Medical Specialties Commons^™

Covid-19 Newsletter (Vol. 120), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Antimicrobial Stewardship Meets Transitions Of Care: Defining Length Of Therapy For Community-Acquired Pneumonia (Cap), Christopher Whitman, Sarah E. Moore, Matthew Song, Brian C. Bohn, Ashley M. Wilde

The University of Louisville Journal of Respiratory Infections

Introduction: Hospital-based antimicrobial stewardship efforts have traditionally focused on inpatient settings. Antibiotic prescribing at discharge is often an overlooked area of focus for antimicrobial stewardship programs. Discharge prescribing optimization is necessary to combat antibiotic overuse.

Methods: This was an observational, retrospective cohort study at a four–adult community hospital system. Four hundred adult patients admitted with community-acquired pneumonia and discharged with antibiotics were included. The primary outcome was overall (inpatient and discharge) antibiotic length of therapy. The secondary outcome was percentage of patients discharged on a fluoroquinolone who had not received one in the hospital. Descriptive statistics were utilized.

Results: The …

Effect Of Bovine Lactoferrin On Seroconversion Following Polio Vaccine Administration In Children: Protocol For A Double-Blinded Randomised Controlled Trial, Atif Habib, Sidrah Nausheen, Shanila Nooruddin, Tooba Javed, Tariq Samejo, Amjad Hussain, Suneeta Namdave, Sehrish Amirali, Muhammad Umer, Lumaan Sheikh

Department of Paediatrics and Child Health

Introduction: The oral polio vaccine (OPV) has substantial results in eliminating wild poliovirus and the vaccine of choice in polio eradication. However, the mucosal immunity induced by the OPV is still uncertain. Literature has shown that bovine lactoferrin (BLF) is a safe and useful protein found in cow's milk with extraordinary antimicrobial, antiviral, antiinflammatory and immune-modulatory functions that help children's gut to fight against micro-organisms like poliovirus. However, limited data exist regarding the effect of BLF on polio vaccine immune response. The primary objective is to evaluate the effect of BLF in enhancing mucosal and humoral immunity in children following …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: Correspondence, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

No abstract provided.

How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan

Master's Projects and Capstones

Mosquitos, the most lethal species throughout human history, are the most prevalent source of vector-borne diseases and therefore a major global health burden. Mosquito-borne disease incidence is expected to shift with environmental change. These changes can be predicted using species distribution models. With the wide variety of methods used for models, consensus for improving accuracy and comparability is needed. A comparative analysis of three recent modeling approaches revealed that integrating modeling techniques compensates for trade-offs associated with a singular approach. An area that represents a critical gap in our ability to predict mosquito behavior in response to changing climate factors, …

Cathelicidin Anti-Microbial Peptide (Camp) Is Toxic During Neonatal Influenza Virus Infection, Nneka Ugwu

St. Chris Research Day

No abstract provided.

Covid-19 Newsletter (Vol. 119), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

Early Short Course Of Neuromuscular Blocking Agents In Patients With Covid-19 Ards: A Propensity Score Analysis., Gianluigi Li Bassi, Kristen Gibbons, Jacky Y Suen, Heidi J Dalton, Nicole White, Amanda Corley, Sally Shrapnel, Samuel Hinton, Simon Forsyth, John G Laffey, Eddy Fan, Jonathon P Fanning, Mauro Panigada, Robert Bartlett, Daniel Brodie, Aidan Burrell, Davide Chiumello, Alyaa Elhazmi, Mariano Esperatti, Giacomo Grasselli, Carol Hodgson, Shingo Ichiba, Carlos Luna, Eva Marwali, Laura Merson, Srinivas Murthy, Alistair Nichol, Mark Ogino, Paolo Pelosi, Antoni Torres, Pauline Yeung Ng, John F Fraser

Department of Anesthesiology Faculty Papers

BACKGROUND: The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis.

