Medicine and Health Sciences Commons^™

The Re-Emerging Association Between Tuberculosis And Diabetes: Lessons From Past Centuries, Jose Cadena, Selvalakshmi Rathinavelu, Juan Carlos Lopez Alvarenga, Blanca I. Restrepo

School of Medicine Publications

The association between tuberculosis (TB) and diabetes mellitus (DM) had a common place in the literature up to the first half of the 20th century, but virtually disappeared with the discovery of insulin to treat DM and antibiotics to cure TB. In the late 1990s the literature began to re-emerge with the worldwide increase in type 2 DM, particularly in TB-endemic countries. Today, type 2 DM is the most prevalent comorbidity among TB patients and the World Health Organization considers it a threat to TB control. We summarize the literature on TB and DM up to the 1960s. Then we …

Novel Pharmacological Therapy In Type 2 Diabetes Mellitus With Established Cardiovascular Disease: Current Evidence, Leonardo Pozo, Fatimah Bello, Andres Suarez, Francisco E. Ochoa-Martinez, Yamely Mendez, Chelsea H. Chang, Salim Surani

School of Medicine Publications

Cardiovascular diseases (CVDs) remain the leading cause of death in the world and in most developed countries. Patients with type 2 diabetes mellitus (T2DM) suffer from both microvascular and macrovascular diseases and therefore have higher rates of morbidity and mortality compared to those without T2DM. If current trends continue, the Center for Disease Control and Prevention estimates that 1 in 3 Americans will have T2DM by year 2050. As a consequence of the controversy surrounding rosiglitazone and the increasing prevalence of diabetes and CVDs, in 2008 the Food and Drug Administration (FDA) established new expectations for the evaluation of new …

Metabolic Control, Quality Of Life, And Body Image In Patients With Glycogen Storage Disease Type Ia, Alexa Bream

Dissertations and Theses (Open Access)

Glycogen storage disease is a group of inborn errors of metabolism, with type Ia being the most common form of the disorder. Glycogen storage disease type Ia (GSDIa) is a multisystemic condition in which individuals have various complications secondary to an inability to properly break down glycogen and to perform gluconeogenesis. Complex management is then necessary for patients and includes dietary modification, frequent cornstarch usage, and evaluation for additional complications such as hepatic adenomas, hypertriglyceridemia, and kidney disease. Previous studies have found lower scores in quality of life and body image in GSDIa patients; however, the specific factors influencing this …

The 5-Ht1a-R Knockout Mouse As A Model Of Later Life Anxiety Disorders: Implications For Sex Differences, Tatyana Budylin

Dissertations, Theses, and Capstone Projects

Anxiety affects nearly twice as many women as it affects men across all cultures and economic groups. Importantly, girls have a higher chance of inheriting anxiety disorders than boys, and many anxiety disorders appear at a very young age. However, little is known about sex differences in brain and behavioral development and how they relate to anxiety in adulthood. Serotonin 1A receptor (5-HT_1A-R) mediated signaling has been implicated in depression and anxiety, however most studies that focus on the involvement of the 5-HT_1A-R have been conducted in adults. Little is known about how the 5-HT_{1A …}

Modelling Appropriate Use Of Trypanocides To Restrict Wide-Spread Multi-Drug Resistance During Chemotherapy Of Animal African Trypanosomiasis, Ibrahim I. Wangwe, Sarah A. Wamwenje, Caroline Mirieri, Nicodemus M. Masila, Lillian Wambua, Benard W. Kulohoma

All Peer-Reviewed Publications

Trypanocide resistance remains a huge challenge in the management of animal African trypanosomiasis. Paucity of data on the prevalence of multi-drug resistant trypanosomes has greatly hindered optimal veterinary management practices. We use mathematical model predictions to highlight appropriate drug regimens that impede trypanocide resistance development in cattle. We demonstrate that using drugs in decreasing resistance order results in a negligible increase in number of cattle with resistant infection, in contrast to a more pronounced increase from trypanocide use in increasing resistance order. We demonstrate that the lowest levels of trypanocide resistance are achieved with combination therapy. We also show that …

The Incidence, Aetiology, And Adverse Clinical Consequences Of Less Severe Diarrhoeal Episodes Among Infants And Children Residing In Low-Income And Middle-Income Countries: A 12-Month Case-Control Study As A Follow-On To The Global Enteric Multicenter Study (Gems), Karen L. Kotloff, Dilruba Nasrin, William C. Blackwelder, Yukun Wu, Tamer Farag, Sandra Panchalingham, Samba O. Sow, Anita K. M. Zaidi, Shahida Qureshi, Farheen Quadri

