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A Multicomponent Quality Improvement Project To Improve Sleep In Hospitalized Patients: A Single Center Pilot Experience, Michelle Konkoly, Alan Kubey, Md Feb 2019

A Multicomponent Quality Improvement Project To Improve Sleep In Hospitalized Patients: A Single Center Pilot Experience, Michelle Konkoly, Alan Kubey, Md

Phase 1

No abstract provided.


Effect Of Tort Reform On Diagnostic Imaging Rates, Israel Ojalva, Ba, Arthur Hong, Md, Mph Feb 2019

Effect Of Tort Reform On Diagnostic Imaging Rates, Israel Ojalva, Ba, Arthur Hong, Md, Mph

Phase 1

Introduction: Defensive medicine, is defined as “order[ing] tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not solely) because of concern about malpractice liability.” Nearly all physician who fear malpractice litigation have admitted to practicing some degree of defensive medicine. In response, many states have enacted policy reforms to lighten the threat of malpractice on physicians.

Objective: The most common defensive medicine behavior is ordering diagnostic imaging tests when it is potentially unwarranted. Many states have enacted non-economic damage caps from 2000-2010. We explored if these laws had an impact on the rates of diagnostic imaging …


Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Katie Holland, Emily Wei, Allison Zibelli Feb 2019

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Katie Holland, Emily Wei, Allison Zibelli

Phase 1

While there are large efforts to decrease readmission rates in the United States, cancer patients represent a population that has been overlooked. Cancer patients are a vulnerable population who make up a large portion of hospital readmissions. Most of the current research on the causes of readmissions in cancer patients focuses on medical chart reviews and insurance claims. Many of these studies fail to incorporate patient input which could further the understanding of the complete burden associated with cancer readmissions. The goal of this study is to understand the personal reasons behind the decision of cancer patients to return to …


Mindfulness-Based Stress Reduction Intervention For The Treatment Of Chronic Pain In The Elderly, Austin Roadarmel, Diane Reibel, Phd, Aleeze Moss, Phd, Andrew Newberg, Md Feb 2019

Mindfulness-Based Stress Reduction Intervention For The Treatment Of Chronic Pain In The Elderly, Austin Roadarmel, Diane Reibel, Phd, Aleeze Moss, Phd, Andrew Newberg, Md

Phase 1

One of the most common complaints of adults in their 80s and above, a growing portion of our population, is chronic pain and it is often inadequately treated. A secular mindfulness-based stress reduction (MBSR) program was developed by Jon Kabat-Zinn in 1979 and has since shown measurable benefits to individuals in decreasing depression, pain, and anxiety. Considering the significant risk of side effects and age-associated changes of pharmacodynamics and pharmacokinetics in the traditional pharmacologic approach to chronic pain in the elderly, non-pharmacologic intervention such as MBSR may be particularly effective for the elderly population.

Methods: We conducted a 6 week, …


An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd Feb 2019

An Evaluation Of Ultrasound-Guided Regional Block Anesthesia In Outpatient Hand Surgery, Daniel Calem, Armen C. Voskeridjian, Md, Michael Rivlin, Md, Pedro Beredjiklian, Md, Mark L. Wang, Md, Phd

Phase 1

Introduction: The utilization of ultrasound-guided peripheral nerve blocks in orthopedic surgery has increased in popularity as the anesthesia of choice for the management of perioperative pain. Peripheral nerve blockade has been shown to increase overall surgical efficiency, improve patient satisfaction, reduce postoperative narcotic use, and decrease the duration of facility admissions, while increasing overall cost-effectiveness. To date, scant literature exists regarding the safety and efficacy of ultrasound-guided supraclavicular blocks used in common hand surgery procedures, and the rate of neurologic and vascular complications remains unknown.

Objective: The purpose of this study was to examine the effectiveness and complication rate of …


Clinical And Pathologic Factors In Breast Cancer Patients With Bone Metastases Undergoing Surgery For Pathologic And Impending Fractures, Emily Bochner, Kerith Wang, Benjamin Leiby, Ayako Miura, William Kevin Kelly Feb 2019

Clinical And Pathologic Factors In Breast Cancer Patients With Bone Metastases Undergoing Surgery For Pathologic And Impending Fractures, Emily Bochner, Kerith Wang, Benjamin Leiby, Ayako Miura, William Kevin Kelly

Phase 1

Introduction: Metastatic lesions to bone carry a poor prognosis. Bone lesions can be responsible for significant morbidity in patients, including pathologic or impending fractures that may require emergent surgical evaluation.

