Diseases Commons^™

Trends In The Clinical Characteristics Of Hiv Infected Patients Initiating Antiretroviral Therapy In Kenya, Uganda And Tanzania Between 2002 And 2009, Elvin H. Geng, Peter W. Hunt, Lameck O. Diero, Sylvester Kimaiyo, Geofrey R. Somi, Pius Okong, David R. Bangsberg, Mwebesa B. Bwana, Craig R. Cohen, Juliana A. Otieno, Deo Wabwire, Batya Elul, Denis Nash, Philippa J. Easterbrook, Paula Braitstein, Beverly S. Musick, Jeffrey N. Martin, Constantin T. Yiannoutsos, Kara Wools-Kaloustian

Publications and Research

Background: East Africa has experienced a rapid expansion in access to antiretroviral therapy (ART) for HIVinfected patients. Regionally representative socio-demographic, laboratory and clinical characteristics of patients accessing ART over time and across sites have not been well described.

Methods: We conducted a cross-sectional analysis of characteristics of HIV-infected adults initiating ART between 2002 and 2009 in Kenya, Uganda and Tanzania and in the International Epidemiologic Databases to Evaluate AIDS Consortium. Characteristics associated with advanced disease (defined as either a CD4 cell count level of less than 50 cells/mm3 or a WHO Stage 4 condition) at the time of ART initiation …

Calf Pre-Weaning Traits And Immunoglobulin Response To Bovine Viral Diarrhea Virus Vaccination, Whitney Downum, A. Hayden Brown Jr., Jeremey G. Powell, E. Beth Kegley, Zelpha B. Johnson, Doug B. Galloway, James A. Hornsby, Billy R. Lindsey

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Calfhood vaccination for bovine viral diarrhea virus (BVDV) is a relatively new concept, and protocols are evolving. Our objective was to determine effects of BVDV type I vaccination protocol, calf behavior (chute score, and chute exit velocity), and gender on calf gain and immunoglobulin (Ig) response. Crossbred calves (n = 64) were randomly allotted to one of two vaccination protocols. In protocol 1, calves were vaccinated at 60 d of age (d 0) and at weaning (d 147). Calves assigned to protocol 2 were vaccinated against BVDV type I at 21 d prior to (d 126) and at weaning (d …

Alzheimer's Disease Association With Chlamydia Pneumoniae, Andrew Short

PCOM Biomedical Studies Student Scholarship

Exogenous bacteria, such as Chlamydia pneumoniae, may be a cause of inflammation that contributes to the progression of Alzheimer's disease (AD). Inflammation has been previously established as a contributor to AD progression. Balin et al. first reported C. pneumoniae in the brains of post-mortem late onset AD patients. PCR analysis showed that 17/19 AD patients were positive for the organism in areas of the brain with typical AD-related neuropathology while 18/19 control patients were PCR-negative. Gerard et al. determined, using real-time PCR, that C. pneumoniae-infected cells colocalize with both neuritic senile plaques and neurofibrillary tangles, the defining pathologies of AD. …

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

Pharmacy Faculty Articles and Research

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 often (75% vs 63%, p = 0.04). PCPs prescribed more antibiotics for travelers' diarrhea that were inconsistent with guidelines (not ordered when indicated 49% vs 6%, p < 0.0001 and ordered when not indicated 21% vs 3%, p < 0.0001). The PTC prescribed antimalarials more often when indicated (98% vs 81%, p < 0.0001), while PCPs prescribed more antimalarials that were inconsistent with guidelines (not ordered when indicated 15% vs 1%, p < 0.0001 and ordered when not indicated 19% vs 2%, p < 0.0001). The PTC ordered more vaccines per patient when indicated (mean = 2.77 vs 2.31, p = 0.0012). PTC patients were more likely to receive vaccines when ordered (mean = 2.38 vs 1.95, p = 0.0039). PCPs recommended more vaccines per patient that were inconsistent with guidelines (not ordered when indicated: mean = 0.78 vs 0.12, p < 0.0001, ordered when not indicated: mean 0.18 vs 0.025, p < 0.0001).

Conclusions. A pharmacist-run pretravel health clinic can …

First Generation Of Gender And Hiv Programs: Seeking Clarity And Synergy, Judith Bruce, Nicole Haberland, Amy Joyce, Eva Roca, Tobey Nelson Sapiano

Poverty, Gender, and Youth

In the past decade, there have been expanding resources to address the underlying gender dimensions of HIV. This has been particularly urgent in sub-Saharan Africa as the female-to-male infection ratios in young populations has reached 3 to 1 and sometimes above. The phrase “gender and HIV” has become commonplace yet does not provide any specific guidance as to target audiences, content, or measurable results. It can include everything from microcredit programs for HIV-positive women, to workplace programs seeking to change negative male norms, to efforts to increase respect for diverse sexual and gender identities. This review, conducted by the Population …

Community Health Workers Can Effectively Provide Information And Referrals To People Living With Hiv In Their Communities, Population Council

