Medicine and Health Sciences Commons^™

Chapter 5. Chronic Obstructive Pulmonary Disease (Copd), David Mannino, Janet Croft, David Brown

David C. Brown

No abstract provided.

Haematopoietic Stem Cells In Spleen Have Distinct Differentiative Potential For Antigen Presenting Cells., Jonathan Tan, Helen O'Neill

Jonathan Tan

Dendritic cells (DC) are known to develop from macrophage dendritic progenitors (MDP) in bone marrow (BM), which give rise to conventional (c)DC and monocytes, both dominant antigen presenting cell (APC) subsets in spleen. This laboratory has however defined a distinct dendritic-like cell subset in spleen (L-DC), which can also be derived in long-term cultures of spleen. In line with the restricted in vitro development of only L-DC in these stromal cultures, we questioned whether self-renewing HSC or progenitors exist in spleen with restricted differentiative capacity for only L-DC. Neonatal spleen and BM were compared for their ability to reconstitute mice …

Acetate Causes Alcohol Hangover Headache In Rats, Christina R. Maxwell, Rebecca Jay Spangenberg, Jan B. Hoek, Stephen D. Silberstein, Michael L. Oshinsky

Department of Neurology Faculty Papers

Background

The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache.

Methods

We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats.

Results

Ethanol initially decreased sensitivity to mechanical stimuli on the face (analgesia), followed 4 to 6 hours later by inflammatory pain. Inhibiting alcohol dehydrogenase extended the analgesia whereas inhibiting aldehyde dehydrogenase decreased analgesia. Neither treatment had nociceptive effects. Direct administration of acetate …

Stem Cells For Spinal Cord Regeneration: Current Status, Zain A. Sobani, Syed A. Quadri, Ather Enam

Section of Neurosurgery

Background: Nearly 11,000 cases of spinal cord injury (SCI) are reported in the United States annually. Current management options give a median survival time of 38 years, however, no rehabilitative measures are available. Stem cells have been under constant research given their ability to differentiate into neural cell lines replacing non functional tissue. Efforts have been made to establish new synapses and provide a conducive environment, by grafting cells from autologous and fetal sources, including embryonic or adult stem cells, Schwann cells, genetically modified fibroblasts, bone stromal cells, and olfactory ensheathing cells and combinations/ variants thereof.
Methods: In order to …

Cast-Saw Burns: Evaluation Of Skin, Cast, And Blade Temperatures Generated During Cast Removal, Franklin D. Shuler Md, Frank N. Grisafi

Orthopaedics

Background: The use of an oscillating saw for cast removal creates a potential for iatrogenic injury and patient discomfort. Burns and abrasions can occur from the heat created by frictional forces and direct blade contact. With use of a cadaver model system, skin temperature measurements were recorded during cast removal with an oscillating saw.

Methods: Casts of uniform thickness were applied to cadavers equilibrated to body temperature. The casts were removed by a single individual while simultaneously measuring temperatures at the skin-padding interface, cast-padding interface, and the blade. Variables tested include two removal techniques, two casting materials (fiberglass and plaster), …

Physician’S Ability To Manually Detect Isolated Elevation In Leg Intracompartmental Pressure., Franklin D. Shuler Md, Matthew J. Dietz

Orthopaedics

Background: Serial physical examination is recommended for patients for whom there is a high index of suspicion for compartment syndrome. This examination is more difficult when performed on an obtunded patient and relies on the sensitivity of manual palpation to detect compartment firmness—a direct manifestation of increased intracompartmental pressure. This study was performed to establish the sensitivity of manual palpation for detecting critical pressure elevations in the leg compartments most frequently involved in clinical compartment syndrome.

Methods: Reproducible, sustained elevation of intracompartmental pressure was established in fresh cadaver leg specimens. Pressures tested included 20 and 40 mm Hg (negative controls) …

The Pseudomonas Aeruginosa Magnesium Transporter Mgte Inhibits Transcription Of The Type Iii Secretion System, Gregory G. Anderson, Timothy L. Yahr, Rustin R. Lovewell, George A. O'Toole

Dartmouth Scholarship

Pseudomonas aeruginosa is an opportunistic pathogen that causes life-long pneumonia in individuals with cystic fibrosis (CF). These long-term infections are maintained by bacterial biofilm formation in the CF lung. We have recently developed a model of P. aeruginosa biofilm formation on cultured CF airway epithelial cells. Using this model, we discovered that mutation of a putative magnesium transporter gene, called mgtE, led to increased cytotoxicity of P. aeruginosa toward epithelial cells. This altered toxicity appeared to be dependent upon expression of the type III secretion system (T3SS). In this study, we found that mutation of mgtE results in increased T3SS …

