Current Search: disease (x)
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Title
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NURSING INTERVENTIONS FOR INTRADIALTYIC HYPOTENSION: USING BLOOD VOLUME MONITORING GUIDED ULTRAFILTRATION.
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Creator
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Cedeno, Suzette S, Montoya, Vicki, Desmarais, Paul, University of Central Florida
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Abstract / Description
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Background: Intradialytic hypotension is a potential complication experienced by patients with end-stage renal disease who receive hemodialysis. This complication occurs during the dialysis treatment in 15-30% of all treatments. The multiple comorbidities that exist in hemodialysis patients predispose them to recurrent intradialytic hypotension episodes. Recurrent intradialytic hypotensive episodes can result in negative short-term and long-term clinical consequences. Short-term consequences...
Show moreBackground: Intradialytic hypotension is a potential complication experienced by patients with end-stage renal disease who receive hemodialysis. This complication occurs during the dialysis treatment in 15-30% of all treatments. The multiple comorbidities that exist in hemodialysis patients predispose them to recurrent intradialytic hypotension episodes. Recurrent intradialytic hypotensive episodes can result in negative short-term and long-term clinical consequences. Short-term consequences include complications such as ischemic events (e.g., heart attacks, strokes), clotting of patient dialysis access, or heart rhythm abnormalities. Long-term consequences include end-organ damage, increased cardiovascular morbidity, and a higher mortality rate. Problem Statement: Available nursing interventions used to treat intradialytic hypotension such as decreased dialysis fluid temperature, changes in the calcium and sodium concentrations in the dialysis fluid and oral medication have limited success. Another existing technological intervention called blood volume monitoring shows greater potential success but is currently underutilized. Purpose: The purpose of this literature review is to synthesize current literature on blood volume monitoring technology used to prevent intradialytic hypotension in hemodialysis patients. Methods: A literature review was conducted analyzing pertinent research articles published in the last ten years, in addition to seminal articles. Seventeen articles were retrieved and analyzed that met criteria. Results: Fourteen of the seventeen research studies reached a consensus on the successful use of blood volume monitoring to decrease intradialytic hypotension and the related symptoms. Conclusion: Results of the literature review support the use of blood volume monitoring technology as an effective nursing intervention to prevent intradialytic hypotension in hemodialysis patients.
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Date Issued
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2019
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Identifier
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CFH2000519, ucf:45670
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000519
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Title
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A META-ANALYSIS OF NEUROMYELITIS OPTICA EPIDEMIOLOGY IN LATIN AMERICAN NATIONS.
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Creator
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Zengotita, Brittany M, Samsam, Mohtashem, University of Central Florida
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Abstract / Description
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Neuromyelitis Optica (NMO) is a rare, autoimmune, neurodegenerative disease selectively affecting the optic nerves and spinal cord. Relapsing NMO is nine times more prevalent in women than in men and approximately one-quarter of NMO patients have symptoms of another autoimmune disorder (National Institute of Health, 2019). NMO has not been linked to any genetic mutations and the cause of the disorder is unknown beyond the general understanding that the body produces anti-aquaporin-4...
Show moreNeuromyelitis Optica (NMO) is a rare, autoimmune, neurodegenerative disease selectively affecting the optic nerves and spinal cord. Relapsing NMO is nine times more prevalent in women than in men and approximately one-quarter of NMO patients have symptoms of another autoimmune disorder (National Institute of Health, 2019). NMO has not been linked to any genetic mutations and the cause of the disorder is unknown beyond the general understanding that the body produces anti-aquaporin-4 antibodies (AQP4) which mistakenly attack cells in the nervous system. NMO affects roughly one percent of that of Multiple Sclerosis (4000-8000 patients total) in the United States, but prevalence rates are abnormally high in a handful of regions around the world, particularly among Latin America, where rates can reach up to 5/100,000 individuals. The results of this study predict that there is a connection between African genetics and NMO, but further studies will need to be conducted in more Latin America nations and other regions to determine prevalence rates as well as genetic analysis of affected individuals.
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Date Issued
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2019
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Identifier
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CFH2000583, ucf:45659
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000583
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Title
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ZINC-FINGER PROTEIN MCPIP IN CELL DEATH AND DIFFERENTIATION.
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Creator
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Younce, Craig, Kolattukudy, Pappachan, University of Central Florida
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Abstract / Description
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Monocyte chemotactic protein-1 (MCP-1) plays a critical role in the development of cardiovascular diseases. How MCP-1 contributes to the development of heart disease is not understood. We present evidence that MCP-1 causes death in cardiac myoblasts, H9c2 by inducing oxidative stress, ER stress and autophagy via a novel Zn-finger protein, MCP-1 induced protein (MCPIP). MCPIP expression caused cell death and knockdown of MCPIP, attenuated MCP-1 induced cell death. Expression of MCPIP resulted...
