Medicine and Health Sciences Commons^™

Laryngeal Granuloma Reduction Following Treatment With High-Dose Oral Steroids., Jordan A Higgs, Lauren E Melley, Omar Ramadan, Robert T Sataloff

Otolaryngology (ENT) Resident Research

No abstract available

Parosteal Lipoma Of The Left Femur: A Case Report., James P Waters, Sydney Horenstein, Austin Egger, Parker Johnsen, Tae Won Kim

Orthopedic Surgery Resident Research

Multidisciplinary team collaboration in the diagnosis of rare tumors such as parosteal lipoma is highly important, especially when suspicious of malignancy. The use of radiological and physical examinations is imperative to monitor recurrence and quality of life.

Laryngeal Cancer Presenting As An Anterior Glottic Web., Razmig Garabet, Lauren E Melley, Omar Ramadan, Robert T Sataloff

Otolaryngology (ENT) Resident Research

No abstract available

Comparison Of Short-Arm Immobilization And Long-Arm Immobilization In Conservatively Managed Distal Radius Fractures: A Meta-Analysis And Systematic Review., Yash P Chaudhry, Genoveffa R Morway, Efstratios A Papadelis, Nikki A Doerr, Kenneth W Graf, Rakesh P Mashru, Henry J Dolch

Orthopedic Surgery Resident Research

Distal radius fractures are often treated conservatively with immobilization. Immobilizing above the elbow limits forearm rotation, though recent literature has suggested the effects on radiographic or functional outcomes may be negligible. This systematic review and meta-analysis aimed to analyze the radiographic and functional outcome scores of distal radius fractures managed with short-arm (SA) immobilization and long-arm (LA) immobilization. An electronic systematic search was performed of the PubMed and EMBASE databases from inception to October 5, 2022. All randomized controlled trials (RCTs) involving patients with acute distal radius fractures undergoing nonoperative treatment (involving application/maintenance of immobilization) comparing above-elbow versus below-elbow constructs …

Nail-Plate Combination Treatment Of Ipsilateral Humeral Shaft And Distal Humerus Fractures - A Case Report., Mark Lagreca, Yash P Chaudhry, Thomas Falconiero, Thomas Muzzonigro, Daniel Lippe, Mitesh Shah

Orthopedic Surgery Resident Research

INTRODUCTION: Humeral shaft and distal humerus fractures have several different treatment options, including plate fixation and intramedullary nailing. Each has its own benefits, but typically, they are not used in conjunction. While nail-plate combinations (NPCs) have become more common in the lower extremity, literature on their use in upper extremity fractures remains scarce.

CASE REPORT: A 74-year-old right-hand dominant male presented after a fall with a closed left transverse midshaft humerus fracture and an associated supracondylar distal humerus fracture with intercondylar extension through a medial column. Due to the segmental nature of his injury, medial column plating was used in …

No Difference In Pullout Strength Between A Bio-Inductive Implant And A Semitendinosus Tendon Graft In A Biomechanical Study Of Medial Patellofemoral Ligament Repair Augmentation., Austin Wetzler, Sean Mcmillan, Erik Brewer, Aakash Patel, Samuel Handy, Merrick Wetzler

Orthopedic Surgery Resident Research

PURPOSE: To compare the pullout strength of a bio-inductive implant (BI) used to augment a medial patellofemoral ligament (MPFL) repair with the pullout strength of semitendinosus graft in a biomechanical cadaveric model.

METHODS: Six matched pairs of cadavers (12 knees) were used in the biomechanical testing comparing semitendinosus tendon (Semi-T) versus a BI. The Semi-T was harvested from 1 of the matched pairs. A standard double-bundle technique using 2 sockets in the upper two-thirds of the patella 15 mm apart was performed. After docking of the graft into the patella, the patella was dissected free of soft tissues and potted …

Vocal Fold Paresis And Bilateral Anterior Laryngeal Saccular Cysts In A Singer., Ryan Witcher, Lauren E Melley, Omar Ramadan, Robert T Sataloff

Otolaryngology (ENT) Resident Research

No abstract available

End Of Life In The Ed – Brain Death And Organ Transplantation, Madison Cohen, Donald Penney

