Medicine and Health Sciences Commons^™

Botox Injection To Treat Strabismus After Infant Botulism Type B Infection, Sarah G Bonaffini, Victoria Cocozza, Jing Jin

Ophthalmology Resident Research

Purpose: The significance of botulinum toxin to ophthalmologists is twofold. Botulism, a medical emergency, frequently presents with ocular findings including blurred vision, diplopia, ptosis, and photophobia as a result of the neurotoxin produced by Clostridium botulinum. However, botulinum toxins also have therapeutic uses for medical conditions including strabismus. The safety and efficacy of Botulinum toxin A in patients with a history of botulism has not been reported.

Observations: We report a 9-week-old infant, diagnosed with type B toxin positive infant botulism treated with human botulism immune globulin, who developed a large angle exotropia. The infant was treated with intramuscular injections …

Clinical Outcomes Of Superior Capsular Reconstruction For Massive, Irreparable Rotator Cuff Tears: A Systematic Review Comparing Acellular Dermal Allograft And Autograft Fascia Lata, Tyler J. Smith, Anirudh K. Gowd, John Kunkel, Lisa Kaplin, John B. Hubbard, Kevin E. Coates, Benjamin R. Graves, Brian R. Waterman

Orthopedic Surgery Resident Research

Purpose: To investigate clinical outcomes after superior capsular reconstruction (SCR) for the treatment of massive and/or irreparable rotator cuff tears treated with either allograft or autograft. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines, in April 2020 a systematic review was performed using PubMed, MEDLINE, EMBASE, and Cochrane databases. Clinical studies were assessed for patient-reported outcomes and range of motion, comparing dermal allografts to fascia lata autografts, with a minimum follow-up of 12 months. Results: A total of 16 clinical studies involving 598 patients (606 shoulders) were included for data analysis, with a weighted …

Perichondritis: Inspect The Lobule, Eli Bress, Jason E Cohn

Otolaryngology (ENT) Resident Research

CASE PRESENTATION: This is a brief report of a 57-year-old Caucasian female presented with a 4-day history of worsening left ear pain. Her symptoms began with left otalgia and otorrhea which progressed to helical erythema, prompting a visit to the emergency department. She was noted to have erythema of the left auricle and swelling of the left auditory meatus. Our otolaryngology service observed erythema of the auricle with sparing of the lobule.

DIAGNOSIS: The diagnosis to be otitis externa with perichondritis was established, and we recommended otic ciprofloxacin-hydrocortisone, IV vancomycin, and ciprofloxacin. The patient had marked improvement and was discharged …

Histone Demethylase Phf8 Drives Neuroendocrine Prostate Cancer Progression By Epigenetically Upregulating Foxa2., Qiuli Liu, Jian Pang, Lin-Ang Wang, Zhuowei Huang, Jing Xu, Xingxia Yang, Qiubo Xie, Yiqiang Huang, Tang Tang, Dali Tong, Gaolei Liu, Luofu Wang, Dianzheng Zhang, Qiang Ma, Hualiang Xiao, Weihua Lan, Jun Qin, Jun Jiang

PCOM Scholarly Papers

Neuroendocrine prostate cancer (NEPC) is a more aggressive subtype of castration-resistant prostate cancer (CRPC). Although it is well established that PHF8 can enhance prostate cancer cell proliferation, whether PHF8 is involved in prostate cancer initiation and progression is relatively unclear. By comparing the transgenic adenocarcinoma of the mouse prostate (TRAMP) mice with or without Phf8 knockout, we systemically examined the role of PHF8 in prostate cancer development. We found that PHF8 plays a minimum role in initiation and progression of adenocarcinoma. However, PHF8 is essential for NEPC because not only is PHF8 highly expressed in NEPC but also animals without …

Piwi-Interacting Rnas: Mitochondria-Based Biogenesis And Functions In Cancer, Jin-Fen Su, Anthony Concilla, Dianzheng Zhang, Fang Zhao, Fang-Fang Shen, Hao Zhang, Fu-You Zhou

PCOM Scholarly Papers

PIWI-interacting RNA (piRNAs), once thought to be mainly functioning in germlines, are now known to play an essential role in somatic and cancerous tissues. Ping-pong cycle initiation and mitochondria-based phased production constitute the core of the piRNA biogenesis and these two processes are well conserved in mammals, including humans. By being involved in DNA methylation, histone marker deposition, mRNA degradation, and protein modification, piRNAs also contribute to carcinogenesis partly due to oncogenic stress-induced piRNA dysregulation. Also, piRNAs play important roles in cancer stemness, drug resistance, and tumor immunology. Results from liquid biopsy analysis of piRNA can be used in both …

Pcom Georgia Do Class Of 2025 Composite Sheet, Philadelphia College Of Osteopathic Medicine

Class Composite Sheets

PCOM Georgia DO Class of 2022 student portraits, matriculating Fall 2020.

