International Public Health Commons^™

Stroke Management In The Time Of Covid, Marwa Elnazeir, Siddharth Narayanan, Kerri Remmel

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19 Radiological Library, Forest W. Arnold, Tracy Vanmeter, Lachlan Smith, Danny Mcgrath, Matthew Grassman, Nishant Patel, William Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Patient With Escherichia Coli Bacteremia And Covid-19 Co-Infection: A Case Report For The Louisville Covid-19 Epidemiology Study, Sarah E. Moore Pharmd, Ashley M. Wilde Pharmd, Bcps-Aqid, Matthew Song Pharmd, Bcidp, Brian C. Bohn Pharmd, Clayton J. Patross Pharmd, Bcps, Bryan Denham Md, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Patients with COVID-19 may have co-infections with other microorganisms. Here we report a case of a patient with an Escheria coli bacteremia secondary to a urinary tract infection, who experienced fevers while on active antimicrobial therapy. The patient was eventually tested for COVID-19 and found to be positive. This case emphasizes the need to suspect COVID-19 even in patients with documented bacterial infection.

Sars-Cov-2 And Bacterial Co-Infection, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Life In The Time Of Covid, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Healthcare Workers In The Time Of Covid, Julio A. Ramirez, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Abo Blood Group Type And Susceptibility To Covid-19 Infection, G. Rafael Fernandez-Botran

The University of Louisville Journal of Respiratory Infections

Since December 2019, the SARS-CoV-2 (COVID-19) pandemic has extended its reach over most of the world, infecting over four million people and causing well over 300,000 deaths so far.[1] A significant percentage of infected patients develop severe symptoms and life-threatening conditions. While COVID-19 infection can affect all ages, available evidence points to older age and pre-existing comorbidities, such as hypertension, diabetes, and coronary heart disease, as important risk factors related to increased mortality rates.[2-4] Moreover, recent reports from China and the U.S. have suggested that susceptibility, and perhaps even mortality, to COVID-19 infection might be influenced by the ABO blood …

Implementation Of The Louisville Covid-19 Surveillance Protocol: Experiences From The University Of Louisville Center Of Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, Dawn Balcom, William Johnson, Amr Aboelnasr, Mutasem Abuhalaweh, Stephen Furmanek, Montray Smith, Amanda Lasnik, Donghoon Chung, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

The lack of available testing for SARS-CoV-2 has been one of the primary challenges in the development and implementation of a comprehensive approach to infection prevention and transmission in the United States (US). In response to the need for increased testing capacities and capabilities, the University of Louisville (UofL) Division of Infectious Diseases Center of Excellence for Research in Infectious Diseases (CERID) initiated the Louisville Coronavirus Surveillance Program, a comprehensive approach to surveillance and testing of patients and healthcare workers. The first specimens were accepted on March 12, 2020, and parallel testing was done using a high-capacity testing process at …

Possible Role Of Tetracyclines On Covid-19: Recycling Well-Known Old Drugs From The Shelf, Martin Gnoni, Raul Vasquez-Gararatti, Angel Mena

The University of Louisville Journal of Respiratory Infections

We are in the midst of a pandemic due to the novel coronavirus SARS-CoV-2. Innovative therapies are in the lookup around the world. Recently, chloroquine and hydroxychloroquine in addition to azithromycin were proposed to be used in patients with severe disease even though strong evidence is lacking. We propose the use of tetracyclines in addition to anti-virals early in the curse of the disease in order to prevent the cytokine storm syndrome associated with COVID-19 and prevent ARDS. The proposed mechanisms of tetracyclines are: 1) anti-apoptotic properties; 2) decrease the Myeloperoxidase and ROS releaser from immune cells; 3) decrease neutrophil …

Depression Is Associated With Decreased Severity And Lower Mortality In Non-Elderly Hospitalized Adults With Influenza In The United States, Timothy L. Wiemken, Daniel Hoft, Jeffrey Scherrer

The University of Louisville Journal of Respiratory Infections

Background: Depression is associated with risk for chronic disease, though its relationship with infectious diseases is less understood. Depression may modify the clinical outcomes of patients with infectious diseases such as influenza via its association with inflammation. The objective of this study was to evaluate the relationships between depression and clinical outcomes in non-elderly adults with influenza infection.