Department of Paediatrics and Child Health

Background: Diarrheal diseases remain a leading cause of illness and death among children younger than 5 years in low-income and middle-income countries. The Global Enteric Multicenter Study (GEMS) has described the incidence, aetiology, and sequelae of medically attended moderate-to-severe diarrhoea (MSD) among children aged 0-59 months residing in censused populations in sub-Saharan Africa and south Asia, where most child deaths occur. To further characterise this disease burden and guide interventions, we extended this study to include children with episodes of less-severe diarrhoea (LSD) seeking care at health centres serving six GEMS sites.
Methods: We report a 1-year, multisite, age-stratified, matched …

Characterization Of Extracellular Vesicles From Human Diabetic Retinopathy Retinal Tissue In Vitro And From Urine Of Human Patients With Diabetic Retinopathy, Jason Mighty

Dissertations, Theses, and Capstone Projects

Diabetic Retinopathy (DR) is a neurovascular complication associated with diabetes mellitus that affects approximately 120 million people worldwide and its prevalence is expected to reach 190 million by 2030. DR diagnosis is accomplished with fundus ophthalmoscopy often when retinal damage and vision loss have already occurred. A group of biomarker being explored for early detection of diseases are extracellular vesicles (EVs), which are nanometer diameter lipid enclosed vesicles, released from all cell types and containing genetic cargo reflective of releasing cell state. EV biomarkers are currently being explored to help monitor disease predisposition, pathogenesis and response to treatment. While an …

The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu

Electronic Theses and Dissertations

Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data …

The Impacts Of Administering Metabolites Of Saccharomyces Cerevisiae On Broiler Performance, Yields And Salmonella Content Of Component Portions, Bill Douglas Potter

Graduate Theses and Dissertations

The impacts of using health-promoting Saccharomyces cerevisiae fermentation metabolites in poultry production and processing can be measured in respect to multiple measures of success. Traditionally this yeast-based compound has been administered to poultry, livestock, poultry, and other species to improve animal performance and production volume output. In addition, Saccharomyces cerevisiae fermentation metabolites have also been shown in more recent research to reduce colonization of pathogenic bacteria in the host organism’s gastro-intestinal tract. In this dissertation, the impacts of administering a functional ingredient containing Saccharomyces cerevisiae metabolites on broiler performance measures and pathogen reduction were measured. One of the studies in …

Development And Evaluation Of Selected Chemoprophylaxis Candidates And A Candidate Live-Attenuated Vaccine For Prevention Of Histomoniasis In Turkeys, Lesleigh Beer

Graduate Theses and Dissertations

Histomoniasis, commonly known as blackhead disease, has increased in prevalence due to the regulatory ban of prophylactics and therapeutics within the past 30 years. The objective of this thesis was to evaluate the efficacy of selected dietary chemoprophylaxis candidates as well as an in vitro live-attenuated vaccine candidate Histomonas meleagridis for prevention of histomoniasis. Chapter one addresses deoxycholic acid and a biliogenic diet intended to endogenously increase production of this secondary bile acid. Deoxycholic acid was effective in vitro but failed to prevent histomoniasis when evaluated during the in vivo experimental disease trial with turkeys. The biliogenic diet did not …

Reducing The Risk: Psychological And Technological Approaches For Improving Handwashing Practices In The Foodservice Industry, Jeffrey Allan Clark

Graduate Theses and Dissertations

As Americans are spending greater portions of their dollar on food consumed outside the home, the foodservice industry plays more of an integral part of daily existence compared to previous generations. Given the numerous annual foodborne illness outbreaks that threaten human lives while undermining confidence in the food supply, food safety is a pertinent issue for industry stakeholders, government regulators, and consumers. Food worker handwashing reduces the risk of foodborne illness transmission, yet compliance with this simple behavior is a complex problem. This dissertation addresses, predominantly, the issue of sub-optimal handwashing practices through applying psychology and technology, including wearable computers …

