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Neurologic Improvement After Thoracic, Thoracolumbar, And Lumbar Spinal Cord (Conus Medullaris) Injuries, James S. Harrop, Md, Swetha Naroji, Mitchell G. Maltenfort, Phd, John K. Ratliff, Md, Stavropoula L. Tjoumakaris, Brian Frank, D. Greg Anderson, M.D., Todd Albert, Md, Alexander R. Vaccaro, Md, Phd

Department of Orthopaedic Surgery Faculty Papers

Study Design. Retrospective. Objective. With approximately 10,000 new spinal cord injury (SCI) patients in the United States each year, predicting public health outcomes is an important public health concern. Combining all regions of the spine in SCI trials may be misleading if the lumbar and sacral regions (conus) have a neurologic improvement at different rates than the thoracic or thoracolumbar spinal cord.

Summary of Background Data. Over a 10-year period between January 1995 to 2005, 1746 consecutive spinal injured patients were seen, evaluated, and treated through a level 1 trauma referral center. A retrospective analysis was performed on 150 patients …

Amyloid-Beta/Fyn–Induced Synaptic, Network, And Cognitive Impairments Depend On Tau Levels In Multiple Mouse Models Of Alzheimer’S Disease, Erik D. Roberson, Brian Halabisky, Jong W. Yoo, Jinghua Yao, Jeannie Chin, Fengrong Yan, Tiffany Wu, Patricia Hamto, Nino Devidze, Gui-Qiu Yu, Jorge J. Palop, Jeffrey L. Noebels, Lennart Mucke

Farber Institute for Neuroscience Faculty Papers

Alzheimer's disease (AD), the most common neurodegenerative disorder, is a growing public health problem and still lacks effective treatments. Recent evidence suggests that microtubule-associated protein tau may mediate amyloid-β peptide (Aβ) toxicity by modulating the tyrosine kinase Fyn.Weshowed previously that tau reduction prevents, and Fyn overexpression exacerbates, cognitive deficits in human amyloid precursor protein (hAPP) transgenic mice overexpressing Aβ. However, the mechanisms by which Aβ, tau, and Fyn cooperate in AD-related pathogenesis remain to be fully elucidated. Here we examined the synaptic and network effects of this pathogenic triad. Tau reduction prevented cognitive decline induced by synergistic effects of Aβ …

Basal Internal Anal Sphincter Tone, Inhibitory Neurotransmission, And Other Factors Contributing To The Maintenance Of High Pressures In The Anal Canal, S. Rattan, J. Singh

Division of Gastroenterology and Hepatology Faculty Papers

Maintenance of the basal tone in the internal anal sphincter (IAS) is critical for rectoanal continence. Effective evacuation requires a fully functional rectoanal inhibitory reflex (RAIR)-mediated relaxation of the IAS via inhibitory neurotransmission (INT). Systematic studies examining the nature of the INT in different species have identified nitric oxide (NO) as the major inhibitory neurotransmitter. However, other mediators such as vasoactive intestinal polypeptide (VIP), ATP, and carbon monoxide (CO) may also play species-specific role under certain experimental conditions. Measurements of the intraluminal pressures in the IAS along with the force of the isolated IAS tissues are the mainstay in the …

The History Of Urological Care And Training At Thomas Jefferson University, Max Koppel, Md, Patrick J. Shenot, Md, Dolores Bryne, Phd, Leonard G. Gomella, Md

Department of Urology Faculty Papers

The Department of Urology at Thomas Jefferson University and Thomas Jefferson University Hospital is generally acknowledged as the oldest formal Department of Urology in the US, formally designated as the Department of Genitourinary Surgery in 1904. The Department has been under the direction of 8 chairmen and has trained over 144 residents and 25 fellows with over 200 Jefferson Medical College graduates specializing in urology. Thomas Jefferson University was originally founded as Jefferson Medical College in 1824. Dr. George McClelland petitioned Jefferson College at Cannonsburg (now Washington and Jefferson College) to add a medical school to their institution. While technically …

