Digital Commons Network^™

Systemic Inflammatory Response Syndrome In Adult Patients With Nosocomial Bloodstream Infections Due To Enterococci, Katharine Bar, Hilmar Wisplinghoff, Richard P. Wenzel, Gonzalo M. L. Bearman, Michael B. Edmond

Internal Medicine Publications

Background Enterococci are the third leading cause of nosocomial bloodstream infection (BSI). Vancomycin resistant enterococci are common and provide treatment challenges; however questions remain about VRE's pathogenicity and its direct clinical impact. This study analyzed the inflammatory response of Enterococcal BSI, contrasting infections from vancomycin-resistant and vancomycin-susceptible isolates.

Methods We performed a historical cohort study on 50 adults with enterococcal BSI to evaluate the associated systemic inflammatory response syndrome (SIRS) and mortality. We examined SIRS scores 2 days prior through 14 days after the first positive blood culture. Vancomycin resistant (n = 17) and susceptible infections (n = 33) were …

Nosocomial Bloodstream Infections Caused By Klebsiella Pneumoniae: Impact Of Extended-Spectrum Β-Lactamase (Esbl) Production On Clinical Outcome In A Hospital With High Esbl Prevalence, Alexandre R. Marra, Sérgio B. Wey, Adauto Castelo, Ana Cristina Gales, Guilherme R. Cal, José R. Do Carmo Filho, Michael B. Edmond, Carlos Alberto Pires Pereira

Internal Medicine Publications

Background The frequency of ESBL producing Klebsiella pneumoniae bloodstream infections (BSI) is high in Brazilian hospitals, however little is known regarding what role, if any, resistance plays in the expected outcome in hospitals with a high prevalence of these pathogens.

Methods From 1996 to 2001, hospital acquired K. pneumoniae BSI were evaluated retrospectively. Each patient was included only once at the time of BSI. ESBL producing strains were identified using the E-test method. The association of variables with the mortality related to bacteremia was included in a stepwise logistic regression model.

Results One hundred and eight hospital acquired K. pneumoniae …

Nectin-2-Mediated Entry Of A Syncytial Strain Of Herpes Simplex Virus Via Ph-Independent Fusion With The Plasma Membrane Of Chinese Hamster Ovary Cells, Mark G. Delboy, Jennifer L. Patterson, Aimee M. Hollander, Anthony V. Nicola

Microbiology and Immunology Publications

Background

Herpes simplex virus (HSV) can utilize multiple pathways to enter host cells. The factors that determine which route is taken are not clear. Chinese hamster ovary (CHO) cells that express glycoprotein D (gD)-binding receptors are model cells that support a pH-dependent, endocytic entry pathway for all HSV strains tested to date. Fusion-from-without (FFWO) is the induction of target cell fusion by addition of intact virions to cell monolayers in the absence of viral protein expression. The receptor requirements for HSV-induced FFWO are not known. We used the syncytial HSV-1 strain ANG path as a tool to evaluate the complex …

Surgical Infection Society Guidelines For Vaccination After Traumatic Injury, Thomas R. Howdieshell, Daithi Heffernan, Joseph T. Dipiro

Publications from the Office of the Dean

Background: Recommendations for vaccination of injured patients against infection are evolving. Newly-recognized infections, safety considerations, changing epidemiology, and redefinition of patient groups at risk are factors that may influence vaccine development priorities and recommendations for immunization. However, recommendations must often be formulated based on incomplete data, forcing reliance on expert opinion to address some crucial questions. These guidelines provide evidence-based recommendations for the prevention or treatment of infectious morbidity and mortality after traumatic injury, such as soft tissue wounds, human or animal bites, or after splenectomy.

Methods: A panel of experts conducted a thorough review of published literature, …

Social Capital, Health And Mental Health In African American Women, Cheryl Lynn Bennett

Theses and Dissertations

Cultural and social influences on mental and physical health are increasingly recognized by social science researchers. Researchers have found that specific, Afrocultural factors are related to the functioning of African Americans. The current research considered whether interdependence is especially salient for African American women since women and African Americans tend to define themselves within the context of social relationships. The study outlines processes affecting the mental and physical health of African American women including communalism, collective efficacy, and social capital. The also study examined the relationship between socioeconomic status and both mental and physical health among African American women in …

Serum Anti-Phosphorylcholine And Anti-Cardiolipin Concentrations Following Periodontal Scaling And Root Planing, Reve W. Chaston

