Medical Specialties Commons^™

Comparative Assessment Of Methicillin Resistant Staphylococcus Aureus Diagnostic Assays For Use In Resource-Limited Settings, A. Ayebare, Lisa M. Bebell, Joel Bazira, S. Ttendo, V. Katawera, David Bangsberg, Mark J. Siedner, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The rise of methicillin-resistant Staphylococcus aureus(MRSA) is a global health concern. Paucity of data on MRSA carriage prevalence and diagnostic methods in resource-limited settings hampers efforts to define the problem and plan an appropriate response. Additionally, high variability in cost and logistical characteristics of MRSA screening methods may impede infection control efforts. We compared the performance of locally-available chromogenic agar BD CHROMagar MRSA II and two PCR-based assays (Hain GenoQuick MRSA and Cepheid Xpert SA Complete) for the detection of asymptomatic MRSA carriage in nasal swabs.

Results: During 2015, we enrolled 500 patients from five hospital …

Synapsis: Philadelphia Campus (2019), Philadelphia College Of Osteopathic Medicine

All Yearbooks

The 2019 Philadelphia Campus Synapsis includes Orientation, White Coat, Gala, Life at PCOM, Anatomy Groups, Radiology, Family Medicine, Match.

Pulmonary Vein Thrombosis Secondary To Tuberculosis In A Non-Hiv Infected Patient, Yonas Raru, Jason Ballengee, Mahmoud Abouzid, Samson Teka

Pulmonology

Tuberculosis has been suggested as an independent risk factor for thromboembolism due to a hypercoagulable state induced by changes in clotting factors, protein C and vascular endothelium. Pulmonary vein thrombosis (PVT) is a rare, potentially serious and life-threatening condition that can be caused by tuberculosis. Its rare occurrence is due to a rich network of venous collateral vessels that drain the lung. PVT can also occur following lobectomy for malignancy, lung transplantation, radiofrequency catheter ablation for atrial fibrillation, sclerosing mediastinitis and following metastatic cancer, such as liposarcoma. Pulmonary vein thrombosis is difficult to diagnose clinically and requires a combination of …

Rasburicase Induced Severe Hemolysis And Methemoglobinemia In A Caucasian Patient Complicated By Acute Renal Failure And Ards, Yonas Raru, Mahmoud Abouzid, Julia Parsons, Fuad Zeid

Pulmonology

Rasburicase is a recombinant urate-oxidase enzyme and is a very important medication for tumor lysis syndrome. Methemoglobinemia and hemolysis are known side effects of rasburicase that result from oxidative stress caused by hydrogen peroxide, a byproduct generated during the breakdown of uric acid to allantoin. Patients with G6PD deficiency have a decreased tolerance to oxidative stress and are therefore at a greater risk of hemolysis and methemoglobinemia with rasburicase. Our patient is a 56-year-old Caucasian male with a recent diagnosis of grade 2-3a non-Hodgkin's lymphoma who presented to our emergency department with shortness of breath and dark discoloration of urine. …

Risk Factors For Pneumonia Following Rib Fractures, Brittany Bowers

Scholarship in Medicine - All Papers

Objective: Pneumonia is a known complication following rib fractures. The purpose of this study is to identify factors associated with the development of pneumonia following rib fractures. Methods: In this retrospective chart review, eligible participants included trauma patients with one or more rib fractures who were admitted to Miami Valley Hospital during 2012 through 2017. Variables studied included age, gender, injury severity score (ISS), mechanism of injury, smoking status, alcohol use, administration of influenza and pneumococcal vaccine, number and side of rib fracture(s), spirometer use, blood transfusion, and intravenous fluid administration.