Serum Monocyte Chemoattractant Protein-1 In Pancreatic Cancer., Jennifer Sullivan, Qiaoke Gong, Terry Hyslop, Harish Lavu, Galina Chipitsyna, Charles Yeo, Hwyda A Arafat

Department of Surgery Faculty Papers

Background/Aims. Pancreatic ductal adenocarcinoma (PDA) has etiological association with chronic inflammation. Elevated circulating levels of inflammatory mediators, such as monocyte chemoattractant protein-1 (MCP-1), are found in obese individuals. We hypothesized that serum MCP-1 levels are elevated in obese PDA patients. Methods. ELISA was used to analyze MCP-1 serum levels in PDA (n = 62) and intraductal papillary mucinous neoplasms (IPMN) (n = 27). Recursive partitioning statistical analysis investigated the relationship between log MCP-1 and clinicopathological parameters. Results. Log MCP-1 values were significantly (P < 0.05) elevated in patients with BMI ≥ 37.5. In patients with BMI < 37.5, average log MCP-1 values were significantly elevated in PDA patients when compared to IPMN patients. Within the IPMN group, higher log MCP-1 levels correlated with increased age. Recursive partitioning analysis of IPMN versus PDA revealed a strategy of predicting characteristics of patients who are more likely to have cancer. This strategy utilizes log MCP-1 as the primary factor and also utilizes smoking status, gender, and age. Conclusion. MCP-1 is a promising biomarker in pancreatic cancer. The potential of using MCP-1 to distinguish PDA from IPMN patients must be studied in larger populations to validate and demonstrate its eventual clinical utility.

The Infected Hip: A Treatment Algorithm, Bahar Adeli, Javad Parvizi Md

Department of Orthopaedic Surgery Faculty Papers

The management of periprosthetic joint infection following total joint arthroplasty is presently a major challenge to orthopedic surgeons. Despite various treatment options available, the two-stage revision procedure is most often chosen in North America because of a high success rate, especially in cases involving resistant organisms. Sometimes the use of antibiotics alone, irrigation with debridement, or a one-stage exchange may be a more appropriate treatment option. Various factors such as the status of a patient’s immune system, time of onset of the infection, as well as susceptibility of causative microorganism should be considered as they play an important role in …

Adrenal Beta-Arrestin 1 Inhibition In Vivo Attenuates Post-Myocardial Infarction Progression To Heart Failure And Adverse Remodeling Via Reduction Of Circulating Aldosterone Levels, Anastasios Lymperopoulos, Phd, Giuseppe Rengo, Md, Carmela Zincarelli, Md, Jihee Kim, Phd, Walter J. Koch, Phd

Center for Translational Medicine Faculty Papers

ABSTRACT

OBJECTIVES: We investigated whether adrenal betaarrestin 1 (betaarr1)-mediated aldosterone production plays any role in post-MI HF progression.

BACKGROUND: Heart failure (HF) represents one of the most significant health problems worldwide and new and innovative treatments are needed. Aldosterone contributes significantly to HF progression after myocardial infarction (MI) by accelerating adverse cardiac remodeling and ventricular dysfunction. It is produced by the adrenal cortex after angiotensin II (AngII) activation of AngII type 1 receptors (AT1Rs), G protein-coupled receptors (GPCRs) that also signal independently of G proteins. G protein-independent signaling is mediated by betaarrestin (betaarr) -1 and -2. We recently reported that …

An Evidence-Based Review Of Fat Modifying Supplemental Weight Loss Products., Amy M Egras, William R Hamilton, Thomas L Lenz, Michael S Monaghan

