No description available.

published_or_final_version / Community Medicine / Master / Master of Public Health

No description available.

No description available.

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No description available.

This study aimed to establish a better candidacy protocol for pediatric heart transplant patients at the University of Arizona Medical Center through a retrospective chart review of pediatric heart transplants held there between the years of 2004 -2009. Sequential patterns related to noncompliance investigated included patient and guardian demographics and past medical, familial, social and psychiatric history. Trends between gender and noncompliance were found as 5/5 noncompliant rejectors were male. Four out of the 5 were between the ages of 16.5 and 21 years old. Seventy percent of medication changes due to medication intolerance were associated with noncompliance. Patients with family members currently or previously suffering from life-threatening illnesses (7/16) had a greater likelihood of having subtherapeutic immunosuppressive trough levels. Of noncompliant rejectors, 4/5 (80%) had a duration of illness prior to transplant > than 6 months. Also, 4/4 patients with pre-transplant depression experienced rejection and 2/4 were noncompliant rejectors.

Post-operative infections are of high concern and are a great risk to patients who have just had an open-heart surgical procedure. Exposing the human body to elements it's clearly not used to, by opening the chest to perform heart surgery, greatly increases a patient's risk of infection. Surgery is usually the last line of defense used by physicians. This is not only because the invasiveness of the procedure, but because of the heightened risk of infection for the patient. In the treatment of surgical patients, the possibility of infection and protocol for treatment must be taken into account. Patients who undergo open-heart procedures, such as CABG's, Valve Repair/Replacement, Aneurysms, and Aortic Root Repair/Replacement, often have compromised immune systems. A compromised immune system, exposure of the chest cavity during surgery, and length of hospital stay are all contributing factors to hospital acquired infections (HAI). Infections vary depending on the nature of the surgery, the institution, surgical technique, and also varies by patient. Pneumonia, sepsis, bacterial endocarditis, and mediastinitis are all potential concerns in patients who have undergone recent open-heart surgery. The recent societal push for a more holistic approach to medicine and an effort for treatments with fewer side effects have lead to increased research in the realm of probiotics. Probiotics are "good bacteria" that are thought to aid in the intestinal microbial balance. They also have been shown to improve gastrointestinal problems. By integrating the use of probiotics into the treatment of post cardiac surgery patients, we expect to see a decrease in gastrointestinal problems and infections. We also believe that this will improve patients' overall health. This preventative treatment will save the hospital millions of dollars in revenue that is spent on treating infections and will also increase hospital bed turnover.