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Human Papillomavirus Vaccination Status And Endorsement Among Undergraduate Nursing Students: A Secondary Data Analysis, Ashley Hollins

Dissertations and Theses (Open Access)

Background: Human papillomavirus (HPV) vaccination has immense potential to prevent HPV-related infections but vaccination rates remain suboptimal. Nurses could potentially increase vaccination rates by providing recommendations and addressing vaccine concerns. As student nurses’ transition into practice, it is important to identify factors that could influence their attitudes and uptake of the HPV vaccine; however, these factors remain unknown.

Purpose: We proposed to: (1) identify factors associated with HPV vaccination status and (2) to identify student nurses’ perception of parental vaccine hesitancy, preferred counseling strategies, and factors associated with intention to counsel parents on HPV.

Methods: The current study was a …

Testing Patterns For Syphilis And Other Sexually Transmitted Infections In Pregnant Women Presenting To Emergency Departments, Ifeoluwa Shoyombo

Dissertations and Theses (Open Access)

Following an initial decrease in the incidence of congenital syphilis from 2008-2012, the rate of congenital syphilis rose by 38% across the United States between 2012-2014 (2). This trend followed a 22% rise in primary and secondary syphilis cases in women during the same period.(1) Vertical transmission of syphilis is a significant public health concern, contributing to stillbirth, infant mortality, and neurologic and skeletal morbidities in survivors. (2) The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women be screened for sexually transmitted infections (STI) including HIV, syphilis, and hepatitis B at the first prenatal visit regardless …

Role Of Disinfectants In The Eradication And Propagation Of Clostridiodes Difficile Infection, Tasnuva Rashid

Dissertations and Theses (Open Access)

Introduction:

Clostridioides difficile is a motile, gram-negative, toxin-producing bacteria responsible for the majority of the nosocomial as well as community-acquired infection in the US and worldwide. A high rate of morbidity, mortality, recurrences, healthcare cost coupled with frequent epidemic outbreaks with drug-resistant strains has classified C. difficile as a pathogen with an urgent threat to human health. Current guidelines regarding disinfectant use are either limited or absent or are not effective in reducing the environmental burden of C. difficile. The aims for this study was first to determine the in vitro efficacy of select hospital disinfectants in eradicating the spores …

University Of Central Florida Graduate Catalog, 2019 - 2020, University Of Central Florida

UCF Catalogs

No abstract provided.

Inspire : Vol 2, Issue 5, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message From The Chair
• A Trip to Seoul, South Korea by Ajeet Kumar Lohana
• Department of Medicine at National and International Forums
• Featured Faculty Profile Dr. Sara Shakil; “Self- motivation and determination are the key elements that are required to take one to the highest levels of excellence.”
• What Are Academics Around the World Reading This Month?
• Publications

Eradicating The Viral Triad In Hemodialysis Units, Beth Adams, Jerry Yee

Nephrology Articles

No abstract provided.

Public Exposure To Outdoor Bioaerosols In Particulate Matter In Las Vegas: Daily And Seasonal Variations, Karey Renee Fortier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bioaerosols are airborne particles of biological origin including viruses, bacteria, pollen, fungi, and fragments of their metabolic products. Bioaerosol exposure may represent a health risk, in particular for risk groups such as immunosuppressed persons, and those suffering from allergies or respiratory diseases. Bioaerosols of sizes

This study seeks to assess outdoor bioaerosol number concentrations and size distributions in Las Vegas, NV, as the first step in understanding their health risks. PM2.5 and PM10 were collected on black polycarbonate filters for 24-hour duration using MiniVol air samplers on UNLV campus in the spring and fall of 2017. Bioaerosols in these samples …

Health Disparities Among Sexual And Gender Minorities, Jennifer Keeley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Decades of research has shown that sexual and gender minorities (SGMs) experience adverse health and mental health outcomes to a greater extent than their heterosexual peers. The need to better understand and eliminate health disparities in the SGM population was recognized by the National Institute on Minority Health and Health Disparities (NIMHD) at NIH. The Secretary of Health at the Department of Health and Human Services approved the designation of the SGM population as a health disparities population in 2016 and called for SGM studies to examine the health needs of the SGM population across SGM subgroups via large representative …

