Respiratory Tract Diseases Commons^™

Developments For The Treatment Of Invasive Infections Due To Multidrug-Resistant Acinetobacter Baumannii, David Laurent, Richard Drew, Dustin Wilson

The University of Louisville Journal of Respiratory Infections

Acinetobacter baumannii is a significant pathogen in healthcare settings (specifically prominent in healthcare- and ventilator-associated pneumonia) due primarily to its virulence and resistance to a wide variety of antimicrobial drug classes, including carbapenems (CRAB). Existing therapies (notably polymyxins, minocycline, tigecycline, amikacin, and sulbactam) often result in suboptimal tissue concentrations, high rates of toxicity, and increasing rates of resistance. Although utilizing combinations of antibiotics (specifically those containing colistin) have been employed, results have been mixed, and control trials are lacking. Eravacycline is a novel tetracycline with an improved pharmacokinetic profile and more potent activity against A. baumannii relative to tigecycline. Cefiderocol …

Plasma Cysteine/Cystine And Glutathione/Glutathione Disulfide Redox Potentials In Hiv And Copd Patients., Walter H. Watson, Jeffrey D. Ritzenthaler, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Tom J. Burke, Yuxuan Zheng, Julio A. Ramirez, Jesse Roman

Faculty and Staff Scholarship

Chronic obstructive pulmonary disease (COPD) is prevalent in patients infected with HIV. The purpose of this study was to test the hypothesis that systemic oxidation correlates with loss of lung function in subjects with COPD, and that HIV infection can contribute to creating such an environment. Subjects were recruited at the University of Louisville in the following groups: HIV-infected (n = 36), COPD (n = 32), HIV and COPD (n = 28), and uninfected controls with normal lung function (n = 34). HIV infection was assessed by viral load and CD4 cell counts. Pulmonary function was determined by spirometry …

Acceptability Of Active Case Finding With A Seed-And-Recruit Model To Improve Tuberculosis Case Detection And Linkage To Treatment In Cambodia: A Qualitative Study, Sovannary Tuot, Alvin K. J. Teo, Danielle Cazabon, Say Sok, Mengieng Ung, Sangky Ly, Sok Chamreun Choub, Siyan Yi

Background

With support of the national tuberculosis (TB) program, KHANA (a local non-governmental organization in Cambodia) has implemented an innovative approach using a seed-and-recruit model to actively find TB cases in the community. The model engaged community members including TB survivors as seed and newly diagnosed people with TB as recruiters to recruit presumptive TB cases in their social network in a snowball approach for screening and linkage to treatment. This study aimed to explore the acceptability of the active case finding with the seed-and-recruit model in detecting new TB cases and determine the characteristics of successful seeds.

Methods

This …

Improving Bronchiolitis Care Across Multiple Care Settings Using A Deimplementation Bundle, Amanda Nedved, Kathleen Berg, Troy Richardson, Amanda Montalbano, Matthew B. Johnson

Posters

Despite the availability of a bronchiolitis CPG; variation in care practices still existed at our institution. The aim of our quality improvement (QI) project was to increase overall adherence with our institutional CPG in patients 60 days to 24 months of age diagnosed with bronchiolitis in the urgent care centers (UCC), emergency departments (ED), and general inpatient units from a baseline of 40.9% to 60% by the end of two bronchiolitis seasons.

Asthma-Related Health Outcomes In New Jersey After A Natural Disaster Event, My Ngoc Thuy Nguyen

Health Services Research Dissertations

The occurrence of a natural disaster event such as a hurricane may further hinder the asthma management of asthmatic individuals. Unmanaged asthma has led to increased work absenteeism, preventable emergency department visits, costly hospitalizations and possibly death in severe cases. To improve asthma management in asthmatic adults in New Jersey (NJ) following a natural disaster event, this study examined whether predisposing, enabling and need factors are predictors for asthma exacerbation and asthma-related health care utilization in New Jersey. A retrospective secondary analysis of New Jersey Behavioral Risk Factor Surveillance System (NJBRFSS) data and New Jersey Asthma Call Back Survey (NJACBS) …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Treating Latent Tuberculosis Infection In Newly Arriving Refugees: An Advanced Practice Nurse Initiative At The University Of Louisville Global Health Center, Linda Goss, Dawn Balcom, Karen Mutsch, Ruth Carrico, Rahel Bosson

Journal of Refugee & Global Health

Background: A review of newly arriving refugees referred to the local health department for latent tuberculosis infection (LTBI) treatment during 2013-2015 revealed a treatment gap of 73%, supporting the need to identify new approaches to treat vulnerable populations and mirrored results in the literature.

