between TCRα and Dad1 gene, and has been implicated in the differential expression of both genes. In this study, we focus our work on the hypersensitive site (HS)1 prime (HS1'), located 3' of the classical Eα enhancer, within the TCRα LCR. We investigated its non- redundant role in TCRα expression in thymic and peripheral T cells as assayed by in vivo and in vitro studies. Furthermore, formation of HS1' in both lymphoid and …

Clinical Guidelines: Where Environment Meets Medicine, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

N/A

Pulmonary Blastomycosis In Vilas County, Wisconsin: Weather, Exposures And Symptoms, Dennis J. Baumgardner, Kiley A. Bernhard, Gina Egan

Journal of Patient-Centered Research and Reviews

Purpose

Blastomycosis is a serious fungal infection contracted by inhalation of Blastomyces spores from the environment. Case occurrence in dogs in Vilas County, Wisconsin, has been associated with antecedent weather. We aimed to explore the effects of weather on the occurrence of human pulmonary blastomycosis in this area, and update exposure factors and symptoms since last published reports.

Methods

Mandatory case reports were reviewed. Chi-square test was used for categorical data of exposures, comparing 1979–1996 (n=101) versus 1997–June 2013 (n=95). Linear regression was used to model local weather data (available 1990–2013; n=126); Southern Oscillation Index (SOI), North Atlantic Oscillation Index …

Predictors And Outcomes Of Mycobacterium Tuberculosis Bacteremia Among Patients With Hiv And Tuberculosis Co-Infection Enrolled In The Actg A5221 Stride Study., John A. Crump, Xingye Wu, Michelle A. Kendall, Prudence D. Ive, Johnstone J. Kumwenda, Beatriz Grinsztejn, Ute Jentsch, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: We evaluated predictors and outcomes of Mycobacterium tuberculosis bacteremia among participants undergoing baseline mycobacterial blood culture in the ACTG A5221 STRIDE study, a randomized clinical trial comparing earlier with later ART among HIV-infected patients suspected of having tuberculosis with CD4-positive T-lymphocyte counts (CD4 counts)/mm(3). We conducted a secondary analysis comparing participants with respect to presence or absence of M. tuberculosis bacteremia.

METHODS: Participants with a baseline mycobacterial blood culture were compared with respect to the presence or absence of M. tuberculosis bacteremia. Baseline predictors of M. tuberculosis bacteremia were identified and participant outcomes were compared by mycobacteremia status.

RESULTS: …

Current Usage Of Animal Assisted Therapy In Nursing Homes In Ramsey County, Minnesota, Lauren K. Duerst, Natalie E. Nikonovich, Ashley M. Young

All Electronic Theses and Dissertations

The main purpose of this study was to determine the use of animal assisted therapy (AAT) for residents living in nursing home facilities in Ramsey County, Minnesota. Furthermore we compiled the thoughts and opinions of each facility director regarding the usage and perceived barriers that accompany the implementation of AAT programs.

Health Disparities On American Indian Reservations: Can Mid-Level Practitioners Make A Difference?, David Evard Johnston

All Electronic Theses and Dissertations

Introduction: American Indians/Alaskan Natives (AI/AN) suffer from a number of health issues and at higher rates than other United States populations. Efforts have been made through the Indian Health Service (IHS) to improve the AI/AN state of health, but healthcare disparities remain. Purpose: The purpose of this study was to assist in identifying options in reducing healthcare disparities on American Indian reservations in South Dakota. The need for recruitment of additional physicians and mid-level practitioners (also known as mid-level providers or advanced practice providers) was assessed, as well as the potential for mid-level practitioners to meet that need. Methods: A …

Metabolic Resting-State Brain Networks In Health And Disease, P. G. Spetsieris, J. H. Ko, C. C. Tang, A. Nazem, W. Sako, S. Peng, Y. Ma, V. Dhawan, D. Eidelberg

Journal Articles

The delineation of resting state networks (RSNs) in the human brain relies on the analysis of temporal fluctuations in functional MRI signal, representing a small fraction of total neuronal activity. Here, we used metabolic PET, which maps nonfluctuating signals related to total activity, to identify and validate reproducible RSN topographies in healthy and disease populations. In healthy subjects, the dominant (first component) metabolic RSN was topographically similar to the default mode network (DMN). In contrast, in Parkinson's disease (PD), this RSN was subordinated to an independent disease-related pattern. Network functionality was assessed by quantifying metabolic RSN expression in cerebral blood …

An Innovative Interactive Modeling Tool To Analyze Scenario-Based Physician Workforce Supply And Demand, S. Gupta, W. S. Black-Schaffer, J. M. Crawford, D. Gross, D. S. Karcher, J. Kaufman, D. Knapman, S. Weintraub, M. B. Cohen, S. J. Robboy, +8 Additional Authors

Journal Articles

Effective physician workforce management requires that the various organizations comprising the House of Medicine be able to assess their current and future workforce supply. This information has direct relevance to funding of graduate medical education. We describe a dynamic modeling tool that examines how individual factors and practice variables can be used to measure and forecast the supply and demand for existing and new physician services. The system we describe, while built to analyze the pathologist workforce, is sufficiently broad and robust for use in any medical specialty. Our design provides a computer-based software model populated with data from surveys …

Reducing The Risk For Waterborne Nosocomial Neonatal Legionellosis, J. S. Cervia

Journal Articles

No abstract provided.

Full-Length Soluble Urokinase Plasminogen Activator Receptor Down-Modulates Nephrin Expression In Podocytes, M. Alfano, P. Cinque, G. Giusti, S. Proietti, M. Nebuloni, S. Danese, S. D'Alessio, M. Genua, P. C. Singhal, J. Mikulak, +5 Additional Authors

Journal Articles

Increased plasma level of soluble urokinase-type plasminogen activator receptor (suPAR) was associated recently with focal segmental glomerulosclerosis (FSGS). In addition, different clinical studies observed increased concentration of suPAR in various glomerular diseases and in other human pathologies with nephrotic syndromes such as HIV and Hantavirus infection, diabetes and cardiovascular disorders. Here, we show that suPAR induces nephrin down-modulation in human podocytes. This phenomenon is mediated only by full-length suPAR, is time-and dose-dependent and is associated with the suppression of Wilms' tumor 1 (WT-1) transcription factor expression. Moreover, an antagonist of alpha v beta 3 integrin RGDfv blocked suPAR-induced suppression of …