The Journal of Integrated Primary Care

Every year thousands of Americans die awaiting an organ transplant. While our knowledge and experience with organ transplantation has only improved, organ availability continues to be a major issue due to a lack of suitable donor organs. A large population of organ donors are those who have been clinically diagnosed as brain dead. Brain death is defined as the irreversible loss of all brain and brainstem functions. Despite brainstem functions being lost, mechanical ventilation and perfusion techniques allow for proper organ maintenance. This gives brain-dead individuals a unique opportunity to serve as multiple organ donors. However, due to mistrust of …

Acquired Anterior Laryngeal Web Following Laryngeal Inhalation Injury., Lauren E Melley, Omar Ramadan, Robert T Sataloff

Otolaryngology (ENT) Resident Research

No abstract available

Postoperative Stomach Volvulus And Pancreatitis Following A Sleeve Gastrectomy., Shane B Devine, Sam J King, Bradley J Chatterton, Kurt D Knepley

Internal Medicine Resident Research

The laparoscopic sleeve gastrectomy is the most common bariatric surgery performed to promote weight loss and improve obesity-related comorbidities. As the number of patients undergoing sleeve gastrectomy increases, so does the prevalence of complications. It is crucial to recognize both common and unusual complications of sleeve gastrectomy to properly diagnose and manage them. We present a unique case of gastric outlet obstruction not visualized on initial imaging and acute pancreatitis following a sleeve gastrectomy. We recommend performing an endoscopy and ordering serum lipase levels in a patient with negative CT scans but persistent postoperative nausea, vomiting, and abdominal pain. The …

Perioperative Opioids And Survival Outcomes In Resectable Head And Neck Cancer: A Systematic Review., Eric V Mastrolonardo, Derek S Mann, Harleen K. Sethi, Bo H Yun, Elliott M Sina, Maria Armache, Brooke Worster, Christopher E Fundakowski, Leila J Mady

Otolaryngology (ENT) Resident Research

BACKGROUND: Opioids are a mainstay in pain control for oncologic surgery. The objective of this systematic review is to evaluate the associations of perioperative opioid use with overall survival (OS) and disease-free survival (DFS) in patients with resectable head and neck cancer (HNC).

METHODS: A systematic review of PubMed, SCOPUS, and CINAHL between 2000 and 2022 was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies investigating perioperative opioid use for patients with HNC undergoing surgical resection and its association with OS and DFS were included.

RESULTS: Three thousand three hundred seventy-eight studies met initial inclusion …

Age-Related Decline In Hippocampal Tyrosine Phosphatase Ptpro Is A Mechanistic Factor In Chemotherapy-Related Cognitive Impairment., Zhimeng Yao, Hongmei Dong, Jianlin Zhu, Liang Du, Yichen Luo, Qing Liu, Shixin Liu, Yusheng Lin, Lu Wang, Shuhong Wang, Wei Wei, Keke Zhang, Qingjun Huang, Xiaojun Yu, Weijiang Zhao, Haiyun Xu, Xiaofu Qiu, Yunlong Pan, Xingxu Huang, Sai-Ching Jim Yeung, Dianzheng Zhang, Hao Zhang

PCOM Scholarly Papers

Chemotherapy-related cognitive impairment (CRCI) or "chemo brain" is a devastating neurotoxic sequela of cancer-related treatments, especially for the elderly individuals. Here we show that PTPRO, a tyrosine phosphatase, is highly enriched in the hippocampus, and its level is tightly associated with neurocognitive function but declined significantly during aging. To understand the protective role of PTPRO in CRCI, a mouse model was generated by treating Ptpro-/- female mice with doxorubicin (DOX) because Ptpro-/- female mice are more vulnerable to DOX, showing cognitive impairments and neurodegeneration. By analyzing PTPRO substrates that are neurocognition-associated tyrosine kinases, we found that SRC and EPHA4 are …

Republication Of "Uses Of Braces And Orthotics For Conservative Management Of Foot And Ankle Disorders"., Osama Elattar, Tyler Smith, Adam Ferguson, Daniel Farber, Keith Wapner

