Digital Commons Network^™

Regorafenib Pulmonary Toxicity: A Case Of Cavitary Lung Disease And Ards Treated With Infliximab, Michael Dong, Mackenzie Kramer, Tanmay Gandhi, Gautam George

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Regorafenib-induced pneumonitis and acute respiratory distress syndrome (ARDS) are rare and poorly characterized toxicities. We describe a 43-year-old male with metastatic colorectal cancer who developed hypoxic respiratory failure after two cycles of regorafenib. Imaging revealed cavitary lung lesions and diffuse ground glass opacities. Despite antibiotics and high-dose corticosteroids, his condition deteriorated, requiring ICU admission and mechanical ventilation. Bronchoalveolar lavage revealed bacterial pathogens, and he was treated for pneumonia. After multidisciplinary discussion, he was assessed to have regorafenib-induced pneumonitis as a major driver of his respiratory failure, and after limited steroid response, infliximab was administered with marked respiratory improvement. However, he …

Association Between Diabetes Mellitus, Hypertension, Obesity, And Diagnosis Of Covid-19 In Puerto Rico, Julian Rene Rivera Rodriguez

Walden Dissertations and Doctoral Studies

The population of Puerto Rico has been heavily affected by chronic diseases; however, data remains limited on the influence of diabetes mellitus (DM), hypertension, and obesity on the probability of COVID-19 diagnosis. The purpose of this quantitative study was to evaluate the association between non-communicable diseases that included DM, obesity, hypertension, and COVID-19 diagnosis, controlling for age and sex and person exposure in Puerto Rico. The sample consisted of 1,463 participants who underwent a polymerase chain reaction (PCR) test for COVID-19 from April 1, 2020, to March 31, 2021. Results from adjusted multivariable logistic regression analyses established that obesity OR …

Interventions To Minimize Unnecessary Antibiotic Use For Acute Otitis Media: A Meta-Analysis., Theresa L. Morin, Amy B. Stein, Rana El Feghaly, Amanda Nedved, Sophie E. Katz, Amy Keith, Heather E. Laferriere, Timothy C. Jenkins, Holly M. Frost

Manuscripts, Articles, Book Chapters and Other Papers

Backgrounds/Objectives: Acute otitis media (AOM) is the leading reason antibiotics are prescribed to children. Despite guidelines advocating for watchful waiting and shorter antibiotic durations, overprescribing remains a concern. This meta-analysis aims to quantify potential reduction in antibiotic days of therapy (DOT) for AOM if prescribers adhered to guidelines. Methods: Cochrane databases were sourced for studies on ear infections, diagnostic accuracy, antibiotic duration, and watchful waiting. Randomized clinical trials, observational studies, and quality improvement reports of children aged 6 months-17 years with uncomplicated AOM published between 2000 and 2024 from the U.S., Canada, and Europe. Of 4187 studies, 425 met selection …

Economic Factors Influencing Utilization Of World Health Organisation-Recommended Anc Visits Among Women In Jordan: An Analysis Of Jordan Population And Family Health Survey 2023, Lilian Nuwabaine, Joseph Kawuki, John Baptist Asiimwe, Benjamin Betunga, Mathius Amperiize, Angella Namulema, Imelda Namatovu, Shamim Nabidda, Patience Annet Nakalega, Quraish Sserwanja

School of Nursing & Midwifery, East Africa

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by identifying and managing complications early during pregnancy. In 2016, the World Health Organization (WHO) updated its guidelines, recommending a minimum of eight ANC visits to improve maternal health outcomes. Despite Jordan’s efforts to enhance maternal healthcare, disparities in ANC utilization persist, particularly among vulnerable populations such as refugees. This study aimed to assess the economic factors influencing utilization of the WHO-recommended eight ANC visits among women in Jordan.

Methods: The study used data from the 2023 Jordan Population and Family Health Survey (JPFHS). A two-stage sampling technique …

Bacterial Identification, Antibiotic Susceptibility Testing (Ast), And Epstein-Barr Virus (Ebv) Testing To Increase Organ Transplantation Within A Western Regional Community, Vedarrius D. Williams

Doctoral Dissertations and Projects

Clinical transplantation demands have increased immensely in recent years and, along with increasing supply shortages, many barriers to successful organ donation arise from a lack of dedicated testing to rule out microbial or bloodborne infections. There are currently minimal, federal regulatory requirements for transplantation specimen testing. The purpose of this study is to explore how to increase the viability and success of transplantations in the Western regions of the United States using kidney, pancreas, and kidney/pancreas transplant data from University Medical Center Southern Nevada (UMCSN) transplant center. UMCSN transplant center and Donor Services Laboratory (DSL) in Las Vegas perform bacterial …

