Diseases Commons^™

Hashimoto’S Disease: The Underactive Thyroid Disease, Patty Anderson

Nursing Student Class Projects (Formerly MSN)

The thyroid gland is part of the endocrine system and has a widespread function that controls multiple organ systems and processes. The main function of the thyroid gland is to produce and secrete two different thyroid hormones: triiodothyronine (T3) and thyroxine (T4), both of which help to meet the metabolic demands of the entire body. When the thyroid gland fails to produce T3/T4 hormones (primary gland failure) or is not activated successfully by the pituitary gland (by the release of thyroid stimulating hormone (TSH)), or hypothalamus, this results in low levels of circulating thyroid hormone. As low levels of the …

Sle And Pregnancy, Patricia Graham

Nursing Student Class Projects (Formerly MSN)

Systemic lupus erythematosus (SLE) is a life-long, life-threatening autoimmune disease which can affect any organ in the body (Marks & Tullus, 2011). SLE disproportionately affects women in a ratio of 9:1 compared to men with most women being affected during child-bearing age (15-50 years) (Ferenkeh-Koroma, 2012). Pregnancy represents a challenge for the patient with SLE. Pregnant patients with SLE are considered high-risk for multiple medical and obstetric complications, as flares are related to increased irreversible organ damage (Ateka- Barrutia & Khamashta, 2013). Severe flares are also associated with poor fetal outcomes (Peart & Clowse, 2014). Successful pregnancies happen in 67% …

Effects Of Enhanced External Counter Pulsation Therapy On Patients With Angina, Valerie Jones

Nursing Student Class Projects (Formerly MSN)

According to the literature, coronary heart disease (CHD) is responsible for 370,000 deaths annually in the United States (Centers for Disease Control and Prevention [CDC], 2015). A symptom commonly associated with CHD is angina (US Department of Health & Human Services, National Institute of Health, National Heart, Lung, and Blood Institute [NIH], 2011). An estimated 300,000 to 900,000 patients in the United States have refractory angina pectoris (RAP), with nearly 100,00 new cases diagnosed yearly (Manchanda, Aggarwal, Aggarwal, & Soran, 2011). Kones describes refractory angina as continued angina class III/IV, in the nonsurgical candidate, with objective evidence of ischemia despite …

Rhabdomyolysis – Understanding The Mechanics, Tawnya Tucker

Nursing Student Class Projects (Formerly MSN)

As a hospital healthcare provider on a Medical/Surgical Unit the probability of examining and treating a patient diagnosed with rhabdomyolysis is scarce. Knowing the mechanics of the disease will assist the provider in evaluating and treating the patient. Awareness of the pathophysiology of the disease is vital in accurately diagnosing and treating the disease. The role of the advanced practice nurse is fundamental in distinguishing possible causes of the phenomenon by recognizing signs and symptoms that occur with the disease. Completing a thorough physical exam on the patient and obtaining special lab tests will assist in identifying the ailment. Treating …

Paradoxical Vocal Fold Motion, Stephen Sherer

Nursing Student Class Projects (Formerly MSN)

Paradoxical vocal fold motion (PVFM), otherwise known as vocal cord dysfunction (VCD) is an abnormal degree the vocal folds adduct upon inspiration causing airflow narrowing. This restriction can cause severe dyspnea and can be misdiagnosed as asthma. The cause of the abnormality related to PVFM has not been directly recognized, but multiple factors or triggers are associated. It is this lack of clarity and association with asthma, exercise, extubation, stress, and gastric reflux that I take interest in this pathology. I have a personal connection with exercise induced asthma. In addition, my sister in-law was recently diagnosed with VCD who …

Implications Of Underlying Pathophysiology Of Osteomyelitis In Diabetics For Nursing Care, Danielle Spencer

Nursing Student Class Projects (Formerly MSN)