Prevalence Of Aggregatibacter Actinomycetemcomitans And Fusobacterium Nucleatum Among Clinical Orthodontic Saliva Samples, Jason Robert Klingler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Changes to the oral microflora occur when there are shifts in the levels of the numerous bacterial species. Changes in bacterial load occur in health, disease, and dental treatments such as orthodontics and can be detected through saliva. Many studies dealing with saliva have centered around detecting bacteria known for correlation with chronic periodontitis and caries. Fewer have focused on bacterial species that contribute to microbial shifts not strictly correlated with disease. Measuring the degree of disease progression or future susceptibility is not always possible with traditional clinical parameters alone.

Aggregatibacter actinomycetemcomitans (AA) is a bacterial strain that serves as …

Queering Utopia: Act Up And The Disruption Of Heteronormativity, Nicholas Lepp

UNLV Theses, Dissertations, Professional Papers, and Capstones

The existing literature on queer utopianism tends to analyze static aesthetic artifacts as opposed to diachronic social movements designed to create material policy changes. This opens room for various criticisms of queer utopianism regarding it being too wishful and devolving into political and social forms of queer dystopia. In order to remedy this concern, this thesis seeks to investigate how queer utopic thought can be used to create long-lasting change. To answer this question, this thesis is broadly divided into two sections—one theoretical and one practical. My theoretical section delves into an analysis of the after-effects of queer utopic cuts …

Effects The 2014 Medicaid Expansion On Seat Belt Use: An Investigation Into Moral Hazard, Paul Pangburn

Economics

Under the Patient Protection and Affordable Care Act, signed into law by President Obama in 2010, health insurance coverage was expanded to 20 million previously uninsured people. Of these, 14.5 million were Medicaid eligible. Moral Hazard, a common research topic in insurance, is defined as when the private actions of an individual in a risk-sharing situation influence the probability of the outcome. There are two types of moral hazard, called ex-post moral hazard and ex-ante moral hazard. In the case of health insurance, ex-post moral hazard is when a health behavior changes after an individual becomes insured. Ex-ante moral hazard, …

The Endosymbiotic Gut Fungus Zancudomyces Culisetae Influences Transstadial Transmission Of Host-Associated Microbiota In The Yellow Fever Mosquito (Aedes Aegypti), Jonas Frankel-Bricker

Boise State University Theses and Dissertations

Mosquitoes are vectors for a variety of human pathogens and have a significant impact on human health worldwide. There is growing evidence that host-associated microbiota influence mosquito vector competence for certain viruses. Transstadial transmission of bacteria from larvae through pupae to adults could affect these interactions, though further studies are needed to fully unravel the mechanisms involved. Current microbiome research primarily focuses on bacterial communities, whereas the potential role endosymbiotic gut fungi have in transstadial transmission dynamics remains largely unknown. Trichomycetes is an ecological group of endosymbiotic microfungi that colonize the digestive tracts of arthropod hosts, including the Yellow Fever …

A Case Of Streptococcus Pneumoniae Meningitis, Allison Zindell, Mithil Patel, Omar Francis

MERF 2019 - Case Reports

This is a case of streptococcus pneumoniae meningitis in an immunocompromised patient.This case discusses the presentation, management, and complications of a 57-year-old female with past medical history significant for Hodgkin's lymphoma in remission and rheumatoid arthritis on immunosuppressive therapy who presented to the emergency department with altered mental status.In the emergency department patient was found to have a fever of39.5 ° C, tachycardia 140s , and hypotensive at 73/40. Laboratory studies were significant for leukocytosis of 24 with a lactic acid of 4. Chest x-ray was negative for pneumonia.CT head was negative for acute intracranial abnormality. Patient was empirically started …

Factors Affecting Healing In The Treatment Of Hidradenitis Suppuritiva, Andrew Worden, Daniel Yoho, Ihab Saab, Aamir Siddiqui

