Digital Commons Network^™

Empiric Deworming And Cd4 Count Recovery In Hiv-Infected Ugandans Initiating Antiretroviral Therapy, Alexander J. Lankowski, Alexander C. Tsai, Michael Kanyesigye, Mwebesa B. Bwana, Jessica E. Haberer, Megan Wenger, Jeffrey N. Martin, David Bangsberg, Peter W. Hunt, Mark J. Siedner

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: There is conflicting evidence on the immunologic benefit of treating helminth co-infections (‘‘deworming’’) in HIV-infected individuals. Several studies have documented reduced viral load and increased CD4 count in antiretroviral therapy (ART) naive individuals after deworming. However, there are a lack of data on the effect of deworming therapy on CD4 count recovery among HIV-infected persons taking ART.

Methodology/Principal Findings: To estimate the association between empiric deworming therapy and CD4 count after ART initiation, we performed a retrospective observational study among HIV-infected adults on ART at a publicly operated HIV clinic in southwestern Uganda. Subjects were assigned as having received …

Cervical Spine Osteomyelitis After Esophageal Dilation In Patients With A History Of Laryngectomy Or Pharyngectomy And Pharyngeal Irradiation, Richard A. Goldman, Md, Jill N. D'Souza, Md, Adam J. Luginbuhl, Md, Joshua E. Heller, Md, Joseph M. Curry, Md, David M. Cognetti, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Dysphagia is a common sequela of the treatment of head and neck cancer and is frequently managed with esophageal dilation in patients with dysphagia secondary to hypopharyngeal stenosis. Reported complications of esophageal dilation include bleeding, esophageal perforation, and mediastinitis. We examine four cases of cervical spine osteomyelitis presenting as a delayed complication of esophageal dilation for hypopharyngeal stenosis in patients with a history of laryngectomy or pharyngectomy and radiation with or without chemotherapy. The history of head and neck surgery and radiation in these patients further complicates the management of the cervical spine osteomyelitis.

Low Zinc Levels Is Associated With Increased Inflammatory Activity But Not With Atherosclerosis, Arteriosclerosis Or Endothelial Dysfunction Among The Very Elderly, Ehimen Aneni, Khurram Nasir

All Publications

BACKGROUND:

Reduced zinc intake has been related to atherogenesis and arteriosclerosis. We verified this assumption in very old individuals, which are particularly prone to both zinc deficiency and structural and functional changes in the arterial wall.

METHODS:

Subjects (n = 201, 80-102 years) with uneventful cardiovascular history and who were not in use of anti-inflammatory treatments in the last 30-days were enrolled. Daily intake of zinc, lipid profile, plasma C-reactive protein (CRP), plasma zinc, flow-mediated dilation (FMD), carotid ultrasonography and cardiac computed tomography were obtained. Young's Elastic Modulus, Stiffness Index and Artery Compliance were calculated.

RESULTS:

There was no significant …

Healthcare For Persons With Intellectual And Developmental Disability In The Community, David A. Ervin, Brian Hennen, Joav Merrick, Mohammed Morad

Pediatrics Faculty Publications

INTRODUCTION: While there has been impressive progress in creating and improving community healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done.

METHODS: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical considerations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and delivery systems, …

Biomarkers Of Acute Myocardial Infarction In The Elderly: Troponin And Beyond, Martin G. Rains, Charles A. Laney, Alison L. Bailey, Charles L. Campbell

Gill Heart & Vascular Institute Faculty Publications

In the broadest context, biological markers, or biomarkers, are molecules that characterize a biological system or process. In the setting of cardiovascular disease, a number of biomarkers have become an integral part of diagnostic and risk stratification strategies. In this review, we will discuss classic and emerging biomarkers of cardiovascular disease and the role of these biomarkers in the diagnosis and prognosis of elderly patients presenting with acute myocardial infarction.

Methylseleninic Acid Sensitizes Notch3-Activated Ovca429 Ovarian Cancer Cells To Carboplatin., Tiffany J. Tzeng, Lei Cao, Yangxin Fu, Huawei Zeng, Wen-Hsing Cheng

CALS Publications

Ovarian cancer, the deadliest of gynecologic cancers, is usually not diagnosed until advanced stages. Although carboplatin has been popular for treating ovarian cancer for decades, patients eventually develop resistance to this platinum-containing drug. Expression of neurogenic locus notch homolog 3 (Notch3) is associated with chemoresistance and poor overall survival in ovarian cancer patients. Overexpression of NICD3 (the constitutively active form of Notch3) in OVCA429 ovarian cancer cells (OVCA429/NICD3) renders them resistance to carboplatin treatment compared to OVCA429/pCEG cells expressing an empty vector. We have previously shown that methylseleninic acid (MSeA) induces oxidative stress and activates ataxia-telangiectasia mutated and DNA-dependent protein …