Biomarkers Of Dietary Omega-6 Fatty Acids And Incident Cardiovascular Disease And Mortality: An Individual-Level Pooled Analysis Of 30 Cohort Studies, Matti Marklund, Jason H. Y. Wu, Fumiaki Imamura, Liana C. Del Gobbo, Amanda Fretts, Janette De Goede, Peilin Shi, Nathan L. Tintle, Maria Wennberg, Stella Aslibekyan, Tzu-An Chen, Marcia C. De Oliveira Otto, Yoichiro Hirakawa, Helle Højmark Eriksen, Janine Kroger, Federica Laguzzi, Maria Lankinen, Rachel A. Murphy, Kiesha Prem, Cecelia Samieri, Jyrki Virtanen, Alexis C. Wood, Kerry Wong, Wei-Sin Yang, Xia Zhou, Ana Baylin, Jolanda M. A. Boer, Ingeborg A. Brouwer, Hannia Campos, Paulo H. M. Chaves, Kuo-Liong Chien, Ulf De Faire, Luc Djousse, Gudny Eiriksdottir, Naglaa El-Abbadi, Nita G. Fouruhi, J. Michael Gaziano, Johanna M. Geleijnse, Bruna Gigante, Graham Giles, Eliseo Guallar, Vilmundur Gudnason, Tamara Harris, William S. Harris, Catherine Helmer, Mai-Lis Hellenius, Allison Hodge, Frank B. Hu, Paul F. Jacques, Jan-Hakan Jansson, Anya Kalsbeek, Kay-Tee Khaw, Woon-Puay Koh, Markku Laakso, Karin Leander, Hung-Ju Lin, Lars Lind, Robert Luben, Juhua Luo, Barbara Mcknight, Jaakko Mursu, Toshiharu Ninomiya, Kim Overvad, Bruce M. Psaty, Eric Rimm, Matthias B. Schulze, David Siscovick, Michael Skjelbo Nielsen, Albert V. Smith, Brian T. Steffen, Lyn Steffen, Qi Sun, Johan Sundstrom, Michael Y. Tsai, Hugh Tunstall-Pedoe, Matti I. J. Uusitupa, Rob M. Van Dam, Jenna Veenstra, Monique Verschuren, Nick Wareham, Walter Willett, Mark Woodward, Jian-Min Yuan, Renata Micha, Rozenn N. Lemaitre, Dariush Mozaffarian, Ulf Risérus

Faculty Work Comprehensive List

BACKGROUND: Global dietary recommendations for and cardiovascular effects of linoleic acid, the major dietary omega-6 fatty acid, and its major metabolite, arachidonic acid, remain controversial. To address this uncertainty and inform international recommendations, we evaluated how in vivo circulating and tissue levels of linoleic acid (LA) and arachidonic acid (AA) relate to incident cardiovascular disease (CVD) across multiple international studies.

METHODS: We performed harmonized, de novo, individual-level analyses in a global consortium of 30 prospective observational studies from 13 countries. Multivariable-adjusted associations of circulating and adipose tissue LA and AA biomarkers with incident total CVD and subtypes (coronary heart disease, …

Prions To Pathways: Safeguarding Against Creutzfeldt-Jakob Disease In The Operating Room, Jessica Mary Adams Atkinson, Sonja Carol Orff

MaineHealth Maine Medical Center

Introduction:

As defined by the Center for Disease Control (CDC, 2018), Creutzfeldt-Jakob Disease (CJD) is a rapidly progressive, rare, transmissible, and fatal illness. Miscoiling of healthy proteins caused by an abnormal isoform of cellular glycoprotein resulting in protein folding has been found to be the molecular mechanism during the pathological process of this malady (Figure 1), (Castle, Gill, 2017). The current problem is that few recommendations are available for organizations to consider how to manage potential CJD patient cases, and institutions are left to compile and develop their own guidelines and/or protocols for clinical practice. The standards of care for …

Novel Mechanisms And Biomarkers In Alcohol-Induced Organ Injury., Christine E. Dolin

Electronic Theses and Dissertations

Background. Ethanol (EtOH) consumption is known to affect multiple organs; this is unsurprising, as the concentration of EtOH in the blood at relevant doses reaches the millimolar range. The overarching goal of this dissertation was to elucidate mechanisms of alcohol-induced organ injury, specifically the effects of alcohol on the hepatic extracellular matrix (ECM) proteome, the alcoholic hepatitis (AH) plasma peptidome, and the effects of alcohol on the renal cortex proteome and transcriptome. Methods. Mice were pair-fed ethanol-containing liquid diet chronically, and then some mice were administered lipopolysaccharide (LPS). Liver sections from these mice were processed in a series of increasingly …

Kounis Syndrome: A Simple Mri With Contrast Turned Into A Life Threatening Condition, Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Mehiar El-Hamdani

Marshall Journal of Medicine

Kounis syndrome [KS] is a hypersensitivity coronary disorder induced by various allergens. It is a rare condition which has been reported in every age group (2-90 years), every race and geographic location, its incidence has been reported to range from 7.9 to 19.4 per 100,000. The presentation of the detrimental effects of KS on coronary arteries ranges from vasospastic angina to allergic myocardial infarction.