Show moreMonocyte chemotactic protein-1 (MCP-1) plays a critical role in the development of cardiovascular diseases. How MCP-1 contributes to the development of heart disease is not understood. We present evidence that MCP-1 causes death in cardiac myoblasts, H9c2 by inducing oxidative stress, ER stress and autophagy via a novel Zn-finger protein, MCP-1 induced protein (MCPIP). MCPIP expression caused cell death and knockdown of MCPIP, attenuated MCP-1 induced cell death. Expression of MCPIP resulted in induction of iNOS and production of reactive oxygen (ROS). It caused induction of NADPH oxidase subunit phox47 and its translocation to the cytoplasmic membrane. Oxidative stress led to the induction of ER stress markers HSP40, PDI, GRP78 and IRE1α. ER stress lead to autophagy as indicated by beclin-1 induction, cleavage of LC3 to LCII and autophagolysosome formation. Here, MCPIP-induced processes lead to apoptosis as indicated by caspase 3 activation and TUNEL assay. This cell death involved caspase 2 and caspase 12 as specific inhibitors of these caspases prevented MCPIP-induced cell death. Inhibitors of oxidative stress inhibited ER stress, and cell death. Specific inhibitors of ER stress inhibited autophagy and cell death. Inhibition of autophagy inhibited cell death. Microarray analysis showed that MCPIP expression caused induction of a variety of genes known to be involved in cell death. MCPIP caused activation of JNK and p38 and induction of p53 and PUMA. These results collectively suggest that MCPIP induces ROS/RNS production that causes ER stress which leads to autophagy and apoptosis through caspase 2/12 and IRE1α JNK/p38-p53-PUMA pathway. These results provide the first molecular insights into the mechanism by which elevated MCP-1 levels associated with chronic inflammation may contribute to the development of heart failure. A role for inflammation and MCP-1 in obesity and diabetes has been implicated. Adipogenesis is a key process involved in obesity and associated diseases such as type 2 diabetes. This process involves temporally regulated genes controlled by a set of transcription factors, C/EBPβ, C/EBPδ, C/EBPα, and PPARγ. Currently PPARγ is considered the master regulator of adipogenesis as no known factor can induce adipogenesis without PPARγ. We present evidence that a novel Zn-finger protein, MCPIP, can induce adipogenesis without PPARγ. Classical adipogenesis-inducing medium induces MCP-1 production and MCPIP expression in 3T3-L1 cells before the induction of the C/EBP family of transcription factors and PPARγ. Knockdown of MCPIP prevents their expression and adipogenesis. Treatment of 3T3-L1 cells with MCP-1 or forced expression of MCPIP induces expression of C/EBPβ, C/EBPδ, C/EBPα, PPARγ and adipogenesis without any other inducer. Forced expression of MCPIP induces adipogenesis in PPARγ-/- fibroblasts. Thus, MCPIP is a newly identified master controller that can induce adipogenesis without PPARγ. Heart failure is a major cause of death in diabetic patients. Hyperglycemia is a major factor associated with diabetes that causes cardiomyocyte apoptosis that leads to diabetic cardiomyopathy. Cardiomyoycte apoptosis is a key event involved in the pathophysiological progression of diabetic cardiomyopathy. We have recently found that in ischemic hearts, MCP-1 can induce the zinc-finger protein, MCP-1 induced protein (MCPIP) that causes cardiomyocyte apoptosis. Although there is evidence that inflammation may play a role in diabetic cardiomyopathy, the underlying mechanisms are poorly understood. In this study, we show that treatment of H9c2 cardiomyoblasts and Neonatal Rat Ventricular Myocytes (NRVM) with 28mmol/L glucose concentration results in the induction of both transcript and protein levels of MCP-1 and MCPIP. Inhibition of MCP-1 interaction with CCR2 via specific antibody or with the G-coupled receptor inhibitors propagermanium and pertussis toxin attenuated glucose-induced cell death. Knockdown of MCPIP with specific siRNA yielded similar results. Treatment of cells with 28mmol/L glucose resulted in increased ROS production and phox47 activation. Knockdown of MCPIP attenuated these effects. The increased ROS production observed in H9c2 cardiomyoblasts and NRVM's resulted in increased ER stress proteins GRP78 and PDI. Knockdown of MCPIP attenuated expression of both GRP78 and PDI. Inhibition of ER stress with TUDC and 4'PBA prevented high glucose-induced cell death death. Treatment of cells with 28mmol/l glucose resulted in autophagy as determined by an increase in expression of beclin-1 and through increased cleavage of LC3I to LC3II. Knockdown of MCPIP attenuated expression of beclin-1 and prevented cleavage of LC3. Addition of the autophagy inhibitors 3'methyladenine and LY294002 attenuated high glucose-induced H9c2 cardiomyoblast death. We conclude that high glucose-induced H9c2 cardiomyoblast death is mediated via MCP-1 induction of MCPIP that results in ROS that leads to ER stress that causes autophagy and eventual apoptosis.
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Date Issued
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2009
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Identifier
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CFE0002888, ucf:48027
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0002888
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Title
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Malondialdehyde (MDA) and Glutathione Peroxidase (GPx) are elevated in Crohns disease-associated with Mycobacterium avium subspecies paratuberculosis (MAP).
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Creator
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Qasem, Ahmad, Naser, Saleh, Masternak, Michal, Parthasarathy, Sampath, Andl, Claudia, University of Central Florida
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Abstract / Description
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Inflamed tissue in Crohn's disease (CD) are continuously producing toxic oxygen metabolites leading to cellular injury and apoptosis. Here, we are evaluating the role of Mycobacterium avium subspecies paratuberculosis (MAP) in oxidative stress in CD by evaluation of lipid peroxidation and antioxidant defense activity. Specifically, we measured malondialdehyde (MDA) level and selenium-dependent glutathione peroxidase (GPx) activity in the plasma from patients and cattle infected with MAP. The...
Show moreInflamed tissue in Crohn's disease (CD) are continuously producing toxic oxygen metabolites leading to cellular injury and apoptosis. Here, we are evaluating the role of Mycobacterium avium subspecies paratuberculosis (MAP) in oxidative stress in CD by evaluation of lipid peroxidation and antioxidant defense activity. Specifically, we measured malondialdehyde (MDA) level and selenium-dependent glutathione peroxidase (GPx) activity in the plasma from patients and cattle infected with MAP. The level of MAP antibodies in bovine sera was determined by IDEXX kit whereas detection of MAP DNA was performed by IS900-based nPCR. A total of 42 cattle (21 infected with MAP and 21 healthy controls), 27 CD subjects, 27 of CD-healthy relatives, 66 subjects with various diseases and 34 non-related healthy subjects were investigated. Overall, GPx activity was significantly higher in MAP infected humans (0.80941(&)#177;0.521) versus MAP (-ve) samples (0.42367(&)#177;0.229 units/ml), P(<)0.01. Similarly, the average of GPx activity in cattle infected with MAP was 1.59(&)#177;0.65 units/ml compared to 0.46907(&)#177;0.28 units/ml in healthy cattle (P(<)0.01). Although it was not statistically significant, MDA average level was higher in MAP infected human samples versus MAP (-ve) controls (1.11(&)#177;0.185 nmol/ml versus 0.805(&)#177;0.151 nmol/ml, respectively). Similarly, MDA average level in CD samples that are MAP+ (1.703(&)#177;0.231 nmol/ml) was higher than CD samples that are MAP (-ve) (1.429(&)#177;0.187 nmol/ml). In cattle, MDA average level in MAP infected samples was significantly higher at 3.818(&)#177;0.45 nmol/ml compared to 0.538(&)#177;0.18 nmol/ml in healthy cattle (P(<)0.01). Clearly, the data demonstrated that MAP infection is associated with oxidative stress and resulting in the pathophysiology of worsening of the condition of CD patients.
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Date Issued
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2016
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Identifier
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CFE0006699, ucf:51906
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0006699
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Title
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Allelic characterization and novel functions of the outer membrane porin U in Vibrio cholerae.
