Diseases Commons^™

Time Of Year Affects Surgical Outcome Of Pediatric Congenital Heart Disease, Krystin Sinclair

Honors Projects in Science and Technology

Approximately 35,000 children are born in the US each year with Congenital Heart Disease (CHD). Surgical timing for many of these conditions is elective, and the distribution of surgical cases, therefore, varies with time of year. The hypothesis of this project is that time of the year for surgery is associated with mortality, length of hospital stay (LOS), and total hospital costs. A retrospective, cohort study was performed, using the Pediatric Health Information Systems (PHIS) Database to investigate these relationships.

Tools And Methods For Zika Prevention In Cachoeira, Bahia, Florence Tesha

Independent Study Project (ISP) Collection

Zika virus, which is mainly transmitted by Aedes aegypti and Aedes albopictus mosquitoes, has become a major health threat in Brazil and other Latin American countries. Brazil is the country that is being most impacted with zika virus in addition to the existing mosquito-borne diseases of dengue and chikungunya. With the increase in zika virus infections, there have also been increasing numbers of infant brain abnormalities such as microcephaly associated to zika. International and local health institutions are working together to control and prevent zika transmission. This project aimed to investigate the various tools and methods employed by the Center …

Neglect Amidst The Zika Epidemic: A Case Study On The Reach Of Government Campaigns And Resources In Quilombo Community Praia Grande, Bahia, Jenna Sherman

Independent Study Project (ISP) Collection

In response to the ongoing Zika epidemic in Brazil, a nationwide campaign has recently been launched targeting the eradication of mosquitoes, preventing the contraction of Zika, and deterring pregnancies. Many remote areas of Brazil, however, may not be being reached by these campaigns or resources to the same extent as more urban or affluent areas of Brazil—despite the existence of the universal healthcare system Sistema Único de Saúde (SUS). My objective, therefore, is to assess which media and on-ground campaigns regarding Zika have reached the minute island town of Praia Grande—a rural fishing Quilombo community of approximately 2,000 occupants off …

La Accesibilidad Al Test De Vph Y Al Papanicolaou Para La Prevención Del Cáncer Cervicouterino En Servicios Públicos De Salud En San Miguel De Tucumán Según La Perspectiva De Los Profesionales De Salud, Eve Cleghorn

Independent Study Project (ISP) Collection

Información contextual: El cáncer cervicouterino es causado por el Virus del Papiloma Humano (VPH) y todavía es un problema actual en Argentina, con alrededor de 5.000 casos nuevos y 1.800 muertes cada año. Sin embargo, es muy prevenible debido a que es una enfermedad de crecimiento lento, y con herramientas correctas de tamizaje y diagnóstico. Estas incluyen la vacuna contra diferente tipos de VPH de alto riesgo y el Papanicolaou, un procedimiento en el cual se examinan las células del cuello de útero que podrían ser indicios de lesiones pre-cancerosas o cancerosas, las cuales pueden ser tratadas. Además, en unas …

The Feminization Of Hiv/Aids In Yunnan, China, Leah Pinckney

Independent Study Project (ISP) Collection

The feminization of HIV is a global phenomenon in which more women are becoming HIV-positive. This not only has tragic consequences for those women but also signifies how HIV transmission in China is changing. Increased sexual transmission has given HIV the ability to move from at-risk groups, such as intravenous drug users and commercial sex workers, to the general population. Despite China’s improved health policies and programs about HIV, this situation poses a serious public health issue allowed to perpetuate because of societal problems surrounding gender. These problems are compounded by socioeconomic inequality brought upon by economic change. While much …

Educación Del Paciente Para El Auto Cuidado De La Diabetes En El Centro De Salud De Primaria Atención: Villa Verde En Partido De Pilar, Buenos Aires, Ethan Leigner