Drugs are the major iatrogenic cause of KS, but virtually everything in the environment around us can cause KS. In recent years contrast mediums used in the radiologic investigation have come forth as a leading cause …

The Effect Of Antihypertensive Dosing On Hypertension In Children With Chronic Kidney Disease, Benjamin A. Matta, Uri S. Alon, Bradley Warady Md, Tarak Srivastava, Darcy Weidemann

Posters

Background

Hypertension (HTN) is a highly prevalent and major risk factor for poor cardiovascular and renal outcomes in chronic kidney disease (CKD). Previous research suggests that HTN is underdiagnosed and undertreated in children with CKD. To our knowledge no studies have investigated the effect of antihypertensive (antiHTN) dose on blood pressure (BP) control in this population.

Objective

To determine the effect of antiHTN dose on HTN status in children with CKD.

Methods

Study population: 255 participants studied in the Chronic Kidney Disease in Children (CKiD) study at their 3rd visit, taking at least 1 antiHTN drug.

Cumulative Drug Dose Index …

Suffering In Silence: Is Gastroparesis Underdiagnosed?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this introduction to Volume 6, Issue 2, the editor-in-chief of the Journal of Patient-Centered Research and Reviews offers additional comment to the clinical review of diabetic gastroparesis authored by Farmer and colleagues (p. 148), regarding the problem of undiagnosed disease. Increased awareness of this entity and appropriate questioning regarding symptoms of diabetic gastroparesis in the primary care setting may prevent the “suffering in silence” experienced by many patients with this complication.

Variation And Change Over Time In Promis-29 Survey Results Among Primary Care Patients With Type 2 Diabetes, Juell Homco, Kristin Rodriguez, David R. Bardach, Elizabeth A. Hahn, Suzanne Morton, Daren Anderson, David Kendrick, Sarah Hudson Scholle

Journal of Patient-Centered Research and Reviews

Purpose: We sought to describe results of patient-reported outcome measures implemented among primary care patients with diabetes and explore factors associated with changes in scores over time.

Methods: Two organizations serving diverse patient populations collected the PROMIS-29 survey at baseline and 3-month follow-up for patients with type 2 diabetes. Bayesian regression analysis was used to examine the relationship between patient characteristics and changes in PROMIS-29 scores. Exploratory analyses assessed relationships between goal-setting and changes in scores.

Results: The study population reported substantially more problems with physical functioning (mean: 42.5 at Site 1 and 38.9 at Site 2) and pain interference …

Diabetic Gastroparesis: Perspectives From A Patient And Health Care Providers, Adam D. Farmer, Caroline E. Bruckner-Holt, Susanne Schwartz, Emma Sadler, Sri Kadirkamanthan

Journal of Patient-Centered Research and Reviews

Gastroparesis is defined as a delay in gastric emptying in the absence of mechanical obstruction in the stomach. Gastroparesis has a number of causes, including postsurgical, secondary to medications, postinfectious, idiopathic, and as a complication of diabetes mellitus, where it is underrecognized. The cardinal symptoms of diabetic gastroparesis are nausea, early satiety, bloating, and vomiting. Diabetic gastroparesis is more common in females and has a cumulative incidence of 5% in type 1 diabetes and 1% in type 2 diabetes. It is associated with a reduction in quality of life and exerts a significant burden on health care resources. The pathophysiology …

Medically Tailored Meals As A Prescription For Treatment Of Food-Insecure Type 2 Diabetics, Leslie J. Rabaut

Journal of Patient-Centered Research and Reviews

Type 2 diabetes mellitus is an immense burden to the health of our population and to our current health care system, and the weight of this burden is only projected to multiply in coming years. A nutritious diet is an indispensable aspect of diabetes treatment, and the lack of access to food engenders poor disease-state control, which correlates with increased health care utilization. Interventions aimed at improving access to food through medically tailored meals (MTMs) have demonstrated effectiveness in improving the health of food-insecure type 2 diabetic patients and reducing health care costs. Further studies are necessary to increase the …

Improving Bronchiolitis Care Across Multiple Care Settings Using A Deimplementation Bundle, Amanda Nedved, Kathleen Berg, Troy Richardson, Amanda Montalbano, Matthew B. Johnson

Posters

Despite the availability of a bronchiolitis CPG; variation in care practices still existed at our institution. The aim of our quality improvement (QI) project was to increase overall adherence with our institutional CPG in patients 60 days to 24 months of age diagnosed with bronchiolitis in the urgent care centers (UCC), emergency departments (ED), and general inpatient units from a baseline of 40.9% to 60% by the end of two bronchiolitis seasons.