Osteomyelitis is an infection of the bone caused by either bacteria, fungi, parasites, viruses or mycobacteria (McCance, et. al., 2014). The infection can enter bone either through an outside source or through the blood from a blood borne infection (McCance, et. al., 2014). The most common bacteria involved with osteomyelitis is Staphylococcus aureus (Hatzenbuehler & Pulling, 2011, p. 1027). Recently, at Dublin Methodist Hospital there has been an increase in the number of osteomyelitis cases in chronic uncontrolled diabetic patients requiring below the knee amputations. Two of the cases specifically were linked to chronic diabetic foot ulcers. Each of these …

The Pathology Of Heart Failure, Kevin Ahman

Nursing Student Class Projects (Formerly MSN)

The topic I have chosen to research is heart failure. I have chosen this topic because I have treated many patients in the ICU with this condition, and find it an interesting pathology. Heart failure affects a significant portion of the patient population, and the rates are increasing. 5.1 million Americans ≥20 years of age have heart failure, projections show that by 2030, the prevalence of HF will increase 25% from 2013 estimates. At 40 years of age, the lifetime risk of developing HF for both men and women is 1 in 5. At 80 years of age, remaining lifetime …

Clostridium Difficile, Kristen Johnson

Nursing Student Class Projects (Formerly MSN)

Clostridium difficile (CD) is an infectious disease that has a direct impact on our healthcare resources. “Clostridium difficile, an anaerobic, spore forming, toxin-forming, gram-positive bacillus, has become the leading cause of health care—associated infectious diarrhea (Walters & Zuckerbraun, 2014, p. 329).” I chose this topic because CD is a hypervirulent organism that is not only affecting hospitalized patients but is now emerging as a community acquired infection. Healthcare treatments and costs are on the rise due to persistent and recurrent CD infections. Understanding the pathogenesis, risk factors, diagnostic testing, and management strategies are important in reducing the spread of CD …

Levels Of 8-Oxodg Predict Hepatobiliary Pathology In Opisthorchis Viverrini Endemic Settings In Thailand., Prasert Saichua, Anna Yakovleva, Christine Kamamia, Amar R. Jariwala, Paul J. Brindley, Jeffrey M. Bethony, + 8 More

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Opisthorchis viverrini is distinct among helminth infections as it drives a chronic inflammatory response in the intrahepatic bile duct that progresses from advanced periductal fibrosis (APF) to cholangiocarcinoma (CCA). Extensive research shows that oxidative stress (OS) plays a critical role in the transition from chronic O. viverrini infection to CCA. OS also results in the excision of a modified DNA lesion (8-oxodG) into urine, the levels of which can be detected by immunoassay. Herein, we measured concentrations of urine 8-oxodG by immunoassay from the following four groups in the Khon Kaen Cancer Cohort study: (1) O. viverrini negative individuals, (2) …

Takotsubo Cardiomyopathy, Angela J. Occidental

Nursing Student Class Projects (Formerly MSN)

Takotsubo cardiomyopathy is a rare, reversible form of cardiomyopathy. First cases of takotsubo cardiomyopathy were described in Japan, twenty years ago (Milinis, & Fisher, 2012). takotsubo cardiomyopathy is a transient left ventricular dysfunction, typically triggered by severe emotional or physical distress. Left ventricular ballooning is characteristic of Takotsubo syndrome. Images of this ballooning resemble a takotsubo vessel used in Japan for collecting octopus, thus the reason for the syndrome name (Pelliccia, et. al, 2014). In recent years, this cardiomyopathy has been described as “Broken heart syndrome” because severe emotional stress has been implicated as the cause of this cardiomyopathy in …

Investigating Duchenne’S Muscular Dystrophy, Ashley Beaujon

Nursing Student Class Projects (Formerly MSN)

Young boys usually present with disordered or delayed motor development, muscle weakness, and possible speech delays in early childhood (Ruiten et al, 2014). The first symptoms almost always show up prior to the age of six years. Parents may notice their young child with DMD having a hard time standing up, walking, or climbing stairs, and many will eventually need a wheelchair to get around (Brennan, 2014). Initial blood tests obtained are remarkable for an elevated creatine kinase (CK) and then diagnosis is typically confirmed with a genetic test showing a mutation in the dystrophin gene (Ruiten et al, 2014). …

