Diseases Commons^™

Iiv-6 Inhibits Nf-Kappab Responses In Drosophila, Cara C. West, Florentina Rus, Ying Chen, Anni Kleino, Monique Gangloff, Don B. Gammon, Neal S. Silverman

Neal Silverman

The host immune response and virus-encoded immune evasion proteins pose constant, mutual selective pressure on each other. Virally encoded immune evasion proteins also indicate which host pathways must be inhibited to allow for viral replication. Here, we show that IIV-6 is capable of inhibiting the two Drosophila NF-kappaB signaling pathways, Imd and Toll. Antimicrobial peptide (AMP) gene induction downstream of either pathway is suppressed when cells infected with IIV-6 are also stimulated with Toll or Imd ligands. We find that cleavage of both Imd and Relish, as well as Relish nuclear translocation, three key points in Imd signal transduction, occur …

Control Of Antiviral Innate Immune Response By Protein Geranylgeranylation, Shigao Yang, Zhaozhao Jiang, Katherine A. Fitzgerald, Donghai Wang

Katherine A. Fitzgerald

The mitochondrial antiviral signaling protein (MAVS) orchestrates host antiviral innate immune response to RNA virus infection. However, how MAVS signaling is controlled to eradicate virus while preventing self-destructive inflammation remains obscure. Here, we show that protein geranylgeranylation, a posttranslational lipid modification of proteins, limits MAVS-mediated immune signaling by targeting Rho family small guanosine triphosphatase Rac1 into the mitochondria-associated endoplasmic reticulum (ER) membranes (MAMs) at the mitochondria-ER junction. Protein geranylgeranylation and subsequent palmitoylation promote Rac1 translocation into MAMs upon viral infection. MAM-localized Rac1 limits MAVS' interaction with E3 ligase Trim31 and hence inhibits MAVS ubiquitination, aggregation, and activation. Rac1 also facilitates …

Limiting Antibiotic Use In Acute Sinusitis: Partly A Matter Of Vocabulary?, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In his issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on an included article that describes the successful use of an electronic medical record best practice alert to reduce the rate of antibiotic prescription for acute sinusitis. Various methods previously tried to improve antibiotic stewardship in this illness are briefly reviewed. Borrowing on the model of acute bronchitis, it is suggested that a change in conveyed diagnostic vocabulary to “sinus cold” when describing acute sinusitis may help limit antibiotics for this predominantly viral infection.

Interventions To Reduce Neonatal Mortality From Neonatal Tetanus In Low And Middle Income Countries - A Systematic Review, Adeel Ahmed Khan, Aysha Zahidie, F. Rabbani

Fauziah Rabbani

Background In 1988, WHO estimated around 787,000 newborns deaths due to neonatal tetanus. Despite few success stories majority of the Low and Middle Income Countries (LMICs) are still struggling to reduce neonatal mortality due to neonatal tetanus. We conducted a systematic review to understand the interventions that have had a substantial effect on reducing neonatal mortality rate due to neonatal tetanus in LMICs and come up with feasible recommendations for decreasing neonatal tetanus in the Pakistani setting. Methods We systemically reviewed the published literature (Pubmed and Pubget databases) to identify appropriate interventions for reducing tetanus related neonatal mortality. A total …

Tuberculous And Cryptococcal Meningitis In A Setting With High Tb And Low Hiv Prevalence, Afrasyab Khan, Bushra Jamil, Rahmat Ali, Sana Sultan

Bushra Jamil

OBJECTIVE: To compare the differences in presentation and outcome of patients with tuberculous meningitis (TBM) and cryptococcal meningitis (CCM). STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from December 1995 to December 2005. METHODOLOGY: Patients with a confirmed diagnosis of TBM or CCM were included in this study. The signs and symptoms, laboratory findings and other variables of patients were entered and analyzed by Statistical Package for Social Sciences (SPSS) Software version 14. RESULTS: We compared 16 patients of TBM with 11 of CCM. None of the patients with TBM were Human Immunodeficiency …

