Medicine and Health Sciences Commons^™

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani

Office of the Provost

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and …

Mpox (Formally Known As Monkeypox), Molly O'Neill, Tricia Lepage, Vanessa Bester, Henry Yoon, Frederick Browne, Eric C. Nemec

Physician Assistant Studies Student Publications

Mpox originates from the Mpox virus, which belongs to the Orthopoxvirus genus of the Poxviridae family.1, 2, 3 Other Orthopoxvirus species include the variola virus (the now eradicated smallpox virus), vaccinia virus (a virus used in the creation of the smallpox vaccine), and cowpox virus.1, 2, 3 The identified clades consist of the West African clade and the Congo Basin clade, each with varying fatality rates of 1% and 10%, respectively.1, 2, 3, 4 Since the eradication of smallpox in 1980, the Mpox virus has emerged as the most relevant Orthopoxvirus infection in humans.

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler

Office of the Provost

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …

Survival Analysis And Prognostic Factors Of The Carcinoma Of Gallbladder, Zainab Feroz, Priyanka Gautam, Sonia Tiwari, Girish C. Shukla, Munish Kuma

Biological, Geological, and Environmental Faculty Publications

Background: The present study aims to evaluate the survival status of patients with gallbladder cancer (GBC) and explore the prognostic factors for the improvement and preventions.
Methods: The study consists of 176 patients with clinically diagnosed gallbladder cancer; the study was conducted between 2019 and 2021 registered at Kamala Nehru Memorial Cancer Hospital, Prayagraj, India. The survival rates were analyzed by the Kaplan-Meier method; survival rate difference was analyzed by log-rank test, prognosis factors; and hazard ratio for mortality outcomes was estimated using Cox regression method.
Results: The overall median survival time of patients was 5 months with the 1-year, …

Drug-Resistant Bacterial Infections: We Need Urgent Action And Investment That Focus On The Weakest Link, Christiane Dolecek, Sadia Shakoor, Buddha Basnyat, Tochi Okwor, Benn Sartorius

Department of Pathology and Laboratory Medicine

Despite high mortality and morbidity, drug-resistant bacterial infections remain the forgotten pandemic. We argue for strengthening of diagnostics, WASH (water, sanitation, and hygiene) and infection prevention and control to reduce drug-resistant infections, as an integral part of sustainable high-quality health services, particularly in low- and middle-income countries.

Oral N-Acetyl Cysteine Versus Rectal Indomethacin For Prevention Of Post Ercp Pancreatitis: A Multicenter Multinational Randomized Controlled Trial, Pezhman Alavinejad, Nguyen-Phuong Nhu Tran, Omid Eslami, Omar El Shaarawy, Omar El Shaarawy, Ahmad Hormati, Seied Saeed Seiedian, Abazar Parsi, Mohammed Hussien Ahmed, Amna Subhan Butt

Section of Gastroenterology

Background: This multicenter multinational RCT designed to compare the efficacy of suppository indomethacin and NAC for prevention of PEP.
Methods: During a 6-month period, all of the ERCP cases in seven referral centers were randomly assigned to receive either 1200 mg oral NAC, indomethacin suppository 100 mg, 1200 mg oral NAC plus indomethacin suppository 100 mg or placebo 2 hours before ERCP. The primary outcomes were the rate and severity of any PEP.
Results: A total of 432 patients included (41.4% male). They were originally citizens of 6 countries (60.87% Caucasian). They were randomly allocated to receive either NAC (group …

Age Related Macular Degeneration, Kathryn J. Hopsicker

Student Publications

This paper is a literature review on the subject Age-Related Macular Degeneration (AMD) with a focus on its etiology, pathophysiology, clinical features, diagnosis, treatment, and prevention. AMD is the leading cause of severe and irreversible central vision loss in in individuals over the age of 55. There are two subtypes of AMD referred to as dry and wet respectively. The etiology of this disease is multifactorial and complex, with no hallmark of disease definitively identified. The distinct pathophysiological features differing in dry and wet AMD are explored in this review as well as its diagnosis and treatment. This disease is …

Identifying Differences: A Key Step In Precision Cardiovascular Disease Prevention, Mahmoud Al Rifai, Salim S. Virani, Vijay Nambi

Office of the Provost

No abstract provided.

