Medical Specialties Commons^™

Use Of Pefloxacin As A Surrogate Marker To Detect Ciprofloxacin Susceptibility In Salmonella Enterica Serotypes Typhi And Paratyphi A, Safia Moin, Mohammad Zeeshan, Sidra Laiq, Ahmed Raheem, Afia Zafar

Department of Pathology and Laboratory Medicine

Objective: To determine the use of pefloxacin as a surrogate marker to detect fluoroquinolone (ciprofloxacin) susceptibility against Salmonella enterica serotypes Typhi and Paratyphi A.
Methods: The prospective, descriptive cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from September 2016 to March 2018, and comprised Salmonella Typhi and Paratyphi A isolates of blood cultures. Disk susceptibility tests and broth microdilution to test minimum inhibitory concentration were performed as per standard guidelines. Data was analysed using SPSS 21.
Results: Of the 138 isolates, 91(66%) were intermediate resistant to ciprofloxacin but were resistant to pefloxacin, 42(30%) were resistant to both …

The Contribution Of Frequency Discrimination Ability To Auditory Temporal Patterning Tests In Children, Ashley G. Flagge, Tara M. Davis, Victoria Henbest

Ashley Flagge Publications

Purpose: The Pitch Patterns Test (PPT) and Duration Patterns Test (DPT) are clinical auditory processing tests that evaluate temporal patterning skills based on pitch (PPT) or duration (DPT) aspects of sound. Although temporal patterning tests are categorized under the temporal processing domain, successful performance on the PPT also relies on accurate pitch discrimination. However, the relationship between pitch discrimination ability and temporal patterning skills have not been thoroughly evaluated. This study examined the contribution of pitch discrimination ability to performance on temporal patterning in children through the use of a pitch discrimination task and the PPT …

An Examination Of Policy And Procedure Practices Of Secondary School Athletic Trainers, Micaela Dunbar-Gaynor, Ericka P. Zimmerman, Victor Liberi

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to identify and describe the status of P&P practices of secondary school athletic trainers. Methods: Following an online informed consent confirmation, participants completed a Policies and Procedures Status questionnaire, including demographics. This was distributed to certified athletic trainers currently employed in the secondary school setting in the United States. The survey consisted of 49 questions about the status of P&Ps using one of the following responses: the practice is in operation and it appears in written form; the practice is in operation but does not appear in written form; the practice …

Comments On The Preliminary Framework For Equitable Allocation Of Covid-19 Vaccine, Ana Santos Rutschman, Julia Barnes-Weise, Robert Gatter, Timothy L. Wiemken

All Faculty Scholarship

On September 1, 2020 the National Academies released a draft framework for Equitable Allocation of a COVID-19 Vaccine. In this response, we analyze the proposed framework and highlight several areas.

Among the proposed changes, we highlight the need for the following interventions. The final framework for distribution of COVID-19 vaccines should give a higher priority to populations made most vulnerable by the social determinants of health. It should incorporate more geography-based approaches in at least some of the four proposed phases of vaccine distribution. It should address the possibility of a vaccine being made available through an emergency use authorization …

An Unexpected Global Health Experience In Manila, Susan Mcanany

Posters

Describes her experience in the NICU of the Fabella Memorial Hospital in Manila, Philippines.

Global Health Elective In Santiago Atitlan, Guatemala, Sarah Greenberg

Posters

Describes her experience working in Hospitalito Atitlan in Santiago Atitlan, Guatemala.

Fit Clinical Decision-Making Unusual Echocardiographic Findings Of Myocarditis Mimicking An Aortic Runoff Lesion, Sarah Studyvin, Christine Symes, Barbara A. Pahud, Nitin Madan

Posters

No abstract provided.

Mucosa-Associated Microbiota In Barrett’S Esophagus, Dysplasia, And Esophageal Adenocarcinoma Differ Similarly Compared With Healthy Controls, Shajan Peter, Amanda Pendergraft,, William Vanderpol, Mel Wilcox, Kondal R. Kyanam Kabir Baig, Casey Morrow, Jacques Izard, Peter J. Mannon

Department of Food Science and Technology: Faculty Publications

Introduction: Alterations in the composition of the human gut microbiome and its metabolites have been linked to gut epithelial neoplasia. We hypothesized that differences in mucosa-adherent Barrett’s microbiota could link to risk factors, providing risk of progression to neoplasia.