Methods: This was a secondary analysis of the Nationwide Inpatient Sample database, years 2012–2016. Hospitalized adults aged 18–65 admitted during each influenza season were included. Depression status was documented via ICD-10 codes. The association between depression and clinical outcomes (e.g., …

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.

Copd Exacerbation Caused By Sars-Cov-2: A Case Report From The Louisville Covid-19 Surveillance Program, Forest W. Arnold, Kamran Mahmood, Angeline Prabhu, Darmaan Aden, Anupama Raghuram, Mark Burns, Leslie A. Beavin, Donghoon Chung, Kenneth E. Palmer, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 53-year-old male with a history of chronic obstructive pulmonary disease (COPD) on home oxygen presented to the hospital with worsening shortness of breath plus cough. He was admitted to the intensive care unit for COPD exacerbation and respiratory failure. A routine evaluation was performed, including a nasopharyngeal swab for a respiratory viral panel, which was negative. His symptoms improved over 48 hours, after which time a surveillance test for SARS-CoV-2 returned as positive. After clinical improvement, he was discharged to home isolation.

How To Prevent Covid-19 In Nurses And Physicians In The Hospital Setting: Universal Test-And-Isolate For All Patients Admitted To Hospitals, Julio A. Ramirez, Ruth Carrico, Forest W. Arnold, Paul Schulz

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Defining The Burden Of Covid-19 In The Kentuckiana Area: Incidence, Epidemiology & Clinical Outcomes Of Patients With Covid-19, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Rationale: Early evaluation of the burden of disease that COVID-19 may produce in a community is critical to appropriately allocate resources for COVID-19 prevention and treatment.

Objective: The primary objective of this study is to define the incidence, epidemiology, and clinical outcomes of patients with COVID-19 in the Louisville, Kentucky, and southern Indiana region (Kentuckiana) of the USA.

Methods: This will be a retrospective observational study of patients in the Kentuckiana region with the diagnosis of COVID-19.

Louisville Coronavirus Surveillance Program, Julio A. Ramirez, Kenneth E. Palmer, Ruth Carrico, Forest W. Arnold, Donghoon Chung, Leslie A Wolf

The University of Louisville Journal of Respiratory Infections

An important feature of COVID-19, the disease produced by the new coronavirus SARS-CoV-2, is the high number of health care workers (HCWs) that acquire the disease. In an initial report of 138 patients hospitalized with COVID-19 pneumonia in China, 40 patients (29%) were HCWs. One reason why HCWs are at higher risk of acquiring COVID-19 is that some patients with COVID-19 are admitted to the hospital without the classical presentation and are therefore not tested for the disease early during hospitalization. Presently in the US, it is recommended to test for COVID-19 when physicians suspect the disease. This subjective approach …

Endemic Human Coronaviruses In Hospitalized Adults With Community-Acquired Pneumonia: Results From The Louisville Pneumonia Study, Forest W. Arnold, Mark V. Burns, Kamran Mahmood, Darmaan Aden, Stephen P. Furmanek, Mahder A. Tella, Connor Glick, Anupama Raghuram, Leslie A. Beavin, Rodrigo Cavallazzi, Dawn Balcom, Leslie A. Wolf, Kenneth E. Palmer, Ruth Carrico, Julio A. Ramirez, The Center Of Excellence For Research In Infectious Diseases (Cerid) Coronavirus Study Group

The University of Louisville Journal of Respiratory Infections

Introduction: There are four endemic serotypes of human coronavirus (HCoV) that may cause community-acquired pneumonia (CAP) in humans. The clinical syndrome of CAP due to HCoVs is not well characterized. The objectives of this study were to evaluate incidence, epidemiology, and outcomes of CAP in adults due to HCoV and to compare them with CAP due to influenza.