MERF 2019 - Clinical Research

Background: Hidradenitis suppurativa (HS) is a chronic and debilitating condition which causes recurrent painful nodules. Patients often progress to develop subdermal abscesses, chronic induration, and suppurative draining sinus tracts. HS causes significant debility and morbidity in patients’ body image, and overall quality of life. Despite this, there is typically a 5-­14 year delay in diagnosis from symptom onset. Treatment of HS depends on disease stage, goals of care, access to care, and frequency of symptoms. We have developed a hidradenitis suppurativa multidisciplinary program (HSMP). We present our experience with surgical treatment for patients with HS who follow in the HSMP. …

Invasive Aspergillosis Of The Liver In An Immunocompetent Patient, Varidhi Nauriyal, Erica Herc

MERF 2019 - Case Reports

Introduction: Invasive aspergillosis is most often seen in immunocompromised patients, although there are rare case reports of infection in immunocompetent hosts. We present a case of an immunocompetent patient with isolated hepatic aspergillosis. Case presentation: A 77-year-old male with chronic kidney disease stage III and history of Whipple procedure for a benign pancreatic mass 12 years prior presented with 1.5 months of fatigue, decreased appetite, chills, nausea, vomiting and diarrhea. Prior to the onset of his illness he was active and functional. Exam was pertinent for right upper quadrant tenderness. Imaging at an outside institution revealed a large heterogeneous liver …

Actinomyces Israelii – A Rare Cause Of Bacterial Peritonitis, Georgiana Marusca, Hind Hadid, Marcus Zervos

MERF 2019 - Case Reports

Background: Actinomyces, a filamentous, gram-positive, facultative anaerobic bacterium, is part of the commensal flora of the oral cavity, gastrointestinal tract and the female genital tract. Actinomyces have low virulence potential and cause opportunistic infection associated with injury to the mucosal barrier, such as that occurring from surgery, trauma, peritoneal dialysis catheter, viscus perforation or intrauterine devices. Infections associated with actinomyces are often reported by imaging studies as masses, pseudotumors or abscesses. Fistulas and sinus tract formation are not uncommon. Primary peritonitis with actinomyces is very rare. We report a case of Actinomyces peritonitis in an elderly gentleman with a history …

Skin And Soft Tissue Infections - The New Kid On The Block, Zohra Chaudhry

MERF 2019 - Case Reports

Introduction: Rapidly growing mycobacterium (RGM) skin and soft tissue infections are increasing in incidence. These infections can be challenging to treat and require multiple antibiotics for prolonged duration.This is a rare case of an immunocompetent male with Mycobacterium Septicum wound infection.Case presentation:52-year-old male with known history of hypertension and end-stage renal disease, was referred to Infectious disease (ID) clinic for multiple skin lesions.Initially noticed lesions near his right elbow and right foot which started as tender, erythematous papules and progressed to pustules with serosanguinous discharge over 2-weeks. He denied working with fish/aquarium, receiving pedicures or any trauma. Physical exam demonstrated …

Impact Of T2 Candida Panel On Species Specific Anti-Fungal De-Escalation, Zohra Chaudhry, Amit Vahia, Sally Askar, Noman Hussain, Mujtaba Hameed, George J. Alangaden

MERF 2019 - Clinical Research

Background: Candidemia is associated with a 30-day mortality of 20-40%, with likelihood of death increasing by 50% for each day therapy is delayed. T2 Candida is approved by the FDA for the diagnosis of candidemia with a sensitivity of 90% and specificity of 98%. The mean time to Candida detection is estimated to be 4.4 hours. Standard blood culture turnaround time is 3 days. Prompt diagnosis is essential to effectively treat candida infection. Methods: Retrospective analyses were conducted on 70 T2MR positive patients. The primary endpoint is time to de-escalation fromechinocandin to fluconazole based on T2 species identified. Secondary endpoints …

Increasing Incidence Of Mdros: An Emerging Global Concern, Zohra Chaudhry, Hind Hadid, Mary B. Perri, Marcus J. Zervos, Indira Brar