Anxiety And Depression Among Outpatients With Type 2 Diabetes: A Multi-Centre Study Of Prevalence And Associated Factors., Ali Khan Khuwaja, Saima Lalani, Raheem Dhanani, Iqbal Syed Azam, Ghazala Rafique, Franklin White

Department of Family Medicine

Background: Anxiety and depression contribute to poor disease outcomes among individuals with diabetes. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors including metabolic components among people with type 2 diabetes. Methods: We conducted a cross-sectional, multi-center study in four out-Patient clinics in Karachi, Pakistan. In all, 889 adults with type-2 diabetes were included in this study. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariable analysis using multiple logistic regression was carried out to evaluate the combined effect of various factors associated with anxiety and …

Psychiatric Comorbidity In Transformed Migraine: Presentation, Treatment, Impact And Outcome, Muhammad A. Abbas M.D, Haseeba Ismaiel, M.D, William B. Young M.D., Mary Hopkins, Stephen D. Silberstein, M.D

Jefferson Journal of Psychiatry

Transformed migraine is one of the subtypes of chronic daily headache (CDH), and is similar to chronic migraine, described in the new International Headache Society (IHS) classification 2004. The term CDH refers to the Headache disorders experienced 15 or more days a month and includes headaches associated with medication overuse. CDH can be divided into primary and secondary varieties. Primary CDH is not related to a structural or systemic illness. It includes diseases such as Transformed migraine (TM). Chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). Secondary CDH has an identifiable underlying cause, including post-traumatic …

Resident Teaching Expectations And Medical Student Feedback, Michael Ignatowski

Jefferson Journal of Psychiatry

Objective Much of resident teaching of medical students occurs in an informal manner, with bedside teaching a common focus. Hence, the ability to monitor such teaching is limited. Feedback about how students perceive the teaching is perhaps one way to more effectively monitor and influence resident teaching.

Ten Year Follow Up Of A Psychiatry Residency Program Merger, Alvi A. Azad, Julianne Flynn, Thomas Matthews, Kenneth Matthews, Joseph Chozinski

Jefferson Journal of Psychiatry

Objective: To report on the successful merger of a civilian and military psychiatry residency. Methods: The reasons for and the history of the merger between the University of Texas Health Science Center at San Antonio and Wilford Hall Air Force Medical Center psychiatry residencies is described. Results: After some false starts, a bottom-up approach was implemented by first merging seminars, then rotations. Conclusions: Combining two psychiatry residencies in order to capitalize on both their strengths can yield a product even greater than the sum of their two programs and the key to a lasting merger is to start with two …

2010 Newsmakers: Celebrating Our Own, Paul Mayne, Jason Winders

Vivian C. McAlister

How will we remember 2010? Probably through these faces. This year, the Western News starts a new, if not wholly original, tradition. Our Newsmakers 2010 section celebrates the best of research, academia and volunteer spirit that we have to offer on this campus. We spotlight, in brief words and striking images, the accomplishments of some of our favourites from the last year. One of the most powerful women in Canada. A student with an eye for the greater good. And a man who would do anything, including posing with a zebra, for the United Way. A football coach. A ground-breaking …

Conjugated Quantum Dots Inhibit The Amyloid Β (1–42) Fibrillation Process, Garima Thakur, Miodrag Micic, Yuehai Yang, Wenzhi Li, Dania Movia, Silvia Giordani, Hongzhou Zhou, Roger M. Levlanc

Department of Physics

Nanoparticles have enormous potential in diagnostic and therapeutic studies. We have demonstrated that the amyloid beta mixed with and conjugated to dihydrolipoic acid- (DHLA) capped CdSe/ZnS quantum dots (QDs) of size approximately 2.5 nm can be used to reduce the fibrillation process. Transmission electron microscopy (TEM) and atomic force microscopy (AFM) were used as tools for analysis of fibrillation. There is a significant change in morphology of fibrils when amyloid β (1–42) (Aβ (1–42)) is mixed or conjugated to the QDs. The length and the width of the fibrils vary under modified conditions. Thioflavin T (ThT) fluorescence supports the decrease …

Patient Perceptions Of Physician Empathy, Satisfaction With Physician, Interpersonal Trust, And Compliance, Mohammadreza Hojat, Daniel Z. Lewis, Kaye Maxwell, Fred Markham, Richard Wender, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

Objectives: This study was designed to investigate psychometric properties of the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and to examine correlations between its scores and measures of overall satisfaction with physicians, personal trust, and indicators of patient compliance.