Results: Among 78 cases and 74 controls, matched for …

Health Literacy: Approach To Colon Cancer In African Americans, Judith Jefferson-Gordon

Doctor of Nursing Practice Program Projects

Health literacy is vitally important for African-Americans (AA), with higher incidence and mortality rates of colon cancer compared to Caucasians nationally and in Ohio. Larrabee's Model for Change to EBP and Self -Efficacy Middle range nursing theory guided this DNP project. A retrospective chart review of AA patients with colon cancer was completed to determine types of teaching methods used by nurses during the clinical encounter. A convenience sample (8%) of AA patients received colon cancer care in the ambulatory setting at the healthcare facility in the Midwest. More than half were female and the remainder were male (65% vs. …

การศึกษาฤทธิ์ของ Fluoxetine ในการยับยั้งการเจริญเติบโตและเหนี่ยวนำการตายแบบ Apoptosis ผ่านวิถี Pi3k/Akt และ Sigma-1 Receptor ใน Leukemic Cell Lines, ชนิชนม์ ชมเชย

Chulalongkorn University Theses and Dissertations (Chula ETD)

Fluoxetine เป็นยากลุ่ม SSRI (selective serotonin reuptake inhibitor) ที่ใช้ในการรักษาโรคซึมเศร้า ยาหลายตัวในกลุ่ม SSRI สามารถจับแบบจำเพาะ sigma-1 receptor แต่ในกรณี fluoxetine จะมีกลไกออกฤทธิ์จำเพาะต่อ serotonin transporter (Ki = 0.81 nM) มากกว่า sigma-1 receptor (Ki = 214–240 nM) หลายงานวิจัยรายงานว่า sigma-1 receptor แสดงออกบนเซลล์มะเร็งหลายชนิด และมีรายงานว่า antagonist สามารถลดการเพิ่มจำนวนและเหนี่ยวนำให้เกิด apoptosis แต่การทำงานร่วมกันระหว่าง fluoxetine กับ sigma-1 receptor ต่อเซลล์มะเร็ง ยังไม่ทราบกลไกการออกฤทธิ์ที่ชัดเจน งานวิจัยนี้มีวัตถุประสงค์เพื่อศึกษาฤทธิ์ของ fluoxetine ในการยับยั้งการแบ่งตัวและเหนี่ยวนำให้เกิด apoptosis ผ่าน sigma-1 receptor ในเซลล์มะเร็งเม็ดเลือดขาว ผลการทดสอบพบว่า fluoxetine สามารถลดเปอร์เซ็นต์การรอดชีวิตของเซลล์ Jurkat และ U937 ได้ โดยมีค่า IC50 เท่ากับ 28 ± 1.4 และ 36 ± 1.6 uM ตามลำดับ เมื่อเซลล์ Jurkat ถูกทดสอบด้วย fluoxetine ตามระดับความเข้มข้นและระยะเวลาที่เพิ่มขึ้น พบว่าfluoxetine สามารถยับยั้งการแบ่งตัวของเซลล์ Jurkat ได้อย่างมีนัยสำคัญทางสถิติ โดยมีกลไกหยุดยั้งวัฎจักรเซลล์ที่ระยะ G2/M และลดการหลั่งไซโตไคน์ IL-2 รวมทั้งเหนี่ยวนำให้เกิด apoptosis โดยการลดการแสดงออกของโปรตีน pro caspase 9 ผ่านการยับยั้งการเกิด phosphorylation ของ AKT ในวิถี PI3K/Akt และ การถูกกระตุ้นของ sigma-1 receptor …

Connecting The Pieces: How Low Back Pain Alters Lower Extremity Biomechanics And Shock Attenuation In Active Individuals, Alexa Johnson

Theses and Dissertations--Rehabilitation Sciences

Low back pain in collegiate athletes has been reported at a rate of 37% from a wide array of sports including soccer, volleyball, football, swimming, and baseball. Whereas, in a military population the prevalence of low back pain is 70% higher than the general population. Compensatory movement strategies are often used as an attempt to reduce pain. Though compensatory movement strategies may effectively reduce pain, they are often associated with altered lower extremity loading patterns. Those who suffer from chronic low back pain tend to walk and run slower and with less trunk and pelvis coordination and variability. Individuals with …