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Creator
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Sakib, Sk Nazmus, Almagro-Moreno, Salvador, Moore, Sean, Roy, Herve, University of Central Florida
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Abstract / Description
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Vibrio cholerae is the etiological agent of the severe diarrheal disease cholera. The bacterium is a natural inhabitant of brackish and estuarine waters . To date, only a subset of V. cholerae strains, those belonging to the pandemic group (PG), can cause cholera in humans while the rest (environmental group, EG) cannot cause the disease. Recently, we discovered that V. cholerae PG contains allelic variations in core genes that confer preadaptation to virulence, which we termed Virulence...
Show moreVibrio cholerae is the etiological agent of the severe diarrheal disease cholera. The bacterium is a natural inhabitant of brackish and estuarine waters . To date, only a subset of V. cholerae strains, those belonging to the pandemic group (PG), can cause cholera in humans while the rest (environmental group, EG) cannot cause the disease. Recently, we discovered that V. cholerae PG contains allelic variations in core genes that confer preadaptation to virulence, which we termed Virulence Adaptive Polymorphisms (VAPs). We identified nine core genes that encode potential VAPs, one of which encodes the outer membrane porin U (OmpU). OmpU provides tolerance to bile and acidic pH, resistance to antimicrobials and facilitates biofilm formation. In this study, several alleles of ompU were analyzed to determine whether these VAPs encode different functional properties. We performed multiple phenotypic assays and observed increased survival for strains encoding the PG-like alleles in the presence of bile, organic acid, anionic detergents and the antimicrobial peptide P2. On the other hand, EG-like alleles only showed increased biofilm formation. Interestingly, tests for motility and tolerance of inorganic acid, polymyxin B and protamine sulphate showed no differences in survival for strains encoding either alleles indicating that some of the properties conferred by OmpU are allelic independent. We have also discovered that V. cholerae OmpU shows resistance against Rifamycin, EDTA and Trifluoperazine and interestingly, Rifamycin has been found to be PG-allele dependent. Our findings provide further evidence that genetic variations in core genes lead to the emergence of virulence adaptive traits in pathogenic V. cholerae and can be extrapolated to other bacterial pathogens.
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Date Issued
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2019
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Identifier
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CFE0007720, ucf:52420
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0007720
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Title
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EXPRESSION AND CHARACTERIZATION OF MYCOBACTERIUM PARATUBERCULOSIS 19KDA WITH POSTTRANSLATIONAL MODIFICATION.
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Creator
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Safavi-Khasraghi, Mitra, Naser, Saleh, University of Central Florida
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Abstract / Description
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Despite the fact that E. coli supports limited posttranslational modification, this bacterium has been universally used as the expression system of choice. Expression of modified proteins in E. coli may lead to expression of recombinant proteins that lack essential immunomodulatory or catalytic components essentials for infectious processes. Previously in our laboratory, pMptb#28 plasmid containing a 4.8 kb insert from M. paratuberculosis has been identified which expressed 16 kDa recombinant...
Show moreDespite the fact that E. coli supports limited posttranslational modification, this bacterium has been universally used as the expression system of choice. Expression of modified proteins in E. coli may lead to expression of recombinant proteins that lack essential immunomodulatory or catalytic components essentials for infectious processes. Previously in our laboratory, pMptb#28 plasmid containing a 4.8 kb insert from M. paratuberculosis has been identified which expressed 16 kDa recombinant protein in E. coli and 19 kDa recombinant protein in Mycobacterium smegmatis. The objective of this study is to identify the ORF sequence, investigate possible posttranslational modification and characterize the protein forms in the two hosts. Earlier in the study, the genome sequence for M. paratuberculosis was not available and therefore sequencing both the 5' and 3' ends of the 4.8 kb insert did not help in the identification of the ORF. However, unidirectional Exonuclease deletion resulted in identification of subclones containing possible ORF sequence. Later on, the publication of the M. paratuberculosis genome sequence along with BLAST analysis of sequences from the subclones resulted in the identification of 486 bp ORF with significant identity to that from M. tuberculosis and M. leprae. Cloning of the 486 ORF coding sequence in E. coli resulted in the expression of 16 kDa protein similar to the calculated predicted size of translated peptide. Cloning of the 486 bp ORF coding sequence in M. smegmatis resulted in the expression of 19 kDa protein similar to that from M. paratuberculosis. The 16/19 kDa forms of the same protein were verified using rabbit anti-M. paratuberculosis antibodies adsorbed in E. coli and M. smegmatis lysates. The size of the 19 kDa proteins was not reduced following treatment with deglycosylation enzymes in absence of any enzyme inhibitors. The 19 kDa product was confirmed not be a glycoprotein when failed to react with ConA stain. The 16/19 kDa forms of the protein were evaluated against T-lymphocytes from Crohn's disease patients and normal controls. T- proliferation assay included controls such as PHA and PPD from M. paratuberculosis. There was not a significant difference between the two forms of the protein (16/19 kDa) against T-cell response from both populations. Overall, the study identified the ORF of the 19 kDa non-glycoprotein from M. paratuberculosis. Moreover, this is the first study which reports that the zoonotic M. paratuberculosis supports posttranslational modification similar to M. tuberculosis and M. leprae pathogens. Although the posttranslational modification component in this 19 kDa nonglycoprotein did not affect T- cell response, the finding is significant toward glycoproteins from M. paratuberculosis and their role in the pathogenesis of this bacterial infection in animals and humans.
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Date Issued
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2006
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Identifier
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CFE0001170, ucf:52851
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0001170
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Title
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Mathematical Modeling of Infectious Diseases with Latency: Homogeneous Mixing and Contact Network.
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Creator
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Carlson, Keith, Shuai, Zhisheng, Mohapatra, Ram, Guha, Ratan, University of Central Florida
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Abstract / Description
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In mathematical epidemiology, the standard compartmental models assume homogeneous mixingin the host population, in contrast to the disease spread process over a real host contact network. One approach to incorporating heterogeneous mixing is to consider the population to be a networkof individuals whose contacts follow a given probability distribution. In this thesis we investigate in analogy both homogeneous mixing and contact network models for infectious diseases that admit latency...
Show moreIn mathematical epidemiology, the standard compartmental models assume homogeneous mixingin the host population, in contrast to the disease spread process over a real host contact network. One approach to incorporating heterogeneous mixing is to consider the population to be a networkof individuals whose contacts follow a given probability distribution. In this thesis we investigate in analogy both homogeneous mixing and contact network models for infectious diseases that admit latency periods, such as dengue fever, Ebola, and HIV. We consider the mathematics of thecompartmental model as well as the network model, including the dynamics of their equations from the beginning of disease outbreak until the disease dies out. After considering the mathematical models we perform software simulations of the disease models. We consider epidemic simulationsof the network model for three different values of R0 and compare the peak infection numbers and times as well as disease outbreak sizes and durations. We examine averages of these numbers for one thousand simulation runs for three values of R0. Finally we summarize results and consider avenues for further investigation.
