Medicine and Health Sciences Commons^™

Multicenter, Randomized Study To Optimize Bowel For Colon Capsule Endoscopy, David Kastenberg, Wilmot C. Burch Jr, David P. Romeo, Pankaj K. Kashyap, David C. Pound, Neophytos Papageorgiou, Ignacio Fernández-Urien Sainz, Carly E. Sokach, Douglas K. Rex

Division of Gastroenterology and Hepatology Faculty Papers

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy (CCE) bowel preparation regimen. METHODS This was a multicenter, prospective, randomized, controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system (PillCam^® COLON 2; Medtronic, Yoqneam, Israel) was utilized. Preparation regimens differed in the 1^st and 2^nd boosts with the Study regimen using oral sulfate solution (89 mL) with diatrizoate meglumine and diatrizoate sodium solution (“diatrizoate solution”) (boost 1 = 60 mL, boost 2 = 30 mL) and the Control regimen oral sulfate …

An Assessment Of Emotional Intelligence In Emergency Medicine Resident Physicians., Dimitrios Papanagnou, Kathryn Linder, Anuj Shah, Kory Scott London, Shruti Chandra, Robin Naples

Department of Emergency Medicine Faculty Papers

OBJECTIVES: To define the emotional intelligence (EI) profile of emergency medicine (EM) residents, and identify resident EI strengths and weaknesses.

METHODS: First-, second-, and third-year residents (post-graduate years [PGY] 1, 2, and 3, respectively) of Thomas Jefferson University Hospital's EM Program completed the Emotional Quotient Inventory (EQ-i 2.0), a validated instrument offered by Multi-Health Systems. Reported scores included total mean EI, 5 composite scores, and 15 subscales of EI. Scores are reported as means with 95% CIs. The unpaired, two-sample t-test was used to evaluate differences in means.

RESULTS: Thirty-five residents completed the assessment (response rate 97.2%). Scores were normed …

An Assessment Of Emotional Intelligence In Emergency Medicine Resident Physicians., Dimitrios Papanagnou, Kathryn M Linder, Anuh Shah, Kory Scott London, Shruti Chandra, Robin Naples

Department of Emergency Medicine Faculty Papers

Objectives: To define the emotional intelligence (EI) profile of emergency medicine (EM) residents, and identify resident EI strengths and weaknesses.

Methods: First-, second-, and third-year residents (post-graduate years [PGY] 1, 2, and 3, respectively) of Thomas Jefferson University Hospital's EM Program completed the Emotional Quotient Inventory (EQ-i 2.0), a validated instrument offered by Multi-Health Systems. Reported scores included total mean EI, 5 composite scores, and 15 subscales of EI. Scores are reported as means with 95% CIs. The unpaired, two-sample t-test was used to evaluate differences in means.

Results: Thirty-five residents completed the assessment (response rate 97.2%). Scores were normed …

Cks1 Expression In Melanocytic Nevi And Melanoma, Anna A. Brożyna, Andrew Aplin, Cynthia Cohen, Grant Carlson, Andrew Joseph Page, Michael Murphy, Andrzej T. Slominski, J. Andrew Carlson

Department of Cancer Biology Faculty Papers

Cyclin-dependent kinase subunit 1 (Cks1) regulates the degradation of p27, an important G1-S inhibitor, which is up regulated by MAPK pathway activation. In this study, we sought to determine whether Cks1 expression is increased in melanocytic tumors and correlates with outcome and/or other clinicopathologic prognostic markers. Cks1 expression was assessed by immunohistochemistry in 298 melanocytic lesions. The frequency and intensity of cytoplasmic and nuclear expression was scored as a labeling index and correlated with clinico-pathological data. Nuclear Cks1 protein was found in 63% of melanocytic nevi, 89% primary and 90% metastatic melanomas with mean labeling index of 7 ± 16, …

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 8, Number 2, Fall 2017

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE), Volume 8, Number 2, Fall 2017

Jcipe 10th Anniversary, June 20, 2017

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Photos from the JCIPE 10th Anniversary, June 20, 2017

Meet An Ipe Champion From Thomas Jefferson University: Rohit Moghe, Rohit A. Moghe

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

I work in various capacities at the hospital that are interprofessional in nature. I bring these experiences to JCIPE as a facilitator for the student groups in the Health Mentors Program (HMP) as well as serving on the JCIPE HMP curricular committee. Both levels of involvement within JCIPE have been rewarding experiences.

