Immune System Diseases Commons^™

Retrospective Review Of Alternative Antibiotic Use In Patients With A Reported Penicillin Allergy At A Community Hospital, Rita Chamoun, Monica Tadros, Amy Montes, Heidi Clarke, Radhan Gopalani

All Publications

No abstract provided.

Autoimmune Hyperphosphatemic Tumoral Calcinosis In A Patient With Fgf23 Autoantibodies., Mary Scott Roberts, Peter D. Burbelo, Daniela Egli-Spichtig, Farzana Perwad, Christopher J. Romero, Shoji Ichikawa, Emily G. Farrow, Michael J. Econs, Lori C. Guthrie, Michael T. Collins, Rachel I. Gafni

Manuscripts, Articles, Book Chapters and Other Papers

Hyperphosphatemic familial tumoral calcinosis (HFTC)/hyperostosis-hyperphosphatemia syndrome (HHS) is an autosomal recessive disorder of ectopic calcification due to deficiency of or resistance to intact fibroblast growth factor 23 (iFGF23). Inactivating mutations in FGF23, N-acetylgalactosaminyltransferase 3 (GALNT3), or KLOTHO (KL) have been reported as causing HFTC/HHS. We present what we believe is the first identified case of autoimmune hyperphosphatemic tumoral calcinosis in an 8-year-old boy. In addition to the classical clinical and biochemical features of hyperphosphatemic tumoral calcinosis, the patient exhibited markedly elevated intact and C-terminal FGF23 levels, suggestive of FGF23 resistance. However, no mutations in FGF23, KL, or FGF receptor 1 …

Hiv Screening In Non-Pregnant Patients Age 13 – 64 Years Old In Primary Care Through The Implementation Of The Cdc Guidelines For Hiv Screening, Ashten M. Martin

Doctor of Nursing Practice

As many as 216,000 people living with HIV are unaware they have the disease. In order to combat the inadvertent spreading of HIV, the CDC recommends screening everyone 13 – 64 years of age. The purpose of this Quality Improvement project was to implement the 2015 Sexually Transmitted Diseases Treatment Guidelines as it pertains to HIV screening within a Southeast Texas rural health clinic. The objectives were 1) educating all staff and patients regarding the CDC recommendations for HIV screening, and 2) increase the number of eligible patients who were offered and received HIV screening. A colored checklist served as …

The Importance Of Early Arthritis In Patients With Rheumatoid Arthritis, Georgiana Iftimie, Ana Maria Alexandra Stanescu, Mihaela A. Iancu, Anca Pantea Stoian, Razvan Hainarosie, Bogdan Socea, Gheorghita Isvoranu, Dragos Marcu, Tiberiu P. Neagu, Camelia C. Diaconu

Journal of Mind and Medical Sciences

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the diagnostic approach of RA has focused on early arthritis. Early arthritis can develop into established RA or another established arthropathy, like systemic lupus erythematosus or psoriatic arthritis. It can have a spontaneous resolution or may remain undifferentiated for indefinite periods of time.

The management of early arthritis has changed considerably in the past few years, under the …

Internalized Hiv Stigma, Art Initiation And Hiv-1 Rna Suppression In South Africa: Exploring Avoidant Coping As A Longitudinal Mediator, Valerie A. Earnshaw, Laura M. Bogart, Jean-Philippe Laurenceau, Brian T. Chan, Brendan G. Maughan-Brown, Janan Dietrich, Ingrid Courtney, Gugu Tshabalala, Catherine Orrell, Glenda E. Gray, David Bangsberg, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Cross‐sectional evidence suggests that internalized HIV stigma is associated with lower likelihoods of antiretroviral therapy (ART) initiation and HIV‐1 RNA suppression among people living with HIV (PLWH). This study examined these associations with longitudinal data spanning the first nine months following HIV diagnosis and explored whether avoidant coping mediates these associations.