Theses and Dissertations

Atherosclerosis is an insidious disease with serious morbidity and mortality including ischemic heart disease, stroke, and myocardial infarction. This condition is progressive and can start early in life eventually leading to large plaques and arterial occlusion. Two key components of this process are the immune system and lipids; in particular, LDL which accumulates within the arterial walls and macrophages which recognize and engulf oxidized-LDL (oxLDL) to form foam cells. Knowing that certain antibodies directed against bacterial antigens such as phosphorylcholine (PC) and cardiolipin (CL) show opsonizing cross-reactivity with oxLDL it can be proposed that there is a link between immune …

Acquisition And Retention Of Bacterial Spores (Bacillus Atrophaeus) By Eight Insect Species, Kieron Marie Torres

Theses and Dissertations

Acquisition and retention of spores of an anthrax surrogate, Bacillus atrophaeus Nakamura ("BG") were evaluated in eight insect species. Species included: house cricket (Acheta domesticus L.), German cockroach (Blatella germanica L.), common house fly (Musca domestics L.), blue bottle fly (Calliphora vomitoria L.), hairy rove beetle Creophilus maxillosus L.), yellow mealworm (Tenebrio molitor L.), common paper wasps (Polistes exclamans exclamans Viereck), red paper wasps (Polistes Carolina L.), red harvester ant (Pogonymyrmex barbatus Smith). Individual insects were offered BG-treated food and sacrificed at specified time intervals following one, two or three meals. Resulting samples were surface-washed five consecutive times then homogenized …

The Association Between Breast Feeding And Being Overweight In Children, Naja Jamil Eldanaf

Theses and Dissertations

Purpose: Obesity/Overweight in children is an epidemic and the most common disorder of childhood in the developed world. Prevalence is increasing, leading to short- and long-term complications. Breastfeeding may protect against childhood obesity, but the debate is ongoing. The main purpose of this project was to assess the relationship between breastfeeding and being overweight in early childhood.Methods: Data were collected from the State and Local Area Integrated Telephone survey; National Survey of Children's Health, 2003. Overall, 16,358 children, ages 3 to 5, were included in the sample. SPSS Complex Sample software was utilized to generate for all analyses. Complex samples …

Characterization Of Vancomycin Resistance In Staphylococcus Aureus, Paige Mccarthy Fox

Theses and Dissertations

In the past decade, Staphylococcus aureus has developed two distinct vancomycin resistance mechanisms. First, the bacterium is capable of generating a thickened, poorly crosslinked cell wall that creates false targets. These targets cause vancomycin to bind at the periphery of the thickened peptidoglycan, allowing normal cell wall formation to continue at the cell membrane. Second, S. aureus has acquired genes from Enterococcus that encode an alternative stem peptide. The genes, known as van genes, alter the target of vancomycin, rendering vancomycin treatment ineffectual.In this work, we attempted to further characterize both mechanisms of vancomycin resistance. First, a potential link between …

Commonwealth Times 2005-11-03

Commonwealth Times, 1969-

No abstract provided.

Commonwealth Times 2005-01-31

Commonwealth Times, 1969-

No abstract provided.

Passive Immunization During Pregnancy For Congenital Cytomegalovirus Infection, Giovanni Nigro, Stuart P. Adler, Renato La Torre, Al M. Best

Pediatrics Publications

BACKGROUND

Currently, there is no effective intervention for a primary cytomegalovirus (CMV) infection during pregnancy.

METHODS

We studied pregnant women with a primary CMV infection. The therapy group comprised women whose amniotic fluid contained either CMV or CMV DNA and who were offered intravenous CMV hyperimmune globulin at a dose of 200 U per kilogram of maternal weight. A prevention group, consisting of women with a recent primary infection before 21 weeks' gestation or who declined amniocentesis, was offered monthly hyperimmune globulin (100 U per kilogram intravenously).

RESULTS

In the therapy group, 31 women received hyperimmune globulin, only 1 (3 …

Epidural Abscess Caused By Streptococcus Milleri In A Pregnant Woman, Russell Lampen, Gonzalo M. L. Bearman

Internal Medicine Publications

Background

Bacteria in the Streptococcus milleri group (S. anginosus, S. constellatus, and S. intermedius) are associated with bacteremia and abscess formation. While most reports of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions, SMG infections during pregnancy have been documented. However, SMG infections in pregnant women are associated with either neonatal or maternal puerperal sepsis. Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia. We report a case of spinal-epidural abscess caused by SMG in a young, pregnant woman without an antecedent history of spinal …

Comparison Of The Systemic Inflammatory Response Syndrome Between Monomicrobial And Polymicrobial Pseudomonas Aeruginosa Nosocomial Bloodstream Infections, Alexandre R. Marra, Gonzalo M. L. Bearman, Richard P. Wenzel, Michael B. Edmond

Internal Medicine Publications

Background Some studies of nosocomial bloodstream infection (nBSI) have demonstrated a higher mortality for polymicrobial bacteremia when compared to monomicrobial nBSI. The purpose of this study was to compare differences in systemic inflammatory response and mortality between monomicrobial and polymicrobial nBSI with Pseudomonas aeruginosa.