MERF 2019 - Basic Science Research

Introduction: With massive efflux of civilians from violence-stricken countries, the high rates of colonization with multidrug-resistant organisms (MDROs) amongst the refugees is an emerging global concern. Our report describes two Middle Eastern patients who suffered severe traumatic injuries in their home countries, subsequently developing chronic wounds. Upon arrival to the United States, the patients sought treatment in our institution for wound infection with MDRO. Materials and methods: Clinical data was collected from the patients’ charts. Identification and susceptibility testing were performed as part of routine identification/susceptibility test in the clinical microbiology laboratory. MICs performed by manual microbroth dilution according to …

Case Of Pneumocystis Pneumonia 6 Years Post-Renal Transplant While On Everolimus, Nikita Desai, Ayooluwa Ayoola

MERF 2019 - Case Reports

Goal of Case report: Presentation of PCP >1-year post-transplant and role of prophylaxis and immunosuppression in transplant patients.Abstract :Pneumocystis pneumonia (PCP) is a rarely occurring pulmonary infection that affects the immunocompromised, and often presents with nonspecific symptoms especially when compared to drug induced pneumonitis.Our patient, a 73-year-old female, presented to the emergency department with a 2 week history of shortness of breath and generalized weakness. She had a recent diagnosis of iron deficiency and had just received her first iron infusion 2 days before without symptomatic relief. Patient also reported increased frequency and a history of recurrent UTI at home, …

Progressive Multifocal Leukoencephalopathy: Opportunistic Infection In Art Era, Amit Vahia, Indira Brar

MERF 2019 - Case Reports

Progressive Multifocal Leukoencephalopathy (PML) is a rare, progressive, fatal disease caused by reactivation of the JC polyomavirus. It is most often encountered in patients who are immunocompromised by way of organ transplantation, hematopoietic stem cell transplant, or on certain immunologically suppressive drugs. Classically, PML has also been described in the HIV/AIDS population, although the incidence has become increasingly rare in the era of antiretroviral therapy (ART). Here, we present a case of a 31 year old gentleman with no previous comorbid conditions who presented to his local hospital with several weeks of progressive generalized muscle weakness, loss of appetite, weight …

A Rare And Newly Recognized Kaposi Sarcoma Herpes Virus-Associated Disease, Faria Ali, Qunfang Li, Akhil Rahman, Vivek Kak, Michael Somero, Chidamber Alamelumangapuram, Richard Santos

MERF 2019 - Case Reports

Introduction: Kaposi sarcoma herpesvirus (KSHV) is associated with Kaposi sarcoma, primary effusion lymphoma and multicentric Castleman disease (KSHV-MCD) in patients infected with human immunodeficiency virus (HIV). We present a case consistent with a newly recognized KSHV inflammatory cytokine syndrome (KICS), distinct from KSHV-MCD. Case Report: A 33-year-old African American male with a prior history of syphilis, HIV/AIDS on Triumeq and stage IV Kaposi sarcoma on Doxorubicin, presented with worsening fatigue, nausea, vomiting, myalgias, dyspnea and anasarca. His CD4 count remained at 33 cells/ul despite a low HIV-1 viral load. He was febrile and treated with multiple antibiotics, while extensive workups …

Hsv Acute Retinal Necrosis – A Painful Threat To Vision, Hind Hadid, Yusuf Alalwan, Firas Askar, Kevin Leikert, Alexander Kuley, Indira Brar

MERF 2019 - Case Reports

Ocular Herpes Simplex (HSV) is a serious infection with variable clinical manifestations ranging from isolated blepharitis and keratitis to vision-threatening uveitis and acute retinal necrosis (ARN). Previously described risk factors include preceding neurosurgery, older age and high-dose corticosteroids. The presence of keratitis is a valuable diagnostic sign, however, when absent, the differential is wide, encompassing autoimmune and idiopathic etiologies. We report the cases of two patients who presented with acute painful vision loss, who subsequently were diagnosed with HSV-2 panuveitis and ARN.Case 1: A 33 year-old healthy female with three prior episodes of unilateral iritis without definitive etiology, presented to …

