Diseases Commons^™

Strategies To Increase Human Immunodeficiency Virus Testing In Rural Areas Of The United States: A Systematic Review, Avery Petrucci, Kristen Custer, Eric C. Nemec

Physician Assistant Studies Student Publications

Purpose: HIV incidence continues to increase, with a large portion of new diagnoses found in rural areas of the United States. The worsening statistics in rural areas may be attributed to stigma alone and contribute to the lack of testing available for patients. The objective of this systematic review is to identify accessible and feasible strategies to increase HIV testing within the rural communities in the United States. Methods: A systematic literature search of CINAHL Complete, MEDLINE with Full Text, and PsycINFO with restrictions of the English language and rural communities outside of the United States through August 2, 2018. …

Inflammation And Immune Evasion Coexist In Treponema Pallidum-Infected Skin, Rodolfo Trujillo, Jorge Cervantes, Kelly L. Hawley, Adriana R. Cruz, Sankhiros Babapoor, Michael Murphy, Soheil S. Dadras, Juan C. Salazar

Biology Faculty Publications

Syphilis is a systemic, multistage, sexually transmitted infection caused by the highly invasive spirochetal bacterium, Treponema pallidum, subspecies pallidum. In the United States, the annual rate of primary and secondary syphilis (SS) between 2002 and 2016 has increased from 2.1 to 8.7 cases per 100,000.¹ Gestational and congenital syphilis cases have also increased in the last few years. There is no evidence of a change in T pallidum susceptibility to penicillin as an explanation for the significant increase in the number of syphilis cases in the United States. It is more likely that changes in risk-taking behavior in …

Will Vestibulo-Ocular Reflex And Balance Rehabilitation Reduce Visual Deficits & Improve Stability Of A Patient With Multiple Sclerosis?, Natalie Hunt, Jennifer Kiggins

Sacred Heart University Scholar

Context: Identification of rehabilitation exercises to decrease symptomology in a patient with Multiple Sclerosis (MS) is necessary for enhancing quality of life. Various vestibulo-ocular reflex (VOR) rehabilitation exercises can help patients adapt to balance problems. Currently, no researcher has utilized the VSR™ Sport and inVision™ systems by NeuroCom® for rehabilitation among patients with MS.

Objective: The purpose of the study was to create a rehabilitation protocol incorporating VOR and balance exercises to decrease visual deficits and improve stability in a patient with MS. This study will examine the effects of rehabilitation and determine if scores improve from baseline testing.

Design: …

Brivaracetam (Briviact): A Novel Adjunctive Therapy For Partial-Onset Seizures, Farbod Khaleghi, Eric C. Nemec

Physician Associate Studies Faculty Publications

Epilepsy is the fourth most common neurological disorder and affects more than 65 million individuals worldwide.This condition is marked by the presence of epileptic seizures, which result from an abnormal synchronous firing of excitatory neurons in the brain. When neurons fire synchronously, a wave of depolarization known as a paroxysmal depolarizing shift occurs. During this period, the neurons experience a lowered resistance to firing, leading to multiple action potentials that generate abnormally increased electrical activity within the brain.

Patient Self-Management: Impact Of Racism-Related Vigilance In The Management Of Hypertension In African-Americans, Rackelle N. Wilkinson-Alston

Writing Across the Curriculum

It is important to understand the role that discrimination plays in health disparities. This paper will discuss racism-related vigilance, and its role in health outcomes in hypertensive African-Americans (AAs). This paper will also attempt to provide insight on how the absence of a culturally competent health care system may predispose AAs to developing stress-induced hypertension due to racism-related vigilance. This paper will explore how community partnership programs may be beneficial interventions for building resilience and promoting positive health behaviors among hypertensive AAs in the face of discrimination-related vigilance.

Gut Bacteria And Their Influence On Metabolic Disorders, Stephanie Sorbara (Class Of 2015)

Biology Undergraduate Publications

The human gut microbial genome encodes for several metabolic processes that are not encoded for in the human genome. Through the study of metagenomics, mice, and human models, researchers have shown that changes in the gut bacterial composition can generate oxidative stress, release endotoxins, and induce lipogenesis. These pathways can disrupt normal metabolic function, resulting in obesity and other related metabolic disorders such as diabetes. Most of the health implications associated with obesity originate from the biological reactions carried out by the gut bacteria, which are strongly impacted by environmental factors. Probiotics, prebiotics and fecal transplantation are methods that can …

Health, Wellness, And The Pursuit Of Happiness: Common Ground For Adults With Cerebral Palsy And Modern Physical Therapists, Lisa Blumberg, Mary E. Gannotti, Diana J. Larocco, Yvette Blanchard

Physical Therapy Faculty Publications

Health, wellness, and happiness are important long-term goals for adulthood, especially for children with cerebral palsy (CP). Physical therapists (PTs) can assist individuals with CP realize these goals; however it requires PTs to have a greater understanding of how to apply impairment, functional, or contextual interventions to meet these goals. A critical gap in knowledge exists about perceptions of happiness and health priorities of adults with CP. The purpose of this paper is to describe the beliefs, feelings, and perceptions of happiness and health of adults with CP as compared to adults without CP, specifically PTs.