College of Pharmacy Faculty Papers

Objective. To review the literature on fat modifying dietary supplements commonly used for weight loss. Methods. Recently published randomized, placebo-controlled trials were identified in PubMed, MEDLINE, International Pharmaceutical Abstracts, Cochrane Database, and Google Scholar using the search terms dietary supplement, herbal, weight loss, obesity, and individual supplement names. Discussion. Data for conjugated linoleic acid (CLA), Garcinia cambogia, chitosan, pyruvate, Irvingia gabonensis, and chia seed for weight loss were identified. CLA, chitosan, pyruvate, and Irvingia gabonensis appeared to be effective in weight loss via fat modifying mechanisms. However, the data on the use of these products is limited. Conclusion. Many obese …

Doctor Of Nursing Practice Students Advocating For Health Care Access, Quality, And Reform: From The Virtual Classroom To Capitol Hill., Mary Lou Manning, Dolores Grosso

College of Nursing Faculty Papers & Presentations

The potential for doctor of nursing practice students to inform and influence the national health care reform movement inspired faculty teaching an online Health and Social Policy course to create an assignment combining comparative effectiveness research with a trip to Capitol Hill to meet with congressional representatives. Preparing for and participating in such an assignment can present challenges for online doctoral students already busy with family and professional responsibilities. However, from both faculty and student perspectives, the lasting value and professional growth are immeasurable. Course details and the theoretical concepts of experiential education are presented, as well as trip logistics …

Assessment Of “Gene-Environment” Interaction In Cases Of Familial & Sporadic Pancreatic Cancer, Theresa Yeo, Ralph Hruban, Kieran Brune, Alison Klein, Shiela Fitzgerald, Charles Yeo

College of Nursing Faculty Papers & Presentations

Background: Pancreatic cancer (PC) is the fourth leading cause of cancer death in the United States. Reported risk factors for PC include: advancing age, a family history of PC, high-risk inherited syndromes, cigarette smoking, exposure to occupational and environmental carcinogens, African-American race, high fat/high cholesterol diet, obesity, chronic pancreatitis, and diabetes mellitus.

Purpose: The purpose of this study was to characterize one of the largest national registries of familial PC (FPC) and sporadic PC (SPC), focusing on demographics, clinical factors, self-reported environmental and occupational lifetime exposures and survival status.

Methods: Retrospective cross-sectional, case-only analysis of FPC cases (n …

Incivility In Healthcare Settings: Manifestations, Root Causes, And Downstream Effects On Patient Care And Productivity, Theresa P. Yeo, Anne Belcher, Charles J. Yeo

College of Nursing Faculty Papers & Presentations

PURPOSE: To investigate the prevalence and effects of incivility in healthcare and educational settings

METHODS: Review of the literature

SEARCH STRATEGY: CINAHL, PubMed, Joint Commission sites searched using terms: incivility, workplace violence, disruptive behavior, bullying

An Innovative Nurse Practitioner Model For Hospitalist Care, Melissa A. Diehl, Msn, Crnp, Mary Devry, Msn, Crnp, Kimberly Covington, Msn, Crnp, Beth Ann Swan, Phd, Crnp, Faan

College of Nursing Faculty Papers & Presentations

Purpose Statement:

The purpose of this poster presentation is to describe a hospitalist model of care developed and implemented by a collaborative care management team.

Human Milk Intake In Preterm Infants: Correlation Of The Preterm Infant Breastfeeding Behavior Scale (Pibbs) And Test Weighing, Ann Phalen

College of Nursing Faculty Papers & Presentations

Conclusions:

Direct observation and the use of the observational instruments are not clinically useful in predicting milk intake in preterm infants.

PHA, PNA, and BFE should not be used arbitrarily as predictor variables

Test weighing is the most reliable method to measure milk intake.

The PIBBS is a reliable instrument when used by trained lactation specialists but not predictive of milk intake in preterm infants for the volume of milk intake in preterm infants.

Parenting Foster Children With Chronic Illness And Complex Medical Needs, Lori S. Lauver Phd

College of Nursing Faculty Papers & Presentations

Conclusions: Parenting foster children with complex health care needs is a life changing experience for the foster families as well as foster children. A multifaceted experience, it has implications not only for nursing but multiple disciplines.