Objective: We evaluated the clinical and pathologic features associated with breast cancer patients with bone metastases who underwent surgery for pathologic or impending fractures.

Methods: A retrospective chart review of 20 breast cancer patients with bone metastases who underwent surgery from the Bone Biorepository Bank at Sidney Kimmel Cancer Center was performed. We evaluated their clinical and pathologic characteristics and performed Fisher’s Exact Testing to explore potential associations.

Results: 90% …


Investigating Gαs Pepducin’S Effect On Β2ar Signaling For Chf Pharmacology, Nida Bajwa, Nathan Hopfinger, Charles Scott Feb 2019

Investigating Gαs Pepducin’S Effect On Β2ar Signaling For Chf Pharmacology, Nida Bajwa, Nathan Hopfinger, Charles Scott

Phase 1

Introduction: Congestive heart failure affects nearly six million Americans and significantly impairs their quality of life. New and better interventions are needed to improve HF patients’ survival and outcomes. Pharmacologics that bias β2AR signaling towards arrestin, which promotes cardiomyocyte survival and contractility, may offer advantages over traditional β-blockers.

Objective: It has been demonstrated that peptides mimicking the C-terminus of the Gαs subunit block downstream signaling of GPCRs. The study’s objective is to determine if a pepducin derived from the C-terminus of the Gαs subunit of the β2AR could block Gs signaling but maintain arrestin-recruitment, thereby producing a …


The Accuracy Of Blood Pressure Measurement By Two Cuff-Less Wearable And Portable Health Devices, Dylan M. Bard, Noud Van Helmond, Christina Hahnen, Nilanjan Haldar, Cecilia Freeman, Jacquelyn N. Hamati, Vignesh Murali, Jeffrey I. Joseph Feb 2019

The Accuracy Of Blood Pressure Measurement By Two Cuff-Less Wearable And Portable Health Devices, Dylan M. Bard, Noud Van Helmond, Christina Hahnen, Nilanjan Haldar, Cecilia Freeman, Jacquelyn N. Hamati, Vignesh Murali, Jeffrey I. Joseph

Phase 1

Introduction: Wearable and portable devices that claim to measure blood pressure without the need of a cuff are becoming increasingly popular among consumers. Given that hypertension is the leading cause for cardiovascular mortality worldwide, a portable technology that allows consumers to easily measure their BP several times a day would be of great value. However, the convenience that portable health technology provides is useless, and even dangerous, if the measurements are inaccurate.

Objective: Investigate the accuracy of two popular commercial cuff-less BP device, the Bodimetrics Performance Monitor and Everlast TR10 watch.

Methods: A sample of 127 ambulatory patients (>18y) …


Efficacy Of Combination Of Immunotherapies In A Murine In A Murine Squamous Cell Carcinoma Model, E. Correia, C. Portocarrero, U. Rodeck Feb 2019

Efficacy Of Combination Of Immunotherapies In A Murine In A Murine Squamous Cell Carcinoma Model, E. Correia, C. Portocarrero, U. Rodeck

Phase 1

Introduction: Head and neck squamous cell carcinomas (HNSCCs) are a type of neoplasm found in the epithelium of the oral cavity, oropharynx, nasopharynx, larynx, or hypopharynx. Recent evidence has demonstrated that 70-90% of HNSCC are associated with Human Papillomavirus (HPV), particularly strain 16 producing oncogenic proteins E6/E7. Currently, HNSCCs are treated with surgery, chemotherapy, and radiation, however immunotherapy with immune checkpoint (PD-1) blocking agents promises to improve outcomes in HNSCC.

Objective: This study examined the therapeutic effects of dual and triple combination immunotherapies in a mouse model of HPV-associated HNSCC.