Independent Study Project (ISP) Collection

Vivir con diabetes cambia toda la vida de una persona. Sin el conocimiento de su autocuidado, el paciente tiene poca oportunidad de seguir viviendo la vida que desean. Sin educación adecuada, los diabéticos probablemente desarrollarán complicaciones que pueden conducir a problemas de salud muy graves y costosos. La prevalencia de diabetes ha ido en aumento en Argentina, y una estrategia efectiva para educar a los pacientes en el autocuidado es más necesaria ahora que nunca. Con un proceso eficiente de orientar a los pacientes a través del autocuidado, Argentina puede manejar mejor a largo plazo el efecto de diabetes y …

Effective Interventions To Reduce The Increase In Elective Cesarean Sections In Low Risk Women, Kimberly Kelsey, Crystal Hunter, Brianna-Kirsten Tan, Sara Shea, Heather Holland, Sasha Riley, Mary Uy, Tenzin Tsomo, Fasha Ruys-Solorzano, Dolma Tso

Student Research Posters

According to the Annals of Family Medicine, the amount of babies born via cesarean section has increased from 4.5% in 1965 to 26.1% in 2002 and nearly 40% of all cesarean sections are repeats. After an extensive literature review, results showed that patients need to be educated about the risks and benefits of vaginal delivery and cesarean delivery. It was also found that there needs to be policy changes to decrease the amount of cesarean sections done and increase the labor and delivery support without using interventions. Further study should be focused on morbidity and mortality very low birth weight …

Add-On Laba In A Separate Inhaler As Asthma Step-Up Therapy Versus Increased Dose Of Ics Or Ics/Laba Combination Inhaler., David B Price, Gene Colice, Elliot Israel, Nicolas Roche, Dirkje S Postma, Theresa W Guilbert, Willem M C Van Aalderen, Jonathan Grigg, Elizabeth V Hillyer, Victoria Thomas, Richard J Martin

Medicine Faculty Publications

Asthma management guidelines recommend adding a long-acting β2-agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler. Risk-domain asthma control was the primary end-point …

Examining Maternal Obesity Effects On Oogenesis, Follicular Development, And Embryonic Myogenesis, Chris Lindeman, Jennifer Wood

UCARE: Research Products

The CDC estimates that more than one-third of U.S. adults (approximately 78.6 million) are obese. Despite national efforts to combat this with diet and exercise, the number of obese adults and children continues to climb. It is critical to emphasize that obesity can lead to lifelong, chronic complications and health risks including hypertension, heart disease, and diabetes.

Diet and obesity also have important impacts on the reproductive health of female including the ability to become pregnant (fertility) and risk for complications during pregnancy. Furthermore, for women who do become pregnant, obesity can affect the development of the embryo and fetus, …

Asessing The Implementation Of Hiv/Aids Programs Amongst Youth Fisherfolk: The Case Of Mbita, Kenya, Edward Ham

Independent Study Project (ISP) Collection

Homa Bay, Nyanza Province has the highest HIV/AIDS prevalence rate in Kenya (25.7%). Risky sexual behaviors are especially prevalent in fishing communities within this area. This study was conducted in Mbita, a sub-county of Homa Bay. The main objective was to determine which factors influence the implementation of HIV/AIDS programs amongst youth fisherfolk (ages 18-24) within beaches around Mbita. Data was collected through survey administration, key-informant interviews, and in depth interviews. The results highlight some interesting correlations, as well as a disturbing picture of the inequities females face within these fishing communities. Furthermore, a novel microclinic peer education HIV/AIDS program …

A Community Hospital Antimicrobial Stewardship Program’S Assessment Of Prolonged Infusion Piperacillin-Tazobactam For Pseudomonas Aeruginosa Pneumonia, Lee Nguyen, Paul Gavaza, Amy Y. Kang, An Nguyen, Liem Hoang, Nguyen Ta

Pharmacy Faculty Articles and Research

Background: The study aim was to determine and compare the length of hospitalization, mortality, clinical stability, and time to clinical stability of a standard infusion (SI) and prolonged infusion (PI) piperacillin-tazobactam (TZP) in Pseudomonas aeruginosa ( PA) pneumonia patients.