Preparing Rural Physiotherapists : Addressing Climate Change Through Entry-Level Education, Kerstin Mcpherson, Christopher Myers

Internet Journal of Allied Health Sciences and Practice

Introduction: Climate change is set to profoundly impact community health and access to healthcare, particularly in rural areas of Australia, which already experience limited access to health services like physiotherapy. The implications of climate change on physiotherapy practice underlie the urgent need to prepare future health practitioners. Entry-level education plays a pivotal role in equipping physiotherapists with the knowledge and skills to address climate-related health challenges effectively. This study aimed to explore the perspectives, awareness, and educational needs of rural physiotherapists in Australia regarding climate change. Methods: A survey was designed and distributed via rural physiotherapist via social media using …

Large Language Models As Information Providers For Appropriate Antimicrobial Use: Computational Text Analysis And Expert-Rated Comparison Of Chatgpt, Claude And Gemini, Marcello Di Pumpo, Maria Rosaria Gualano, Danilo Buonsenso, Francesca Raffaelli, Daniele Donà, Vittorio Maio, Patrizia Laurenti, Walter Ricciardi, Leonardo Villani

College of Population Health Faculty Papers

OBJECTIVES: Antimicrobial resistance is a critical public health threat. Large language models (LLMs) show great capability for providing health information. This study evaluates the effectiveness of LLMs in providing information on antibiotic use and infection management.

METHODS: Using a mixed-method approach, responses to healthcare expert-designed scenarios from ChatGPT 3.5, ChatGPT 4.0, Claude 2.0 and Gemini 1.0, in both Italian and English, were analysed. Computational text analysis assessed readability, lexical diversity and sentiment, while content quality was assessed by three experts via DISCERN tool.

RESULTS: 16 scenarios were developed. A total of 101 outputs and 5454 Likert-scale (1-5) scores were obtained …

Vaccine Effectiveness Against Influenza A(H1n1), A(H3n2), And B-Associated Hospitalizations, United States, 1 September 2023 To 31 May 2024, Nathaniel M Lewis, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

BACKGROUND: The 2023-2024 influenza season included sustained elevated activity from December 2023 to February 2024 and continued activity through May 2024. Influenza A(H1N1), A(H3N2), and B viruses circulated during the season.

METHODS: During 1 September 2023 to 31 May 2024, a multistate sentinel surveillance network of 24 medical centers in 20 US states enrolled adults aged ≥18 years hospitalized with acute respiratory illness. Consistent with a test-negative design, cases tested positive for influenza viruses by molecular or antigen test, and controls tested negative for influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Vaccine effectiveness (VE) against influenza-associated hospitalization …

Alterations Of The Upper Respiratory Microbiome Among Children Living With Hiv Infection In Botswana, Sweta M Patel, John Farirai, Mohamed Z Patel, Sifelane Boiditswe, Leabaneng Tawe, Shimane Lekalake, Mogomotsi Matshaba, Andrew P Steenhoff, Tonya Arscott-Mills, Kristen A Feemster, Samir S Shah, Nathan Thielman, Coleen K Cunningham, Lawrence A David, David M Murdoch, Matthew S Kelly

Faculty, Staff and Students Publications

Children living with HIV (CLWH) are at high risk of colonization and infection by respiratory pathogens, though this risk can be reduced by other microbes in the upper respiratory microbiome. The impact of HIV infection on the pediatric upper respiratory microbiome is poorly understood, and we sought to address this knowledge gap by identifying associations between HIV infection and the nasopharyngeal microbiomes of Batswana children. We enrolled Batswana CLWH (< 5 years) and age- and sex-matched HIV-exposed, uninfected and HIV-unexposed, uninfected children in a cross-sectional study. We used shotgun metagenomic sequencing to compare nasopharyngeal microbiomes by HIV status. Among the 143 children in this study, HIV and HIV-associated immunosuppression were associated with alterations in nasopharyngeal microbiome composition, including lower abundances of Corynebacterium species associated with resistance to bacterial pathogen colonization. These findings suggest that the upper respiratory microbiome may contribute to the high risk of respiratory infections among CLWH.