Article: http://jdc.jefferson.edu/nursfp/17/

Global To Local: Apic Chapters Build Community Awareness For Iipw In Their Communities, Janiene Torch Bohannon, Mary Lou Manning, Louise Hesse, Patrice Fitzsimons, Linda Huddleston, Colleen Chapple, Leanne Mikielski, Diana Doughty, Ossama Rassian, Maha Fathy, Lamia Fouad, Mostafa Abdel Nasser

College of Nursing Faculty Papers & Presentations

No abstract provided.

Jefferson Alumni Bulletin – Volume 60, Number 1, Winter 2011

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

Features:

• Women in Medicine: Bridging the Gaps
• Time & Place
• Jefferson Women: Leaders Through the Decades
• Personal Stories

Mitochondrial Genome Sequence Analysis: A Custom Bioinformatics Pipeline Substantially Improves Affymetrix Mitochip V2.0 Call Rate And Accuracy., Hongbo M Xie, Juan C Perin, Theodore G Schurr, Matthew C Dulik, Sergey I Zhadanov, Joseph A Baur, Michael P King, Emily Place, Colleen Clarke, Michael Grauer, Jonathan Schug, Avni Santani, Anthony Albano, Cecilia Kim, Vincent Procaccio, Hakon Hakonarson, Xiaowu Gai, Marni J Falk

Department of Biochemistry and Molecular Biology Faculty Papers

BACKGROUND: Mitochondrial genome sequence analysis is critical to the diagnostic evaluation of mitochondrial disease. Existing methodologies differ widely in throughput, complexity, cost efficiency, and sensitivity of heteroplasmy detection. Affymetrix MitoChip v2.0, which uses a sequencing-by-genotyping technology, allows potentially accurate and high-throughput sequencing of the entire human mitochondrial genome to be completed in a cost-effective fashion. However, the relatively low call rate achieved using existing software tools has limited the wide adoption of this platform for either clinical or research applications. Here, we report the design and development of a custom bioinformatics software pipeline that achieves a much improved call rate …

Ventral Hernia Repairs: 10 Year Single Institution Review At Thomas Jefferson University Hospital, Frederick C. Sailes, Md, Jason Walls, Md, Daria Guelig, Md, Mike Mirzabeigi, Ma, William D. Long, Ms, Albert Crawford, Phd, John H. Moore Jr, Md, Facs, Steven E. Copit, Md, Gary A. Tuma, M.D, James Fox, Md

Department of Surgery Faculty Papers

Abstract

Background Definitive repair of recurrent ventral hernias using abdominal wall reconstruction techniques is an essential tool in the armentarium for general and plastic surgeons. Ramirez 1 et al describes the “component separation” technique to mobilize the rectus-abdominus internal oblique and external oblique flap to correct the defect. The recurrence rate of incisional hernias increases to 20% after gastric bypass or extensive weight loss.2 The incidence of ventral hernias after failed recurrent hernia repair increases to 40%.3 It has been reported that utilizing the sliding myofascial flap repair technique, the recurrence rate was reduced to 8.5%.4

Materials and Methods This …

Potential For Interdependent Development Of Trna Determinants For Aminoacylation And Ribosome Decoding., Cuiping Liu, Howard Gamper, Hanqing Liu, Barry S Cooperman, Ya-Ming Hou

Department of Biochemistry and Molecular Biology Faculty Papers

Although the nucleotides in tRNA required for aminoacylation are conserved in evolution, bacterial aminoacyl-transfer RNA synthetases are unable to acylate eukaryotic tRNA. The cross-species barrier may be due to the absence of eukaryote-specific domains from bacterial aminoacyl-transfer RNA synthetases. Here we show that whereas Escherichia coli CysRS cannot acylate human tRNA(Cys), the fusion of a eukaryote-specific domain of human CysRS overcomes the cross-species barrier in human tRNA(Cys). In addition to enabling recognition of the sequence differences in the tertiary core of tRNA(Cys), the fused eukaryotic domain redirects the specificity of E. coli CysRS from the A37 present in bacterial tRNA(Cys) …

