Medical Specialties Commons^™

Epidemiologic Survey Of Legionella Urine Antigen Testing Within A Large Wisconsin-Based Health Care System, Caroline P. Toberna, Hannah M. William, Jessica J. F. Kram, Kayla Heslin, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Legionella pneumophila pneumonia is a life-threatening, environmentally acquired infection identifiable via Legionella urine antigen tests (LUAT). We aimed to identify cumulative incidence, demographic distribution, and undetected disease outbreaks of Legionella pneumonia via positive LUAT in a single eastern Wisconsin health system, with a focus on urban Milwaukee County.

Methods: A multilevel descriptive ecologic study was conducted utilizing electronic medical record data from a large integrated health care system of patients who underwent LUAT from 2013 to 2017. A random sample inclusive of all positive tests was reviewed to investigate geodemographic differences among patients testing positive versus negative. Statistical comparisons …

How Immune T-Cell Augmentation Can Help Prevent Covid-19: A Possible Nutritional Solution Using Ketogenic Lifestyle, Ravi K. Kamepalli Md,Fidsa,Cwsp

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19, Colleagues, Confusion, And Conversations, Nathanael R. Sanchez M.D., Katherine S. Lee , M.D., Karen Weaver M.D.

Clinical Research in Practice: The Journal of Team Hippocrates

During the COVID-19 pandemic, doctors in a community hospital reflect on their decision-making regarding treatment options for COVID-19. Whether to use hydroxychloroquine is the treatment discussed in most detail.

484— Modeling Social Distancing Methods And Their Effectiveness In Combating The Spread Of Ebola, Rachel Fair

GREAT Day Posters

Ebola Virus Disease (EVD) is a rare but severe disease that is transmitted among humans through direct-contact with, and close proximity to, infected bodily fluids. From 2014-16, West Africa experienced the largest Ebola outbreak ever recorded, infecting over 28,000 people, and killing over 11,000. Although the symptoms of EVD are treatable, the disease can be extremely deadly, with an average of 50% EVD cases resulting in fatality. In areas where healthcare is scarce and vaccinations are not readily available, the practices of social distancing and self-quarantining have been shown to be highly effective in combating the spread of EVD. To …

Covid-19 In The United States: Insights From Healthcare Systems, Aaron Harris, Nancy Foster, David Reich, Amy Compton-Phillips

Articles, Abstracts, and Reports

During this COCA Call, presenters will discuss the current impact of the COVID-19 pandemic on healthcare systems in the U.S., including key successes and challenges from the hospital response perspective.

Chinese Expert Consensus On Critical Care Ultrasound Applications At Covid-19 Pandemic, Faqin Lv, Md, Jinrui Wang, Md, Xing Yu, Md, Aiping Yang, Md, Ji-Bin Liu, Md, Linxue Qian, Md, Huixiong Xu, Md, Ligang Cui, Md, Mingxing Xie, Md, Xi Liu, Md, Chengzhong Peng, Md, Yi Huang, Md, Haiyan Kou, Md, Shengzheng Wu, Md, Xi Yang, Md, Bin Tu, Md, Huaping Jia, Md, Qingyi Meng, Md, Je Liu, Md, Ruizhong Ye, Md

Department of Radiology Faculty Papers

The spread of new coronavirus (SARS-Cov-2) follows a different pattern than previous respiratory viruses, posing a serious public health risk worldwide. World Health Organization (WHO) named the disease as COVID-19 and declared it a pandemic. COVID-19 is characterized by highly contagious nature, rapid transmission, swift clinical course, profound worldwide impact, and high mortality among critically ill patients. Chest X-ray, computerized tomography (CT), and ultrasound are commonly used imaging modalities. Among them, ultrasound, due to its portability and non-invasiveness, can be easily moved to the bedside for examination at any time. In addition, with use of 4G or 5G networks, remote …

Clinical Support: An Unconventional Request – Providence’S 100 Million Masks Initiative, Carrie Grinstead, Heather J. Martin, Laurie Schwing (Ed.)

Articles, Abstracts, and Reports

In early March, Seattle, WA, was the epicenter of the US COVID-19 pandemic. Providence St. Joseph Health had seen the first reported US case of COVID-19 on January 20 [1] and quickly found itself responding to a growing crisis, with little information about how best to care for patients while protecting frontline staff.

On March 16, 2020, Providence System Library Services received an email from senior leadership with the subject line: “Urgent – An Unconventional Request.” We were asked to pause all other work to search for viable mask patterns that could be easily and quickly made at home by …

A Crisis Is A Terrible Thing To Waste: Recovering A Sense Of Agency In Coronavirus Times, Steven F. Freeman

School of Continuing and Professional Studies Coronavirus Papers

No abstract provided.