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Date Issued
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2016
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Identifier
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CFE0006276, ucf:51054
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0006276
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Title
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Immuno-PCR detection of Lyme borreliosis.
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Creator
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Halpern, Micah, Ballantyne, John, Cunningham, Glenn, Fookes, Barry, University of Central Florida
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Abstract / Description
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Lyme borreliosis, more commonly referred to as Lyme disease, is the fastest growing zoonotic disease in North America with approximately 30,000 confirmed cases and 300,000 estimated infections per year. In nature, the causative agent of Lyme disease, the bacterium Borrelia burgdorferi, cycles between Ixodes sp. ticks and small mammals. Humans become infected with Lyme disease after being bitten by an infected tick. The primary indicator of a Borrelia burgdorferi infection is a bull's eye rash...
Show moreLyme borreliosis, more commonly referred to as Lyme disease, is the fastest growing zoonotic disease in North America with approximately 30,000 confirmed cases and 300,000 estimated infections per year. In nature, the causative agent of Lyme disease, the bacterium Borrelia burgdorferi, cycles between Ixodes sp. ticks and small mammals. Humans become infected with Lyme disease after being bitten by an infected tick. The primary indicator of a Borrelia burgdorferi infection is a bull's eye rash typically followed by flu-like symptoms with treatment consisting of a 2-4 week course of antibiotics. If not treated, later stages of the disease can result in arthritis, cardiovascular and neurological symptoms. Diagnosis of Lyme disease is challenging and currently requires a complex laboratory diagnostic using indirect detection of host-generated antibodies by a two-tiered approach consisting of an enzyme linked immunosorbent assay (ELISA) followed by IgM and IgG immunoblots. Although two-tier testing has provided an adequate approach for Lyme disease diagnosis, it has weaknesses including subjective analysis, complex protocols and lack of reagent standardization. Immuno-PCR (iPCR) is a method that combines ELISA-based detection specificity with the sensitivity of PCR signal amplification and has demonstrated increased sensitivity for many applications such as detection of disease biomarkers but has yet to be applied for diagnosis of Lyme disease.Herein, using iPCR and recombinant B. burgdorferi antigens, an assay for both the direct and the indirect detection of Lyme disease was developed and demonstrated improved sensitivity for detection of B. burgdorferi antibodies using a murine model. Moreover, we present evidence using human Lyme disease patient serum samples that iPCR using both multiple antigens and a unique single hybrid antigen is capable of achieving increased sensitivity and specificity compared to existing methodology. These data represent the first demonstration of iPCR for Lyme disease diagnosis and support the replacement of two-tier testing with a more simplified and objective approach.
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Date Issued
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2013
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Identifier
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CFE0005346, ucf:50470
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0005346
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Title
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Improving Chronic Kidney Disease Care with Group Visits.
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Creator
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Montoya, Vicki, Sole, Mary, Norris, Anne, Wink, Diane, Abbott, Lionel, University of Central Florida
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Abstract / Description
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First year death rates remain unacceptable high for the end-stage renal disease (ESRD) population. New effective methods are vital to improve first year morbidity and mortality outcomes for the population transitioning from Stage 4 chronic kidney disease (CKD) to ESRD)/Stage 5 CKD. Based on current methods, evidence-based recommendations made by nephrology providers are frequently not heeded by patients in Stage 4 CKD. Low levels of patient knowledge, self-efficacy, and a poor ability to self...
Show moreFirst year death rates remain unacceptable high for the end-stage renal disease (ESRD) population. New effective methods are vital to improve first year morbidity and mortality outcomes for the population transitioning from Stage 4 chronic kidney disease (CKD) to ESRD)/Stage 5 CKD. Based on current methods, evidence-based recommendations made by nephrology providers are frequently not heeded by patients in Stage 4 CKD. Low levels of patient knowledge, self-efficacy, and a poor ability to self-manage CKD negatively influence a patient's ability to follow provider recommendations. The group visit (GV) intervention has demonstrated improvements in disease-related outcomes through increased levels of patient knowledge, self-efficacy, and disease self-management for other chronic diseasses such as diabetes and congestive heart failure (CHF). No data are available for the use of GVs in CKD.The purpose of the study was to develop and test a nurse practitioner-facilitated chronic CKD GV model versus usual nephrology care for Stage 4 CKD patients (knowledge, self-efficacy/self-management, physiological data, and satisfaction). As classified by the National Kidney Foundation's (NKF) staging system, Stage 4 CKD is considered severe kidney disease, with a decrease in the functional capacity of the kidney as determined by a glomerular filtration rate (GFR) of 15-30 ml/min. It is common for patients with Stage 4 CKD to progress to Stage 5 CKD/end-stage renal disease (ESRD), requiring dialysis or transplantation to survive.Preliminary instrumentation and feasibility studies were conducted prior to a pilot study of a CKD GV model. The development and validation of the Stage 4 CKD Knowledge Instrument was completed with 59 Stage 4 patients. Findings supported reliability (Kuder-Richardson-20 [KR] = .89) and content validity (I-CVI = .97, S-CVI= 1.0) Feasibility of the CKD GV model was assessed with a single group, pretest-posttest design using a convenience sample of eight Stage 4 patients. Results demonstrated an improvement in knowledge of CKD from a median of 69% to 86% (p =.012). No improvements were noted in self-efficacy scores (p = .230). GV satisfaction ranged from very good to excellent. Feasibility was supported by a high retention rate (100%). No barriers to participant recruitment or GV implementation were encountered.The pilot study used a two-group, repeated measures experimental design, with a sample of 30 Stage 4 CKD patients from two office locations of an outpatient nephrology practice. Patients were randomized to the GV intervention or to usual nephrology care. CKD-knowledge, self-efficacy, and self-management scores were collected at baseline, six months, and nine months. Physiological data were measured at baseline, six months, and nine months. GV satisfaction was obtained after the completion of GVs (six months). Nephrology practice satisfaction was obtained from by both groups at nine months. MANOVA for repeated measures was calculated for data collected at the three time points.Twenty-six of 30 patients completed the study, with four patients ineligible to complete the study due to progression to ESRD and dialysis initiation. GV attendance was 92%. CKD knowledge was statistically improved for both groups (F(1.498, 34.446) = 6.363, P = .008). While not statistically significant, a favorable upward trend in the mean scores for the subscales of self-management (communication, partnership in care, and self-care) was demonstrated in the GV patients, with a lack of improvement found in the usual care group for these subscales. Self-efficacy scores revealed a non-significant improvement in mean scores for the GV patients during the GVs, not seen with usual care patients. GV satisfaction was again high with the vast majority of patients requesting use of GVs in their future nephrology care. Current methods of intervention in the Stage 4 CKD population have made little impact on reducing first-year ESRD mortality and morbidity rates. Opportunities to intervene in the poor outcomes begin in the predialysis care of Stage 4 patients. Based on the documented success of multidisciplinary approaches in predialysis care, of GVs in other chronic diseases, and of chronic illness care based on the CCM, a high probability for success exists with the application of GVs in CKD. Although limited by a small sample size, promising improvements in the subscales of disease self-management, self-efficacy, CKD knowledge, and high satisfaction with the GV model for GV participants were revealed in this study. Further research is warranted for the CKD GV model on a larger randomized sample in other locations. Much needed data would be provided on which to base decisions for use of the CKD GV intervention in the predialysis care of Stage 4 patients.