Reproductive Health

A number of studies reported high levels of sexually transmitted infections among people living with HIV (PLHIV). Unfortunately, prevention interventions targeting PLHIV in the community are not common in Kenya, and most PLHIV who are not on ART have limited access to prevention information and risk-reduction counseling. The Population Council’s APHIA II Operations Research Project conducted a research project to address these gaps. This study was conducted in 2010 in collaboration with the International Center for Reproductive Health and the National AIDS and STI Control Programme. The findings show that the intervention had a number of positive outcomes and concludes …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Malaria, Intestinal Parasitic Infection, Anemia, And Malnourishment In Rural Cameroonian Villages With An Assessment Of Early Interventions, D. J. Richardson, K. R. Richardson, K. E. Richardson, J. Gross, P. Tsekeng, B. Dondji, S. Foulefack

Journal of the Arkansas Academy of Science

Malaria, water-borne diarrheal diseases, and geohelminth infections, combined with severe malnutrition ravage entire villages throughout subSaharan Africa. The Bawa Health Initiative (BHI) is a 501c(3) non-profit organization with the goal of implementing a comprehensive public health program in an attempt to address these problems in a series of rural villages located in the West Province of Cameroon, Africa. Interventions include the provision of permethrin-treated bed nets to reduce the transmission of malaria, the installation of biosand water filters to reduce the prevalence of water-borne diseases, and a geohelminth control program utilizing mass treatment with albendazole. This study details the results …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

The Cardiac Atlas Project--An Imaging Database For Computational Modeling And Statistical Atlases Of The Heart, Carissa G. Fonseca, Michael Backhaus, David A. Bluemke, Randall D. Britten, Jae Do Chung, Brett R. Cowan, Alan H. Kadish

Office of the President Publications and Research

MOTIVATION: Integrative mathematical and statistical models of cardiac anatomy and physiology can play a vital role in understanding cardiac disease phenotype and planning therapeutic strategies. However, the accuracy and predictive power of such models is dependent upon the breadth and depth of noninvasive imaging datasets. The Cardiac Atlas Project (CAP) has established a large-scale database of cardiac imaging examinations and associated clinical data in order to develop a shareable, web-accessible, structural and functional atlas of the normal and pathological heart for clinical, research and educational purposes. A goal of CAP is to facilitate collaborative statistical analysis of regional heart shape …

Investigations Into The Use Of The M-Protein For The Production Of A Vaccine Against Streptococcus Equi Subspecies Equi Using Chicken Igy, Rachel Lantz

Senior Honors Theses

Strangles is a destructive disease in horses caused by an infection of the bacteria Streptococcus equi subspecies equi. Current vaccines designed to protect horse populations for this infection are only 50% effective at preventing the disease. The aim of this study was to develop a vaccine against Streptococcus equi by targeting the antiphagocytic virulence factor of the bacteria, the M-Protein (SeM18). SeM18 was expressed using the ampicillin resistant pET vector system and purified by metal affinity column using Cu(II). Purified protein was used to vaccinate chickens, and the anti-SeM18 IgY present in the yolk of the eggs produced by …

Current Review Of In Nivo Gbm Rodent Models: Emphasis On The Cns-1 Tumour Model, Valerie L. Jacobs, Pablo A. Valdes, William F. Hickey, Joyce A. De Leo

Dartmouth Scholarship

GBM (glioblastoma multiforme) is a highly aggressive brain tumour with very poor prognosis despite multi-modalities of treatment. Furthermore, recent failure of targeted therapy for these tumours highlights the need of appropriate rodent models for preclinical studies. In this review, we highlight the most commonly used rodent models (U251, U86, GL261, C6, 9L and CNS-1) with a focus on the pathological and genetic similarities to the human disease. We end with a comprehensive review of the CNS-1 rodent model.

United Airways Disease Among Florists, Muge Akpinar-Elci, Omur C. Elci, Aygul Odabasi

Community & Environmental Health Faculty Publications

Previously we observed an excess risk for occupational asthma among florists with rhinitis. To further evaluate the link between upper and lower airways, we investigated united airways disease in the same occupational group. Occupational history, symptoms and atopy were investigated among 128 florists. Age-, smoking-, and gender-adjusted risks were calculated using logistic regression models comparing symptomatic and asymptomatic individuals. The prevalence of work-related rhinitis symptoms was 13.3%, conjunctivitis symptoms and asthma-like symptoms were 14.1%. We observed an excess risk of work-related asthma symptoms among florists with work-related conjunctivitis (OR: 8.5, 95% CI: 2.4-29.9) and rhinitis (OR: 13.1, 95% CI: 3.0- …

Mathematical Model To Assess The Relative Effectiveness Of Rift Valley Fever Countermeasures, Holly Gaff, Colleen Burgess, Jacqueline Jackson, Tianchan Niu, Yiannis Papelis, David Hartley

Biological Sciences Faculty Publications

Mathematical modeling of infectious diseases is increasingly used to explicate the mechanics of disease propagation, impact of controls, and sensitivity of countermeasures. The authors demonstrate use of a Rift Valley Fever (RVF) model to study efficacy of countermeasures to disease transmission parameters. RVF is a viral infectious disease that propagates through infected mosquitoes and primarily affects animals but also humans. Vaccines exist to protect against the disease but there is lack of data comparing efficacy of vaccination with alternative countermeasures such as managing mosquito population or destroying infected livestock. This paper presents a compartmentalized multispecies deterministic ordinary differential equation model …

Clinical Use Of Probiotics: A Survey Of Physicians’ Beliefs And Practice Patterns, Anastasia Ensminger

Master's Theses and Doctoral Dissertations

Background: Probiotics have the potential to be used as a preventive agent or adjuvant therapy for various medical conditions, and recent research is beginning to illuminate some of the associated benefits. Some clinicians currently prescribe probiotics in practice. Understanding physicians’ beliefs and practice patterns regarding the use of probiotics will help identify current practices, barriers preventing their acceptance, and the sources of information that impact clinical practice.

