Medical Specialties Commons^™

The Struggling Infectious Diseases Fellow: Remediation Challenges And Opportunities, Michael T Melia, Armando Paez, Gail Reid, Lisa M Chirch, Vera P Luther, Brian G Blackburn, Federico Perez, Emily Abdoler, Daniel R Kaul, Susan Rehm, Nada Harik, Alice Barsoumian, Anna K Person, Heather Yun, J David Beckham, Susan Boruchoff, Paloma F Cariello, James B Cutrell, Christopher J Graber, Dong Heun Lee, Eileen Maziarz, Molly L Paras, Raymund R Razonable, Roseanne Ressner, Anne Chen, Brian Chow, Gerome Escota, Erica Herc, Andrew Johnson, Ryan C Maves, Obinna Nnedu, Heather Clauss, Prathit Kulkarni, Paul S Pottinger, Jose A Serpa, Tanaya Bhowmick, Marvin Bittner, Darcy Wooten, Beata Casanas, Rachel Shnekendorf, Emily A Blumberg

Faculty, Staff and Students Publications

Remediation of struggling learners is a challenge faced by all educators. In recognition of this reality, and in light of contemporary challenges facing infectious diseases (ID) fellowship program directors, the Infectious Diseases Society of America Training Program Directors' Committee focused the 2018 National Fellowship Program Directors' Meeting at IDWeek on "Remediation of the Struggling Fellow." Small group discussions addressed 7 core topics, including feedback and evaluations, performance management and remediation, knowledge deficits, fellow well-being, efficiency and time management, teaching skills, and career development. This manuscript synthesizes those discussions around a competency-based framework to provide program directors and other educators with …

Probable African Tick Bite Fever In The United States, Kami Lowery, Theodore Rosen

Faculty, Staff and Students Publications

African tick bite fever (ATBF) is a tick-borne rickettsial disease most often observed in North American and European tourists returning home from the southern portion of Africa. Ticks infected with Rickettsia africae transmit this parasitic bacterium to humans, who subsequently develop an influenza-like illness, one or more inoculation eschars, and in some cases, a cutaneous rash. Because ATBF often presents with non-specific symptoms that suggest other infectious diseases, establishing the diagnosis may be difficult. Confirmatory assays, including serology and nucleic acid amplification, may take weeks to return and cannot help with acute treatment decisions. We present a case of a …

A Novel Case Of Bacterial Meningitis In A Patient With Loeys-Dietz, Lacey D. Colvin Do, Christy Fagg

Infectious Disease

No abstract provided.

Comparison Of The Id Now Influenza A & B 2, Cobas Influenza A/B, And Xpert Xpress Flu Point-Of-Care Nucleic Acid Amplification Tests For Influenza A/B Virus Detection In Children, Neena Kanwar, Jeff Michael, Kathryn Doran, Emily Montgomery, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

© 2020 Kanwar et al. Early diagnosis of influenza (Flu) is critical for patient management and infection control. The ID Now influenza A & B 2 (ID Now) assay (Abbott Laboratories), Cobas influenza A/B nucleic acid test (LIAT; Roche Molecular Systems, Inc.), and Xpert Xpress Flu (Xpert; Cepheid) are rapid, point-of-care molecular assays for Flu virus detection. The study aim was to compare the performances of these three commercially available Clinical Laboratory Improvement Amendments (CLIA)-waived Flu virus assays. We prospectively enrolled 201 children platforms, as per the manufacturers' instructions. CDC Flu A/B PCR was used as a reference method to …

A Decerebrating Female: A Rare Presentation Of Acute Disseminated Encephalomyelitis Due To Measles, Natasha Del Rio, Yordan Orive, Andres Sobrado, Ruben Cabrera, Ilde Manuel Lee, Troy Hoang, Sherard Lacaille, Ricardo Garcia-Rivera, Robert Hernandez

Internal Medicine

No abstract provided.