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Date Issued
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2013
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Identifier
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CFE0004724, ucf:49827
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0004724
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Title
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MOLECULAR TYPING OF MYCOBACTERIAL ISOLATES CULTURED FROM THE TISSUE OF INFLAMMATORY BOWEL DISEASE (CROHN'S DISEASE) PATIENTS.
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Creator
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Adams, Leanne M, Naser, Saleh, University of Central Florida
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Abstract / Description
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The role of Mycobacterium avium subsp paratuberculosis (MAP) in the etiology and pathogenesis of inflammatory bowel disease (IBD) including Crohn's Disease (CD), has been investigated. The fastidious characteristics and cross reactivity of MAP with other members in Mycobacteria have produced significant challenges in their detection and identification. In this two year pilot study, an array of three PCR molecular assays based on the detection of sequences from the16S rRNA, IS1245, and IS900...
Show moreThe role of Mycobacterium avium subsp paratuberculosis (MAP) in the etiology and pathogenesis of inflammatory bowel disease (IBD) including Crohn's Disease (CD), has been investigated. The fastidious characteristics and cross reactivity of MAP with other members in Mycobacteria have produced significant challenges in their detection and identification. In this two year pilot study, an array of three PCR molecular assays based on the detection of sequences from the16S rRNA, IS1245, and IS900 genes, belonging to members of the MAC, have been developed and optimized into a common protocol to be used as a rapid and accurate diagnostic tool regarding M. avium complex (MAC) infection. The PCR protocol time was reduced by half, and the sensitivity and specificity of the molecular assays has been significantly improved barring the need for southern hybridization. This improved methodology was employed for the molecular typing of MAC in 100 resected, full-thickness tissue samples removed from IBD patients. The tissue samples were homogenized, decontaminated, and inoculated into two mycobacterial culture media systems. A total of 328 Bactec and Mycobacteria Growth Indicator Tube (MIGT) cultures were evaluated for positive MAC growth. Harvested cells were then subjected to genomic DNA extraction and subsequent PCR typing. The I6 S rRNA-based PCR resulted in detection of 26/28 (93%) MAC in Bactec cultures. Specifically, 25/28 (89%) of positive MAC indicated the presence of IS1245 specific to M. avium subsp avium (MAV), and 6/28 (21%) produced results consistent with the presence of IS900 following nested PCR. Moreover, 20/100 (20%) of MGIT cultures were positive for MAP. Sequence analysis was performed on amplified regions of the IS900 element from seven isolates. A nucleotide alignment revealed that 2/7 isolates demonstrated 100% homology to Bovine MAP and 5/7 isolates showed 96-99% homology to sequenced Bovine MAP published in GenBank. The detection of at least two Bovine derived MAP in IBD tissue will have great impact on the epidemiology and reclassification of IBD. The significant homology of the other five isolates to Bovine derived MAP suggests a diversity in the geographical distribution of MAP regarding Johne's disease and CD. Ultimately, the etiology, diagnosis, and the treatment of IBD as well as control and prevention measures may be enhanced with better tools for investigating emerging infectious diseases.
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Date Issued
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2004
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Identifier
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CFE0000031, ucf:46125
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0000031
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Title
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DEMAND STUDY FOR DENTAL HYGIENE BACHELOR DEGREE PROGRAM.
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Creator
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Driscoll, Annelise, Liberman, Aaron, University of Central Florida
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Abstract / Description
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The following is a study to determine if sufficient demand exists to start a Bachelor of Science and Master of Science degree program in dental hygiene through a joint agreement for completion degrees between Valencia Community College and the University of Central Florida. To accomplish this objective two survey instruments were administered to randomly selected licensed dentists and dental hygienists in the state of Florida. Dental hygienists represented the potential student base for the...
Show moreThe following is a study to determine if sufficient demand exists to start a Bachelor of Science and Master of Science degree program in dental hygiene through a joint agreement for completion degrees between Valencia Community College and the University of Central Florida. To accomplish this objective two survey instruments were administered to randomly selected licensed dentists and dental hygienists in the state of Florida. Dental hygienists represented the potential student base for the proposed programs, and dentists represented the potential and prospective employers of graduated students of the proposed programs. To determine demand and demand characteristics, one survey instrument was mailed to 1,000 dental hygienists who were randomly selected using SAS software from a population of N=12,066 dental hygienists actively licensed to practice in the state of Florida. This sample of hygienists was approximately 8.3% of the total population. Of the 1,000 samples, 134 (or 13.4%) were returned. Of the 134 surveys returned, 123 (n=123) were included in this study. Eleven surveys were not included because of a majority of missing data or because the respondent indicated he or she already possessed a Bachelor or Master degree. A Likert-scale questionnaire was sent to each group of actively licensed dentists and actively licensed dental hygienists from the state of Florida. Responses from dental hygienists were overwhelmingly positive towards the addition of the Bachelor of Science degree program with an online distance-learning component. Those in favor of the Bachelor of Science degree program also provided a favorable response towards adding a Master of Science degree program in dental hygiene. The dentists, as potential future employers, also showed strong support in their responses for the additional degree programs with an additional management track component and believed it would elevate the professional standards of the dental hygiene field.
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Date Issued
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2009
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Identifier
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CFE0002842, ucf:48048
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0002842
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Title
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PALEOPATHOLOGY IN ANCIENT EGYPT: EVIDENCE FROM THE SITES OF DAYR AL-BARSHā AND SHEIKH SAID.