Methods: This retrospective study evaluated length of hospitalization, mortality, clinical stability, and time to clinical stability with either SI-TZP or PI-TZP therapy in hospitalized patients diagnosed with PA pneumonia between January 01, 2008 and June 30, 2014. Patients were included in the study if they received ≥2 days of TZP, were diagnosed with PA pneumonia, and had TZP therapy …

Intimin Likely Used To Cause Disease During Competition With Commensal Escherichia Coli, Dominique J. Richburg

Senior Honors Theses

The intimin gene in the Locus of Enterocyte Effacement (LEE) island of pathogenicity is the primary attachment mechanism in Citrobacter rodentium. Intimin is a bacterial adhesin (protein) that attaches to obtain a niche/nutrient and thrive within the intestine. Intimin was deleted within C. rodentium to study colonization and pathogenesis in the murine intestine. Additionally, C. rodentium is an attaching/effacing pathogen, and a useful murine model in understanding Enterohemorrhagic Escherichia coli (EHEC) infection in humans. E. coli and C. rodentium cause gastroenteritis in humans and mice, respectively. C. rodentium is a murine pathogen commonly used to model gastrointestinal disease because …

Re-Inventing Adherence: Toward A Patient-Centered Model Of Care For Drug-Resistant Tuberculosis And Hiv, Max R. O'Donnell, A. Daftary, M. Frick, Y. Hirsch-Moverman, K. R. Amico, M. Senthilingam, A. Wolf, J. Z. Metcalfe, P. Isaakidis, J. L. Davis, J. R. Zelnick, J.C.M. Brust, N. Naidu, M. Garretson, David Bangsberg, N. Padayatchi, G. Friedland

OHSU-PSU School of Public Health Faculty Publications and Presentations

BACKGROUND—Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care.

OBJECTIVE—To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support.

DISCUSSION—Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TB-HIV could be improved by fully implementing team-based patient-centered …

Biventricular Myocardial Performance Is Impaired In Proportion To Severity Of Obstructive Sleep Apnea, Selahattin Akyol, Mustafa Cortuk, Ahmet Oytun Baykan, Kemal Kiraz, Abdurrezzak Borekci, Taner Seker, Mustafa Gur, Murat Cayli

The Texas Heart Institute Journal

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity and death. Little information is available regarding the relationship between the severity of OSA and myocardial performance in OSA patients who have normal ejection fractions. We prospectively investigated this relationship, using the tissue-Doppler myocardial performance index (TD-MPI).

We conducted overnight, full-laboratory polysomnographic examinations of 116 patients, and calculated the left and right ventricular TD-MPIs. Patients were classified into 3 groups in accordance with their apnea-hypopnea index (AHI) levels: AHImild (≥5 to <15), AHImoderate (≥15 to <30), and AHIsevere (≥30).

Left and right ventricular TD-MPI values were higher in the AHIsevere group than in the AHImild and …

Cardiac Papillary Fibroelastoma: Single-Institution Experience With 14 Surgical Patients, Walid K Abu Saleh, Odeaa Al Jabbari, Basel Ramlawi, Michael J Reardon

The Texas Heart Institute Journal

In general, treatment for symptomatic and asymptomatic cardiac papillary fibroelastoma is surgical resection-particularly of left-sided lesions, because of the risk of systemic embolization. However, few institutions have enough experience with these tumors to validate this approach. We present our institutional experience with papillary fibroelastoma and discuss our current approach. We searched our institution's cardiac tumor database, identified all patients diagnosed with cardiac papillary fibroelastoma from 1992 through 2014, and recorded the clinical and pathologic characteristics of each case. We found 14 patients (mean age, 60.5 ± 12.3 yr) who had 18 lesions. Eleven patients (79%) were symptomatic; however, we could …

