Influenza Humans Commons^™

Predicting 30-Day Mortality In Hospitalized Patients With Community-Acquired Pneumonia Using Statistical And Machine Learning Approaches, Timothy L. Wiemken, Stephen P. Furmanek, William A. Mattingly, Brian E. Guinn, Rodrigo Cavallazzi, Rafael Fernandez-Botran, Leslie A Wolf, Connor L. English, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Predicting if a hospitalized patient with community-acquired pneumonia (CAP) will or will not survive after admission to the hospital is important for research purposes as well as for institution of early patient management interventions. Although population-level mortality prediction scores for these patients have been around for many years, novel patient-level algorithms are needed. The objective of this study was to assess several statistical and machine learning models for their ability to predict 30-day mortality in hospitalized patients with CAP.

Methods: This was a secondary analysis of the University of Louisville (UofL) Pneumonia Study database. Six different statistical and/or machine …

A 49-Year-Old Woman With Chronic Skin Lesions, Acute Mental Status Changes And New Pulmonary Infiltrate: Case Discussion From The University Of Louisville Hospital, Bhavani Puskur, Youssef Khafateh, Srikant Ramachandruni, Veronica Corcino, Mark Burns, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Clinical Research: Educational Videos - The Process Of Clinical Research: Step-By-Step From Idea To Publication, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Clinical research can be defined as the creation and dissemination of new knowledge with the goal to improve outcomes in patients with a particular health problem. In this short video, Dr. Julio Ramirez, from the University of Louisville, offers an overview of the process of clinical research and describe how an investigator moves from the generation of an idea to the publication of study findings.

What’S New With The Flu?, Boriana Marintcheva

Bridgewater Review

No abstract provided.

Emergency Preparedness Competencies Among Nurses In Northwest Arkansas, Taylor A. Matlock

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Despite years of training and experience, evidence suggests nurses report wide gaps in emergency competencies and disaster preparedness. Further, nurses report low levels of familiarity in competencies related to planning for disasters, implementing disaster guidelines, and assessing patients exposed to biological and chemical agents. This research sought to establish the self-reported level of emergency preparedness competencies of nurses in Northwest Arkansas, an area that faces a diverse set of potential disasters ranging from nuclear accidents to pandemic disease. Additionally, differences between of the level of preparedness by education level or work specialty were studied. The results are alarming in that …

Clinical & Translational Research In Pneumonia: Defining A Research Agenda For Today And Tomorrow, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

From the Editor in Chief

The reason for this special supplement of the Journal is to inform readers of a scientific research conference supported by the National Institutes of Health (NHI). The NIH Research Conference Grant (R13) supports high quality scientific conferences in areas that are important to the NIH's mission and to the public health. We just received notification that the National Heart, Lung, and Blood Institute (NHLBI) has approved the application for an international research conference entitled: DzClinical & Translational Research in Pneumonia: Defining a Research Agenda for Today and Tomorrowdz. The conference will be held on Wednesday, …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

The Cost Of Cost-Sharing: The Impact Of Medicaid Benefit Design On Influenza Vaccination Uptake, Charles Stoecker, Alexandra M Stewart, Megan Lindley

Health Policy and Management Faculty Publications

ncome persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts) on vaccine uptake in the fee-for-service Medicaid population 19–64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012. Data on influenza vaccination uptake were taken from the Behavioral Risk Factor Surveillance System. We used a differences-in-differences framework, controlling for national trends and state differences, to estimate the effect of each benefit design factor on vaccination uptake in different Medicaid-eligible populations. …

Haemophilus Influenzae Type B Invasive Disease In Amish Children, Missouri, Usa, 2014, Angela L. Myers, Mary Anne Jackson, Lixin Zhang, Douglas S. Swanson, Janet R. Gilsdorf

Manuscripts, Articles, Book Chapters and Other Papers

© 2017, Centers for Disease Control and Prevention (CDC). All rights reserved. During 5 months in 2014, three Amish children in Missouri, USA, were diagnosed with invasive Haemophilus influenzae type b infection. Two were rural neighbors infected with a genetically similar rare strain, sequence type 45. One child had recently traveled, raising the possibility of maintenance of this strain among unvaccinated carriers in Amish communities.