Methods: Treatment modalities included a tumor vaccine (attenuated Listeria monocytogenes …


Stage Of Disease And Likelihood Of Surgical Intervention In Colon Cancer Patients: An Exploratory Analysis Of The Seer Database, R. Denneny, D. Delgado, V. Nguyen, J. Subramoney, B. George, E. Mitchell, Md Feb 2019

Stage Of Disease And Likelihood Of Surgical Intervention In Colon Cancer Patients: An Exploratory Analysis Of The Seer Database, R. Denneny, D. Delgado, V. Nguyen, J. Subramoney, B. George, E. Mitchell, Md

Phase 1

Introduction/Objectives: Colorectal cancer (CRC) remains as the third-leading cause of cancer-related deaths amongst both men and women in the United States. However, the mortality rate from CRC continues to drop, which has been attributed to increased surgical polyp removal. This study explored the association between disease stage and the likelihood of surgical intervention as primary treatment for the disease.

Methods: Retrospective cohort study analysis using de-identified patient data from the NCI’s Surveillance, Epidemiology, and End Results (SEER) database from 1998-2015. Inclusion criteria included patients with colon cancer, over 18 years of age, with known disease in either the proximal or …


Racial Disparities In Head And Neck Cancers In An Urban Hospital, Jessica Kraus-Lavy, Charnita Zeigler-Johnson, Scott W Keith, Frances Guiles, David Cognetti, Voichita Bar-Ad, Rita S. Axelrod, Md Feb 2019

Racial Disparities In Head And Neck Cancers In An Urban Hospital, Jessica Kraus-Lavy, Charnita Zeigler-Johnson, Scott W Keith, Frances Guiles, David Cognetti, Voichita Bar-Ad, Rita S. Axelrod, Md

Phase 1

Introduction: Head and neck cancer incidence rates are higher for white residents in Philadelphia, while related mortality rates are highest for black residents. It is unclear how risk factors like HPV and smoking contribute to these disparities. The goal of this study is to determine which factors are associated with head and neck cancers in a diverse patient population from a Philadelphia hospital.

Methods: Cancer registry data from Thomas Jefferson University was used to obtain records from 922 head and neck cancer patients. One patient of other race was excluded. Twenty in-situ cancer cases were excluded. Chi-square tests were used …


Are We Doing It For The Money? A Salary Survey Of The United States Surgical Program Directors, Alexander Hoey, Ba, Brian Hoey, Md, Stanislaw Stawicki, Md Feb 2019

Are We Doing It For The Money? A Salary Survey Of The United States Surgical Program Directors, Alexander Hoey, Ba, Brian Hoey, Md, Stanislaw Stawicki, Md

Phase 1

Compensation packages and job responsibilities for United States surgical program directors (PD) vary considerably from one institution to the next. With limited compensation data available for PD’s, this survey reassesses and compares the salaries, benefits, duties, and contract arrangements of all allopathic U.S. surgical PDs. Questionnaires regarding these areas of interest were mailed out electronically to all of the PDs and data was compared between the individuals’ responses using Chi-Squared and Fischer Exact Tests. Fifty-five percent of the PDs responded, revealing significant variation in total compensation packages, size of the dedicated stipend for the role, and time spent on clinical …


Long Term Effects Of Ovum Donation On Donors, Danielle Garfunkel, Andrea Braverman Feb 2019

Long Term Effects Of Ovum Donation On Donors, Danielle Garfunkel, Andrea Braverman

Phase 1

Introduction: As infertility affects 17% of couples, IVF has become a key, increasingly prevalent option for couples with oocyte donors providing eggs to infertile women in ~13.7% of IVF cycles. Despite the growing prevalence of donation, there are no long-term follow up studies on the emotional and health effects of donation. We cannot appropriately counsel patients regarding the risks of the donation procedure without understanding its effects.

Objective: This study sets out to identify the long-term effects of oocyte donation on donors’ mental state and physical health and how the attitudes and concerns of oocyte donors regarding their donation …


Assessing The Operative Log Data Of Traditional (5+2) Vs. Integrated (0+5) Vascular Training Programs, Ernest Gillan, Bs, Anthony Feghali, Md, Tuong Nguyen, Md, Dawn Salvatore, Md, Paul Dimuzio, Md, Babak Abai, Md Feb 2019

Assessing The Operative Log Data Of Traditional (5+2) Vs. Integrated (0+5) Vascular Training Programs, Ernest Gillan, Bs, Anthony Feghali, Md, Tuong Nguyen, Md, Dawn Salvatore, Md, Paul Dimuzio, Md, Babak Abai, Md

Phase 1

Introduction: In 2006, the Accreditation Council for Graduate Medical Education (ACGME) approved an integrated 5 year vascular surgery residency program. Operative experience can be used as a surrogate marker for success in the evolving field of vascular surgery training.