Dengue Virus Ns2b/Ns3 Protease Inhibitors Exploiting The Prime Side, Kuan-Hung Lin, Akbar Ali, Linah Rusere, Djade I. Soumana, Nese Kurt Yilmaz, Celia A. Schiffer

Celia A. Schiffer

The mosquito-transmitted dengue virus (DENV) infects millions of people in tropical and subtropical regions. Maturation of DENV particles requires proper cleavage of the viral polyprotein, including processing of 8 of the 13 substrate cleavage sites by dengue virus NS2B/NS3 protease. With no available direct-acting antiviral targeting DENV, NS2/NS3 protease is a promising target for inhibitor design. Current design efforts focus on the nonprime side of the DENV protease active site, resulting in highly hydrophilic and nonspecific scaffolds. However, the prime side also significantly modulates DENV protease binding affinity, as revealed by engineering the binding loop of aprotinin, a small protein …

Impact Of Neuraminidase Inhibitors On Influenza A(H1n1)Pdm09-Related Pneumonia: An Individual Participant Data Meta-Analysis, Stella G Muthuri, Sudhir Venkatesan, Puja R Myles, Jo Leonardi-Bee, Wei Shen Lim, Abdullah Al Mamun, Ashish P Anovadiya, Wildo N Araújo, Eduardo Azziz-Baumgartner, Clarisa Báez, Carlos Bantar, Mazen M Barhoush, Matteo Bassetti, Bojana Beovic, Roland Bingisser, Isabelle Bonmarin, Victor H Borja-Aburto, Bin Cao, Jordi Carratala, María R Cuezzo, Justin T Denholm, Samuel R Dominguez, Pericles A D Duarte, Gal Dubnov-Raz, Marcela Echavarria, Sergio Fanella, James Fraser, Zhancheng Gao, Patrick Gérardin, Maddalena Giannella, Sophie Gubbels, Jethro Herberg, Anjarath L Higuera Iglesias, Peter H Hoeger, Matthias Hoffmann, Xiaoyun Hu, Quazi T Islam, Mirela F Jiménez, Amr Kandeel, Gerben Keijzers, Hossein Khalili, Gulam Khandaker, Marian Knight, Gabriela Kusznierz, Ilija Kuzman, Arthur M C Kwan, Idriss Lahlou Amine, Eduard Langenegger, Kamran B Lankarani, Yee-Sin Leo, Rita Linko, Pei Liu, Faris Madanat, Toshie Manabe, Elga Mayo-Montero, Allison Mcgeer, Ziad A Memish, Gokhan Metan, Dragan Mikić, Kristin G I Mohn, Ahmadreza Moradi, Pagbajabyn Nymadawa, Bulent Ozbay, Mehpare Ozkan, Dhruv Parekh, Mical Paul, Wolfgang Poeppl, Fernando P Polack, Barbara A Rath, Alejandro H Rodríguez, Marilda M Siqueira, Joanna Skręt-Magierło, Ewa Talarek, Julian W Tang, Antoni Torres, Selda H Törün, Dat Tran, Timothy M Uyeki, Annelies Van Zwol, Wendy Vaudry, Daiva Velyvyte, Tjasa Vidmar, Paul Zarogoulidis, Jonathan S Nguyen-Van-Tam

Gerben Keijzers

BACKGROUND:

The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection.

METHODS:

A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids.