Gracilis Myocutaneous Flap For Perineal Defect Reconstruction After Left Hemivulvectomy For Locally Invasive Vulvar Cancer – A Case Report And A Literature Review, Nicolae Bacalbasa, Irina Balescu, Andreea Mereuta, Alina Tanase, Adriana Ghelmene, Mihaela Vilcu, Iulian Brezean

Journal of Mind and Medical Sciences

Performing radical surgery for locally advanced vulvar cancer is usually associated with the occurrence of large perineal defects. In order to provide a better healing process of the perineal wound, different reconstructive techniques have been proposed.

We present the case of a 63-year-old female patient diagnosed with locally advanced vulvar cancer for which a left hemivulvectomy with bilateral inguinal lymph node dissection was performed. After completion of the resection phase, the reconstruction with gracilis myocutaneous flap was performed. The patient developed a non-union of the flap. However, it slowly healed without any surgical re-intervention.

Gracilis myocutaneous flap seems to be …

Xanthogranulomatous Pyelonephritis: Presentation And Management, Răzvan C. Petca, Răzvan I. Popescu, Cristian Mareș, Claudia Mehedințu, Bogdan Mastalier, Dumitru Cristinel Badiu, Nicoleta Măru, Vlad D. Constantin, Aida Petca

Journal of Mind and Medical Sciences

Xanthogranulomatous pyelonephritis (XGP) is characterized by the presence of lipid-laden foamy macrophages with both acute and chronic phase inflammatory cells. The aim of the study is to present our experience about patients with Xanthogranulomatous pyelonephritis. 29 patients were evaluated through a complete anamnesis and the preoperative management included routine blood and biochemical tests, urine culture and renal ultrasound, intravenous urography and computed tomography (CT). All patients underwent open nephrectomy followed by the pathological exam. The main symptoms of these patients were fever and flank pain. Preoperative laboratory tests revealed anemia, leukocytosis and increasing levels of blood urea nitrogen (BUN) and …

Immune And Inflammatory Pathways In Non-Alcoholic Steatohepatitis (Nash). An Update, Sorina Cezara Coste, Ionela Popovici, Andreea Maria Stefan, Iulia Breaban, Adela Sitar Taut, Simina Tarmure Sarlea, Angela Cozma, Dorel Sampelean, Olga Hilda Orasan, Vasile Negrean, Lucia Maria Procopciuc

Journal of Mind and Medical Sciences

Non-alcoholic steatohepatitis (NASH), also known as fatty liver disease (FLD), is a major public health problem. It is considered to be the hepatic manifestation of the metabolic syndrome. Chronic inflammation of the liver is an essential key in the progression from simple hepatic steatosis to steatohepatitis, the evolutionary stage of fatty liver disease. Moreover, the innate immune system plays a crucial role in the progression of hepatic inflammation. For this reason, it is of utmost importance to elucidate the connections between immune mechanisms, Toll-like receptor cytokine signalling, in order to find new effective treatments. Further studies are necessary to test …

The Relationship Between Gut Microbiota And Spontaneous Bacterial Peritonitis In Patients With Liver Cirrhosis - A Literature Review, Roxana-Emanuela Popoiag, Anca Mihaela Pantea Stoian, Adrian P. Suceveanu, Andra I. Suceveanu, Laura Mazilu, Irinel R. Parepa, Laura M. Serban, Mihai Paunica, Catalina Motofei, Carmen Fierbinteanu Braticevici

Journal of Mind and Medical Sciences

Gut microbiota is an essential component in the pathogenesis of liver cirrhosis and its complications. There is a direct relationship between the gut and the liver called the gutliver axis through which bacteria can reach the liver through the portal venous blood. However, it remains unclear how bacteria leave the intestine and reach the fluid collection in the abdomen. A series of mechanisms have been postulated to be involved in the pathogenesis of spontaneous bacterial peritonitis (SBP) and other complications of liver cirrhosis, including bacterial translocation, bacterial overgrowth, altered intestinal permeability and dysfunctional immunity. The hepatic function may also be …