Objective: The purpose of this study is to compare the operative experience of those graduating from the traditional (5+2) vascular training program with the integrated (0+5) program.

Methods: National operative case log data supplied by the ACGME was gathered and organized for vascular surgery residents graduating between 2013 and 2018. Mean case numbers were compared between integrated vascular residents and traditional …


High Density Of Tumor-Associated Macrophage Staining Correlates With Poor Clinicopathologic Markers In Head And Neck Squamous Cell Carcinoma: A Meta-Analysis, Alexander Knops, Ba, Ayan Kumar, Bs, Brian Swendseid, Md, Ubaldo E. Martinez-Outshoorn, Md, Larry Harshyne, Phd, Nancy Philp, Phd, Ulrich Rodeck, Md, Phd, Christopher Snyder, Adam Luginbuhl, Md, David Cognetti, Md, Jennifer Johnson, Md, Joseph Curry, Md Feb 2019

High Density Of Tumor-Associated Macrophage Staining Correlates With Poor Clinicopathologic Markers In Head And Neck Squamous Cell Carcinoma: A Meta-Analysis, Alexander Knops, Ba, Ayan Kumar, Bs, Brian Swendseid, Md, Ubaldo E. Martinez-Outshoorn, Md, Larry Harshyne, Phd, Nancy Philp, Phd, Ulrich Rodeck, Md, Phd, Christopher Snyder, Adam Luginbuhl, Md, David Cognetti, Md, Jennifer Johnson, Md, Joseph Curry, Md

Phase 1

Background: Head and neck squamous cell carcinoma (HNSCC) develops within a complex cellular microenvironment that promotes tumor growth, but also represents many potential therapeutic targets. Macrophage presence within that environment has been implicated in the growth, aggression, and persistence of HNSCC. Current literature reports variable degrees of association between tumor-associated macrophage (TAMs) density and clinicopathologic markers of disease.Inconsistent findings may result from grouping of TAM subtypes, which include both M1 (pro-inflammatory) and M2 (immunosuppressive). Our aim is to define the prognostic significance of the phenotypes of tumor-associated macrophages in HNSCC.

Methods: We conducted a meta-analysis of the existing publications investigating …


Cellular Milieu Imparts Distinct Pathological Α-Synuclein Strains In Α-Synucleinopathies, Ronald Gathagan, Chao Peng, Dustin Covell, Coraima Medellin, Anna Stieber, John L. Robinson, Bin Zhang, Rose M. Pitkin, Modupe F. Olufemi, Kelvin C. Luk, John Q. Trojanowski, Virginia M.Y. Lee Feb 2019

Cellular Milieu Imparts Distinct Pathological Α-Synuclein Strains In Α-Synucleinopathies, Ronald Gathagan, Chao Peng, Dustin Covell, Coraima Medellin, Anna Stieber, John L. Robinson, Bin Zhang, Rose M. Pitkin, Modupe F. Olufemi, Kelvin C. Luk, John Q. Trojanowski, Virginia M.Y. Lee

Phase 1

Introduction: In Lewy body diseases-including Parkinson's disease, without or with dementia, dementia with Lewy bodies, and Alzheimer's disease with Lewy body co-pathology -α-synuclein (α-Syn) aggregates in neurons as Lewy bodies and Lewy neurites. By contrast, in multiple system atrophy α-Syn accumulates mainly in oligodendrocytes as glial cytoplasmic inclusions (GCIs)

Objective: Our objective was to determine the conformational and biological profiles of a-Syn strains.