Methods: The Louisville Pneumonia Study (LPS) is a prospective observational study of hospitalized adult patients with CAP in the city of Louisville. Patients enrolled in the LPS in whom a respiratory viral panel polymerase chain reaction (PCR) was obtained were evaluated. Incidence, …

Community-Acquired Pneumonia Due To Endemic Human Coronaviruses Compared To 2019 Novel Coronavirus: A Review, Julio A. Ramirez, Ruth Carrico, Rodrigo Cavallazzi, Leslie A. Beavin, Anupama Raghuram, Mark V. Burns, Kamran Mahmood, Darmaan Aden, Angeline Prabhu, Dawn Balcom, Stephen P. Furmanek, Leslie A Wolf, Kenneth E. Palmer, Mahder A. Tella, Connor Glick, Forest W. Arnold, The Center Of Excellence For Research In Infectious Diseases (Cerid) Coronavirus Study Group

The University of Louisville Journal of Respiratory Infections

The human coronaviruses (HCoVs) are an important etiology of community-acquired respiratory tract infections. Community-acquired pneumonia (CAP) may be caused by serotypes of endemic HCoVs or highly pathogenic HCoVs. In this review, we compared clinical characteristics, management, outcomes, and infection control practices for patients with CAP due to endemic HCoVs versus patients with CAP due to 2019 novel coronavirus (SARS-CoV-2).

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

Community-Acquired Pneumonia Pathogenesis In Patients With Chronic Obstructive Pulmonary Disease, Julio A. Ramirez, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Plasma Cysteine/Cystine And Glutathione/Glutathione Disulfide Redox Potentials In Hiv And Copd Patients., Walter H. Watson, Jeffrey D. Ritzenthaler, Paula Peyrani, Timothy L. Wiemken, Stephen P. Furmanek, Andrea Reyes-Vega, Tom J. Burke, Yuxuan Zheng, Julio A. Ramirez, Jesse Roman

Faculty and Staff Scholarship

Chronic obstructive pulmonary disease (COPD) is prevalent in patients infected with HIV. The purpose of this study was to test the hypothesis that systemic oxidation correlates with loss of lung function in subjects with COPD, and that HIV infection can contribute to creating such an environment. Subjects were recruited at the University of Louisville in the following groups: HIV-infected (n = 36), COPD (n = 32), HIV and COPD (n = 28), and uninfected controls with normal lung function (n = 34). HIV infection was assessed by viral load and CD4 cell counts. Pulmonary function was determined by spirometry …

Association Of Urine Levels Of C-Reactive Protein With Clinical Outcomes In Patients With Pneumonia: A Pilot Study, Subathra Marimuthu, Vidyulata Salunkhe, Stephen P. Furmanek, Leslie A Wolf

The University of Louisville Journal of Respiratory Infections

Finding relevant biomarkers as a potential predictor of severity for patients hospitalized with community acquired pneumonia (CAP), in addition to the clinical scoring system, could advance progress towards more effective patient management. The inflammatory marker, C-reactive protein (CRP), which is elevated in the pathogenesis of many infectious diseases, may be a key biomarker target for CAP. Previous studies have shown that serum CRP may be a useful diagnostic marker for pneumonia in hospitalized patients with acute respiratory symptoms. The main aims of this study were to determine the correlation between serum and urine CRP levels in hospitalized patients with CAP, …

An Overview Of The Health Profile Of Syrian Refugees Arriving In Kentucky From 2012-2017, Camila Calderon, Annie Rominger

Journal of Refugee & Global Health

Background:

The civil unrest in Syria has led to millions of displaced Syrians. The United States has relocated over 15,000 Syrian refugees, mostly arriving since 2015. Little is known about the health of Syrian refugees entering the United States.