Objectives: 1) Describe an advanced practice registered nurse (APRN) led alternative approach to LTBI treatment in the refugee population; and 2) evaluate the impact of a 12-week regimen for LTBI on treatment acceptance, adherence and completion.

Methods: During the initial health screening visit, treatment options were provided for those identified with LTBI consisting of either a …

The Effect Of A Child's Guardian's Health Literacy On Asthma Knowledge In Pediatric Patients, Sylvan Ryder

DNP Projects

PURPOSE: The purpose of this project is to determine if there is a correlation between a guardian’s health literacy and their knowledge of their child’s asthma management.

METHODS: This is a cross-sectional study conducted in the University of Kentucky Pediatric Pulmonology Clinic in Lexington, Kentucky. The analysis focused on how a parent’s health literacy level effected their asthma knowledge. The Rapid Estimation of Adult Literacy in Medicine-Short Form was used to measure health literacy. An asthma knowledge questionnaire with a Likert-scale design was used to measure asthma knowledge. The sample included eight parents of children with an asthma diagnosis collected …

The Impact On Cost, Quality, And Patient Satisfaction When Delivering Care To Acutely Ill Adults In An At-Home Care Model Versus An Inpatient Hospital Setting., Franchesca M. Adams

Honors Theses and Capstones

The impact on cost, quality, and patient satisfaction when delivering care to acutely ill adults in an at-home care model versus an inpatient hospital setting. Hospital level care for certain acute conditions can be safely delivered in the patient’s home while lowering the cost per episode of care, maintaining or improving patient experience, and improving safety and patient/care giver education as well as care coordination, at the Critical Access Hospital (CAH) level.

Can Capture Be Used To Identify Undiagnosed Patients With Mild-To-Moderate Copd Likely To Benefit From Treatment?, Nancy K. Leidy, Fernando J. Martinez, Karen G. Malley, David M. Mannino, Meilan K. Han, Elizabeth D. Bacci, Randall W. Brown, Julia F. Houfek, Wassim W. Labaki, Barry J. Make, Catherine A. Meldrum, Wilson Quezada, Stephen Rennard, Byron Thomashow, Barbara P. Yawn

Preventive Medicine and Environmental Health Faculty Publications

Background: COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE™) uses five questions and peak expiratory flow (PEF) thresholds (males ≤350 L/min; females ≤250 L/min) to identify patients with a forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC)11 60%–80% predicted) who may also benefit from diagnosis and treatment.

Methods: Data from the CAPTURE development study were used to test its sensitivity (SN) and specificity (SP) differentiating mild-to-moderate COPD (n=73) from no COPD (n=87). SN and SP for differentiating all COPD cases (mild to severe; n=259) from those without COPD (n=87) were …

Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph

Doctor of Nursing Practice Final Manuscripts

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …

Systematic Literature Review Of Indoor School Exposure To Pm2.5 In Children, Brittany Wagner, Ami Zota

GW Research Days 2016 - 2020

Asthma is a chronic respiratory disease that puts a strain on lung function and breathing. It is the leading cause of school absenteeism and hospitalization for American children. Genetics play a major role in allergy related disease development such as asthma, but environmental exposures are proving to be a potential contributor to childhood asthma. Despite the sufficient data regarding air pollution, there is a huge knowledge gap regarding indoor air quality and its relationship with health outcomes such as asthma. Many of the studies available only look at outdoor air pollution levels, while children spend the majority of their time …

Chile: Air Pollution, Kara Eder

Global Public Health

Chile faces a constant issue of air pollution, reaping respiratory health problems for citizens in urban areas. While the many cases over the past century have increased officials to take action on the issue, the growing infrastructure and economy of the country makes it difficult to regulate harmful emissions. Wood-burning heaters within urban residential areas also contribute to the unhealthy smog. Ingestion of these forms of matter in the air causes respiratory symptoms such as bronchitis and cardiovascular disease. Bans on such heaters and taxes on vehicle emissions were placed in order to prevent the severity of pollutants in the …