Treatment And Prevention Of Human Rotavirus (Hrv) In Developing Countries: The Potential Of Avian Immunoglobulin Y, Christa Brown

Senior Honors Theses

Rotavirus gastroenteritis is a leading cause of childhood mortality, killing ~1400 children younger than five daily, primarily through severe diarrheal dehydration. Eighty-five percent of this mortality occurs in developing countries where rotavirus vaccines are not widely implemented and are only partially effective. In those countries, it has proven difficult to implement the recommended supportive therapies like oral rehydration therapy (ORT) on a wide scale due to lack of both medical infrastructure and private economic investment combined with cultural bias against ORT. IgY targeting human rotavirus (anti-HRV IgY) shows potential as a passive immunotherapy that reduces rotavirus-associated morbidity and mortality, augments …

Bioprosthetic Aortic Valve Endocarditis In Association With Enterococcus Durans, Luca Fallavollita, Lorena Di Gioacchino, Fabrizio Balestrini

The Texas Heart Institute Journal

Enterococci are common organisms associated with endocarditis, but infection by Enterococcus durans is very rare. To our knowledge, only 3 cases have been reported in the medical literature, and all 3 have involved native valves. Here we publish the first reported case (to our knowledge) of E. durans endocarditis in association with a bioprosthetic aortic valve. After the organism and its antibiotic susceptibility were identified, the 74-year-old male patient was treated successfully with teicoplanin and gentamicin, over a course of 6 weeks.

Advancing A Guiding Catheter Across A Mechanical Aortic Valve, Wassim Shatila, Guilherme V Silva

The Texas Heart Institute Journal

No abstract provided.

Longitudinal Changes In Vascular Risk Markers And Mortality Rates Among A Latino Population With Hypertension, Matthew C Pflederer, Carlin S Long, Brenda Beaty, Edward P Havranek, Philip S Mehler, Angela Keniston, Mori J Krantz

The Texas Heart Institute Journal

Vascular markers such as pulse-wave velocity and carotid intima-media thickness (CIMT) might improve the prediction of incident cardiovascular disease beyond traditional risk factors. These vascular markers have not been well characterized in minority populations and might be more useful than inflammatory biomarkers. We conducted a prospective, longitudinal cohort study among hypertensive patients in an urban safety-net hospital. We evaluated inflammatory biomarkers, arterial pulse-wave velocity, and carotid intima-media thickness at baseline, 1 year, and 2 years. The primary outcome variable was CIMT. Generalized linear mixed-effects models were used to evaluate associations between CIMT and predictive variables accounting for the correlation of …

Women’S Views On The Challenges And Solutions In Preventing The Gendered Spread Of Hiv In Masxha, Cato Manor, Paige Mcmahon

Independent Study Project (ISP) Collection

Despite numerous national prevention efforts, South Africa remains at the epicenter of the HIV/AIDS epidemic. The burden of the epidemic is extremely heterogeneous, with province, race, gender, age, and socioeconomic status serving as key variables in determining HIV prevalence rates. Black African women are disproportionately affected by the epidemic, with those between the ages of 20 and 34 having an HIV prevalence rate of 31.6%, the highest in the country (Shisana et al., 2014). The purpose of this study was to engage with black African women about the challenges they believe women face in protecting themselves against HIV, and potential …

Migrant Access To Healthcare: A Study Of Undocumented Migrant Access To Sexual Healthcare & Family Planning Services In Switzerland In 2016, Emily Egbert

Independent Study Project (ISP) Collection

The Swiss healthcare system has experienced a significant influx of vulnerable migrants over the past few years. This presents a challenge to providers and policy makers to account for and provide aid to these non-­‐ Swiss citizens, such as undocumented migrants (UDM), whose status and circumstances may impede their access to healthcare. Along with this, various cultural barriers may present further challenges to access to the health system. This paper explores UDM access to health through the lens of sexual healthcare and family planning. In examining sexual health, the issues of sexually transmitted infections (STIs), HIV/AIDS, and sexual violence were …