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Creator
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Malnasi, Cindy, Dupras, Tosha, University of Central Florida
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Abstract / Description
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For centuries, people have been fascinated with how the ancient Egyptians lived, and particularly how they died. Although Egyptologists in the past had a greater interest in the treasures that accompanied the dead, there has now been a shift in focus on the actual ancient Egyptians themselves and their ways of life. Recognizing the health and disease status of ancient Egyptians has become particularly important. The aim of this research project is to document the paleopathology of the...
Show moreFor centuries, people have been fascinated with how the ancient Egyptians lived, and particularly how they died. Although Egyptologists in the past had a greater interest in the treasures that accompanied the dead, there has now been a shift in focus on the actual ancient Egyptians themselves and their ways of life. Recognizing the health and disease status of ancient Egyptians has become particularly important. The aim of this research project is to document the paleopathology of the individuals from the sites of Dayr al-Barshā and Sheikh Said encompassing the Old Kingdom (2686 ÃÂ 2160 BC), the First Intermediate Period (2160 ÃÂ 2055 BC), and the Middle Kingdom (2055-1650 BC) periods. The site of Dayr al-Barshā was most importantly the necropolis, or burial site, used by the inhabitants of the ancient city of Hermopolis Magna, and it was also a very prominent quarry site. Today, Dayr al-Barshā is a large scale archaeological site that has been divided into eleven zones. The results of this research reveal a documented list of paleopathologies that include traumatic conditions, congenital anomalies, joint diseases, infectious diseases, hematological disorders, dental pathology, neoplastic conditions, and various other conditions that ailed the people in their daily lives. Fractures and dental diseases are the paleopathologies that occurred most frequently. These pathologies provide important knowledge about the living conditions and occupations during the span of the Old Kingdom through the Middle Kingdom.
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Date Issued
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2010
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Identifier
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CFE0003119, ucf:48643
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0003119
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Title
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A COUPLED CFD-LUMPED PARAMETER MODEL OF THE HUMAN CIRCULATION: ELUCIDATING THE HEMODYNAMICS OF THE HYBRID NORWOOD PALLIATIVE TREATMENT AND EFFECTS OF THE REVERSE BLALOCK-TAUSSIG SHUNT PLACEMENT AND DIAMETER.
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Creator
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Ceballos, Andres, Kassab, Alain, Bai, Yuanli, Deng, Weiwei, DeCampli, William, Divo, Eduardo, University of Central Florida
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Abstract / Description
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The Hybrid Norwood (HN) is a relatively new first stage procedure for neonates with Hypoplastic Left Heart Syndrome (HLHS), in which a sustainable univentricular circulation is established in a less invasive manner than with the standard procedure. A computational multiscale model of such HLHS circulation following the HN procedure was used to obtain detailed hemodynamics. Implementation of a reverse-BT shunt (RBTS), a synthetic bypass from the main pulmonary to the innominate artery placed...
Show moreThe Hybrid Norwood (HN) is a relatively new first stage procedure for neonates with Hypoplastic Left Heart Syndrome (HLHS), in which a sustainable univentricular circulation is established in a less invasive manner than with the standard procedure. A computational multiscale model of such HLHS circulation following the HN procedure was used to obtain detailed hemodynamics. Implementation of a reverse-BT shunt (RBTS), a synthetic bypass from the main pulmonary to the innominate artery placed to counteract aortic arch stenosis, and its effects on local and global hemodynamics were studied.A synthetic and a 3D reconstructed, patient derived anatomy after the HN procedure were utilized, with varying degrees of distal arch obstruction, or stenosis, (nominal and 90% reduction in lumen) and varying RBTS diameters (3.0, 3.5, 4.0 mm). A closed lumped parameter model (LPM) for the peripheral or distal circulation coupled to a 3D Computational Fluid Dynamics (CFD) model that allows detailed description of the local hemodynamics was created for each anatomy. The implementation of the RBTS in any of the chosen diameters under severe stenosis resulted in a restoration of arterial perfusion to near-nominal levels. Shunt flow velocity, vorticity, and overall wall shear stress levels are inverse functions of shunt diameter, while shunt perfusion and systemic oxygen delivery correlates positively with diameter. No correlation of shunt diameter with helicity was recorded.In the setting of the hybrid Norwood circulation, our results suggest: (1) the 4.0mm RBTS may be more thrombogenic when implemented in the absence of severe arch stenosis and (2) the 3.0mm and 3.5mm RBTS may be a more suitable alternative, with preference to the latter since it provides similar hemodynamics at lower levels of wall shear stress.
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Date Issued
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2015
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Identifier
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CFE0005772, ucf:50068
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0005772
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Title
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MATHEMATICAL MODELS OF MOSQUITO POPULATIONS.
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Creator
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Reed, Hanna, Shuai, Zhisheng, University of Central Florida
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Abstract / Description
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The intent of this thesis is to develop ordinary differential equation models to better understand the mosquito population. We first develop a framework model, where we determine the condition under which a natural mosquito population can persist in the environment. Wolbachia is a bacterium which limits the replication of viruses inside the mosquito which it infects. As a result, infecting a mosquito population with Wolbachia can decrease the transmission of viral mosquito-borne diseases,...
Show moreThe intent of this thesis is to develop ordinary differential equation models to better understand the mosquito population. We first develop a framework model, where we determine the condition under which a natural mosquito population can persist in the environment. Wolbachia is a bacterium which limits the replication of viruses inside the mosquito which it infects. As a result, infecting a mosquito population with Wolbachia can decrease the transmission of viral mosquito-borne diseases, such as dengue. We develop another ODE model to investigate the invasion of Wolbachia in a mosquito population. In a biologically feasible situation, we determine three coexisting equilibria: a stable Wolbachia-free equilibrium, an unstable coexistence equilibrium, and a complete invasion equilibrium. We establish the conditions under which a population of Wolbachia infected mosquitoes may persist in the environment via the next generation number and determine when a natural mosquito population may experience a complete invasion of Wolbachia.
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Date Issued
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2018
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Identifier
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CFH2000299, ucf:45845
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000299
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Title
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INVESTIGATING THE ROLE OF THE CASPASE-6 CLEAVAGE FRAGMENT OF MUTANT HUNTINGTIN IN HUNTINGTON DISEASE PATHOGENESIS.
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Creator
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McKinnis, Jourdan A, Southwell, Amber, University of Central Florida
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Abstract / Description
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Huntington disease (HD) is a devastating and fatal neurodegenerative disease. At the moment, no disease modifying therapies are available, with only symptomatic treatment offered to alleviate psychiatric and some types of motor deficits. As a result, many people will continue to suffer and die from this disease. Small molecule therapies have failed to provide benefit in HD, necessitating more complex gene therapy approaches and the identification of less traditional therapeutic targets. A...