The South Sudan: Tuberculosis, Blake Schwarz

Global Public Health

The South Sudan is a country that recently gained independence from the Sudan after a bloody twenty year civil war. They lost nearly two million lives during the war, and are now ravaged by Tuberculosis, or TB. After gaining their independence in 2011, the South Sudan has an average of 18,000 cases of TB at any time. This would consider TB in the South Sudan an endemic, as it always has a base level of TB cases that does not vary. There is medication for TB that is available to the citizens on the South Sudan, but the prescription is …

Tonga: Chronic Diseases, Muhammad Taimoor

Global Public Health

Tonga is an Archipelago in the south Pacific Ocean, south of Samoa. The public health brief project is on chronic diseases in Tonga. The total population of Tonga was 107,122 in 2010. The Free Wesleyan Church of Tonga is the established religion in Tonga. Tongan’s make up the majority of the population but there are other ethnicities such as Euromericans and Europeans too. The major challenges faced by Tonga are decaying infrastructure, low economy, and political corruption. The widespread of non-communicable diseases such as cancer is a major health issue in Tonga. 74% of all adults in Tonga are the …

United Arab Emirates: Mers-Cov, Sarmad Nawaz Khan

Global Public Health

United Arab Emirates is a federal absolute monarchy in Western Asia at the South East end of the Arabian Peninsula on the Persian Gulf, bordering Oman to the East and Saudi Arabia to the south, as well as sharing maritime borders with Qatar to the west and Iran to the north. The current population of the UAE is 9,457,851. It is a federation of hereditary absolute monarchies, governed by a Federal Supreme Council made up of seven Emirs. The external and internal challenges faced by United Arab Emirates are some security and political issues and in the field of business. …

Health Systems Readiness For Adopting Mhealth Interventions For Addressing Non-Communicable Diseases In Low- And Middle-Income Countries: A Current Debate, Anam Shahil Feroz, Muhammad Masood Kadir, Sarah Saleem

Community Health Sciences

In low-and-middle-income countries, epidemiologic transition is taking place very rapidly from communicable diseases to non-communicable diseases. NCDs mortality rates are increasing faster and nearly 80% of NCDs deaths occur in LMICs. Existing weak health systems of LMICs are undergoing a devastating human and economic toll as a result of increasing treatment costs and losses to productivity from NCDs. At the same time, the increasing penetration of mobile phone technology and the spread of cellular network and infrastructure have led to the introduction of the mHealth field. While mHealth field offers a great promise to prevent and control non-communicable diseases in …

Variations In Practice Of Apnea Test For Brain Death: Review From A Multihospital Health Care System, Jeffrey Stein, Marvi V. Rijhwani, Ernesto Brauer

Journal of Patient-Centered Research and Reviews

Background: Ventilation encompasses both active and passive processes. Air is initially drawn into the lungs due to a negative intrathoracic pressure created using the respiratory muscles, most importantly the diaphragm. In contrast, expiration is the passive relaxation of the respiratory muscles. Oxygenation occurs when oxygen diffuses across the alveolar-capillary membrane. The ability to oxygenate without ventilation has been termed apneic diffusion oxygenation or apneic oxygenation. We believe it is crucial to keep alveoli open in order for adequate oxygenation to occur. This can be achieved with the aid of positive end-expiratory pressure (PEEP). We investigated this concept in patients who …

Lung Cytokines And Systemic Inflammation In Patients With Copd., Alessandra Morello Gearhart, Rodrigo Cavallazzi, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Umair Gauhar, Hiram Rivas-Perez, Jesse Roman, Julio A. Ramirez, Rafael Fernandez-Botran

Faculty and Staff Scholarship

Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by lung and systemic inflammation. The role of cytokines in local and systemic inflammation in COPD is not well understood. This study aimed to compare plasma and bronchoalveolar lavage (BAL) fluid cytokine levels in COPD and non-COPD subjects with the intent of better understand their potential roles in driving local and systemic inflammation.