Feline-Human Zoonoses Transmission In North Africa: A Systematic Review, Breck Peterson

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

Throughout human history, domestic animal species have represented a unique zoonotic disease risk for the transmission of pathogens ranging from viral, bacterial, parasitic, and fungal. In North Africa, cats have a particularly long record and occupy a specialized niche within many communities. This systematic review was conducted to analyze the current and historical literature documenting the breadth and variety of zoonoses in North Africa, specifically relating to the domesticated feline. Multiple electronic databases were searched on January 16, 2019 for published reports on feline zoonoses in North Africa. A total of 76 studies met the inclusion criteria for a full …

Diabetes Mellitus And Necrotizing Fasciitis – A Deadly Combination; Case Report, Alexandra Toma, Laura Mazilu, Andra Iulia Suceveanu, Florentina Gherghiceanu, Camelia Sandu, Cristina Bica, Liliana Florina Andronache, Ioana Paunica, Lavinia Alexandra Moroianu

Journal of Mind and Medical Sciences

Necrotizing fasciitis is a rapidly destructive affliction of soft tissues, with a mortality rate that may reach 73% of the cases. It is characterized by a progressive inflammation and extended necrosis of the subcutaneous tissue and the fascia. Necrotizing fasciitis was first described in 1848, and later in 1920 Meleney identified 20 patients in China in which the infection was presumably triggered by hemolytic streptococcus, linking pathological bacteria to the condition. In 1952, Wilson coined the term necrotizing fasciitis although without successfully identifying the specific pathological bacteria involved. In most cases, both risk and aggravating factors are present, the main …

Microbiota: The Missing Link In The Etiology Of Inflammatory Bowel Disease, Micu Ioan Sergiu, Madalina Elena Manea, Musat Marilena, Dumitru Andrada, Popoiag Roxana Emanuela

Journal of Mind and Medical Sciences

Within its twisted and tight walls, where a hostile and arid environment prevails, the lumen of the digestive tract nests a true microuniverse called the microbiota. The existing relationship between humans and these microorganisms is one in which both benefit, creating a condition called Eubiosis.

The dynamic relationship existing between the microbiota and the human body can be affected at various times, leading to an imbalance that may have important implications on health and generating a condition called Disbiosis.

Recent studies have highlighted possible links between several diseases with incompletely elucidated etiology and disturbances of the microbiota. In this review …

Coronavirus Disease 2019 (Covid-19), Matthew Dunbar

Pharmacy Student Scholarship

No abstract provided.

Delivering Infectious Disease Interventions To Women And Children In Conflict Settings: A Systematic Review, Sarah Meteke, Marianne Stefopulos, Daina Als, Michelle Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Mariella Munyuzangabo, Reena P. Jain, Shailja Shah, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Conflict has played a role in the large-scale deterioration of health systems in low-income and middle-income countries (LMICs) and increased risk of infections and outbreaks. This systematic review aimed to synthesise the literature on mechanisms of delivery for a range of infectious disease-related interventions provided to conflict-affected women, children and adolescents.
Methods: We searched Medline, Embase, CINAHL and PsychINFO databases for literature published in English from January 1990 to March 2018. Eligible publications reported on conflict-affected neonates, children, adolescents or women in LMICs who received an infectious disease intervention. We extracted and synthesised information on delivery characteristics, including delivery …

Our Multi-Pandemic, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

Application of systems thinking to identify and understand complex problems and to discover innovative ways to intervene has been advocated separately within public health, education, finance, and many other spheres of society. We need it now for the multi-pandemic.

No Double Trouble: How To Reopen The Economy., Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

This policy introduces a measure of choice, consonant with our culture. Those younger than 65 can make their own personal tradeoffs between heath and livelihood, while older people, knowing that the virus will be spreading more quickly through the population will be even more cautious, thus preventing their early deaths. We return decisions to people while ensuring that the sum total of decisions does not overwhelm our hospitals. One felicitous result of this policy is that the virus will spread more quickly through the healthier population. This means that when the elderly re-engage in social life they will encounter fewer …

Systems View Of Coronavirus, Sung Won Paek, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

No one envisioned the kinds of problems that emerged from the novel coronavirus nor had anyone considered its interactive scope. Now is the time to begin to redesign our processes and systems so that when confronted again we can cope and navigate better. Everyone needs to be a partner in these redesigns and each of the health, social, educational, and other systems must be integrated because it is their interconnections that coproduce and give meaning to our lives.