Metabolomics Analysis Identifies Intestinal Microbiota-Derived Biomarkers Of Colonization Resistance In Clindamycin-Treated Mice, Robin L.P. Jump, Myreen Tomas, Abhishek Deshpande, Curtis J. Donskey

Faculty Scholarship

Background: The intestinal microbiota protect the host against enteric pathogens through a defense mechanism termed colonization resistance. Antibiotics excreted into the intestinal tract may disrupt colonization resistance and alter normal metabolic functions of the microbiota. We used a mouse model to test the hypothesis that alterations in levels of bacterial metabolites in fecal specimens could provide useful biomarkers indicating disrupted or intact colonization resistance after antibiotic treatment. Methods: To assess in vivo colonization resistance, mice were challenged with oral vancomycin-resistant Enterococcus or Clostridium difficile spores at varying time points after treatment with the lincosamide antibiotic clindamycin. For concurrent groups of …

Safety Of Celecoxib And Nonselective Nonsteroidal Anti-Inflammatory Drugs In Juvenile Idiopathic Arthritis: Results Of The Phase 4 Registry, Rachel E. Sobel, Daniel J. Lovell, Hermine I. Brunner, Jennifer E. Weiss, Paula W. Morris, Beth S. Gottlieb, Elizabeth C. Chalom, Lawrence K. Jung, Karen B. Onel, Lisa Petiniot, Donald P. Goldsmith

Pediatrics Faculty Publications

Background

This study aimed to assess long-term safety and developmental data on juvenile idiopathic arthritis (JIA) patients treated in routine clinical practice with celecoxib or nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs).

Methods

Children aged ≥2 to <18 years with rheumatoid-factor–positive or –negative polyarthritis, persistent or extended oligoarthritis, or systemic arthritis were enrolled into this prospective, observational, multicenter standard-of-care registry. Eligible patients were newly or recently prescribed (≤6 months) an nsNSAID or celecoxib. Enrolled patients were followed to the end of the study, whether they remained on the original NSAID, switched, or discontinued therapy altogether. All adverse events (AEs) regardless of severity were captured in the database.

Results

A total of 274 patients (nsNSAID, n = 219; celecoxib, n = 55) were observed for 410 patient-years of observation. Naproxen, meloxicam, and nabumetone were the most frequently used nsNSAIDs. At baseline, the celecoxib group was older, had a numerically longer median time since diagnosis, and a numerically higher proportion of patients with a history of gastrointestinal-related NSAID intolerance. AEs reported were those frequently …

Predictors Of Hospital Stay And Mortality In Dengue Virus Infection-Experience From Aga Khan University Hospital Pakistan, Muhammad Abdul Mabood Khalil, Jackson Tan, Muhammd Ashhad Ullah Khalil, Safia Awan, Manickam Rangasami

Section of Nephrology

Background: Dengue virus infection (DVI) is very common infection. There is scarcity of data on factor associated with increased hospitalstay and mortality in dengue virus infection (DVI). This study was done to know about factors associated with increased hospital stay and mortality in patients admitted with DVI.

Results: Out of 532 patients, two third (72.6%) had stay ≤3 days while one third (27.4%) had stay greater than 3 days. The mean length of hospital stay was 3.46 ± 3.45 days. Factors associated with increased hospital stay (>3 days) included AKI (acute kidney injury) (Odd ratio 2.98; 95% CI 1.66-5.34), …

Unmet Need For Contraception And Unintended Pregnancies Among Women Of Reproductive Age Group: A Situation Analysis, Sumera Aziz Ali, Savera Aziz Ali

School of Nursing & Midwifery

Each year approximately 210 million pregnancies occur worldwide and more than one-third (75 to 80 million) of these are unintended, more than half of these (46 million) unintended pregnancies undergo unsafe abortions. In Pakistan 16% of the births are reported to be unwanted and if the unwanted fertility is eliminated, total fertility in Pakistan would be 3.1 births per woman. Total demand for family planning in Pakistan is 55%, while the contraceptive prevalence rate is 35% and unmet need for family planning is 20%. Reasons for unmet need and unintended pregnancy include lack of permission, fear of side effects, poor …

A Filtration System That Greatly Reduces Aluminum In Calcium Gluconate Injection, Usp Used To Prepare Parenteral Nutrition Solutions, Robert A. Yokel, Wesley R. Harris, Christopher D. Spilling, Vasiliy P. Abramov, Jason M. Lone, Robert J. Kuhn

Pharmaceutical Sciences Faculty Publications

OBJECTIVE: The study objective was to reduce aluminum (Al) in Calcium Gluconate Injection, US Pharmacopeia (USP) used in the preparation of parenteral nutrition (PN) solutions.

