Browsing by Author "Dbeibo, Lana"

Now showing 1 - 6 of 6
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    Assessment of a Universal Preprocedural Screening Program for COVID-19
    (Cambridge, 2021) Dbeibo, Lana; Kuebler, Kari; Keen, Alyson; George, Annie; Kelley, Kristen; Sadowski, Josh; Basham, Laura; Beeson, Terrie; Schmidt, C. Max; Beeler, Cole; Webb, Douglas; Medicine, School of Medicine
    Objectives Study objectives were to: (1) Determine the value of a COVID-19 universal preprocedural screening program; and (2) Using the results of asymptomatic positive screens, determine the safety of resuming elective procedures. Design This was a descriptive study detailing the process and findings from implementation of a COVID-19 universal preprocedural screening program. Setting An adult academic tertiary center in Indiana. Patients Patients were included in the analysis if they were screened 96 hours prior to or within 24 hours after undergoing a procedure in the operating room, cardiac catheterization lab, or endoscopy. Methods A report was generated from the electronic health record of patients undergoing procedures from a six week period of time (May 4th-June 14th, 2020). Health records for positive screens were reviewed and classified as symptomatic if they met either criteria: (1) screen performed due to presence of COVID-19 symptoms; (2) documentation of symptoms at the time of the screen. Patients with a positive screen that did not meet symptomatic criteria were classified as asymptomatic. Descriptive statistics were used to calculate frequencies and percentages for the included sample. Results The initial sample included 2,194 patients, comprised of 46 positive and 2,148 negative screens. Out of the 46 patients who had a positive test, 17 were asymptomatic, resulting in an asymptomatic rate of 0.79% (17/2165). Conclusion Findings validated the value of the program through identification of a low rate of asymptomatic positive screens and procedural team adoption and sustainment. Findings may help inform decision making of like organizations attempting to enhance safety while resuming elective procedures.
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    “Clinical Characteristics, Outcomes and Prognosticators in Adult Patients Hospitalized with COVID-19”
    (Elsevier, 2020-07-08) Gavin, Warren; Campbell, Elliott; Zaidi, Adeel; Gavin, Neha; Dbeibo, Lana; Beeler, Cole; Kuebler, Kari; Abdel-Rahman, Ahmed; Luetkemeyer, Mark; Kara, Areeba; Medicine, School of Medicine
    Background: COVID-19 is a novel disease caused by SARS-CoV-2. Methods: We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into three groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV and those who received MV and died during hospitalization. Results: There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8 , 55.8 and 72.7 years respectively (p=.0001). Of those who received MV and died, 61% were male (p=.01). More than half the patients ( n=90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, LDH > 445.6 units/L and BNP > 104.75 pg/mL had odds ratios of 10.5, 5 , 4.5 and 2.9 respectively forMV (p < .05 for all). Peak BNP > 167.5 pg/mL had an odds ratio of 6.7 for inpatient mortalitywhen mechanically ventilated (p= .02).Conclusions: Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, LDH and BNP may serve as early indicators of disease trajectory.
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    Clinical comparison and agreement of PCR, antigen, and viral culture for the diagnosis of COVID-19: Clinical Agreement Between Diagnostics for COVID19
    (Elsevier, 2022) Agard, Amanda; Elsheikh, Omar; Bell, Drew; Relich, Ryan F.; Schmitt, Bryan H.; Sadowski, Josh; Fadel, William; Webb, Douglas H.; Dbeibo, Lana; Kelley, Kristen; Carozza, Mariel; Lei, Guang-Shen; Calkins, Paul; Beeler, Cole; Medicine, School of Medicine
    The aim of this study is to compare the COVID-19 nasopharyngeal PCR (NP PCR) to antigen, nasal PCR, and viral culture. One-hundred-and-fourteen risk-stratified patients were tested by culture, nasal PCR, NP PCR, and Ag testing. Twenty (48%) of the high risk and 23 (32%) of the low risk were NP PCR positive. Compared with NP PCR, the sensitivity of nasal PCR, Sofia Ag, BinaxNOW Ag, and culture were 44%, 31%, 37%, and 15%. In the high risk group, the sensitivity of these tests improved to 71%, 37%, 50%, and 22%. Agreement between tests was highest between nasal PCR and both antigen tests. Patients who were NP PCR positive but antigen negative were more likely to have remote prior COVID-19 infection (p<0.01). Nasal PCR and antigen positive patients were more likely to have symptoms (p = 0.01).
