Medicine and Health Sciences Commons^™

Cronobacter Sakazakii Bacteremia In A 76-Year-Old Woman: A Case Report, Amy Y. Kang, Nancy Garcia, Bhanu Sud, Lee Nguyen

Pharmacy Faculty Articles and Research

Cronobacter sakazakii, commonly found in contaminated infant formula and thereby causes infantile bacteremia, is rarely associated with adult bacteremia. We present the tenth case of C. sakazakii bacteremia in adults. The patient is a 76-year-old woman who resides in a skilled nursing facility and presents with risk factors including bullous pemphigoid, Type II diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, and anemia. The therapy was started with intravenous ciprofloxacin and vancomycinempirically. After consultation with an Infectious Diseases specialist, ciprofloxacin and vancomycin was replaced with meropenem based on the patient’s extensive bullous lesions, history of ESBL infections, and possible pneumonia. Later, …

Accelerating The Dual Elimination Of Mother‐To‐Child Transmission Of Syphilis And Hiv: Why Now?, James Kiarie, Chandra K. Mishra, Marleen Temmerman, Lori Newman

Obstetrics and Gynaecology, East Africa

Even though the elimination of congenital syphilis has been on the maternal and child health (MCH) agenda for over a decade, elimination has not yet been achieved; what, then, are the factors currently facilitating the elimination of mother-to-child transmission (MTCT) of syphilis?

Long-Term Risk Of Type 2 Diabetes Mellitus In Relation To Bmi And Weight Change Among Women With A History Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Edwina Yeung, Deirdre K. Tobias, Frank B. Hu, Allan A. Vaag, Jorge Chavarro, James L. Mills, Louise Groth Grunnet, Katherine Bowers, Sylvia H. Ley, Michele Kiely, Sjurdur F. Olsen, Cuilin Zhang

Publications and Research

Aims/hypothesis—Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM.

Methods—We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women’s Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% …

Tslp-Induced Mechanisms And Potential Therapies For Crlf2 B-Cell Acute Lymphoblastic Leukemia, Olivia L. Francis

Loma Linda University Electronic Theses, Dissertations & Projects

Childhood CRLF2 B-cell Acute Lymphoblastic Leukemia (CRLF2 B-ALL) is a high-risk form of leukemia that is associated with poor patient survival outcomes. CRLF2 B-ALL is five times more prevalent in Hispanic children than others and is associated with a higher rate of relapse, thus contributing significantly to childhood cancer health disparities. This disease occurs due to alterations of the CRLF2 gene, leading to overexpression of the CRLF2 protein- a component of the receptor signaling complex for the cytokine Thymic Stromal LymphoPoietin (TSLP) on the surface of B-ALL cells. TSLP has been shown to induce proliferation of human and mouse B-cell …

Secretion Of Heat-Labile Enterotoxin By Porcine-Origin Enterotoxigenic Escherichia Coli And Relation To Virulence, Prageeth Rukshan Wijemanne

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Heat-labile enterotoxin (LT) is an important virulence factor secreted by some strains of porcine-origin enterotoxigenic Escherichia coli (pETEC). The prototypic human-origin strain H10407 secretes LT via a type II secretion system (T2SS), but its presence or importance in pETEC has not been established. Exposure of pETEC to glucose has been shown to result in different secretion levels of LT. Furthermore, the relationship between the level of LT secreted and the virulence potential of the respective pETEC strain has not been established. To determine the relationship between the capacity to secrete LT and virulence in wild-type (WT) pETEC, 16 strains isolated …

Treating The Patient Who Has The Disease, Emily J Gibson

The Texas Heart Institute Journal

No abstract provided.

Symptoms Of Depression Among Patients Attending A Diabetes Care Clinic In Rural Western Kenya, Kristen Shirey, Simon M. Manyara, Lukoye Atwoli, Ryan Tomlin, Benson Gakinya, Stephanie Cheng, Jemima Kamano, Jeremiah Laktabai, Sonak Pastakia

Internal Medicine, East Africa

Objective: The prevalence of diabetes in sub-Saharan Africa is rising, but its relationship to depression is not well-characterized. This report describes depressive symptom prevalence and associations with adherence and outcomes among patients with diabetes in a rural, resource-constrained setting.

Methods: In the Webuye, Kenya diabetes clinic, we conducted a chart review, analyzing data including medication adherence, hemoglobin A1c (HbA1c), clinic attendance, and PHQ-2 depression screening results.