Percutaneous Thromboaspiration Of Left Main Coronary Artery Vegetation In A Patient With Aortic Valve Infective Endocarditis And Acute Coronary Syndrome, Matthew B Morton, Jeremy Russo, Malanka Lankaputhra, Christopher Merry, Dion Stub

Journal of the Saudi Heart Association

Acute myocardial infarction from a vegetation is a rare complication of infective endocarditis. Thrombolysis, percutaneous coronary intervention with balloon angioplasty, stenting, and thromboaspiration, and surgery have all been described in this challenging clinical scenario. A woman with staphylococcal bioprosthetic aortic valve infective endocarditis developed acute myocardial infarction due to a vegetation invading the left main coronary artery, which was successfully managed with percutaneous thromboaspiration.

J Am Coll Dent 2021 88 1

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

Investigating Patient Non-Attendance To Healthcare Appointments In Türkiye: Data From A State Hospital And An Oral And Dental Health Center, Eyüp Sari, Ali̇ Ni̇yazi̇ Kurtcebe, Ci̇han Döğer, Recep Aydin

Turkish Journal of Medical Sciences

Background/aim: To determine the frequency and reasons for appointment nonattendance in a state hospital and a dental health center in a densely populated district of Türkiye, and to identify related factors to guide preventive measures.

Materials and methods: This retrospective cross-sectional study included patients who scheduled appointments at Ankara Etimesgut State Hospital and Etimesgut Oral and Dental Health Center through the Centralized Patient Appointment System (Merkezi Hekim Randevu Sistemi; MHRS) in February 2024. Nonattendees were contacted in March 2024 to determine reasons for nonattendance.

Results: A total of 30,552 appointments were analyzed (1978 dental, 28,574 hospital). The overall nonattendance rate …

Fear Of Covid-19 And Hygiene Behaviors: A Study Of Secondary School Students In İstanbul ​, Zozan Göksu, Hayri̇ye Kirkoyun Uysal, Mehmet Demi̇rci̇, Di̇lek Dülger, Seda Eki̇ci̇

Turkish Journal of Medical Sciences

Background/aim: This study investigates the relationship between fear of COVID-19, measured using the Fear of COVID-19 Scale (FCV-19S), and the hygiene behaviors of secondary school students, assessed with the Hygiene Behavior Scale (HBS).

Materials and methods: Included in this cross-sectional study were 206 secondary school students. The study data were analyzed using multivariate linear regression.

Results: No relationship was found between the fear of COVID-19 scale (FCV-19S) score of the student sample and the mean total HBS and subdimension values (p > 0.05). It was noted that positive hygiene behaviors decreased as the scale score increased. Students with retired mothers scored …

Impact Of Systemic Statins On Periodontal Health: A Retrospective Study In A Lebanese Population, Elsa Boustany, Georgio Saad, Wassim Al Manhal

International Arab Journal of Dentistry

Introduction: Statins, primarily used for cholesterol management, have shown potential in improving periodontal health due to their anti-inflammatory and bone-regenerative properties.

Methods: A retrospective study was conducted on 30 patients under statin medication. A control group of 30 non-statin users was selected using propensity score matching (PSM) to minimize bias. Data on pocket depth, attachment loss, and radiographic bone loss were collected at two time points: T0 and T1. Statistical analysis was performed using RStudio, with a significance threshold set at p < 0.05.

Results: The study revealed significant decrease in pocket depth (p = 0.0027), attachment loss (p …

Optimal Antibiotic Use In The Intensive Care Unit, Scott T Micek, M Cristina Vazquez Guillamet, Daniel Reynolds, Sarah Matuszak, Lauren Kolodziej, Marin H Kollef

2020-Current year OA Pubs

BACKGROUND: Antibiotic resistance has emerged as one of the most important factors influencing the outcomes of patients with life-threatening infections in the ICU. The increasing prevalence of antibiotic-resistant infections globally highlights the importance of this issue for all intensivists.

MAIN BODY: Antibiotic utilization in the ICU should be optimized to ensure that timely appropriate treatment is administered in a way that minimizes the subsequent emergence of antibiotic resistance. Antibiotic strategies have been developed to assist clinicians in achieving this important balance. Familiarity with local ICU pathogens and their antibiotic susceptibilities is at the forefront of optimizing ICU antibiotic practices. Moreover, …

J Am Coll Dent 2018 85 1

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

Learning From Covid-19: Clinical Trials, Health Information Technology, And Patient Mortality, Christos Nicolaides, Avinash Collis, Seth Benzell, Indranil Bardhan