Meet An Ipe Champion From Thomas Jefferson University: Michaela Scotten, Michaela Scotten, Ots

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

As part of the two-year curriculum for my Master's degree in Occupational Therapy, I engaged in the Health Mentors Program. Additionally, I had the honor of volunteering with No One Dies Alone through the student IPE interest group throughout my last year. My main involvement with JCIPE was through Student Hotspotting, beginning July, 2016 (offered through Camden Coalition of Healthcare Providers Primary Care Progress, and Association of American Medical Colleges). I had the opportunity to work with an interdisciplinary team of eight students and four faculty members to identify "super-utilizing" patients with complex psychosocial and healthcare needs. As a team, …

Letter To The Editors, Ian A. Cook Pharmd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

I am a Pharmacist and a 2014 graduate of the Jefferson College of Pharmacy. Currently, I work in a retail pharmacy that is located inside an infectious disease clinic. Most of my patients are HIV positive and receive comprehensive care in the clinic. Every day I interact with CMA's, nurses, social workers, laboratory professionals, an addiction counselor, psychiatrists and prescribers. Together, we function as a healthcare team to provide integrated and seamless care for our patients.

The 360 Degree Approach: Patient Forward App Development In The Healthcare Space, Rob Mruczek, Tori Styner

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The Jefferson Teamwork Observation Guide (JTOG) is a responsive, modern mobile application designed to bring this honesty to healthcare. The app helps to evaluate teamwork at a healthcare system from all possible angles, giving a true 360 degree view of the experience of all participants in a medical setting. A patient's experience in a health system is hardly ever the result of a single employee of that health system, but rather a team of people dedicated to that patient's care, who all have a role in taking care of the patient's particular needs. The best teams, just like the best …

Listen In Silence: Narrative Medicine With Interprofessional Teams, Deepthiman Gowda Md, Mph

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

My interest in health humanities began in medical school when I took an elective on literature and medicine with Robert Coles. Reading works by Raymond Carver and William Carlos Williams, we explored the patient's experience of illness and probed the ethical and emotional challenges of giving care. It seemed as if a curtain had been pulled to reveal marvelous hidden rooms, places where new understandings of health and illness could be had. I recognized that some things that were true about illness could not be understood using a scientific lens. The singular, lived experience of those who are sick or …

Using Trauma Case-Based Learning To Inspire Interprofessional Readiness Among Future Health Professionals, Jeanne Felter Phd, Lpc, Stephen Didonato Phd, Lpc, Amy Baker Ms, Pa-C, Richard Hass Phd, Michelle D. Gorenberg Otd, Otr/L

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Background

It is well established in the literature that patient outcomes and quality of care are optimized when disciplines work together (Chonienne et al., 2010). Interprofessional practice (IPP) among health professionals is even more important when working with individuals exposed to trauma, which can result in disrupted physical, cognitive, and social development, and manifest in an array of physical and psychological symptoms (e.g. Felitti & Anda, 1998). Consequently, professionals across social service and healthcare systems may encounter and simultaneously serve trauma-affected individuals. However, healthcare and behavioral health systems are historically fragmented and frequently fail to provide the coordinated and integrated …

From The Editors

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Greetings to all as we embark upon the last weeks of 2017! This fall has been a busy time for JCIPE in many different ways. At the end of September, thirteen JCIPE staff, faculty and students attended the Collaborative Practice conference held in Banff, Alberta, Canada. JCIPE delivered one invited pre-conference workshop and five peer-reviewed, accepted live presentations focusing on a wide range of our activities including Hotspotting, the Health Mentors Program, the Jefferson Teamwork Observation Guide (JTOG) and programmatic sustainability. We learned a lot relative to new program ideas, assessment suggestions and faculty development - just to name a …