Incidence Of Typhoid And Paratyphoid Fever In Bangladesh, Nepal, And Pakistan: Results Of The Surveillance For Enteric Fever In Asia Project, Mohammad Tahir Yousafzai, Sadia Shakoor, Irum Fatima Dehraj, Junaid Mehmood, Rozina Thobani, Aneeta Hotwani, Najeeb Rehman, Seema Irfan, Abdul Momin Kazi, Mohammed J. Hunzai

Department of Paediatrics and Child Health

Background: Precise enteric fever disease burden data are needed to inform prevention and control measures, including the use of newly available typhoid vaccines. We established the Surveillance for Enteric Fever in Asia Project (SEAP) to inform these strategies.
Methods: From September, 2016, to September, 2019, we conducted prospective clinical surveillance for Salmonella enterica serotype Typhi (S Typhi) and Paratyphi (S Paratyphi) A, B, and C at health facilities in predetermined catchment areas in Dhaka, Bangladesh; Kathmandu and Kavrepalanchok, Nepal; and Karachi, Pakistan. Patients eligible for inclusion were outpatients with 3 or more consecutive days of fever in the last 7 …

Potential Impact Of 2017 American College Of Cardiology/American Heart Association Hypertension Guideline On Contemporary Practice: A Cross-Sectional Analysis From Ncdr Pinnacle Registry, Aliza Hussain, Salim S. Virani, Luke Zheng, Ty J. Gluckman, William B. Borden, Frederick A. Masoudi, Thomas M. Maddox

Office of the Provost

Background Clinical implications of change in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the diagnosis and management of hypertension, compared with recommendations by 2014 expert panel and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7), are not known. Methods and Results Using data from the NCDR (National Cardiovascular Data Registry) PINNACLE (Practice Innovation and Clinical Excellence) Registry (January 2013-Decemver 2016), we compared the proportion and clinical characteristics of patients seen in cardiology practices diagnosed with hypertension, recommended antihypertensive treatment, and achieving blood pressure (BP) goals …

Viral Hepatitis - The Road Traveled And The Journey Remaining, Ghulam Fareed Malik, Noval Zakaria, Muhammad Ibrahim Majeed, Faisal Wasim Ismail

Section of Gastroenterology

Hepatitis is defined as inflammation of the liver and is commonly due to infection with The hepatotropic viruses - hepatitis A, B, C, D and E. Hepatitis carries one of the highest disease burdens globally and has caused significant morbidity and mortality among different patient populations. Clinical presentation varies from asymptomatic or acute flu-like illness to acute liver failure or chronic liver disease, characterized by jaundice, hepatomegaly and ascites among many other signs. Eventually, this can lead to fibrosis (cirrhosis) of the liver parenchyma and carries a risk of development into hepatocellular carcinoma. Hepatitis B and C are most notorious …

Characterisation Of Lung Function Trajectories And Associated Early-Life Predictors In An Australian Birth Cohort Study, Francesca Sanna, Francesca Locatelli, Peter D. Sly, Elisha White, Jane Heyworth, Graham L. Hall, Rachel E. Foong, David Blake

Research outputs 2022 to 2026

Background There is growing evidence that lung function in early-life predicts later lung function. Adverse events over the lifespan might influence an individual’s lung function trajectory, resulting in poor respiratory health. The aim of this study is to identify early-life risk factors and their impact on lung function trajectories to prevent long-term lung impairments. Methods Our study included participants from the Raine Study, a prospective pregnancy cohort, with at least two spirometry measurements. Lung function trajectories from the 6-to 22-year follow-ups were characterised using finite mixture modelling. Multinomial logistic regression analyses were used to evaluate the association between early-life predictors …