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes …

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were …

A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin

The University of Louisville Journal of Respiratory Infections

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority of including …

Vaccine Coverage And Adherence To Epi Schedules In Eight Resource Poor Settings In The Mal-Ed Cohort Study, Christel Hoest, Jessica C. Seidman, Gwenyth Lee, James A. Platts-Mills, Syed Asad Ali, Maribel Paredes Olortegui, Pascal Bessong, Ram Chandyo, Sudhir Babji, Venkata Raghava Mohan

Department of Paediatrics and Child Health

Background: Launched in 1974, the Expanded Program on Immunization (EPI) is estimated to prevent two-three million deaths annually from polio, diphtheria, tuberculosis, pertussis, measles, and tetanus. Additional lives could be saved through better understanding what influences adherence to the EPI schedule in specific settings.
Methods: The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) study followed cohorts in eight sites in South Asia, Africa, and South America and monitored vaccine receipt over the first two years of life for the children enrolled in the study. Vaccination histories were obtained …

Influenza Vaccination In School-Aged Children, Isabella Jao, Chloe Mcfadin, Nica Nuguid, Dan Recinto, Kaitlin Van Ryn

Student Research Posters

Should schools in the United States require children between the ages of six months to 17 years to have flu vaccination shots? Influenza is a serious disease that can lead to hospitalization and sometimes even death. According to the Center of Disease Control (CDC), every flu season varies, and an influenza infection can affect people differently. Millions of people get the flu every year, hundreds of thousands of people are hospitalized, and thousands or tens of thousands of people die from flu-related causes every year. Everyone is at risk for influenza, but the highest risk lies within children who are …

Vitamin D Supplementation To Prevent Acute Respiratory Tract Infections: Systematic Review And Meta-Analysis Of Individual Participant Data, Adrian R. Martineau, David A. Jolliffe, Richard L. Hooper, Lauren Greenberg, John F. Aloia, Peter Bergman, Gal Dubnov-Raz, Susanna Esposito, Davaasambuu Ganmaa, Adit A. Ginde, Emma C. Goodall, Cameron C. Grant, Christopher J. Griffiths, Wim Janssens, Ilkka Laaksi, Semira Manaseki-Holland, David Mauger, David R. Murdoch, Rachel Neale, Judy R. Rees

Dartmouth Scholarship

OBJECTIVES To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect. DESIGN Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials. DATA SOURCES Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a …

The Une Flu Crew: An Interprofessional Influenza Prevention Team, Christina Tsui, Annie Beauregard, Nathan Stoddard, Samantha Grela, Allison Bubar, Elise Reddington, Nicolette Schwab, Adam Lessard, Thomas Wickham

UNE Flu Crew

Research poster stemming from IPEC mini-grant funded student project The UNE Flu Crew: An Interdisciplinary Approach to the Assessment of Knowledge, Beliefs and Perceptions surrounding Influenza Immunizations and the Promotion of Preventing Infection. Osteopathic medicine and public health students collaborated to assess the knowledge and perceptions regarding the influenza vaccine among the University of New England’s student and faculty populations. The project also provided a peer-to-peer education model where members of the Flu Crew designed a teaching curriculum and provided community outreach to the UNE Biddeford campus and local community schools.

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

The Frequency Of Influenza And Bacterial Co-Infection: A Systematic Review And Meta-Analysis., Eili Y. Klein, Bradley Monteforte, Alisha Gupta, Wendi Jiang, Larissa May, Yu-Hsiang Hsieh, Andrea Freyer Dugas

Emergency Medicine Faculty Publications

AIM: Co-infecting bacterial pathogens are a major cause of morbidity and mortality in influenza. However, there remains a paucity of literature on the magnitude of co-infection in influenza patients.

METHOD: A systematic search of MeSH, Cochrane Library, Web of Science, SCOPUS, EMBASE, and PubMed was performed. Studies of humans in which all individuals had laboratory confirmed influenza, and all individuals were tested for an array of common bacterial species, met inclusion criteria.

RESULTS: Twenty-seven studies including 3,215 participants met all inclusion criteria. Common etiologies were defined from a subset of eight articles. There was high heterogeneity in the results (I(2) …

Google Flu Trends Spatial Variability Validated Against Emergency Department Influenza-Related Visits., Joseph Jeffrey Klembczyk, Mehdi Jalalpour, Scott Levin, Raynard E Washington, Jesse M. Pines, Richard E Rothman, Andrea Freyer Dugas

Emergency Medicine Faculty Publications

BACKGROUND: Influenza is a deadly and costly public health problem. Variations in its seasonal patterns cause dangerous surges in emergency department (ED) patient volume. Google Flu Trends (GFT) can provide faster influenza surveillance information than traditional CDC methods, potentially leading to improved public health preparedness. GFT has been found to correlate well with reported influenza and to improve influenza prediction models. However, previous validation studies have focused on isolated clinical locations.

OBJECTIVE: The purpose of the study was to measure GFT surveillance effectiveness by correlating GFT with influenza-related ED visits in 19 US cities across seven influenza seasons, and to …