RESULTS:

Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, …

Impact Of Neuraminidase Inhibitors On Influenza A(H1n1)Pdm09-Related Pneumonia: An Individual Participant Data Meta-Analysis, Stella G Muthuri, Sudhir Venkatesan, Puja R Myles, Jo Leonardi-Bee, Wei Shen Lim, Abdullah Al Mamun, Ashish P Anovadiya, Wildo N Araújo, Eduardo Azziz-Baumgartner, Clarisa Báez, Carlos Bantar, Mazen M Barhoush, Matteo Bassetti, Bojana Beovic, Roland Bingisser, Isabelle Bonmarin, Victor H Borja-Aburto, Bin Cao, Jordi Carratala, María R Cuezzo, Justin T Denholm, Samuel R Dominguez, Pericles A D Duarte, Gal Dubnov-Raz, Marcela Echavarria, Sergio Fanella, James Fraser, Zhancheng Gao, Patrick Gérardin, Maddalena Giannella, Sophie Gubbels, Jethro Herberg, Anjarath L Higuera Iglesias, Peter H Hoeger, Matthias Hoffmann, Xiaoyun Hu, Quazi T Islam, Mirela F Jiménez, Amr Kandeel, Gerben Keijzers, Hossein Khalili, Gulam Khandaker, Marian Knight, Gabriela Kusznierz, Ilija Kuzman, Arthur M C Kwan, Idriss Lahlou Amine, Eduard Langenegger, Kamran B Lankarani, Yee-Sin Leo, Rita Linko, Pei Liu, Faris Madanat, Toshie Manabe, Elga Mayo-Montero, Allison Mcgeer, Ziad A Memish, Gokhan Metan, Dragan Mikić, Kristin G I Mohn, Ahmadreza Moradi, Pagbajabyn Nymadawa, Bulent Ozbay, Mehpare Ozkan, Dhruv Parekh, Mical Paul, Wolfgang Poeppl, Fernando P Polack, Barbara A Rath, Alejandro H Rodríguez, Marilda M Siqueira, Joanna Skręt-Magierło, Ewa Talarek, Julian W Tang, Antoni Torres, Selda H Törün, Dat Tran, Timothy M Uyeki, Annelies Van Zwol, Wendy Vaudry, Daiva Velyvyte, Tjasa Vidmar, Paul Zarogoulidis, Jonathan S Nguyen-Van-Tam

Gerben Keijzers

BACKGROUND:

The impact of neuraminidase inhibitors (NAIs) on influenza-related pneumonia (IRP) is not established. Our objective was to investigate the association between NAI treatment and IRP incidence and outcomes in patients hospitalised with A(H1N1)pdm09 virus infection.

METHODS:

A worldwide meta-analysis of individual participant data from 20 634 hospitalised patients with laboratory-confirmed A(H1N1)pdm09 (n = 20 021) or clinically diagnosed (n = 613) 'pandemic influenza'. The primary outcome was radiologically confirmed IRP. Odds ratios (OR) were estimated using generalised linear mixed modelling, adjusting for NAI treatment propensity, antibiotics and corticosteroids.

RESULTS:

Of 20 634 included participants, 5978 (29·0%) had IRP; conversely, …

Sensing Of Hsv-1 By The Cgas-Sting Pathway In Microglia Orchestrates Antiviral Defence In The Cns, Line S. Reinert, Katarina Lopusna, Henriette Winther, Chenglong Sun, Martin K. Thomsen, Ramya Nandakumar, Trine H. Mogensen, Morten Meyer, Christian Vaegter, Jens R. Nyengaard, Katherine A. Fitzgerald, Soren R. Paludan

Katherine A. Fitzgerald

Herpes simplex encephalitis (HSE) is the most common form of acute viral encephalitis in industrialized countries. Type I interferon (IFN) is important for control of herpes simplex virus (HSV-1) in the central nervous system (CNS). Here we show that microglia are the main source of HSV-induced type I IFN expression in CNS cells and these cytokines are induced in a cGAS-STING-dependent manner. Consistently, mice defective in cGAS or STING are highly susceptible to acute HSE. Although STING is redundant for cell-autonomous antiviral resistance in astrocytes and neurons, viral replication is strongly increased in neurons in STING-deficient mice. Interestingly, HSV-infected microglia …

Georgia's Collaborative Approach To Expanding Mosquito Surveillance In Response To Zika Virus: A Case Study, R. Christopher Rustin, Deonte Martin, Varadan Sevilimedu, Sarbesh Pandeya, Haresh Rochani, Rosmarie Kelly