Rebound Growth Of Infantile Hemangiomas After Propranolol Therapy., Sonal D. Shah, Eulalia Baselga, Catherine Mccuaig, Elena Pope, Julien Coulie, Laurence M. Boon, Maria C. Garzon, Anita N. Haggstrom, Denise Adams, Beth A. Drolet, Brandon D. Newell, Julie Powell, Maria Teresa García-Romero, Carol Chute, Esther Roe, Dawn H. Siegel, Barbara Grimes, Ilona J. Frieden

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Propranolol is first-line therapy for problematic infantile hemangiomas (IHs). Rebound growth after propranolol discontinuation is noted in 19% to 25% of patients. Predictive factors for rebound are not completely understood and may alter the management approach. The goal of the study was to describe a cohort of patients with IHs treated with propranolol and to identify predictors for rebound growth.

METHODS: A multicenter retrospective cohort study was conducted in patients with IHs treated with propranolol. Patient demographic characteristics, IH characteristics, and specifics of propranolol therapy were obtained. Episodes of rebound growth were recorded. Patients' responses to propranolol …

Kidney Disease Progression In Autosomal Recessive Polycystic Kidney Disease., Katherine M. Dell, Matthew Matheson, Erum A. Hartung, Bradley A. Warady, Susan L. Furth

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To define glomerular filtration rate (GFR) decline, hypertension (HTN), and proteinuria in subjects with autosomal recessive polycystic kidney disease (ARPKD) and compare with 2 congenital kidney disease control groups in the Chronic Kidney Disease in Children cohort.

STUDY DESIGN: GFR decline (iohexol clearance), rates of HTN (ambulatory/casual blood pressures), antihypertensive medication usage, left ventricular hypertrophy, and proteinuria were analyzed in subjects with ARPKD (n = 22) and 2 control groups: aplastic/hypoplastic/dysplastic disorders (n = 44) and obstructive uropathies (n = 44). Differences between study groups were examined with the Wilcoxon rank sum test.

RESULTS: Annualized GFR change in subjects …

Injury Risk Assessment Of The Femur In Children With Osteogenesis Imperfecta, Jessica Marie Fritz

Dissertations (1934 -)

Osteogenesis imperfecta (OI) is a genetic disorder characterized by increased bone fragility and decreased bone mass, which leads to high rates of bone fracture. OI has a prevalence of 1/5,000 to 1/10,000 in the United States. About 90% of persons with OI have a genetic mutation in the coding for collagen type I, which is the major protein of connective tissues, including bone. While its prevalence classifies it as a rare disease, it is the most common disorder of bone etiology. Until recently, little was known about the mechanics and materials of OI bone or their impact on fracture risk. …

Paediatric Tuberculosis In Bhopal, Madhya Pradesh, India: Dots, Diagnosis, And Determinants, Emma Klein

Independent Study Project (ISP) Collection

Tuberculosis (TB) is one of the world’s largest public health challenges, and it has a disproportionate impact on India. In children, TB is a serious but understudied illness due to the complexity of case-notification and relative lack of public health importance. This study took place over the course of one month in Bhopal, Madhya Pradesh, India. In a mixed method study consisting of 53 quantitative patient interviews and qualitative interviews with healthcare providers, social determinants of TB in this setting were investigated as well as challenges faced at all stages of healthcare delivery. Malnutrition and housing were the most severe …

"Mi Niño Con Asma": Hispanic/Latina Mothers, Environmental Justice, And Photovoice At The Front Lines Of The Asthma Epidemic, Robin A. Evans-Agnew Rn, Phd, Julie Postma Rn, Phd, Lee Sledd M. Ed

Journal of Health Disparities Research and Practice

Asthma is an important environmental justice concern for first generation Mexican-Americans. Families experience disparities in housing conditions, access to care, and legal marginalization. Little is known about how Hispanic/Latina mothers of children with asthma navigate these oppressions.

