Medicine and Health Sciences Commons^™

Who Helps Our Helpers? Rediscovering Joy In Medicine By Addressing Secondary Trauma, Donald M. Friedman, Md, Vic Compher, Mss, Lcsw

Department of Medicine Posters

Poster presented at International Conference of Physician Health in Boston Massachusetts.

Supplementary handout with definitions and extensive bibliography available at bottom of page.

Film is basis for poster: Portraits of Professional Caregivers-Their Passion. Their Pain (click on picture to view movie trailer)

Quotes about movie from IMDB

Learning objectives

1. Become more aware of what secondary trauma is and its prevalence in health care professionals

2. Recognize the importance of personal wellness and intentional self-care by physicians and other allied professionals

3. Encourage the development of medical systems in the formation of effective peer support structures

Context/background

The documentary filmmaker, …

Cannabinoid Receptor Type-2 Modulates Nociceptive Signaling Molecules In A Model Of Post-Concussion Headache, Jarred M. Stratton, Lan Cheng, Ashley L. Tyburski, Jessica Perino, Melanie B Elliott

Department of Neurosurgery Posters

Abstract

The goal of this study was to investigate the role of the cannabinoid receptor type-2 (CB₂R) in the trigeminal pain pathway in a model of post-concussion headache. Sprague Dawley rats were randomized to receive either a repeated mild closed head injury (CHI) or served as incision controls. Changes in CGRP, nNOS, and IBA-1 were assessed in the trigeminal nucleus caudalis (TNC) and trigeminal ganglia via IHC. A subset of CHI rats received either a cannabinoid receptor type 2 (CB₂R) anti-inflammatory agonist (JWH133), an NSAID (Ketorolac), or vehicle and underwent von Frey testing for trigeminal allodynia. …

Use Of Propensity Score Matching To Identify A Strong Association Between Health Care Provider Advice Not To Smoke And Quit Attempts Among Mid-Adolescent Smokers, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background:

• Nearly 1 out of 7 U.S. adolescents is a current cigarette smoker by the time they leave high school. ¹
• Although almost one third of adolescents who saw a healthcare provider in the past month were advised to quit or avoid tobacco,² research on the influence of provider advice on quit attempts among adolescent smokers has shown mixed results. ³
• These results may be due to selection bias—adolescent smokers who get advice may be different from those who do not on a range of factors including age of initiation, smoking frequency, attitudes toward smoking, exposure to other anti-tobacco …

Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria For The Allocation Of Dual Kidneys In Adults, Jill N. D'Souza, Md, Katherine Mckee-Cole, Md, Abigail Strang, Md, Patrick Barth, Md, Aaron Chidekel, Md, Udayan Shah, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract:

Objective The recognition of wound-related complications following pediatric tracheotomy is on the rise. These complications can have a significant impact on clinical course as well as on hospital healthcare costs to the tracheotomy dependent child and family

Methods A tracheotomy database was created in 2000 and reviewed for incidence of major and minor complications.

Setting Tertiary Care Pediatric Referral Center

Results We identified a post-tracheotomy complication rate of 19.9%, of which the most common complication was wound breakdown (65% of complications).

Conclusion Rate of post-tracheotomy wound-care complications is 12.9%. Wound description is subjective and prone to inter-observer variability. A …

Role Of Target Specific Oral Anticoagulation After Operative Management Of Venous Thoracic Outlet Syndrome, Jeontaik Kwon, Md, Paul J. Dimuzio, Md, Babak Abai, Md, Dawn Salvatore, Md, Taki Galanis, Md, Geno J. Merli, Md, Luis H. Eraso, Md

Department of Surgery Posters

Background:

The purpose of this study is to review the efficacy of Target Specific Oral Anticoagulants (TSOAC) versus vitamin K antagonist (VKA) for post-surgical anticoagulation in patient with primary subclavian vein thrombosis. Rivaroxaban, a factor Xa inhibitor, was the first TSOAC approved by the FDA in 2012 for the treatment and prevention of deep vein thrombosis. However, the efficacy and safety of TSOAC for prevention of recurrent deep vein thrombosis after revascularization of upper extremity compression syndromes is largely unknown.

Effects Of Preoperative Aspirin On Major Outcomes In Graded High-Risk Patients Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Jordan E. Goldhammer, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Among patients with cardiovascular disease, nearly 70% take preventive aspirin.¹
• The benefits of aspirin are greater as a patient’s risk of cardiovascular events increases; patients with a lower risk of cardiovascular events derive less of a benefit from aspirin.²
• The effect of aspirin in surgical patients has not yet been investigated, in particular if there is an optimal effect based on operative risk when undergoing cardiac surgery.