Acute Pancreatitis, Laura Skidmore

Nursing Student Class Projects (Formerly MSN)

Acute pancreatitis (AP) can be a singular incidence, a relapsing process or exacerbations of chronic pancreatitis. AP is a rapidly developing inflammatory disorder of the pancreas and can affect other organ systems. The process begins when pancreatic enzymes are activated prematurely and leak into surrounding tissue. The digestive process begins before reaching the intestines. AP is characterized clinically by abdominal pain and elevated levels of pancreatic enzymes in the blood. The pathogenesis is not fully understood however, a number of conditions are known to induce the disorder such as gallstones and chronic alcohol abuse (Schub & Kornusky, 2014)

Cardiac Tamponade, Ashley Miner

Nursing Student Class Projects (Formerly MSN)

The topic the author chose to research is cardiac tamponade. Cardiac tamponade occurs when fluid builds up in the pericardial cavity, which is the cavity that surrounds the heart. Cardiac tamponade can occur due to various reasons, including myocardial infarctions, pericarditis, traumas, and placement of pacer wires. Palpitations, chest pain, and shortness of breath are common symptoms that occur with cardiac tamponade. Pericardiocentesis and a pericardial window are two interventions that are commonly used to treat cardiac tamponade. Cardiac tamponade is a medical emergency and without any intervention, may lead to cardiac arrest and possible death. The author chose cardiac …

Myasthenia Gravis And Implications For The Certified Registered Nurse Anesthetist, Matthew Predick

Nursing Student Class Projects (Formerly MSN)

In healthcare and, specifically anesthesia, there are many conditions that require various considerations by the prudent provider. An example of a condition requiring special attention is myasthenia gravis. Myasthenia gravis is an autoimmune disease in which skeletal muscle weakness and rapid fatigue result from destruction of nicotinic acetylcholine receptors [7]. Although the prevalence is not overwhelmingly high with most recent estimates of prevalence around 14 to 20 per 100,000 people in the United States [5] and 20 per 100,000 worldwide [9], inappropriate perioperative management of those with this ailment can result in serious consequences. Understanding the pathophysiology, various treatments (both …

Idiopathic Pulmonary Fibrosis: Understanding Has Led To Exciting Treatments, William Metz

Nursing Student Class Projects (Formerly MSN)

Pulmonary fibrosis can be described as an excessive amounts of fibrous connective lung tissue in the lung. Idiopathic pulmonary fibrosis(IPF) is the most common form of interstitial lung disease(ILD). When an obvious cause cannot be determined, a diagnosis of Idiopathic pulmonary fibrosis is made. The mean survival for patients is approximately 3-5 years from time of diagnosis. IPF is found primarily in men over 50 years of age, with a history of cigarette smoking with concurrent environmental and occupational inhalation exposures(Leslie, 2011, p. 592). Pulmonary fibrosis has been identified by early pathologists at the beginning of the last century. During …

Cervical Spinal Cord Injury, Melissa Schimmel

Nursing Student Class Projects (Formerly MSN)

A spinal cord injury (SCI) can occur at any level of the spinal cord. A SCI involves an interruption between the brain and the body due to an injury or damage to the spinal cord (Sheppard Center, 2011, p1.). The location and extent of the injury is important because it will determine the severity and extent of dysfunction. The higher the injury is to the spinal cord, the more severe the loss of motor function (Sheppard Center, 2011, p.4). The spinal cord injuries are classified by based on the extent of injury, motor and sensory losses. The injury is considered …

Abdominal Aortic Aneurysm: A Silent Killer, Kristen Springer

Nursing Student Class Projects (Formerly MSN)

Rupture of an abdominal aortic aneurysm (AAA) is a significant cause of mortality in the United States. “Often asymptomatic, AAA is considered a silent killer because it frequently remains undiagnosed until the time of rupture or the patient’s death” (Gordon & Toursarkinssian, p. 242). As healthcare professionals, being aware of the pathophysiology, risk factors and symptoms influencing this disease is important in aiding early diagnosis and treatment, helping to reduce complications and mortality rates of those affected.