Orthopedic Surgery Resident Research

Nonsurgical management is almost always considered the first-line treatment for the vast majority of foot and ankle pathologies. Foot orthoses, shoe modifications, and therapeutic footwear are considered essential tools for successful conservative management of different foot and ankle disorders. Orthopedic foot and ankle surgeons should have a meticulous understanding of the lower extremity biomechanics as well as the pathoanatomy and the sequelae of diseases affecting the foot and/or ankle. This is essential to the understanding of the desired effects of the different inserts, orthotics, shoe modifications, or braces that may be prescribed for these conditions. In this article, we will …

Establishment Of A Consensus Protocol To Explore The Brain Pathobiome In Patients With Mild Cognitive Impairment And Alzheimer's Disease: Research Outline And Call For Collaboration., Richard Lathe, Nikki M Schultek, Brian J. Balin, Garth D Ehrlich, Lavinia Alberi Auber, George Perry, Edward B Breitschwerdt, David B Corry, Richard L Doty, Robert A Rissman, Peter L Nara, Ruth Itzhaki, William A Eimer, Rudolph E Tanzi

PCOM Scholarly Papers

Microbial infections of the brain can lead to dementia, and for many decades microbial infections have been implicated in Alzheimer's disease (AD) pathology. However, a causal role for infection in AD remains contentious, and the lack of standardized detection methodologies has led to inconsistent detection/identification of microbes in AD brains. There is a need for a consensus methodology; the Alzheimer's Pathobiome Initiative aims to perform comparative molecular analyses of microbes in post mortem brains versus cerebrospinal fluid, blood, olfactory neuroepithelium, oral/nasopharyngeal tissue, bronchoalveolar, urinary, and gut/stool samples. Diverse extraction methodologies, polymerase chain reaction and sequencing techniques, and bioinformatic tools will …

The Daily Activity Of Patients With Heart Failure During Covid-19 Pandemic., Christine Sykalo, Ugochukwu Egolum, Hua Ling

PCOM Scholarly Papers

BACKGROUND: Sedentary behavior is thought to contribute to worsening heart failure syndromes. Here, we examined whether the shelter-in-place order during the coronavirus disease 2019 (COVID-19) pandemic changed daily activity duration, which was monitored by an implantable cardiac device-based multisensor index and alert algorithm called HeartLogic.

METHODS: We performed a retrospective review of the HeartLogic data from patients with heart failure managed at our clinic and compared the individual daily activity duration 90 days prior to vs. after implementation of the shelter-in-place order. The activity data were prepared by Boston Scientific. Demographic data were extracted from our electronic medical record.

RESULTS: …

Commencement, South Georgia (2023), Philadelphia College Of Osteopathic Medicine

Commencements

South Georgia Campus Commencement Program, 2023. Degrees include Doctor of Osteopathic Medicine and Master of Science in Biomedical Sciences.

Commencement Speaker: Jim Matney, Colquitt Regional Medical Center

Commencement, Georgia (2023), Philadelphia College Of Osteopathic Medicine

Commencements

Georgia Campus Commencement Program, 2023. Degrees include Doctor of Osteopathic Medicine, Doctor of Pharmacy, Doctor of Physical Therapy, Master of Science in Biomedical Sciences, Master of Science in Medical Laboratory Science, and Master of Science in Health Sciences - Physician Assistant Studies.

Commencement Speaker: Julie Ginn Moretz, Augusta University Health System

Commencement, Philadelphia (2023), Philadelphia College Of Osteopathic Medicine

Commencements

Philadelphia Campus Commencement Program, 2023. Degrees include Doctor of Osteopathic Medicine, Doctor of Philosophy in Educational Psychology, Doctor of Psychology in Clinical Psychology, Doctor of Psychology in School Psychology, Educational Specialist in School Psychology, Master of Science in Applied Behavioral Analysis, Master of Science in Applied Positive Psychology, Master of Science in Biomedical Sciences, Master of Science in Forensic Medicine, Master of Science in Mental Health Counseling, Master of Science in Organizational Development and Leadership, Master of Science in Health Sciences - Physician Assistant Studies, Master of Science in Public Health Management and Administration, and Master of Science in School …

Upper Urinary Tract Transitional Cell Carcinoma And Lymph Node Involvement: Pre And Post Operative Outcomes, Brittney Henderson, Son Young, Mark Quiring, Scott Serpico, Edward Wu, Emma Troyer, Ryan Moriarty, Thomas Mueller, Gordon Brown