Defining The Phenotypes Of Sickle Cell Disease., Samir K. Ballas

Department of Medicine Faculty Papers

The sickle cell gene is pleiotropic in nature. Although it is a single gene mutation, it has multiple phenotypic expressions that constitute the complications of sickle cell disease. The frequency and severity of these complications vary considerably both latitudinally in patients and longitudinally in the same patient over time. Thus, complications that occur in childhood may disappear, persist or get worse with age. Dactylitis and stroke, for example, occur mostly in childhood, whereas leg ulcers and renal failure typically occur in adults. It is essential that the phenotypic manifestations of sickle cell disease be defined accurately so that communication among …

Update On Pain Management In Sickle Cell Disease., Samir K Ballas

Department of Medicine Faculty Papers

Acute pain is the hallmark of sickle cell disease and is the most common cause of hospital admissions. Tissue damage due to vaso-occlusion releases numerous inflammatory mediators that initiate the transmission of painful stimuli that culminate in the perception of pain. The acute sickle cell painful crisis evolves along four phases. Each phase is coupled with changes in certain markers of the disease. Hospital readmission occurs within 1 week in about 16% of discharged patients and within 1 month in about 50% of discharged patients. Failure to treat acute pain aggressively may lead to chronic pain syndrome which, in turn, …

Tdp-43 Potentiates Alpha-Synuclein Toxicity To Dopaminergic Neurons In Transgenic Mice., Tian Tian, Cao Huang, Jianbin Tong, Ming Yang, Hongxia Zhou, Xugang Xia

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

TDP-43 and α-synuclein are two disease proteins involved in a wide range of neurodegenerative diseases. While TDP-43 proteinopathy is considered a pathologic hallmark of sporadic amyotrophic lateral sclerosis and frontotemporal lobe degeneration, α-synuclein is a major component of Lewy body characteristic of Parkinson's disease. Intriguingly, TDP-43 proteinopathy also coexists with Lewy body and with synucleinopathy in certain disease conditions. Here we reported the effects of TDP-43 on α-synuclein neurotoxicity in transgenic mice. Overexpression of mutant TDP-43 (M337V substitution) in mice caused early death in transgenic founders, but overexpression of normal TDP-43 only induced a moderate loss of cortical neurons in …

Protein Modification By Arginylation, Hideko Kaji, Akira Kaji

Department of Biochemistry and Molecular Biology Faculty Papers

The modification of protein by arginine catalyzed by arginyltransferases (ATE1) described by the Kashina group in this issue shows that arginylation of protein occurs widely in biology and is being recognized as a key regulatory reaction such as phosphorylation of proteins (Wang et al., 2011).

Acetate Causes Alcohol Hangover Headache In Rats, Christina R. Maxwell, Rebecca Jay Spangenberg, Jan B. Hoek, Stephen D. Silberstein, Michael L. Oshinsky

Department of Neurology Faculty Papers

Background

The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache.

Methods

We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats.

Results

Ethanol initially decreased sensitivity to mechanical stimuli on the face (analgesia), followed 4 to 6 hours later by inflammatory pain. Inhibiting alcohol dehydrogenase extended the analgesia whereas inhibiting aldehyde dehydrogenase decreased analgesia. Neither treatment had nociceptive effects. Direct administration of acetate …

Phosphorylation Meets Nuclear Import: A Review., Jonathan D Nardozzi, Kaylen Lott, Gino Cingolani