Differences In The M1 And M2 Macrophage Subtypes Between The Sexes Determine Susceptibility To Francisella Tularensis Infection, Michelle Arlene Sanchez

Open Access Theses & Dissertations

Francisella tularensis is the causative agent of the human disease tularemia. It is highly infectious with as few as 10 microorganisms via inhalation causing a lethal infection. F. tularensis infects a variety of cell types, including macrophages and neutrophils, since it needs to enter, survive and proliferate in order to cause pathogenicity. Disease is the result of over activating the host's own inflammatory response initiated by the macrophage's response to infection.

Known differences exist in the intensity of the inflammatory response between the sexes which leads to differences in sensitivity to autoimmune and infectious disease. Males tend to be more …

Where Are The Paediatricians? An International Survey To Understand The Global Paediatric Workforce, Beth D. Harper, Waceke Nganga, Robert Armstrong, Kevin D. Forsyth, Hazen P. Ham, William J. Keenan, Christiana M. Russ

Paediatrics and Child Health, East Africa

Objective: Our primary objective was to examine the global paediatric workforce and to better understand geographic differences in the number of paediatricians globally. Secondary objectives were to describe paediatric workforce expectations, who provides children with preventative care and when children transition out of paediatric care.

Design: Survey of identified paediatric leaders in each country.

Setting: Paediatric association leaders worldwide.

Main outcome measures: Paediatrician numbers, provision of primary care for children, age of transition to adult care.

Results: Responses were obtained from 121 countries (73% of countries approached). The number of paediatricians per 100 000 children ranged from a median of …

Improving Access To Clean Water In Rural Ecuador: The Connection Between Willingness To Pay And Population Health, Micalea Leaska

Capstone Collection

Climate change is affecting social and environmental determinants of health through access to safe drinking water, safely managed sanitation systems, and access to health care services and the ability for individuals to break free from unsuitable circumstances. Ecological disturbances such as those caused by climate change can cause a shift in host vectors or a change in habitat that results in a greater likelihood of the pathogen coming in contact with humans. Water, sanitation, and hygiene (WASH) services and their accessibility to populations can directly impact a community’s vulnerability to diseases and limiting factors to increase economic growth. If rural …

Relationship Between Gestational Diabetes And A Positive Depression Screen, Onegarach Herbert Ozelle

Master of Medicine in Obstetrics and Gynecology

Introduction: Gestational diabetes mellitus (GDM) and its treatment have a marked effect on women’s lives consequently aggravating psychosocial disruptions of a normal pregnancy. The demand for behavioural adaptation as well as postulated biological interactions are likely to increase the risk of maternal depression in GDM patients. There is however inadequate literature concerning the relationship between GDM and depression. Objective: To compare the proportion of women with GDM who screen positive for depression and the proportion of women without GDM who screen positive for depression at the Aga Khan University Hospital, Nairobi. Socio-demographic factors associated with a positive depression screen were …

Comparison Of Vaginal Microbiota In Women With Spontaneous Preterm Labour Versus Those With Term Labour, Edgar Gulavi

Master of Medicine in Obstetrics and Gynecology

Background: Preterm birth presents a challenge on a global scale with a disease burden that is on the rise. It is a leading cause of perinatal morbidity and mortality worldwide with approximately 15 million preterm births every year. Kenya has a 12% preterm birth rate with about 190,000 babies born preterm every year. The female lower genital tract bacterial community plays a vital role in maternal and neonatal health. An association between altered vaginal microbial composition and preterm birth has been demonstrated in previous studies. However, findings in terms of composition and diversity of these bacteria across the few studies …

Death With Dignity For The Seemingly Undignified: Denial Of Aid In Dying In Prison, Kathleen Messinger