Economics Faculty Articles and Research

During the COVID-19 pandemic, deaths per case in the United States decreased from 7.46% in April 2020 to 1.76% in April 2021. One mechanism that could explain this decline is a learning effect associated with testing of new treatments by hospitals. Hospitals that participated in clinical trials developed better organizational capabilities to diagnose and treat COVID-19 patients. Simultaneously, hospitals used health information technologies (IT) that integrated health information across healthcare providers to facilitate greater learning and sharing of best practices. Using US county-level data on clinical trial participation, use of health IT, and COVID-19 cases and deaths, we show that …

Functional Roles Of The Complement Immune System In Cardiac Inflammation And Hypertrophy, Kathryn D Hok, Haydn E Rich, Anthony Shadid, Lavanya Gunamalai, Tingting Weng-Mills, Rajarajan A Thandavarayan, Nirmal K Banda, Marie-Francoise Doursout, Marcos I Restrepo, Pooja Shivshankar

The Brown Foundation: Institute of Molecular Medicine

Cardiac inflammation and hypertrophy develop as a pathologic response to an array of insults, such as myocardial infarctions, chronic systemic hypertension, and valvular defects. Due to the high prevalence of such conditions, there is an increasing need to prevent and halt cardiac hypertrophy. Because cardiac damage and subsequent remodeling can lead to arrhythmias, heart failure, and even sudden cardiac death, inhibition of cardiac hypertrophy is key to reducing cardiovascular-related mortality. The immune system is the driving force behind inflammatory reactions. All three pathways of complement system activation-classical, lectin, and alternative-are implicated in developing cardiac damage, inflammation, and hypertrophy due to …

Emotional Intelligence Training Correlates With Medical Students’ Apprehension Of Ai In Healthcare: A Single-Institution, Observational Study, Austin P. Runde, Shambhavi Mishra, Marina Feffer, Ramzan Shahid

School of Medicine

Background: The use of artificial intelligence (AI) in healthcare is becoming increasingly widespread. While AI has been touted to improve many aspects of the field, its potential to undermine the doctor-patient relationship has also been recognized. It is not known what future physicians believe regarding the potential effects of AI on physicians' professional relationships. It is also unknown whether formal training in emotional intelligence (EI) and resilience strategies influences medical students' opinions on the use of AI in healthcare.

Objective: To ascertain medical students’ opinion on the potential impact of AI on various EI-related aspects of healthcare, such as its …

Establishing Priority Pediatric Antimicrobial Stewardship Interventions In The Us: Findings From A Delphi Consensus Study., Harry Obeng, Emmanuel Tetteh, Sara Malone, Lauren Walsh, Tyler Walsh, Fernando J. Bula-Rudas, Ritu Banerjee, Adam W. Brothers, Joshua C. Herigon, Katie Namtu, Scott Weissman, Daniel Riggsbee, Jared Olson, Debra Lynn Palazzi, Ann L. Wirtz, Matthew Sattler, Jessica Tansmore, Brittany A. Rodriguez, Monica Abdelnour, Joshua R. Watson, Alison C. Tribble, Jessica Gillon, Mari Nakamura, Sarah Jones, Jason G. Newland, Virginia R. Mckay

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND/OBJECTIVES: Antimicrobial resistance (AMR) is a major global health threat, with children at higher risk due to developmental differences in drug metabolism, limited treatment options and inappropriate antibiotic use. Pediatric antimicrobial stewardship programs (ASPs) face implementation challenges, often relying on adult-based guidelines and limited pediatric-specific evidence. This study aimed to identify and prioritize the most critical areas for pediatric ASP intervention development through a structured, multi-round Delphi consensus process with experts in antimicrobial stewardship and infectious diseases.

METHOD: A four-round modified Delphi process was conducted to identify and prioritize key pediatric ASP interventions. Experts in antimicrobial stewardship and infectious diseases …

Establishing Priority Pediatric Antimicrobial Stewardship Interventions In The Us: Findings From A Delphi Consensus Study, Harry Obeng, Emmanuel Tetteh, Sara Malone, Matthew Sattler, Monica Abdelnour, Virginia R Mckay, Et Al.

2020-Current year OA Pubs

BACKGROUND/OBJECTIVES: Antimicrobial resistance (AMR) is a major global health threat, with children at higher risk due to developmental differences in drug metabolism, limited treatment options and inappropriate antibiotic use. Pediatric antimicrobial stewardship programs (ASPs) face implementation challenges, often relying on adult-based guidelines and limited pediatric-specific evidence. This study aimed to identify and prioritize the most critical areas for pediatric ASP intervention development through a structured, multi-round Delphi consensus process with experts in antimicrobial stewardship and infectious diseases.