Methods: Research participants included 535 out-patients (between 18-75 years old, 66% female). A survey was mailed to participants which included the JSPPPE (5-item), a scale for measuring overall satisfaction with the primary care physician (10-item), and demographic questions. Patients were also asked about compliance with their physician's recommendation for preventive tests (colonoscopy, mammogram, and PSA for age and gender …

Conformation Dependent Monoclonal Antibodies Distinguish Different Replicating Strains Or Conformers Of Prefibrillar Aβ Oligomers, Rakez Kayed, Isabel Canto, Leonid Breydo, Suhail Rasool, Tamas Lukacsovich, Jessica Wu, Ricardo Albay, Anna Pensalfini, Stephen Yeung, Elizabeth Head, J. Lawrence Marsh, Charles Glabe

Sanders-Brown Center on Aging Faculty Publications

BACKGROUND: Age-related neurodegenerative diseases share a number of important pathological features, such as accumulation of misfolded proteins as amyloid oligomers and fibrils. Recent evidence suggests that soluble amyloid oligomers and not the insoluble amyloid fibrils may represent the primary pathological species of protein aggregates.

RESULTS: We have produced several monoclonal antibodies that specifically recognize prefibrillar oligomers and do not recognize amyloid fibrils, monomer or natively folded proteins. Like the polyclonal antisera, the individual monoclonals recognize generic epitopes that do not depend on a specific linear amino acid sequence, but they display distinct preferences for different subsets of prefibrillar oligomers. Immunological …

A Comparative Study Of Embedded And Anesthetized Zebrafish In Vivo On Myocardiac Calcium Oscillation And Heart Muscle Contraction, Brian S. Muntean, Christine M. Horvat, James H. Behler, Wissam A. Aboualaiwi, Andromeda M. Nauli, Frederick E. Williams, Surya M. Nauli

Pharmacy Faculty Articles and Research

The zebrafish (Danio rerio) has been used as a model for studying vertebrate development in the cardiovascular system. In order to monitor heart contraction and cytosolic calcium oscillations, fish were either embedded in methylcellulose or anesthetized with tricaine. Using high-resolution differential interference contrast and calcium imaging microscopy, we here show that dopamine and verapamil alter calcium signaling and muscle contraction in anesthetized zebrafish, but not in embedded zebrafish. In anesthetized fish, dopamine increases the amplitude of cytosolic calcium oscillation with a subsequent increase in heart contraction, whereas verapamil decreases the frequency of calcium oscillation and heart rate. Interestingly, verapamil also …

Vitamin A Supplementation For Preventing Morbidity And Mortality In Children From 6 Months To 5 Years Of Age, Aamer Imdad, Kurt Herzer, Evan Mayo-Wilson, Mohammad Yawar Yakoob, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Vitamin A deficiency (VAD) is a major public health problem in low and middle income countries affecting 190 million children under 5. VAD can lead to many adverse health consequences, including death.
Objectives: To evaluate the effect of vitamin A supplementation (VAS) for preventing morbidity and mortality in children aged 6 months to 5 years.
Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2010 Issue 2), MEDLINE (1950 to April Week 2 2010), EMBASE (1980 to 2010 Week 16), Global Health (1973 to March 2010), Latin American and Caribbean Health Sciences (LILACS), metaRegister of Controlled …

Zinc Supplementation For The Prevention Of Pneumonia In Children Aged 2 Months To 59 Months, Zohra S. Lassi, Batool A. Haider, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background:Pneumonia is a leading cause of morbidity and mortality in children younger than five years of age. Most deaths occur during infancy and in low-income countries. Daily regimens of zinc have been reported to prevent acute lower respiratory tract infection and reduce child mortality.
Objectives: To evaluate the effectiveness of zinc supplementation in the prevention of pneumonia in children aged two to 59 months.
Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 2), which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to January Week 2, 2010), EMBASE …

Jefferson Kimmel Cancer Center Support Groups

Bodine Journal

Listing of Jefferson Kimmel Cancer Center Support Groups.

Research Department Of Radiation Oncology

Bodine Journal

Listing of Basic Research Studies/Grants and Clinical Research Studies/Grants.

Young Investigator Awards

Bodine Journal

Robert Den, MD, Laura Doyle, MS, Nitin Ohri, MD and Evan Wuthrick, MD

New Faculty Members

Bodine Journal

New faculty members: Voichita (Voika) Bar Ad, MD and Wenyin Shi, MD, PhD.