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2019, Kayla R Stover, Elias B Chahine, David Cluck, Sarah Green, Daniel B Chastain, Darrell Childress, Carmen Faulkner-Fennell, Katherine Lusardi, Edo-Abasi U. Mcgee, Michelle Turner, P Brandon Bookstaver, Christopher M Bland

PCOM Scholarly Papers

Staying current on literature related to antimicrobial stewardship can be challenging given the ever-increasing number of published articles. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2019. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training and to identify potential intervention opportunities within one's institution.

Lipocalin-2 Deficiency May Predispose To The Progression Of Spontaneous Age-Related Adiposity In Mice, Keya Meyers, María López, Joanna Ho, Savannah Wills, Srujana Rayalam, Shashidharamurthy Taval

PCOM Scholarly Papers

Lipocalin-2 (Lcn2) is an innate immune protein elevated by several orders of magnitude in various inflammatory conditions including aging and obesity. Recent studies have shown that Lcn2 is secreted by adipocytes in response to inflammation and is categorized as a new adipokine cross-linking innate immunity and metabolic disorders including obesity. However, the involvement of Lcn2 and its function during the progression of obesity is largely unknown. Recently, browning of white adipose tissue (WAT) has gained attention as a therapeutic strategy to combat obesity. Herein, we have shown that treatment of mature 3T3-L1 adipocytes with recombinant Lcn2 (rec-Lcn2) resulted in the …

The Use Of Local Medial Plantar Artery Flap For Heel Reconstruction: A Systematic Review., Jude L Opoku-Agyeman, Amber Allen, Kayla Humenansky

Plastic Surgery Resident Research

BACKGROUND: Soft tissue reconstruction of the heel represents a daunting challenge for reconstructive surgeons, given the weight-bearing role and anatomical properties of the glabrous skin on the plantar surface. For soft tissue defects in this area, the medial plantar artery (MPA) flap has been described as an optimal reconstructive option. Many studies have reported on the use of the medial plantar artery flap for soft tissue coverage of the heel. There currently exists no systematic review on the topic.

AIM: The aim of this article is to review the literature on the use of local medial plantar artery flap for …

A Simple Technique For Intraoperative Scalp Skin Graft Depilation Using Dermabond®, Jude L Opoku-Agyeman, Kayla Humenansky, Brooke Burkey

Plastic Surgery Resident Research

Skin grafting is an essential aspect of burn and wound reconstruction. Split-thickness skin grafts (STSGs) harvested from the scalp are used for wound and burn reconstruction. Skin grafts from the scalp bear hair and hair particles. Residual hair fragments and pieces of hair in the graft have been associated with many complications, including foreign body reaction similar to pseudofolliculitis and chronic inflammation that can lead to infections. It is important to remove the hair and the hair particles from the scalp graft before its application to the donor site. Traditionally, surgeons have employed some techniques including saline agitation and mechanical …

Percutaneous Coil Embolization To Manage Pulmonary Artery Hemorrhage After Distal Endarterectomy, Chirantan Mangukia, Paul Forfia, Anjali Vaidya, Veronica Williams, Dmitry Niman, Parth Rali, Yoshiya Toyoda

Internal Medicine Resident Research

Selective pulmonary artery coil embolization can be a viable treatment option for acute pulmonary hemorrhage after pulmonary thromboendarterectomy.

Obesity And Its Effect On Outcomes In Same-Day Bilateral Total Knee Arthroplasty, Ethan A Remily, Nequesha S Mohamed, Wayne A Wilkie, Tyler Smith, Anthony Judice, Salvador Forte, James Nace, Ronald E Delanois

Orthopedic Surgery Resident Research

Background: The niche surgery of same-day bilateral total knee arthroplasty (sd-BTKA) continues to create debate amongst specialists in arthroplasty. To date, there is a significant lack of literature on obese patients undergoing sd-BTKA, and no study has evaluated outcomes of this procedure when compared to non-obese patients. Therefore, this study will perform a retrospective analysis to compare (I) incidence, (II) demographics, and (III) complications of sd-BTKA in non-obese, obese, and morbidly obese patients in the United States from 2009 to 2016.