Show moreHuntington disease (HD) is a devastating and fatal neurodegenerative disease. At the moment, no disease modifying therapies are available, with only symptomatic treatment offered to alleviate psychiatric and some types of motor deficits. As a result, many people will continue to suffer and die from this disease. Small molecule therapies have failed to provide benefit in HD, necessitating more complex gene therapy approaches and the identification of less traditional therapeutic targets. A previous study demonstrated that preventing cleavage of the huntingtin (HTT) protein, the protein that when mutated causes HD, by caspase 6 (C6) at amino acid 586 prevents the onset of disease in transgenic HD model mice. This suggests that inhibiting the toxicity initiated by N586 cleavage could be a promising therapeutic strategy, but a safe and specific way to do this in humans has not been identified. General C6 inhibition is not a feasible strategy due to the vital functions it plays throughout life. Thus, the purpose of this study was to investigate whether the C6 cleavage fragment of HTT, N586, is itself a toxic species of HTT or if it initiates a toxic proteolytic pathway in order to identify more viable therapeutic strategies for HD. To accomplish this, we are using novel and highly sensitive immunoprecipitation and flow cytometry (IP-FCM) protein detection assays, specific for the N586 neoepitope of HTT, to evaluate the in vivo persistence of N586 in HD model mice. If N586 is detected, it is likely that it is itself toxic and promoting its degradation may be beneficial. Conversely, if it is not detected, N586 cleavage likely initiates a toxic degradation pathway and promoting its stability may be beneficial. The results of these studies have the potential to define new therapeutic strategies for HD that can be addressed more specifically than generalized C6 inhibition for the prevention of N586-mediated toxicity. The selective targeting of N586 toxicity, either to promote or prevent its degradation depending on our results, would ensure that therapeutic activity is restricted to HTT and reduce the potential for deleterious off-target effects
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Date Issued
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2018
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Identifier
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CFH2000395, ucf:45801
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000395
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Title
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VOICE ONSET TIME PRODUCTION IN INDIVIDUALS WTH ALZHEIMER'S DISEASE.
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Creator
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Baker, Julie Baker, Ryalls, Jack, University of Central Florida
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Abstract / Description
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In the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer's disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. Recordings were gathered and digitized. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM...
Show moreIn the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer's disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. Recordings were gathered and digitized. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM-compatible computer. VOT measures for the participants' six stop consonant productions were subjected to statistical analysis. The results of the study indicated that differences in VOT values were not statistically significant in the speakers with Alzheimer's disease from the normal control speakers.
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Date Issued
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2006
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Identifier
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CFE0001269, ucf:46918
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0001269
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Title
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REAL TIME REVERSE TRANSCRIPTION-POLYMERASE CHAIN REACTION FOR DIRECT DETECTION OF VIABLE MYCOBACTERIUM AVIUM SUBSPECIES PARATUBERCULOSIS IN CROHN'S DISEASE PATIENTSANDASSOCIATION OF MAP INFECTION WITH DOWNREGUALTION IN INTERFERON-GAMMA RECEPTOR (INFG1) GENE IN CROHN'S DISEASE PATIENTS.
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Creator
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Chehtane, Mounir, Naser, Saleh, University of Central Florida
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Abstract / Description
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Association of Mycobacterium avium subspecies paratuberculosis (MAP) with Crohn's disease (CD) and not with ulcerative colitis (UC), two forms of inflammatory bowel disease (IBD), has been vigorously debated in recent years. This theory has been strengthened by recent culture of MAP from breast milk, intestinal tissue and Blood from patients with active Crohn's disease. Culture of MAP from clinical samples remained challenging due to the fastidious nature of MAP including its lack of cell...
Show moreAssociation of Mycobacterium avium subspecies paratuberculosis (MAP) with Crohn's disease (CD) and not with ulcerative colitis (UC), two forms of inflammatory bowel disease (IBD), has been vigorously debated in recent years. This theory has been strengthened by recent culture of MAP from breast milk, intestinal tissue and Blood from patients with active Crohn's disease. Culture of MAP from clinical samples remained challenging due to the fastidious nature of MAP including its lack of cell wall in infected patients. The advent of real time PCR has proven to be significant in infectious disease diagnostics. In this study, real time reverse transcriptase PCR (RT-PCR) assay based on targeting mRNA of the IS900 gene unique to MAP has been developed. All variables included in RNA isolation, cDNA synthesis and real time PCR amplification have been optimized. Oligonucleotide primers were designed to amplify 165 bp specific to MAP and the assay demonstrated sensitivity of 4 genomes per sample. In hope this real time RT-PCR may aid in the detection of viable MAP cells in Crohn's disease patients, a total of 45 clinical samples were analyzed. Portion of each sample was also subjected to 12 weeks culture followed by standard nested PCR analysis. The samples consisted of 17 cultures (originated from 13 CD, 1 UC and 3 NIBD subjects), 24 buffy coat blood (originated from 7 CD, 2 UC, 11 NIBD and 4 healthy subjects) and 4 intestinal biopsies from 2 CD patients. Real time RT-PCR detected viable MAP in 11/17 (65%) of iii suspected cultures compared to 12/17 (70%) by nested PCR including 77% and 84% from CD samples by both methods, respectively. Real time RT-PCR detected MAP RNA directly from 3/7 (42%) CD, 2/2 (100%) UC and 0/4 healthy controls similar to results following long term culture incubation and nested PCR analysis. Interestingly, real time RT-PCR detected viable MAP in 2/11 (13%) compared to 4/11 (26%) by culture and nested PCR in NIBD patients. For tissue samples, real time RT-PCR detected viable MAP in one CD patient with the culture outcome remains pending. This study clearly indicates that a 12-hr real time RT-PCR assay provided data that are similar to those from 12 weeks culture and nested PCR analysis. Consequently, use of real time In our laboratory, we previously demonstrated a possible downregulation in the Interferon-gamma receptor gene (IFNGR1) in patients with active Crohn's disease using microarray chip analysis. In this study, measurement of RNA by real time qRT-PCR indicated a possible downregulation in 5/6 CD patients compared to 0/12 controls. The preliminary data suggest that downregulation in INFGR1 gene, and the detection of viable MAP in CD patients provides yet the strongest evidence toward the linkage between MAP and CD etiology.