METHOD: A four-round modified Delphi process was conducted to identify and prioritize key pediatric ASP interventions. Experts in antimicrobial stewardship and infectious diseases …

Establishing Priority Pediatric Antimicrobial Stewardship Interventions In The Us: Findings From A Delphi Consensus Study, Harry Obeng, Emmanuel Tetteh, Sara Malone, Lauren Walsh, Tyler Walsh, Fernando J Bula-Rudas, Ritu Banerjee, Adam W Brothers, Joshua C Herigon, Katie Namtu, Scott Weissman, Daniel Riggsbee, Jared Olson, Debra Lynn Palazzi, Ann Wirtz, Matthew Sattler, Jessica Tansmore, Brittany A Rodriguez, Monica Abdelnour, Joshua R Watson, Alison C Tribble, Jessica Gillon, Mari Nakamura, Sarah Jones, Jason G Newland, Virginia R Mckay

Faculty, Staff and Students Publications

Background/objectives: Antimicrobial resistance (AMR) is a major global health threat, with children at higher risk due to developmental differences in drug metabolism, limited treatment options and inappropriate antibiotic use. Pediatric antimicrobial stewardship programs (ASPs) face implementation challenges, often relying on adult-based guidelines and limited pediatric-specific evidence. This study aimed to identify and prioritize the most critical areas for pediatric ASP intervention development through a structured, multi-round Delphi consensus process with experts in antimicrobial stewardship and infectious diseases.

Method: A four-round modified Delphi process was conducted to identify and prioritize key pediatric ASP interventions. Experts in antimicrobial stewardship and infectious diseases …

Targeting The Bcl2 Family: Advances And Challenges In Bh3 Mimetic-Based Therapies, Nabanita Mukherjee, James Sheetz, Yiqun Shellman

Student Papers, Posters & Projects

The BCL2 family of proteins plays a pivotal role in regulating apoptosis and cellular homeostasis, making them critical therapeutic targets in cancer and other diseases characterized by pathological cell survival. BH3 mimetics, small molecules that selectively inhibit anti-apoptotic BCL2 family members, have achieved significant clinical success, particularly in hematologic malignancies. However, several challenges remain, including resistance mechanisms, toxicity (such as MCL1 inhibitor-associated cardiotoxicity), and the intricate balance between apoptotic and non-apoptotic functions. This review provides a comprehensive overview of BCL2 family biology, the development and clinical application and outcomes of BH3 mimetics, and the emerging resistance mechanism known as double-bolt …

Vaccine And Treatment Evaluation Units: A Historical Perspective, Robert B Belshe, David I Bernstein, Kathryn M Edwards, Sharon E Frey, Wendy A Keitel, Myron M Levine, John J Treanor, Peter F Wright

Faculty, Staff and Students Publications

On 27 February 1962, Surgeon General Luther Terry announced a new vaccine development program within the National Institute of Allergy and Infectious Diseases (NIAID). Initially, the plan had three components: (1) special laboratories and facilities for development of prototype vaccines; (2) pilot lot production facilities and preliminary vaccine trial sites; and (3) larger lot production capacity and expanded human testing. Respiratory viruses were targeted as the top priority for vaccine development. Over 5 decades, this program has evolved and expanded to include multiple academic vaccine evaluation sites within the network, now labeled as the Vaccine and Treatment Evaluation Units (VTEUs). …

A Quantitative Analysis Of Postmarketing Safety Events Of Breakthrough Medicines, Richard Judson Davis

Walden Dissertations and Doctoral Studies

Adverse events to medicines pose a risk to the public health of patients. Breakthrough therapy medicines are designed to address unmet medical needs and are often approved on an expedited timeline; however they are also criticized for lacking an adequate understanding of their risk profile at the time of approval. This study examined the relationship between the number of concomitant medicines, as well as the approved therapeutic indication, and the outcomes of reported adverse events associated with medicines approved under the breakthrough therapy designation. The conceptual framework applied in this retrospective, cross-sectional, quantitative study is the process of pharmacovigilance, which …

Multimodal Reprogramming Of The Tumor Microenvironment By Mmr And Dual Checkpoint Blockade In Hepatocellular Carcinoma Models, Mulu Z. Tesfay, Aleksandra Cios, Khandoker Usran Ferdous, Randal S. Shelton, Bahaa Mustafa, Camila C. Simoes, Murat Gokden, Isabelle R. Miousse, Kimberly J. Krager, Marjan Boerma, Alicja Urbaniak, Anuradha Kunthur, Sri Obulareddy, Joshua M. Eichhorn, Steven R. Post, Jean Christopher Chamcheu, Omeed Moaven, Chiswili Y. Chabu, Dan G. Duda, Matteo Conti, Bruno Nardo, Rang Govindarajan, Martin E. Fernandez-Zapico, Lewis R. Roberts, Mitesh J. Borad, Martin J. Cannon, Alexei G. Basnakian, Bolni M. Nagalo