Lacosamide And Levetiracetam Have No Effect On Sharp-Wave Ripple Rate, Jan Kudlacek, Jan Chvojka, Antonin Posusta, Lubica Kovacova, Seung Bong Hong, Shennan A. Weiss, Md, Phd, Kamila Volna, Petr Marusic, Jakub Otahal, Premysl Jiruska

Department of Neurology Faculty Papers

Pathological high-frequency oscillations are a novel marker used to improve the delineation of epileptogenic tissue and, hence, the outcome of epilepsy surgery. Their practical clinical utilization is curtailed by the inability to discriminate them from physiological oscillations due to frequency overlap. Although it is well documented that pathological HFOs are suppressed by antiepileptic drugs (AEDs), the effect of AEDs on normal HFOs is not well known. In this experimental study, we have explored whether physiological HFOs (sharp-wave ripples) of hippocampal origin respond to AED treatment. The results show that application of a single dose of levetiracetam or lacosamide does not …

Grand Rounds: Year End Roundup, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Use your break to expand your knowledge by checking out the many Grand Rounds posted in the Jefferson Digital Commons. Topics range from nasal reconstruction to sexuality and aging. With hours of Grand Rounds to experience (see some samples below), your holiday will transform from boredom to excitement! Happy holidays from the Jefferson Digital Commons!

Season Of The Year Influences Infection Rates Following Total Hip Arthroplasty, Samuel Rosas, Alvin C. Ong, Leonard T. Buller, Karim G. Sabeh, Tsun Yee Law, Martin W. Roche, Victor H. Hernandez

Department of Orthopaedic Surgery Faculty Papers

To research the influence of season of the year on periprosthetic joint infections. METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau (Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections (mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the …

Ependymomas Overexpress Chemoresistance And Dna Repairrelated Proteins, Sherise D. Ferguson, Shouhao Zhou, Joanne Xiu, Yuuri Hashimoto, Nader Sanai, Lyndon Kim, Santosh Kesari, John De Groot, David Spetzler, Amy B. Heimberger

Department of Neurosurgery Faculty Papers

Background: After surgery and radiation, treatment options for ependymoma are few making recurrence a challenging issue. Specifically, the efficacy of chemotherapy at recurrence is limited. We performed molecular profiling on a cohort of ependymoma cases in order to uncover therapeutic targets and to elucidate the molecular mechanisms contributing to treatment resistance. Results: This ependymoma cohort showed minimal alterations in gene amplifications and mutations but had high expression rates of DNA synthesis and repair enzymes such as RRM1 (47%), ERCC1 (48%), TOPO1 (62%) and class III β-tublin (TUBB3) (57%), which are also all associated with chemoresistance. This cohort also had high …

Venous Thromboembolism Within Professional American Sport Leagues., Meghan Bishop, Matthew Astolfi, Eric M. Padegimas, Peter F. Deluca, Sommer Hammoud

Department of Orthopaedic Surgery Faculty Papers

Background: Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes.

Purpose: To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes.

Study Design: Descriptive epidemiology study.

Methods: An …

Of Pools, Oceans, And The Dead Sea., Samir K. Ballas

Department of Medicine Faculty Papers

In a comprehensive study in this issue of Blood, Carden and colleagues describe the importance of the tonicity of IV fluids used in the treatment of patients with sickle cell disease (SCD) during vaso-occlusive crises (VOCs). Hypertonic fluids decreased sickle red blood cell (sRBC) deformability, increased occlusion, and increased sRBC adhesion in microfluidic human microvasculature models. Hypotonic fluids decreased sRBC adhesion but prolonged sRBC transit time. Fluids with intermediate tonicities resulted in optimal changes that reduced the risk of vaso-occlusion. © 2017 by The American Society of Hematology.

