Pathological Conditions, Signs and Symptoms Commons^™

Delirium Update For Postacute Care And Long-Term Care Settings: A Narrative Review., Martin M Forsberg

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Advances have been made in our understanding of the neuropathogenesis, recognition, and strategies for reducing the incidence of delirium in acute-care settings. However, relatively little attention has been given to delirium in elderly patients in the postacute care (PAC) and long-term care (LTC) settings. The present article reviews the most relevant current research pertaining to this population. Hospital patients with delirium are often discharged to PAC settings. Delirium that develops in the LTC setting is often more insidious and subtle in presentation. Despite incorporating systematic screening tools for delirium in PAC and LTC settings, delirium prevention strategies have not yet …

Orientia Tsutsugamushi Secretes Two Ankyrin Repeat-Containing Effectors Via A Type 1 Secretion System To Inhibit Host Nf-Κb Function, Sean M. Evans

Theses and Dissertations

Scrub typhus is a potentially fatal infection that threatens one billion persons in the Asia-Pacific region and is caused by the obligate intracellular bacterium, Orientia tsutsugamushi. How this organism facilitates its intracellular survival and pathogenesis is poorly understood. Intracellular bacterial pathogens utilize the Type 1 (T1SS) or Type 4 secretion system (T4SS) to translocate ankyrin repeat-containing proteins (Anks) into the host cell to modulate host cell processes. The O. tsutsugamushi genome encodes one of the largest known bacterial Ank libraries as well as Type 1 and Type 4 secretion systems (T1SS and T4SS), which are expressed during infection. In …

The Clinical Utility Of Concomitant Pten And Fas Deletion As An Early Indicator For Prostate Adenocarcinoma Subtypes That Lead To Extracapsular Metastasis, Brendan J. Coulter, Phillip Harries

Electronic Theses & Dissertations

The utility of genes PTEN and FAS as prognostic markers for the identification of early and/or aggressive prostatic adenocarcinomas is seemingly validated in the study results we obtained using fluorescence in-situ hybridization (FISH) of archived paraffin embedded surgical prostate core biopsy samples obtained from two CLIA and CAP licensed anatomical pathology labs (Bostwick Laboratories, Uniondale, NV and GoPath Laboratories, Buffalo Grove, IL). From early benign subsets of sample cases to aggressive extracapsular invasive tumors, the presence of random deletions evolves into clonal populations of co-deletion of both genes at question. We identify independent research that demonstrates the ability of these …

An Unusual Case Of Escherichia Coli Meningitis And Bacteremia In An Elderly Woman Presenting With Intractable Low Back Pain, Andrea M. Lauffer, Mahmoud Shorman, Carl Mccomas

Marshall Journal of Medicine

Abstract

Introduction:

We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain.

Case Description:

A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli.

Conclusion:

In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older …

Spinal Cord Injury And Autonomic Dysreflexia- A Case Report, Apurva Bhatt, Brit Moore, Talal Asif, Kristy E. Steigerwalt, Rebecca R. Pauly

Marshall Journal of Medicine

Autonomic dysreflexia (AD) is a life threatening condition affecting patients with spinal cord lesions T6 level and above. A 51 year old male with a history of paraplegia due to a C6 spinal cord injury (30 years prior) presented with recurrent debilitating episodic diaphoresis, hypertension, low body temperature, and bradycardia. Previous hospitalizations presumed sepsis from UTI to be the etiology, however on further evaluation his symptoms were consistent with undiagnosed AD. This article describes a unique case presentation and reviews AD in depth, including the etiology, pathophysiology and management.

The Role Of Neurovascular Compromise, Autoimmune Antibodies And Neuronal Calcium Sensor Proteins During The Onset And Progression Of Alzheimer's Disease - Linking The Retina With The Brain, Hao Wu

Graduate School of Biomedical Sciences Theses and Dissertations

Alzheimer's disease (AD), the main cause of dementia, is a progressive and irreversible neurodegenerative disease. The pathological hallmarks of the disease include bloodbrain barrier (BBB) breach, neurofibrillary tang les and amyloid plaques. Also, emerging evidence has raised the possibility that instead of a secondary consequence, the neuroinflammation contributes to the development and early progression of AD. However, the mechanism underlying the blood-neural barrier (BNB), chronic inflammation and neuronal degenerative diseases (NDDs) remain to be elucidated.

To explore the role of the chronic inflammation in NDDs and delineate the early steps of these diseases, in vivo drug-induced and transgenic mouse models …

Blood-Tissue Barriers And Autoantibodies In Neurodegenerative Disease Pathogenesis: An Approach To Diagnostics And Disease Mechanism, Eric Luria Goldwaser

Graduate School of Biomedical Sciences Theses and Dissertations

Brain homeostasis can be affected in a number of ways that lead to gross anatomical, cellular, and molecular disturbances giving rise to diseases like Alzheimer’s disease (AD) and related dementias. Unfortunately, the mechanistic pathoetiology of AD’s hallmark features of cerebral amyloid plaque buildup and neuronal death are still disputed. Using human brain AD sections, immunohistochemistry experiments revealed internalized surface proteins, co-localized to an expanded lysosomal compartment. Other stains for amyloid-β1-42 (Aβ42) and various immunoglobulin (Ig) species displayed them leaking out of the cerebrovasculature through a dysfunctional blood-brain barrier (BBB), binding to neurons in the vicinity, and localizing to intracellular vesicles …