Methods: Paired biopsies from both diseased and nonaffected esophagus (as well as gastric cardia and gastric juice for comparison) from patients with intestinal metaplasia (n = 10), low grade dysplasia (n = 10), high grade dysplasia (n = 10), esophageal adenocarcinoma (n = 12), and controls (n = 10) were processed for mucosa-associated bacteria …

Targeting Homologous Recombination Addicted Tumors: Challenges And Opportunities, Talia Golan, Jonathan Brody, Md

Kimmel Cancer Center Faculty Papers

Recent advances in next generation sequencing (NGS) and molecular subtyping of tumors have opened the door to clinically available targeted therapies. Although the treatment of many solid tumors still rely on a steady regimen of non-targeted chemotherapeutic agents, it is becoming increasingly more apparent that certain tumors with defects in DNA damage repair (DDR) genes may be exquisitely sensitive to DNA damaging agents or therapies targeting key elements of this pathway such PARP1, ATR, or ATM. Still, for tumors with DDR defects the challenges are multi-fold including: (I) identifying these tumors in patients in time for a window of opportunity …

Comparison Of Outcomes In Level I Vs Level Ii Trauma Centers In Patients Undergoing Craniotomy Or Craniectomy For Severe Traumatic Brain Injury., Nohra Chalouhi, Nikolaos Mouchtouris, Fadi Al Saiegh, Robert M Starke, Thana Theofanis, Somnath Das, Jack Jallo

Department of Neurosurgery Faculty Papers

BACKGROUND: Traumatic brain injury (TBI) carries a devastatingly high rate of morbidity and mortality.

OBJECTIVE: To assess whether patients undergoing craniotomy/craniectomy for severe TBI fare better at level I than level II trauma centers in a mature trauma system.

METHODS: The data were extracted from the Pennsylvania Trauma Outcome Study database. Inclusion criteria were patients > 18 yr with severe TBI (Glasgow Coma Scale [GCS] score less than 9) undergoing craniotomy or craniectomy in the state of Pennsylvania from January 1, 2002 through September 30, 2017.

RESULTS: Of 3980 patients, 2568 (64.5%) were treated at level I trauma centers and 1412 …

A Brief History Of Quality Improvement In Health Care And Spinal Surgery., Kevin Hines, Nikolaos Mouchtouris, John J Knightly, James Harrop

Department of Neurosurgery Faculty Papers

While medical and technological advances continue to shape and advance health care, there has been growing emphasis on translating these advances into improvement in overall health care quality outcomes in the United States. Innovators such as Abraham Flexner and Ernest Codman engaged in rigorous reviews of systems and patient outcomes igniting wider spread interest in quality improvement in health care. Codman's efforts even contributed to the founding of the American College of Surgeons. This society catalyzed a quality improvement initiative across the United States and the formation of the Joint Commission on Accreditation of Hospitals. Since that time, those such …

Quality Improvement And Spine Surgery., James Harrop

Department of Neurosurgery Faculty Papers

AO Spine North American (AOSNA) is honored to have the ability to present this focused issue on improving quality health care for spine patients. This issue is dedicated to improvements in quality for patient benefits.

Mirna- And Cytokine-Associated Extracellular Vesicles Mediate Squamous Cell Carcinomas, Joseph P. Flemming, Brianna L. Hill, Mohammed W. Haque, Jessica Raad, Claudine S. Bonder, Larry A. Harshyne, Ulrich Rodeck, Adam J. Luginbuhl, James K. Wall, Iii, Kenneth Y. Tsai, Peter J Wermuth, Andrew M. Overmiller, Mỹ G. Mahoney

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Covid-19, Serendipity, And Strange Interlude: Gloria In Absurdicum With An Apology To Ovid, Lawrence Charles Parish, W Clark Lambert

Department of Dermatology and Cutaneous Biology Faculty Papers

The absurd edicts initially issued by several governors, including those of Michigan and New York, prohibiting physicians from ordering hydroxychloroquine for patients suspected of or diagnosed with COV-19 are reprehensible. Their reasoning is beyond the pale.

Hydroxychloroquine was first approved by the FDA in 1955 and has a remarkable safety record in its use as a preventative for malaria and in the treatment of several immunologic and/or light induced diseases. Its use came about serendipitously, and its mechanism of action is unclear, but the fact remains that it seems to work.