Mediterranean Diet Is An Effective Method For Treating Type 2 Diabetes In Adults, Amy Bois

Health Sciences Undergraduate Publications

Type 2 diabetes has been a health issue for many years, and as more people throughout the world become obese or overweight this issue becomes more serious. Type 2 diabetes is called insulin resistance which means the body does not use insulin properly. At first the pancreas will make extra insulin, but over time the pancreas is not able to keep up and cannot make enough insulin to keep blood glucose at normal levels. Type 2 diabetes is most common in adults who are obese or overweight, and this health problem can be life-threatening. There is no cure for type …

The Longitudinal Course Of Attention Deficit/Hyperactivity Disorder In Velo-Cardio-Facial Syndrome, Kevin M. Antshel, Kaitlin Hendricks, Robert J. Shprintzen, Wanda Fremont, Anne Marie Higgins, Stephen V. Faraone, Wendy R. Kates

Communication Disorders Faculty Publications

OBJECTIVE: To evaluate predictors of persistence of attention deficit/hyperactivity disorder (ADHD) in a large sample of children with velo-cardio-facial syndrome (VCFS) with and without ADHD followed prospectively into adolescence. STUDY DESIGN: Children with VCFS with (n = 37) and without (n = 35) ADHD who were on average 11 years old at the baseline assessment and 15 years old at the follow-up assessment were comprehensively assessed with structured diagnostic interviews and assessments of behavioral, cognitive, social, school, and family functioning. Control participants both with and without ADHD were also followed prospectively. RESULTS: In adolescence, 65% of children with VCFS continued …

Eastern Equine Encephalitis: An Assessment Of Vermont’S Treatment Plan And The Lack Of Preventative Treatment, Lauren E. Bierman

Writing Across the Curriculum

When an avian host and the Culiseta melanura mosquito meet in fresh water hardwood swamps, the Eastern Equine Encephalitis virus (EEE) is spread to the bird community. When that same bird is bitten by a mosquito that feeds on humans, such as the Aedes, Coquillettidia, and Culex species, the EEE virus has found its bridge vector. EEE is a rare disease in humans; the Centers for Disease Control and Prevention (CDC) reported in 2010 that the virus affects an average of 6 people per year (Epidemiology & Geographic Distribution section, para 2). In 2010, blood collected from deer …

Overt Cleft Palate Phenotype And Tbx1 Genotype Correlations In Velo-Cardio-Facial/Digeorge/22q11.2 Deletion Syndrome Patients, Sean Herman, Tingwei Guo, Donna M. Mcdonald Mcginn, Anna Blonska, Alan L. Shanske, Anne S. Bassett, Eva Chow, Mark Bowser, Molly Sheridan, Frits Beemer, Koen Devriendt, Ann Swillen, Jeroen Breckpot, Maria Christina Digilio, Bruno Marino, Bruno Dallapiccola, Courtney Carpenter, Xin Zheng, Jacob Johnson, Jonathan Chung, Anne Marie Higgins, Nicole Philip, Tony J. Simon, Karlene Coleman, Damian Heine Suñer, Jordi Rosell, Wendy R. Kates, Marcella Devoto, Elaine Zackai, Tao Wang, Robert J. Shprintzen, Beverly Emanuel, Bernice Morrow, International Chromosome 22q11.2 Consortium

Communication Disorders Faculty Publications

Velo-cardio-facial syndrome/DiGeorge syndrome, also known as 22q11.2 deletion syndrome (22q11DS) is the most common microdeletion syndrome, with an estimated incidence of 1/2,000 – 1/4,000 live births. Approximately 9–11% of patients with this disorder have an overt cleft palate (CP), but the genetic factors responsible for CP in the 22q11DS subset are unknown. The TBX1 gene, a member of the T-box transcription factor gene family, lies within the 22q11.2 region that is hemizygous in patients with 22q11DS. Inactivation of one allele of Tbx1 in the mouse does not result in CP, but inactivation of both alleles does. Based on these data, …