METHODS: We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 …

Burden, Clinical Characteristics, Risk Factors, And Seasonality Of Adenovirus 40/41 Diarrhea In Children In Eight Low-Resource Settings, Godfrey Guga, Sarah Elwood, Caroline Kimathi, Gagandeep Kang, Margaret N. Kosek, Aldo A M Lima, Pascal O. Bessong, Amidou Samie, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Biological & Biomedical Sciences

Background: The application of molecular diagnostics has identified enteric group adenovirus serotypes 40 and 41 as important causes of diarrhea in children. However, many aspects of the epidemiology of adenovirus 40/41 diarrhea have not been described.
Methods: We used data from the 8-site Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project birth cohort study to describe site- and age-specific incidence, risk factors, clinical characteristics, and seasonality.
Results: The incidence of adenovirus 40/41 diarrhea was substantially higher by quantitative polymerase chain reaction than enzyme immunoassay and peaked at ∼30 episodes …

Medical Students In Karachi And Covid-19: Myths And Facts, Omer Bin Khalid Jamil, Muhammad Muhib, Muhammad Anas Abbal, Amna Muhammed Ahmed, Hafsa Hayat Khan, Nabeela Yar Khan

Department of Surgery Docs

Objectives: COVID-19 pandemic brought mortalities, morbidities, fear, and financial despair among people around the world. As it advanced, misinformation and myths about it caught wildfire, contributing to misbelief among the already shocked population. Medical students are the building blocks of the medical community and can provide a pivotal role in combating COVID-19 misinformation by delivering correct knowledge and awareness to the non-medical population of the country. Hence, it is important to assess their knowledge and perception of COVID-19 myths. Therefore, this study evaluates medical student's knowledge regarding myths and misinformation related to COVID-19 infection and its vaccine. The study also …

Covid-19 Newsletter (Vol. 118), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

A Case Of Intracranial Empyema After Bacterial Sinusitis, Eric Doane, Bhumi Shah, Robert Belfer

Rowan-Virtua Research Day

Acute sinusitis in the pediatric population is a common presentation in the emergency department. Most cases are viral and can be managed conservatively and will resolve spontaneously in 7-10 days. Even in cases of bacterial sinusitis, patients can typically be discharged with oral antibiotics and close follow up with the pediatrician.

There is however a small subset of patients who will develop a rare lethal complication, an intracranial empyema. While the incidence in the developed world has decreased as antibiotics become more available, it is still estimated to occur in up to 5% of severe cases requiring hospitalization (1) . …

Case Report: Covid Arm (Covid Vaccine Arm), Joseph Pagano, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

We report the case of a 38-year-old male physician who was vaccinated with the Pfizer vaccine. He experienced arm pain and swelling on the vaccinated arm as well as systemic symptoms, including fever, chills, headache and weakness. The systemic symptoms improved after the use of oral prednisone. A review of the literature on the COVID vaccine is presented.

Covid-19, Vaccination, And Heart Transplantation, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Improving Antibiotic Durations For Skin And Soft Tissue Infections In Pediatric Urgent Care Clinics, Megan Hamner

Research Days

Watch recording of live event

Problem Statement/Question: Although national guidelines recommend 5-7 days of oral antibiotics for most skin and soft tissue infections (SSTIs), in 2019, CMH urgent care clinics (UCCs) prescribed > 7-day courses for 42% of patients diagnosed with SSTIs. Prolonged antibiotic courses result in increased patient burden, cost and adverse events which could be prevented by prescribing shorter courses.

Background/Project Intent (Aim Statement): To increase the percentage of patients receiving 5- 7 days of oral antibiotics for SSTIs from 58% to 75% by December 31st, 2021, in CMH UCCs.

Methods (include PDSA cycles): We formed a multidisciplinary team …

Maternal Antepartum Administration Of Lactoferrin Ameliorates Neonatal Infection By Bacteremia-Producing Escherichia Coli In Mice, Charity Dunlop

Research Days

Background: E. coli is a major cause of neonatal sepsis. Vaginal pathogenic E. coli strains ascend into the pregnant uterus infecting the offspring of colonized mothers. Lactoferrin (LF) is an antibacterial and immunomodulatory glycoprotein that has been given to preterm newborns to prevent lateonset sepsis. However, the effects of maternal LF administration to prevent neonatal E. coli invasive infection have not been studied.

Objectives/Goal: Our goal was to test the hypothesis that LF pre-treatment of pregnant mice administered prenatally will significantly reduce the bacterial load in their embryos following infection with E. coli.

Methods/Design: Human LF 100 mcg/mL or placebo …

Repeat Tracheal Aspirates In Pediatric Intensive Care Patients: Understanding Clinical Application, Edward Lyon

Research Days

Background: Tracheal aspirate cultures (TA) are regularly obtained in the pediatric intensive care unit (PICU) when clinical changes in intubated or tracheostomy dependent children occur. Positive TA results are often unable to distinguish infection from colonization. There is no data describing the frequency and impact of repeated TAs on patients in the PICU.

Goal: Our objectives were to describe the frequency of repeated TAs in PICU children and emergence of multidrug resistant organisms (MDRO), identify bacterial profile of TAs, and examine antibiotic prescribing patterns related to these cultures.

Methods: A retrospective chart review occurred on 15 patients in the PICU …

Covid-19 Newsletter (Vol. 117), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.

The Racial Divide: A Follow Up Study On Racial Disparity Amongst Covid-19 Survivors In An Urban Community, Christopher Millet, Emily Racoosin, Spandana Narvaneni, George Horani, Sherif Roman, Alisa Farokhian, Arslan Chaudhry, Sohail Chaudhry, Yezin Shamoon, Humberto Jimenez, Patrick Michael, Jin Suh

Journal of Community Hospital Internal Medicine Perspectives

Background Studies have shown that COVID-19 has had a disproportionate effect on minority groups in both the clinical and social settings in America. We conducted a follow up study on patients previously diagnosed with COVID-19 one year ago in an urban community in New Jersey. The purpose of the study was to evaluate the socioeconomic impact of COVID-19 as well as assess for receptiveness towards COVID-19 vaccination amongst various ethnic groups.

Methods This was a prospective cohort study consisting of patients who had recovered from COVID-19 one year prior. The patients included in the study had a confirmed COVID-19 diagnosis …

Neurosyphilis: A Monkey Among Men, Cameron Rowe Do, Nathan Buckley Do, Bhaskar Chhetri Md, Suresh Paudel Md

Journal of Community Hospital Internal Medicine Perspectives

Neurosyphilis is the progression of the untreated sexually transmitted infection caused by Treponema pallidum. When the initial infection is not adequately treated, progression of primary syphilis can lead to a wide variety of serious health sequelae. While neurosyphilis can appear up to 10-30 years after the initial infection, syphilis can invade the nervous system at any stage of infection and can imitate symptoms of many other diseases. This variety of symptoms is why syphilis has been called “The Great Pretender” or “The monkey among diseases” (12). This is a case report of an 83-year-old female with a history of multiple …

Relatedness Of Urinary Escherichia Coli Strains And Connection Between Strain Type And Clinical Presentation, Anet Szatkowski, Venkathesh Bai, Matthew D. Sims

Posters

INTRODUCTION
Urine is often not a sterile body fluid. When bacteria in the urine cause symptoms it is by definition a urinary tract infection (UTI). The specific symptoms will point toward a bladder infection (cystitis) or a kidney infection (pyelonephritis). Presence of bacteria in the urine without symptoms defines asymptomatic bacteriuria (AB). Despite requiring symptoms to diagnose a UTI, often AB is misdiagnosed as a UTI and treated with antibiotics when none are needed. Escherichia coli is the most common cause of UTIs accounting for 80-90% of community-acquired UTIs and 30-50% of nosocomial UTIs. The goals of this study are …

Quality Improvement Study On Human Papilloma Virus (Hpv) Vaccination Uptake In Hiv Patients, Hassan Akram, Paul Johnson, Trini A Mathew

Posters

INTRODUCTION HPV is strongly associated with cervical cancer and cancers of vagina, vulva, penis, anus, rectum. In 2019, WHO identified vaccine hesitancy as top 10 global threats and planned to increase the HPV vaccine coverage. In June 2019 Advisory Committee on Immunization Practices (ACIP) in the US recommended shared clinical decision-making regarding HPV vaccinations in adults aged 26 through 45 years. The goal of this project is to evaluate the uptake of HPV vaccination and challenges in the HIV patients at Beaumont Hospital.

Resistance In Gram-Negative Bacteria In The Pediatric Patient Population By Age And Sex, Benjamin Malamet, Matthew Sims

Posters

INTRODUCTION
Previous research within the Beaumont Infectious Diseases Research Program found an increase in antibiotic resistance in adult males versus females. Furthermore, there is a peak in resistance in 18-29-year-old males, not seen in females. The origin of this early peak of antibiotic resistance in adults is unclear. This study examines these trends in the pediatric patient population.