Preparedness Of Nurses For Malignant Hyperthermia, Melissa Flemming

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a potentially life threatening disorder that occurs following exposure to certain inhaled anesthetics such as halothane, isoflurane, sevoflurane, desflurane, enflurane, ether, and methoxyflurane alone or in combination with the depolarizing muscle relaxant, succinylcholine (Seifert,, Wahr, Pace, Cochrane, & Bagnola, 2014, p. 189). Patients experiencing malignant hyperthermia may progress to death if it is not recognized and treated early. Patient outcomes improve the earlier an intervention is given. Malignant hyperthermia is not a common condition and, therefore, nurses are frequently unfamiliar with the common signs, symptoms, and treatments. Malignant hyperthermia can occur in a variety of settings …

The Importance Of Evaluation And Management Of Sepsis, Severe Sepsis, And Septic Shock, Katherine Herda

Nursing Student Class Projects (Formerly MSN)

Sepsis is a life-threatening and complicated host response to the presence of infection that is affecting millions of individuals around the world each year (Dellinger et al., 2013, p. 583). According to Gray et al. (2013), sepsis is not only one of the primary causes of hospital admission but it is also a leading cause of morbidity and mortality worldwide (p. 397). Severe sepsis and septic shock are the more advanced and detrimental stages of sepsis, which are starting to increase in incidence and are killing one in four (and sometimes more) individuals infected (Dellinger et al., 2013, p. 583). …

Noroviruses As A Cause Of Diarrhea In Immunocompromised Pediatric Hematopoietic Stem Cell And Solid Organ Transplant Recipients, X. Ye, J. N. Van, F. M. Munoz, P. A. Revell, Claudia A. Korinetz, R. A. Krance, R. L. Atmar, M. K. Estes, H. L. Koo

ETSU Faculty Works

Case reports describe significant norovirus gastroenteritis morbidity in immunocompromised patients. We evaluated norovirus pathogenesis in prospectively enrolled solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients with diarrhea who presented to Texas Children's Hospital and submitted stool for enteric testing. Noroviruses were detected by real-time reverse transcription polymerase chain reaction. Clinical outcomes of norovirus diarrhea and non-norovirus diarrhea patients, matched by transplanted organ type, were compared. Norovirus infection was identified in 25 (22%) of 116 patients, more frequently than other enteropathogens. Fifty percent of norovirus patients experienced diarrhea lasting ≥14 days, with median duration of 12.5 days (range 1–324 …

A Combination Sms And Transportation Reimbursement Intervention To Improve Hiv Care Following Abnormal Cd4 Test Results In Rural Uganda: A Prospective Observational Cohort Study, Mark J. Siedner, Data Santorino, Alexander J. Lankowski, Michael Kanyesigye, Mwebesa B. Bwana, Jessica E. Haberer, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Up to 50 % of HIV-infected persons in sub-Saharan Africa are lost from care between HIV diagnosis and antiretroviral therapy (ART) initiation. Structural barriers, including cost of transportation to clinic and poor communication systems, are major contributors.

Methods: We conducted a prospective, pragmatic, before-and-after clinical trial to evaluate a combination mobile health and transportation reimbursement intervention to improve care at a publicly operated HIV clinic in Uganda. Patients undergoing CD4 count testing were enrolled, and clinicians selected a result threshold that would prompt early return for ART initiation or further care. Participants enrolled in the pre-intervention period (January – …

Inhaled Nitric Oxide As An Adjunctive Treatment For Cerebral Malaria In Children: A Phase Ii Randomized Open-Label Clinical Trial, Juliet Mwanga-Amumpaire, Ryan W. Carroll, Elisabeth Baudin, Elisabeth Kemigisha, Dorah Nampijjah, Kenneth Mworozi, Data Santorino, Dan Nyehangane, Daniel I. Nathan, Pierre De Beaudrap, Jean-Francois Etard, Martin Feelish, Bernadette O. Fernandez, Annie Berssenbrugge, David Bangsberg, Kenneth D. Bloch, Yap Boum Ii, Warren M. Zapol

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background. Children with cerebral malaria (CM) have high rates of mortality and neurologic sequelae. Nitric oxide (NO) metabolite levels in plasma and urine are reduced in CM.