R. Christopher Rustin

Post-Herpetic Paresis Of The Lower Extremity: An Unusual Complication Of Shingles, Leah Diane Stalnaker, Lynne J. Goebel, Md

Lynne J. Goebel

Herpes zoster, or shingles, is a disease process caused by re-activation of varicella zoster virus in the dorsal root ganglia. Most commonly, it presents with burning pain and a characteristic vesicular rash. However neurologic complications may occur, most often including neuralgia, and less commonly paresis. We present a case of post-herpetic paresis in an 86- year- old female.

Hla Class I Supertype Associations With Clinical Outcome Of Secondary Dengue Virus Infections In Ethnic Thais, Sasijit Vejbaesya, Rungrot Thongpradit, Siripen Kalayanarooj, Komon Luangtrakool, Panpimon Luangtrakool, Robert V. Gibbons, Duangporn Srinak, Somporn Ngammthaworn, Kusuma Apisawes, In-Kyu Yoon, Stephen J. Thomas, Richard G. Jarman, Anon Srikiatkhachorn, Sharone Green, Dasnayanee Chandanayingyong, Sangshin Park, Jennifer Friedman, Alan L. Rothman, Henry A.F. Stephens

Sharone Green

BACKGROUND: Human leukocyte antigen (HLA) supertypes are groups of functionally related alleles that present structurally similar antigens to the immune system.

OBJECTIVES: To analyze HLA class I supertype associations with clinical outcome in hospitalized Thai children with acute dengue illness.

METHODS: Seven hundred sixty-two patients and population-matched controls recruited predominantly in Bangkok were HLA-A and -B typed. HLA supertype frequencies were compared and tested for significant dengue disease associations using logistic regression analyses. Multivariable models were built by conducting forward stepwise selection procedures.

RESULTS: In the final logistic regression model, the HLA-B44 supertype was protective against dengue hemorrhagic fever (DHF) …

News From Cart, Patricia Fanning, Amos Nwosu

Patricia J. Fanning

No abstract provided.

Evaluation Of Cardiac Involvement In Children With Dengue By Serial Echocardiographic Studies, Tawatchai Kirawittaya, In-Kyu Yoon, Sineewanlaya Wichit, Sharone Green, Francis A. Ennis, Robert V. Gibbons, Stephen J. Thomas, Alan L. Rothman, Siripen Kalayanarooj, Anon Srikiatkhachorn

Sharone Green

BACKGROUND: Infection with dengue virus results in a wide range of clinical manifestations from dengue fever (DF), a self-limited febrile illness, to dengue hemorrhagic fever (DHF) which is characterized by plasma leakage and bleeding tendency. Although cardiac involvement has been reported in dengue, the incidence and the extent of cardiac involvement are not well defined. METHODS AND PRINCIPAL FINDINGS: We characterized the incidence and changes in cardiac function in a prospective in-patient cohort of suspected dengue cases by serial echocardiography. Plasma leakage was detected by serial chest and abdominal ultrasonography. Daily cardiac troponin-T levels were measured. One hundred and eighty …

The Spatial Dynamics Of Dengue Virus In Kamphaeng Phet, Thailand, Piraya Bhoomiboonchoo, Robert V. Gibbons, Angkana Huang, In-Kyu Yoon, Darunee Buddhari, Ananda Nisalak, Natkamol Chansatiporn, Mathuros Thipayamongkolgul, Siripen Kalanarooj, Timothy Endy, Alan L. Rothman, Anon Srikiatkhachorn, Sharone Green, Mammen P. Mammen, Derek A. Cummings, Henrik Salje

Sharone Green

BACKGROUND: Dengue is endemic to the rural province of Kamphaeng Phet, Northern Thailand. A decade of prospective cohort studies has provided important insights into the dengue viruses and their generated disease. However, as elsewhere, spatial dynamics of the pathogen remain poorly understood. In particular, the spatial scale of transmission and the scale of clustering are poorly characterized. This information is critical for effective deployment of spatially targeted interventions and for understanding the mechanisms that drive the dispersal of the virus.

