Digital Commons Network^™

The Centers For Medicare And Medicaid Services’ Approach To Value-Based Purchasing, Bettina Berman

Value-Based Purchasing Newsletter

Although evidence suggests that both the quality and the affordability of health care can be improved¹, it is likely that such improvements will come at great cost. Healthcare expenditures in the United States (U.S.) are expected to rise precipitously - from $1.5 trillion in 2005 to over $4 trillion in 2016.² Medicare, the nation’s single largest health care purchaser, spent an estimated $425 billion on health services in 2007. With the projected growth in Medicare beneficiaries, the amount may surpass $800 billion by 2017, placing the government under significant pressure to control health care costs.³

This …

Uncle Sam's Debut On The Value-Based Purchasing Stage, Neil I. Goldfarb

Value-Based Purchasing Newsletter

No abstract provided.

Women's History Month 2008

Diversity Programs

Lectures and Events during Women's History Month, March 2008.

Transcription Factor Signal Transducer And Activator Of Transcription 5 Promotes Growth Of Human Prostate Cancer Cells In Vivo, Ayush Dagbadorj, Robert A. Kirken, Benjamin Leiby, James Karras, Marja T. Nevalainen

Department of Cancer Biology Faculty Papers

Purpose: Stat5a/b is the key mediator of prolactin (Prl) effects in prostate cancer cells via activation of Jak2. Prl is locally produced growth factor in human prostate cancer. Prl protein expression and constitutive activation of Stat5a/b are associated with high histological grade of clinical prostate cancer. Moreover, activation of Stat5a/b in primary prostate cancer predicts early disease recurrence. Here, we inhibited Stat5a/b by several different methodological approaches. Our goal was to establish a proof-of-principle that Stat5a/b is critical for prostate cancer cell viability in vitro and for prostate tumor growth in vivo.

Experimental Design: We inhibited Stat5a/b protein expression by …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 4, Iss. 1, March 2008

Public Health Link

This issue includes a faculty spotlight on Dr. Crawford, an article by Dr. Plumb "Addressing the Public Health Crisis in Philadelphia" and program announcements.

Hemorrhage Into An Occult Spinal Ependymoma After Epidural Anesthesia, Peter G. Campbell, John K. Birknes, Ashwini D. Sharan, James S. Harrop, Alexander R. Vaccaro, John K. Ratliff

Department of Orthopaedic Surgery Faculty Papers

Summary of Background Data: Five cases of hemorrhage into a spinal neoplasm after spinal or epidural anesthesia are reported in the literature. Presentation ranges from severe low back pain to acute cauda equina syndrome.

Methods: A case study of a patient who hemorrhaged into an intradural, extramedullary spinal cord mass was performed. A detailed literature review is also provided.

Results: A 27 year old female underwent epidural anesthesia for Cesarean section delivery. She presented with a 3 week history of increasing low back pain with bilateral radiculopathy. Imaging studies revealed a large hemorrhagic intradural mass compressing the lower conus medullaris …

Anthony Frederick Depalma, Md: Educator, Researcher And Clinical Care Doctor., Phillip J. Marone

Department of Orthopaedic Surgery Faculty Papers

My first meeting with Dr. DePalma was in 1957 as an intern in his office on the 6th floor of the Curtis Clinic. He and I spoke for a while about the residency and he looked at me and said “you know you are going to be 33 years old before you make a plug nickel.” I replied, “well I don’t make any money now, so what is the difference?” He laughed and I got the residency. In the next two years, I spent many hours in the operating room with Dr. DePalma and learned quickly how skilled a surgeon …

Gating Charge Immobilization In Kv4.2 Channels: The Basis Of Closed-State Inactivation., Kevin Dougherty, Jose A De Santiago-Castillo, Manuel Covarrubias