Hiv-1 Subtypes And Drug Resistance Mutations Among Female Sex Workers Varied In Different Cities And Regions Of The Democratic Republic Of Congo, Eun Hee Kwon, Godefroid M. A. Musema, Jessica Boelter, Sydney Townsend, Desire Tshala-Katumbay, Patrick K. Kayembe, John T. West, Charles Wood

Nebraska Center for Virology: Faculty Publications

Background Complex mosaic structures of HIV-1 were found in the Democratic Republic of Congo (DRC). Currently, there is limited information on the circulating HIV-1 strains, the distribution of these strains and antiretroviral (ART) resistant viruses in different regions of the country, and the HIV-1 strains harbored by the high-risk groups like female sex workers (FSW) reported to be the source of recombinant and ART resistant viruses.

Methods Dried Blood Spots (DBS), collected from 325 infected FSWs in ten cities from 2012 DRC HIV/STI Integrated Biological and Behavioral Surveillance Survey, were tested for HIV-1 genotypes and antiretroviral resistance mutations. Regional segregation …

How The Cervical Microbiota Contributes To Cervical Cancer Risk In Sub-Saharan Africa, Cameron Klein, Crispin Kahesa, Julius Mwalselage, John T. West, Charles Wood, Peter C. Angeletti

Nebraska Center for Virology: Faculty Publications

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Particular states of the cervicovaginal microbiota and viral infections are associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better knowledge of the regional cervicovaginal microbiome is required This review establishes current knowledge of HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiota in sub-Saharan Africa. Because …

The Kaposi’S Sarcoma-Associated Herpesvirus (Kshv) Gh/Gl Complex Is The Predominant Neutralizing Antigenic Determinant In Kshv-Infected Individuals, Yasaman Mortazavi, Salum J. Lidenge, Tara Tran, John T. West, Charles Wood, For Yue Tso

Nebraska Center for Virology: Faculty Publications

Kaposi’s sarcoma-associated herpesvirus (KSHV) is the etiological agent of Kaposi’s sarcoma (KS), one of the most prevalent cancers of people living with HIV/AIDS in sub-Saharan Africa. The seroprevalence for KSHV is high in the region, and no prophylactic vaccine against the virus is available. In this study, we characterized the antigenic targets of KSHV-specific neutralizing antibodies (nAbs) in asymptomatic KSHV-infected individuals and KS patients with high nAbs titers. We quantified the extent to which various KSHV envelope glycoproteins (gB, ORF28, ORF68, gH, gL, gM, gN and gpK8.1) adsorbed/removed KSHV-specific nAbs from the plasma of infected individuals. Our study revealed that …

Mycoplasma Co-Infection Is Associated With Cervical Cancer Risk, Cameron Klein, Kandali Samwel, Crispin Kahesa, Julius Mwaiselage, John T. West, Charles Wood, Peter C. Angeletti

Nebraska Center for Virology: Faculty Publications

Tanzania faces one of the highest cervical cancer burdens in the world. Recent work has suggested that the bacterial family Mycoplasmataceae is associated with higher levels of human papillomavirus (HPV), human immunodeficiency virus (HIV), and pre-cancerous cervical lesions. Mycoplasmataceae infection in Tanzania is not well understood, especially when considering the differences between sexually transmitted species of Mycoplasmataceae. To establish the prevalence of common Mycoplasmataceae cervical infections and evaluate their relationship with risk factors for cervical cancer, 1160 Tanzanian women responded to an epidemiological questionnaire and were tested for HIV, HPV, cervical lesions, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma spp., and Lactobacillus …

Epstein Barr Virus-Immortalizedｂlymphocytes Exacerbate Experimental Autoimmune Encephalomyelitis In Xenograft Mice, Pascal Polepole, Alison Bartenslager, Yutong Liu, Thomas M. Petro, Samodha C. Fernando, Luwen Zhang

Nebraska Center for Virology: Faculty Publications

Multiple sclerosis (MS) is the most common autoimmune disorder affecting the central nervous system. Epstein-Barr virus (EBV) is a causative agent for infectious mononucleosis (IM) that is associated with MS pathogenesis. However, the exact mechanism by which EBV, specifically in IM, increases the risk for MS remains unknown. EBV immortalizes primary B lymphocytes in vitro and causes excessive B lymphocyte proliferation in IM in vivo. In asymptomatic carriers, EBV-infected B lymphocytes still proliferate to certain degrees, the process of which is tightly controlled by the host immune systems. Experimental autoimmune encephalomyelitis (EAE) mimics key features of MS in humans and …