An Update On Cardiovascular Disease, Susan H. Davide, Audra E. Haynes

Publications and Research

In the United States, cardiovascular is the leading cause of death in men and women, and most racial and ethnic groups. There are several types of heart conditions; the most common type is coronary heart disease, also known as coronary artery disease or ischemic heart disease, which can cause acute myocardial infarction. Other heart conditions which can lead to heart failure include a past history of myocardial infarction, abnormal heart valves, heart muscle disease, or congenital heart muscle disease. In adults ages 65 and younger, approximately 2 in 10 deaths are caused from coronary artery disease and about 18.2 million …

Hypertension Guidelines And Coronary Artery Calcification Among South Asians: Results From Masala And Mesa, Jaideep Patel, Anurag Mehta, Mahmoud Al Rifai, Michael J. Blaha, Khurram Nasir, John W. Mcevoy, Ambarish Pandey, Alka M. Kanaya, Namratha R. Kandula, Salim S. Virani

Office of the Provost

Untreated hypertension may contribute to increased atherosclerotic cardiovascular disease (ASCVD) risk in South Asians (SA). We assessed HTN prevalence among untreated adults free of baseline ASCVD from the MASALA & MESA studies. The proportion of participants who received discordant recommendations regarding antihypertensive pharmacotherapy use by the 2017-ACC/AHA and JNC7 Guidelines across CAC score categories in each race/ethnic group was calculated. Compared with untreated MESA participants (n = 3896), untreated SA (n = 445) were younger (55±8 versus 59±10 years), had higher DBP (73±10 versus 70±10 mmHg), total cholesterol (199±34 versus 196±34 mg/dL), statin use (16% versus 9%) and …

Integument: Guidelines For The Care Of People With Spina Bifida, Patricia Beierwaltes, Sharon Munoz, Jennifer Wilhelmy

School of Nursing Publications

PURPOSE:

Skin-related issues have a significant impact on health, activities of daily living, and quality of life among people with spina bifida. Data presented by select clinics that participate in the National Spina Bifida Patient Registry reported that 26% of individuals had a history of pressure injuries with 19% having had one in the past year. The spina bifida community lack direct guidelines on prevention of these and other skin related issues. The Integument (skin) Guidelines focus on prevention, not treatment, of existing problems.

METHODS:

Using a consensus building methodology, the guidelines were written by experts in spina bifida and …

“Tomorrow Never Dies”: Recent Advances In Diagnosis, Treatment, And Prevention Modalities Against Coronavirus (Covid-19) Amid Controversies, Partha Laskar, Murali M. Yallapu, Subhash C. Chauhan

School of Medicine Publications and Presentations

The outbreak of novel coronavirus disease (2019-nCoV or COVID-19) is responsible for severe health emergency throughout the world. The attack of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found to be responsible for COVID-19. The World Health Organization has declared the ongoing global public health emergency as a pandemic. The whole world fights against this invincible enemy in various capacities to restore economy, lifestyle, and safe life. Enormous amount of scientific research work(s), administrative strategies, and economic measurements are in place to create a successful step against COVID-19. Furthermore, differences in opinion, facts, and implementation methods laid additional layers …

Considerations For Events And Gatherings, Centers For Disease Control And Prevention

Pandemic Response and Religion in the USA: Law and Public Policy

No abstract provided.

Early Covid-19 Interventions Failed To Replicate St. Louis Vs. Philadelphia Outcomes In The United States, Aliea M. Jalali, Brent M. Peterson, Thushara Galbadage

Faculty Articles & Research

The Coronavirus disease 2019 (COVID-19) pandemic has elicited an abrupt pause in the United States in multiple sectors of commerce and social activity. As the US faces this health crisis, the magnitude, and rigor of their initial public health response was unprecedented. As a response, the entire nation shutdown at the state-level for the duration of approximately one to three months. These public health interventions, however, were not arbitrarily decided, but rather, implemented as a result of evidence-based practices. These practices were a result of lessons learned during the 1918 influenza pandemic and the city-level non-pharmaceutical interventions (NPIs) taken across …