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Date Issued
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2005
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Identifier
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CFE0000629, ucf:46504
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFE0000629
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Title
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STRUCTURAL TRANSITION DURING FIBRILLOGENESIS OF AMYLOID ? PEPTIDE.
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Creator
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Sidrak, George, Tatulian, Suren, University of Central Florida
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Abstract / Description
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Alzheimer's Disease (AD) is a neurodegenerative disease marked by progressive neuronal cell death, leading to dementia. AD is the most common disease that results in dementia and largely affects the elderly, with five million people in the United States diagnosed with the disease as of 2015 and approximately 35 million people worldwide. Diseases resulting in dementia cost the US healthcare system an estimated $172 billion in 2010 and that cost is expected to increase as the population ages...
Show moreAlzheimer's Disease (AD) is a neurodegenerative disease marked by progressive neuronal cell death, leading to dementia. AD is the most common disease that results in dementia and largely affects the elderly, with five million people in the United States diagnosed with the disease as of 2015 and approximately 35 million people worldwide. Diseases resulting in dementia cost the US healthcare system an estimated $172 billion in 2010 and that cost is expected to increase as the population ages and as diagnostic techniques improve so that more people are treated (Holtzman, 2011). The disease was first reported by psychiatrist Alois Alzheimer at the onset of the 20th century, when one of his patients "suffered memory loss, disorientation, hallucinations and delusions and died at the age of 55," then was found to have severe brain atrophy post-mortem (Cipriani, Dolciotti, Picchi, & Bonuccelli, 2011). There are palliative treatments available that marginally slow disease progression but there is currently no cure for the disease (Awasthi, Singh, Pandey, & Dwivedi, 2016). More research is needed to develop effective therapeutic strategies to combat the disease. Currently, AD cytotoxicity is believed to be caused by increased amyloid ? (A?) peptide plaque deposition in the brain, as described by the amyloid cascade hypothesis (Barage & Sonawane, 2015). The current understanding is that oligomers of A? peptide lead to neuronal death through multiple mechanisms, most notably hyper-phosphorylation of the tau protein. Having a better understanding of the structural changes in the fibrillization process of A? will provide a broader insight into mechanisms of cell death and open new possibilities for pharmacological treatments, which is what this research intends to provide.
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Date Issued
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2017
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Identifier
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CFH2000178, ucf:45994
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000178
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Title
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SYSTEMATIC REVIEW AND META-ANALYSIS: TUBERCULOSIS, TNFΑ INHIBITORS, AND CROHN'S DISEASE.
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Creator
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Cao, Brent L, Naser, Saleh A., University of Central Florida
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Abstract / Description
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Inflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs...
Show moreInflammation is often a protective reaction against harmful foreign agents. However, in many disease conditions, the mechanisms behind the inflammatory response are poorly understood. Often times, the inflammation causes adverse effects, such as joint pain, abdominal pain, fever, fatigue, and loss of appetite. Thus, many treatments aim to inhibit the inflammatory response in order to control adverse symptoms. Such treatments include TNFα inhibitors. However, a major risk associated with drugs inhibiting tumor necrosis factor alpha (TNFα) is serious infection, including tuberculosis (TB). Anti-TNFα therapy is used to treat patients with Crohn's disease, for which the risk of tuberculosis may be even more concerning. Recent literature suggests Crohn's might involve Mycobacterium avium subspecies paratuberculosis (MAP), an intracellular TB-like bacterium. This study seeks to investigate the risk of developing TB in patients with Crohn's disease treated with TNFα inhibitors. A meta-analysis synthesized existing evidence. Evidence came from published randomized, double-masked, placebo-controlled trials of TNFα inhibitors for treatment of adult Crohn's disease. Twenty-three trials were identified, including 5,669 patients. The risk of tuberculosis was significantly increased in anti-TNFα treated patients, with a risk difference of 0.028 (95% confidence interval [CI], 0.0011-0.055). The odds ratio was 4.85 (95% CI, 1.02-22.99) when all studies were included and 5.85 (95% CI, 1.13-30.38) when studies reporting zero tuberculosis cases were excluded. The risk of tuberculosis is increased in patients with Crohn's disease treated with TNFα inhibitors. The medical community should be alerted about this risk and the potential for TNFα inhibitor usage favoring granulomatous infections and worsening the patient condition.
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Date Issued
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2018
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Identifier
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CFH2000360, ucf:45909
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000360
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Title
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EFFECTS OF DIETARY FACTORS ON THE INCIDENCE AND PROGRESSION OF NON-ALCOHOLIC FATTY LIVER DISEASE.
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Creator
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Lessans, Spencer L, Altomare, Deborah A., University of Central Florida
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Abstract / Description
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Non-alcoholic fatty liver disease (NAFLD) is a liver disorder linked to obesity that is rapidly increasing in incidence worldwide. It is a disorder that ranges in severity; from a benign condition of hepatic steatosis to a potentially deadly one resulting in cirrhosis and hepatocellular carcinoma. It is currently known that NAFLD is strongly associated with various aspects of metabolic syndrome: insulin resistance, elevated triglyceride levels, obesity, and type two diabetes mellitus. The...
Show moreNon-alcoholic fatty liver disease (NAFLD) is a liver disorder linked to obesity that is rapidly increasing in incidence worldwide. It is a disorder that ranges in severity; from a benign condition of hepatic steatosis to a potentially deadly one resulting in cirrhosis and hepatocellular carcinoma. It is currently known that NAFLD is strongly associated with various aspects of metabolic syndrome: insulin resistance, elevated triglyceride levels, obesity, and type two diabetes mellitus. The multifactorial pathogenesis of NAFLD is still uncertain and closer attention is needed on the effect of one's diet on NAFLD. In this study, we directly compare a westernized diet containing high levels of fat and fructose to a diet high in fat and containing cholate using mouse models in order to determine the role of each dietary factor in the incidence and severity of the different stages of NAFLD. We will evaluate the severity of hepatic steatosis and hepatocellular damage via hematoxylin and eosin (H&E) stained liver tissue and the severity of hepatic fibrosis via trichrome-stained liver tissue. Our hypothesis is that mice on the fructose-based diet are expected to have higher levels of hepatic steatosis and hepatocellular damage relative to mice on the cholate-based diet while mice on the cholate-based diet are expected to have higher levels of hepatic fibrosis relative to the fructose-based diet. The results of this study will aid in elucidating and strengthening the connection between one's diet and the prevalence and severity of NAFLD.
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Date Issued
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2018
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Identifier
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CFH2000340, ucf:45913
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Format
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Document (PDF)
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PURL
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http://purl.flvc.org/ucf/fd/CFH2000340
Pages