Results: Among 253 patients, 20.9% screened positive for depression. Prevalence in females was higher than in males; 27% vs 15% (p = 0.023). Glycemic control trends were better in those screening negative; at 24 …

Association Of Markers Of Inflammation With Sleep And Physical Activity Among People Living With Hiv Or Aids, Michael D. Wirth, Jason R. Jaggers, Wesley D. Dudgeon, James R. Hebert, Shawn D. Youngstedt, Steven N. Blair, Gregory A. Hand

Faculty and Staff Scholarship

This study examined associations of sleep and minutes spent in moderate-vigorous physical activity (MVPA) with C-reactive protein (CRP) and interleukin (IL)-6 among persons living with HIV (PLWH). Cross-sectional analyses (n=45) focused on associations of inflammatory outcomes (i.e., CRP and IL-6) with actigraph-derived sleep duration, latency, and efficiency; bedtime; wake time; and wake-after-sleep-onset; as well as MVPA. Least square means for CRP and IL-6 by levels of sleep and MVPA were computed from general linear models. Individuals below the median of sleep duration, above the median for bedtime, and below the median of MVPA minutes had higher CRP or IL-6 levels. …

Magnetic Resonance Imaging In Pediatric Pulmonary Hypertension, Ayhan Pektas, Rana Olgunturk, Ayhan Cevik, Semiha Terlemez, Emre Kacar, Yusuf Ali Oner

The Texas Heart Institute Journal

The present study aims to determine the efficacy and reliability of cardiovascular magnetic resonance imaging in establishing the diagnosis and prognosis of pulmonary hypertension in children.

This is a retrospective comparison of 25 children with pulmonary hypertension and a control group comprising 19 healthy children. The diagnosis of pulmonary hypertension was made when the mean pulmonary artery pressure was ≥25 mmHg by catheter angiography.

The children with pulmonary hypertension had significantly lower body mass indices than did the healthy children (P=0.048). In addition, the children with pulmonary hypertension had significantly larger main pulmonary artery diameters and ascending aortic diameters (both …

Is Autologous Or Heterologous Pericardium Better For Valvuloplasty? A Comparative Study Of Calcification Propensity, Wen-Jian Jiang, Yong-Chao Cui, Jin-Hua Li, Xiu-Hui Zhang, Huan-Huan Ding, Yong-Qiang Lai, Hong-Jia Zhang

The Texas Heart Institute Journal

Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium.

We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at …

Is Autologous Or Heterologous Pericardium Better For Valvuloplasty? A Comparative Study Of Calcification Propensity, Arthur W Bracey

The Texas Heart Institute Journal

No abstract provided.

Target-Specific Oral Anticoagulants: Should We Switch From Warfarin?, Payam Safavi-Naeini, Mohammad Saeed

The Texas Heart Institute Journal

No abstract provided.

Overcoming The Fear Of The Lion: A Courageous Film About Genetic Testing And Huntington's Disease, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Distribution And Diversity Of The Vectors Of Rift Valley Fever Along The Livestock Movement Routes In The Northeastern And Coastal Regions Of Kenya, Samwel O. Arum, Christopher W. Weldon, Benedict Orindi, Tobias Landmann, David P. Tchouassi, Hippolyte D. Affognon, Rosemary Sang

All Peer-Reviewed Publications

Background: Knowledge of vector ecology is important in understanding the transmission dynamics of vector borne disease. In this study, we determined the distribution and diversity of mosquitoes along the major nomadic livestock movement routes (LMR) in the traditional pastoral ecozone of northeastern Kenya. We focused on the vectors of Rift Valley fever virus (RVFv) with the aim of understanding their ecology and how they can potentially influence the circulation of RVFv. Methods: Mosquito surveys were conducted during the short and long rainy seasons from November 2012 to August 2014 using CO2-baited CDC light traps at seven sites selected for their …

Heart Failure Patient Self-Care: An Evidence-Based Outpatient Management Program, Christine Marie Ensign, Shelley Hawkins, Barry Greenberg

Doctor of Nursing Practice Final Manuscripts

Background: According to the American Heart Association, there are over 5 million people in the United States with heart failure (HF) and projections suggest the prevalence of HF will increase by 46% through 2030. HF is the most common cause of hospital admissions in the United States for patients age 65 years or older and despite improvement outcomes, national readmission rates remain high at 23%. Current guidelines recommend health professionals provide comprehensive HF education and counseling that is not only focused on knowledge, but also on skills of management and self-care behaviors. In order to achieve quality patient-centered care, …

Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien

Doctor of Nursing Practice Final Manuscripts

Background and Purpose: In the United States, 79 million people are pre-diabetic: most have no symptoms. If left untreated, 37% will develop diabetes within 4 years. Fourteen percent of United States health care expenditures are related to diabetic complications. This Evidenced Based Project (EBP) involved a behavioral lifestyle change with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week. It was also designed to reduce risk factors and glycated hemoglobin A1c (HgA1c) levels.