Prophylaxis Of Food Allergen Sensitivity, Dustin Gottfeld

Physician Assistant Studies | Student Articles

Food allergies can have a severe and drastic effect on a person’s lifestyle, while prevention of allergic disease can help to ensure others do not have to live with this burden. There are a variety of differing hypotheses that offer explanations for the early development of food allergies, particularly peanut allergies. Two of the foremost hypotheses are the Hygiene Hypothesis and the Dual-Allergen Hypothesis. The Hygiene Hypothesis claims that the diversity of a child’s microbiota creates a beneficial balance of microorganisms which can help prevent the development of allergic disease. Alternatively, the Dual-Allergen Hypothesis states that early environmental exposure to …

Field Testing Integrated Interventions For Schistosomiasis Elimination In The People's Republic Of China: Outcomes Of A Multifactorial Cluster-Randomized Controlled Trial, Gail M. Williams, Yue-Sheng Li, Darren J. Gray, Zheng-Yuan Zhao, Donald A. Harn, Lisa M. Shollenberger, Sheng-Ming Li, Xinglin Yu, Zeng Feng, Jia-Gang Guo, Jie Zhou, Yu-Lan Dong, Yuan Li, Biao Guo, Patrick Driguez, Marina Harvie, Hong You, Allen G. Ross, Donald P. Mcmanus

Biological Sciences Faculty Publications

Despite significant progress, China faces the challenge of re-emerging schistosomiasis transmission in currently controlled areas due, in part, to the presence of a range of animal reservoirs, notably water buffalo and cattle, which can harbor Schistosoma japonicum infections. Environmental, ecological and social-demographic changes in China, shown to affect the distribution of oncomelanid snails, can also impact future schistosomiasis transmission. In light of their importance in the S. japonicum, lifecycle, vaccination has been proposed as a means to reduce the excretion of egg from cattle and buffalo, thereby interrupting transmission from these reservoir hosts to snails. A DNA-based vaccine (SjCTPI) …

Guinea : Malaria, Madeleine Jacobson

Global Public Health

This brief analyzes malaria in Guinea and its impacts on individuals and the society. It consists of a geographic and demographic presentation of Guinea which includes information about its location, climate, natural resources, ethnic groups, politics and social internal and external challenges where human trafficking, lack of healthcare and refugees are discussed. The brief analyzes malaria´s transmission, diagnosis, preventions and a suggestion for an intervention.

Malaria is a vector-borne disease, which means that living organisms that can transmit infectious diseases between humans or from animals to humans, spread malaria. 70 percent of all malaria deaths occur in age years, but …

Uganda: Malaria, Sui Hnem

Global Public Health

Malaria is an infectious disease caused by mosquito bite. It is a major health problem in Uganda and is a major cause of mortality and morbidity. Pregnant women and children are the most infected groups in the country. The Ugandan government did their best to keep children and women healthy by providing clinics near the villages and advocating home treatment for malaria. Although, the government is very supportive in preventing and promoting the malaria, people did not seek healthcare as much as they should. The reason for not seeking healthcare was because they feel healthy, or the clinic had long …

United Arab Emirates: Mers-Cov, Sarmad Nawaz Khan

Global Public Health

United Arab Emirates is a federal absolute monarchy in Western Asia at the South East end of the Arabian Peninsula on the Persian Gulf, bordering Oman to the East and Saudi Arabia to the south, as well as sharing maritime borders with Qatar to the west and Iran to the north. The current population of the UAE is 9,457,851. It is a federation of hereditary absolute monarchies, governed by a Federal Supreme Council made up of seven Emirs. The external and internal challenges faced by United Arab Emirates are some security and political issues and in the field of business. …

Hiv/Aids: Nigeria, Lauren Tropinski

Global Issues in Public Health

Nigeria has one of the largest prevalence rates of HIV infections in Africa. HIV is a communicable disease that is transmitted by bodily fluids through unprotected sex, using contaminated needles, or mother to child. The most affected populations include heterosexuals who have unprotected sex, followed by sex workers, and men who have sex with men. People will experience three stages of HIV before the last stage referred to as AIDS. Rapid diagnostic tests are used to diagnose the disease. There is no cure for HIV/AIDS. However, people with HIV are given antiretrovirals to keep HIV at a low level throughout …