Methods: Longitudinal data were collected from 398 South African PLWH recruited from testing centres in 2014 to 2015. Self‐report data, including internalized stigma and avoidant coping (denying and distracting oneself from stressors), were collected one week and three months following HIV diagnosis. ART initiation at six months and …

Hand Issues On Scleroderma Patients, Ana Font Hernandez

Publications and Research

Based on the design of a 3D-printed spoon prototype, we surveyed scleroderma patients about the device's value. 75% of patients mentioned having problems on their hands due to scleroderma. 85% of patients said their hand form changed because of the disease. Answers to the frequency or speed of the changes provide inconclusive results. The 3D printing technology has the potential to solve specific issues scleroderma patients face in their daily lives. Nevertheless, further research is needed to fully understand how hands shape change over time.

Griffithsin Carrageenan Fast Dissolving Inserts Prevent Shiv Hsv-2 And Hpv Infections In Vivo, Nina Derby, Manjari Lal, Meropi Aravatinou, Larisa Kizima, Patrick Barnable, Axia Rodriguez, Manshun Lai, Asa Wesenberg, Shweta Ugaonkar, Keith Levendosky, Olga Mizenina, Kyle Kleinbeck, Jeffrey D. Lifson, M. Melissa Peet, Zachary Lloyd, Michael Benson, Walid Heneine, Barry R. O'Keefe, Melissa Robbiani, Elena Martinelli, Brooke Grasperge, James Blanchard, Agegnehu Gettie, Natalia Teleshova, José Fernández-Romero, Thomas M. Zydowsky

Publications and Research

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) strategies with proven in vivo efficacy rely on antiretroviral drugs, creating the potential for drug resistance and complicated treatment options in individuals who become infected. Moreover, ondemand products are currently missing from the PrEP development portfolio. Griffithsin (GRFT) is a non-antiretroviral HIV entry inhibitor derived from red algae with an excellent safety profile and potent activity in vitro. When combined with carrageenan (CG), GRFT has strong activity against herpes simplex virus-2 (HSV-2) and human papillomavirus (HPV) in vitro and in vivo. Here, we report that GRFT/CG in a freeze-dried fast dissolving insert (FDI) …

Hla-C Downregulation By Hiv-1 Adapts To Host Hla Genotype, Nathaniel D. Batchel, Gisele Umviligihozo, Suzanne Pickering, Talia Mota, Hua Liang, Gregory Q. Del Prete, Pramita Chatterjee, Guinevere Q. Lee, Rasmi Thomas, Mark A. Brockman, Stuart Neil, Mary Carrington, Bosco M. Bwana, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-1 can downregulate HLA-C on infected cells, using the viral protein Vpu, and the magnitude of this downregulation varies widely between primary HIV-1 variants. The selection pressures that result in viral downregulation of HLA-C in some individuals, but preservation of surface HLA-C in others are not clear. To better understand viral immune evasion targeting HLA-C, we have characterized HLA-C downregulation by a range of primary HIV-1 viruses. 128 replication competent viral isolates from 19 individuals with effective anti-retroviral therapy, show that a substantial minority of individuals harbor latent reservoir virus which strongly downregulates HLA-C. Untreated infections display no change in …

Congenital Zika Virus Infection In Immunocompetent Mice Causes Postnatal Growth Impediment And Neurobehavioral Deficits, Amber M. Paul, Dhiraj Acharya, Biswas Neupane, E. Ashley Thompson, Gabriel Gonzalez-Fernandez, Katherine M. Copeland

Publications

A small percentage of babies born to Zika virus (ZIKV)-infected mothers' manifest severe defects at birth, including microcephaly. Among those who appeared healthy at birth, there are increasing reports of postnatal growth or developmental defects. However, the impact of congenital ZIKV infection in postnatal development is poorly understood. Here, we report that a mild congenital ZIKV-infection in pups born to immunocompetent pregnant mice did not display apparent defects at birth, but manifested postnatal growth impediments and neurobehavioral deficits, which include reduced locomotor and cognitive deficits that persisted into adulthood. We found that the brains of these pups were smaller, had …

Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi

Journal of Health Disparities Research and Practice

Couples in HIV serodiscordant relationships frequently desire children. Although partners who are virally suppressed pose almost no risk of transmitting HIV to their partners, partners who are inconsistently on therapy may transmit HIV to their partners when attempting to conceive. Pre-exposure prophylaxis (PrEP) is an available safer conception strategy for these couples but is not consistently offered. We sought to better understand barriers to PrEP implementation for couples seeking conception and patient perceptions on what providers could do to encourage use. We conducted in-depth, qualitative interviews with 11 participants representing six couples taking PrEP for safer conception in a safety-net …

Targeting Pro-Inflammatory Function Of Microglia Using Small Molecules To Combat Neurodegeneration, Gabrielle C. Williams, Priya Prakash, Gaurav Chopra

The Summer Undergraduate Research Fellowship (SURF) Symposium

Microglia are the brain’s resident immune cells that are responsible for maintaining homeostasis in healthy conditions. During injury or infection, resting microglia get activated and produce pro-inflammatory cytokines such as IL-1b, IL-1a, IL-6, etc. along with reactive oxygen species like nitric oxide (NO) to combat neuroinflammatory diseases such as Alzheimer’s disease (AD). Inflammation is characterized by the activation of resident-immune cells in the brain called microglia that respond to the eat-me signals released by the toxic amyloid beta peptides as well as the dying neurons in the microenvironment. Recent studies have shown that activated microglia induce neuronal death by secreting …

Prevalence And Correlates Of Physical And Sexual Intimate Partner Violence Among Women Living With Hiv In Uganda, Cynthia R. Young, Angela Kaida, Jerome Kabakyenga, Winnie R. Muyindike, Nicholas Musinguzi, Jeffrey N. Martin, Peter W. Hunt, David Bangsberg, Jessica E. Haberer, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Intimate partner violence (IPV) is a significant global health problem. Women who experience IPV have increased HIV incidence, reduced antiretroviral adherence, and a lower likelihood of viral load suppression. There is a lack of evidence regarding how to effectively identify and support women living with HIV (WLWH) experiencing IPV, including uncertainty whether universal or targeted screening is most appropriate for lower-resourced settings. We examined physical and sexual IPV prevalence and correlates among WLWH in Uganda to understand the burden of IPV and factors that could help identify women at risk.

Methods: We utilized data from women receiving …

Distribution And Performance Of Cardiovascular Risk Scores In A Mixed Population Of Hiv-Infected And Community-Based Hiv-Uninfected Individuals In Uganda, Anthony N. Muiru, Prossy Bibangambah, Linda Hemphill, Ruth Sentongo, Kim June-Ho, Virginia A. Triant, David R. Bangsberg, Alexander C. Tsai, Jeffrey N. Martin, Jessica E. Haberer, Yap Boum Ii, Jorge Plutzky, Peter W. Hunt, Samson Okello, Mark J. Siedner

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The utility and validity of cardiovascular diseases (CVD) risk scores are not well studied in sub-Saharan Africa. We compared and correlated CVD risk scores with carotid intima media thickness (c-IMT) among HIV-infected and uninfected people in Uganda.

Methods: We first calculated CVD risk using the (1) Framingham laboratory–based score; (2) Framingham nonlaboratory score (FRS-BMI); (3) Reynolds risk score; (4) American College of Cardiology and American Heart Association score; and (5) the Data collection on Adverse Effects of Anti-HIV Drugs score. We then compared absolute risk scores and risk categories across each score using Pearson correlation and kappa statistics, respectively. …

Hiv/Aids Knowledge & Perceptions On A College Campus, Gabriel Navarro

Honors College Theses

Our research project surveyed students at Pace University (both on the New York City and Pleasantville campuses) and looked into their understanding of Human Immunodeficiency Virus (HIV) & Acquired Immunodeficiency Syndrome (AIDS). The goal was to better understand students’ knowledge regarding HIV/AIDS, and the ways in which they might be misinformed. Our research looked to see if there was any stigma surrounding student’s perceptions of the virus and its transmission. The study also asked students about their sexual practices. Specifically, we utilized an Institutional Review Board approved survey, to ask students about their sexual behavior to see if they were …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …

South Africa, Hiv/Aids, And Education, Katie Roberts

Master's Projects and Capstones

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are huge problems in South Africa. HIV is a disease that attacks a person’s immune system and, if not properly treated, can lead to AIDS. While there is a treatment—antiretroviral drugs—HIV remains a highly stigmatized disease. This field project focuses on reducing stigma so people are unafraid to get tested or seek treatment. Created to benefit both teachers and their learners, the goal of this mathematics curriculum (consisting of 12 lesson plans and worksheets) is to begin HIV/AIDS awareness in school so accurate information is learned and stigma is reduced. The …

Hiv Mortality Difference Between Black And White Women, Carlos O. Nesbeth, Rajiv Kandala, Syed Najeeb, Ruksana Nazneen, Banglore Murthy

Journal of Health Disparities Research and Practice

OBJECTIVE

In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups^². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities.

METHODS

Information was accessed through public data, the US Census, and the US Compressed Mortality File.

RESULTS

In these descriptive data from 1987 through 2015, including reliable HIV …

Food Insecurity And Pre-Hypertension, Pre-Diabetes In Adult Women: Results From The 2007-2010 National Health And Nutrition Examination Survey, Michelle L. Redmond, Phd, Ms, Fanglong Dong, Phd, Philip Twumasi-Ankrah, Phd, Robert B. Hines, Phd, Mph, Lisette T. Jacobson, Phd, Mpa, Ma, Elizabeth Ablah, Phd, Mph, Judy Johnston, Ms, Rd/Ld, Tracie C. Collins, Md, Mph, Mhcds

Journal of Health Disparities Research and Practice

Background

Being food insecure is generally defined as the limited or uncertain availability of safe and nutritious foods and is linked to poor nutrition and fully progressed diet-sensitive chronic diseases. However, little is known about the association between food insecurity and pre-clinical disease such as pre-hypertension and pre-diabetes. This study sought to examine the associations between food insecurity and pre-clinical disease among a racially/ethnically diverse population of women.

Methods

Using data from 2007-2010 NHANES, we examined associations between food security and pre-clinical disease among women 18-65 years. Chi-square tests were used to examine differences in demographic variables. Bivariate and multivariable …

Assistive Utensil: A Spork For Hand Tremors And Spatial Awareness, Ana Font Hernandez, Jacob Kabariti, Troy Taylor

Publications and Research

In this poster, we present a 3D printed solution for hand tremors and special awareness. Our spork is an assistive device designed and 3D printed for patients suffering from scleroderma, systemic sclerosis, Parkinson's, multiple sclerosis, drug withdrawal, etc. The scale-based handle will act as a counterweight to offset the contents on the other end and reduce shakiness. The larger grip allows an easy and comfortable hold. The product will be 3D printed for a customizable fit and at an affordable price. Lastly, the product will include a haptic feedback sensor to assist the visually impaired in locating food contents on …

Barriers To Pregnancy Spacing In Women Living With Hiv: A Series Of Informational Interviews, Rachel K. Scott, Piyapa Praditpan, Patricia Tanjutco, Elizabeth Laidlaw, Regina Zopf, Manon M. Schladen

The Qualitative Report

For reproductive-age women living with HIV, birth spacing allows for optimization of maternal health and viral suppression to prevent mother-to-child transmission of HIV. We conducted semi-structured informational interviews to explore use of contraception for birth spacing. Interviews were transcribed and analyzed. Audio files were reviewed to capture non-explicit data. We interviewed 18 multiparous HIV positive women. All described experiences with at least one contraceptive method. Six themes emerged: Burden of contraception, Failure of birth control, Impact of youth and lack of life experience, Community beliefs about birth control, Lack of partner cooperation, and Altruism. Women viewed birth spacing favorably. Young …

The Effect Of Dust Mite Extract On Esophageal Tight Junctions In Eosinophilic Esophagitis, Kyle Hinz