Methods: The following methods were used to collect and analyze data: Recombinant α-Syn purification and in vitro fibrillization. Preparation of sarkosyl-insoluble fractions from disease and control brains. Sandwich ELISA. Cell cultures. Stereotaxic injection of sarkosyl-insoluble fraction of …


Sickle Cell Disease And Variation In The Par4 Receptor, Matthew Lankiewicz, Steven E. Mckenzie, Leonard Edelstein, Stephanie Renna Feb 2019

Sickle Cell Disease And Variation In The Par4 Receptor, Matthew Lankiewicz, Steven E. Mckenzie, Leonard Edelstein, Stephanie Renna

Phase 1

Sickle cell disease disproportionately affects African Americans in the U.S. Much can still be learned regarding determinants of frequency and severity of painful vaso-occlusive episodes in these patients. It has been reported that a variant in PAR4 (protease-activated receptor 4) has a unique distribution among African Americans. One variant (Thr120) is hyperactive, while the other (Ala120) is hypoactive. This receptor is present on platelets, vascular cells, and nociceptors. We wish ultimately to test the hypothesis that sickle cell patients with the hyperactive PAR4 receptor have greater pain severity. A genotype-phenotype correlation would have prognostic value. An adequately powered study to …


Minimally Invasive Surgery In Neonates With Congenital Anomalies: Experience From The Nsqip-P, Emily Sagalow, Katerina Dukleska, Md, Courtney Devin, Md, Erin Teeple, Md, Scott W. Cowan, Md, Charles D. Vincour, Md, Loren Berman, Md Feb 2019

Minimally Invasive Surgery In Neonates With Congenital Anomalies: Experience From The Nsqip-P, Emily Sagalow, Katerina Dukleska, Md, Courtney Devin, Md, Erin Teeple, Md, Scott W. Cowan, Md, Charles D. Vincour, Md, Loren Berman, Md

Phase 1

Background: Congenital diaphragmatic hernias (CDH) and tracheoesophageal fistulas (TEF) are managed with minimally invasive surgery (MIS) or open surgery. Little is known about the patient populations and outcomes for those treated by each approach. Hypothesis/Specific Aims: We expect that there will be fewer complications, better outcomes, and longer operative times for the MIS group versus the open group.

Methods: National Surgical Quality Improvement Program-Pediatric Participant Use Files (NSQIP-P PUFs) from 2012-2015 were used to identify neonates (up to 30 days old) who underwent CDH and TEF repair. The patient characteristics, post-operative complications, and 30-day mortality were analyzed using multivariable logistic …


Network Influence Of The Cerebellum For Predicting Dbs Response In Patients With Advanced Parkinson’S Disease, Lucy Li, Jennifer Muller, Sara Thalheimer, Mackenzie D. Silverman, Mahdi Alizadeh, Tsao-Wei Liang, Kelly Layton, Daniel Kremens, Victor Romo, Feroze Mohamed, Chengyuan Wu Feb 2019

Network Influence Of The Cerebellum For Predicting Dbs Response In Patients With Advanced Parkinson’S Disease, Lucy Li, Jennifer Muller, Sara Thalheimer, Mackenzie D. Silverman, Mahdi Alizadeh, Tsao-Wei Liang, Kelly Layton, Daniel Kremens, Victor Romo, Feroze Mohamed, Chengyuan Wu

Phase 1

Introduction: Deep brain stimulation (DBS) is a treatment option for reducing motor symptoms in patients with Parkinson’s Disease (PD) when first-line medication becomes ineffective. Existing literature has hypothesized that the clinical outcome of DBS may depend on brain connectivity profiles of the stimulation site to distant brain regions. However, the potential of brain connectivity profiles to predict response to DBS in PD remains unclear.

Objective: This study aimed to investigate how changes in structural and functional connectivity may relate to patient response to DBS, through the examination of brain network changes using graph theory.

Methods: Ten patients with advanced PD …


Retrospective Chart Review Assessing Factors That Contribute To Network Leakage In Postoperative Pancreatic Cancer Patients, Nazanin Sarpoulaki, Christian Fernandez, Md, Mark Hurwitz, Md Feb 2019

Retrospective Chart Review Assessing Factors That Contribute To Network Leakage In Postoperative Pancreatic Cancer Patients, Nazanin Sarpoulaki, Christian Fernandez, Md, Mark Hurwitz, Md

Phase 1

Introduction: Standard of care for resectable pancreatic cancer includes surgery, chemotherapy, with consideration of radiotherapy. Thomas Jefferson University Hospital (TJUH) is a large volume institution for pancreatectomy. Rate of subsequent in-network adjuvant treatment are far less which may impact outcomes. We will elucidate variables that influence coordinated patient care.