METHODOLOGY/PRINCIPAL FINDINGS: We geocoded the home locations of 4,768 confirmed dengue cases admitted to the main hospital in Kamphaeng Phet …

Preliminary Evaluation Of Near Infrared Spectroscopy As A Method To Detect Plasma Leakage In Children With Dengue Hemorrhagic Fever, Babs R. Soller, Anon Srikiatkhachorn, Fengmei Zou, Alan L. Rothman, In-Kyu Yoon, Robert V. Gibbons, Siripen Kalayanarooj, Stephen J. Thomas, Sharone Green

Sharone Green

BACKGROUND: Dengue viral infections are prevalent in the tropical and sub-tropical regions of the world, resulting in substantial morbidity and mortality. Clinical manifestations range from a self-limited fever to a potential life-threatening plasma leakage syndrome (dengue hemorrhagic fever). The objective of this study was to assess the utility of near infrared spectroscopy (NIRS) measurements of muscle oxygen saturation (SmO2) as a possible continuous measure to detect plasma leakage in children with dengue.

METHODS: Children ages 6 months to 15 years of age admitted with suspected dengue were enrolled from the dengue ward at Queen Sirikit National Institute for Child Health. …

Sequential Dengue Virus Infections Detected In Active And Passive Surveillance Programs In Thailand, 1994-2010, Piraya Bhoomiboonchoo, Ananda Nisalak, Natkamol Chansatiporn, In-Kyu Yoon, Siripen Kalayanarooj, Mathuros Thipayamongkolgul, Timothy Endy, Alan L. Rothman, Sharone Green, Anon Srikiatkhachorn, Darunee Buddhari, Mammen P. Mammen, Robert V. Gibbons

Sharone Green

BACKGROUND: The effect of prior dengue virus (DENV) exposure on subsequent heterologous infection can be beneficial or detrimental depending on many factors including timing of infection. We sought to evaluate this effect by examining a large database of DENV infections captured by both active and passive surveillance encompassing a wide clinical spectrum of disease.

METHODS: We evaluated datasets from 17 years of hospital-based passive surveillance and nine years of cohort studies, including clinical and subclinical DENV infections, to assess the outcomes of sequential heterologous infections. Chi square or Fisher's exact test was used to compare proportions of infection outcomes such …

Classification Of Dengue Illness Based On Readily Available Laboratory Data, James Potts, Stephen Thomas, Anon Srikiatkhachorn, Pra-On Supradish, Wenjun Li, Ananda Nisalak, Suchitra Nimmannitya, Timothy Endy, Daniel Libraty, Robert Gibbons, Sharone Green, Alan Rothman, Siripen Kalayanarooj

Sharone Green

The aim of this study was to examine retrospective dengue-illness classification using only clinical laboratory data, without relying on X-ray, ultrasound, or percent hemoconcentration. We analyzed data from a study of children who presented with acute febrile illness to two hospitals in Thailand. Multivariable logistic regression models were used to distinguish: (1) dengue hemorrhagic fever (DHF) versus dengue fever (DF), (2) DHF versus DF + other febrile illness (OFI), (3) dengue versus OFI, and (4) severe dengue versus non-severe dengue + OFI. Data from the second hospital served as a validation set. There were 1,227 patients in the analysis. The …

Expert–Novice Differences In Mental Models Of Viruses, Vaccines, And The Causes Of Infectious Disease, Benjamin D. Jee, David H. Uttal, Amy N. Spiegel, Judy Diamond