Methods To Remotely Eliminate Biofilm From Medical Implants Using 2.4 Ghz Microwaves, Brett Glenn

Mechanical Engineering Undergraduate Honors Theses

Infections associated with biofilm growth are usually challenging to eradicate due to their high tolerance toward antibiotics [11, 12]. Biofilms often form on the inert surfaces of medically implanted devices [13]. No matter the sophistication, microbial infections can develop on all medical devices and tissue engineering constructs [12]. Related infections lead to 2 million cases annually in the U.S., costing the healthcare system over $5 billion in additional healthcare expenses [12].

Novel solutions to biofilm’s microbial colonization span the spectrum of engineering and science disciplines. Yet a practical solution still does not exist. The research presented here will explore a …

Creating Access Individuals With Disabilities Who Are Experiencing Homelessness, Megan C. Sanchez

Capstone Projects and Master's Theses

The Gilroy Compassion Center is a homeless resource center and day center for the people experiencing homelessness in Gilroy. The city of Gilroy experienced the largest increase in people experiencing homelessness with a 64% increase from 2015. With an increase in the population comes an increased need for basic services, such as restrooms and showers. To address this need Gilroy Compassion Center has fitted their day Center with restrooms and showers. Yet with limited funding available the organization was unable to make them compliant with the Americans with Disability Act. This project was developed to secure funding through a county …

Elucidating The Mechanism Of Action Of Experimental Compound Sw33 In Toxoplasma Gondii, Sean Watson

Theses/Capstones/Creative Projects

In recent years, antimicrobial drug resistance has become widespread and thus triggered an ever-growing need for the development of new, efficacious drug treatments. As an antimicrobial drug is developed, its mechanism of action is often identified before it becomes a potential candidate for clinical use. One potential method for identifying mechanism of action is chemical mutagenesis, in which induction of drug-resistant populations is followed by whole-genome sequencing of several clonal isolates. The subsequent observation of identical point mutations in the same gene across multiple drug-resistant populations can indicate a likely molecular target. However, this technique lacks the capacity to facilitate …

An Unusual Case Of Autoimmune Hemolytic Anemia-Thinking Outside The Box, Paul Williams, Scott Schwartz, Ileana Lopez-Plaza

MERF 2019 - Case Reports

A 27 year old male with no significant past medical history presented to an outside hospital for chief complaints of nausea/vomiting, epigastric pain, and acute jaundice. Initial laboratory workup revealed a hemoglobin of 5.5 g/dl, normal WBC and platelet count, elevated direct bilirubin (10 mg/dl), elevated lactate dehydrogenase (969 IU/L), low haptoglobin (<8 mg/dl), the peripheral smear revealed rare polychromasia and spherocytes, a positive direct antiglobulin test (DAT: BS +, IgG +, C3d -) with presence of warm autoantibodies. All infectious disease testing was negative. Anti nuclear antibodies were not identified. The initial CT abdomen showed a normal sized spleen. The patient was diagnosed with idiopathic warm autoimmune hemolytic anemia and was treated with pulsed steroids, one dose of Rituximab, and transfused with a total of 13 units packed red blood cells. The patient did not respond to medical treatment, and after one week, the patient was transferred to our institution for escalation of care. At our institution, Transfusion Medicine was consulted and advised only transfusion of phenotypically matched pack red blood cells for significantly symptomatic anemia or hemodynamic instability, as the patient continued a downtrend in the hemoglobin despite continued transfusion support. Decadron was added to his therapy, as well as IVIG that needed to be discontinued due to infusion related shortness of breath and chest pain. Another dose of Rituxan along with vincristine and cyclophosphamide were also given. Despite these efforts, the patient’s hemoglobin continued to drop despite an additional 9 RBC units transfused at our institution, reaching a low of 2.1 g/dl. In addition, the patient develop left lower quadrant pain accompanied by bloody bowel movements. A repeat CT scan of the abdomen was performed, which revealed an enlarged spleen with a span of 16.5 cm in its maximum dimension. Due to concerns for splenic infarction and/or rupture, and since the patient was not a candidate for surgery, partial splenic artery embolization (PSAE) was performed as an alternative approach. The lower to mid portions of the spleen were embolized individually with 500-700 micrometer Embosphere microspheres followed with a gelfoam/contrast slurry mixed with gentamicin. 30% residual viable spleen was seen on the final DSA. 6 hours post procedure, a dramatic increase in hemoglobin was observed without any additional transfusion support. The patient suffered severe left upper quadrant abdominal pain that was controlled medically. After close observation the patient was discharged home 2 days later. At home the patient was doing well symptomatically with the exception of persistent left upper quadrant pain. He had no clinical or laboratory signs of recurrent hemolysis. Hemoglobin was 12.1 g/dl. On April 2018, due to persistent left upper quadrant pain, the patient was scheduled for a laparoscopic splenectomy that was performed without complications. During this hospitalization a type and screen was performed in preparation for surgery. No warm autoantibodies were detected; however, additional new alloantibodies were identified.Hypersplenism and/or reticulocytopenia are infrequent complications of a warm autoimmune hemolytic anemia, constituting a life threatening complication that may not respond to standard therapy and may not qualify for surgical intervention. The above patient did not improve with any medical therapies, continued with a decreasing trend in hemoglobin that was accompanied by increasing lactate levels with no elevated troponin or signs of cardiac compromise. PSAE achieved a dramatic response that was maintained through follow up. Due to recurrent pain from the embolization, the patient eventually received a splenectomy once he was stable.