Methods. This randomized trial assessed the efficacy of inhaled NO versus nitrogen (N2) as an adjunctive treatment for CM patients receiving intravenous artesunate.We hypothesized that patients treated with NO would have a greater increase of the malaria biomarker, plasma angiopoietin-1 (Ang-1) after 48 hours of treatment.

Results. Ninety-two children with CM were randomized to receive either inhaled 80 part per million NO or N₂ for 48 or more hours. Plasma Ang-1 levels …

Shiga Toxin-Producing Escherichia Coli (Stec) Detection Strategies With Formalin-Fixed Stec Cells, Christopher Adam Baker

Graduate Theses and Dissertations

Certain pathogenic Escherichia coli known as Shiga toxin (Stx)-producing Escherichia coli (STEC) are commensals in cattle, and typically cause bloody diarrhea in humans once the Stx toxin is secreted in invaded intestinal epithelial cells. Infections with STEC cells can lead to hemolytic uremic syndrome, which is commonly associated with kidney failure. Several STEC serogroups have been declared adulterants in raw, non-intact ground meat, and future regulations could potentially lead to a higher number of STEC serogroup detection strategies for these pathogenic microorganisms. Microbiological research laboratories may benefit from formalin-fixed STEC cells for periodic (daily, weekly, monthly, among others) instrument validation/calibration …

Effects Of Antiretroviral Therapy On Kaposi’S Sarcoma–Associated Herpesvirus (Kshv) Transmission Among Hiv-Infected Zambian Children, Landon Olp, Veenu Minhas, Clement Gondwe, Chipepo Kankasa, Janet M. Wojcicki, Charles Mitchell, John T. West, Charles Wood

Nebraska Center for Virology: Faculty Publications

Background: The risk of Kaposi’s sarcoma–associated herpesvirus (KSHV) acquisition among children is increased by HIV infection. Antiretroviral therapy (ART) was recently made widely available to HIV-infected children in Zambia. However, the impact of early ART on KSHV transmission to HIV-infected children is unknown.

Methods: We enrolled and followed a cohort of 287 HIV-exposed, KSHV-negative children under 12 months of age from Lusaka, Zambia, to identify KSHV seroconversion events. Potential factors associated with KSHV infection—with an emphasis on HIV, ART, and immunological measures—were assessed through structured questionnaires and blood analyses. Incidence rate, Kaplan- Meier, and multivariable Cox regression models were used …

Hla-Dqa1 And Plcg2 Are Candidate Risk Loci For Childhood-Onset Steroid-Sensitive Nephrotic Syndrome., Rasheed A. Gbadegesin, Adebowale Adeyemo, Nicholas J A Webb, Larry A A. Greenbaum, Asiri Abeyagunawardena, Shenal Thalgahagoda, Arundhati Kale, Debbie Gipson, Tarak Srivastava, Jen-Jar Lin, Deepa Chand, Tracy E. Hunley, Patrick D. Brophy, Arvind Bagga, Aditi Sinha, Michelle N. Rheault, Joanna Ghali, Kathy Nicholls, Elizabeth Abraham, Halima S. Janjua, Abiodun Omoloja, Gina-Marie Barletta, Yi Cai, David D. Milford, Catherine O'Brien, Atif Awan, Vladimir Belostotsky, William E. Smoyer, Alison Homstad, Gentzon Hall, Guanghong Wu, Shashi Nagaraj, Delbert Wigfall, John Foreman, Michelle P. Winn, Mid-West Pediatric Nephrology Consortium

Manuscripts, Articles, Book Chapters and Other Papers

Steroid-sensitive nephrotic syndrome (SSNS) accounts for >80% of cases of nephrotic syndrome in childhood. However, the etiology and pathogenesis of SSNS remain obscure. Hypothesizing that coding variation may underlie SSNS risk, we conducted an exome array association study of SSNS. We enrolled a discovery set of 363 persons (214 South Asian children with SSNS and 149 controls) and genotyped them using the Illumina HumanExome Beadchip. Four common single nucleotide polymorphisms (SNPs) in HLA-DQA1 and HLA-DQB1 (rs1129740, rs9273349, rs1071630, and rs1140343) were significantly associated with SSNS at or near the Bonferroni-adjusted P value for the number of single variants that were …

