Pediatrics & Women's Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30293
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Browsing Pediatrics & Women's Health by Author "Bui, Priya"
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Item Human Papillomavirus (HPV) and Oropharyngeal Cancer in the LGBT Population(2020) Raines-Milenkov, Amy; Bui, Priya; Fulda, Kimberly; Thompson, Erika; Fernando, Shane; Felini, Martha; Aziz, HadiaPurpose: In 2015, HPV-positive oropharyngeal squamous cell carcinoma (oropharyngeal SCC) became the most prevalent HPV-associated cancer in the United States. Oral HPV infection disproportionately affects gay and bisexual males, with men who have sex with men almost twice as likely to have a high-risk oral HPV infection than men with predominantly female sex partners. Despite the rise of HPV-positive oropharyngeal SCC, the rate of HPV vaccination among male adolescents in Texas lags behind the national rate of vaccine uptake. This review examines the barriers to vaccination uptake in gay and bisexual males. Methods: The databases used for this review were PubMed Central, UpToDate, and the Center for Disease Control. Key words searched included HPV rates in LGBT, HPV Oropharyngeal cancer, HPV vaccine barriers, and HPV vaccination rates in LGBT. Results: Three main barriers to vaccination were identified in the LGBT population. These barriers included lack of recommendation from a healthcare provider, lack of funding for new age of majority individuals, and outdated marketing strategies. Conclusion: The most important factor that determines whether a LGBT adolescent receives the HPV vaccine is a recommendation from a healthcare provider. Additionally, when the HPV vaccine is marketed as preventing anal, penile, and oral cancer in males versus just preventing genital warts, the intent of an LGBT patient to initiate the vaccination series is greater. Further research should be done to determine which educational methods and marketing materials used by a healthcare provider impact a patient's decision to vaccinate most significantly.Item Polypharmacy in management of a pediatric patient with GBS(2020) Yuet, Wei; Bui, Priya; Kim, SuhhyunBackground: Guillain-Barre Syndrome (GBS) is an immune-mediated polyneuropathic disease usually provoked by a preceding infection. It is characterized by peripheral nerve damage, presenting with "ascending paralysis" of the lower limbs, eventually leading to respiratory paralysis if no proper interventions are taken. Current pediatric GBS management involves minimizing residual symptoms by combining medications and physical therapy. This case presents a 3-year-old female who sustained numerous adverse effects secondary to polypharmacy in managing residual GBS symptoms. Case Information: A 3-year-old female with a history of recurrent upper respiratory disease, presented with fever, cough, diffuse pain, and refusal to eat. Her history is positive for a 2-week prior hospitalization for poor eating, emesis, and pain. During this past admission, she tested positive for parainfluenza. A physical exam revealed signs of GBS: fine-motor incoordination, generalized decrease in strength and tone in lower extremities with decreased deep tendon reflexes. She also had elevated CSF proteins and red blood cell counts, and MRI showed diffuse cranial and spinal nerve root enhancements. Upon discharge, she was prescribed fifteen medications for allergies, insomnia, and residual neuropathic symptoms and three had anticholinergic properties and five were CNS depressants. The usage of multiple CNS depressants may exacerbate the adverse effects, which in this case were ataxia, confusion, drowsiness, and weakness. Upon discontinuing therapeutic duplications, patient showed significant improvement on rehabilitation. Conclusions: Polypharmacy should be considered in complex management cases since it may affect the patient's overall