METHODS: A flow-through filter containing an immobilized chelator that complexes Al from Calcium Gluconate Injection, USP as it flows through the filter was designed, refined by design modifications, and extensively tested. When a small-volume parenteral vial containing 100 mL of Calcium Gluconate Injection, USP is connected on the inlet side of the filter, and the outlet side is connected to an evacuated receiving vial, the filtered solution is drawn into the receiving vial. This constitutes …

1,25-Dihydroxyvitamin D Alters Lipid Metabolism And Epithelialto- Mesenchymal Transition In Metastatic Epithelial Breast Cancer Cells, Alle Nicole Barnard

Open Access Theses

Evidence suggests that high vitamin D status (marked by serum 25-hydroxyvitamin D, 25(OH)2 D) is associated with a decreased risk of breast cancer. It has been established that 1,25-dihydroxyvitamin D (1,25(OH) 2 D) can alter glycolysis and the Krebs cycle of breast cancer cells (Jiang et al., 2010; Zheng et al., 2013) but little information is available on 1,25(OH) 2 D's alterations of lipid metabolism in breast cancer cells. Thus, the current research investigates if there was an effect of 1,25(OH) 2 D on proteins that regulate lipid metabolism in MCF10A, MCF10A-ras, MCF10CA1h, and MCF10CA1a epithelial breast cancer cells. While …

Oncolog, Volume 59, Number 07, July 2014, Sarah Bronson, Joe Munch, Bryan Tutt, K. Stuyck

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

• Side Effects of Targeted Molecular Agents Vary According to Mechanism of Action: The main side effects of cytotoxic chemotherapy are notorious. But the side effects of newer, targeted molecular agents are less well known, so patients receiving such drugs may not know what to expect and may require additional guidance from physicians
• INBRIEF: Study Finds Less Frequent Bisphosphonate Treatment Equivalent to Standard Regimen
• RAS Mutation Status May predict Outcomes After Surgery for Colorectal Cancer Liver Metastases
• HPV Test Does Not Replace Pap Test for Cervical cancer Screening: The recent approval of a human papillomavirus (HPV) test for cervical cancer screening …

What's New In Spine Surgery., Keith H Bridwell, Paul A Anderson, Scott D Boden, Han Jo Kim, Alexander Vaccaro, Md, Phd, Jeffrey C Wang

Rothman Institute Papers

No abstract provided.

A Coordinated School Health Approach To Obesity Prevention Among Appalachian Youth: Middle School Student Outcomes From The Winning With Wellness Project, William T. Dalton Iii, Karen Schetzina, Elizabeth Conway-Williams

International Journal of Health Sciences Education

The Winning With Wellness (WWW) project was a school-based obesity prevention program that was developed to promote healthy eating and physical activity in youth residing in rural Appalachia. The project was based on the Coordinated School Health model (Centers for Disease Control and Prevention (CDC), 2013a) and used a community-based participatory research approach with an emphasis on feasibility and sustainability. The purpose of this study was to examine self-reported health outcomes for middle school students across the course of the intervention. Sixth grade middle school students (N = 149; 52% girls) from four schools in Northeast Tennessee completed a …

Targeting Cancer Metabolism With Ketosis And Hyperbaric Oxygen, Angela M. Poff

USF Tampa Graduate Theses and Dissertations

Cancer cells exhibit an abnormal metabolic phenotype characterized by glycolysis and lactate fermentation in the presence of oxygen, a phenomenon known as the Warburg effect. This dysregulated metabolism plays an important role in every aspect of cancer progression, from tumorigenesis to invasion and metastasis. The Warburg effect is a common phenotype shared by most, if not all, cancer types. It is especially prominent in metastatic tumors, which are notoriously resistant to treatment and responsible for the majority of cancer-related deaths. Thus, metabolic therapies which target the Warburg effect could offer novel therapeutic options for most cancer patients, including those with …

Refugee Health In Montgomery County: A Retrospective Descriptive Study Of Refugee Health Screening Results From April 2007 - April 2008, Marjan Lyons

Master of Public Health Program Student Publications

Introduction: The top refugee health concerns characteristically are associated with parasitic infections, infectious diseases such as malaria, tuberculosis, and parasites, as well as nutritional deficiencies such as anemia, and malnourishment. Understanding the specific health needs of the refugee population will not only improve the transition of the refugees within the United States healthcare systems, but also improve public health within the community.