Obesity Early In Adulthood Increases Risk But Does Not Affect Outcomes Of Hepatocellular Carcinoma, Manal M. Hassan, Reham Abdel-Wahab, Ahmed Kaseb, Ahmed Shalaby, Alexandria Phan, Hashem El-Serag, Ernest Hawk, Jeff Morris, Kanwal Pratap Singh Raghav, Ju-Seog Lee, Jean-Nicolas Vauthey, Gehan Bortus, Harrys Torres, Christopher Amos, Robert Wolff, Donghui Li

Dartmouth Scholarship

Despite the significant association between obesity and several cancers, it has been difficult to establish an association between obesity and hepatocellular carcinoma (HCC). Patients with HCC often have ascites, making it a challenge to accurately determine body mass index (BMI), and many factors contribute to the development of HCC. We performed a case–control study to investigate whether obesity early in adulthood affects risk, age of onset, or outcomes of patients with HCC.

Unraveling The Mysteries Of The Mitochondria In Huntington's Disease – And Getting Fast, Clear, And Useful Results From Research Studies, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

The Self-Reported Sexual Behaviors Of Single Older African Americans, Victoria Foster, Patricia C. Clark, Marcia M. Holstad

Journal of Health Disparities Research and Practice

Abstract

African Americans are disproportionally affected by HIV/AIDS, but little is known about the risky sexual behaviors of older African Americans. This cross-sectional, comparative study, investigated the self-reported sexual behaviors of sexually active older African Americans. The nonrandom sample (N = 78) included single African American men (59%) and women (41%), 50-74 years of age. Participants were recruited from various community sites, and data were collected with a standard sexual history questionnaire. Participants reported practicing risky behaviors such having unprotected oral, anal, and vaginal sex (96.5%), and having multiple sex partners (37.2%). There were several significant gender differences such …

Exercise Improves Host Response To Influenza Viral Infection In Obese And Non-Obese Mice Through Different Mechanisms., Kristi J. Warren, Molly M. Olson, Nicholas J. Thompson, Mackenzie L. Cahill, Todd A. Wyatt, Kyoungjin J. Yoon, Christina M. Loiacono, Marian L. Kohut

Journal Articles: Pulmonary & Critical Care Med

Obesity has been associated with greater severity of influenza virus infection and impaired host defense. Exercise may confer health benefits even when weight loss is not achieved, but it has not been determined if regular exercise improves immune defense against influenza A virus (IAV) in the obese condition. In this study, diet-induced obese mice and lean control mice exercised for eight weeks followed by influenza viral infection. Exercise reduced disease severity in both obese and non-obese mice, but the mechanisms differed. Exercise reversed the obesity-associated delay in bronchoalveolar-lavage (BAL) cell infiltration, restored BAL cytokine and chemokine production, and increased ciliary …

Cationic Cell-Penetrating Peptides Are Potent Furin Inhibitors, Bruno Ramos-Molina, Adam N. Lick, Amir Nasrolahi Shirazi, Donghoon Oh, Rakesh Tiwari, Naglaa Salem El-Sayed, Keykavous Parang, Iris Lindberg

Pharmacy Faculty Articles and Research

Cationic cell-penetrating peptides have been widely used to enhance the intracellular delivery of various types of cargoes, such as drugs and proteins. These reagents are chemically similar to the multi-basic peptides that are known to be potent proprotein convertase inhibitors. Here, we report that both HIV-1 TAT47-57 peptide and the Chariot reagent are micromolar inhibitors of furin activity in vitro. In agreement, HIV-1 TAT47-57 reduced HT1080 cell migration, thought to be mediated by proprotein convertases, by 25%. In addition, cyclic polyarginine peptides containing hydrophobic moieties which have been previously used as transfection reagents also exhibited potent furin inhibition in vitro …