A Ten-Year Retrospective Evaluation Of Acute Flaccid Myelitis At 5 Pediatric Centers In The United States, 2005-2014., Margaret M. Cortese, Anita K. Kambhampati, Jennifer E. Schuster, Zaid Alhinai, Gary R. Nelson, Gloria J. Guzman Perez-Carrillo, Arastoo Vossough, Michael A. Smit, Robert C. Mckinstry, Timothy Zinkus, Kevin R. Moore, Jeffrey M. Rogg, Meghan S. Candee, James J. Sejvar, Sarah E. Hopkins

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Acute flaccid myelitis (AFM) is a severe illness similar to paralytic poliomyelitis. It is unclear how frequently AFM occurred in U.S. children after poliovirus elimination. In 2014, an AFM cluster was identified in Colorado, prompting passive US surveillance that yielded 120 AFM cases of unconfirmed etiology. Subsequently, increased reports were received in 2016 and 2018. To help inform investigations on causality of the recent AFM outbreaks, our objective was to determine how frequently AFM had occurred before 2014, and if 2014 cases had different characteristics.

METHODS: We conducted a retrospective study covering 2005-2014 at 5 pediatric centers in 3 …

Characterization Of A Species E Adenovirus Vector As A Zika Virus Vaccine, Brianna L. Bullard, Brigette N. Corder, David N. Gordon, Theodore C. Pierson, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

The development of a safe and efficacious Zika virus (ZIKV) vaccine remains a global health priority. In our previous work, we developed an Adenovirus vectored ZIKV vaccine using a low-seroprevalent human Adenovirus type 4 (Ad4-prM-E) and compared it to an Ad5 vector (Ad5-prM-E). We found that vaccination with Ad4-prM-E leads to the development of a strong anti-ZIKV T-cell response without eliciting significant anti-ZIKV antibodies, while vaccination with Ad5-prM-E leads to the development of both anti-ZIKV antibody and T-cell responses in C57BL/6 mice. However, both vectors conferred protection against ZIKV infection in a lethal challenge model. Here we continued to characterize …

Severe Malaria Due To Plasmodium Falciparum, Hamid Hussaini, Rage Geringer Md, Gregory Hicks Md, Oliwier Dziadkowiec

Internal Medicine

No abstract provided.

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Social Values For Health Technology Assessment In Canada: A Scoping Review Of Hepatitis C Screening, Diagnosis And Treatment, Caroline O'Keefe-Markman, Kristina Dawn Lea, Christopher Mccabe, Elaine Hyshka, Tania M. Bubela

Office of the Provost

Background: Health care system decision makers face challenges in allocating resources for screening, diagnosis and treatment of hepatitis C. Approximately 240,000 individuals are infected with the hepatitis C virus (HCV) in Canada. Populations most affected by HCV include Indigenous people, people who inject drugs, immigrants and homeless or incarcerated populations as well as those born between 1946 and 1965. Curative but expensive drug regimens of novel direct acting antivirals (DAAs) are available. We aim to identify social values from academic literature for inclusion in health technology assessments.
Methods: We conducted a scoping review of academic literature to identify and analyze …

Injection Drug Use And Care Charges For Infective Endocarditis, Verity N. Ramirez, Jenny L. Carwile, Kristina Rokas, Wendy Craig, Kinna Thakarar

Journal of Maine Medical Center

No abstract provided.

Sé Un Héroe Tú También, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Prevalence Of The Hypervirulent Nap1/Bi/027 Strain Of C. Difficile In Southwestern Virginia And Risk Factors Associated With Infection, Andrew O. Hanna, Anthony Baffoe-Bonnie, Shikha Vasudeva

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

C. difficile infection (CDI) incidence has increased over the last several decades. The BI/NAP1/027 ribotype was discovered in 2005 and has since been responsible for multiple outbreaks in the US and Canada. This subtype of C. Difficile is known to be more virulent in vivo and produce more severe disease. Limited regional data of the prevalence of this ribotype is available, which could help guide treatment. Using infection control data from a large regional hospital and a VA medical center, this study documented the prevalence of the 027 ribotype in Southwest Virginia. Patients were included if they were tested at …

A Case Of Listeria Monocytogenes Meningitis Complicated By Hydrocephalus And Intraventricular Hemorrhage: A Review Of Treatment Options And Outcomes, S. Gerstein, P. Gautam-Goyal, S. Goyal

Journal Articles

© 2020 The Authors Listeria monocytogenes is a gram-positive bacillus known to cause various human infections including central nervous system infections. The most common central nervous system manifestations are meningitis and rhomboencephalitis, however rare complications including hydrocephalus and intracerebral hemorrhage can occur and are associated with increased mortality and incidence of lasting neurologic sequelae. The mortality ranges from 17 % to greater than 30 % in patients with neurological involvement [1–3]. Various case reports have studied the differing treatment approaches and outcomes of patients who experienced these complications, and there is still no consensus on optimal treatment approaches. In this …

Comparison Of Four Molecular In Vitro Diagnostic Assays For The Detection Of Sars-Cov-2 In Nasopharyngeal Specimens., W Zhen, R Manji, E Smith, Gj Berry

Journal Articles

No abstract provided.