Methods: Health records from Public Health - Dayton & Montgomery Country were used to obtain the prevalence of both acute and chronic health conditions within the newly resettled refugee population. There were a total of 193 refugees included …

Resveratrol And Cancer: Focus On In Vivo Evidence, Lindsay G. Carter, John A. D'Orazio, Kevin J. Pearson

Graduate Center for Nutritional Sciences Faculty Publications

Resveratrol is a naturally occurring polyphenol that provides a number of anti-aging health benefits including improved metabolism, cardioprotection, and cancer prevention. Much of the work on resveratrol and cancer comes from in vitro studies looking at resveratrol actions on cancer cells and pathways. There are, however, comparatively fewer studies that have investigated resveratrol treatment and cancer outcomes in vivo, perhaps limited by its poor bioavailability when taken orally. Although research in cell culture has shown promising and positive effects of resveratrol, evidence from rodents and humans is inconsistent. This review highlights the in vivo effects of resveratrol treatment on breast, …

Correlational Studies Of Organophosphate Levels And Endocrine Disruption, Immunomodulation, And Altered Glucose Homeostasis In A Human Population Study, Carrie Mckean

Dissertations

Organophosphate (OP) pesticides have become the most widely used insecticides since the removal of organochlorine pesticides (“Ch4 Organophosphate Insecticides.pdf,” n.d.) and are generally the most toxic of all pesticides to vertebrates (Soltaninejad & Abdollahi, 2009). As a result, ongoing research has been aimed at further understanding potential health effects from exposure.

The aim of this dissertation research project is to investigate and characterize correlations of OP body burden with human health effects. This research involves an investigation into three pertinent areas concerning OP exposure: thyroid disruption, altered hematology biomarkers, and alterations of glucose homeostasis. Data under investigation come exclusively from …

An Update On Breast Cancer Screening And Prevention., Maria Syl D. De La Cruz, Mona Sarfaty, Richard C Wender

Department of Family & Community Medicine Faculty Papers

The goal of this article is to provide clinical guidance on breast cancer screening and prevention in primary care. The discussion highlights the importance of risk assessment, including screening options and risk-reduction strategies, for women at average and high risk. We review recommendations for breast cancer screening, evaluate current evidence on primary prevention, examine current practice patterns, and consider the impact of recent changes within health care.

Understanding The Power Of Perinatal Events And Metabolic Status In Childhood., Bonita Falkner, Julie Ingelfinger

Department of Medicine Faculty Papers

No abstract provided.

Outpatient Management Of Heart Failure In The United States, 2006-2008, Kailash Mosalpuria, Sunil K Agarwal, Sirin Yaemsiri, Bredy Pierre-Louis, Samir Saba, Rene Alvarez, Stuart D Russell

The Texas Heart Institute Journal

Better outpatient management of heart failure might improve outcomes and reduce the number of rehospitalizations. This study describes recent outpatient heart-failure management in the United States.

We analyzed data from the National Ambulatory Medical Care Survey of 2006–2008, a multistage random sampling of non-Federal physician offices and hospital outpatient departments.

Annually, 1.7% of all outpatient visits were for heart failure (51% females and 77% non-Hispanic whites; mean age, 73 ± 0.5 yr). Typical comorbidities were hypertension (62%), hyperlipidemia (36%), diabetes mellitus (35%), and ischemic heart disease (29%). Body weight and blood pressure were recorded in about 80% of visits, and …

Insulin Pump Class: Back To The Basics Of Pump Therapy, Sara Wilson Reece, Cheryl Williams

Research Day

Insulin pump therapy is a common mechanism for insulin delivery in Type 1 diabetes mellitus as well as in some patients with Type 2 diabetes mellitus. At the Longstreet Clinic, approximately 3% of patients on insulin therapy utilize insulin pumps. After several patients on insulin pump therapy experienced severe hypoglycemic episodes while driving, the need for review of insulin pump survival skills were identified. The insulin pump class which was conducted in a small group setting reviewed all of the necessary survival skills for effective insulin pump therapy. Pre- and post-class hemoglobin A1c values and emergency room visits as well …