Journal of Criminal Law and Criminology

The medical community has fundamentally changed how we think about life and death. Humans in privileged parts of the world are living longer and have access to life-saving treatment. The focus on quantity of life then has shifted to emphasizing quality of life and questioning whether longevity should at the expense of comfort or satisfaction. The conversation surrounding quality of life, and by extension end-of-life care, has included whether a competent adult has a right, or should have a right to end their own life on their own terms. The history of aid in dying is wrought with political ideology, …

Detection Of Human Plasma Glucose Using A Self-Powered Glucose Biosensor, Gymama Slaughter, Tanmay Kulkarni

Bioelectrics Publications

This work presents the characterization of a self-powered glucose biosensor using individual sequential assays of human plasma glucose obtained from diabetic patients. The self-powered glucose biosensor is exploited to optimize the assay parameters for sensing plasma glucose levels. In particular, the biofuel cell component of the system at pH 7.4, 37 °C generates a power density directly proportional to plasma glucose and exhibited a maximum power density of 0.462 mW·cm⁻² at a cell voltage of 0.213 V in 5 mM plasma glucose. Plasma glucose is further sensed by monitoring the charge/discharge frequency (Hz) of the integrated capacitor functioning as …

Calibrated Short Tr Recovery Mri For Rapid Measurement Of Brain-Blood Partition Coefficient And Correction Of Quantitative Cerebral Blood Flow, Scott William Thalman

Theses and Dissertations--Biomedical Engineering

The high prevalence and mortality of cerebrovascular disease has led to the development of several methods to measure cerebral blood flow (CBF) in vivo. One of these, arterial spin labeling (ASL), is a quantitative magnetic resonance imaging (MRI) technique with the advantage that it is completely non-invasive. The quantification of CBF using ASL requires correction for a tissue specific parameter called the brain-blood partition coefficient (BBPC). Despite regional and inter-subject variability in BBPC, the current recommended implementation of ASL uses a constant assumed value of 0.9 mL/g for all regions of the brain, all subjects, and even all species.

The …

Autologous Peripheral Nerve Grafts To The Brain For The Treatment Of Parkinson's Disease, Andrew Welleford

Theses and Dissertations--Neuroscience

Parkinson’s disease (PD) is a disorder of the nervous system that causes problems with movement (motor symptoms) as well as other problems such as mood disorders, cognitive changes, sleep disorders, constipation, pain, and other non-motor symptoms. The severity of PD symptoms worsens over time as the disease progresses, and while there are treatments for the motor and some non-motor symptoms there is no known cure for PD. Thus there is a high demand for therapies to slow the progressive neurodegeneration observed in PD. Two clinical trials at the University of Kentucky College of Medicine (NCT02369003, NCT01833364) are currently underway that …

Frailty In Patients Undergoing Left Ventricular Assist Device Implantation, Candice Falls

Theses and Dissertations--Nursing

Heart failure is a progressive condition that affects over 5.7 million Americans and costs associated with heart failure account for 2-3 % of the national health care budget. The high rates of morbidity and mortality along with increased costs from readmissions associated with advanced heart failure have led to the exploration of advanced treatments such as left ventricular assist devices (LVADs). LVADS have demonstrated morbidity and mortality benefit but cost remains extensive with costs per quality-adjusted years > $400,000. With this in mind, it is important to identify those who are most likely to benefit from an LVAD to avoid unfavorable …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Understanding The Contributions Of Alzheimer’S Disease & Cardiovascular Risks To Cerebral Small Vessel Disease Manifest As White Matter Hyperintensities On Magnetic Resonance Imaging (Mri), Omar M. Al-Janabi

Theses and Dissertations--Clinical and Translational Science

Introduction: Alzheimer’s Diseases (AD) & cerebral small vessel disease associated with cardiovascular risk factors (cSVD) frequently coexist, differentially affecting both imaging and clinical features associated with aging and dementia. We hypothesized that Magnetic Resonance Imaging (MRI) can be used in novel ways to identify relative contributions of AD & cardiovascular risks to cSVD and brain atrophy, generating new biomarkers & insights into mixed disease states associated with cognitive decline and dementia.