Skin Cancer: Causes, Prevention, And Treatment, Lauren Queen

Senior Honors Theses

The purpose of this thesis is to analyze the causes, prevention, and treatment of skin cancer. Skin cancers are defined as either malignant or benign cells that typically arise from excessive exposure to UV radiation. Arguably, skin cancer is a type of cancer that can most easily be prevented; prevention of skin cancer is relatively simple, but often ignored. An important aspect in discussing the epidemiology of skin cancer is understanding the treatments that are available, as well as the prevention methods that can be implemented in every day practice. It is estimated that one in five Americans will develop …

Israel : Translocation Of Rabies, Sarah Baker

Global Public Health

Israel is now faced with a steady growing public health threat as canine rabies has reemerged in the northern region of Israel. While the steady increase in cases is of notable alarm, moreover the close contact most often shared between dog and human populations is of much more concern from a public health prospective. Rabies is a vaccine-preventable disease. Vaccinating dogs has proven to be the most cost-effective strategy for preventing rabies in people. Additionally, education on bite prevention and rabid animal behaviors for both children and adults is an essential extension of the long term rabies vaccination program that …

Towards An Integrated Primary And Secondary Hiv Prevention Continuum For The United States: A Cyclical Process Model, Tim Horn, Jennifer Sherwood, Robert H. Remien, Denis Nash, Judith D. Auerbach

Publications and Research

Introduction: Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized.

Discussion: We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well …

Defining And Targeting Health Disparities In Chronic Obstructive Pulmonary Disease, Roy A. Pleasants, Isaretta L. Riley, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

The global burden of chronic obstructive pulmonary disease (COPD) continues to grow in part due to better outcomes in other major diseases and in part because a substantial portion of the worldwide population continues to be exposed to inhalant toxins. However, a disproportionate burden of COPD occurs in people of low socioeconomic status (SES) due to differences in health behaviors, sociopolitical factors, and social and structural environmental exposures. Tobacco use, occupations with exposure to inhalant toxins, and indoor biomass fuel (BF) exposure are more common in low SES populations. Not only does SES affect the risk of developing COPD and …

Using A Tailored Health Information Technology- Driven Intervention To Improve Health Literacy And Medication Adherence In A Pakistani Population With Vascular Disease (Talking Rx) - Study Protocol For A Randomized Controlled Trial, Ayeesha Kamran Kamal, Abdul Muqeet, Kashfa Farhat, Wardah Khalid, Anum Jamil, Ambreen Gowani, Aliya Amin Muhammad, Fabiha Zaidi, Danyal Khan, Touseef Elahi, Shahrukh Sharif, Syedah Saira Bokhari, Nasir Rahman, Fateh Ali Tipoo Sultan, Saleem Sayani, Salim S. Virani

Section of Internal Medicine

Background: Vascular disease, manifesting as myocardial infarction and stroke, is a major cause of morbidity and mortality, especially in low- and middle-income countries. Current estimates are that only one in six patients have good adherence to medications and very few have sufficient health literacy. Our aim is to explore the effectiveness and acceptability of Prescription Interactive Voice Response (IVR) Talking Prescriptions (Talking Rx) and SMS reminders in increasing medication adherence and health literacy in Pakistani patients with vascular disease.
Methods: This is a randomized, controlled, single center trial. Adult participants, with access to a cell phone and a history of …

The Role Of Occupational Therapy In The Prevention Of Infant Torticollis & Plagiocephaly, Anne H. Zachry

Faculty Presentations

AOTA includes health promotion as an Intervention approach in the Occupational Therapy Practice Framework: Domain and Process. As health care professionals, occupational therapy practitioners are responsible for promoting public health and wellness. Occupational therapists need to educate parents and caregivers about the importance of varying infant positions, providing tummy time, and limiting infant time spent in baby gear.