Digital Commons Network^™

Ceftriaxone-Induced Immune Hemolytic Anemia From Treatment Of Post-Treatment Lyme Disease Syndrome, Jillian Catral, Emily Hitchcock

Providence St. Vincent Internal Medicine 2020

INTRODUCTION: Drug-induced immune hemolytic anemia (DIIHA) is a rare though likely underreported entitythat is associated with significant morbidity and mortality. • Ceftriaxone is a commonly used antibiotics with a well-documented association with DIIHA. The mechanism is a drug-dependent antibody, immune-complex mediated reaction which can be severe, leading to organ failure, shock, and even death. • While the majority of cases are in children, a recent literature review had one-third of cases being adults, with up to 30-40% mortality in all ages. • This case describes an adult patient treated for the controversial diagnosis of post-treatment Lyme disease syndrome (PTLDS) …

Swimming Through Lake Placid: A Major Headache, Elizabeth Severson, Claudia Leonard

Providence St. Vincent Internal Medicine 2020

Introduction: Leptospirosis is caused by Leptospira species, a spirochete bacterium that affects animals and humans. The disease can range from mild flu-like illness to multi-organ failure. While likely underreported, the incidence according to the World Health Organization can range from 0.1 to 10 per 100,000 depending on climate Leptospirosis is commonly associated with occupational or recreational exposures

Case Report: A 43 year-old previously healthy man presented with two weeks of myalgias, fevers, neck pain and throbbing headache. The patient competed in an Iron Man event in upstate New York one month prior to presentation. Initial investigation demonstrated a …

Purpura Fulminans Due To Mssa Toxic Shock Syndrome, Leah Grant, Rachel Plotinsky

Providence St. Vincent Internal Medicine 2020

Introduction: Purpurafulminansis a rare and serious complication of anacute infectious process, characterized by large purpuricskin lesions, fever, hypotension, and DIC. The mostcommon infectious cause of purpurafulminansismeningococcal disease, though few case reports in theliterature describe Staph aureusas a causative organism.

Case Report: •A 53 year-old woman with a history of heart blocks/ppacemaker placement in 2002 presented to the ED withnausea, vomiting, fevers, chills, diffuse muscle pain and asyncopalepisode. •She was found to have multi-organ dysfunction on labs,including AKI and thrombocytopenia.On hospital day 2, shedeveloped acrocyanosis. She became febrile & hypotensive requiring transfer tothe ICU for vasopressor support. Blood cultures were obtained. …

Rapid Review Of Community Engagement And Social Mobilization Strategies For Covid-19 Response: Study Description, Sarah Blake, Thoai Ngo

Poverty, Gender, and Youth

This project is a rapid review of evidence on interventions intended to mobilize community-level action to control infectious disease outbreaks in low resource and humanitarian contexts. The primary aims are to provide a critical analysis of current evidence on community engagement in preparing for or responding to infectious disease outbreaks and other emergencies; and to identify approaches and practices that can inform efforts to address COVID-19-related risks in low resource settings. In addition to documenting lessons and potential good practices from past crises, we will identify critical gaps in current evidence.

The Dangers Of Gardening – Nocardia Infection In An Immunocompromised Patient, Gerald Hutfles, Justin Jin

Providence Portland Medical Center Internal Medicine 2020

The Dangers Of Gardening –

Nocardia Infection In An Immunocompromised Patient

Gerald Hutfles, DO

Providence Portland Medical Center – Portland, OR

Additional Authors: Justin Jin, MD

Introduction: Nocardia is a gram-positive, partially-acid fast, aerobic, branching bacillus that can be found in soil and water. It is typically an opportunistic pathogen, with most infections occurring in the immunocompromised. Disease can be localized or disseminated, preferring pulmonary, nervous, and cutaneous tissues. Optimal antimicrobial therapy depends on speciation of the isolate, as Nocardia may exhibit variable antimicrobial susceptibility. A high clinical suspicion and appropriate empiric antimicrobial therapy is necessary. This clinical case …

Understanding Haitian Immigrant's Health Practices, George Namara

Honors Capstones

Due to the growing population of Haitian immigrants in the United States, it is important to increase nurses’ cultural competency by understanding Haitians’ health practices as they may differ from western medicine. Google scholar and online databases through Northern Illinois University’s online library were used to access research articles regarding factors related to the health practices of the Haitian people. Factors include the use of religious practitioners for management of chronic conditions, preference for traditional remedies over western medicine, mistrust of healthcare professionals, and cultural barriers, such as language.