Objective: To evaluate variables that correlate with follow up and adjuvant treatment of pancreatic cancer patients at TJUH.

Methods: Retrospective medical chart reviews will be performed with data from patients with pancreatic cancer who have undergone resection at TJUH from April 2017 to March 2018. Patient demographics, clinical, and pathologic information …


Factors Associated With Stage At Presentation Among Patients With Rare Pancreatic Tumors: An Exploratory Analysis Of The Seer Database, J. Subramoney, D. Delgado, V. Nguyen, R. Denneny, B. George, E. Mitchell, Md Feb 2019

Factors Associated With Stage At Presentation Among Patients With Rare Pancreatic Tumors: An Exploratory Analysis Of The Seer Database, J. Subramoney, D. Delgado, V. Nguyen, R. Denneny, B. George, E. Mitchell, Md

Phase 1

Introduction: Rare pancreatic carcinomas (PC) account for roughly 15% of all pancreatic cancers and approximately 8,300 new cases within the US annually. Little research compares initial stage at diagnosis among rare vs. common pancreatic tumors. The aim of this study was to examine associations between tumor histology and initial stage at diagnosis among cases of rare pancreatic cancers.

Methods: Retrospective cohort study, using the NCI’s Surveillance, Epidemiology, and End Results (SEER) 1990-2015 database. We included patients diagnosed with pancreatic cancer aged 18+. Histology was classified into four categories (ductal, carcinoid, mucinous adenocarcinoma, and undetermined) and stage was dichotomized …


Management Of Retinoblastoma In Older Children (>5 Years) Using Intra-Arterial Chemotherapy: Comparison Of Outcomes To Pre-Chemotherapy And Intravenous Chemotherapy Eras, Evan Selzer, Ms, R. Joel Welch, Md, Pascal Jabbour, Md, Ann Leahey, Md, Carol L. Shields, Md Feb 2019

Management Of Retinoblastoma In Older Children (>5 Years) Using Intra-Arterial Chemotherapy: Comparison Of Outcomes To Pre-Chemotherapy And Intravenous Chemotherapy Eras, Evan Selzer, Ms, R. Joel Welch, Md, Pascal Jabbour, Md, Ann Leahey, Md, Carol L. Shields, Md

Phase 1

Introduction: Intra-arterial chemotherapy (IAC) has emerged as an effective treatment for retinoblastoma (RB), but little information exists regarding its use in older patients (>5 years). We evaluate the use of IAC (2008-2018) for RB in older patients and compare outcomes to those in the pre-chemotherapy (<1994) and intravenous chemotherapy (IVC) (1994-2007) eras.

Objective: To evaluate the hypothesis that IAC is effective in managing RB in older patients.

Methods: We performed a retrospective analysis of all patients older than 5 years who were treated with IAC for RB from 2008-2018 on the Ocular Oncology Service at the Wills Eye Hospital. Comparisons were made to historic, …


17-Hydroxyprogesterone Caproate Does Not Prevent Preterm Birth In Women With A Twin Pregnancy And A Prior Singleton Spontaneous Preterm Birth, Breanna Valcarcel, Bs, Andrew Ward, Md, Huda Al-Kouatly, Md, Vincenzo Berghella, Md, Victoria Greenberg, Md Feb 2019

17-Hydroxyprogesterone Caproate Does Not Prevent Preterm Birth In Women With A Twin Pregnancy And A Prior Singleton Spontaneous Preterm Birth, Breanna Valcarcel, Bs, Andrew Ward, Md, Huda Al-Kouatly, Md, Vincenzo Berghella, Md, Victoria Greenberg, Md

Phase 1

INTRODUCTION: Prior spontaneous preterm birth (sPTB) is a risk factor for recurrent sPTB. Weekly 17-hydroxyprogesterone caproate (17P) is used to prevent sPTB in singletons, but there is insufficient evidence on its benefit in twin pregnancies.