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Kv4 channels mediate the somatodendritic A-type K+ current (I(SA)) in neurons. The availability of functional Kv4 channels is dynamically regulated by the membrane potential such that subthreshold depolarizations render Kv4 channels unavailable. The underlying process involves inactivation from closed states along the main activation pathway. Although classical inactivation mechanisms such as N- and P/C-type inactivation have been excluded, a clear understanding of closed-state inactivation in Kv4 channels has remained elusive. This is in part due to the lack of crucial information about the interactions between gating charge (Q) movement, activation, and inactivation. To overcome this limitation, we engineered a charybdotoxin …

The Management Of Keloids: Hands-On Versus Hands-Off., James Studdiford, Amber Stonehouse, Marc Altshuler, Elliot Rinzler

Department of Family & Community Medicine Faculty Papers

Keloids are benign fibrous growths that appear in scar tissue. The lesions can be severely disfiguring and early recognition of genetic lesions is crucial. This case report outlines and reviews the important management strategies for these lesions and the requirement for extensive counseling for the patient and their family. Many potential medical and surgical interventions exist. Unfortunately, these lesions tend to recur and overall outcomes remain poor. Given patient susceptibility to disfiguring results, surgical intervention should be used with extreme caution.

Online Teaching Preparedness: What About Faculty?, Elizabeth Elkind, Rnc, Msn, Mba, Phd(C), Kellie Smith, Edd, Rn

College of Nursing Faculty Papers & Presentations

Faculty development and online teaching: What about faculty? Drexel University’s e-learning 2.0 conference. Philadelphia, PA (podium presentation).

18 PowerPoint slides.

Whiplash: Diagnosis, Treatment, And Associated Injuries., Sanjay Yadla, John K. Ratliff, James Harrop

Department of Neurology Faculty Papers

STUDY DESIGN: Focused review of the current literature.

OBJECTIVE: To identify and synthesize the most current data pertaining to the diagnosis and treatment of whiplash and whiplash-associated disorders (WAD), and to report on whiplash-related injuries.

METHODS: A search of OVID Medline (1996-January 2007) and the Cochrane database of systematic reviews was performed using the keywords whiplash and WAD. Articles under subheadings for pathology, diagnosis, treatment, and epidemiology were chosen for review after identification by the authors.

RESULTS: A total of 485 articles in the English language literature were identified. Thirty-six articles pertained to the diagnosis, treatment, epidemiology of whiplash, and …

Inhibition Of Oncogene-Induced Inflammatory Chemokines Using A Farnesyltransferase Inhibitor., Katharine C Degeorge, Brent R Degeorge, James S Testa, Jay L Rothstein

Kimmel Cancer Center Faculty Papers

BACKGROUND: Farnesyltransferase inhibitors (FTI) are small molecule agents originally formulated to inhibit the oncogenic functions of Ras. Although subsequent analysis of FTI activity revealed wider effects on other pathways, the drug has been demonstrated to reduce Ras signaling by direct measurements. The purpose of the current study was to determine if FTI could be used to inhibit the inflammatory activities of a known Ras-activating human oncoprotein, RET/PTC3. RET/PTC3 is a fusion oncoprotein expressed in the thyroid epithelium of patients afflicted with thyroid autoimmune disease and/or differentiated thyroid carcinoma. Previous studies have demonstrated that RET/PTC3 signals through Ras and can provoke …

Rx For Pennsylvania: Healing The Healthcare System

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Retail Medicine, Eric J. Moskowitz Md/Mba Candidate, 2009, David B. Nash Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Chronic Care At The Crossroads

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Cancer Rehabilitation: An Expanding Need, Deborah Franklin Phd,Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

A Global Phr, David B. Nash, Md, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Surgical Versus Nonsurgical Therapy For Lumbar Spinal Stenosis., James N Weinstein, Tor D Tosteson, Jon D Lurie, Anna N A Tosteson, Emily Blood, Brett Hanscom, Harry Herkowitz, Frank Cammisa, Todd Albert, Scott D Boden, Alan Hilibrand, Harley Goldberg, Sigurd Berven, Howard An

Rothman Institute Papers

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials.

METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, …

Surgical Versus Nonsurgical Therapy For Lumbar Spinal Stenosis., James N Weinstein, Tor D Tosteson, Jon D Lurie, Anna N A Tosteson, Emily Blood, Brett Hanscom, Harry Herkowitz, Frank Cammisa, Todd J Albert, Scott D Boden, Alan Hilibrand, Harley Goldberg, Sigurd Berven, Howard An

Rothman Institute Papers

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials.

METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, …

Rosai-Dorfrman Disease Of The Colon, Rahul A. Nathwani, Lawrence Kenyon, Thomas E. Kowalski

Department of Medicine Faculty Papers

Rosai-Dorfman disease (RDD), formerly referred to as "sinus histiocytosis with massive lymphadenopathy," was first described by Rosai and Dorfman in 1969. Initially believed to be a disease limited to the lymph nodes, RDD is now recognized as involving a variety of organs. Although GI involvement has been reported, it remains rare. To our knowledge, there have been no cases of RDD reported in the gastroenterology literature and no cases evaluated with EUS.

Celecoxib Concentration Predicts Decrease In Prostaglandin E2 Concentrations In Nipple Aspirate Fluid From High Risk Women, Edward R. Sauter, Wenyi Qin, John E. Hewett, Rachel L. Ruhlen, John T. Flynn, George Rottinghaus, Yin-Chieh Chen

Department of Molecular Physiology and Biophysics Faculty Papers

BACKGROUND: Epidemiologic studies suggest that long term low dose celecoxib use significantly lowers breast cancer risk. We previously demonstrated that 400 mg celecoxib taken twice daily for 2 weeks lowered circulating plasma and breast nipple aspirate fluid (NAF) prostaglandin (PG)E2 concentrations in post- but not premenopausal high risk women. We hypothesized that circulating concentrations of celecoxib influenced PGE2 response, and that plasma levels of the drug are influenced by menopausal status. To address these hypotheses, the aims of the study were to determine: 1) if circulating plasma concentrations of celecoxib correlated with the change in plasma or NAF PGE2 concentrations …

Rehabilitation Of Neuromyelitis Optica (Devic’S Syndrome): 3 Case Reports, Adam L. Schreiber, Guy W. Fried, Christopher S. Formal, Bryan X. Desouza

Department of Rehabilitation Medicine Faculty Papers

We describe the inpatient clinical rehabilitation course of three patients with neuromyelitis optica (NMO; Devic’s Syndrome). These patients had varying functional deficits. Each patient improved in several functional independence measures (FIM domains), but had minimal to no progress in other domains after acute rehabilitation stays between 1 to 1.5 months. NMO is a severe central nervous system demyelinating syndrome distinct from MS, characterized by optic neuritis, myelitis, and at least two of three criteria: longitudinally extensive cord lesion, MRI nondiagnostic for multiple sclerosis, or NMO-IgG seropositivity. Persons with NMO may demonstrate improved function with rehabilitation efforts; though gains may be …

Black History Month 2008 Supplement

Diversity Programs

Lectures, Cultural Events and Cuisine during Black Heritage Month, February 2008.

Black Heritage Month 2008

Diversity Programs

Lectures, Cultural Events and Cuisine during Black Heritage Month, February 2008.