Methods: The National Inpatient Sample (NIS) database was queried for all individuals that underwent sd-BTKA from 2009 to 2016. …

Perinatal Docosahexaenoic Acid Supplementation Improves Cognition And Alters Brain Functional Organization In Piglets., Xi Fang, Wenwu Sun, Julie Jeon, Michael Azain, Holly Kinder, Jeongyoun Ahn, Hee Cheol Chung, Ryan S Mote, Nikolay M Filipov, Qun Zhao, Srujana Rayalam, Hea Jin Park

PCOM Scholarly Papers

Epidemiologic studies associate maternal docosahexaenoic acid (DHA)/DHA-containing seafood intake with enhanced cognitive development; although, it should be noted that interventional trials show inconsistent findings. We examined perinatal DHA supplementation on cognitive performance, brain anatomical and functional organization, and the brain monoamine neurotransmitter status of offspring using a piglet model. Sows were fed a control (CON) or a diet containing DHA (DHA) from late gestation throughout lactation. Piglets underwent an open field test (OFT), an object recognition test (ORT), and magnetic resonance imaging (MRI) to acquire anatomical, diffusion tensor imaging (DTI), and resting-state functional MRI (rs-fMRI) at weaning. Piglets from DHA-fed …

Perspectives On The Intracellular Bacterium Chlamydia Pneumoniae In Late-Onset Dementia, Brian J. Balin Phd

PCOM Scholarly Papers

Purpose of Review

Chronic diseases remain a daunting challenge for clinicians and researchers alike. While difficult to completely understand, most chronic diseases, including late-onset dementias, are thought to arise as an interplay between host genetic factors and environmental insults. One of the most diverse and ubiquitous environmental insults centers on infectious agents. Associations of infectious agents with late-onset dementia have taken on heightened importance, including our investigations of infection by the intracellular respiratory bacterium, Chlamydia pneumoniae (Cpn), in late-onset dementia of the Alzheimer’s type.

Recent Findings

Over the last two decades, the relationship of this infection to pathogenesis …

Endovascular Treatment Of Cervical Myelopathy From Brachiocephalic Venous Stenosis., Craig Schreiber, Alex Anavim, Mark Kotapka, Paul Brady

Neurosurgery Resident Research

Central venous stenosis is a rare cause of neurologic pathology. Here we present a case of brachiocephalic vein stenosis causing cervical myelopathy through venous engorgement. Our patient was a 51-y/o male who presented with ambulatory dysfunction so he was evaluated for cervical myelopathy. Imaging revealed cord compression from venous engorgement and brachiocephalic vein stenosis. He was treated with angioplasty and vessel stenting which significantly improved flow on postintervention imaging. In conclusion, preoperative vascular imaging should be considered in myelopathic patients as it can detect this rare but dangerous etiology.

Ampk And Mtor Impose Dualistic Regulation Of Mitophagy And Autophagy In In Vitro Models Of Prostate Cancer, Brianne Richardson

PCOM Biomedical Studies Student Scholarship

Prostate cancer is the abnormal growth and proliferation of previously normal cells of the prostate and has the second highest incidence in men worldwide. Physiologic manipulation of AMP-activated protein kinase (AMPK), a highly conserved enzyme responsible for regulation of energy homeostasis during metabolic stress, is a potential treatment, especially for metastatic, castration-resistant prostate cancers. AMPK is a known inhibitor of the enzyme mTOR, the final enzyme in the PKT/AKT/mTOR pathway responsible for cell growth and proliferation signaling. The hypothesis of this project is that activation of AMPK leads to increased mTOR-dependent mitophagy and subsequent autophagy in prostate cancer cells. The …

Correlation Of Ape1 With Vegfa And Cd163+ Macrophage Infiltration In Bladder Cancer And Their Prognostic Significance, Lin-Ang Wang, Bo Yang, Tang Tang, Yuxin Yang, Dianzheng Zhang, Hualing Xiao, Jing Xu, Luofu Wang, Li Lin, Jun Jiang

PCOM Scholarly Papers

The present study sought to estimate the applicability of apurinic/apyrimidinic endodeoxyribonuclease 1 (APE1), vascular endothelial growth factor A (VEGFA) expression and CD163+ tumor‑associated macrophage (TAM) ratio as prognostic factors in bladder cancer (BCa). A total of 127 patients with bladder urothelial cancer who underwent radical cystectomy at Daping Hospital were recruited between January 2013 and January 2017, including 45 cases of non‑muscle invasive BCa (NMIBC) and 82 of MIBC. Immunohistochemical detection of APE1, VEGFA and CD163, as well as multiple immunofluorescence staining for APE1, VEGFA, CD163 and CD34, were performed on tissue samples. For APE1 and VEGFA, the staining was …