OBJECTIVE: We hypothesized that 17P weekly injections would reduce the likelihood of sPTB in women carrying a twin pregnancy with a history of singleton sPTB.

METHODS: We performed a retrospective case control study of women with a twin gestation and prior singleton sPTB between 2005 and 2016. The study group consisted of women with a twin gestation that received weekly 17P starting at 16 to …


Implementation Of Psychological Interview And Testing In A Large Sperm Bank, Catherine Sham, Andrea Braverman, Robert Mora, Makenzie Perdue, Jaime Shamonki Feb 2019

Implementation Of Psychological Interview And Testing In A Large Sperm Bank, Catherine Sham, Andrea Braverman, Robert Mora, Makenzie Perdue, Jaime Shamonki

Phase 1

Introduction: Historically, sperm donor applicants have been medically but not psychologically evaluated by mental health professionals (MHPs). As social norms and legislation shift toward non-anonymous donation, psychological assessments can provide opportunities to exclude unqualified donors and allow donors to consider the long-term implications of donating.

Objective: To determine the effectiveness of psychological screening in identifying unqualified sperm donors, and to evaluate psychological reasons for disqualification through clinical interview and testing.

Methods: A retrospective chart review of 229 potential donors who passed initial qualification at a major sperm bank from February 2017 to February 2018. All potential donors were evaluated by …


Association Of Cyp2c19*17 Allele And Choice Of P2y12 Inhibitor On Cardiovascular Outcomes Following Percutaneous Coronary Intervention, Yash Varma, Bs, Craig R. Lee, Phd, Pharmd, Joseph S. Rossi, Md, George A. Stouffer, Md Feb 2019

Association Of Cyp2c19*17 Allele And Choice Of P2y12 Inhibitor On Cardiovascular Outcomes Following Percutaneous Coronary Intervention, Yash Varma, Bs, Craig R. Lee, Phd, Pharmd, Joseph S. Rossi, Md, George A. Stouffer, Md

Phase 1

Introduction: The CYP2C19*17 allele variant is a gain-of-function polymorphism which increases levels of the active metabolite of clopidogrel.

Objective: *17 is associated with increased bleeding risk during clopidogrel therapy, but it is unclear whether alternative P2Y12 inhibitors, prasugrel and ticagrelor, produce better clinical outcomes in patients undergoing percutaneous coronary intervention (PCI).

Methods: A single-center observational study was conducted in 928 PCI patients who received CYP2C19 testing and dual anti-platelet therapy (DAPT). Risk of major adverse cardiovascular or cerebrovascular events (MACCE) and clinically significant bleeding over 12 months were compared across genotype and DAPT groups by proportional hazards regression.

Results: 584 …


Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Emily Wei, Katie Holland, Allison Zibelli, Md Feb 2019

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Emily Wei, Katie Holland, Allison Zibelli, Md

Phase 1

Introduction: Readmission rates of cancer patients remain high, while the rates of many other conditions are decreasing in the United States. Cancer patients are a plurality of patients readmitted to hospitals within 30 days of discharge, and have a high rate of avoidable readmission. Therefore, it is important to understand why these readmissions happen in order to prevent their occurrence.

Objective: This study hopes to identify specific, and potentially personal, reasons that bring cancer patients back to the hospital. Patient perspective may reveal trends that are not apparent in medical record chart reviews. This information can present an opportunity to …


A Study Of Wellness Education As A Burnout Coping Strategy, Abhishek Surampudy, Allen Friedland, Md, Himani Divatia, Do, Tina Hu, Md Feb 2019

A Study Of Wellness Education As A Burnout Coping Strategy, Abhishek Surampudy, Allen Friedland, Md, Himani Divatia, Do, Tina Hu, Md

Phase 1

Introduction: The MedScape National Physician Burnout & Depression 2018 report states that over 40% of responding physicians reported burnout, with 12% reporting clinical depression. As such, there is a need to study burnout mitigation.

Objective: This study seeks to validate the hypothesis that intervention will prevent burnout and promote physician well-being.