Research Day

Background: Upper urinary tract transitional cell carcinomas (UUT-TCC) comprise any malignancy arising from the renal pelvis to distal ureter. These cancers account for approximately 5-10% of all urothelial tumors. Two-thirds of cases are invasive with an estimated 5-year survival rate less than 50%. Pathologic staging, invasion into local structures, and lymph node involvement influence the overall survival rate. Lymph node dissection (LND) is associated with higher overall survival rates in UUT-TCC patients, likely by decreasing regional lymph node metastasis. Current literature suggests that removing eight to ten regional lymph nodes may improve survival. The outcomes of upper urinary tract malignancies …

Pustular Psoriasis And The Potential Therapeutic Usage Of An Il-36 Receptor Monoclonal Antibody, Jeannel T. Miclat, Shafik Habal

Research Day

Pustular psoriasis is an uncommon subtype of psoriasis that dramatically affects the quality of life of affected patients. Pustules can emerge anywhere along the trunk, limbs, soles, palms, and fingers, which debilitates the functionality of these appendages. Currently, there are no approved treatments for pustular psoriasis in the US; off-label usage of psoriasis vulgaris medications is usually prescribed. These treatments are insufficient for patients with difficult to manage or severe forms of pustular psoriasis. Psoriasis vulgaris biologic medications mainly target the IL-17 and IL-23 axis. However, novel clinical findings have demonstrated that pustular psoriasis’s central inflammatory axis depends on the …

The Impact Of Medication Therapy Management Services On Pediatric Patients With Medical Complexities, Charisma Osuagwu, Erica Wong, Savion Carswell, Sophia Jenkins, Xinyu Wang, Yujin Kim

Research Day

Introduction

Medication Therapy Management (MTM) is a service provided by healthcare providers to ensure the best medical outcomes, particularly for those with multiple chronic conditions. It is often provided for senior populations supported under the Centers for Medicare & Medicaid Services. Studies show that patients provided with MTM services have higher medication adherence rates and experience fewer complications. However, there are few studies on MTM counseling in pediatric populations. In this literature review study, we investigated the potential impact of MTM services for underserved pediatric populations with chronic conditions or disabilities who are likely to benefit from MTM services.

Methods …

Modified Excisional Biopsy Technique For Confirmed Or Highly Suspected Melanomas, Batul Momin, Katrina Hansen

Research Day

There are a variety of biopsy techniques for sampling confirmed or highly suspicious melanomas, including excisional, scoop-shave or “saucerization”, shave, and punch biopsy. Herein, we present a case in which a combination approach of saucerization and excisional biopsy was used for a patient with an inadequately sampled melanoma. In the literature, excisional biopsy remains the gold standard for diagnosing melanoma. This technique is accomplished with a full-thickness, fusiform removal of the lesion with a scalpel to the level of adipose tissue (2). The drawback to this technique is the slightly distorted anatomy that can occur during wound closure. Albeit rare, …

A Bone Of Contention: A Dynamic Ultrasound Assessment Of The Role Of The Radial Head In The Arthrokinematics Of The Proximal Radioulnar Joint, Kolson Lamb, Madison D. Hendricks, Courtney E. Grimes, Cameron A. Johnson, David Nguyen, Ruth Maher

Research Day

INTRODUCTION: The arthrokinematics of the proximal radioulnar joint (PRUJ) are believed to follow the convex-concave rule, meaning that when the convex radial head articulates with the concave radial notch on the ulna, rolling and gliding occur in opposite directions during forearm pronation and supination. Previous research using helical computerized tomography (CT) identified that the sequence of joint actions is in contrast with this rule, which would indicate a posterior glide of the radius on the ulna during pronation movement and the converse during supination.