Methods: Three experiments were conducted to address the overarching hypothesis. First, we visually rated the clinical MRI of 325 participants from a community-based cross-sectional sample to elucidate the relative …

A Pilot Study Of A Multiple Health Behavior Change Intervention For Smokers, Srihari Seshadri

Theses and Dissertations--Clinical and Translational Science

Background: Being both obese and a smoker increases the probability of developing type 2 diabetes, cardiovascular disease, and cancer, diseases that impact Kentucky residents disproportionately. Kentucky (KY) has a high incidence of obesity (34.2%) and smoking (24.5 %). Weight gain associated with smoking cessation also can undermine health benefits of quitting, and may lead to smoking relapse.

Aim: The aim of the pilot study was to implement and evaluate a Multiple Health Behavioral Change (MHBC) program that combines Cooper Clayton Method to Stop Smoking (CCMSS) and the Diabetes Prevention Program (DPP) for weight control.

Method: A 15-week intervention was administered …

Protocolized Volume De-Resuscitation In Critically Ill Patients, Brittany Dawn Bissell

Theses and Dissertations--Clinical and Translational Science

While early fluid resuscitation may be a necessary component to decrease mortality in the majority of critically ill patients admitted to the intensive care unit, the benefit of continued administration after the first 24 hours is less clear. Paradoxically, a positive fluid balance secondary to intravenous fluid receipt has been associated with diverse and persistent perpetuating detriment on a multitude of organ systems. Continued clinical harm has been demonstrated on pulmonary and renal function as well as patient outcomes such as rates of mortality and length of stay. Despite the growing body of evidence supporting the potential adverse aspects of …

Changes In Muscle Size, Quality And Power Are Related To Physical Function In Patients With Critical Illness, Kirby Mayer

Theses and Dissertations--Rehabilitation Sciences

Patients admitted to intensive care unit (ICU) are known to develop significant impairments in physical function. Patients with critical illness suffer up to 30% reductions in muscle size within the first ten days of admission to the ICU. Muscle strength testing, Medical Research Council-sum score, is current gold-standard to diagnosis ICU-acquired weakness and predicts risk of mortality and long-term physical function. Muscle power different from muscle strength in that it accounts for velocity of movement, is potentially a better independent predictor of function that has not been studied in this population. In addition, we hypothesize that muscle size and quality …

Organizational Models In Athletic Training And The Effect On The Quality Of Care Delivered, Matthew Ferreira

Graduate Theses, Dissertations, and Problem Reports (ETD)

Context: Quality of care is an ethical priority to all healthcare professionals. Healthcare fields such as nursing and physical therapy have made changes in staff size and focus that have increased the quality of care provided to patients. The athletic training field has not made changes to the organizational structure. Thus, the quality of care delivered by athletic trainers is an understudied topic. Likewise, the organizational models have just recently been explored in the literature. Objective: Identify differences in the three models of organization (academic, athletic, and medical) related to quality of care delivered and coverage versus care. Design: This …

Adaptation Of The Streptococcal Collagen-Like Protein 1, Scl1, Of Group A Streptococcus To Recognize Fibronectin Type Iii Repeats, Dudley H. Mcnitt

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Group A Streptococcus (GAS) is responsible more than 700 million infections worldwide each year. Most of these infections start with initial colonization of the throat and skin, which is augmented by surface adhesins. The streptococcal collagen-like protein 1 (Scl1) is a major adhesin expressed by GAS that contains an N-terminal sequence-variable (V) domain, protruded away from the cell surface by the collagen domain. The Scl-V domain is comprised of three pairs of anti-parallel α-helices interconnected by surface-exposed loops. For attachment, GAS adhesins require a portal of entry, such as a wound or breach in the epithelium, to enter …

Regulation Of The Long Non-Coding Rna Fam83h-As1 By Human Papillomavirus In Cervical Cancer, Jamie Ann Barr Ph.D.

