Medicine and Health Sciences Commons^™

Collagen Fibrils And Proteoglycans Of Peripheral And Central Stroma Of The Keratoconus Cornea - Ultrastructure And 3d Transmission Electron Tomography, Aljoharah Alkanaan, Robert J. Barsotti, Omar Kirat, Adnan Khan, Turki Almubrad, Saeed Akhtar

PCOM Scholarly Papers

Keratoconus (KC) is a progressive corneal disorder in which vision gradually deteriorates as a result of continuous conical protrusion and the consequent altered corneal curvature. While the majority of the literature focus on assessing the center of this diseased cornea, there is growing evidence of peripheral involvement in the disease process. Thus, we investigated the organization of collagen fibrils (CFs) and proteoglycans (PGs) in the periphery and center of KC corneal stroma. Three-dimensional transmission electron tomography on four KC corneas showed the degeneration of microfibrils within the CFs and disturbance in the attachment of the PGs. Within the KC corneas, …

Mta3 Represses Cancer Stemness By Targeting The Sox2ot/Sox2 Axis, Liang Du, Lu Wang, Jinfeng Gan, Zhimeng Yao, Wan Lin, Junkuo Li, Yi Guo, Yuping Chen, Fuyou Zhou, Sai-Ching Jim Yeung, Robert P Coppes, Dianzheng Zhang, Hao Zhang

PCOM Scholarly Papers

Cancer cell stemness (CCS) plays critical roles in both malignancy maintenance and metastasis, yet the underlying molecular mechanisms are far from complete. Although the importance of SOX2 in cancer development and CCS are well recognized, the role of MTA3 in these processes is unknown. In this study, we used esophageal squamous cell carcinoma (ESCC) as a model system to demonstrate that MTA3 can repress both CCS and metastasis in vitro and in vivo. Mechanistically, by forming a repressive complex with GATA3, MTA3 downregulates SOX2OT, subsequently suppresses the SOX2OT/SOX2 axis, and ultimately represses CCS and metastasis. More importantly, MTA3

Validation Of A 5-Item Tool To Measure Patient Assessment Of Clinician Compassion In The Emergency Department., Praveen Sabapathi, Michael B. Roberts, Brian M Fuller, Michael A Puskarich, Christopher W Jones, J Hope Kilgannon, Valerie Braz, Christina Creel-Bulos, Nathaniel Scott, Kristina L Tester, Anthony Mazzarelli, Stephen Trzeciak, Brian W Roberts

PCOM Scholarly Papers

BACKGROUND: To test if the 5-item compassion measure (a tool previously validated in the outpatient setting to measure patient assessment of clinician compassion) is a valid and reliable tool to quantify a distinct construct (i.e. clinical compassion) among patients evaluated in the emergency department (ED).

METHODS: Cross-sectional study conducted in three academic emergency departments in the U.S. between November 2018 and April 2019. We enrolled adult patients who were evaluated in the EDs of the participating institutions and administered the 5-item compassion measure after completion of care in the ED. Validity testing was performed using confirmatory factor analysis. Cronbach's alpha …

Pcom Georgia Do Class Of 2024 Composite Sheet, Philadelphia College Of Osteopathic Medicine

Class Composite Sheets

PCOM Georgia DO Class of 2022 student portraits, matriculating Fall 2019.

Use Of Integra For Reconstruction After Nevi Resection: A Systematic Review And Pooled Analysis Of Reported Cases, Jude Opoku-Agyeman, Kayla Humenansky, Wellington Davis Iii, Paul Glat

Plastic Surgery Resident Research

BACKGROUND:

The use of Integra Dermal Reconstruction Template has emerged as an option for wound reconstruction, after resection of congenital nevi, especially giant congenital nevi. There have been many reports on Integra use in the literature for this purpose. This systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes.

METHODS:

Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Studies were analyzed if they met the inclusion criteria. Pooled …

Pcom Georgia Do Class Of 2023 Composite Sheet, Philadelphia College Of Osteopathic Medicine

Class Composite Sheets

PCOM Georgia DO Class of 2023 student portraits, matriculating Fall 2019.