Amy N. Spiegel

Humans are exposed to viruses everywhere they live, play, and work. Yet people’s beliefs about viruses may be confused or inaccurate, potentially impairing their understanding of scientific information. This study used semi-structured interviews to examine people’s beliefs about viruses, vaccines, and the causes of infectious disease. We compared people at different levels of science expertise: middle school students, teachers, and professional virologists. The virologists described more entities involved in microbiological processes, how these entities behaved, and why. Quantitative and qualitative analyses revealed distinctions in the cognitive organization of several concepts, including infection and vaccination. For example, some students and teachers …

Exosomes From Hepatitis C Infected Patients Transmit Hcv Infection And Contain Replication Competent Viral Rna In Complex With Ago2-Mir122-Hsp90, Terence N. Bukong, Fatemeh Momen-Heravi, Karen Kodys, Shashi Bala, Gyongyi Szabo

Gyongyi Szabo

Antibodies targeting receptor-mediated entry of HCV into hepatocytes confer limited therapeutic benefits. Evidence suggests that exosomes can transfer genetic materials between cells; however, their role in HCV infection remains obscure. Here, we show that exosomes isolated from sera of chronic HCV infected patients or supernatants of J6/JFH1-HCV-infected Huh7.5 cells contained HCV RNA. These exosomes could mediate viral receptor-independent transmission of HCV to hepatocytes. Negative sense HCV RNA, indicative of replication competent viral RNA, was present in exosomes of all HCV infected treatment non-responders and some treatment-naive individuals. Remarkably, HCV RNA was associated with Ago2, HSP90 and miR-122 in exosomes isolated …

Introduction: A Changing Indonesia, Maribeth Erb, Kathleen M. Adams

Kathleen M. Adams

No abstract provided.

Interview With Celia Schiffer, Celia Schiffer

Celia A. Schiffer

Celia Schiffer, a Professor in Biochemistry and Molecular Pharmacology; a former Director of UMass Center for AIDS Research; and a Founder and Co-Director for the Institute for Drug Resistance (University of Massachusetts Medical School, MA, USA). Schiffer has an undergraduate degree in physics from the University of Chicago, with a PhD in biophysics from University of California, San Francisco (CA, USA). She was a postdoctoral associate first at the ETH in Zurich and then at Genentech in San Francisco. Schiffer has published more than 100 peer reviewed journal articles. Her laboratory primarily uses structural biology, biophysical and chemistry techniques to …

Prototypical Recombinant Multi-Protease Inhibitor Resistant Infectious Molecular Clones Of Human Immunodeficiency Virus Type-1, Vici Varghese, Yumi Mitsuya, W. Jeffrey Fessel, Tommy F. Liu, George Melikian, David Katzenstein, Celia Schiffer, Susan Holmes, Robert Shafer

Celia A. Schiffer

The many genetic manifestations of HIV-1 protease inhibitor (PI) resistance present challenges to research into the mechanisms of PI-resistance and the assessment of new PIs. To address these challenges, we created a panel of recombinant multi-PI resistant infectious molecular clones designed to represent the spectrum of clinically relevant multi-PI resistant viruses. To assess the representativeness of this panel, we examined the sequences of the panel's viruses in the context of a correlation network of PI-resistance amino acid substitutions in sequences from more than 10,000 patients. The panel of recombinant infectious molecular clones comprised 29 of 41 study-defined PI-resistance amino acid …

The Science Of Prevention Strategies, Rachel Abrishami, Jeffery A. Goad

Jeff Goad

"From newborn screening for Phenylkentonurea (PKU) and the birth dose of Hepatitis B vaccine to prostate and breast cancer screening and pneumococcal immunization for older adults, the science of health maintenance is multi-tiered and spans the lifetime of an individual. Primary, secondary, and tertiary prevention strategies are used in concert with each other to enable healthcare professionals and their patients to sustain and improve the quality of life."