Zika Virus, Nurto A. Abdulla

Nursing Student Class Projects (Formerly MSN)

Zika virus infection, a mosquito-borne flavivirus that causes febrile illness associated with rash, has been rapidly emerging in the Western Hemisphere over the past few months. The virus was rarely identified until outbreaks occurred on Yap Island in the Federated States of Micronesia in 2007, Fresh Polynesia in 2013, and Easter Island in 2014 (Chen & Hamer, 2016). The virus was initially detected in Brazil in 2015, in the northeast, and was subsequently identified in other states and several South American countries, including Colombia, Ecuador, Suriname, Venezuela, French Guyana, and Paraguay. Local transmission has been documented in Central America in …

Role Of Interleukin-3 In An Experimental Model Of Mouse Cerebral Malaria Caused By Plasmodium Berghei Anka, Brendon R. Perry

Senior Honors Projects, 2010-2019

Malaria is a life-threatening mosquito-borne disease caused by parasites of the genus Plasmodium, with about 200 million new cases reported each year. In rodent models of malaria, a variety of immune proteins called cytokines have been noted to either promote or suppress protective immunity. While the cytokine interleukin-3 (IL-3) clearly promotes host defense against some intestinal nematode parasites, few studies have reported a similar function for IL-3 in the pathophysiology of malaria. In this study, we investigated the role of IL-3 in a mouse model of cerebral malaria caused by Plasmodium berghei ANKA. We infected wild-type (WT) and IL-3 …

Characterization Of Bacterial Pathogens Involved In Aerobic Vaginitis: Prevalence, Strain Characterization And Sequelae, Leslie A. Lafferty

Graduate School of Biomedical Sciences Theses and Dissertations

Aerobic vaginitis (AV) is a more recently defined infection that involves aerobic pathogenic bacteria that replace the normal flora of the vaginal tract. It is commonly mistaken for other vaginal infections, such as bacterial vaginosis (BV), because they share many common symptoms. AV leads to complications during pregnancy, such as premature delivery and amnion infection, and is diagnosed by indications that range from vaginal discharge to inflammation. Because this infection is difficult to diagnose differentially from other vaginal infections, it is important to determine what pathogens are involved in AV so that we may have the ability to detect them. …

Programming Heart Disease: Does Poor Maternal Nutrition Alter Expression Of Cardiac Markers Of Proliferation, Hypertrophy, And Fibrosis In Offspring?, Cathy Chun

Honors Scholar Theses

Maternal malnutrition can affect fetal organogenesis, metabolic processes, and factors involved in developmental regulation. Of the many physiological effects poor maternal nutrition can induce in offspring, one of the most important organs affected is the heart. Cardiovascular disease has been associated with poor maternal diet. It also been suggested that hypertension can originate during impaired intrauterine growth and development. Hypertension can trigger hypertensive heart disease and is associated with numerous heart complications. We hypothesized that poor maternal nutrition would alter critical growth factors associated with normal heart development, specifically, insulin-like growth factor (IGF)-1, IGF-2, transforming growth factor (TGF)β, and connective …

Gene Expression Profiling In An Alzheimer's Disease Mouse Model, Matthew R. Dalton

Senior Honors Theses

Explaining precisely how Alzheimer’s disease (AD)—the world’s most common form of dementia—materializes in the human brain has proven to be one of the most elusive ends in modern medicine. Progressive memory loss, neurodegeneration, and the presence of abnormal protein aggregates of amyloid-beta (Aβ) and neurofibrillary tangles (NFT) characterize this disease. Genome sequencing provides researchers with the ability to better identify disease-related changes in gene expression, some of which may play a role in the initiation and progression toward the AD-like state. Intimate interactions between tissues have been observed in many diseases, particularly between the brain and blood. This analysis seeks …

Overcoming Cancer Multidrug Resistance Through Inhibition Of Microparticles, Sora Vysotski, Rivka Winzelberg, Mariana Babayeva

Touro College of Pharmacy (New York) Publications and Research

One of the main obstacles to success of chemotherapy agents is the development of cancer resistance. Cancer multidrug resistance (MDR) is thought to arise from over-expression of efflux transporters on cancer cells’ plasma membranes. Recently, microparticles (MP) were found to play a major role in mediating the resistance to antineoplastic agents. Microparticles can confer MDR phenotype to cancer cells though 3 complimentary pathways: 1) Intercellular transfer of P-gp and MRP1; 2) Intercellular transfer of regulatory nucleic acids that ensure acquisition of MDR phenotype; and 3) Internal sequestration of anticancer drugs to reduce the amount of free active drug. Compounds that …

Identification Of The Effects Of Diabetes Mellitus On The Brain, Tryphina A. Mikhail