Objective:

To determine the effects of preoperative aspirin on major outcomes after cardiac surgery in patients with low, medium, and high predicted operative mortality as determined by the EuroSCORE risk …

Preoperative Aspirin And Major Perioperative Outcomes In Patients With Hypertension Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Hypertension is prevalent in patients undergoing cardiac surgery and associated with a higher incidence of cardiovascular complications.
• Aspirin has been shown to prevent cardiovascular events in patients with a high risk of cardiovascular disease.
• Very few studies have investigated aspirin and hypertension, particularly its effects on major outcomes in hypertensive patients undergoing cardiac surgery.^1,2

Objective

To determine the effects of preoperative aspirin on postoperative outcomes for patients with hypertension undergoing cardiac surgery.

To examine the impact of chronic kidney disease and heart failure superimposed with hypertension on outcomes after cardiac surgery.

Benefits Of Wireless Telephone Technologies For Bilaterally Implanted Adults, Louisa Liang, Au.D., Paula Marcinkevich, Au.D.

Department of Otolaryngology - Head and Neck Surgery Posters

Introduction

Cochlear implant (CI) recipients often have difficulty conversing on the telephone, particularly in noise. Successful use of landline and cellular telephones also can be limited because of less-than-optimal phone placement with respect to the sound processor microphone. One solution for recipients of Advanced Bionics cochlear implants may be the use of new streaming technologies from Phonak to improve the ability to talk on the phone. In addition to reducing interference caused by noise, use of these technologies is not strictly placement-dependent and also allows bilateral/bimodal recipients to take advantage of hearing with two ears.

The primary objective of this …

Patient Perception Of Telehealth Primary Care Video Visits, Rhea E. Powell, Md, Mph, Jeffrey Henstenburg, Bs, Grace Cooper, Ba, Judd Hollander, Md, Kristin L. Rising, Md, Ms

Department of Medicine Posters

Introduction

• Telehealth (TH) is an innovative model of care delivery with potential to provide more patient-centered healthcare, allowing patients to receive care when and where is most convenient.
• To date, little is known about patient perceptions of receiving care with the use of TH video visits.

An Evaluation Of A Sexual Health Education Program For Adolescents In A Residential Treatment Program In The Philadelphia Area, Rachel Powell (Student), P. Smith, Amy Leader

College of Population Health Posters

BACKGROUND

The US is currently experiencing an epidemic; millions of American adolescents are affected by sexually transmitted diseases (STDs), teen pregnancy and intimate partner violence (IPV), costing the country both socially and economically:

• Adolescents 15-24 years of age account for 50% of the 20 million new STD cases each year
• US birth rates are significantly higher than countries in Europe
  • 6.8 times higher than teens living in the UK
  • 13.9 times higher than teens living the EU
• In 2010 18.7% of adolescents ages 11-17 experienced IPV for the first time
• Adolescents who are diagnosed with an STD, are teen parents …

Sonographic Findings Of A Semi-Professional Football Player With 1st Mtp Joint Pain: Gout Or Turf Toe?, David Jeong, Md, Caqsm, Cep, Rmsk, Danielle Snyderman, Md, Lauren Hersh, Md, Jeremy Close, Md

Department of Family & Community Medicine Posters

Purpose

Aim : To review the applications and indications of sonography for forefoot disorders, especially gout and plantar plate injury of 1^st MTP joint.

Introduction

• Forefoot disorders are common but forefoot ultrasound is underutilized.
• Point-of-Care Ultrasound was utilized in initial workup evaluating acute on chronic 1^st MTP joint pain in our case study.

Detection Of Circulating Tumor Cells In Uveal Melanoma By The Photoacoustic Method, Ryan M. Weight, Shingo Sato, Masahiro Ohara, Mizue Terai, Michael Mastrangelo, Marlana Orloff, Benjamin Goldschmidt, John Viator, Takami Sato

Department of Medical Oncology Posters

Abstract

Circulating tumor cells (CTCs) have been shown to be a prognostic marker in breast cancer¹. We hypothesize that circulating melanoma cell (CMC) detection could be utilized in the management of uveal melanoma, including early intervention. Prior methodologies for circulating uveal melanoma cell (CUMC) detection have been fraught with poor sensitivity, limiting their clinical utility². Development of an improved method is necessary to establish the clinical utility of CUMC monitoring. Photoacoustics, also referred to as laser-induced ultrasound, is a novel platform for the detection and capture of CMCs. Photoacoustics uses short duration pulsed light to create …

Dsg2 Increases Exosome Release And Enhances Egfr/C-Src Content: A Mechanism For Intercellular Mitogenic Effect, Andrew M. Overmiller, Jennifer A. Pierluissi, Peter J Wermuth, Ubaldo E. Martinez-Outshoorn, Md, Madalina Tuluc, Adam J. Luginbuhl, Joseph Curry, Larry A. Harshyne, James K. Wahl, Iii, Andrew P. South, M G Mahoney

