Graduate
November 25, 2020
Constructing and evaluating alternative prediction models for identifying clinically relevant cases in an STD clinic
Background: Many STD clinics have incorporated “express visits” – testing-only visits without a clinician evaluation. To identify which patients can safely receive express care at the Public Health–Seattle & King County (PHSKC) STD Clinic, we constructed and evaluated alternative triage algorithms based on computer assisted self-interview (CASI) responses. Methods: We evaluated the performance of the…
Sexual behavior patterns and condom use in newly sexually active female university students
Objectives: Describe sexual behavior patterns and condom use in newly sexually active female university students. Methods: We conducted a retrospective cohort study (years 2000 – 2007) of university women enrolled either before or within three months of sexual debut who completed Web-based sexual behavior diaries biweekly and attended clinic visits every four months for up…
Host and environmental correlates of multi-drug resistance in Kenyan children with acute bacterial diarrhea
Bacterial diarrhea results in significant morbidity and mortality in children in sub-Saharan Africa. Antibiotic treatment can be a life-saving intervention, but the emergence of antibiotic resistance limits its clinical efficacy. Data on the burden and risk factors for antibiotic resistance in enteric pathogens are needed to inform diarrhea management recommendations and resistance control interventions. Stool/rectal…
November 24, 2020
Performance of commercial enzyme-linked immunosorbent assays (ELISA) for diagnosis of HSV-1 and HSV-2 infection in a clinical setting
Background FDA-approved ELISA assays for determining type-specific herpes simplex virus (HSV) serostatus are widely used in clinics. We compared the performance of such assays with the University of Washington western blot (UW WB) in patients who sought confirmation of their HSV serostatus. Methods We reviewed charts of all persons evaluated at the Westover Heights Clinic…
Polyomavirus-negative Merkel cell carcinoma: a more aggressive subtype based on analysis of 282 cases using multi-modal tumor virus detection
Previous studies have reached conflicting conclusions regarding the proportion of Merkel cell carcinomas (MCCs) that contain the Merkel cell polyomavirus (MCPyV) and the clinical significance of tumor viral status. To address these controversies, we detected MCPyV large T antigen using immunohistochemistry with two distinct antibodies and viral DNA using quantitative PCR. Tumors were called virus-positive…
The 2014 chikungunya virus outbreak in the U.S. Virgin Islands: epidemiology, long-term health outcomes, and economic burden
Background: Chikungunya virus (CHIKV), an emerging and acutely debilitating alphavirus transmitted by the Aedes aegypti and Aedes albopictus mosquito, was introduced into the Americas in December of 2013. As of April 2016, almost 2 million suspected or confirmed cases have been reported in 45 different countries in the Americas. Acute symptoms of the virus include…
Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention: prospective studies in HIV-uninfected men and women
Antiretroviral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) alone or when co-formulated with emtricitabine (FTC), the same medication used for treatment of HIV infection, is a recommended and highly effective strategy to reduce the risk of sexual acquisition of HIV. The central objective of the studies described in this dissertation was to quantify the…
Hypertension and diabetes treatment and risk of adverse outcomes among breast cancer patients
Background: Management of comorbidities is a critical issue among 2.9 million breast cancer survivors in the U.S. Hypertension and diabetes are two common chronic conditions affecting this patient population. Despite the generally good safety profile of widely used antihypertensive medications and diabetes treatments, few studies have examined their relationships with adverse breast cancer outcomes. In…
Methylomic and Transcriptomic Insights Linking Air Pollution and Atherosclerosis
Background: Current literature demonstrates a compelling relationship between long-term air pollution exposure and cardiovascular diseases such as atherosclerosis. DNA methylation is a potential mediator of the air pollution-atherosclerosis association because 1) exposure to particulate matter is associated with alterations in DNA methylation, and 2) alterations in DNA methylation are found in atherosclerotic lesions and are…
Prevalence of mixed neuropathologies in autopsied older adults and associations with clinical disease progression
Introduction: Many older adults have multiple brain pathologies (aka mixed neuropathologies) at autopsy; however, the clinical importance of mixed neuropathologies is not well established. The objectives of this dissertation were 1.) to examine the prevalence of Alzheimer’s disease neuropathologic change (ADNC), Lewy body disease (LBD), vascular brain injury (VBI), and their co-occurrence and 2.) to…
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