Genotype And Cardiovascular Phenotype Correlations With Tbx1 In 1,022 Velo-Cardio-Facial/Digeorge/22q11.2 Deletion Syndrome Patients, Tingwei Guo, Donna Mcdonald-Mcginn, Anna Blonska, Alan L. Shanske, Anne S. Bassett, Eva Chow, Mark Bowser, Molly Sheridan, Frits Beemer, Koen Devriendt, Ann Swillen, Jeroen Breckpot, Maria C. Digilio, Bruno Marino, Bruno Dallapiccola, Courtney Carpenter, Xin Zheng, Jacob Johnson, Jonathan Chung, Anne Marie Higgins, Nicole Philip, Tony J. Simon, Karlene Coleman, Damian Heine-Suner, Jordi Rosell, Wendy R. Kates, Marcella Devoto, Elizabeth Goldmuntz, Elaine Zackai, Tao Wang, Robert J. Shprintzen, Beverly Emanuel, Bernice Morrow, The International Chromosome 22q11.2 Consortium

Communication Disorders Faculty Publications

Haploinsufficiency of TBX1, encoding a T-box transcription factor, is largely responsible for the physical malformations in velo-cardio-facial /DiGeorge/22q11.2 deletion syndrome (22q11DS) patients. Cardiovascular malformations in these patients are highly variable, raising the question as to whether DNA variations in the TBX1 locus on the remaining allele of 22q11.2 could be responsible. To test this, a large sample size is needed. The TBX1 gene was sequenced in 360 consecutive 22q11DS patients. Rare and common variations were identified. We did not detect enrichment in rare SNP (single nucleotide polymorphism) number in those with or without a congenital heart defect. One exception …

Identifying And Co-Managing The Hiv-Infected Adult: A Guidebook For Primary Care Clinicians, Jason Leider, Susan F. Lelacheur, Julie G. Stewart Dnp, Mph

Nursing Faculty Publications

This guidebook was designed to help primary care clinicians improve their performance in terms of HIV identification and co-management. Surmounting barriers to opt-out screening, making an HIV diagnosis, and preventing transmission and opportunistic infections will be discussed, as will selection of initial therapy and considerations for patients receiving antiretroviral therapy (ART).

The Impact Of Infectious Disease On Chronic Disease: A Review Of Contemporary Findings, Wendy Bjerke

All PTHMS Faculty Publications

Infectious diseases are among the top causes of death in adults and children. Chronic diseases such as cardiovascular disease and cancer are among the top causes of death in adults. Associations between bacterial and viral infectious agents and subsequent development of chronic disease have been made in the past but are currently being reexamined with more rigor and specificity. This review examines infectious disease agent causes and associations with cancer, cardiovascular disease, metabolic disease, and neurodegenerative disease. These associations will impact future research, surveillance, treatment, and prevention of both infectious and chronic diseases.

Hiv: Make The Diagnosis And Take The Next Step, Julie G. Stewart, Amy R. Weinberg

Nursing Faculty Publications

With the CDC urging screening for all willing patients, providers will be testing and managing a growing number of HIV-positive individuals.

The CDC estimates that with more than 40,000 new infections annually, more than 1.2 million people in the United States are living with HIV-and 24% to 27% may not be aware of their infection status.1 Studies have shown that HIV is often diagnosed late in the disease process, when the individual has already developed AIDS, which typically occurs 8 to 11 years after HIV infection.2 Research also points to missed opportunities to offer HIV testing and diagnose the infection …

Associations Between Performance On The Rey-Osterrieth Complex Figure And Regional Brain Volumes In Children With And Without Velocardiofacial Syndrome, Kevin M. Antshel, Jena Peebles, Nuria Abdulsabur, Anne Marie Higgins, Nancy Roizen, Robert J. Shprintzen, Wanda Fremont, Robert Natasi, Wendy R. Kates

Communication Disorders Faculty Publications

Ninety-two children with velocardiofacial syndrome (VCFS), a genetic disorder caused by a microdeletion of chromosome 22q11.2 and an age, race, and gender-ratio comparable sample of 59 control participants were included in the project. Participants received an MRI as well as a comprehensive neuropsychological battery; the primary outcome measure in the current report is the Rey-Osterrieth Complex Figure (ROCF). Children with VCFS performed less well on the ROCF and have lower whole brain volume compared to controls. After controlling for whole brain volume differences, children with VCFS have bilaterally less parietal lobe gray and white matter yet more frontal lobe white …

The Neural Correlates Of Non-Spatial Working Memory In Velocardiofacial Syndrome (22q11.2 Deletion Syndrome), Wendy R. Kates, Beth R. Krauss, Nuria Abdulsabur, Dierdre Colgan, Kevin M. Antshel, Anne Marie Higgins, Robert J. Shprintzen

Communication Disorders Faculty Publications

Velocardiofacial syndrome (VCFS), also known as 22q11.2 deletion syndrome, is a neurogenetic disorder that is associated with both learning disabilities and a consistent neuropsychological phenotype, including deficits in executive function, visuospatial perception, and working memory. Anatomic imaging studies have identified significant volumetric reductions in the parietal lobe of individuals with VCFS, but several studies have reported that the frontal lobe is relatively preserved. We used functional magnetic resonance imaging to investigate the neural correlates of non-spatial working memory in 17 youths with VCFS, 10 of their unaffected siblings, and 10 community controls (with the same proportion of learning disabilities as …

