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Tyler, TX, United States

The University of Texas Health Science Center at Tyler is a health institution located in Tyler, Texas. Originally named "East Texas Tuberculosis Sanitarium", it was established in 1947 as a tuberculosis treatment facility at the location of Camp Fannin. The University of Texas System assumed management of the center in 1977.The center serves as both a hospital — caring for over 140,000 patients annually — and medical research facility.A Camp Fannin Memorial stands today on the campus. Wikipedia.

Griffith D.E.,University of Texas Health Science Center at Tyler | Aksamit T.R.,Rochester College
Current Opinion in Infectious Diseases | Year: 2012

PURPOSE OF REVIEW: The prevalence of nontuberculous mycobacterial (NTM) lung disease is increasing in the USA. Clinicians are therefore encountering these patients with increasing frequency, with the attendant multiple therapeutic challenges presented by NTM lung disease including relatively frequent (compared with tuberculosis) treatment failure. RECENT FINDINGS: Critical elements for the successful treatment of Mycobacterium avium complex (MAC) lung disease include aggressive first therapeutic attempts and avoidance of the emergence of macrolide-resistant MAC strains, which are associated with worse treatment response and increased mortality. Reliably effective therapy for M. abscessus lung disease remains elusive but still usually requires parenteral agents. Lung resection surgery for selected patients is an important adjunct for both MAC and M. abscessus lung disease. Aside from surgery and parenteral antibiotics, there are very few data to support the efficacy of other drugs or interventions for patients who have failed the first-line therapy. SUMMARY: Clinicians who manage NTM lung disease will inevitably encounter patients who fail the first-line therapy. The choices for effective treatment of these patients are depressingly sparse. It is critically important to avoid creation of macrolide-resistant MAC strains and to carefully choose those NTM lung disease patients who will benefit from surgery. © 2012 Lippincott Williams & Wilkins, Inc. Source

Nonnenmann M.W.,University of Texas Health Science Center at Tyler
Journal of occupational and environmental hygiene | Year: 2010

Work in animal production facilities often results in exposure to organic dusts. Previous studies have documented decreases in pulmonary function and lung inflammation among workers exposed to organic dust in the poultry industry. Bacteria and fungi have been reported as components of the organic dust produced in poultry facilities. To date, little is known about the diversity and concentration of bacteria and fungi inside poultry buildings. All previous investigations have utilized culture-based methods for analysis that identify only biota cultured on selected media. The bacterial tag-encoded flexible (FLX) amplicon pyrosequencing (bTEFAP) and fungal tag-encoded flexible (FLX) amplicon pyrosequencing (fTEFAP) are modern and comprehensive approaches for determining biodiversity of microorganisms and have not previously been used to provide characterization of exposure to microorganisms in an occupational environment. This article illustrates the potential application of this novel technique in occupational exposure assessment as well as other settings. An 8-hr area sample was collected using an Institute of Medicine inhalable sampler attached to a mannequin in a poultry confinement building. The sample was analyzed using bTEFAP and fTEFAP. Of the bacteria and fungi detected, 116 and 39 genera were identified, respectively. Among bacteria, Staphylococcus cohnii was present in the highest proportion (23%). The total inhalable bacteria concentration was estimated to be 7503 cells/m3. Among the fungi identified, Sagenomella sclerotialis was present in the highest proportion (37%). Aspergillus ochraceus and Penicillium janthinellum were also present in high proportions. The total inhalable fungi concentration was estimated to be 1810 cells/m3. These estimates are lower than what has been reported by others using standard epifluorescence microscope methods. However, no study has used non-culture-based techniques, such as bTEFAP and fTEFAP, to evaluate bacteria and fungi in the inhalable fraction of a bioaerosol in a broiler production environment. Furthermore, the impact of this bTEFAP and fTEFAP technology has yet to be realized by the scientific community dedicated to evaluating occupational and environmental bioaerosol exposure. Source

Allen T.C.,University of Texas Health Science Center at Tyler
Archives of Pathology and Laboratory Medicine | Year: 2010

Context.-The term small airways disease encompasses a generally poorly understood group of lung diseases that may arise primarily within the small airways or secondarily from diseases primarily affecting the bronchi or lung parenchyma. Their histology may be confusing; however, because treatments and prognoses vary, correct pathologic diagnosis is important. Objective.-To present a nonexhaustive review of the pathology of primary and secondary small airways diseases, including small airways disease related to tobacco; to various other exposures, including mineral dusts; to diseases involving other areas of the lung with secondary bronchiolar involvement; and to recently described bronchiolitic disorders. Data Sources.-Current literature is reviewed. Conclusions.-Small airways diseases include a wide variety of diseases of which the pathologist must consider. Uncommon conditions such as diffuse idiopathic neuroendocrine cell hyperplasia and diffuse panbronchiolitis may show relatively specific diagnostic features histologically; however, most small airways diseases exhibit nonspecific histologic features. Conditions not considered primary pulmonary diseases, such as collagen vascular diseases, bone marrow transplantation, and inflammatory bowel disease, must also be considered in patients with small airways changes histologically. Clinical and radiologic correlation is important for obtaining the best possible diagnosis. Source

Howard S.T.,University of Texas Health Science Center at Tyler
Tuberculosis | Year: 2013

Mycobacterium abscessus is an emerging cause of respiratory disease and soft tissue infections. Whole genome sequencing and other molecular approaches are enhancing our understanding of outbreaks, antibiotic resistance mechanisms, and virulence properties, and of the phylogeny of the M. abscessus complex. Infection models are providing further insights into factors such as colony phenotype that impact host-pathogen interactions. This paper reviews recent developments in our understanding of genetic variation in M. abscessus and the potential relevance for disease and treatment. © 2013 Elsevier Ltd. Source

Griffith D.E.,University of Texas Health Science Center at Tyler
Current Opinion in Infectious Diseases | Year: 2010

Purpose of Review: There is increasing awareness that nontuberculous mycobacteria (NTM) lung diseases are becoming more prevalent. Nontuberculous mycobacterial diseases could legitimately be seen as an emerging public-health threat. Recent Findings: Nontuberculous mycobacterial lung disease associated radiographically with nodules and bronchiectasis occurs primarily in women. These patients are associated with a specific morphotype, including low BMI, tall stature, scoliosis, pectus excavatum and mitral valve prolapse. The pathophysiologic link between these findings and the development of bronchiectasis and NTM disease remains unclear. As with tuberculosis, the tumor-necrosis factor alpha (TNF-alpha) blockers also predispose to NTM infection that can be severe. The most frustrating aspect of NTM therapy remains the generally poor correlation between in-vitro antibiotic susceptibility and in-vivo response to antimicrobials. A possible insight into this phenomenon is the recent discovery of an inducible macrolide resistance (erm) gene in Mycobacterium fortuitum and Mycobacterium abscessus. This gene can produce in-vivo resistance without resulting in a 'resistant' MIC for macrolides. Summary: The NTM pose an increasing problem for clinicians and are associated with significant obstacles that thwart successful treatment of NTM disease. Continued progress in the areas of disease pathogenesis and therapy will improve the outlook for these patients. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

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