Methods:

Syrian refugees in Kentucky who had a medical screening and documented RHA from October 2012 to September 2017 were included in the study. The information is collected and stored in the Arriving Refugee Informatics Surveillance and Epidemiology (ARIVE) database. This study is a retrospective review of the ARIVE database to describe the general health of the Syrian refugees …

Factors Associated With Full Immunization Coverage Among Children Up To 12 Months, Kakuma Mission Hospital, Turkana County, Kenya, Kevin Lomuria, Naomi Nyakio, Elvis Oyugi, James A. Ransom

Journal of Refugee & Global Health

The 2014 Kenya Demographic Health Survey showed that only 56.7% of children in Turkana County had received all recommended vaccines by 12 months of age, which is 12% below national and 24% below World Health Organization global coverage rates. This study aimed to identify factors that influence full immunization coverage (FIC) by 12 months of age in Kakuma Mission Hospital (KMH), Turkana County, in 2015. Kakuma is the site of a UNHCR refugee camp, established in 1969. Administration of vitamin A by 6 months of age and administration of measles-containing vaccine by 9 months of age were predictive of FIC.

Barriers To Health Among Idps In Kabul, Afghanistan: A Qualitative Study, Yagana Parwak, Madhavi Dandu, Rohini J. Haar

Journal of Refugee & Global Health

Background: Forced displacement is a significant problem for regions experiencing prolonged humanitarian crises due to armed conflict. Afghanistan, having experienced over four decades of conflict, has an estimated 1.2 million internally displaced persons (IDPs), a majority of which are concentrated in urban centers. IDPs have limited resources and face challenges accessing health services through traditional channels, leading to a disproportionate burden of morbidity and mortality. Health care facilities created for and existing within IDP camps also face numerous challenges. We aim to understand the structural factors that negatively impact health and the specific barriers to healthcare access for IDPs using …

Vitamin Deficiencies Among Resettled Refugees In Buffalo, Ny, Tyler B. Evans, Myron Glick Md

Journal of Refugee & Global Health

Background

Vitamin deficiency in the developing world is a considerable public health issue that is often overlooked. Refugees are some of the most vulnerable populations, since they rely almost exclusively on the nutrition provided by refugee camps. Buffalo, NY resettles the fourth largest number of refugees per capita among cities in the United States (US).

Objective

We examined the prevalence of vitamin A, B2, B12, and D deficiencies among refugees who had been recently resettled to Buffalo, NY and referred to our practice for assessment. Our exploratory objective was to examine potential differences in the prevalence of vitamin deficiencies among …

Uncovering The Stories Behind The Numbers : A Case Study Of Maternal Death Surveillance And Response In Goma, Democratic Republic Of Congo., Baraka Muvuka

Electronic Theses and Dissertations

Globally, 303 000 women die each year from preventable causes related to pregnancy, with the Democratic Republic of Congo (DRC) having the tenth highest maternal mortality rate. Maternal Death Surveillance and Response (MDSR) is a surveillance-action cycle that aims to eliminate preventable maternal mortality by linking actionable data on maternal deaths with multi-level actions. While countries are increasingly adopting MDSR, there are research gaps on its implementation, outcomes, and best practices in developing countries including the DRC. This study assessed MDSR implementation in Goma Health Zone (HZ), DRC, specifically its structure, process, quality, outcomes, and influencing factors. A qualitative case …

A Woman With A Lung Infiltrate And Brain Abscesses: Case Discussion From The University Of Louisville Hospital, Veronica Corcino, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Assessment Of Pneumonia Severity Indices As Mortality Predictors, Connor L. English, Thomas Chandler, Brian E. Guinn, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

BACKGROUND

The leading cause of infectious disease death in the United States is community-acquired pneumonia (CAP). Several pneumonia severity indices exist and are widely used as tools to assist physicians regarding site of care based on risk of death. However, limited data exists that discerns which of the most commonly used severity scores is the best predictor of mortality across multiple time points. The objective of this study is to determine the best mortality predictor at different time points between four of the most commonly used pneumonia severity scores.

METHODS

This was a secondary analysis of a prospective, multicenter, population-based, …

A Man With Acute Severe Pneumonia: Case Discussion From The University Of Louisville Hospital, Viswanathan Nagarajan, Srinivas R. Dontineni, Veronica Corcino, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Current And Future Antiviral Medications To Treat Influenza: Mechanisms Of Action, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.