Methods: The interventional approach was modeled after the Diabetes Prevention Program (DPP) and Group Lifestyle Balance Program. Participants were …

Fatalism, Diabetes Management Outcomes, And The Role Of Religiosity, Vincent Berardi, John Bellettiere, Orit Nativ, Slezak Ladislav, Melbourne Hovell, Orna Baron-Epel

Psychology Faculty Articles and Research

This study aimed to determine whether fatalistic beliefs were associated with elevated levels of glycated hemoglobin (HbA1c) and to establish the role of religiosity in this relationship. A cross-sectional survey was conducted on a sample of 183 Jewish adults with diabetes visiting a large medical center in northern Israel. Self-administered questionnaires assessed level of religiosity, fatalistic beliefs, diabetes management behaviors, and demographic/personal characteristics; laboratory tests were used to measure HbA1c. Multivariate regression indicated that fatalism was significantly associated with HbA1c (β = 0.51, p = 0.01). The association was no longer statistically significant after including self-reported religiosity in the …

Transition After Breast Cancer Treatment: Implementing Survivorship Care Plans, Susan Hope Klein

Doctor of Nursing Practice Final Manuscripts

The success of cancer treatments have resulted in a rapid growth of survivors, providing the impetus for the oncology community to examine models of care supporting smooth transition from active treatment to survivorship care. While initially a recommendation of the Institute of Medicine, treatment summaries and survivorship care plans are now an accreditation requirement for many organizations. This article describes the implementation of an evidence based practice project designed to meet these standards while improving the knowledge and satisfaction of a population of breast cancer patients at a community-based oncology practice.

Preliminary Evaluation Of The Disease Surveillance System During Influenza Outbreaks Of Pandemic Scale, Eric Meisheri, Diana M. Prieto, Peter Holvenstot, Richard Vanenk

Frontiers in Public Health Services and Systems Research

In the United States it is currently unknown whether the influenza surveillance system is capable of producing timely and accurate data for case estimation during an outbreak of pandemic scale. This simulation provides a preliminary evaluation of the surveillance system’s ability to collect data and produce timely and accurate trends of cases confirmed with an influenza virus. For the evaluation, a computer-based simulation of the data-collection process was used, which was validated with real demographic and epidemiologic information. The results were analyzed to determine the most significant behavioral and operational factors influencing the data collection and to propose the exploration …

Amyotrophic Lateral Sclerosis, The Primary Motor Neuron Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Amyotrophic lateral sclerosis is a degenerative neurological disease that damages nerve cells in the brain, in particular the neurons that are involved in voluntary muscle movements. Internationally the disorder is also known as Charcot’s disease and motor neuron disease. In the United States, amyotrophic lateral sclerosis is often referred to as Lou Gehrig’s disease, motor neuron disease, and more colloquially ALS. Amyotrophic Lateral Sclerosis is the most prominent of the five motor neuron diseases, distinguishing itself from the others through degeneration of both upper motor neurons (UMN) and lower motor neurons (LMN) respectively. The “Father of neurology” Jean-Marie Charcot founded …

Novel Advances In Alzheimer's Disease, Jacob P. Naumann

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Alzheimer’s disease, the most common form of dementia in adults, is a progressive degenerative neurological disease that affects memory, cognition, and behavior. Dr. Alois Alzheimer discovered and diagnosed the irreversible disease in 1906 after documenting the famous case of Auguste Deter.¹ Since the discovery of the disease, numerous advances have made it possible to not only better understand the causal factors, but also to improve the medical diagnosis and preventative measures that healthcare providers can implement. For the first time since 1984, the National Institute on Aging (NIAA) and the Alzheimer’s Association (AA) proposed and published new diagnostic guideline …

In-Patient Self-Management Diabetes Education, Amy Matthews

Master's Projects and Capstones

The diabetes program strives to provide diabetes self-management education to the in-patient with diabetes. The specific aim is to improve and standardize diabetes education for the inpatient with diabetes by June 2015. The microsystem is a medical surgical unit for patients 18 years and older who present with diabetes as either a primary diagnosis or secondary diagnosis. Fifty percent of the diabetes patients on this unit are ages 65-89 years old, twenty nine percent are ages 50-64. The unit has 32 beds and is filled to capacity ninety five percent of the time. The fishbone diagram revealed our microsystem lacked …

Cardiovascular Disease Performance Measures In The Outpatient Setting In India: Insights From The American College Of Cardiology's Pinnacle India Quality Improvement Program (Piqip), Ankur Kalra, Yashashwi Pokharel, Ravi S. Hira, Samantha Risch, Veronique Vicera, Qiong Li, Ram N. Kalra, Prafulla G. Kerkar, Ganesh Kumar, Salim S. Virani