Problem: The purpose of this paper is to describe the discourses of environmental justice of a group Hispanic/Latina caregivers of children with asthma.

Method: A photovoice design was used with Hispanic/Latina mothers (n=11) in Tacoma, Washington, to take, discuss, select and display phototexts to policymakers that communicated their experiences and opinions in managing asthma for their child. Using critical narrative analysis, phototexts were …

The Construct And Predictive Validity Of Psychosocial Correlates Of Television Viewing, Raheem Paxton, Pascal Jean-Pierre, Saehwan Park, Yong Gao Dr., Stephen Herrmann, G J. Norman

Journal of Health Disparities Research and Practice

Background: Many studies have examined the consequences of prolonged television viewing, but few studies have examined the psychological states that contribute to this behavior. In this study, we evaluated the construct and predictive validity of psychosocial correlates of television viewing in a population of African American (AA) breast cancer survivors (BCS).

Methods: AA BCS (N = 342, Mean age = 54 years) completed measures of decisional balance, self-efficacy, family support, and time spent watching television online. Exploratory structural equation modeling (ESEM) was used to examine the construct and predictive validity as well as the differential item functioning of the instruments …

Dental Health Practices In Us College Students: The American College Health Association-National College Health Assessment Findings, Lori Dewald Edd, Atc, Mches, F-Aahe

Journal of Health Disparities Research and Practice

Objective: The purpose of this study is to investigate the dental health seeking practices of US college students. Participants: The total number of college students who participated in the ACHA-NCHA survey from 2000-2013 was 1,201,531. Methods: The data requested were the demographic questions and the dental health question from both the ACHA-NCHA I and II. The data were analyzed using SPSS version 20. Results: The percentage of students who reported having a dental exam and cleaning in the last year averaged 76.6% in this study period of time. However, dental health care declined annually following their freshman year. More females …

Pain In Photodynamic Therapy, Mircea Tampa, Maria Isabela Sârbu, Mădălina Irina Mitran, Cristina Iulia Mitran, Adrian Dumitru, Vasile Benea, Simona Roxana Georgescu

Journal of Mind and Medical Sciences

Photodynamic therapy is a modern treatment with applications in several medical specialties, which has been intensely studied in the last years. The main indications in dermatology are actinic keratosis, superficial basal cell carcinoma and Bowen's disease- common skin disorders in which photodynamic therapy proved its efficacy. At present, the use of photodynamic therapy for the treatment of other skin disorders is profoundly researched. Pain is the most common and redoubtable adverse effect of photodynamic therapy and it is the most important factor affecting the patient's adherence to treatment. The aim of this article is to look over the most recent …

Single-Nucleotide Polymorphisms In Psca And The Risk Of Breast Cancer In A Chinese Population., Meng Wang, Xijing Wang, Sidney W. Fu, Zhijun Dai, Tianbo Jin, + 10 Additional Authors

Medicine Faculty Publications

This study explored the associations between common PSCA single-nucleotide polymorphisms (rs2294008, rs2978974, and rs2976392) and breast cancer among 560 breast cancer cases and 583 controls (Chinese Han women). We found rs2294008 was significantly associated with a high risk of breast cancer (homozygote model, odds ratio [OR]: 1.67, 95% confidence interval [CI]: 1.06–2.59; recessive, OR: 1.64, 95% CI: 1.06–2.53). And stratification by menopausal status revealed an association of the minor allele of rs2294008 with breast cancer risk among premenopausal (homozygote model, OR: 2.41, 95% CI: 1.03–5.66; recessive, OR: 2.80, 95 % CI: 1.21–6.47) and postmenopausal women (allele model, OR: 1.29, 95% …