A Comparison Of Pharmacist Travel-Health Specialists' Versus Primary Care Providers' Recommendations For Travel-Related Medications, Vaccinations, And Patient Compliance In A College Health Setting, Melissa J. Durham, Jeffery A. Goad, Lawrence S. Neinstein, Mimi Lou

Jeff Goad

Background. Pretravel medication and vaccination recommendations and receipt were compared between primary care providers (PCPs) without special training and clinical pharmacists specializing in pretravel health. Methods. A retrospective chart review of patients seen for pretravel health services in a pharmacist-run travel clinic (PTC) compared to PCPs at a University Student Health Center. Vaccine/medication recommendations were assessed for consistency with national/international guidelines. Medical/pharmacy records were queried to determine the receipt of medications/vaccinations. Results. The PTC recommended antibiotics for travelers' diarrhea were given more often when indicated (96% vs 50%, p < 0.0001), and patients seen in the PTC received their medications more …

Immunization Update, Karl M. Hess, Jeffery A. Goad

Jeff Goad

"Immunization represents a very effective primary prevention strategy to curb the rate of vaccine preventable diseases...Pharmacists can play a leading role in vaccination by serving as an advocate, facilitator, and active immunizer. As an advocate, pharmacists provide vaccine education while motivating people to get immunized. As a facilitator, pharmacy’s can host other groups, such as the visiting nurses association, to come into the pharmacy and vaccinate. As an active immunizer, however, pharmacists serve their greatest role by giving immunizations to adolescents and adults."

The Common Cold: What Pharmacists Need To Know, Peggy Han, Peggy Mcmillan, Jeffery A. Goad

Jeff Goad

A primer on the common cold for pharmacists, including its causes and pathophysiology and how to assess and treat patients.

Vaccine-Preventable Diseases In Travelers, Edith Mirzaian, Jeffery Goad, Ani Amloian, Fady Makar

Jeff Goad

Travel to the developing world is increasing among those from developed countries, placing them at risk for vaccine preventable and non-vaccine preventable diseases. From 2007-2011, the GeoSentinel Network reported 737 returned travelers with a vaccine preventable disease. While it is essential that clinicians use vaccines when available for a disease of risk, they should also be aware that the vast majority of diseases acquired by travelers are non-vaccine preventable. The vaccine preventable diseases can be divided into routine travel vaccines, special travel vaccines and routine vaccines used for travel. The routine travel vaccines include Hepatitis A and B, typhoid; special …

Hemorrhagic Fever Viruses, Jeffery A. Goad, J Nguyen

Jeff Goad

Viral hemorrhagic fever (VHF) viruses are diverse and include arenaviruses, bunyaviruses, filoviruses, and flaviviruses. Lassa fever, South American hemorrhagic fever (HF), Rift Valley HF, Crimean-Congo HF, Ebola, Marburg, yellow fever, and dengue fever are well known examples of the hemorrhagic fever viruses. They are often difficult to diagnose and treat resulting in significant morbidity and mortality. Transmission varies from vector borne to person-to-person. The common clinical presentation includes fever, myalgia, microvascular damage, and hemorrahage as well as a history of travel to the tropics. If VHF is suspected, strict infection control procedures must be implemented to prevent the spread of …

Classification Of Dengue Illness Based On Readily Available Laboratory Data, James Potts, Stephen Thomas, Anon Srikiatkhachorn, Pra-On Supradish, Wenjun Li, Ananda Nisalak, Suchitra Nimmannitya, Timothy Endy, Daniel Libraty, Robert Gibbons, Sharone Green, Alan Rothman, Siripen Kalayanarooj

Alan Rothman

The aim of this study was to examine retrospective dengue-illness classification using only clinical laboratory data, without relying on X-ray, ultrasound, or percent hemoconcentration. We analyzed data from a study of children who presented with acute febrile illness to two hospitals in Thailand. Multivariable logistic regression models were used to distinguish: (1) dengue hemorrhagic fever (DHF) versus dengue fever (DF), (2) DHF versus DF + other febrile illness (OFI), (3) dengue versus OFI, and (4) severe dengue versus non-severe dengue + OFI. Data from the second hospital served as a validation set. There were 1,227 patients in the analysis. The …