A Modern Cat-Tas-Trophe? The Relationships And Impacts Between Feral Cat Management And Sustainable Urban Development: A Literature Review, Gage Mofield

Honors Theses

For this literature review, I will be reviewing the impacts that feral populations have on sustainable development, specifically in urban environments, and doing an intensive analysis of the economic, social, and most significant, environmental impacts that feral cats have on the respective urban environment. Following this, I will then be reviewing the different management strategies that currently are in place for managing feral cat populations, specifically lethal methods of feral cat management, and then analyzing a non-lethal feral cat management program known as “TNR”, which stands for Trap-Neuter-Return, and seeing which methodology is the best suited for managing urban feral …

Decreasing Hospitalization In Infants, William Hang

MSN Capstone Projects

Infants are the most vulnerable population at risk for serious diseases. Respiratory syncytial virus (RSV) is a disease that can be detrimental in infants because of their immature lungs and immune system. Palivizumab, a humanized monoclonal antibody medication, given every 28-30 days has been shown to reduces RSV symptoms and decrease rates of hospitalization by 15%. By reducing the rate of hospital stay, it will also reduce cost.

Endothelial Hspa12b Exerts Protection Against Sepsis-Induced Severe Cardiomyopathy Via Suppression Of Adhesion Molecule Expression By Mir-126, Xia Zhang, Xiaohui Wang, Min Fan, Fei Tu, Kun Yang, Tuanzhu Ha, Li Liu, John Kalbfleisch, David Williams, Chuanfu Li

ETSU Faculty Works

Heat shock protein A12B (HSPA12B) is predominately expressed in endothelial cells (ECs) and has been reported to protect against cardiac dysfunction from endotoxemia or myocardial infarction. This study investigated the mechanisms by which endothelial HSPA12B protects polymicrobial sepsis–induced cardiomyopathy. Wild-type (WT) and endothelial HSPA12B knockout (HSPA12B–/–) mice were subjected to polymicrobial sepsis induced by cecal ligation and puncture (CLP). Cecal ligation and puncture sepsis accelerated mortality and caused severe cardiac dysfunction in HSPA12B–/– mice compared with WT septic mice. The levels of adhesion molecules and the infiltrated immune cells in the myocardium of HSPA12B–/– septic mice were markedly greater than …

Increasing Vaccination Rates Of Children Up To 24 Months Old At Pmg Milwaukie Family Medicine, Justin Ferley, Rachel Jackson, Aubrey Miller, Sebastian Reeve, Christelle Serra-Van Brunt, Jamie Skreen, Jeffrey Sun, John Yates, Daniel Ruegg

Milwaukie Family Medicine 2020

Increasing Vaccination Rates of children up to 24 months old at PMG Milwaukie Family Medicine

Authors: Justin Ferley DO; Rachel Jackson MD; Aubrey Miller MD; Sebastian Reeve MD; Christelle Serra Van-Brunt DO; Jamie Skreen DO; Jeffrey Sun DO; John Yates MD; Daniel Ruegg MD

Introduction: Each year in the US, 42000 adults and 300 children die of vaccine preventable diseases. Yet across the country, clinics – including ours – fall short of the CDC Healthy People 2020 goals of pediatric vaccination rates. This resident-led quality improvement (QI) project aimed to improve our clinic vaccination rates in the under …

2020-April-29-Etsu Student Earns Society Of Critical Care Medicines Star Research Award, University Marketing And Communication, East Tennessee State University

ETSU News

Star Research Achievement Award

JOHNSON CITY (April 29, 2020) – Dr. Tuqa Alkhateeb, a third-year Ph.D. student in East Tennessee State University’s Department of Biomedical Sciences, was selected as a recipient of the Star Research Achievement Award by the Society of Critical Care Medicine (SCCM). 