Department of Dermatology and Cutaneous Biology Posters

Abstract:

Exosomes are nanoscale membrane-derived vesicles that are secreted by cancer cells and play a critical role in modulating the tumor microenvironment and disease pathogenesis. Dsg2, a desmosomal cadherin often overexpressed in skin malignancies including squamous cell carcinoma (SCC), can activate EGFR/c-Src signaling and promote oncogenesis. We sought to address the potential role of Dsg2 in exosome biogenesis and intercellular signaling in SCC. Here, purified exosomes from SCC cells and head/neck SCC patient sera were enriched with a processed 65 kDa membrane-associated C-terminal fragment of Dsg2. Cells overexpressing Dsg2 had increased exosome release and protein content and produced particles enriched …

Association Between Knowledge And Performance In Clerkships And Usmle Step 2 Ck Scores: Implications For Counseling And Academic Decision-Making, Abigail Kay, Md, Kristin Desimone, Md, Jon Veloski, Ms, Steven Herrine, Md

Department of Family & Community Medicine Posters

Background

Step 2 CK scores are of increasing importance in medical student career planning. In the National Resident Matching Program 2014 Program Director Survey, Step 1 scores were the highest-rated among 33 factors used in screening applicants to be interviewed (94% cited it with a mean rating of 4.1 on a 5 point Likert scale); Step 2 scores were rated fourth in importance (80% cited it, mean rating of 4.1). When citing factors for ranking a given applicant, Step 1 scores ranked 5^th (80% cited, with mean rating of 4.1) and Step 2 CK scores ranked 7^th (71% …

Use Of Propensity Score Matching To Identify A Strong Association Between Strategic Concentration To Mitochondria-Sr Associations Of The Mitochondrial Ca2+ Uniporter: Ca2+ Uptake Hotspots In The Cardiac Mitochondria, Sergio De La Fuente, Caitlin Vail, Elorm J. Agra, Kira Holmstrom, Junhui Sun, Jyotsna Mishra, Toren Kinkel, Elizabeth Murphy, Suresh K. Joseph, Shey-Shing Shen, György Csordás

Department of Pathology, Anatomy, and Cell Biology Posters

Introduction:

• Control of the mitochondrial ATP production by SR-derived Ca²⁺ signals includes local, nanodomain Ca²⁺ transfer from ryanodine receptors (RyR2) to the mitochondrial matrix (excitation-bioenergetics coupling).
• Ca²⁺ crosses the inner mitochondrial membrane (IMM) via the mtCU, a low-affinity Ca²⁺-activated Ca²⁺ channel complex.
• The surface area of cardiac IMM is extensively enhanced by cristae folding; however, mitoplast patch clamp studies showed mtCU current density the lowest amongst a range of tissues (Fieni 2012. Nat Commun).

Gaining Competencies During Early Medical Training: Medical Students As Teaching Assistants In Dissection-Based Anatomy Course, Martin T. Brown, Bruce Fenderson, Guiyan Zhang

Department of Pathology, Anatomy, and Cell Biology Posters

Introduction and Objectives

• In 2002, ACGME identified six ACGME Core Competencies: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice.
• AAMC recommended lists of similar competencies for the curricula of medical schools. Competency based curricula have been widely implemented in medical schools.
• Effective shifting in the graduate medical educational programs has been reported in various clinical specialties.
• There is a lack of reported efforts and development on competency training in early preclinical years of medical education.

Objectives:

• To explore methods for strengthening medical students’ competency training during preclinical undergraduate medical education.
• To measure …

Rare Case Of Large Adrenal Mass, Anitha Somasundaram, Md, Edward B. Ruby, Md

Department of Neurosurgery Posters

Background:

Giant hemangiomas of the adrenal gland are very rare. We present a case of giant adrenal hemangioma presenting as adrenal incidentaloma.

Health Care Providers Advice Not To Smoke And Quit Attempts Among Mid-Adolescent Smokers, Russell K. Mcintire, Phd, Mph

College of Population Health Posters

Background

• Nearly 1 out of 7 U.S. adolescents is a current cigarette smoker by the time they leave high school. ¹
• Although almost one third of adolescents who saw a healthcare provider in the past month were advised to quit or avoid tobacco,² research on the influence of provider advice on quit attempts among adolescent smokers has shown mixed results. ³
• These results may be due to selection bias—adolescent smokers who get advice may be different from those who do not on a range of factors including age of initiation, smoking frequency, attitudes toward smoking, exposure to other anti-tobacco …