Advanced Education Nursing In Rural Communities, Beth Ann Swan, Ksenia Zukowsky, Margaret M. West, Anthony J. Frisby, Mary Powell, Lori Lauver, Alexis Marsella

The Selected Works of Anthony J. Frisby, PhD

Through support from the Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing, the Jefferson School of Nursing (JSN) has expanded its Adult, Family and Neonatal Nurse Practitioner programs, currently offered at the urban Center City Campus, to the rural Danville Campus. In addition, the Doctor of Nursing Practice (DNP) program is offered at both sites. Expansion of the program has increased the clinical learning experience sites for enrollees and the number and distribution (race/ethnicity, age, gender) of master's and doctoral prepared nurses employed and practicing in rural and underserved areas. …

The Yin And Yang Of Fcγ Receptors In Itp, Steven E. Mckenzie

Department of Medicine Faculty Papers

The Fcγ receptors contribute to the susceptibility to autoimmune diseases such as ITP in several ways: (1) they modulate dendritic cell antigen processing and presentation, (2) they modulate antibody production by B cells, and (3) they participate in effector cell functions, such as phagocytosis, antibody-dependent cellular cytotoxicity, and mediator release. The key finding in recent years has been the appreciation that the activating Fcγ receptors, encoded by FCGR2A, -2C, -3A, and -3B, compete with the inhibitory Fcγ receptor, encoded by FCGR2B, to determine cellular responses to immune complexes and antibody-coated cells.

Project Esl: Enhancing Student Learning For Esl Nursing Students, Mary Powell, Barbara Hoerst, Gloria Kersey-Matusiak, Lyn Buchheit, Terry Mcgee, Alexis Marsella

College of Nursing Faculty Papers & Presentations

It is incumbent upon nursing programs to recognize the demographics and issues involved in training nursing students for whom English is not their first language. Project ESL used a variety of techniques to boost academic success, facilitate progress through graduation, and develop faculty sensitivity to language and cultural issues.

Implementing A Graduate Nursing Program At A Distance Through An Urban-Rural Partnership., Ksenia Zukowsky, Beth Ann Swan, Mary Powell, Lori S. Lauver, Margaret Mary West, Anthony J. Frisby

The Selected Works of Anthony J. Frisby, PhD

The purposes of this poster presentation are to 1) describe the implementation of a master’s of science in nursing (MSN) program by providing access to rigorous distance education to students living in rural Pennsylvania; 2) discuss building a critical mass of master’s prepared advanced practice nurse experts in rural communities; and 3) share formative and summative evaluation information.

Through funding from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Nursing, the Jefferson School of Nursing (JSN) expanded its MSN program currently offered at the urban Philadelphia campus to the …

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

College of Nursing Faculty Papers & Presentations

The experience of parenting foster children with chronic illness and complex medical needs was explored in a phenomenological inquiry with 10 foster families. Thirteen participants currently fostering chronically ill children with complex medical needs were interviewed. Recorded interviews were transcribed and analyzed using van Manen's method. Data analysis yielded five essential themes: Foster parents described being committed to the child in their care, coming to know the needs of a medically complex foster child, and identifying effective and ineffective interventions encountered through day-to-day living with a medically complex child. Furthermore, they shared what it was like to experience loss of …

Abeta42 Mutants With Different Aggregation Profiles Induce Distinct Pathologies In Drosophila., Koichi Iijima, Hsueh-Cheng Chiang, Stephen A Hearn, Inessa Hakker, Anthony Gatt, Christopher Shenton, Linda Granger, Amy Leung, Kanae Iijima-Ando, Yi Zhong

Department of Biochemistry and Molecular Biology Faculty Papers

Aggregation of the amyloid-beta-42 (Abeta42) peptide in the brain parenchyma is a pathological hallmark of Alzheimer's disease (AD), and the prevention of Abeta aggregation has been proposed as a therapeutic intervention in AD. However, recent reports indicate that Abeta can form several different prefibrillar and fibrillar aggregates and that each aggregate may confer different pathogenic effects, suggesting that manipulation of Abeta42 aggregation may not only quantitatively but also qualitatively modify brain pathology. Here, we compare the pathogenicity of human Abeta42 mutants with differing tendencies to aggregate. We examined the aggregation-prone, EOFAD-related Arctic mutation (Abeta42Arc) and an artificial mutation (Abeta42art) that …