Methods: This cross-sectional study analyzed data from 65 subjects: 31 with COPD confirmed by spirometry and 34 non-COPD controls. All subjects underwent spirometry, plasma sample collection, and bronchoscopy/BAL. Levels of 21 inflammatory cytokines were measured in the plasma (systemic …

Different Types Of Housing And Respiratory Health Outcomes, Wen Qi Gan, Wayne T. Sanderson, Steven R. Browning, David M. Mannino

Preventive Medicine and Environmental Health Faculty Publications

Evidence has shown that housing conditions may substantially influence the health of residents. Different types of housing have different structures and construction materials, which may affect indoor environment and housing conditions. This study aimed to investigate whether people living in different types of housing have different respiratory health outcomes. The data from the 1999–2006 National Health and Nutrition Examination Survey were used for the analyses. The types of housing included houses, townhouses, apartments, and mobile homes. Respiratory symptoms included wheezing, coughing, sputum, and dyspnea; respiratory diseases included asthma, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD). Multiple logistic regression …

Multiple Myeloma Baseline Immunoglobulin G Level And Pneumococcal Vaccination Antibody Response, Michael A. Thompson, Martin K. Oaks, Maharaj Singh, Karen M. Michel, Michael P. Mullane, Husam S. Tarawneh, Angi Kraut, Kayla J. Hamm

Journal of Patient-Centered Research and Reviews

Infections are a major cause of morbidity and mortality in multiple myeloma (MM), a cancer of the immune system. Vaccination clinical efficacy endpoints have not been demonstrated, and there are limited data on surrogate markers of efficacy. This pilot study evaluated sequential immunologic markers after standard pneumococcal vaccination (PV) in patients with MM and non-MM controls. Vaccination was standard for PV (PCV13 or PPV23), with laboratory testing at baseline and at 2, 4, 12 and 24 weeks after vaccination. Immunoglobulin G (IgG) antibodies to pneumococcal antigens were detected by ELISA. Prevaccination total IgG levels and IgG subclass levels were also …

Lung Ultrasound As A Diagnostic Tool For Radiographically-Confirmed Pneumonia In Low Resource Settings, L E. Ellington, R H. Gilman, M A. Chavez, F Pervaiz, J Marin-Concha, P Compen-Chang, S Riedel, S J. Rodriguez, C Gaydos, J Hardick, J M. Tielsch, M Steinhoff, J Benson, E A. May, D Figueroa-Quintanilla, W Checkley

Global Health Faculty Publications

Background

Pneumonia is a leading cause of morbidity and mortality in children worldwide; however, its diagnosis can be challenging, especially in settings where skilled clinicians or standard imaging are unavailable. We sought to determine the diagnostic accuracy of lung ultrasound when compared to radiographically-confirmed clinical pediatric pneumonia.

Methods

Between January 2012 and September 2013, we consecutively enrolled children aged 2–59 months with primary respiratory complaints at the outpatient clinics, emergency department, and inpatient wards of the Instituto Nacional de Salud del Niño in Lima, Peru. All participants underwent clinical evaluation by a pediatrician and lung ultrasonography by one of three …

Population-Based Pertussis Incidence And Risk Factors In Infants Less Than 6 Months In Nepal., Michelle M Hughes, Janet A Englund, Jane Kuypers, James M Tielsch, Subarna K Khatry, Laxman Shrestha, Steven C Leclerq, Mark Steinhoff, Joanne Katz

Global Health Faculty Publications

Background.

Pertussis is estimated to cause 2 percent of childhood deaths globally and is a growing public health problem in developed countries despite high vaccination coverage. Infants are at greatest risk of morbidity and mortality. Maternal vaccination during pregnancy may be effective to prevent pertussis in young infants, but population-based estimates of disease burden in infants are lacking, particularly in low-income countries. The objective of this study was to estimate the incidence of pertussis in infants less than 6 months of age in Sarlahi District, Nepal.

Methods.

Nested within a population-based randomized controlled trial of influenza vaccination during pregnancy, infants …

Neutrophil Function In Elderly Patients Hospitalized With Community- Acquired Pneumonia, Jorge Perez San Juan, Lisandra Rodriguez Hernandez, Timothy L. Wiemken, Robert R. Kelley, Rafael Fernandez-Botran, Martin Gnoni, Paula Peyrani, Madhavi J. Rane, Forest W. Arnold, Julio A. Ramirez, Silvia Uriarte, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Advanced age is associated with immunosenescence as well as increased risk for poor outcomes during episodes of community-acquired pneumonia (CAP). Data on neutrophil function in hospitalized elderly patients with CAP is lacking. In this study we compared neutrophil function in elderly and non-elderly hospitalized patients with CAP.