The Star Research Award is intended to recognize excellence in critical care research and high-quality original investigative research. Accompanying the award was the opportunity to present her research findings at the SCCM 49th Critical Care …

Bacterial Load In Virtual Reality Headsets, Benjamin Creel

Honors Theses

Virtual reality technology is a rapidly growing field of computer science. Virtual reality utilizes headsets which cover the user’s eyes, nose, and forehead. In this study, I analyzed the potential for these headsets to become contaminated with bacteria. The nosepieces and foreheads of two HTC Vive VR headsets of the Department of Computer Science of the University of Mississippi were sampled over the course of a seven-week Immersive Media (CSCI 447) course. Serial dilutions were performed, and samples were plated on various culture media. Following incubation, counts of bacteria were determined. DNA was extracted from bacterial growth on plates from …

Empiric Treatment For Suspected Malaria In The United States: A Case Report., Jonathan C. Li, Emma Lundsmith

Division of Internal Medicine Faculty Papers & Presentations

Malaria in the United States is rare and most commonly presents among returning travelers from endemic areas. Diagnosis is classically dependent on a positive blood smear or polymerase chain reaction (PCR) test. The objective of this case report is to highlight a case of suspected malaria in a high-risk individual with negative diagnostic testing where a trial of empiric treatment was initiated based on clinical presentation after a thorough discussion of risks and benefits. However, empiric treatment based on a single case is limiting. We present a case of a 56-year-old man with extensive travel history throughout Asia, who presented …

Drugging Chemokine Receptors: Biased Cxcr3 Agonists Differentially Regulate Chemotaxis And Inflammation, Jeffrey Smith, Dylan Eiger, Chia-Feng Tsai, Lowell Nicholson, Rachel Glenn, Priya Alagesan, Amanda Macleod, John Jacobs, Tujin Shi, Sudarshan Rajagopal

Providence Portland Medical Center Internal Medicine 2020

Drugging Chemokine Receptors: Biased CXCR3 Agonists Differentially Regulate Chemotaxis And Inflammation

Jeffrey Smith, MD, PhD

Providence Portland Medical Center – Portland, OR

Additional Authors: Dylan Eiger, BS; Chia-Feng Tsai, PhD; Lowell Nicholson,MD; Rachel Glenn, BS; Priya Alagesan, BS; Amanda MacLeod, MD; John Jacobs, PhD; Tujin Shi, PhD; Sudarshan Rajagopal, MD,PhD

Introduction: G protein-coupled receptors (GPCRs) are the largest class of transmembrane receptors and the target of ~30% of FDA approved drugs. It is now well established that GPCRs can signal through multiple transducers, including classical heterotrimeric G proteins but also GPCR kinases and β-arrestins (1). While these signaling pathways can …

Impact Of Real-Time Antimicrobial Stewardship Team Intervention Versus Conventional Microbiology Reporting On Time To Appropriate Antimicrobial Therapy In Patients With Enterobacterales Bacteremia, Scott C. King, Alyssa B Christensen, Brent Footer, Timothy G. Shan, Kim Health, Ivor Thomas, Margaret Oethinger

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2020

Scott C. King

Alyssa B. Christensen, Brent W. Footer, Timothy G. Shan, Kim Health, Ivor Thomas, and Margret Oethinger

Impact of real-time antimicrobial stewardship team intervention versus conventional microbiology reporting on time to appropriate antimicrobial therapy in patients with Enterobacterales bacteremia.