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    Evaluation of CpxRA as a Therapeutic Target for Uropathogenic Escherichia coli Infections
    (American Society for Microbiology, 2018-02-20) Dbeibo, Lana; van Rensburg, Julia J.; Smith, Sara N.; Fortney, Kate R.; Gangaiah, Dharanesh; Gao, Hongyu; Marzoa, Juan; Liu, Yunlong; Mobley, Harry L.T.; Spinola, Stanley M.; Medicine, School of Medicine
    CpxRA is an envelope stress response system found in all members of the family Enterobacteriaceae; CpxA has kinase activity for CpxR and phosphatase activity for phospho-CpxR, a transcription factor. CpxR also accepts phosphate groups from acetyl phosphate, a glucose metabolite. Activation of CpxR increases the transcription of genes encoding membrane repair and downregulates virulence determinants. We hypothesized that activation of CpxR could serve as an antimicrobial/antivirulence strategy and discovered compounds that activate CpxR in Escherichia coli by inhibiting CpxA phosphatase activity. As a prelude to testing such compounds in vivo, here we constructed cpxA (in the presence of glucose, CpxR is activated because of a lack of CpxA phosphatase) and cpxR (system absent) deletion mutants of uropathogenic E. coli (UPEC) CFT073. By RNA sequencing, few transcriptional differences were noted between the cpxR mutant and its parent, but in the cpxA mutant, several UPEC virulence determinants were downregulated, including the fim and pap operons, and it exhibited reduced mannose-sensitive hemagglutination of guinea pig red blood cells in vitro In competition experiments with mice, both mutants were less fit than the parent in the urine, bladder, and kidney; these fitness defects were complemented in trans Unexpectedly, in single-strain challenges, only the cpxA mutant was attenuated for virulence in the kidney but not in the bladder or urine. For the cpxA mutant, this may be due to the preferential use of amino acids over glucose as a carbon source in the bladder and urine by UPEC. These studies suggest that CpxA phosphatase inhibitors may have some utility for treating complex urinary tract infections.
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    Seroprevalence of SARS-CoV-2 Antibodies Among Healthcare Workers With Differing Levels of COVID-19 Patient Exposure
    (Cambridge University Press, 2020-08-03) Hunter, Benton R.; Dbeibo, Lana; Weaver, Christopher; Beeler, Cole; Saysana, Michele; Zimmerman, Michelle; Weaver, Lindsay; Emergency Medicine, School of Medicine
    Healthcare employees were tested for antibodies against SARS-CoV-2. Among 734 employees, the prevalence of SARS-CoV-2 antibodies was 1.6%. Employees with heavy COVID-19 exposure had similar antibody prevalence as those with limited or no exposure. Guidelines for PPE use seem effective for preventing COVID-19 infection in healthcare workers.
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    Strategies for the successful implementation of disinfecting port protectors to reduce CLABSI in a large tertiary care teaching hospital
    (Elsevier, 2019-12) Beeler, Cole; Kerley, Denise; Davis, Carmen; Hazen, Dana; Snyderman, William; Lyons, Kathy; Sadowski, Josh; Sweeney, Jennifer; Dbeibo, Lana; Kelley, Kristen; Webb, Douglas H.; Medicine, School of Medicine
    Disinfecting port protectors are a supplement to the central line–associated bloodstream infection prevention bundle as an optional recommendation from the Centers for Disease Control and Prevention. Despite evidence of effectiveness, few centers have successfully reported systematic, sustained implementation of these devices. In this article, we discuss a successful implementation in a large tertiary care teaching hospital, using an evidence-based, multidisciplinary approach.