Theses & Dissertations

Eosinophilic Esophagitis (EE) is a chronic inflammatory disease that effects individuals of all ages. EE is mediated by an allergen response, causing the release of thymic stromal lymphopoietin (TSLP), and subsequent inflammation and eosinophil migration and infiltration of the esophagus through the activation of the JAK/STAT pathway and CD4+ T-cells. EE has typically been associated with food allergies, but studies have shown that aeroallergens can cause EE as well. Current treatments of EE have primarily focused on nonspecific methods, though anti-TSLP is beginning to be tested as a possible treatment for EE. The aim of this study was to see …

Hiv/Aids: Ethiopia, Luzana Girmay

Global Issues in Public Health

AIDS is a public health problem that affects the immune system of the human body which results in people getting affected by other diseases easily. This syndrome is caused by a pathogen known as HIV (Human Immunodeficiency Virus). There are numerous means of transmissions; some of which are drug use, contact with fluids like blood, semen, rectal fluids, and breast milk but the main mode of transmission is through sexual intercourse. The symptoms of HIV/AIDS include fever, rash, and night sweats. The highest number of HIV positive people are located in Africa, which is about 23.8 million people. Of those …

A Model For Rigorously Applying The Exploration, Preparation, Implementation, Sustainment (Epis) Framework In The Design And Measurement Of A Large Scale Collaborative Multi-Site Study, Jennifer E. Becan, John P. Bartkowski, Danica K. Knight, Tisha R. A. Wiley, Ralph Diclemente, Lori Ducharme, Wayne N. Welsh, Diana Bowser, Kathryn Mccollister, Matthew Hiller, Anne C. Spaulding, Patrick M. Flynn, Andrea Swartzendruber, Megan F. Dickson, Jacqueline Horan Fisher, Gregory A. Aarons

Center on Drug and Alcohol Research Faculty Publications

Background

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.

Methods

The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the …

Differential Diagnosis Of Pan-Uveitis: Behçet’S Disease, Peter Blosser, Remil Simon, Courtney Ridner

Appalachian Student Research Forum

This report describes the case of a 56-year-old man who presented with blurry vision, increased intraocular pressure, and conjunctival injection after posterior chamber intraocular lens implantation. Initially post-operative endophalmitis and foreign body inflammation were considered as differential diagnoses, but after further examination pan-uveitis was diagnosed. Uveitis is an ocular finding that may indicate several diseases, one of which is Behçet’s Disease. During the interview, the patient mentioned a history of apthous ulcers and genital ulcers which then lead to the clinical diagnosis of Behçet’s Disease. This report emphasizes that Behçet’s Disease is rare in Caucasians. Therefore, is frequently misdiagnosed in …

Inhibition Of Tnf-Alpha Decreases Microglia Activation In Rats Neonatally Treated With Poly I:C, Heath W. Shelton, Russell W. Brown

Appalachian Student Research Forum

Introduction: Current medical treatment for individuals diagnosed with schizophrenia (SCHZ) primarily relies on the inhibition of the dopamine D₂ receptor that has been shown to be supersensitive in these patients. Treatment occurs through the use of antipsychotic medication which leads to a number of debilitating dose-dependent side effects, such as weight gain, agranulocytosis, and seizures. Patients diagnosed with SCHZ have also been shown to have increased inflammation in their central nervous system (CNS), particularly within specific brain regions such as the prefrontal cortex and hippocampus. This is in large part due to the interaction between a pro-inflammatory cytokine called …

Clinical-Evolutional Particularities Of The Cryoglobulinemic Vasculitis In The Case Of A Patient Diagnosed With Hepatitis C Virus In The Predialitic Phase, Daniel C. Caragea, Larisa Săndulescu, Vlad Pădureanu, Mircea C. Forțofoiu, Costin Streba, Lidia Boldeanu, Mihail V. Boldeanu, Mircea Popescu-Drigă, Marius E. Ciurea, Maria Forțofoiu, Ion Rogoveanu, Tudorel Ciurea, Cristin C. Vere

Journal of Mind and Medical Sciences

Hepatitis C virus (HCV) represents a fundamental issue for public health, with long term evolution and the gradual appearance of several complications and associated pathologies. One of these pathologies is represented by cryoglobulinemic vasculitis, a disorder characterized by the appearance in the patient’s serum of the cryoglobulins, which typically precipitate at temperatures below normal body temperature (37°C) and dissolve again if the serum is heated. Here, we describe the case of a patient diagnosed with HCV that, during the evolution of the hepatic disease, developed a form of cryoglobulinemic vasculitis. The connection between the vasculitis and the hepatic disorder was …