Methods We performed a historical cohort study on 98 adults with P. aeruginosa (Pa) nBSI. SIRS scores were determined 2 days prior to the first positive blood culture through 14 days afterwards. Monomicrobial (n = 77) and polymicrobial BSIs (n = 21) were compared.

Results 78.6% of BSIs were caused by monomicrobial P. aeruginosa infection (MPa) …

Virginia Commonwealth University Bulletin Vcu Faculty [2005], Virginia Commonwealth University

VCU Bulletins

Listing of University faculty including rank and degrees.

The Scarab (2005-01)

The Scarab, 1952-2010

From the cover: "Official Organ of the Alumni Association of the Medical College of Virginia."

Long-Term Consequences Of West Nile Virus In Virginia., Diana Cruz Ocampo

Theses and Dissertations

Objective: The purpose of this investigation was to describe the long-term effects and functional outcomes of patients in Virginia who were reported to the Virginia Department of Health with West Nile virus (WNV) non-neuroinvasive and neuroinvasive disease. The study identified the duration of symptoms after initial illness, the number of persons who fully recovered versus the number who continue to be symptomatic and how patients' quality of life differed after illness.Methods: The study population was drawn from 60 human cases that met the surveillance case definition for non-neuroinvasive and neuroinvasive WNV illness in Virginia between 2002-2004. Information was collected during …

Certified Registered Nurse Anesthetist Performance And Perceptions: Use Of A Handheld, Computerized, Decision Making Aid During Critical Events In A High-Fidelity Human Simulation Environment, Vicki C. Coopmans

Theses and Dissertations

With the increasing focus on patient safety and human error, understanding how practitioners make decisions during critical incidents is important. Despite the move towards evidence-based practice, research shows that much decision making is based on intuition and heuristics (“rules of thumb”). The purpose of this study was to examine and evaluate the methodologic feasibility of a strategy for comparing traditional cognition versus the use of algorithms programmed on a personal digital assistant (FDA) in the management of unanticipated critical events by certified registered nurse anesthetists (CRNAs).

A combined qualitative-quantitative methodology was utilized. The quantitative element consists of a pilot study …

Erythrocyte-Associated Transients In Capillary Po2 In The Rat Spinotrapezius Muscle During Hemodilution With Hespan And A Hemoglobin-Based Oxygen Carrier, Matthew Barker

Theses and Dissertations

Hemoglobin-based oxygen carriers for use as transfusion fluids have emerged as a leading technology directed at stemming shortages of a safe blood supply and providing a readily available resuscitation fluid in various trauma situations. The purpose of this investigation was to determine the effects of isovolemic hemodilution with Hespan and a hemoglobin-based oxygen carrier (HBOC) on erythrocyte-associated transients (EATs) in capillary PO2. The particulate nature of blood flow in capillaries, when observed from a stationary observation point, results in fluctuations of PO2 as alternating red blood cells and plasma gaps move through the detection region. Therefore, through experimental methods which …

Infant Oral Health: A Survey Of General Dentists, Pediatric Dentists, And Pediatricians In Virginia, Rhea Delcastillo Davis

Theses and Dissertations

Purpose: The purpose of this study was to examine the knowledge, attitudes, and experiences related to infant oral health for both dental and medical providers.Methods: A survey of infant oral health care was sent to 300 randomly selected general dentists, 300 randomly selected pediatricians, and all pediatric dentists in Virginia. The survey contained questions regarding the providers' routine infant oral health care regimen. In addition demographic data from the provider was collected. Responses to the questionnaire were tabulated and percent frequency distributions for responses to each item computed. Percents for all items were based on the total number of respondents …

Genetic Variability, Pathogen Susceptibility, Subspecies Identity And Conservation Of The Endangered Northern Flying Squirrel (Glaucomys Sabrinus) In Virginia, James Lincoln Sparks Jr.