Disseminated Cryptococcal Disease In Liver Cirrhosis, Tommy Parraga Acosta, Indira Brar

MERF 2019 - Case Reports

Introduction: Cryptococcus is an environmental yeast that is typically associated with human immunodeficiency virus (HIV), and transplant recipients. Invasive disease has been described in patients with liver disease, however it is not a common occurrence. We describe a case of disseminated Cryptococcus neoformans infection in a patient with liver cirrhosis. Case presentation: 53-year-old male, with history of Hepatitis C infection, liver cirrhosis, Sjogren’s syndrome, venous thromboembolism (VTE), was admitted to the hospital for worsening debility and weakness. In a recent hospital admission for acute kidney injury (AKI), he was found to have spontaneous bacterial peritonitis secondary to Klebsiella pneumoniae and …

Expect The Unexpected! A Rare Case Of Nocardia Bacteremia, Smitha Gudipati, Kamil Khorfan, John E. Mckinnon, Erica S. Herc

MERF 2019 - Case Reports

Background: Nocardia species are partially acid fast, aerobic, gram-positive, branching filamentous bacteria that are found ubiquitously in the soil, decaying vegetable matter and aquatic environments. The Nocardia species most commonly associated with infections in humans are caused by asteroides (80-90%) followed by brasiliensis, farcinica and nova1. Nocardia spp. can cause serious pulmonary infections which are associated with frequent metastatic brain abscesses. Nocardia bacteremia is rarely reported and usually only seen in immunocompromised patients. We present a case of a central line associated Nocardia bloodstream infection in an immunocompetent patient. Case presentation: 53 year old Caucasian male with a history of …

Diagnosing And Managing Pcp, Tb And Pe In An Hiv Infected Patient, Omar Khan, Anne Chen

MERF 2019 - Case Reports

Introduction: Pulmonary manifestations in the Human immunodeficiency virus (HIV) infected patient can lead to a broad differential diagnosis. Co-infection with Pneumocystis jiroveci pneumonia (PCP) and pulmonary tuberculosis (TB) in the HIV infected patient has been described before. Additionally, HIV can lead to a hypercoagulable state placing patients at risk for VTE. This case report examines a patient with HIV presenting with PCP pneumonia, active pulmonary TB, and bilateral pulmonary embolism. Case Presentation: A 57 year old African American male with a past medical history of HIV with noncompliance with treatment who presented with fatigue, nausea, and decreased appetite. He had …