Honors Undergraduate Theses

As more studies accumulate on the impact of diabetes mellitus on the central nervous system, they resound with the same conclusion - diabetes has a detrimental effect on cognition regardless of the presence of comorbidities. Less consistent however, are the specific mental processes wherein these declines are noticeable, and the structural changes that accompany these reductions in mental capacity. From global atrophy to changes in the volume of gray and white matter, to conflicting results regarding the effects of hypo- and hyperglycemic states on the development of the hippocampus, the studies display a variety of results. The goal of this …

Sepsis-Review Of Screening For Sepsis By Nursing, Nurse Driven Sepsis Protocols And Development Of Sepsis Hospital Policy/Protocols, Matthew Mccaffery, Omobola Onikoyi, Dilisha Rodrigopulle, Ali Syed, Suzanne Jones, Laura Mansfield, Murali G. Krishna

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Sepsis is one of the leading causes of death in the United States. In order to decrease the morbidity and mortality associated with sepsis in patients, early detection is vital, and so screening protocols have been developed. The Surviving Sepsis Campaign has developed an evidence based screening guideline that has been adapted by various institutions. Having specific criteria in detecting a septic patient is the defining factor in screening for sepsis by nursing staff. In order for the sepsis protocol to be effective, it is necessary that nursing and other front line staff be educated. Institutional barriers regarding implementation of …

Sepsis: Epidemiology, Pathophysiology, Classification, Biomarkers And Management, Noah Pirozzi, Nima Rejali, Matthew Brennan, Anuj Vohra, Trevor Mcginley, Murali G. Krishna

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Every physician has been trained early in their careers on how to recognize and manage sepsis. Although sepsis has been one of the most researched ailments in medicine, it also remains one of the deadliest diseases in the face of recent advances. In this current article, we review the diagnostic and management criteria for Systemic Inflammatory Response Syndrome (SIRS), sepsis, severe sepsis, septic shock, and Multi Organ Dysfunction Syndrome (MODS). We then examine the implications of the “surviving sepsis” campaign as well as explore the philosophy of Early Goal Directed Therapy (EGDT) and its role in the modern day management …

Is Acupuncture Effective In Reducing The Pain Intensity Due To Primary Dysmenorrhea?, Allison Eichenlaub

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: the objective of this selective EBM review is to determine whether or not acupuncture is effective in reducing the pain intensity due to primary dysmenorrhea in women ages 15 to 35.

STUDY DESIGN: Review of three randomized control trials (RCTs) written in English, one of which was published in 2011 and two in 2013.

DATA SOURCES: Three non-blind randomized control trials published in peer reviewed journals found via PubMed.

OUTCOME MEASURED: Pain intensity due to primary dysmenorrhea was measured using visual analog scale (VAS), Cox Menstrual Symptom Scale (CMSS), and Cox Retrospective Symptom Scale (RSS COX2 – average …

Perceptions And Attitudes Of A Sample Of Primary Care Patients Receiving Psychological Care From Their Pcp, Nadine Henzes Gowarty

PCOM Psychology Dissertations

With millions of Americans suffering from a mental health disorder and slightly more than half receiving treatment, the demand for psychological services far outweighs the number of practitioners available to provide direct care. Therefore, the majority of all primary-care visits are based on psychosocial factors; one third of a PCP’s caseloads consist of patients with mental-health problems. Given the fact that PCPs provide comprehensive psychosocial care, it is important to determine the beliefs and perceptions of their patients. Results from this study identified numerous factors that influence the relationship between patients receiving mental health care from their PCP. Specifically, if …

Assessing The Expression Of Astrocytic Markers In Retinal Ganglion Cell Projection Of Lcr/Hcr Rats, Isabella K. Bartholomew, Samuel Crish, James Holda, Jordan Renna, Gina Wilson

Williams Honors College, Honors Research Projects

Metabolic Syndrome is a human condition that presents with various metabolic issues such as abnormal distribution of body fat, high blood pressure, and a prothrombotic state, among other problems (Alberti,et al, 2005). This syndrome is a risk factor for visual disorders, such as glaucoma, and is often associated with increased levels of neuroinflammation. Currently, the animal model used to replicate this syndrome is The Low Capacity Runner and High Capacity Runner Rat Model. These rats have been bred based on their running capacities for 30+ generations to have drastic metabolic differences. We assessed key areas of the retinal ganglion cell …

Vague Neuroglycopenic Complaints Camouflage Diagnosis Of Adolescent Insulinoma: A Case Report., Kelsee Halpin, Ryan Mcdonough, Patria Alba, Jared Halpin, Vivekanand Singh, Yun Yan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Insulinoma is a rare diagnosis in the general population with estimates of 1 in 250,000 people per year. Reports of these pancreatic islet cell tumors are even more unusual in children and adolescents. Chronic hypoglycemia due to an insulinoma often presents with neuroglycopenic symptoms that can easily be overlooked, especially in adolescents where nonspecific complaints are common. This may result in delayed diagnosis with prolonged periods of untreated hypoglycemia and associated complications. The rarity of pediatric insulinoma, vagueness of presenting symptoms, and challenge of tumor localization make insulinoma a true diagnostic quandary for clinicians.

CASE PRESENTATION: In this report, …