Elucidating The Regulon Of A Fur-Like Protein In Mycobacterium Avium Subsp. Paratuberculosis (Map), Fernanda Miyagaki Shoyama, Taveesak Janetanakit, John P. Bannantine, Raul G. Barletta, Srinand Sreevatsan

Nebraska Center for Virology: Faculty Publications

Intracellular iron concentration is tightly regulated to maintain cell viability. Iron plays important roles in electron transport, nucleic acid synthesis, and oxidative stress. A Mycobacterium avium subsp. paratuberculosis (MAP)-specific genomic island carries a putative metal transport operon that includes MAP3773c, which encodes a Fur-like protein. Although well characterized as a global regulator of iron homeostasis in multiple bacteria, the function of Fur (ferric uptake regulator) in MAP is unknown as this organism also carries IdeR (iron dependent regulator), a native iron regulatory protein specific to mycobacteria. Computational analysis using PRODORIC identified 23 different pathways involved in respiration, metabolism, and virulence …

Covid-19 Newsletter (Vol. 2), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Comparison Of Clinical Presentation And Out-Comes Of Chikungunya And Dengue Virus Infections In Patients With Acute Undifferentiated Febrile Illness From The Sindh Region Of Pakistan, Uzma Shahid, Joveria Farooqi, Kelli L. Barr, Syed Faisal Mahmood, Bushra Jamil, Kehkashan Imtiaz, Zahida Azizullah, Faisal Malik, Dhani Prakoso, Maureen T. Long, E. Khan

Department of Pathology and Laboratory Medicine

Background: Arboviruses are a cause of acute febrile illness and outbreaks worldwide. Recent outbreaks of Chikungunya virus (CHIKV) in dengue endemic areas have alarmed clinicians as unique clinical features differentiating CHIKV from Dengue virus (DENV) are limited. This has complicated diagnostic efforts especially in resource limited countries where lab testing is not easily available. Therefore, it is essential to analyse and compare clinical features of laboratory confirmed cases to assist clinicians in suspecting possible CHIKV infection at time of clinical presentation.
Methodology: A prospective point prevalence study was conducted, with the hypothesis that not all patients presenting with clinical suspicion …

Traditional Funeral And Burial Rituals And Ebola Outbreaks In West Africa: A Narrative Review Of Causes And Strategy Interventions, Chulwoo Park

Faculty Publications

Introduction: In West Africa, traditional funerals and burials have proven main contributors to the spread of infectious diseases, such as Ebola, plague, the Marburg virus, and others. Although the World Health Organization has provided guidelines for the safe burial process after learning of the culture of the afterlife in Ebola-affected areas, little effort has been made to integrate theoretical interventions and models for changing West Africans’ funeral behavior. This research was conducted to study 1) the background of traditional burial rituals, 2) interventions to contain Ebola outbreaks in West Africa, and 3) a strategic approach to future disease outbreak in …

Emerging Therapeutic Strategies For Covid-19 Patients, Shudong Zhu, Xialing Guo, Kyla Geary, Dianzheng Zhang

PCOM Scholarly Works

Over 100,000 cases of COVID-19 patients infected with the novel coronavirus SARS-COV-2 have been reported worldwide in approximately 2 months, resulting in over 3000 deaths. Potential therapeutic strategies, including remdesivir, chloroquine phosphate, abidol, lopinavir/ritonavir, plasma, antibody, vaccine and stem cells are discussed in this review. With the number of patients increasing daily, there is an urgent need for effective therapeutic intervention.

Covid-19 Clinical Guidance For The Cardiovascular Care Team, Thomas M. Maddox, Eric C. Stecker, Biykem Bozkurt, Nathalie Demichelis, John U. Doherty, Andrew Freeman, Tyler J Gluckman, Dipti Itchhaporia, Andrew P. Miller, Andrea L. Price, Lonny Reisman, Prem Soman, Mohammad Madjid, Scott D. Solomon, Orly Vardeny

Articles, Abstracts, and Reports

COVID-19 is a quickly evolving public health emergency. The guidance provided in this document is based on the best available published information and expert evaluation. This document is intended to supplement, not supersede, relevant guidance from the Centers for Disease Control and Prevention, state and local health authorities, and your institution’s infectious disease containment, mitigation, and response plan.

Financial And Labor Benefits Of The Individual Tb Risk Assessment Model For Annual Tb Screening, Kristin Sims Mph Cic Cpps Fapic, Amy Gutierrez Rn, Msn

Infection Control

TB rates are at an all time low in the U.S. and serial TB testing is inefficient and burdensome. Here we describe a model to guide TB screening based on occupational and non-occupational risk. Facility-level risk is taken into account only to drive policy. This methodology will reduce the cost and labor burden of TB screening.

This poster was presented at the SHEA Decennial: 6th International Conference on Healthcare Associated Infections

Our Wicked Problem, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

The Coronavirus is more than a health problem. It is a “wicked” problem disrupting work, education, travel, politics, financial indicators, and more. This label came about in 1973 to help describe a special class of situations that are volatile, uncertain and ambiguous, often difficult to recognize, and difficult or impossible to solve because of incomplete, contradictory, and changing requirements. There is no clear problem definition due to interdependencies so the problem cannot be fully understood until after the solution comes about.