Objective: To identify and describe physicians’ beliefs and practice patterns regarding the use of probiotics.

Methods: A cross-sectional online questionnaire was administered to 130 physicians employed by or affiliated with Danville …

Can Ultrafiltration Be Used As Primary Treatment Of Congestive Heart Failure?, Jennifer Tallis

PCOM Physician Assistant Studies Student Scholarship

Objective: To determine whether ultrafiltration can be used as primary treatment of Congestive Heart Failure.

Is Sildenafil Citrate A Safe And Effective Treatment For Pulmonary Hypertension In Adults?, Atekelt Tadese

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine whether or not the Phosphodiesterase inhibitors drug Sildenafil Citrate is safe and effective treatment for Pulmonary Hypertension in adults

Are Proton Pump Inhibitors A Safe And Effective Treatment For Gastroesophageal Reflux Disease In Infants Less Than Twelve Months Old?, Mariah Smith

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not proton pump inhibitors are a safe and effective treatment for gastroesophageal reflux disease in infants less than twelve months old.

Is 5% Imiquimod Cream More Efficacious At Sustained Clearance Of Genital Warts At 3 Months Compared To 1% Imiquimod, Ablation Therapy, And A Placebo Vehicle Cream?, David A. Smith

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not 5% Imiquimod is more efficacious at sustained treatment of genital warts at 3 months compared to 1% Imiquimod, ablation, and a placebo vehicle cream.

Is Opt-80 A Safe And Effective Treatment For Patients With C.Difficile Infection?, Heather A. Shupp

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: Objective of this systematic review is to determine whether or not OPT-80 is a safe and effective treatment for patients with C.difficile infection.

Is Topical 1% Pimecrolimus Cream An Effective Treatment For Rosacea?, Lauren Sloan

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not topical 1% pimecrolimus cream is an effective treatment for rosacea.

The Effectiveness And Safety Of Antibiotic Treatment In Healing Tympanic Membrane Perforation In Aboriginal Children, Shannon M. Rice

PCOM Physician Assistant Studies Student Scholarship

The objective of this systematic review is to determine whether or not antibiotic treatment is safe and effective in healing tympanic membrane (TM) perforation in Aboriginal children diagnosed with chronic suppurative otitis media and otitis media with effusion less than 16 years of age.

Is Alitretinoin (9-Cis-Retinoic Acid) Safe And Effective For Use In Hand Eczema?, Jeanne K. Seeberger

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine if Alitretinoin is a safe and effective alternative to current treatments in reducing the symptoms of Hand Eczema (HE)

Is Liraglutide Safe And Effective As A Monotherapy For The Treatment Of Obesity In Type 2 Diabetics And Healthy Individuals?, Erica Sheeran

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not liraglutide is safe and effective as a monotherapy for the treatment of obesity in type 2 diabetics and healthy individuals.

Is L-Carnitine An Effective Treatment To Improve The Quality Of Life For Patients With Rett Syndrome?, Bernadette Mason

PCOM Physician Assistant Studies Student Scholarship

Objective: To determine “Is L-carnitine an effective treatment to improve the quality of life for patients with Rett Syndrome?”

Is Esomeprazole (Nexium) More Effective Than Omeprazole (Prilosec) In Reducing Heartburn And In Increasing The Rate Of Esophageal Healing In Adults With Endoscopically Diagnosed Erosive Esophagitis (Ee)?, Shawn P. Mahoney

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether Esomeprazole (Nexium) is more safe and effective than Omeprazole (Prilosec) in reducing Heartburn and in increasing the rate of esophageal healing in adults with endoscopically diagnosed Erosive Esophagitis (EE)

How Safe And Effective Is Infliximab In The Treatment Of Children With Moderate To Severe Crohn’S Disease?, Jackie Linh

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not “how safe and effective is infliximab in treatment of children with moderate to severe Crohn’s disease?”

Does A Diet That Consists Of High Fiber Prevent The Recurrence Of Colorectal Adenomas In Patients Who Have Previously Had At Least One Adenoma Detected Via Colonoscopy?, Conor Luskin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: To determine whether ingesting a diet high in fiber will decrease the incidence of colorectal adenoma recurrence in a person who has previously had colorectal adenomas.

Is Acupuncture An Effective Treatment For Patients With Irritable Bowel Syndrome?, Amy Leber

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not acupuncture is an effective treatment for patients with Irritable Bowel Syndrome.