Introduction:

The benefit of rapid laboratory speciation combined with real time antimicrobial stewardship team (AMT) interventions has been shown to improve patient outcomes and decrease hospital costs. The Providence Oregon region conducts direct from blood culture matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) identification, which results in decreased time to organism identification. The MALDI-TOF identification has allowed the AMT …

Sti & Prep Updates, Marshal Miller, Md, Aahivs, Sunny Lai, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Apply key findings from the DISCOVER trial to PrEP clinical decision-making
• Understand the gaps in PrEP research for cisgender women and adolescents
• Understand the use of on-demand pre-exposure prophylaxis
• Review Current treatment recs and emerging data on Gonococcal and Chlamydial infection
• Discuss diagnostic and management options for non-gonococcal urethritis

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Recent Articles on COVID-19

2020-04-29 Daily Unm Global Health Covid-19 Briefing, Christophe G. Lambert, Shawn Stoicu, Ingrid Hendrix, Lori D. Sloane, Susan Atlas, Anastasiya Nestsiarovich, Praveen Kumar, Nicolas Lauve, Alexandra Yingling, Melissa Cosse, Lauren Tagliaferro Epler, Allison Price, Fiona Nguyen, Ariel Hurwitz, Jenny Situ, Ryen Ormesher, Timothy Campbell, Perez Olewe, Clinton Onyango, Kristine Tollestrup, Cristian Bologa, Jens Langsjoen, Gregory Mertz, Douglas J. Perkins

HSC Covid 19 Briefings

Executive Summary:

NM cases. NM coronavirus origins. Governor update tomorrow. Temporary drivers licenses. Negative tracing app sentiment. CA reopening plans. US travel screening. Influenza reductions w/COVID control. German flu vaccine prep. 1.5B jobs at risk. National health expenditures. US economy shrinks. Aerosolized virus in hospitals. Cellphone disease spread prediction. Social distancing study. Isolation policy effectiveness. Contact tracing to end AIDS/HIV. Homeless shelter prevalence. Predicting herd immunity. Cooler temperatures reduce transmission. NEJM rationing rationalization. ECMO regional planning. Canadian ECMO prioritization. Healthcare worker mental health. Infectious Diseases Society guidelines. US hospitalist guide. Managing pregnancies. Coagulopathy management. Hysteroscopy consensus. Renal transplant immunosuppression. Two …

Accidental Botulism Poisoning: A Case Of Pickled Herring, Garrett Spencer, Greg Flick

Providence St. Vincent Internal Medicine 2020

INTRODUCTION: Botulism is a rare cause of neuromuscular weakness that presents a diagnostic challenge in the face of respiratory collapse. Pupil and bulbar paralysis aid prompt recognition and treatment, as clinical confirmation can be time intensive and limited by sample integrity. Early treatment can halt paralysis and prevent ICU and ventilator days.

CASE DESCRIPTION: A 74-year-old male with hypertension and DVT presented with acute weakness and respiratory failure after three days of cough and diarrhea. Upon ICU admission for mechanical ventilation, we discovered sluggish pupils, mild ptosis, and proximal muscle weakness. Symptoms then progressed to unresponsive pupils, complete ptosis, and …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

2020-04-28_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

The Sars Pandemic And Its Impact On The Hospitality Industry For Crisis Mitigation, Rachel Robie

Hospitality Graduate Student Scholarship

This article proves that pandemics greatly affect the hospitality and tourism industry. Certain infectious diseases and pandemics spread rapidly in hospitality settings and lead to global outbreak. Global outbreak of deadly diseases has the capability to financially hurt the hospitality and tourism industry. It’s important for the hospitality industry to have knowledge of previous global pandemic outbreak cases and their influences and effects on the industry. The following research article focuses specifically on the SARS pandemic outbreak’s impact on the hospitality industry. The information in this research article provides factual advice that can be applied and contributed to hospitality crisis …

Uab Launches Research Studies To Combat Covid-19, Alicia Rohan

Browse All News

No abstract provided.