Manic Symptoms And Behavioral Dysregulation In Youth With Velocardiofacial Syndrome (22q11.2 Deletion Syndrome)., Alka Aneja, Wanda Fremont, Kevin M. Antshel, Stephen V. Faraone, Nuria Abdulsabur, Anne Marie Higgins, Robert J. Shprintzen, Wendy R. Kates

Communication Disorders Faculty Publications

Mania and bipolar disorder have been reported in adolescents and adults with velocardiofacial syndrome (VCFS; also known as 22q11.2 deletion syndrome). Children with VCFS have a high prevalence of attention-deficit/hyperactivity disorder (ADHD), which may constitute a risk factor for the eventual development of bipolar disorder in this population. Therefore, we sought to determine whether children with VCFS exhibit more manic symptoms than community controls that also may have learning disorders and ADHD. The study population consisted of 86 children with VCFS and 36 community controls from ages 9 to 15 years, using measures of Young Mania Rating Scale-Parent Version, Schedule …

Impact Of An Adherence Program On The Health And Outlook Of Hiv-Infected Patients Failing Antiretroviral Therapy, Michael F. Parry, Pamela Wright, Julie G. Stewart, Gavin Mcleod, James Tucker, Amy R. Weinberg

Nursing Faculty Publications

Background: We prospectively studied the impact of an adherence counselor on the outcome of patients failing antiretroviral therapy because of nonadherence. Methods: Forty-six patients, identified as chronically nonadherent were enrolled. Individual attention was provided using the information, motivation and behavioral methodology. HIV RNA (viral load, in copies/mL), CD4 count (in cells/[mm.sup.3]), and body weight before and after the adherence counselor were measured. Qualitative outcome and patient satisfaction were assessed by deidentified third-party interviews. Results: Over half completed at least 1 year; only 8 patients were lost to follow-up. Mean CD4 counts increased significantly (P < .05) for completers at 6 and 12 months. Viral loads decreased between baseline and 6 months. Most clients reported subjective benefit from working with the adherence counselor. Conclusion: Although few clients showed complete virologic suppression, the value of an adherence counselor was validated. Longer term adherence programs should be evaluated.

Collaborative Management Of Hiv Infection In The Community: An Effort To Improve The Quality Of Hiv Care, Michael F. Parry, Julie G. Stewart, P. Wright, Gavin X. Mcleod

Nursing Faculty Publications

Our hospital led a multidisciplinary community team to improve the quality of care delivered to HIV-infected clients utilizing a disease management approach in a US metropolitan community of 150,000 people. Community needs assessment and client and community surveys were used to define the problems. Patient care flowcharting and the creation of an electronic patient database facilitated patient tracking across the entire community. Clinical guidelines and a consultation and referral immunology clinic standardized care practices. Measurable improvements in the quality of care were noted in multiple areas. Flowchart completion rates rose from 44% to 100%; medication adherence assessment rose from 82% …

Typical Symptoms Are Predictive Of Acute Coronary Syndromes In Women, Kerry A. Milner, Marjorie Funk, Amy L. Arnold, Viola Vaccarino

Nursing Faculty Publications

Background: Previous research suggests that the presentation of acute coronary syndromes (ACS) may differ in women and men. No study has prospectively evaluated the role of a comprehensive set of typical and atypical symptoms and whether different symptoms on presentation predict ACS diagnosis in women and men. Methods and Results: We directly observed 246 women and 276 men seen in the emergency department with symptoms suggestive of ACS and documented their symptoms verbatim. ACS was eventually diagnosed in 89 (36%) women and 124 (45%) men on the basis of standard electrocardiogram and cardiac enzyme criteria. Presence of typical symptoms (chest …

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …

Differences Between Blacks And Whites With Coronary Heart Disease In Initial Symptoms And In Delay In Seeking Care, Sally B. Richards, Marjorie Funk, Kerry A. Milner

Nursing Faculty Publications

BACKGROUND: Mortality rates for coronary heart disease are higher in blacks than in whites. OBJECTIVES: To examine differences between blacks and whites in the manifestation of symptoms of coronary heart disease and in delay in seeking treatment. METHODS: Patients were directly observed as they came to an emergency department with symptoms suggestive of coronary heart disease. The sample included 40 blacks and 191 whites with a final diagnosis of angina or acute myocardial infarction. RESULTS: After controlling for pertinent demographic and clinical characteristics, logistic regression analysis revealed that blacks were more likely than whites to have shortness of breath (odds …