Convergent Evolution Of Conserved Mitochondrial Pathways Underlies Repeated Adaptation To Extreme Environments, Ryan Greenway, Nick Barts, Chathurika Henpita, Anthony P Brown, Lenin Arias Rodriguez, Carlos M Rodríguez Peña, Sabine Arndt, Gigi Y Lau, Michael P Murphy, Lei Wu, Dingbo Lin, Michael Tobler, Joanna L Kelley, Jennifer H. Shaw

PCOM Scholarly Papers

Extreme environments test the limits of life; yet, some organisms thrive in harsh conditions. Extremophile lineages inspire questions about how organisms can tolerate physiochemical stressors and whether the repeated colonization of extreme environments is facilitated by predictable and repeatable evolutionary innovations. We identified the mechanistic basis underlying convergent evolution of tolerance to hydrogen sulfide (H₂S)-a toxicant that impairs mitochondrial function-across evolutionarily independent lineages of a fish (Poecilia mexicana, Poeciliidae) from H₂S-rich springs. Using comparative biochemical and physiological analyses, we found that mitochondrial function is maintained in the presence of H₂S in sulfide …

Congenital Pulmonary Airway Malformation (Cpam): An Interesting Ent Consultation., James Ding, Lauren E Melley, Alexander Manteghi

Otolaryngology (ENT) Resident Research

A 13-month-old boy was referred to the emergency department from the pediatrician’s office for increased shortness of breath. A 2-view chest X-ray was ordered revealing right hemithorax hyperlucency, minimal lung markings, and leftward mediastinal shift.

Nasal Bone Fractures: Differences Amongst Sub-Specialty Consultants, Jason E. Cohn, Sammy Othman, Michael Toscano, Tom Shokri, Jason D Bloom, Seth Zwillenberg

Otolaryngology (ENT) Resident Research

BACKGROUND: Nasal fractures constitute the largest proportion of facial trauma each year, however, there is no consensus management. In this study, we investingated the role of the consultant and the functional and aesthetic outcomes of procedures performed to address nasal bone fractures.

METHODS: A retrospective chart review of patients who sustained nasal bone fractures was conducted from 8/1/14 through 1/23/18. Categorical variables were analyzed using chi-squared testing and Fisher's exact test, where appropriate, while continuous variables were compared using Mann-Whitney U testing.

RESULTS: During the study period, 136 patients met inclusion criteria for full analysis. The mean age of this …

Myo/Nog Cells Expressing Muscle Proteins Are Present In Preretinal Membranes From Patients With Proliferative Vitreoretinopathy., Jacquelyn Gerhart, Nathan Morrison, Lindsay Gugerty, David Telander, Arturo Bravo Nuevo, Mindy George-Weinstein

PCOM Scholarly Papers

Proliferative vitreoretinopathy (PVR) is a complication of rhegmatogenous retinal detachment and ocular trauma. The disease is characterized by development of membranes that may apply traction to the retina and cause redetachment. Membrane contractions are attributed to myofibroblasts arising from retinal pigment epithelial cells, glia and fibroblasts. The progenitors of myofibrobasts in the lens are Myo/Nog cells that express the skeletal muscle transcription factor MyoD and bone morphogenetic protein inhibitor Noggin. The retina and choroid also contain Myo/Nog cells that respond to stress. We examined preretinal PVR membranes from three ocular trauma patients with retinal detachment for Myo/Nog cells and their …

Are We Meeting The Demand For Pharmacist-Led Antimicrobial Stewardship Programs During Postgraduate Training-Year 1 (Pgy1)?, Edo-Abasi U. Mcgee, Arrington D Mason-Callaway, Brent L. Rollins

PCOM Scholarly Papers

In the United States of America, pharmacists play a pivotal role in antimicrobial stewardship; training from postgraduate residency may hone knowledge and skills gained from didactic pharmacy education. Specifically, the first year of postgraduate training, the learner may become an "everyday steward in training" and may go on to complete a second year in infectious diseases. However, there are a limited number of second year infectious diseases programs. The current demand for pharmacist to participate in and or lead stewardship is disproportionate to available specialized training. The first year of post-graduate training has to be setup to ensure appropriate preparation, …

To Balloon Or Not To Balloon, The Current State Of Management Of Eustachian Tube Dysfunction., David J. Lafferty, Brian J Mckinnon

Otolaryngology (ENT) Resident Research

While otologic complaints are a common reason for patients to present to an otolaryngologist, Eustachian tube dysfunction (ETD) remains a poorly understood disease whose management is unclear. Among the general population in the United States, ETD has a prevalence of 4.6% among adults and 6.1% among children. Eustachian tube dysfunction is not just a common diagnosis for otolaryngologists, ETD accounted for 2 million visits for patients less than 20 years old to primary care providers and over 2 million visits for patients older than 20 years old between 2005 and 2012. Despite the commonality of ETD, opinions differ wildly among …