Retrospective Impact Of Covid-19 Pandemic On Hypertension Management In Primary Care, Carly Barnes, Jayme Johnston, Judy Wong

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Clinical Pathways Leading To Antibiotic Initiation In Patients With Suspected Infection And Their Association With Delays And Mortality, X Han, C Lopez-Espina, P A. Verhoef, A Spicer, A Bhargava, L Schmalz, Matthew Sims, Alexandra Halalau, Nicholas Maddens, Aimee Espinosa

Conference Presentation Abstracts

Rationale: Delayed antibiotic therapy is associated with increased mortality in patients hospitalized with infection. The decision toinitiate therapy in patients with suspected infection is influenced by a variety of information, such as vital signs, and laboratoryresults. Identifying different patterns of events that lead to initiation is necessary to discover factors that could serve as targets forinterventions to expedite this process. We aimed to identify the most common sequences of events that precede antibioticordering and to quantify the time intervals between each event that contribute to antibiotic delays. Methods: This was aretrospective study of adult patients hospitalized at 4 community hospitals …

Identification Of Ciprofloxacin Resistance Factors Via In Vivo Evolution Of Aeromonas Veronii In The Medicinal Leech, Lauren Daddi

Honors Scholar Theses

Infections from ciprofloxacin (Cp) resistant (Cp^R) Aeromonas veronii have been reported in increasing numbers among patients receiving leech therapy in recent years. Mutations in DNA gyrase, gyrA S83I, and DNA topoisomerase IV, parC E91K, along with acquisition of the qnrS2 gene located on the pAv42 plasmid, have been identified as genetic factors contributing to Cp^R in A. veronii. A strain of A. veronii harboring all known resistance factors was previously constructed and has a Cp minimum inhibitory concentration (MIC) of 3 µg/ml, which remains below the resistance threshold of 4 µg/ml and well below the high …

The Epidemiology Of Extended Spectrum Beta-Lactamase-Producing Enterobacterales In Nebraska, 2018 – 2021, Axel A. Vazquez Deida

Capstone Experience: Master of Public Health

Background: Extended spectrum beta-lactamase (ESBL)-producing Enterobacterales are considered a serious public health threat by the United States Centers for Disease Control and Prevention. However, surveillance of ESBL-producing Enterobacterales is currently limited to select states and the epidemiology of these antibiotic-resistant bacteria in Nebraska is still not well understood.

Objective: To describe the incidence of ESBL-producing Enterobacterales across local health department (LHD)-jurisdictions as well as at the state-level over time and assess population-specific factors associated with infection or colonization with these pathogens in Nebraska.

Methods: A retrospective, cross-sectional analysis of public health surveillance data reported to the Nebraska Department of …

Analysis Of Blood Borne Pathogen Exposure Monitoring Protocol Adherence In An Academic Medical Center: A Seven Year Analysis And Literature Review, Natavoot N. Chongswatdi Md, Callie Seaman Md, Diane Harman Rn, Bsn, William Rollyson Md, Adam M. Franks Md

Marshall Journal of Medicine

Introduction

Health care workers (HCW) are at risk for occupational blood borne pathogen exposures (BBPE). Effective prevention and management of BBPEs relies upon reporting and post-exposure follow-up protocol adherence. As post-exposure monitoring completion is largely unexplored, seven years of a university healthcare system’s BBPE exposure data was explored and compared to documented rates.

Methods

The Marshall Health Occupational Health and Wellness division collected seven years (2012-2018) of BBPE follow-up monitoring adherence rates and demographic data. Data for HCW occupation, exposure incident, and source patient disease status were evaluated. Differences were analyzed with Chi square, Fischer Exact and logistic regression tests. …

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine As An Alternative For Treatment In Hiv Positive Patients, Aravindh Nirmalan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Mantsios A, Murray M, Karver TS, et al. Efficacy and Freedom: Patient Experiences with the Transition from Daily Oral to Long-Acting Injectable Antiretroviral Therapy to Treat HIV in the Context of Phase 3 Trials. AIDS Behav. 2020;24(12):3473-3481. https://doi.org/10.1007/s10461-020-02918-x

for a young adult patient struggling with adherence.

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.