Effects Of An Osteoporosis Educational Intervention: Knowledge And Self-Efficacy Of Prevention In Young Adult Collegiate Females, Valerie A. Bollenbacher

Evidence-Based Practice Project Reports

Osteoporosis is a silent and potentially debilitating chronic illness. In 2012, the CDC reported that 4.5 million women over the age of 50 were diagnosed with osteoporosis in the United States. Within the next 20 years, 41 million women worldwide are projected to have osteoporosis. The annual financial burden of osteoporosis is estimated to be 19 billion dollars. The objective of this evidence-based practice project was to answer the clinical question: In young adult collegiate females, how does an osteoporosis educational intervention compared to current education effect osteoporosis knowledge and self-efficacy of osteoporosis prevention over a one-month time period? The …

"Can’T Touch This": Empowering Children With Severe Food Allergy In The Residential Camp Setting 2014, Alexsandra Dubin

Master's Theses

The purpose of this project was to create an empowerment program for children with severe food allergy (SFA) in a residential camp setting. Despite recent advancements in research, there is no cure for SFA, thus there is a need for programs to help children manage their allergies and cope with the ramifications of their condition. Quality of life is a major concern for children with SFA, as the constant fear of exposure to an allergen can lead to high levels of anxiety. This is particularly noteworthy because, barring exposure to an allergen, these children are otherwise healthy and symptom free. …

Preventing Falls With Vitamin D, Franklin D. Shuler Md, Phd, Thomas Schlierf, Matthew Wingate

Orthopaedics

Falls are the number one cause for injury-related morbidity and mortality in West Virginia’s seniors. Multiple independent variables contribute to the risk of a fall: previous falls, alterations in balance and vision, impairments in gait and strength, and medications most highly correlate with the risk for a fall. Vitamin D supplementation is emerging as an easy, safe and well-tolerated fall reduction/prevention strategy due to the beneficial effects on the musculoskeletal system with improvements in strength, function and navigational abilities. From meta-analysis data, maximal fall reduction benefit in seniors is achieved when correcting vitamin D deficiency and when using adjunctive calcium …

Fact Sheet #2: How Do Mainecare Providers Perform On Childhood Screening And Prevention?, Jean A. Talbot Phd, Mary Lindsey Smith Phd, Msw, Kimberley S. Fox Mpa

Population Health & Health Policy

The annual Survey of Children Served by MaineCare, which collects a wealth of data on the experiences of MaineCare families, examines the extent to which MaineCare providers follow Bright Futures guidelines during well-child visits. This fact sheet presents findings on Bright Futures adherence from the 2013 survey.

The Role Of Amp-Activated Protein Kinase (Ampk) In Regulating The Early Stages Of Acute Pancreatitis, Mohamed Shitia

Honors Scholar Theses

Acute pancreatitis is an inflammatory disease that is initiated by the activation and retention of digestive zymogens inside pancreatic acinar cells (acini). It is proposed that adenosine monophosphate-activated protein kinase (AMPK) regulates early responses of acute pancreatitis in acini. A recent study shows that induction of experimental pancreatitis in isolated rat acini with supraphysiologic cerulein (orthologue of cholecystokinin) increases intracellular zymogen activation, but decreases AMPK levels. Furthermore, in vitro pharmacologic stimulation of AMPK reduces zymogen activation, having a protective effect. In this study, the effectiveness of two AMPK activators was examined in two separate in vivo pancreatitis models. In the …

Validity Of The Zephyr Bioharness For Vertical Power Output And Ground Reaction Forces, Fuad Haydar

Health, Human Performance and Recreation Undergraduate Honors Theses

Overtraining has become a major problem in college sports today and there is an increasing need for devices to track or measure the amount of stress is being put on the bodies of athletes. One such device is the ZephyrTM BioHarness, which is a puck-like device worn on the chest and is the centerpiece of this study. Researchers wanted to answer the question of whether the ZephyrTM was an effective and valid tool to measure the amount of force placed on the body during a single vertical jump. There were 20 male participants used in this study, 10 Division I …

Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

Recognizing that traditional models of health care delivery and payment often produce fragmented and costly care and poor outcomes for those with the highest needs, many reforms under the Affordable Care Act (ACA) focus on realigning payment incentives and integrating care. These reforms presuppose the existence of supporting infrastructure and capacity, including dedicated care management staffing and health information technology and exchange. With a focus on community-dwelling older adults in need of integrated physical, behavioral health services, and long term services and supports (LTSS), this brief reviews the opportunities and challenges these reform initiatives present for rural communities: How easily …