Physical Exercise – The Friend Or The Enemy Of The Patient With Pulmonary Tuberculosis?, Victoria Maria Ruta, Teodora Gabriela Alexescu, Simina Tarmure, Vasile Negrean, Monica Carmen Pop, Nicoleta Motoc, Iulia Olimpia Pfingstgraf, Mirela Georgiana Perne, Lorena Ciumarnean, Simona Valeria Clichici, Adina Milena Man

Journal of Mind and Medical Sciences

Introduction. Tuberculosis, a major cause of morbidity and mortality, is the second cause of death from an infectious disease, after HIV/AIDS. Each second, a new infection occurs around the globe. Pulmonary tuberculosis can equally affect a performance athlete as well as an aspiring athlete. Physical exercise must be individualized and customized. Pulmonary rehabilitation guides 3 recommend types of exercises for patients with obstructive pathology: stretching, cardiovascular exercise or aerobics. Exercises must be started under medical supervision and must be interrupted if: the ventricular altitude increases above the maximum estimated level for the age, oxygen saturation (SaO2). Aim. The current review …

Total And Free Plasma Bilirubin And Clinical Outcomes In Severe Hyperbilirubinemia, Sean M. Riordan, Jean-Baptiste Lepichon, Steven Shapiro, Tina Slusher, Fatima Abdullahi, Hafsat M. Suleiman, Victor C. Pam, Mamu B. Samuel, Christopher S. Yilgwan, Christian Isichei, Idris Y. Mohammed

Posters

Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) have become relatively uncommon in high income countries but remain a major cause of morbidity and mortality in low- and middle-income countries. To better understand the relationship between free (Bf) and total (TB) bilirubin levels and the development of ABE and KSD we followed infants born in three large tertiary centers in northern and central Nigeria (Jos, Kano and Zaria).

Weighted Pathway Genetic Load Analysis Of Hyperbilirubinemic Infants Indicates A Potential Genetic Component For Susceptibility To Bilirubin Neurotoxicity, Sean M. Riordan, Jean-Baptiste Lepichon, Steven Shapiro, John Cowden, Monica Villagullen, Laurence Thielemans, Dina Villanueva Garcia, Jesus Aguirre-Hernandez

Posters

Severe kernicterus spectrum disorder (KSD) is described as motor and auditory deficits resulting from brain damage caused by hyperbilirubinemia. The severity of HB does not always predict the severity of injury. The lack of a strong monogenetic link to susceptibility suggests bilirubin-induced brain damage may be due to impaired bilirubin response pathways. This poster describes work to use a modified pathway genetic load (mPGL) score method to perform a targeted genetic analysis of whole exome data from patients with various degrees of neonatal HB, with an ultimate goal of developing a neonatal screen to susceptibiltiy to bilirubin neurotoxicity.

Prevention Of Oral Mucositis In Cancer Patients, Patricia E. Biel

Evidence-Based Practice Project Reports

Oral mucositis [OM] is one of the most severe non-hematological problems related to cancer treatments and can impact quality of life. It is linked to poorer outcomes due to the associated weight loss, pain, dehydration, and risk of developing life-threatening infections. The purpose of this evidence-based practice project was to determine if OM is preventable with the use of an oral care protocol and zinc supplementation when compared to use of oral care protocols alone. The Johns Hopkins Nursing Evidence-Based Practice Model was used to guide project implementation in an outpatient oncology office. Recommendations were developed from an exhaustive review …

Direct Lung Sampling Indicates That Established Pathogens Dominate Early Infections In Children With Cystic Fibrosis., Peter Jorth, Zarmina Ehsan Md, Amir Rezayat, Ellen Caldwell, Christopher Pope, John J. Brewington, Christopher H. Goss, Dan Benscoter, John P. Clancy, Pradeep K. Singh

Manuscripts, Articles, Book Chapters and Other Papers

Culture and sequencing have produced divergent hypotheses about cystic fibrosis (CF) lung infections. Culturing suggests that CF lungs are uninfected before colonization by a limited group of CF pathogens. Sequencing suggests diverse communities of mostly oral bacteria inhabit lungs early on and diversity decreases as disease progresses. We studied the lung microbiota of CF children using bronchoscopy and sequencing, with measures to reduce contamination. We found no evidence for oral bacterial communities in lung lavages that lacked CF pathogens. Lavage microbial diversity varied widely, but decreases in diversity appeared to be driven by increased CF pathogen abundance, which reduced the …