School of Graduate Studies Faculty Publications

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, thus, there is an urgent need to develop more effective therapeutic options for this dismal condition. Tumor-infiltrating lymphocytes (TILs) are associated with improved response to immune checkpoint blockade in HCC, but their low abundance in most cases limits their therapeutic efficacy. Here, we demonstrate, in mice, that low-dose intratumoral immunovirotherapy with the trivalent measles, mumps, and rubella vaccine (MMR) induces superior tumor-growth delay and extended host survival compared to individually administered vaccines for measles, mumps, or rubella viruses. Further, our results show that MMR therapy synergizes with PD-1 and …

From Awareness To Integration: Leading The Change For Occupational Therapy, Shirley A. Wells

Occupational Therapy Faculty Publications

In her lecture for the inaugural Dr. Lela A. Llorens Award of Excellence for Diversity, Equity, and Inclusion, Dr. Shirley A. Wells acknowledges the growing importance of creating more inclusive and equitable environments across all aspects of health care, with occupational therapy being no exception. Inclusion and integration are fundamental values that should be woven into every part of the practice of occupational therapy. It is not enough to be aware of these concepts; occupational therapists must actively engage in Acts of Inclusion and Integration in their delivery of care, collaboration with clients and colleagues, and shaping of the future …

Infective Endocarditis And Meningitis In A Healthy Newborn Without Underlying Heart Disease, Due To Streptococcus Agalactiae - A Case Report., Dalal Siddig Idris, Muath Mohammed Al Ghamdi, Maria Laura Bellovalls, Mohammed Fararjeh

Journal of the Saudi Heart Association

Streptococcus Agalactiae endocarditis is a rare clinical entity in newborns with a normal structured heart. It is generally characterized by acute onset, the presence of large vegetations, rapid valvular destruction and frequent complications, particularly embolization. Mortality is high with medical therapy alone. We are reporting a rare case of infective endocarditis (IE) with mitral valve vegetation in a 9-day old healthy newborn following Streptococcus Agalactiae sepsis, complicated by meningitis and micro-abscesses. Mitral valve (MV) vegetation was removed surgically; the patient received intravenous antibiotics for six weeks. Transthoracic echocardiography after surgery showed severe MV regurgitation and severe pulmonary hypertension which was …

Practicing With Intent: How To Teach An Old Dogma New Tricks, Matthew C Phillips, Kusha Davar, Sarah Freling, Steven Y C Tong, Todd C Lee, Emily G Mcdonald, Travis B Nielsen, Noah Wald-Dickler, Alfredo J Mena Lora, Rachael A Lee, Fergus Hamilton, Daniel M Musher, Rodrigo P L Costa, Bassam Ghanem, Rachel Baden, Brad Spellberg

Faculty, Staff and Students Publications

Clinicians are constantly bombarded with an onslaught of newly published data, yet they must make clinical decisions despite a dearth of clinical data. Sometimes, they may fall back on clinical practices entrenched by experience, unaware that they are upheld by dogmatic tradition rather than robust evidence. Ideally, the totality of evidence must be assessed and utilized for clinical decision-making, irrespective of entrenched orthodoxy. Here, we explore the questions, how much evidence is needed to revise established clinical practices and, more fundamentally, can data alone truly catalyze such shifts.

Correlation Of Immunological Biomarkers And Severity Of Pneumonia In Pediatric Patients, Dhifaf Abdulrhaman, Mohammed B Hassan

Al-Nisour Journal for Medical Sciences

Among children under five, pneumonia stands as a major contributor to both illness and death, creating a significant challenge for global health efforts. This study aimed to evaluate the correlation between radiological severity, clinical parameters (such as fever and oxygen saturation), and laboratory markers (including CRP levels, white blood cell count, and the neutrophil-to-lymphocyte ratio) in pediatric patients with pneumonia. A retrospective analysis was conducted on 51 hospitalized children with severe pneumonia admitted to Al Mansour Pediatric Hospital in Baghdad from July 2024 to February 2025. The results revealed a strong association between radiologic severity and clinical indicators, with higher …