Methods: Prospective study of healthy controls (HC) and patients hospitalized with CAP nonelderly (NE-CAP) and elderly (E-CAP). Blood samples were obtained on the day of hospitalization. The following neutrophil functional assays were performed: degranulation of secretory vesicles (CD35), degranulation of specific granules (CD66b), phagocytosis, and hydrogen peroxide (H₂O₂) …

Recurrent Pneumonia Among Japanese Adults: Disease Burden And Risk Factors, Tomoko Ishifuji, Eiichiro Sando, Norihiro Kaneko, Motoi Suzuki, Paul E. Kilgore, Koya Ariyoshi, Konosuke Morimoto, Naoto Hosokawa, Makito Yaegashi, Masahiro Aoshima, Adult Pneumonia Study Group - Japan (Apsg-J)

Department of Pharmacy Practice

Background: In Japan and other societies with rapidly aging populations, recurrent pneumonia (RP) is a major clinical problem yet only limited information exists regarding the burden of this disease.

Methods: A prospective study of adult pneumonia was conducted to investigate the incidence of RP and potential risk factors. From February 1, 2012 to January 31, 2013, patients aged ≥ 15 years who were diagnosed with pneumonia were prospectively enrolled in a representative community hospital located in central Japan. Patients were followed for one-year to evaluate the recurrence of pneumonia and characteristics associated with RP. Cox proportional hazards models were constructed …

Febrile Rhinovirus Illness During Pregnancy Is Associated With Low Birth Weight In Nepal., Erin K Philpott, Janet A Englund, Joanne Katz, James Tielsch, Subarna Khatry, Stephen C Leclerq, Laxman Shrestha, Jane Kuypers, Amalia S Magaret, Mark C Steinhoff, Helen Y Chu

Global Health Faculty Publications

BACKGROUND: Adverse birth outcomes, including low birth weight (LBW), defined as <2500 >grams, small-for-gestational-age (SGA), and prematurity, contribute to 60%-80% of infant mortality worldwide and may be related to infections during pregnancy. The aim of this study was to assess whether febrile human rhinovirus (HRV) illness is associated with adverse birth outcomes.

METHODS: Active household-based weekly surveillance was performed for respiratory illness episodes in pregnant women as part of a community-based, prospective, randomized trial of maternal influenza immunization in rural Nepal. Rhinovirus (HRV) febrile illness episodes were defined as fever plus cough, sore throat, runny nose, and/or myalgia with HRV detected …

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 …

Vitamin D Supplementation To Prevent Acute Respiratory Tract Infections: Systematic Review And Meta-Analysis Of Individual Participant Data, Adrian R. Martineau, David A. Jolliffe, Richard L. Hooper, Lauren Greenberg, John F. Aloia, Peter Bergman, Gal Dubnov-Raz, Susanna Esposito, Davaasambuu Ganmaa, Adit A. Ginde, Emma C. Goodall, Cameron C. Grant, Christopher J. Griffiths, Wim Janssens, Ilkka Laaksi, Semira Manaseki-Holland, David Mauger, David R. Murdoch, Rachel Neale, Judy R. Rees

Dartmouth Scholarship

OBJECTIVES To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect. DESIGN Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials. DATA SOURCES Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a …

Indoor Tobacco Legislation Is Associated With Fewer Emergency Department Visits For Asthma Exacerbation In Children., Christina E. Ciaccio, Tami Gurley-Calvez, Theresa I. Shireman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: During the past 3 decades, numerous cities and states have adopted laws that ban smoking in public indoor spaces. The rationale for these policies has been to protect nonsmokers from the adverse health effects of secondhand smoke.

OBJECTIVE: To determine whether the implementation of indoor smoking legislation is associated with a decrease in emergency department visits for asthma in children.

METHODS: This retrospective analysis used a natural experiment to estimate the impact of clean indoor air legislation on the rate of emergency department admissions for asthma exacerbation in children. Data were obtained from the Pediatric Health Information System. A …