Chagas Disease In The New York City Metropolitan Area., C. Zheng, O. Quintero, E. K. Revere, M. B. Oey, F. Espinoza, Y. A. Puius, D. Ramirez-Baron, C. R. Salama, L. F. Hidalgo, H. B. Tanowitz, +5 Additional Authors

Journal Articles

Background:Chagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor. Methods:We review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment. Results:The most common country of origin of our patients was El Salvador (n …

Coronavirus Disease 2019 (Covid-19) Presenting As Purulent Fulminant Myopericarditis And Cardiac Tamponade: A Case Report And Literature Review., A Khatri, F Wallach

Journal Articles

No abstract provided.

Perivascular Macrophages In The Neonatal Macaque Brain Undergo Massive Necroptosis After Simian Immunodeficiency Virus Infection, Diana G. Bohannon, Yueying Wang, Colin H. Reinhart, Julian B. Hattler, Jiangtao Luo, Hamid R. Okhravi, Jianshui Zhang, Qingsheng Li, Marcelo J. Kuroda, Woong-Ki Kim

Nebraska Center for Virology: Faculty Publications

We previously showed that rhesus macaques neonatally infected with simian immunodeficiency virus (SIV) do not develop SIV encephalitis (SIVE) and maintain low brain viral loads despite having similar plasma viral loads compared to SIV-infected adults. We hypothesize that differences in myeloid cell populations that are the known target of SIV and HIV in the brain contribute to the lack of neonatal susceptibility to lentivirus-induced encephalitis. Using immunohistochemistry and immunofluorescence microscopy, we examined the frontal cortices from uninfected and SIV-infected infant and adult macaques (n = 8/ea) as well as adults with SIVE (n = 4) to determine differences in myeloid …

Erysipelothrix Rhusiopathiae Endocarditis, T. Wang, D. Khan, N. Mobarakai

Journal Articles

© 2020 Erysipelothrix rhusiopathiae is a zoonotic gram positive coccobacillus. It is rarely found in humans as an occupational pathogen that mainly infects animal handlers. There are three forms of human infection: localized erysipeloid, diffuse cutaneous form and lastly, bacteremia that could progress to infective endocarditis. We present a case of a 59-year-old male who was found to have E. rhusiopathiae bacteremia that was diagnosed as aortic valve endocarditis with severe aortic regurgitation. The patient was treated with ampicillin-sulbactam then transitioned to six weeks of intravenous ampicillin. This report summarizes a rare organism that causes a serious human infection and …

Morphea (Localized Scleroderma) Presenting With Recurrent Skin And Soft Tissue Infections: A Diagnostic Dilemma., A. M. Khatri, M. Mclemore, P. Malhotra

Journal Articles

Morphea or localized scleroderma is reported to be triggered through diverse stimuli. We present a case of morphea that presented as a non-healing wound with superimposed methicillin-sensitive Staphylococcus aureus (MSSA) infection. In our case, morphea was thought to have been potentially triggered by a post-surgical infection. We discuss the potential infectious triggers and common infections that may confound the diagnosis.

Carbapenemase Producing Klebsiella Pneumoniae (Kpc) Meningitis From Chronic Otitis Media, S. Anwar, S. Acharya, S. Thapa, J. Rabadi, N. Mobarakai

Journal Articles

© 2020 The Authors Meningitis and brain abscess caused by carbapenemase-producing Klebsiella pneumoniae (KPC) is rarely described in the medical literature. Such infections have been described after neurosurgical medium or post-trauma. We describe an unusual case of KPC meningitis originating from with long term intravenous antibiotics.

Characterization Of A Speciese Adenovirus Vector As A Zika Virus Vaccine, Brianna L. Bullard, Brigette N. Corder, David N. Gordon, Theodore C. Pierson, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

The development of a safe and efficacious Zika virus (ZIKV) vaccine remains a global health priority. In our previous work, we developed an Adenovirus vectored ZIKV vaccine using a low-seroprevalent human Adenovirus type 4 (Ad4-prM-E) and compared it to an Ad5 vector (Ad5-prM-E). We found that vaccination with Ad4-prM-E leads to the development of a strong anti-ZIKV T-cell response without eliciting significant anti-ZIKV antibodies, while vaccination with Ad5-prM-E leads to the development of both anti-ZIKV antibody and T-cell responses in C57BL/6 mice. However, both vectors conferred protection against ZIKV infection in a lethal challenge model. Here we continued to characterize …

Endothelial Injury And Glycocalyx Degradation In Critically Ill Coronavirus Disease 2019 Patients: Implications For Microvascular Platelet Aggregation, Douglas Fraser

Data and Test Instruments

No abstract provided.

Inflammation Profiling Of Critically Ill Coronavirus Disease 2019 Patients, Douglas Fraser

Data and Test Instruments

No abstract provided.

Novel Outcome Biomarkers Identified With Targeted Proteomic Analyses Of Plasma From Critically Ill Coronavirus Disease 2019 Patients, Douglas Fraser

Data and Test Instruments

No abstract provided.

Evaluation Of Antibody Response Directed Against Porcine Reproductive And Respiratory Syndrome Virus Structural Proteins, Hung Q. Luong, Huong T.L. Lai, Hiep L.X. Vu

Nebraska Center for Virology: Faculty Publications

Luciferase-immunoprecipitation system (LIPS), a liquid phase immunoassay, was used to evaluate antibody responses directed against the structural proteins of PRRSV in pigs that were experimentally infected with virulent PRRSV strains. First, the viral N protein was used as a model antigen to validate the assay. The LIPS results were highly comparable to that of the commercial IDEXX PRRS X3 ELISA. Subsequently, the assay was applied to simultaneously measure antibody reactivity against all eight structural proteins of PRRSV. The highest immunoreactivities were detected against GP3, M, and N proteins while the lowest reactivity was detected against ORF5a protein. Comparative analysis of …

First-Time Characterization Of Viable But Non-Culturable Proteus Mirabilis: Induction And Resuscitation, Reham Wasfi, G. R. Abdellatif, H. M. Elshishtawy, Hossam M. Ashour

USF St. Petersburg Campus Faculty Publications

Pathogenic bacteria can enter into a viable but non-culturable (VBNC) state under unfavourable conditions. Proteus mirabilis is responsible for dire clinical consequences including septicaemia, urinary tract infections and pneumonia, but is not a species previously known to enter VBNC state. We suggested that stress-induced P. mirabilis can enter a VBNC state in which it retains virulence. P. mirabilis isolates were incubated in extreme osmotic pressure, starvation, low temperature and low pH to induce a VBNC state. Resuscitation was induced by temperature upshift and inoculation in tryptone soy broth with Tween 20 and brain heart infusion broth. Cellular ultrastructure and gene …

Inhibition Of Penicillin-Binding Protein 2: Toward New Therapeutics For Antimicrobial-Resistant Gonorrhea, Jonathan M. Turner

MUSC Theses and Dissertations

Gonorrhea is the second most common sexually transmitted bacterial infection in the United States, with nearly 600,000 cases reported in 2018 by the Centers for Disease Control. Alarmingly, the causative agent Neisseria gonorrhoeae has developed resistance to a number of antimicrobials over the last century. With limited options remaining, the CDC now recommends dual therapy with ceftriaxone and azithromycin to decrease the likelihood of resistance development. However, strains with combined cephalosporin and macrolide resistance have now emerged, raising concerns of a post-antibiotic future in which untreatable gonorrhea would impose enormous human and economic cost. The discovery and development of novel …

Regulatory Malfunctions In The Drug Patent Ecosystem, Ana Santos Rutschman

All Faculty Scholarship

Patent protection for several of the world’s best-selling and most promising drugs — biologics — has begun waning. Over the next few years, many other drugs in this category will lose critical patent protection. In principle, this should open the United States market to competition, as more manufacturers are now able to produce relatively cheaper versions of these expensive drugs, known as biosimilars. That, however, has not been the case. This Article examines this problem in the context of the articulation between anticompetitive behaviors and regulatory interventions in the biopharmaceutical arena, and argues for a novel solution: a timelier response …