Our Invisible Enemy, Larry M. Starr, Darshi Mody

School of Continuing and Professional Studies Coronavirus Papers

The novel coronavirus is invisible to the eye because it is microscopic measuring 80-160 nanometers in size; a nanometer is one billionth of a meter.

While we cannot see it in the air or on a surface, millions of us have seen the virus in full color when we discuss it on the local and national TV news, in articles and stories online, and in print media. This is because the virus is routinely pictured and used to attract us to the information being presented. The paradox is that millions of people can now recognize this invisible enemy.

Repeatedly presenting …

Disruptive Effects Of The Coronavirus – Errors Of Commission And Of Omission?, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

It is increasingly evident that the coronavirus disease, COVID-19, is more than a health problem; it is and will continue to adversely affect work and workplaces, education, families and social engagements, political and environmental dimensions, and financial indicators. Apart from its health ramifications, the crisis is revealing serious challenges in the global supply chain. Those difficulties are, at least in part, consequences of unwise, short-sighted business decisions made over the course of decades to outsource and downsize.

Pandemic Lockdown Must Fail: Save Lives Without Crippling The Economy, Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

In the following working paper, I want to make a plea for what I am calling a “reverse quarantine”—quarantining people who are over 65 (who number 52 million), before they get sick. We need to complement this policy with federally funded and locally organized efforts to support seniors in place, drawing on the wellsprings of American pragmatism, the capacity to respond in emergencies, American volunteerism, and neighbor-to-neighbor assistance. We can’t turn quarantine into imprisonment. We must work as hard as we can to create a psychological sense of community at a moment when, paradoxically, social distancing is driving us apart. …

Comparing The Outcomes Of Ceftaroline Plus Vancomycin Or Daptomycin Combination Therapy Versus Monotherapy In Adults With Complicated And Prolonged Methicillin-Resistant Staphylococcus Aureus Bacteremia Initially Treated With Supplemental Ceftaroline, Omar Ahmad, Timothy N. Crawford, Thein Myint

Internal Medicine Faculty Publications

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia confers considerable morbidity and mortality. Although vancomycin or daptomycin monotherapy is usually curative, prolonged bacteremia necessitating supplemental ceftaroline has occurred. The practice has led to the question of whether to continue with ceftaroline following bacteremia resolution.

METHODS: Adult patients hospitalized with MRSA bacteremia at the University of Kentucky Medical Center between January 2015 and December 2017 were retrospectively reviewed. Study subjects required supplemental ceftaroline due to 4 or more days of bacteremia despite vancomycin or daptomycin. They additionally had accompanying native valve infective endocarditis, osteomyelitis, or brain abscess. Patients were divided into two cohorts. …

Screening For Hepatitis C Virus Infection In Adolescents And Adults: Updated Evidence Report And Systematic Review For The Us Preventive Services Task Force, Roger Chou, Tracy Dana, Rongwei Fu, Bernadette Zahker, Jesse Wagner, Shaun Ramirez, Sara Grusing, Janice H. Jou

OHSU-PSU School of Public Health Faculty Publications and Presentations

IMPORTANCE: A 2013 review for the US Preventive Services Task Force (USPSTF) of hepatitis C virus (HCV) screening found interferon-based antiviral therapy associated with increased likelihood of sustained virologic response (SVR) and an association between achieving an SVR and improved clinical outcomes. New direct-acting antiviral (DAA) regimens are available.

OBJECTIVE: To update the 2013 review on HCV screening to inform the USPSTF.

DATA SOURCES: Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through February 2019, with surveillance through September 2019.

STUDY SELECTION: Randomized clinical trials (RCTs) and nonrandomized treatment studies of HCV …

Post Tuberculosis Treatment Infectious Complications, Desmond Hsu, Muhammad Irfan, Kauser Jabeen, Nousheen Iqbal, Rumina Hasan, Giovanni Battista Migliori, Alimuddin Zumla, Dina Visca, Rosella Centis, Simon Tiberi

Department of Pathology and Laboratory Medicine

Following greater attention and follow-up of patients with treated pulmonary tuberculosis (TB), it has emerged that infections are more likely to occur in this cohort of patients. This comes as no surprise, as pulmonary TB is a destructive process that leads to cicatrization, alteration of parenchyma, bronchiectasis, and scarring of the lung, with reduction of lung volumes and an impact on pulmonary function. In addition to relapse and re-infection with TB, other pathogens are increasingly recognized in post-TB patients. This paper serves as a summary and guide on how to approach the post-TB patient with new signs and symptoms of …