Office of the Provost

Background: India has a growing burden of cardiovascular disease (CVD), yet data on the quality of outpatient care for patients with coronary artery disease, heart failure, and atrial fibrillation in India are very limited. We collected data on performance measures for 68 196 unique patients from 10 Indian cardiology outpatient departments from January 1, 2011, to February 5, 2014, in the American College of Cardiology's PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP). PIQIP is India's first national outpatient CVD quality-improvement program.
Methods and results: In the PIQIP registry, we estimated the prevalence of CVD risk factors …

The Search For Huntington's Disease Treatments Is Indeed 'Rocket Science' – And We Can All Help Build The Rocket, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

Functional Analysis Of The Molluscum Contagiosum Virus Mc160 Death Effector Domain-Containing Protein Rxdl Motif, Sarah Weber

Seton Hall University Dissertations and Theses (ETDs)

The Molluscum contagiosum virus (MCV) is a member of the Poxviridae family that causes benign skin lesions. MCV lesions persist on average for 8-12 months in otherwise healthy individuals. MCV lesions are characterized by reduced inflammation. The persistence and reduction of inflammation at the site of MCV lesions have been attributed to MCV immune evasion genes. MCV encodes two death effector domain (DED) containing proteins, MC159 and MC160. DEDs are found in cellular proteins such as FADD and procaspase-8. These cellular proteins are involved in several innate immune responses such as apoptosis and activation of interferon (IFN). Presumably, MC159 and …

Draft Genome Sequences Of Six Different Staphylococcus Epidermidis Clones, Isolated Individually From Preterm Neonates Presenting With Sepsis At Edinburgh's Royal Infirmary, Paul Walsh, M. Bekaert, J. Carroll, T. Manning, B. Kelly, A. O'Driscoll, X. Lu, C. Smith, P. Dickinson, K. Templeton, P. Ghazal, Roy D. Sleator

Department of Biological Sciences Publications

Herein, we report the draft genome sequences of six individual Staphylococcus epidermidis clones, cultivated from blood taken from different preterm neonatal sepsis patients at the Royal Infirmary, Edinburgh, Scotland, United Kingdom.

A Novel Caspase 8 Selective Small Molecule Potentiates Trail-Induced Cell Death, Octavian Bucur, Gabriel Gaidos, Achani Yatawara, Bodvael Pennarun, Chamila Rupasinghe, Jérémie Roux, Stefan Andrei, Bingqian Guo, Alexandra Panaitiu, Maria Pellegrini, Dale Mierke, Roya Khosravi-Far

Dartmouth Scholarship

Recombinant soluble TRAIL and agonistic antibodies against TRAIL receptors (DR4 and DR5) are currently being created for clinical cancer therapy, due to their selective killing of cancer cells and high safety characteristics. However, resistance to TRAIL and other targeted therapies is an important issue facing current cancer research field. An attractive strategy to sensitize resistant malignancies to TRAIL-induced cell death is the design of small molecules that target and promote caspase 8 activation. For the first time, we describe the discovery and characterization of a small molecule that directly binds caspase 8 and enhances its activation when combined with TRAIL, …

Deciphering Signals From Huntington’S Disease Brains In The Search For Treatments, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

The Medical Response To The Black Death, Joseph A. Legan

Senior Honors Projects, 2010-2019

This paper discusses the medical response to the Black Death in both Europe and the Middle East. The Black Death was caused by a series of bacterial strands collectively known as Yersinia pestis. The Plague originated in the Mongolian Steppes. It was spread westward by the east-west trading system. Once it arrived in the Crimea in 1346, Italian merchants helped spread it throughout the Mediterranean. Medicine in Europe and the Middle East were centered on Galen’s theory of humors. There were many religious explanations for the Plague, but the main medical explanation was the spread of bad air, or …

Structural Studies Of The Ig58 Domain Of The Giant Muscle Protein Obscurin, Matthew C. Oehler

Senior Honors Projects, 2010-2019

Obscurin (720-900 kD) is a giant sarcomeric signaling protein that is the only known link

between the cytoskeleton and the surrounding membrane structure. Mutations to obscurin

and to obscurin binding partners have been linked to human muscle diseases such as

hypertrophic cardiomyopathies and muscular dystrophy. These diseases likely occur due

to the abrogation of specific molecular interactions necessary for suitable function. To

more fully understand how specific mutations lead to disease, here we solve the highresolution

structure of obscurin Ig58. The literature shows that an Arg8Gln mutation to

the Ig58 domain of obscurin is associated with hypertrophic cardiomyopathy (HCM).

Chemical …