A Decade In Review: A Systematic Review Of Universal Influenza Vaccines In Clinical Trials During The 2010 Decade, Brigette N. Corder, Brianna L. Bullard, Gregory Poland, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

On average, there are 3–5 million severe cases of influenza virus infections globally each year. Seasonal influenza vaccines provide limited protection against divergent influenza strains. Therefore, the development of a universal influenza vaccine is a top priority for the NIH. Here, we report a comprehensive summary of all universal influenza vaccines that were tested in clinical trials during the 2010–2019 decade. Of the 1597 studies found, 69 eligible clinical trials, which investigated 27 vaccines, were included in this review. Information from each trial was compiled for vaccine target, vaccine platform, adjuvant inclusion, clinical trial phase, and results. As we look …

Species D Adenoviruses As Oncolytic Viral Vectors, Brianna L. Bullard, Brigette N. Corder, Eric A. Weaver

Nebraska Center for Virology: Faculty Publications

Oncolytic adenoviruses (Ad) have shown promising results in the therapeutic treatment of cancer. Ad type 5 (Ad5) is the most extensively utilized Ad type. However, several limitations exist to using Ad5 as an oncolytic virus, including high levels of anti-Ad5 neutralizing antibodies in the population, binding of the Ad5 hexon to blood coagulation factor X leading to liver sequestration and toxicity, and reduced expression of the primary receptor CAR on many tumors. Here, we use in vitro methods to explore the oncolytic potential of four alternative Ad types (Ad26, 28, 45, and 48) belonging to the species D Ad subgroup …

Recommendations For Measuring Hiv Reservoir Size In Cure- Directed Clinical Trials., Luis J. Montaner, Qingsheng Li

Nebraska Center for Virology: Faculty Publications

Therapeutic strategies are being clinically tested either to eradicate the latent HIV reservoir or to achieve virologic control in the absence of antiretroviral therapy (ART). Attaining this goal will require a consensus on how best to measure the levels of persistently-infected cells with the potential to cause viral rebound upon ART cessation to assess the results of cure-directed strategies in vivo. Current measurements assess different aspects of the HIV provirus and its functionality, and produce divergent results. Here, we provide the collective insight and position from the BEAT-HIV Martin Delaney Collaboratory on which viral measurements to prioritize in HIV cure-directed …

The Evolving Pharmacotherapeutic Landscape For The Treatment Of Sickle Cell Disease., Samir K Ballas

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is an extremely heterogeneous disease that has been associated with global morbidity and early mortality. More effective and inexpensive therapies are needed. During the last five years, the landscape of the pharmacotherapy of SCD has changed dramatically. Currently, 54 drugs have been used or under consideration to use for the treatment of SCD. These fall into 3 categories: the first category includes the four drugs (Hydroxyurea, L-Glutamine, Crizanlizumab tmca and Voxelotor) that have been approved by the United States Food and Drug Administration (FDA) based on successful clinical trials. The second category includes 22 drugs that …

Identifying And Addressing Barriers To Treatment For Child Sexual Abuse Survivors And Their Non-Offending Caregivers, Kate Theimer, Akemi E. Mii, Emily Sonnen, Kelsey Mccoy, Katie Meidlinger, Brittany Biles, T. Zachary Huit, Mary F. Flood, David J. Hansen

Department of Psychology: Faculty Publications

Mental health treatment is a critical part of an effective and compassionate response to the disclosure of child sexual abuse (CSA). Given the vast negative consequences for children and families following CSA, engagement in treatment can benefit youth and their non-offending caregivers. Yet, these families face unique barriers to treatment initiation, adherence, and effectiveness. The identification of these barriers allows clinicians, researchers, and policy makers to increase treatment utilization, engagement, and value. The current review and its recommendations derive from the existing literature combined with knowledge gained from a clinical research team with more than 20 years of experience offering …

Young-Onset Hypertension In Malaysia: A Mixed-Methods Study, Yi Yi Khoo

Student Works (2020-2029)

The continuous cumulative presence of raised blood pressure (BP) when young is a strong predictor of future cardiovascular risk. This study, which was conducted between June 2018 and December 2019, aimed to elucidate the epidemiology of young-onset hypertension (YOH) in Malaysia during the period 2006–2015, and to explore the underlying experiences and perspectives of young adults living with hypertension. Phase I involved a systematic review to identify variables for the secondary data analysis. In Phase II, data on respondents aged 18–39 diagnosed with YOH according to the 7th Joint National Committee Report (United States) were extracted from three National Health …