Calnexin Is Necessary For T Cell Transmigration Into The Central Nervous System, Amber M. Paul, Joanna Jung, Paul Eggleton, Alison Robinson, Jessica Wang, Nick Gutowski

Publications

In multiple sclerosis (MS), a demyelinating inflammatory disease of the CNS, and its animal model (experimental autoimmune encephalomyelitis; EAE), circulating immune cells gain access to the CNS across the blood-brain barrier to cause inflammation, myelin destruction, and neuronal damage. Here, we discovered that calnexin, an ER chaperone, is highly abundant in human brain endothelial cells of MS patients. Conversely, mice lacking calnexin exhibited resistance to EAE induction, no evidence of immune cell infiltration into the CNS, and no induction of inflammation markers within the CNS. Furthermore, calnexin deficiency in mice did not alter the development or function of the immune …

Studies Of Amino Acid Mutations In Drug Resistance Of The Smo Protein, Eunice Wintona

UNO Student Research and Creative Activity Fair

Smoothened receptor (SMO) is a protein that in humans, is encoded by the SMO gene. A systemic mutation in its binding pocket helps predict the sensitivity of mutant proteins to different drugs. Known as a GPCR-like receptor, it is a component of the hedgehog signaling pathway; a pathway involved in body patterning and the regulation of adult stem cells. An uncontrolled or inappropriate activation of the Hedgehog pathway drives tumor progression in cancers and a number of birth defects. To achieve these goals, the molecular modeling software MOE was used to build small molecules and drug molecules like Vismodegib and …

Central Nervous System Histoplasmosis: Multicenter Retrospective Study On Clinical Features, Diagnostic Approach And Outcome Of Treatment, Joseph Wheat, Thein Myint, Ying Guo, Phebe Kemmer, Chadi A. Hage, Colin Terry, Marwan M. Azar, James Riddell, Peter Ender, Sharon Chen, Kareem Shehab, Kerry Cleveland, Eden Esguerra, James Johnson, Patty Wright, Vanja Douglas, Pascalis Vergidis, Winnie Ooi, John Baddley, David Bamberger, Raed N. Khairy, Holenarasipur R. Vikram, Elizabeth Jenny-Avital, Geetha Sivasubramanian, Karen Bowlware, Barbara Pahud, Juan Sarria, Townson Tsai, Maha Assi, Satish Mocherla

Internal Medicine Faculty Publications

Central nervous system (CNS) involvement occurs in 5 to 10% of individuals with disseminated histoplasmosis. Most experience has been derived from small single center case series, or case report literature reviews. Therefore, a larger study of central nervous system (CNS) histoplasmosis is needed in order to guide the approach to diagnosis, and treatment.

A convenience sample of 77 patients with histoplasmosis infection of the CNS was evaluated. Data was collected that focused on recognition of infection, diagnostic techniques, and outcomes of treatment.

Twenty nine percent of patients were not immunosuppressed. Histoplasma antigen, or anti-Histoplasma antibodies were detected in the …

Frequency And Factors Associated With Adult Immunization In Patients Visiting Family Medicine Clinics At A Tertiary Care Hospital, Karachi, Samar Zaki, Asma Usman, Swaleha Tariq, Sameena Shah, Iqbal Azam Syed, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: The goal of this study was to determine the frequency and factors associated with adult immunization in patients visiting family medicine clinics at a tertiary care hospital in Karachi.
Methods: A cross-sectional study was conducted from March 2014 to March 2015 in a tertiary care hospital in Karachi, Pakistan. Participants more than 18 years were invited to participate in the study. A pretested questionnaire was used to collect information. Data were entered and analyzed using IBM SPSS Statistics for Windows, version 19.0 (Armonk, NY: IBM Corp).
Results: A total of 340 patients were surveyed. The majority of patients …