Revisiting The Expanded Use Of Hyperbaric Oxygen Therapy For Treatment Of Resistant Migraines, David V Matera, Brian Smith, Benjamin Lam

PCOM Scholarly Papers

There are currently 13 indications approved by the U.S. Food and Drug Administration for use of hyperbaric oxygen therapy. The European Consensus Conference on Hyperbaric Medicine has 28 indications approved for its use. However, neither includes the use of hyperbaric oxygen therapy for neurological conditions such as migraines with aura. Recent research has made the attempt to fully understand the use of hyperbaric therapy in treatment of neurological conditions, but results have so far been inconclusive. We report a 23-year-old female with an 11-year history of migraines with aura who has received inadequate pharmacological treatment for her migraines since she …

An Unusual Presentation Of Subglottic Stenosis Necessitating Urgent Tracheostomy, Jacob Burdett, Alexander Manteghi

Otolaryngology (ENT) Resident Research

By definition, the subglottis is the area of the larynx immediately below the vocal folds extending to the level of the inferior border of the cricoid cartilage. This area represents the narrowest portion of the pediatric airway and is the most common site of iatrogenic stenosis. This stenosis is generally secondary to increased rates of intubation in infants of prematurity. Evaluation and treatment for subglottic stenosis represents one of the most common airway consultations within pediatric otolaryngology. Goals of therapy include securing a safe airway and restoring subglottic patency. In this clinical case, we present a unique pattern and presentation …

Surgical Configurations Of The Pectoralis Major Flap For Reconstruction Of Sternoclavicular Defects: A Systematic Review And New Classification Of Described Techniques, Jude Opoku-Agyeman, David Matera, Jamee Simone

Plastic Surgery Resident Research

The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. We also provide an algorithm for the selection of these flap variants for sternoclavicular defect reconstruction.

METHODS:

EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to August …

The Role Of Autophagy In Myocardial Ischemia/Reperfusion Injury In Isolated Rat Hearts, Aloysius C. Ibe Ii

PCOM Biomedical Studies Student Scholarship

Autophagy is a housekeeping process used to remove damaged cytoplasmic constituents and protein aggregates. However, a debate persists on whether autophagy is beneficial or detrimental when an ischemic/reperfusion (I/R) insult occurs in the heart. This study tested the effects of autophagy enhancers (rapamycin and trehalose) and an autophagy inhibitor (3-methyladenine) on cardiac function and infarct size after global ischemia (30 minutes) and reperfusion (45 minutes) when given prior to ischemia (pre-treatment) or at the beginning of reperfusion (post-treatment). Rapamycin (25nM) pre-treatment and post-treatment significantly restored final left ventricular developed pressure (LVDP) to 75.4±9.1% and 60±5% of initial baseline respectively (both …

An Interesting Secondary Airway Lesion In An Infant With Laryngomalacia, William L. Valentino, David Lafferty, Alexander Manteghi

Otolaryngology (ENT) Resident Research

A 2-month-old male with a prior diagnosis of laryngomalacia (LM) presented to the emergency department in respiratory distress with worsening inspiratory stridor, suprasternal retractions, and a dry cough. A chest X-ray and lateral neck radiograph were performed and demonstrated no abnormalities. Flexible laryngoscopy revealed the same, previously observed moderately prolapsed arytenoids and an omega-shaped epiglottis with shortened aryepiglottic (AE) folds. He also had a right lower neck mass. He was scheduled for a direct laryngoscopy and bronchoscopy (DLB) and supraglottoplasty. During the DLB, LM and anterior compression of the midtrachea was noted. Lysis of the AE folds was performed in …

A Renal Cell Carcinoma With Biallelic Somatic Tsc2 Mutation: Clinical Study And Literature Review., Jian Pang, Linang Wang, Jing Xu, Qiubo Xie, Qiuli Liu, Dali Tong, Gaolei Liu, Yiqiang Huang, Xingxia Yang, Jinhong Pan, Xiaochu Yan, Qiang Ma, Dianzheng Zhang, Jun Jiang

PCOM Scholarly Papers

OBJECTIVES: To elucidate the effect of the biallelic somatic TSC2 mutations, identified in one adolescent patient, in renal cell carcinoma (RCC).