Theses and Dissertations

I examined the population genetic structure of three known subspecies of Glaucomys sabrinus from Appalachia, Washington State, and two previously unexamined populations from Mount Rogers National Recreation Area (MRNRA) in Southwestern Virginia. Mean FST (0.107) and an AMOVA (P G. sabrinus subspecies populations in the southern Appalachians are genetically differentiated. Glaucomys sabrinus at MRNRA were less inbred than expected. Gene flow, a consensus tree based on Nei's genetic distance, elevated heterozygosity and morphometric data suggest that the MRNRA G. sabrinus population is an intergrade of the two recognized Appalachian subspecies, G. s. fuscus and G. s. coloratus. I compared inbreeding …

The Relationship Between Breastfeeding And The Development Of Asthma In Early Childhood, River Anne Pugsley

Theses and Dissertations

Purpose: Asthma can have significant adverse effects on the health and quality of life of children, and the prevalence of this condition continues to rise. Breastfeeding may protect against asthma, but some uncertainty remains. The purpose of this study was to further examine the relationship between breastfeeding and the risk of developing asthma in early childhood. Methods: Data were collected from the State and Local Area Integrated Telephone Survey: National Survey of Children's Health, 2003. The study population consisted of 33,315 children ages 0 to 5 years. Prevalence rates of asthma and breastfeeding ,were calculated, as were crude and Mantel-Haenszel …

The Scarab (2004-06)

The Scarab, 1952-2010

From the cover: "Official Organ of the Alumni Association of the Medical College of Virginia."

Evaluation Of The Hayes E. Willis Health Center In South Richmond -- Has It Served Its Targeted Population?, Shannon Nicole Shaw

Theses and Dissertations

Objective: The Hayes E. Willis Health Center (HWHC) was opened in a neighborhood of South Richmond in October 1993 to remove the barriers that prevented South Richmond residents from accessing primary healthcare services. The major objective of this study was to determine the effectiveness of the HWHC in providing primary care to the South Richmond Community deemed to be in need. An additional objective was to describe the changes in characteristics of clinic users and illnesses seen over time.Methods: Patient data was compared from the HWHC�s first full year of operation in which patient data was collected (1995) to the …

A Structural Equation Model Examining The Effects Of Gulf War Stress Exposure On Subsequent Mental And Physical Health Problems Among Gulf War Veterans, Frank J. Kenny

Theses and Dissertations

The goal of this dissertation is to better understand the complex relationship between the stresses encountered by US. service personnel during the Gulf War and eventual physical and psychological health outcomes among its veterans. By developing and validating a stress model using structural equation modeling techniques, it is hoped that knowledge regarding wartime stress and its potential impact on the health of veterans will be gained. This knowledge can be used to guide future policy decisions on how to minimize the deleterious health consequences associated with deployment and combat, as well as furnishing a basis for future studies that examine …

C-Reactive Protein Levels In Generalized Aggressive Periodontitis Patients, Trang Nguyen Salzberg

Theses and Dissertations

Background: There is mounting evidence to indicate that periodontitis may be a risk factor for cardiovascular disease (CVD). Periodontitis may be linked to CVD as either an etiologic mechanism or a predisposing factor that can hasten disease progression. Proinflammatory cytokines, elevated fibrinogen, and platelet aggregation are all potential mechanisms. The purpose of this study is to compare and review the serological differences in subjects with severe periodontitis, some of which involve established risk factors for atherosclerosis, particularly heightened C-reactive protein levels. Methods: A total of 184 subjects, comprising of two periodontal subgroups, non-periodontal (NP = 91) and generalized aggressive periodontitis …

The Scarab (2003-06)

The Scarab, 1952-2010

From the cover: "Official Organ of the Alumni Association of the Medical College of Virginia."

Shafer Court Connections (2003-03)

Shafer Court Connections, 1994-2010

For alumni of the Academic Campus of Virginia Commonwealth University.

Adefovir Dipivoxil For The Treatment Of Hepatitis B E Antigen–Positive Chronic Hepatitis B, Patrick Marcellin , M.D., Ting-Tsung Chang , M.D., Seng Gee Lim , M.D., Myron J. Tong , Ph.D., M.D., William Seivert , M.D., Mitchell L. Shiffman , M.D., Lennox Jeffers , M.D., Zachary Goodman , M.D., Ph.D., Michael S. Wulfsohn , M.D., Ph.D., Shelly Xiong , Ph.D., John Fry , B.Sc., Carol L. Brosgart , M.D.

Internal Medicine Publications

BACKGROUND

In preclinical and phase 2 studies, adefovir dipivoxil demonstrated potent activity against hepatitis B virus (HBV), including lamivudine-resistant strains.

METHODS

We randomly assigned 515 patients with chronic hepatitis B who were positive for hepatitis B e antigen (HBeAg) to receive 10 mg of adefovir dipivoxil (172 patients), 30 mg of adefovir dipivoxil (173), or placebo (170) daily for 48 weeks. The primary end point was histologic improvement in the 10-mg group as compared with the placebo group.

RESULTS

After 48 weeks of treatment, significantly more patients who received 10 mg or 30 mg of adefovir dipivoxil per day than …

Commonwealth Times 2002-09-30

Commonwealth Times, 1969-

No abstract provided.