A Simple And Accurate Rule-Based Modeling Framework For Simulation Of Autocrine/Paracrine Stimulation Of Glioblastoma Cell Motility And Proliferation By L1cam In 2-D Culture., Justin Caccavale, David Fiumara, Michael Stapf, Liedeke Sweitzer, Hannah J. Anderson, Jonathan Gorky, Prasad Dhurjati, Deni S. Galileo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Glioblastoma multiforme (GBM) is a devastating brain cancer for which there is no known cure. Its malignancy is due to rapid cell division along with high motility and invasiveness of cells into the brain tissue. Simple 2-dimensional laboratory assays (e.g., a scratch assay) commonly are used to measure the effects of various experimental perturbations, such as treatment with chemical inhibitors. Several mathematical models have been developed to aid the understanding of the motile behavior and proliferation of GBM cells. However, many are mathematically complicated, look at multiple interdependent phenomena, and/or use modeling software not freely available to the research …

Editorial: Murine Models Of Leukemia And Lymphoma, Christine E. Cutucache, Pierluigi Porcu

Kimmel Cancer Center Faculty Papers

No abstract provided.

A Rare Case Of Hemophagocytic Lymphohistiocytosis Of Unknown Etiology, Ida Micaily, Marie Helene Gagnon, Richard Friedenheim, Jason A. Damsker

Division of Internal Medicine Faculty Papers & Presentations

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon cytokine storm syndrome marked which can cause high mortality. In adults, acquired HLH usually has an underlying infectious, autoimmune or malignant process that triggers the syndrome. In this case report, we present a 64-year old Caucasian male presenting with productive cough, fevers, weight loss and altered mental status who was ultimately found to have HLH of unknown etiology.

Employing Pharmacy Students To Improve The Medication Use Process For Underserved Patients With A History Of Mental Health Or Substance Use Disorders, Ashley Maister, Pharmd Candidate, Toni Campanella, Pharmd Candidate, Roshni S. Patel, Pharmd, Bcps

College of Pharmacy Posters

Project HOME is a non-profit organization in Philadelphia that provides housing, employment opportunities, medical care, and education for chronically homeless individuals with serious mental health conditions.

One nurse oversees the medication use process at three of Project HOME’s residences; however, non-clinical staff are responsible for carrying out the medication use process.

The purpose of this project was to identify how the Jefferson College of Pharmacy’s APhA-ASP chapter could assist Project HOME with their medication-related needs and improve the medication use process.

A Novel Mutation In St14 At A Functionally Significant Amino Acid Residue Expands The Spectrum Of Ichthyosis-Hypotrichosis Syndrome., Leila Youssefian, Andrew Touati, Amir Hossein Saeidian, Omid Zargari, Sirous Zeinali, Hassan Vahidnezhad, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Mutations in the ST14 gene, encoding the serine protease matriptase, have been associated with ichthyosis-hypotrichosis syndrome (IHS), a Mendelian disorder with skin and hair manifestations which include, in addition to ichthyosis and hypotrichosis, hypohidrosis and follicular atrophoderma. However, the understanding of the specific consequences of mutations in ST14 on the development of this syndrome is incomplete.

RESULTS: Using a targeted next-generation sequencing array of 38 ichthyosis-associated genes on a large cohort of 180 ichthyosis patients from a primarily consanguineous background, a previously unreported homozygous p.Asp482Asn mutation in ST14 was identified in a patient with IHS. This mutation affects an …

Optimal Management Of Post-Traumatic Radioulnar Synostosis, Arthur Lee Osterman, Melissa S. Arief

Department of Orthopaedic Surgery Faculty Papers

Post-traumatic radioulnar synostosis is a rare complication after forearm or elbow injury that can result in loss of motion and significant disability. Risk factors include aspects of the initial trauma and of the surgical treatment of that trauma. Surgical intervention for synostosis is the standard of care and is determined based on the location of the bony bridge. Surgical timing is recommended between 6 months and 2 years with recent advocacy for the 6- to 12-month period after radiographs demonstrate bony maturation but early enough to prevent further stiffness and contractures. For most types of synostosis, surgical resection with interposition …

Reorganization Of Thalamic Intrinsic Connectivity Following Anterior Temporal Lobectomy, Xiaosong He, Chaitanya Ganne, Michael R. Sperling, Ashwini Sharan, Joseph I. Tracy

Department of Neurosurgery Posters

The thalamus has played a crucial role in determining surgical outcome following anterior temporal lobectomy (ATL) in temporal lobe epilepsy (TLE) (He, et al., 2017). Before successfully quantifying the impact of the thalamus on ATL outcomes, this structure’s own intrinsic connectivity must be understood. Accordingly, we characterize thalamic intrinsic connectivity through resting-state fMRI (rsfMRI) longitudinally, exploring its change pre- to post-surgery.