Department of Biochemistry and Molecular Biology Faculty Papers

Phosphorylation is the most common and pleiotropic modification in biology, which plays a vital role in regulating and finely tuning a multitude of biological pathways. Transport across the nuclear envelope is also an essential cellular function and is intimately linked to many degeneration processes that lead to disease. It is therefore not surprising that phosphorylation of cargos trafficking between the cytoplasm and nucleus is emerging as an important step to regulate nuclear availability, which directly affects gene expression, cell growth and proliferation. However, the literature on phosphorylation of nucleocytoplasmic trafficking cargos is often confusing. Phosphorylation, and its mirror process dephosphorylation, …

Psychiatric Comorbidity In Transformed Migraine: Presentation, Treatment, Impact And Outcome, Muhammad A. Abbas M.D, Haseeba Ismaiel, M.D, William B. Young M.D., Mary Hopkins, Stephen D. Silberstein, M.D

Jefferson Journal of Psychiatry

Transformed migraine is one of the subtypes of chronic daily headache (CDH), and is similar to chronic migraine, described in the new International Headache Society (IHS) classification 2004. The term CDH refers to the Headache disorders experienced 15 or more days a month and includes headaches associated with medication overuse. CDH can be divided into primary and secondary varieties. Primary CDH is not related to a structural or systemic illness. It includes diseases such as Transformed migraine (TM). Chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). Secondary CDH has an identifiable underlying cause, including post-traumatic …

Resident Teaching Expectations And Medical Student Feedback, Michael Ignatowski

Jefferson Journal of Psychiatry

Objective Much of resident teaching of medical students occurs in an informal manner, with bedside teaching a common focus. Hence, the ability to monitor such teaching is limited. Feedback about how students perceive the teaching is perhaps one way to more effectively monitor and influence resident teaching.

Ten Year Follow Up Of A Psychiatry Residency Program Merger, Alvi A. Azad, Julianne Flynn, Thomas Matthews, Kenneth Matthews, Joseph Chozinski

Jefferson Journal of Psychiatry

Objective: To report on the successful merger of a civilian and military psychiatry residency. Methods: The reasons for and the history of the merger between the University of Texas Health Science Center at San Antonio and Wilford Hall Air Force Medical Center psychiatry residencies is described. Results: After some false starts, a bottom-up approach was implemented by first merging seminars, then rotations. Conclusions: Combining two psychiatry residencies in order to capitalize on both their strengths can yield a product even greater than the sum of their two programs and the key to a lasting merger is to start with two …

Patient Perceptions Of Physician Empathy, Satisfaction With Physician, Interpersonal Trust, And Compliance, Mohammadreza Hojat, Daniel Z. Lewis, Kaye Maxwell, Fred Markham, Richard Wender, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

Objectives: This study was designed to investigate psychometric properties of the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and to examine correlations between its scores and measures of overall satisfaction with physicians, personal trust, and indicators of patient compliance.

Methods: Research participants included 535 out-patients (between 18-75 years old, 66% female). A survey was mailed to participants which included the JSPPPE (5-item), a scale for measuring overall satisfaction with the primary care physician (10-item), and demographic questions. Patients were also asked about compliance with their physician's recommendation for preventive tests (colonoscopy, mammogram, and PSA for age and gender …

Awake Vs. Asleep Placement Of Spinal Cord Stimulators: A Cohort Analysis Of Complications Associated With Placement, Steven M. Falowski, Md, Amanda Celii Md, Anthony K. Sestokas Phd, Daniel M. Schwartz Phd, Craig Matsumoto Mpas, Ashwini Sharan Md

Department of Neurosurgery Faculty Papers

Introduction: Patients will typically undergo awake surgery for permanent implantation of SCS in an attempt to optimize electrode placement using patient feedback about the distribution of stimulation-induced paresthesia. The present study compared efficacy of first-time electrode placement under awake conditions with that of neurophysiologically-guided placement under general anesthesia.

Methods: A retrospective review was performed of 387 SCS surgeries among 259 patients which included 167 new stimulator implantation to determine whether first time awake surgery for placement of spinal cord stimulators is preferable to non-awake placement.

Results: The incidence of device failure for patients implanted using neurophysiologically-guided placement under general anesthesia …