Hypogeusia As The Initial Presenting Symptom Of Covid-19, Lauren E Melley, Eli Bress, Erik Polan

PCOM Scholarly Papers

COVID-19 is the disease caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which first arose in Wuhan, China, in December 2019 and has since been declared a pandemic. The clinical sequelae vary from mild, self-limiting upper respiratory infection symptoms to severe respiratory distress, acute cardiopulmonary arrest and death. Otolaryngologists around the globe have reported a significant number of mild or otherwise asymptomatic patients with COVID-19 presenting with olfactory dysfunction. We present a case of COVID-19 resulting in intensive care unit (ICU) admission, presenting with the initial symptom of disrupted taste and flavour perception prior to respiratory …

Prenatal Counseling From Obstetricians As A Potential Point Of Intervention To Increase Childhood Vaccination Rates In Pennsylvania, Kaitlyn Davis

PCOM Capstone Projects

Vaccine hesitancy is a major public health concern in Pennsylvania, and the reasons for it vary from religious to philosophical. One subgroup of vaccine hesitant parents chooses not to vaccinate because they are misinformed and uneducated about the significance and the safety of vaccines. The objective of this study is to consider the use of an infographic to encourage pregnant women to ask their obstetricians about the importance and safety of vaccines as a way of increasing childhood vaccination rates.

Finding points of intervention to increase childhood vaccination rates is important. In order for a population to maintain herd immunity, …

Facilitating Firearm Safety Counseling In Pediatric Primary Care To Decrease Gun Deaths In Children And Teens In Philadelphia, Bianca Lacay

PCOM Capstone Projects

Gun violence is a public health epidemic that affects the lives of children. The United States has the highest firearm deaths in children and adolescents among other high-income countries (University of Michigan, 2019). The Second Amendment ratified in 1791 protects the rights of citizens to keep and bear arms. This policy made by the founding fathers underlie controversial debates in the present day, resulting in different federal, state, and local gun laws. Due to the varying gun policies, firearm homicide rates of children and adolescents are climbing like never before. Firearms suicide is even more frequent than homicide and is …

Effect Of Maternal Microbiome On Offspring Neurodevelopment: A Review, Zoe Beausoleil

PCOM Capstone Projects

The purpose of this paper is to delve into the maternal influence on the offspring microbiome, and how maternal lifestyle factors and choices; mode of birth, feeding method, stress and the interventions used to alleviate said stress, maternal age, substance use, exercise, and nutrition, alter the microbiome and therefore affect the neurodevelopment of the offspring. The human microbiome is composed of billions of bacteria, fungi, protozoa, and viruses that occupy the gut, skin and other areas of the body. Numerous studies have illustrated the importance of the microbiome in healthy human physiologic processes including energy metabolism, gut health, immune function …

Exploring The Connections Between Alcohol Abuse And Cognitive Deficits: A Review Of Alcohol’S Effects On Brain Development And Memory Formation, Marykate Decker

PCOM Capstone Projects

Often overlooked and trivialized, Alcohol Use Disorder (AUD) affects 15 million Americans over the age of 18. As of 2015, it was reported that only 6.7% of these individuals received treatment necessary to recover. Perhaps even more alarming, the NIH reports alcohol to be the third leading preventable cause of death in the United States annually. As these numbers steadily increase, scientists have become more interested in alcohol addiction and reward pathways, memory deficiencies secondary to alcohol abuse, and the potential development of pathologies like Wernicke-Korsakoff Syndrome.

Previous studies have shown that excessive drinking damages nerve cells that ultimately affect …

Lifelong Psychopathology Stemming From Childhood Maltreatment: A Review Of Structural And Neurobehavioral Changes, Nicole Borden

PCOM Capstone Projects

This review investigates the link between childhood maltreatment and structural changes in the brain as well as psychopathology later on in life. Childhood maltreatment was compared to the time of onset of psychopathology and the severity of symptoms. The relationship between the type of trauma and socioemotional cognition was also analyzed. Childhood maltreatment is a serious problem that can hinder a child’s ability to develop into a healthy adult. Not only does it induce unhealthy amounts of stress on the child, but it also can negatively affect brain development. Many mental health problems can arise from childhood maltreatment, some minor, …

A Proposal To Implement A Must-Use Mandate For Prescription Drug Monitoring Programs In Philadelphia, Anugraha Kutty

PCOM Capstone Projects

No abstract provided.