Intermediate-Term Risk Of Stroke Following Cardiac Procedures In A Nationally Representative Data Set., Laura Stein, Alison Thaler, John W. Liang, Stanley Tuhrim, Amit S. Dhamoon, Mandip S. Dhamoon

Department of Neurology Faculty Papers

BACKGROUND: Studies on stroke risk following cardiac procedures addressed only perioperative and long-term risk following limited higher-risk procedures, were poorly generalizable, and often failed to stratify by stroke type. We calculated stroke risk in the intermediate risk period following cardiac procedures compared with common noncardiac surgeries and medical admissions.

METHODS AND RESULTS: The Nationwide Readmissions Database contains readmission data for 49% of US admissions in 2013. We compared age-adjusted stroke readmission rates up to 90 days postdischarge. We used Cox regression to calculate hazard ratios, up to 1 year, of stroke risk comparing transcatheter aortic valve replacement versus surgical aortic …

Utilization Of Care By Infants With Neonatal Abstinence Syndrome In Delaware, Michele K. Savin, Dnp, Aprn, Nnp-Bc

College of Nursing Posters

Introduction: There is little information regarding use of expected well care by infants diagnosed with neonatal abstinence syndrome (NAS) post initial discharge. We describe expected and unexpected utilization of care by infants with NAS in the first year of life.

Methods: A de-identified State of Delaware Medicaid data set was obtained. Included were all infants with an ICD-9 code for NAS from 01/01/2012-12/31/2014. All associated medical claims were extracted for one year after birth. Utilization rates of primary care, immunizations, urgent or emergency care, and re-hospitalization were quantified.

Results: 499 of 522 babies were able to be fully analyzed. The …

Decoding Critical Long Non-Coding Rna In Ovarian Cancer Epithelial-To-Mesenchymal Transition., Ramkrishna Mitra, Xi Chen, Evan J. Greenawalt, Ujjwal Maulik, Wei Jiang, Zhongming Zhao, Christine M. Eischen

Department of Cancer Biology Faculty Papers

Long non-coding RNA (lncRNA) are emerging as contributors to malignancies. Little is understood about the contribution of lncRNA to epithelial-to-mesenchymal transition (EMT), which correlates with metastasis. Ovarian cancer is usually diagnosed after metastasis. Here we report an integrated analysis of >700 ovarian cancer molecular profiles, including genomic data sets, from four patient cohorts identifying lncRNA DNM3OS, MEG3, and MIAT overexpression and their reproducible gene regulation in ovarian cancer EMT. Genome-wide mapping shows 73% of MEG3-regulated EMT-linked pathway genes contain MEG3 binding sites. DNM3OS overexpression, but not MEG3 or MIAT, significantly correlates to worse overall patient survival. DNM3OS knockdown results in …

The Technique Of S2-Alar-Iliac Screw Fixation: A Literature Review, Ai-Min Wu, Dong Chen, Chun-Hui Chen, Yu-Zhe Li, Li Tan Li Tang, Kevin Phan, Kern Singh, Brittany E. Haws, Daniele Vanni, Yusef I. Mosley, Srinivas K. Prasad, James Harrop, Zhong-Ke Lin, Yan Lin, Wen-Fei Ni, Xiang-Yang Wang

Department of Neurosurgery Faculty Papers

The distal fixation in thoracolumbar deformity surgery can be challenging for spine surgeons. When isolated S1-pedicle screws are utilized as the sole distal fixation in long thoracolumbar posterior constructs, there is a high rate of failure, due to loosening, breakage, and pseudarthrosis. Unfortunately, with iliac screw fixation the entry point at the posterior superior iliac spine requires considerable soft tissue dissection and may potentially increase the likelihood of wound complications. S2-alar-iliac (S2AI) screw fixation technique was developed recently to provide increased fixation with a lower profile screw and rod construct. These screws can be inserted with percutaneous or free hand …