Graduate Theses, Dissertations, and Problem Reports (ETD)

Non-coding RNAs (NcRNAs), such as long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been found to be involved in a variety of critical biological processes, and dysregulation of ncRNAs have been involved with several human diseases including cancer.

High-risk human papillomavirus (HPV) infection is one of the first events in the process of carcinogenesis in cervical and a subset of head and neck cancers. The expression of the viral oncoproteins E6 and E7 is essential in this process by inactivating the tumor suppressor proteins p53 and Rb, respectively, in addition to their interactions with other host proteins and regulation of …

Elderly Bleeding Risk Of Direct Oral Anticoagulants In Nonvalvular Atrial Fibrillation: A Systematic Review And Meta-Analysis Of Cohort Studies, Jessika Lobraico-Fernandez, Salma Baksh, Eric C. Nemec

Physician Associate Studies Faculty Publications

Introduction The 2014 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Rhythm Society (HRS) guidelines recommend anticoagulation to reduce clot formation and the risk of thromboembolic events in patients with atrial fibrillation but does not specify guidelines for the elderly population. Direct oral anticoagulants (DOACs) are newer US FDA-approved alternatives to warfarin and include dabigatran, rivaroxaban, apixaban and edoxaban. The efficacy of DOACs is heavily researched, but few studies have evaluated their bleeding risk. Objectives This systematic review and meta-analysis investigates which DOAC has the lowest bleeding risk in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods CINAHL and MEDLINE …

Evaluation Of A Cognitive Training Program And Its Effects On Healthy Older Adults, Nathan Jensen

All Graduate Theses, Dissertations, and Other Capstone Projects

As one ages, some degree of cognitive decline is expected. Despite this, declines in cognitive abilities and the possibility of dementia is a common concern among older adults. In response to these concerns, a variety of cognitive training programs have been developed that aim to improve or maintain cognitive functioning. Prior literature has shown mixed or limited findings on cognitive changes after implementation of cognitive training. This study evaluated the effectiveness of a cognitive training program designed for older adults with no to minimal cognitive decline. The current study included 18 participants who engaged in two one-hour cognitive training sessions …

The Effect Of Dorsal Rhizotomy On Renal Sodium Excretion Following Dorsal Spinal Stimulation, Tanko Tijani Ahmed

All Graduate Theses, Dissertations, and Other Capstone Projects

Hypertension is one of the most common risk factors in the development of heart disease, stroke and end stage renal failure. Sympathetic overactivity is believed to be one of the main mechanism behind resistant hypertension. Renal denervation has been used to treat resistant hypertension, although this procedure is an invasive one. Spinal cord stimulation (SCS) is a known modality to treat ischemic pain, angina pectoris, and peripheral vascular diseases. In previous studies in this laboratory, unilateral spinal cord stimulation in spontaneously hypertensive rat (SHR) at 67% of the motor threshold increased urinary sodium and water excretion significantly, without affecting mean …

Associations Between Income, Acculturation, Country Of Origin, And Type Ii Diabetes Among African Immigrants To Ontario, Canada, Girma Aman Goshe

Walden Dissertations and Doctoral Studies

Diabetes has become a longstanding public health challenge around the world. Over the last 3 decades, the number of people with Type II diabetes (T2DM) has grown to an epidemic level in Canada. Prior research indicated African immigrants residing in Ontario, Canada experienced a 2-4 times higher prevalence of T2DM than Canadian-born individuals. The social determinants of health theoretical framework guided this study assessing the relationship of the risk factors with T2DM. A quantitative, cross-sectional design was employed using the 2007-2014 Canadian Community Health Survey data. The random sample included 1,526 African immigrants residing in Ontario, Canada. Descriptive, bivariate, and …