Access To Renal Transplantation And Post-Transplantation Prognosis (Retrapp) Study Of Adults In Malaysia, Kim Soon Peter Gan

Student Works (2020-2029)

Introduction Renal transplantation (RT) is recognised as the preferred treatment modality for end-stage renal disease. However, Malaysian transplantation rates have been low compared to other countries. Numerous clinical determinants have been associated with renal transplant recipient' (RTRs) health, which is the main focus of the healthcare fraternity. Coincident with the rising interest for equitable healthcare, many studies in the high-income countries have examined the disparities in RT. On the contrary, little is known about the association of socioeconomic gradient of RTRs on the access and outcome of RT in Malaysia, a low- and middle-income country. ReTRAPP was designed to explore …

Broken And Forgotten: A Case Of Unintentionally Retained Foreign Object, Hong Loan Nguyen, Lauren Nicholas Herrera, Ali Cheema, Pralay Kumar Sarkar

Faculty, Staff and Students Publications

Central venous catheter have become ubiquitous with greater than 15 million catheter days/year in the intensive care setting alone. However, the procedure carries with it several immediate and other delayed complications that can result in significant morbidity, mortality, and increased healthcare cost. We report a rare case of significantly delayed complications associated with intravascular loss of guide wire during central venous catheter placement and its impact on patient's long term management. The case highlights not only the importance of proper technique and safety precaution in performing an increasingly common procedure, but also the need for timely identification and rectification of …

Meta-Analysis Comparing Watchmantm And Amplatzer Devices For Stroke Prevention In Atrial Fibrillation, Indranill Basu Ray, Dibbendhu Khanra, Sumit Shah, Sudhanva Char, Xiaoming Jia, Wilson Lam, Nilesh Mathuria, Mehdi Razavi, Bhavna Jain, Dhanunjaya Lakkireddy, Saibal Kar, Andrea Natale, Adedayo Adeboye, John Lynn Jefferies, Sripal Bangalore, Samuel Asirvatham, Mohammad Saeed

Faculty, Staff and Students Publications

Background: For patients with atrial fibrillation who are at high risk for bleeding or who cannot tolerate oral anticoagulation, left atrial appendage (LAA) closure represents an alternative therapy for reducing risk for thromboembolic events.

Objectives: To compare the efficacy and safety of the Amplatzer and Watchman^TM LAA closure devices.

Methods: A meta-analysis was performed of studies comparing the safety and efficacy outcomes of the two devices. The Newcastle-Ottawa Scale was used to appraise study quality.

Results: Six studies encompassing 614 patients were included in the meta-analysis. Overall event rates were low for both devices. No significant differences between the …

Spironolactone In Pulmonary Arterial Hypertension: Results Of A Cross-Over Study, Zeenat Safdar, Adaani Frost, Arya Basant, Anita Deswal, E O'Brian Smith, Mark Entman

Faculty, Staff and Students Publications

The renin–angiotensin–aldosterone system is implicated in the pathophysiology of pulmonary arterial hypertension. We undertook this study to determine the effects of spironolactone, a mineralocorticoid receptor blocker, on collagen metabolism in pulmonary arterial hypertension patients. After obtaining institutional review board approval and informed consent, 42 pulmonary arterial hypertension patients were prospectively enrolled and 35 patients completed the 16-week randomized double-blinded crossover clinical trial. Subjects received 50 mg spironolactone or placebo and at the end of week 8, treatment arm was switched. Circulating levels of collagen biomarkers, brain natriuretic peptide, and aldosterone levels were measured, and six-minute walk distance, liver function tests, …

Utilization Of A Continuous Pericapsular Nerve Group (Peng) Block With An Opioid-Sparing Repair Of A Femoral Neck Fracture In A Pediatric Patient, Karla Wyatt, Moustafa Zidane, Chyong-Jy Joyce Liu

Faculty, Staff and Students Publications

In the pediatric population, femoral neck fractures are usually associated with high-impact trauma and often present with pain in the groin area. Regional anesthesia can offer adjunctive therapy for acute pain management. Various techniques have been employed to circumvent pain related to hip fractures and resultant hip surgery. Neuraxial, lumbar plexus, caudal, epidural, fascia iliaca, and femoral continuous nerve block techniques are advantageous in mitigating hip pain. However, these approaches require patient repositioning during placement and carry the potential for motor blockade with resultant weakness. A newly described method, the Pericapsular Nerve Group (PENG) block, allows for analgesia of the …