Methods: 200 medical professionals attending the November 2018 NMPRA conference in Orlando were administered a survey to assess attitudes and prevalence of burnout. Education about burnout was provided through an information booth, handouts, and discussions. A monthly newsletter about wellness will seek to inspire participants. Another survey after 6 …


Predictors Of Ventriculostomy Infection In A Large Cohort, Christine Wamsley, Ba, Ahmad Sweid, Md, Stavropoula Tjoumakaris, Md, Erica J. Mann, Ba, Christopher Neely, Bs, Jeffrey Head, Ba, Michael R. Gooch, Md, Nabeel Herial, Md, Robert Rosenwasswer, Md, Pascal Jabbour, Md Feb 2019

Predictors Of Ventriculostomy Infection In A Large Cohort, Christine Wamsley, Ba, Ahmad Sweid, Md, Stavropoula Tjoumakaris, Md, Erica J. Mann, Ba, Christopher Neely, Bs, Jeffrey Head, Ba, Michael R. Gooch, Md, Nabeel Herial, Md, Robert Rosenwasswer, Md, Pascal Jabbour, Md

Phase 1

Introduction: External ventricular drains (EVDs) are neurosurgical devices used to treat hydrocephalus and monitor intracranial pressure. Ventriculostomy-associated infections (VAIs) are a complication of EVD placement associated with increased morbidity and mortality, as well as cost. A previous study at Jefferson reported a decrease in VAI’s with the use of antibiotic-coated catheters.

Objective: The aim of this study was to assess the current rate of VAI’s and determine risk factors associated with infections.

Methods: Using Epic, the electronic medical records software, we conducted a retrospective review of patients who underwent EVD placement at Thomas Jefferson University Hospital and Jefferson Hospital for …


Sociodemographic Background Characteristics Of Patients Who Participate In A Lung Cancer Screening Program, Amber Zhang, Marcella Pimpinelli, Brooke Ruane, Russell K. Mcintire, Julie Barta, Md, Hee-Soon Juon, Bridget Jackson Feb 2019

Sociodemographic Background Characteristics Of Patients Who Participate In A Lung Cancer Screening Program, Amber Zhang, Marcella Pimpinelli, Brooke Ruane, Russell K. Mcintire, Julie Barta, Md, Hee-Soon Juon, Bridget Jackson

Phase 1

Introduction: Despite decreasing lung cancer incidence and mortality rates, disparities in prevalence and outcomes persist between Black and White patients. Secondary analysis of the National Lung Screening Trial found screening with low-dose CT (LDCT) reduced lung cancer mortality more in Blacks than Whites. However, it is unknown if racial disparities exist in screening results, and the involved sociodemographic factors.

Objective: The study aims to analyze characteristics that may predict screening outcomes (Lung-RADS category) in patients who received LDCT through the Jefferson Lung Cancer Screening Program (LCSP).

Methods: Retrospective data (n=733, May 2015 to July 2017) were merged with prospective …


Selection Criteria For Posterior Circulation Stroke And Functional Outcome Following Mechanical Thrombectomy, Vivian Xu, Ahmad Sweid, Md, Stavropoula Tjoumakaris, Md, Kavya Shivashankar, Ba, Karim Hafazalla, Bs, Michael R. Gooch, Md, Nabeel Herial, Md, Robert H. Rosenwasswer Md, Pascal Jabbour, Md Feb 2019

Selection Criteria For Posterior Circulation Stroke And Functional Outcome Following Mechanical Thrombectomy, Vivian Xu, Ahmad Sweid, Md, Stavropoula Tjoumakaris, Md, Kavya Shivashankar, Ba, Karim Hafazalla, Bs, Michael R. Gooch, Md, Nabeel Herial, Md, Robert H. Rosenwasswer Md, Pascal Jabbour, Md

Phase 1

Objective: 20% of all acute ischemic strokes (AIS) are caused by posterior circulation strokes, which carry an intensified mortality touching 95%. Early recanalization improves outcome as shown by several reports; however, safety, patient selection, and prognostic factors remain lacking. An investigation of the safety and prognostic factors for posterior circulation mechanical thrombectomy (MT) was performed.

Methods: A retrospective review of patients presenting with posterior circulation AIS, who underwent MT between 2010 and 2018.

Results: Of 443 patients who underwent MT for AIS, 83 patients had posterior circulation strokes. 95% of procedures were conducted under general anesthesia. The median NIHSS upon …