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Lead Me to Lead Screening: Improving Lead Screening Rates at Urban, High-Risk Family Medicine Clinic
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MALDI-TOF Mass Spectrometry Used in Diagnosis of Nocardiosis in a Patient With a Renal Transplant
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Central Nervous System Antiviral Pharmacology
Get PDFSoon after viral infection, viruses like Human Immunodeficiency Virus (HIV) and SARS-CoV-2 can disseminate throughout the body and establish reservoirs in the central nervous system (CNS). The persistence of viruses in cells of these reservoirs is a major obstacle to virus eradication. This is due to the abundance of cells/receptors that these viruses utilize to gain entry into cells found at these various reservoir sites. Consequently, these same anatomical sites also may be pharmacologic sanctuaries, as evidenced by concentrations of antiretroviral drugs (ARVs) and antivirals (AVs) that are lower in reservoirs than those in peripheral blood; in some cases, these low ARV concentrations have been associated with evidence for low-level ongoing virus replication in the CNS. Neurological complications associated with viral infection are well recognized with both HIV and SARs-CoV-2 infection and are a continuing problem. Ensuring that ARVs/AVs can cross the blood-brain barrier (BBB) and maintain adequate exposure to inhibit viral replication in the CNS is a pharmacotherapeutic challenge that requires attention, especially in recent years (i.e., NeuroHIV, Long COVID). Strategies to maximize these efforts include optimizing the selection of an ARV/AV and increased dosing/intervals of ARV/AV in hopes of achieving optimal pharmacodynamic (PD) endpoints in the CNS. The inhibitory concentration is commonly the level at which 50%, 90%, or 95% (IC50-95) of in-vitro viral replication is inhibited utilizing wild-type viruses. Pharmacokinetic/pharmacodynamic (PK/PD) endpoints are further complicated as no clear exposure thresholds have been identified in the CSF or CNS. The lack of such information leaves gaps in our understanding of the relative efficacy of various ARVs/AVs in the CSF/CNS. Further, assessing drug concentrations in the CNS in patients is difficult as it requires invasive methods for CSF (i.e., lumbar puncture) and tissue collection. This brings to light the utilization of pre-clinical models for potential CNS penetration. The work conducted in this dissertation highlights novel pharmacologic methods used to assess CSF and CNS penetration of various ARVs for HIV and AVs for SARs-CoV-2 using both pre-clinical and clinical models
Editorial: Intersection of Diet, Intestinal Microbiota, and their Metabolites on Cancer Prevention
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Get PDFThe Impact of a Living with Diabetes Experience on Students\u27 Attitudes and Perceptions
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A Novel Study to Assess Diagnostic Medical Sonography Students Belongingness in the Clinical Learning Environment
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Learner Influence on Pediatric Patient Experience: Exploring Family Members’ Perspectives
Get PDFThis is a published abstract from the UNMC Spotlight on Scholarship 2024