2020-04-28 Daily Unm Global Health Covid-19 Briefing, Christophe G. Lambert, Shawn Stoicu, Lori D. Sloane, Susan Atlas, Anastasiya Nestsiarovich, Praveen Kumar, Nicolas Lauve, Kathryn Foos, Emma Wolinsky, Melissa Cossé, Jenny Situ, Susie Pham, Jennifer Thompson, Fiona Nguyen, Ryen Ormesher, Avanika Mahajan, Timothy Campbell, Lynnmarie Jarratt, Samantha Paltrow-Krulwich, Alyse Raboff, Stephen Esguerra, Lauren Tagliaferro Epler, Ariel Hurwitz, Alexandra Yingling, Clinton Onyango, Perez Olewe, Cristian Bologa, Jens Langsjoen, Orrin Myers, Douglas J. Perkins

HSC Covid 19 Briefings

Executive Summary:

NM case update. NM antibody testing. Las Cruces essential worker screening. Small business closure inequity. More jobless benefits. Santa Fe furloughs. NM Funeral homes prepared. NM oil sector hit. State-by-state restrictions/reopenings. US testing expansion. JAMA on prisons. NY reopening focus. Farmers euthanizing animals. New Zealand success. Stockholm herd immunity. UK worst-hit in Europe. Japanese island lockdown. Spain multi-phase plan. Economic damage lockdown duration. Oil price impacts. Aerosol intubation box. Family cluster transmission. US contact tracing lacking. Chinese tracing system. Early US deaths undercounted. More poison center calls. Homeless shelter infection. Reduced coronary syndrome admissions. Italian predicted model. GIS …

2020-04-27_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

Gw Covid-19 Intelligence Reports: April 27, 2020, George Washington University

GW COVID-19 Intelligence Reports

No abstract provided.

Sars-Cov-2 Infection In A Patient On Chronic Hydroxychloroquine Therapy: Implications For Prophylaxis, Khalid M. Dousa, Sharad S. Malavade, Jennifer Furin, Barbara Gripshover, Marjorie Hatszegi, Leila Hojat, Elie Saade, Robert A. Salata

Faculty Scholarship

People exposed to COVID-19 have a risk of developing disease, and health care workers are at risk at a time when they are badly needed during a health care crisis. Hydroxychloroquine and chloroquine have been used as treatment and are being considered as prophylaxis. Our patient developed COVID-19 while on hydroxychloroquine and although more work is needed, this calls into question the role of these medications as preventive therapy.

Infectious Diseases Society Of America Guidelines On The Treatment And Management Of Patients With Covid-19, Amy Hirsch, Yngve Falck-Ytter

Faculty Scholarship

Background: There are many pharmacologic therapies that are being used or considered for treatment of COVID-19. There is a need for frequently updated practice guidelines on their use, based on critical evaluation of rapidly emerging literature. Objective: Develop evidence-based rapid guidelines intended to support patients, clinicians and other health-care professionals in their decisions about treatment and management of patients with COVID-19. Methods: IDSA formed a multidisciplinary guideline panel of infectious disease clinicians, pharmacists, and methodologists with varied areas of expertise. Process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and …

Effects Of Individual Orsay Virus Proteins On The Intracellular Pathogen Response Of C. Elegans, Barbara Chen, Jessica N. Sowa

Biology Student Work

In order to cause infection, pathogens must avoid destruction by the host immune system. However, how pathogens evolved to evade host immunity is not fully understood. Mammals have two systems of immunity, innate and adaptive, which are regulated by complex interactions between the two systems. In order to study innate immunity exclusively, the roundworm C. elegans is a useful invertebrate model because it lacks adaptive immunity and the complexities that arise from interactions between the two types of immunity. The goal of this project is to investigate whether the individual expression of the Orsay virus capsid and delta-fusion proteins can …

Identifying Novel Triggers Of The Intracellular Pathogen Response (Ipr) In C. Elegans, Catherine T. Byrnes, Jessica N. Sowa

Biology Student Work

The intracellular pathogen response (IPR) is a cell signaling pathway found in C. elegans that is triggered when pathogenic microorganisms invade, and immune responses attempt to eliminate the threat. Due to the relative simplicity of C. elegans, they are an excellent model organism to analyze the cell signaling pathways triggered by various pathogens. They lack the complex immune systems of larger organisms, making it easier to study the involved cell signaling pathways. Past studies have shown that the IPR can also be triggered via intestinal wounding. Heat stress, viral infection, and proteasome stress are all known triggers of the IPR. …