METHODS: Mutation analyses, immunohistochemistry and real-time polymerase chain reaction (PCR) were conducted.

RESULTS: Two novel somatic mutations of TSC2 in unilateral and solitary RCC samples from a 14-year-old female were identified. The pathological features suggest the tumor as a clear-cell renal cell carcinoma. In addition, immunohistochemistry revealed elevated levels of phosphorylated S6K1. Results from in vitro cellular experiments suggest that the mutant TSC2 proteins were quickly degraded and they failed to repress the phosphorylation of S6K1 and STAT3, which …

Preview Pal: Multimodal Learning Modules Devised To Facilitate Learning And Advance Metacognition In Graduate Students, Cierra Lewis

PCOM Biomedical Studies Student Scholarship

A student may possess the necessary skills to enter graduate level programs but may still struggle with metacognition and self-directed learning. The focus of this study is to provide targeted resources to graduate level students that will both facilitate learning and guide advancement of metacognitive skills. The general study design included the creation of digital learning modules for a single course, their distribution to students as well as the evaluation of student access and course performance. The learning modules, designated ‘Preview Pal’, were structured to creatively engage learners with varied learning style preferences in order to benefit all students in …

Comparing The Efficacy Of Pharmacological Preconditioning With Myristic Acid-Conjugated, Tat- Conjugated And Native Protein Kinase C Epsilon Peptide Activator In Myocardial Ischemia/Reperfusion (Mi/R) Models, Anahi Mcintyre

PCOM Biomedical Studies Student Scholarship

Protein kinase C epsilon (PKCε) activation is a central mediator of the cardioprotection conferred by myocardial ischemic preconditioning (IPC). PKCε activation via PKCε peptide activator (PKCε+, HDAPIGYD) prior to ischemia is a pharmacologic mimic of IPC. However, native PKCε+ requires the use of cell permeabilization methods, such as conjugation to known carrier peptides, for effective intracellular targeting to mitigate cardiac damage. Our study compares PKCε+ conjugated to either myristic acid (Myr- PKCε+) or transactivating (TAT) carrier peptide (YGRKKRRQRRR-CC- PKCε+) with native PKCε+ pretreatment and untreated control I/R hearts to evaluate the efficacy of these cell permeable peptide analogs in attenuating …

Quinolone Allergy, Edoabasi U. Mcgee, Essie Samuel, Bernadett Boronea, Nakoasha Dillard, Madison N Milby, Susan J Lewis

PCOM Scholarly Papers

Quinolones are the second most common antibiotic class associated with drug-induced allergic reactions, but data on quinolone allergy are scarce. This review article discusses the available evidence on quinolone allergy, including prevalence, risk factors, diagnosis, clinical manifestations, cross-reactivity, and management of allergic reactions. Although the incidence of quinolone allergy is still lower than beta-lactams, it has been increasingly reported in recent decades, most likely from its expanded use and the introduction of moxifloxacin. Thorough patient history remains essential in the evaluation of quinolone allergy. Many diagnostic tools have been investigated, but skin tests can yield false-positive results and in vitro …

Topography Study Of Fixa: Generation Of A Lipid Anchored Molecular Ruler With Attached Inhibitor, Nickolas P. Buchanan

PCOM Biomedical Studies Student Scholarship

Blood coagulation, an important hemostatic property, is directed through activation of proteolytic enzymes known as serine proteases to generate a fibrin plug. Using multiple proteases allows for localized and precise regulation of blood coagulation within the circulatory system. Factor IX, a serine protease, is a key activator in the coagulation cascade by activating Factor X. For activation of FX to occur, FIXa must be in proper conformation on the platelet surface with cofactor FVIIIa to increase enzymatic abilities of FIXa a billion-fold. Current research looks at structure and function of FIXa yet neglects structural plasticity on the membrane, with function …

Effect Of Acute Ingestion Of Green Tea Extract And Lemon Juice On Oxidative Stress And Lipid Profile In Pigs Fed A High-Fat Diet., Xi Fang, Michael Azain, Kristi Crowe-White, Jennifer Mumaw, Janet A Grimes, Chad Schmiedt, Michele Barletta, Srujana Rayalam, Hea Jin Park

PCOM Scholarly Papers

Green tea and its catechins have been shown to ameliorate high fat diet-induced oxidative stress and hyperlipidemia. However, low bioavailability of catechins limits their therapeutic potential. Lemon juice (LJ) has been suggested to enhance the bioavailability of catechins in vitro. This study investigated the antioxidative and hypolipidemic efficacy of a single dose of green tea extract (GTE) or GTE plus LJ (GTE + LJ) in high-fat diet fed pigs. Sixteen pigs ingested a single dose of GTE (190 mg/kg/day) or GTE + LJ (0.75 mL/kg/day) mixed with low-fat (LF; 5% fat) or high-fat (HF; 22% fat) diets and blood samples …

Outcome Of Pharmacists’ Counseling Infusion Center Patients On Chemotherapy, Sonia Amin Thomas, Kayla Waymyers

Research Day

Patient education for patients getting chemotherapy is vital to their survival. The purpose of this study is to discuss the outcomes of counseling patients in an infusion center getting chemotherapy in terms of impact on quality of life, satisfaction and emergency room visitations. This study was conducted to determine patient satisfaction after being counseled by a pharmacist and if hospitalizations were prevented after education by a pharmacist.This was a single center, prospective, survey-based study at a small community hospital infusion center that consists of approximately five chairs. The study consisted of 15 patients, over the course of six months (April-October …

Use Of Atypical Antipsychotics In Prolonged Mechanical Ventilation Related Anxiety, Leanne Honeycutt Varner, Irandokht Khaki Najafabadi, Megan Boudouin, Terri Tenhoor, Laverne Patterson

Research Day

Anxiety should be a key factor for consideration in an inpatient setting, especially for those in the intensive care unit or any patient requiring long term mechanical ventilation. A multidisciplinary team from Dekalb Medical created a therapist driven protocol for prolonged mechanical ventilation weaning, which requires patients to be evaluated for ventilation associated anxiety. Presented here is a case of a 57-year-old African American female who reported to with a chief complaint of respiratory failure. Upon further investigation by the medical team, she was noted to be in hypercapnic respiratory failure and was initially treated with Bilevel Positive Airway Pressure …

Medication Use Evaluation Of Intravenous Acetaminophen In Surgical Patients, Irandokht Khaki Najafabadi, Duy Vu, Hyeseung Kang, Samuel N. John, Hua Ling

Research Day

Purpose: Intravenous acetaminophen was introduced to the WellStar North Fulton hospital formulary in February 2018. Hospital protocol restricts intravenous acetaminophen use to 24 hours doses in postoperative patients who are not candidates for non-steroidal anti-inflammatory drug (NSAID) therapy for the relief of mild to moderate pain, in order to reduce opioid utilization in the operative setting. The main purpose of this study was to evaluate the compliance with restrictions for use of intravenous acetaminophen among surgical patients at our institution.

Methods: The electronic health record system was used to identify surgical patients who received at least one dose …

Allicin Reverses Diabetes-Induced Dysfunction Of Human Coronary Artery Endothelial Cells, Daniel Horuzsko, Margeaux Lacavera, Handong Ma, Yan Wu, Shu Zhu, Richard E. White

Research Day

Cardiovascular disease (CVD) is the leading cause of death in the United States, and is the major source of morbidity and mortality associated with diabetes mellitus. Because the incidence of diabetes continues to increase, reducing the risk of CVD in diabetes will continue to be a major focus of cardiovascular research. An early manifestation of diabetes-induced CVD is dysfunction of the vascular endothelium, as indicated by depressed production of NO. Our findings now demonstrate depressed activity of endothelial nitric oxide synthase (eNOS) in diabetes, and suggest that treating human coronary artery endothelial cells with allicin, the major bioactive organosulfur component …

Medication Use Evaluation Of Human 4-Factor Prothrombin Complex Concentrate (Pcc), Lauren Avery, Duy Vu, Hua Ling

Research Day

Purpose: To evaluate appropriate usage of 4-factor PCC based on indication and dosage in patients requiring urgent anticoagulation reversal experiencing a life-threatening bleed, or preparing for an invasive procedure/surgery at WellStar North Fulton Hospital.

Methods: The electronic health record system will identify patients who have received at least one dose of 4-factor PCC. Patient name and medical record number will be de-identified and excluded from data collection. The following data will be collected: patient age, gender, indication, specific agent being reversed (if available), dosage, total number of doses given, location of bleed, 30 minute INR differential, other factors …

Muscle Circumference And Tendon Width Correlation In Rotator Cuff Tears, Michael Marcinko, Michael Bamimore, Mark Ujevic

Research Day

Introduction: Rotator cuff tears are a common pathology presenting in much of the population especially those with repetitive overhead activity. There are many papers that looked at the supraspinatus as the most commonly torn rotator cuff muscle, however, there is a lack of research on the correlation between muscle morphology and injury. This was the framework for our anatomical study using cadavers, in which the circumference of the muscle bellies and tendon widths of the supraspinatus and infraspinatus muscles were measured.

Methods: 27 Cadavers provided by the Physician assistant program and first-year Osteopathic students in their respective anatomy …

Protein Kinase C Beta Ii Peptide Inhibitor Elicits Robust Effects On Attenuating Myocardial Ischemia/Reperfusion Injury, Daphne Metellus, Christina Lipscombe, Chinyere Ebo, Arjun Nair, Harsh Patel, Annam Humayun, Jennifer Dang, Megan Michaels, Matthew Finnegan, Lucy Checchio, Faosat Muftau-Lediju, Faosat Martorana, Anahi Mcintyre, Qian Chen, Robert J. Barsotti, Lindon H. Young

Research Day

Reperfusion injury contributes to myocardial tissue damage following a heart attack partly due to the generation of reactive oxygen species (ROS) upon cardio-angioplasty. Protein kinase C beta II (PKCβII) inhibition during reperfusion with peptide inhibitor (N-myr-SLNPEWNET; PKCβII-) decreases ROS release and leukocyte infiltration in rat hind-limb and myocardial ischemia/reperfusion (I/R) studies, respectively. However, the role of activating PKCβII during reperfusion has not been previously determined. In this study, we hypothesize that myristoylated (myr)-PKCβII- will decrease infarct size and improve post-reperfused cardiac function compared to untreated controls, whereas PKCβII peptide activator (N-myr-SVEIWD; myr-PKCβII+) will show no improvement …

The Effects Of Protein Kinase C Beta Ii Peptide Modulation On Superoxide Release In Rat Polymorphonuclear Leukocytes, Christina Lipscombe, Chinyere Ebo, Daphne Metellus, Jennifer Dang, Annam Humayun, Arjun Nair, Harsh Patel, Megan Michaels, Matthew Finnegan, Lucy Checchio, Faosat Muftau-Lediju, Faosat Martorana, Qian Chen, Robert J. Barsotti, Lindon H. Young

Research Day

Phorbol 12-myristate 13-acetate (PMA; a diacylglycerol mimetic) is known to augment polymorphonuclear leukocyte (PMN) superoxide (SO) release via protein kinase C (PKC) activation. However, the role of PKC beta II (βII) mediating this response is not known. It’s known that myristic acid (myr-) conjugation facilitates intracellular delivery of the cargo sequence, and that putative PKCβII activator and inhibitor peptides work by augmenting or attenuating PKCβII translocation to cell membrane substrates (e.g. NOX-2). Therefore, we hypothesize that myr- conjugated PKCβII peptide-activator (N-myr-SVEIWD; myr-PKCβ+) would increase PMA-induced rat PMN SO release, whereas, myr-PKCβII peptide-inhibitor (N-myr-SLNPEWNET; myr-PKCβ-) would attenuate this response compared to …

A Case Report: The Myxomatous Mystery, Joseph Kim, Nicole P. Pantle, Jacquelyn E. Fisher

Research Day

Introduction: Primary cardiac tumors are rare with an incidence rate of 1.38 new cases per 100,000 individuals per year. Of these tumors, 75% are benign in origin and the most common type is a myxoma with a frequency of over 50%. Myxomas most commonly arise from the left atrium followed by the right atrium. Clinical presentation of a myxoma varies depending on the location, size, and shape of the tumor. For example, a patient diagnosed with a myxoma may have constitutional symptoms, cardiovascular symptoms, pulmonary symptoms etc. or may be entirely asymptomatic. Since there is no specific symptoms presented …

Colorectal Cancer In Patients Under Age 50: Staging And Mortality At A Single Institution, Jaclyn Malat, Sarah Martin, Adrian Ong, Michael Brown

Research Day

Objective: The aim of this study is to compare stage and mortality in colorectal cancer (CRC) patients above and below age 50. We hypothesize that patients under age 50 will be diagnosed at a higher stage and have a lower mortality rate. Reports show an increase in CRC diagnoses in younger patients, however, data on this patient population is limited and further investigation is required.

Methods: A 20-year review of electronic medical records was completed from 1997 to 2017 of all patients diagnosed with CRC. This data was aggregated and univariate analysis was performed.

Results: Of the …

The Effects Of Metformin, Aminoguanidine, And Pyridoxamine On Methylglyoxal Induced Cardiac Myocyte Injury, Amanda Harvey, Rose Martorana, Julia Colangeli, Hafsa Ahmed, Dean Delgado, Alisa Kim, Robinderpaul Sandhu, Robert J. Barsotti, Lindon H. Young, Qian Chen

Research Day

Advanced glycation end (AGE) products have been under investigation for their role in cardiovascular disease in complications. Methylglyoxal, a byproduct of glucose metabolism, is elevated in the blood of diabetic patients and has shown to be an important intermediate in the production of AGEs. Due to the highly reactive structure of methylglyoxal, it can produce high levels of reactive oxygen species (ROS) within the cell via mitochondrial modification which results in a loss of cell membrane potential and possible cell death. The role of methylglyoxal in cardiac cells is not well known; in this study methylglyoxal induced cell injury and …

Renal Epithelioid Angiomyolipoma: Genomic Characterization And Malignant Potential, Alan Wang, Kyle A. Blum, Jonathan Coleman, Paul Russo, A. Ari Hakimi

Research Day

Introduction:

Renal angiomyolipoma (AML) is one of the most common benign kidney tumors diagnosed. Epithelioid angiomyolipoma (eAML) is a rare variant of these kind of masses that have been classified by the World Health Organization as a potentially malignant mesenchymal neoplasm that metastasizes in one-third of cases. However, conflicting reports have brought in to question the true malignant potential of eAML. Due to eAMLs overall rarity, few studies have characterized this entity. In this study, we further define eAML by describing its genomic alterations and malignant potential by comparing it to a cohort of AML patients at a large-volume cancer …

Acute Surgical Vs. Non-Surgical Management For Ocular And Peri-Ocular Burns: Oculoplastic Systematic Review And Meta-Analysis, Kevin Klifto, Ala Elhelali, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Burn related injury to the face involving the structures of the eyes, eyelids, eyelashes, and/or eyebrows could result in multiple reconstructive procedures to improve functional and cosmetic outcomes, and correct complications following poor acute phase management. This systematic review and meta-analysis compared 272 surgical to 535 non-surgical interventions within one month of patients suffering burn-related injuries to 465 eyes, 253 eyelids, 90 eyelashes, and 0 eyebrows and evaluated associated outcomes and complications. The PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases were systematically and independently searched. Patient and clinical characteristics, surgical and medical interventions, outcomes and complications were …