Diseases Commons^™

Transvenous Nonfluoroscopic Pacemaker Implantation During Pregnancy Guided By 3-Dimensional Electroanatomic Mapping, Jacob Hartz, Bradley C. Clark, Seiji Ito, Elizabeth D Sherwin, Charles I Berul

Pediatrics Faculty Publications

Patients with congenital heart disease are at ongoing risk of developing both bradyarrhythmias and tachyarrhythmias decades after surgical repair. Rarely, arrhythmias can be exacerbated during pregnancy and require emergent intervention. Here, we report unique experience with nonfluoroscopic pacemaker implantation during pregnancy. Ionizing radiation, even in low doses, is associated with an increased risk of malignancy, and a fetus may be at particularly increased risk.1, 2 Over the past 2 decades, the use of fluoroscopy in cardiac ablation procedures has become nearly obsolete with the development of 3-dimensional (3D) electroanatomic mapping software such as CARTO (Biosense-Webster, Diamond Bar, CA) …

Mycn Amplification Is Associated With Repressed Cellular Immunity In Neuroblastoma: An In Silico Immunological Analysis Of Target Database, Peng Zhang, Xiaofang Wu, Moushumi Basu, Chen Dong, Pan Zhang, Yang Liu, Anthony D. Sandler

Pediatrics Faculty Publications

Purpose: RNA and DNA sequencing data are traditionally used to discern intrinsic cellular pathways in cancer pathogenesis, their utility for investigating the tumor microenvironment (TME) has not been fully explored. This study explores the use of sequencing data to investigate immunity within the TME.

Experimental design: Here, we use immune cell fraction estimation analysis to determine the immune profiles in the microenvironment of neuroblastoma (NB) based on RNA-seq data in the TARGET database. The correlation between immune cell transcripts and prognosis in pediatric NB is also investigated.

Results: In silico analysis revealed a strong inverse correlation between MYCNamplification and …

Disorders Of Metal Metabolism, Carlos Ferreira, William A. Gahl

Pediatrics Faculty Publications

Trace elements are chemical elements needed in minute amounts for normal physiology. Some of the physiologically relevant trace elements include iodine, copper, iron, manganese, zinc, selenium, cobalt and molybdenum. Of these, some are metals, and in particular, transition metals. The different electron shells of an atom carry different energy levels, with those closest to the nucleus being lowest in energy. The number of electrons in the outermost shell determines the reactivity of such an atom. The electron shells are divided in sub-shells, and in particular the third shell has s, p and d sub-shells. Transition metals are strictly defined as …

H-Ipse Is A Pathogen-Secreted Host Nucleus Infiltrating Protein (Infiltrin) 3 Expressed Exclusively By The Schistosoma Haematobium Egg Stage, Luke Pennington, Abdulaziz Alouffi, Evaristus Mbanefo, Debalina Ray, David Heery, Theodore Jardetzky, Michael Hsieh, Franco Falcone

Urology Faculty Publications

Urogenital schistosomiasis, caused by the parasitic trematode Schistosoma haematobium, affects over 112 million people worldwide. As with S. mansoniinfections, the pathology in urogenital schistosomiasis is mainly related to the egg stage, which induces granulomatous inflammation of affected tissues. Schistosoma eggs and their secretions have been studied extensively for the related S. mansoniorganism which is more amenable to laboratory studies. Indeed, we have shown that IPSE/alpha-1 (M-IPSE herein), a major protein secreted from S .mansoni eggs, can infiltrate host cells. Although M-IPSE function is unknown, its ability to translocate to their nucleus and bind DNA suggests a possible …

Antibiotic Prophylaxis In Orbital Fractures., Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz

Ophthalmology Faculty Publications

Purpose:

To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection.

Design:

Retrospective cohort study.

Participants:

All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics.

Main Outcome Measures:

Development of orbital infection.

Results:

One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received …

Diabetes Mellitus: Concerns, Treatment Options, And The Future, Ryan Curry

Biology: Student Scholarship & Creative Works

Diabetes is a serious disease that is becoming very serious worldwide. This review will discuss some of the treatment options that are available for type two diabetes with a comparison to insulin management. It will discuss the history, genetics, economics, and also the future of diabetes management.

Trinidad & Tobago : Hiv Epidemic, Madison Caldwell

Global Public Health

Trinidad and Tobago are twin islands located in the Caribbean off the coast of Venezuela. In the recent years since about 1990, citizens of this country have been greatly affected by the HIV epidemic. HIV stands for human immunodeficiency virus and is spread through infected seman, blood, or vaginal fluids usually through sexual intercourse. As this virus continues to progress in the body, it will eventually turn into AIDS, which stands for acquired immunodeficiency syndrome. Once HIV progresses to AIDS, the outcome is ultimately fatal, hence why there is a dire need to promote awareness and methods of intervention to …

Singapore : Severe Acute Respiratory Syndrome (Sars), Dexter Lipps

Global Public Health

Singapore ranks as one of the healthiest countries in the world and its healthcare system has been regarded as one of the most efficient. While a minority of the population experience any chronic diseases such as diabetes or asthma, one illness, severe acute respiratory syndrome or SARS has been prevalent in the country since the global outbreak in 2003. SARS is a virus causing disease that is easily transmitted through the air. In 2003, Singapore, along with much of the world, saw a high rate of infection for the disease. An in depth look revealed that three women traveling home …

New Zealand : Mumps Outbreak, Kathryn Evans

Global Public Health

The purpose of this Health Brief is to discuss the outbreak of mumps in New Zealand during the summer of 2017. The year saw more cases than the past sixteen years combined. The reason that New Zealand, a high-income country that generally does not struggle with communicable diseases, may be experiencing this outbreak is low vaccination rates in the 1990’s. It appears that there was a decline in coverage for the MMR immunization at this time due to several factors. These include a transition in the timing of the second dose of MMR, a change from four years to eleven …

Nepal : Healthcare And Sanitation Issues Resulting From Frequent Natural Disasters In Nepal, Jake Lauderdale

Global Public Health

This Public Health Brief calls to attention the issues plaguing Nepal as a result of both frequent natural disasters and poor healthcare infrastructure. The geographic characteristics of Nepal are shown to be a major factor in the damage and aftermath of natural disasters such as earthquakes. Due to its status as a poor and economically weakened country, Nepal must rely heavily on outside aid in order to alleviate the pressure of frequently occurring natural disasters. Despite work being done by several Non-Governmental Organizations, Nepal has a long way to go before they are able to independently manage the outcomes of …

Peru : Zika Virus, Benjamin Martin

Global Public Health

This document covers zika virus as a public health issue in Peru. Peru is a coastal country in South America. It has a population of 31,777,000 and faces many problems in the years to come. Some of those problems are a largely informal economy, the melting of glaciers, and lots of the population are impoverish and under-educated. These challenges the country is facing makes zika virus more dangerous. Zika virus is a disease that is spreading across the world and is most dangerous to pregnant women because it can cause birth defects for the child, such as microcephaly. In this …

Afghanistan : Tuberculosis, Emily Fulk

Global Public Health

Afghanistan, a country in the Middle East, faces the epidemic of an infectious bacterial lung disease called Tuberculosis, or TB. Tuberculosis is fairly easy to spread, as the bacteria that causes it are spread from one person to another through tiny droplets released into the air via coughs and sneezes. Despite the widespread amounts of individuals affected with TB, it is known to be easily curable using a six month treatment. And so public health officials have implemented a program called DOTS, or Directly Observed Treatment Short Course in Kabul City to test the effectiveness of this treatment. The DOTS …

Burundi : Water Scarcity, Isabel Salas

Global Public Health

Burundi is located near the African great lakes region of East Africa. This country is one of the poorest and hungriest countries throughout the world because of this they are facing multiple problems with communicable disease. These families are seeing a reduction in the amount of water available to them and based on this they are receiving water from external sources such as wells and lakes. Most of the water throughout Burundi is contaminated with Phytoplankton which increase cholera outbreaks in this area. It has also been shown that uranium impacts the water throughout the wells and lakes. Both of …

Guam : Mumps, Taylor Covert

Global Public Health

In the years of 2009-2010, Guam experienced an outbreak of mumps that was widespread throughout the country. Mumps is a disease in which the parotid gland located in the face and neck region swells and can cause inflammation in the brain. Though a majority of the citizens were vaccinated for MMR, there was still a problem throughout the nation. The vaccine is provided in a number of doses, three being the optimal amount. It was later revealed that citizens who were vaccinated only received two doses, not fully protecting them from the illness. 505 cases were reported overall for this …

Chad : Hepatitis E, Hanna Pegarsch

Global Public Health

Contaminated drinking water in Chad is the main source for a Hepatitis E outbreak, leading Chad citizens to develop severe illness including jaundice, liver-failure, miscarriage, and death. There are 0.4 physicians for every 10,000 people living in Chad needing healthcare. Of the citizens in Chad, only 42% have access to uncontaminated drinking water. With such a long incubation period for Hepatitis E, the citizens don’t know they are spreading the illness to the rest of their community. Even with the symptoms, the citizens don’t have the access or the capacity for treatment, making Hepatitis E an epidemic in Chad.

Namibia : Hiv As A National Issue, Elisabeth Vlasak

Global Public Health

Namibia is located on the southwestern coast of Africa, bordering Angola, Botswana, Zambia, South Africa, and the Atlantic Ocean. Namibia has a population of 2,265,000, as of 2016. Namibia has many challenges, including food insecurity and malnutrition, access to health services, unequal distribution of wealth, but HIV/AIDS is one of the country’s leading challenges. It is estimated that the overall adult infection rate of HIV/AIDS is 15.4% and it is the leading cause of death in Namibia. Adults ages 18-24 are the most at-risk for the disease. Some of the major risk factors are declining condom use, misinformation, social stigma, …

Zimbabwe : Malaria, Ashton Hutcheson

Global Public Health

Zimbabwe, a developing country in southeastern Africa, has a population of over 15 million people. The large majority of this population is at risk for various prevalent infectious disease including the significant threat that is Malaria. Zimbabwe is a country within what the World Health Organization determines as the “WHO African Region.” This region is where 90% of Malaria deaths occur worldwide. This brief provides reasons why malaria is such a major problem including the country’s general lack of clinics and key risk factors associated with contracting malaria. It was found that those most at-risk for malaria live in houses …

Guatemala : Chagas Disease, Audrey Datzman

Global Public Health

Chagas disease is a parasitic and vector-borne endemic prevalent across Latin American countries, particularly Guatemala. The parasite, Trypanosoma cruzi, is spread through triatomine insect vectors often found in low-income housing. Already claiming twelve-thousand deaths in 2016, Guatemala faces a major challenge in attempting to eliminate the triatomine vectors of Chagas disease. Various interventions have been undertaken in the country, including insecticide-based control and community-based vector surveillance.

Ukraine : Papillary Thyroid Cancer, Elizabeth Paris

Global Public Health

Ukraine is a middle- to low- income country run by a semi-presidential republic, after the banning of the Communist party in the early 1990's. While the nation faces various internal and external challenges, including unemployment rates and war with Russia, Ukraine also continues to face a major public health issue that originated in the 1980's. In 1986, an explosion was triggered at the nuclear power plant in Chernobyl, Ukraine. The explosion released radioactive iodine into the ground, water, and air, and it was discovered soon after that this had a long-lasting effect on health. It has been observed that rates …

Gabon : Hiv/Aids, Amanda Lindau

Global Public Health

Gabon is a country in West Africa that has a population of 1.8 million and is a relatively poor nation. It has had quite a few public health and political problems in the last couple of years. These problems include water and electricity shortages along with HIV/AIDS. HIV seems to be one of the biggest public health problems in Gabon at this moment. There is quite a bit of the population that is living with this virus. However, there are many people that are living with this virus but either do not understand the severity of it or just do …

Pseudomembranous Tracheitis Caused By Aspergillus Fumigatus In The Setting Of High Grade T-Cell Lymphoma, Prashant Malhotra, Karan Singh, Paul Gill, Sonu Sahni, Mina Makaryus, Arunabh Talwar

Touro College of Osteopathic Medicine (New York) Publications and Research

Pseudomembranous tracheitis (PMT) is a rare condition most commonly caused by fungal or bacterial infection that is characterized by a pseudomembrane that partially or completely covers the tracheobronchial tree. PMT is most commonly found in immunocompromised patient populations, such as post-chemotherapy, AIDS, post-transplant and hematological malignancies. Due to its rarity, PMT is often not included in the differential diagnosis. This case describes a 65 year old male with persistent fever and refractory cough despite high dose empiric antibiotics. Subsequent bronchoscopy with biopsy revealed pseudomembranous tracheitis due to Aspergillus fumigatus in the setting of T-cell lymphoma. PMT should be considered in …

Primary Pulmonary Malt Lymphoma Presenting As Non-Resolving Pneumonia, Asma Iftikhar, Albert Magh, Muhammed Azaz Cheema, Sarah Thappa, Sonu Sahni, Stephen Karbowitz

Touro College of Osteopathic Medicine (New York) Publications and Research

Primary lung lymphoma (PLL) is a rare unilateral or bilateral lung disorder that is challenging to diagnose solely based on clinical and radiological presentation. PLL may be misdiagnosed as pneumonia or a lung tumor due to non-specific findings. PLL is most frequently a mucosa-associated lymphoid tissue (MALT) lymphoma, a type of extranodal low-grade B-cell lymphoma most commonly discovered in the gastrointestinal tract. PLL should be considered in the differential diagnosis of non-resolving pneumonias. Herein we present a case of an 84-year-old patient discovered to have a primary pulmonary MALT lymphoma presenting as a non-resolving pneumonia causing a clinical challenge.

Exercise Tolerance Improves After Pulmonary Rehabilitation In Pulmonary Hypertension Patients, Arunabh Talwar, Sonu Sahni, Sameer Verma, Sara Z. Khan, Sean Dhar, Nina Kohn

Touro College of Osteopathic Medicine (New York) Publications and Research

Pulmonary rehabilitation (PR) is part of the recommended management plan of pulmonary hypertension (PHTN) and is important to better quality of life and exercise tolerance. This study aimed at determining effectiveness of PR on exercise capacity. Retrospective chart analysis was conducted on patients referred to our PHTN clinic for PR. Patients who had PHTN diagnosed on right heart catheterization (defined by mean pulmonary artery pressure>25 mmHg) and completed a standardized 12-week PR program were considered for the study. Patients’ baseline exercise tolerance was recorded as speed attainable on a treadmill and duration of exercise in minutes. Demographics, age, sex, …

Socioeconomic Status And Its Relationship To Chronic Respiratory Disease, Sonu Sahni, Ankoor Talwar, Sameer Khanijo, Arunabh Talwar

Touro College of Osteopathic Medicine (New York) Publications and Research

Socioeconomic status (SES) is defined as an individual’s social or economic standing, and is a measure of an individual’s or family’s social or economic position or rank in a social group. It is a composite of several measures including income, education, occupation, location of residence or housing. Studies have found a lower SES has been linked to disproportionate access to health care in many diseases. There is emerging data in pulmonary diseases such as COPD, asthma, cystic fibrosis, pulmonary hypertension and other chronic respiratory conditions that allude to a similar observation noted in other chronic diseases. In the setting of …

Hyaluronidase: A Potential New Treatment For Acute Respiratory Distress Syndrome, C. Leblanc, Robert Stern

Touro College of Osteopathic Medicine (New York) Publications and Research

Acute respiratory distress syndrome, also known as diffuse alveolar damage, is an acute injury to the lungs. Patients experience severe shortness of breath and require mechanical ventilation. It is not a specific disease, but an acute lung dysfunction associated with a variety of disorders: pneumonia, shock, sepsis, and trauma. A similar lesion occurs in newborn infants, called hyaline disease of the newborn. It occurs in premature babies and has the same pathophysiological mechanism as acute respiratory distress syndrome. Hyaline membranes are a pathologic feature of acute respiratory distress syndrome, consisting of basophilic structures that coat alveolar surfaces. They prevent oxygen …

Nationwide Trends In Inpatient Admissions Of Pulmonary Hypertension In The United States From 2000 To 2013, Rutuja R. Sikachi, Sonu Sahni, Dhruv Mehta, Abhishek Agarwal, Abhinav Agrawal

Touro College of Osteopathic Medicine (New York) Publications and Research

Introduction: Pulmonary Hypertension (PH) is a disorder of the pulmonary vasculature with high mortality and bears a large economic burden on the healthcare system. We conducted a review of the largest inpatient database in the United States and analyzed the trends in hospitalizations due to PH from the turn of the century (2000) to 2013 to evaluate the rate of hospitalizations and determine the cost and mortality associated with PH.

Material and methods: We analyzed the National Inpatient Sample Database (NIS) for all patients in which PH (Primary or Secondary) or cor pulmonale was the primary discharge diagnosis …

Hiv-Care Access Among People With Incarceration Experience In St. Petersburg, Russia, Monica S. Ruiz, Robert Heimer, Olga Levina, N. Badosova, V. Rassokhin, A. Belyakov, N. Belyakov

Prevention and Community Health Faculty Publications

Background: Little is known about the clinical care experiences of HIV-infected persons in St. Petersburg who have experience with incarceration. To address this question, we conducted a capture-recapture study to identify individuals who had been diagnosed with HIV infection while incarcerated and who subsequently presented for medical care in St. Petersburg, Russia following release from prison.

Methods: We matched 292 HIV-positive prisoners tested by the prison system in 2010 to the medical records at the St. Petersburg AIDS Center in the following 4 years.

Results: The data analysis shows that as many as half of HIV+ prisoners fail to seek …

Ards Pathophysiology, Lisa K. Bowman

Nursing Student Class Projects (Formerly MSN)

Acute respiratory distress syndrome (ARDS) is a condition that involves severe injury to the lung and was first identified during the Vietnam War. Continual research has been performed which has led to multiple treatment modalities. Some treatment modalities are viewed as controversial which proves that more research regarding ARDS needs completed in order to improve patient outcomes. Further education and investment in bedside interventions will continue to improve the clinical treatment and survival rates of affected patients.

Transition Into Adult Care: Factors Associated With Level Of Preparedness Among Adolescents Living With Hiv In Cambodia, Siyan Yi, Chanrith Ngin, Khuondyla Pal, Vohith Khol, Sovannary Tuot, Sokunmealiny Sau, Penhsun Ly

Background: Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia.

Methods: In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15–17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a …

Using Risk-Tracing Snowball Approach To Increase Hiv Case Detection Among High-Risk Populations In Cambodia: An Intervention Study, Srean Chhim, John Macom, Chettana Pav, Nirada Nim, Phearun Yun, Sopheap Seng, Siyan Yi

Background: Early HIV diagnosis and initiation onto antiretroviral therapy may prevent ongoing spread of HIV. Risk Tracing Snowball Approach (RTSA) has been shown to be effective in detecting new HIV cases in other settings. The main objective of this study is to evaluate the effectiveness of RTSA in increasing the rate of newly identified HIV cases among high-risk populations. Our second objective was to evaluate the effectiveness of RTSA, as compared to the walk-in group, in increasing the number of HIV tests and early case detection.

Methods: This study was conducted from April 1 to September 30, 2016 at two …