The Gucy2c Tumor Suppressor Is The Nexus Of A Paracrine Hormone Axis Preventing Radiotherapy-Induced Gastrointestinal (Gi) Toxicity, E. J. Wuthrick, P. Li, J. E. Lin, A. P. Dicker, D. Leeper, S. A. Waldman

Bodine Journal

Purpose/Objective: Radiation-induced GI toxicity is the primary dose limitation compromising therapy in cancer patients treated with radiation therapy. GUCY2C is the intestinal receptor for diarrheagenic bacterial enterotoxins and the endogenous paracrine hormones guanylin and uroguanylin. Following genomic insult, cyclic (c)GMP produced by ligand activation of GUCY2C enhances DNA damage sensing and repair in intestinal cells. Here, we show that the GUCY2C-cGMP axis mediates p53-dependent radioprotection of intestinal epithelial cells.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Departmental Information-Thomas Jefferson University, Jefferson Medical College, Department Of Radiation Oncology

Bodine Journal

Directory of Attending Physicians, Division of Molecular Radiology, Division of Medical Physics, Radiation Oncology Residents, Medical Physics Residents/Research Staff and Administration.

Chart Rounds In The Digital Age: A Survey Of North American Institutions, M. A. Whiton, A. P. Dicker, E. J. Wuthrick, L. Doyle, A. S. Harrison, Y. R. Lawrence

Bodine Journal

Purpose/Objective(s): In light of public concerns regarding the quality of radiation treatment delivery, we surveyed the utilization of “chart rounds” or peer-review quality assurance meetings, within North American academic institutions.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Potential For Dose-Escalation In The Post-Prostatectomy Setting With Intensitymodulated Radiation Therapy: A Dosimetric Study Using Eortc Consensus Guidelines For Target Volume Contours, M. Studenski, A. Harrison, S. Anamalayil, A. Harvey, E. Trabulsi, Y. Xiao, Y. Yu, A. P. Dicker, T. N. Showalter

Bodine Journal

Purpose: Radiation therapy (RT) is delivered after radical prostatectomy (RP) for prostate cancer (PC). Although intensity modulated radiation therapy (IMRT) has become standard in definitive RT for PC, dosimetric data in support of post-RP IMRT are limited. This study was designed to quantify benefits of IMRT versus 3D conformal RT (3DCRT) with respect to dose sparing of rectum and bladder and target volume coverage. Motivated by the desire to deliver higher radiation doses and to quantify the dosimetric impact of IMRT, we retrospectively analyzed images in order to: 1) identify a preferred IMRT beam arrangement; 2) evaluate the dosimetric advantages …

Costs Of Early Adjuvant Radiation Therapy After Radical Prostatectomy: A Decision Analysis, T. N. Showalter, K. A. Foley, E. Jutkowitz, C. Lallas, A. J. Harvey, E. J. Trabulsi, L. G. Gomella, A. P. Dicker, L. T. Pizzi

Bodine Journal

Purpose/Objective(s): Prospective, randomized trials support adjuvant radiation therapy (RT) for adverse pathologic features after radical prostatectomy (RP). However, adjuvant RT is not universally delivered in this setting. Criticisms of adjuvant RT include toxicity, financial costs, potential overtreatment, and effectiveness of salvage RT. The objective of this study was to construct a decision analytic model to estimate real world cost of RT vs. no RT within the context of the effectiveness of early adjuvant RT for prostate patients based on published clinical results of the Southwest Oncology Group prospective trial of adjuvant RT (SWOG 8794).

American Society for Therapeutic Radiation Oncology …

Mirab: An Image-Guided Multichannel Robot For Prostate Brachytherapy, T. Podder, I. Buzurovic, K. Huang, Y. Yu

Bodine Journal

Purpose: To date, twelve robotic systems have been developed worldwide for brachytherapy, especially for seed implantation. However, the only system that has provision for simultaneous insertion of multiple needles is the MIRAB system. This article reports the feasibility and efficacy of the MIRAB robot as ultrasound image-guided autonomous delivery of radioactive seeds for treating prostate cancers.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Intensity Modulated Radiation Therapy Compared With 3d Conformal Radiotherapy For Craniospinal Irradiation In Adults – Do We Gain Anything?, X. Shen, M. Studenski, A. Harrison, Y. Xiao, T. Biswas

Bodine Journal

Purpose: Craniospinal irradiation (CSI) remains one of the most technically challenging planning processes in radiation oncology due to its long shape especially in adults and complex target volume. In addition, CSI is associated with significant acute and late morbidities. We undertook a dosimetric analysis to determine if intensity modulated radiation therapy (IMRT) could improve target coverage while sparing normal tissue structures compared to classic 3D conformal radiation (3D‐CRT) planning.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Reirradiation For Recurrent Meningioma, N. Ohri, A. Wojcieszynski, J. J. Evans, D. W. Andrews, M. Werner-Wasik

Bodine Journal

Purpose/Objective(s): Management options for meningioma include observation, surgical resection, and radiation therapy (RT). In cases of progressive or recurrent disease after RT, similar options exist. The control rate following a second course of RT is unknown.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA