Diseases Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Enhancing Diabetic Patient Continuous Glucose Monitoring Access, Colleen Ildefonso

Master's Projects and Capstones

Problem: Diabetic patients utilize treatments that require frequent monitoring and medication changes based on their blood sugar results. Continuous Glucose Monitoring (CGM) is more commonly used for diabetes management as time in range is becoming more prevalent to measure diabetes outcomes. Many diabetic patients find CGM use more accessible than finger sticks and glucometers. In contrast, others utilize the technology to closely monitor their blood sugars for interventions throughout the day. However, older adults have difficulty facilitating new CGM technology and may require further reinforcement using additional education methods such as teach-back.

Context: The endocrinology clinic serves a patient population, …

Alzheimer’S Disease Genetic Risk And Cognitive Reserve In Relationship To Long-Term Cognitive Trajectories Among Cognitively Normal Individuals, Corinne Pettigrew, Jurijs Nazarovs, Anja Soldan, Vikas Singh, Jiangxia Wang, Timothy Hohman, Logan Dumitrescu, Julia Libby, Brian Kunkle, Alden L. Gross, Sterling Johnson, Qiongshi Lu, Corinne Engelman, Colin L. Masters, Paul Maruff, Simon M. Laws, John C. Morris, Jason Hassenstab, Carlos Cruchaga, Susan M. Resnick, Melissa H. Kitner-Triolo, Yang An, Marilyn Albert

Research outputs 2022 to 2026

Background:

Both Alzheimer’s disease (AD) genetic risk factors and indices of cognitive reserve (CR) influence risk of cognitive decline, but it remains unclear whether they interact. This study examined whether a CR index score modifies the relationship between AD genetic risk factors and long-term cognitive trajectories in a large sample of individuals with normal cognition.

Methods:

Analyses used data from the Preclinical AD Consortium, including harmonized data from 5 longitudinal cohort studies. Participants were cognitively normal at baseline (M baseline age = 64 years, 59% female) and underwent 10 years of follow-up, on average. AD genetic risk was measured by …

How Does Apolipoprotein E Genotype Influence The Relationship Between Physical Activity And Alzheimer’S Disease Risk? A Novel Integrative Model, Jaisalmer De Frutos Lucas, Kelsey R. Sewell, Alejandra García-Colomo, Shaun Markovic, Kirk I. Erickson, Belinda M. Brown

Research outputs 2022 to 2026

Background:

Wide evidence suggests that physical activity (PA) confers protection against Alzheimer’s disease (AD). On the other hand, the apolipoprotein E gene (APOE) ε₄ allele represents the greatest genetic risk factor for developing AD. Extensive research has been conducted to determine whether frequent PA can mitigate the increased AD risk associated with APOE ε₄. However, thus far, these attempts have produced inconclusive results. In this context, one possible explanation could be that the influence of the combined effect of PA and APOE ε₄ carriage might be dependent on the specific outcome measure utilised.

Main body:

In …

Longitudinal Association Of Remnant Cholesterol With Joint Arteriosclerosis And Atherosclerosis Progression Beyond Ldl Cholesterol, Zhiyuan Wu, Jinqi Wang, Haiping Zhang, Huiying Pan, Zhiwei Li, Yue Liu, Xinlei Miao, Ze Han, Xiaoping Kang, Xia Li, Xiuhua Guo, Lixin Tao, Wei Wang

Research outputs 2022 to 2026

Background: Arteriosclerosis and atherosclerosis are closely related with cardiovascular disease (CVD) risk. Remnant cholesterol (RC) could predict CVD. However, its effect on joint arteriosclerosis and atherosclerosis progression remains unclear. This study aims to evaluate the association of RC with joint arteriosclerosis and atherosclerosis progression trajectories in the general population. Methods: This study collected data across five biennial surveys of the Beijing Health Management Cohort from 2010 to 2019. Multi-trajectory model was used to determine the joint arteriosclerosis and atherosclerosis progression patterns by brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI). We also performed discordance analyses for RC vs. …

Mental Health And Experiences Of Pregnancy Among Black Women And Birthing People With Type 1 Diabetes (T1d), Madeleine E. Marcus

Doctoral Dissertations

This dissertation explored the potential effects of intersections of oppression (i.e., anti-Black racism, diabetes discrimination, and sexism) on mental health and pregnancy experiences among Black women and birthing people with Type 1 diabetes (T1D). Previous studies about pregnancy and T1D have included mainly white, cisgender women. Three participants qualified for inclusion in the present study and participated in semi-structured interviews, which the researcher analyzed using an interpretative phenomenological analysis (IPA) framework. Participants described feeling uncertain about whether aspects of their pregnancy experiences were related to obstetric and/or medical racism. Similarly, participants sometimes seemed uncertain about how racism may affect their …

Abdominal Aortic Calcification, Bone Mineral Density And Fractures: A Systematic Review And Meta-Analysis Of Observational Studies, Abadi K. Gebre, Joshua R. Lewis, Kevin Leow, Pawel Szulc, David Scott, Peter R. Ebeling, Marc Sim, Germaine Wong, Wai H. Lim, John T. Schousboe, Douglas P. Kiel, Richard L. Prince, Alexander J. Rodriguez

Research outputs 2022 to 2026

Background: Abdominal aortic calcification (AAC) has been inconsistently associated with skeletal health. We aimed to investigate the association of AAC with bone mineral density (BMD) and fracture risk by pooling the findings of observational studies. Methods: MEDLINE, EMBASE, Web of Science, and Google Scholar were searched (August 2021). All clinical studies that assessed the association between AAC and BMD or fracture were included. AAC was categorized into any/advanced (all higher reported groups) versus no/less advanced (lowest reported group). Pooled standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CI) were determined for BMD and fracture, respectively, using …

Additive Effects Of Cyclic Peptide [R4w4] When Added Alongside Azithromycin And Rifampicin Against Mycobacterium Avium Infection, Melissa Kelley, Kayvan Sasaninia, Arbi Abnousian, Ali Badaoui, James Owens, Abrianna Beever, Nala Kachour, Rakesh Kumar Tiwari, Vishwanath Venketaraman

Pharmacy Faculty Articles and Research

Mycobacterium avium (M. avium), a type of nontuberculous mycobacteria (NTM), poses a risk for pulmonary infections and disseminated infections in immunocompromised individuals. Conventional treatment consists of a 12-month regimen of the first-line antibiotics rifampicin and azithromycin. However, the treatment duration and low antibiotic tolerability present challenges in the treatment of M. avium infection. Furthermore, the emergence of multidrug-resistant mycobacterium strains prompts a need for novel treatments against M. avium infection. This study aims to test the efficacy of a novel antimicrobial peptide, cyclic [R4W4], alongside the first-line antibiotics azithromycin and rifampicin in reducing M. avium survival. Colony-forming unit (CFU) …

Stiff Person Syndrome: A Rare Presentation Of A Rare Disorder, Muhammad Hammad Sharif, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

Stiff Person Syndrome (SPS) is a rare autoimmune disease that is caused by the lack of inhibition to excitatory neurotransmitters in the central nervous system (CNS) which then leads to inappropriate and excessive motor unit firing causing stiffness, a characteristic feature of the disease. SPS has an incidence of one case in a million and occurs in the middle-aged population with a female predominance. SPS mostly occurs in the background of autoimmune disorders like type 1 diabetes, thyroid disorders, pernicious anemia, and less often, vitiligo. The pathophysiology is not completely understood; however, there is a strong correlation between high …

Non-Histaminergic Angioedema Following Infection With Covid-19, Sheza Malik, Basil George Verghese, S Shahzad Mustafa

Advances in Clinical Medical Research and Healthcare Delivery

Non-respiratory manifestations of COVID-19, including dermatological manifestations, have been reported, and although urticaria associated with COVID-19 has been reported, there have been no reports of non-histaminergic angioedema following infection with mild COVID-19. Non-histaminergic angioedema has a gradual onset and is characterized by submucosal swelling without accompanying urticaria or pruritus, and poor response to antihistamines and corticosteroids. We report a case of non-histaminergic angioedema in a 29-year-old woman with a history of mild COVID-19 infection. Our case highlights the fact that early diagnosis of non-histaminergic angioedema in mild COVID-19 patients is crucial for effective treatment and requires a high level of …

Mutation-Induced Changes In The Stability, B-Cell Epitope, And Antigenicity Of The Sars-Cov-2 Variant Spike Protein: A Comparative Computational Stud, Nira Meirita Wijayanti, Muhammad Hermawan Widyananda, Lailil Muflikhah, Nashi Widodo

Karbala International Journal of Modern Science

The spike (S) protein is a major antigenicity site that targets neutralizing antibodies and drugs. The growing number of S protein mutations has become a severe problem for developing effective vaccines. Here, we investigated four severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that were the most infectious and widespread during the COVID-19 pandemic to determine the trends and patterns of mutation-induced changes in the stability, B-cell epitope, and antigenicity of the SARS-CoV-2 S protein. The data showed that the Beta and Gamma variants had three mutations on the receptor-binding domain (RBD), which is the specific site on the S …

Prevention And Reduction Of Catheter-Associated Urinary Tract Infection, Lea F. Garin

Master's Projects and Capstones

Abstract

Problem: Fifteen to twenty-five percent of hospitalized patients receive indwelling urinary catheters (IUCs) during their hospital stay and are at high risk for catheter-associated urinary tract infections, according to the Centers for Disease Control and Prevention (CDC, 2015).

Context: A CAUTI Prevention program was implemented in a community hospital surgical unit to address concerns of high rates of CAUTI.

Interventions: Staff training/education, pre-CAUTI and post-CAUTI prevention survey, hand hygiene, bundle care audit, and staff competency for indwelling urinary catheter insertion were implemented to prevent and reduce CAUTI cases in the surgical unit.

Measures: The Standardized Infection Ratio …

Unknown Rectal Lesions: A Case Of Severe Proctitis Secondary To Mpox In The Setting Of Concomitant Hiv, Syphilis, Hsv, And Chlamydia, Nicole Robertson Mph, James Crosby Do, Cynthia R. Young Md, Msc, Anne E. Sayers Md, Nicholas J. Van Sickles Md

ePublications of Emerging Medical Research Scholars

Introduction:

Mpox emerged as a public health crisis with limited research describing co-occurring HIV and sexually transmitted infections (STIs). We present a case of severe proctitis secondary to Mpox with concomitant HIV (Human Immunodeficiency Virus), syphilis, HSV (Herpes Simplex Virus), and chlamydia and review presentation, diagnosis, treatment, and prevention of Mpox with concurrent STIs.

Case Presentation:

34-year-old male living with HIV (LWH) presenting with worsening rectal pain, multiple anal papules, and fever. His laboratory workup revealed simultaneous positive results for orthopoxvirus, chlamydia, and HSV-1 PCR. We initiated tecovirimat due to rectal involvement and uncontrolled pain. He subsequently developed lesions on …

Referral Patterns For Pediatric Sports-Related Concussion In One New England Health Care System, Joseph Benert, Amy Haskins Phd, Christina T. Holt, Krystian Bigosinski

Journal of Maine Medical Center

Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system.

Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June …

Under One Roof – An Integrated Clinic For Substance Use Disorder And Viral Hepatitis/Hiv Treatment, Sarah Hipkens, Emily Caron, Wendy Craig, Kinna Thakarar

Journal of Maine Medical Center

Introduction: Integration of viral hepatitis/HIV care and substance use disorder (SUD) treatment has been shown to improve patient outcomes, but data are lacking in rural states like Maine. Our study objective was to assess the baseline characteristics and outcomes of patients with SUD who receive combined substance use and viral hepatitis/HIV treatment at a recently established “Bridge Program” in our rural state.

Methods: We conducted a retrospective chart review of patients enrolled in the Bridge Program between January 2020 and November 2021. We then performed a descriptive analysis of demographics, health characteristics, preventive services, and treatment outcomes.

Results: A total …

Preparing For Pandemics: Lesson Plan Design For Children In Elementary School, Daniella Rivera, Enkhtsogt (Steve) Sainbayar, Saleem Choudry, Brittany Vaughn Pierce, Roxana Nouri-Nikbakht, Joy H. Lewis D.O., Phd

Intellectus

Context: The COVID-19 pandemic necessitated distance learning to attenuate the spread of the virus, and school-aged children were particularly affected by this change. Because of their age and education level, children generally lacked understanding about the pandemic and the preventive measures necessary to prevent the spread of this and other infectious diseases. It is unknown how many schools nationwide incorporated disease-prevention education in their curriculums during the pandemic. Therefore, developing distance learning interventions that convey these topics at their level of understanding is important to improve health literacy and raise their awareness of factors that positively influence health.

Objective: To …

Responding To Disproportionate Skin Cancer Rates Affecting Adult Men Aged 18-60, Aaron Thompson

Capstone Collection

Skin cancer is a deadly disease that kills significantly more men than women every year. At the same time, women are more than twice as likely to apply daily sun protection factor (SPF) than men. This research study explores how key stakeholders within the skin care industry have responded to the data showing increasing disparities between male and female skin cancer rates. To fulfill the objectives of this research study, qualitative data was collected from six semi-structured interviews with adult males between the ages of 18 and 60. The interviews were intentionally designed to engage with the American, adult male’s …

Association Of Birth Weight And Preterm Birth With Subsequent Risk For Hypertension In Women From The Women’S Health Initiative, Christian P. Daniele

Masters Theses

Hypertension is a chronic disease with an estimated prevalence of nearly 50% in US adults. In addition to sociodemographic and lifestyle factors, evidence suggests that in utero and early life exposures may contribute to life-long risk of hypertension. This study aimed to investigate the potential associations between an individual’s birthweight and preterm birth status with their risk for hypertension in the Women’s Health Initiative (WHI) cohort. WHI is a large, multi-racial cohort of postmenopausal women. At study entry, birthweight and preterm birth status were self-reported by category (< 6 lbs., 6-7 lbs. 15 oz., 8-9 lbs. 15 oz., or ≥ 10 lbs.; ≥ 4 weeks premature or full term). Baseline and incident hypertension status were self-reported; mean systolic blood pressure, diastolic blood pressure, and 30-second pulse were also recorded at baseline by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to generate crude and adjusted beta estimates, odds ratios, and hazards ratios, respectively. After adjusting for demographic and lifestyle factors, we found that participants born at a low birthweight had a higher mean systolic blood pressure than participants born at a normal birthweight and were at increased risk for both baseline and incident hypertension. Women born at a higher birthweight had a lower mean systolic blood pressure and were at lower risk for baseline and incident hypertension. When compared to participants born full term, participants born preterm were at increased risk for baseline and incident hypertension. These results support current research on early life exposures and health risks later in life. Long term follow-up or targeted counseling may be required for individuals born prematurely or at low birthweights to prevent and treat hypertension and associated cardiovascular outcomes.

Evaluation Of The Virulence Potential Of Avian Pathogenic Escherichia Coli Isolated From Broiler Breeders With Colibacillosis In Mississippi, Jiddu Joseph

Theses and Dissertations

Avian pathogenic Escherichia coli (APEC) is a bacterium that is responsible for colibacillosis in birds. However, information about broiler breeder APEC isolates is limited, but the data is critical due to the transfer of this bacteria down the production pyramid to progenies resulting in high mortality. Therefore, we evaluated the phenotypic virulence characteristics of 28 isolates using embryo lethality and day-old chick challenge assays. Also, the in vitro adhesion and invasion potential of selected nine isolates were identified. Results showed more than 1/3^rd of the isolates were highly virulent and the virulence increased as the number of virulence-associated genes …

Effectiveness Of Intervention Studies Based On Diet And/Or Physical Activity In Treatment, Prevention, And Management Of Diabetes Among South Asians: A Systematic Review, Ishaan Arora

Theses and Dissertations

The purpose of this study was to describe diet and/or physical activity-based interventions and their control in cardiometabolic risk factors of diabetes for the South Asian (SA) population. A systematic review was conducted in accordance with the PRISMA guidelines. Seventeen randomized control trials meeting the inclusion criteria were included for analysis. Interventions with type-2 diabetic SA showed significant improvements in HbA1c% (4/5 studies), fasting blood glucose (3/4 studies), and postprandial glucose (2/2 studies). Interventions with at-risk/prediabetic and non-diabetic SA showed a modest change in overall outcomes, with significant change reported for post-prandial insulin (3/4 studies), BMI and weight (2/4 studies), …