OBJECTIVES: The aims of this study are to determine the arthrokinematics of the PRUJ while being …

Is There Any Benefit To Adding Corticosteroids To Radiofrequency Ablation Treatments: A Systemic Review., Lee James, Petar Jen, Nikolas Jen, Stefan Jen

Research Day

Introduction: Radiofrequency ablation (RFA) is a procedure done for chronic pain which uses thermal energy to nociceptive pathways with the goal of disrupting pain signaling. The thermal energy leads to nervous tissue disruption using radiofrequency currents through an electrode placed near the target area. RFA has been shown to have an increase in pain reduction as well as an increase in functional ability when compared to corticosteroid injections (CSI), another common treatment for both acute and chronic pain. Many clinicians have logically combined RFA and CI together to achieve a synergistic effect. This study aims to look at the current …

Silicone Stenting For Chronic Ureteral Obstruction Improves Stent Exchange Frequency, Bebe Eke, Noah Canvasser

Research Day

Introduction and Objective

Chronic ureter stenting is recommended for patients with malignant ureteral obstruction, or with benign ureteral obstruction that cannot tolerate or do not want definitive surgical management. Stents are exchanged at time intervals often limited by stent encrustation. Prior in vitro studies have demonstrated that silicone stents have less encrustation. Our objective was to compare patients undergoing chronic exchanges with polymer-based and silicone stents.

Methods

This IRB-approved retrospective study included all adult patients who underwent chronic ureter stent exchange from August 2017 through August 2022. Patients were stented with either a Boston Scientific PercuflexTM Plus or a Cook …

A Nine-Year Longitudinal Case Study Of A 27-Year-Old Male With Neurocysticercosis Presenting With New Onset Seizures, Ciara Doyle, Veronica Thompson, Amanda Ho, Joy Zarandy

Research Day

Background:

Taenia solium is a cestode endemic to regions of Latin America, Asia, sub-Saharan Africa and Oceania, and serves as the most common cause of acquired epilepsy in the world. T. solium eggs are transmitted fecal-orally when a human or pig host ingests contaminated food or water. Larvae hatch from the intestines and invade into muscle, tissue, or organs, forming cysts called cysticerci. Cysticerci involving the central nervous system is termed neurocysticercosis (NCC). Patients with NCC typically remain asymptomatic for 3-5 years in the viable stage until the host’s immune response is activated in the degenerating stage. Immune-mediated degradation of …

A Headfirst Approach – Concussion Management And Novel Diagnostic Testing, Madison Cohen, Kevin Wang, Julienne Ryland, Donald Penney

Research Day

INTRODUCTION: The incidence of concussions has become increasingly prevalent across a multitude of sports. Despite this, the current guidelines for concussion management are not well defined, which creates a significant barrier to proper evaluation and care.

OBJECTIVES: This manuscript was designed to help physicians, athletic trainers, coaches, and parents understand the clinical signs of concussion and management from the moment of injury to the athlete’s return to play. Additionally, we reviewed post-concussion sequelae and their incidence following concussion management.

METHODS: In order to better define the current approach to the management of sports-related concussions we completed a comprehensive literature review …

End Of Life In The Ed – Brain Death And Organ Transplantation, Madison Cohen, Robert Griffin, Donald Penney

Research Day

Brain death is defined as the irreversible loss of all brain and brainstem functions. While the criteria for diagnosing brain death have been established and refined since 1995, physicians remain uncomfortable with making the diagnosis leading to delays in pronouncing the patient as brain dead. While seemingly benign, a delay in pronouncing a patient as brain dead can place a financial burden on the family and cause additional and unnecessary emotional distress. Furthermore, delayed pronunciation of death causes improper delegation of the medical care team's resources and loss of the patient's potential to serve as an organ donor. The purpose …

An Investigation Of Oral Sex As A Risk Factor For Recurrent Vaginitis: A Case Study, Humza M. Baig, Kate B. Barker, Joy Zarandy

Research Day

Background:

Recurrent Vaginitis is defined as having three or more confirmed episodes within a year. Recurrence rates of vaginitis have been reported in up to 60% of previously infected women. The most common bacterial cause is due to Gardnerella vaginalis, while Candida albicans is the most common fungal cause; both microorganisms can cause opportunistic infections when imbalances occur in the vaginal environment. Commonly known risk factors include multiple sex partners, unprotected sex, douching, recent antibiotic use, and estrogen therapy.

Case Presentation:

A healthy 34-year-old female is complaining of recurrent episodes of vaginitis since the birth of her son two years …

Participation Of Children And Youth With And Without Cerebral Palsy Across Settings: An Exploratory Study, Teresa Long Pierce, Alyssa Laforme Fiss

Research Day

Introduction: Cerebral Palsy is one of the most common pediatric health conditions resulting in childhood disability. Children with CP experience varying levels of functional impairments due to muscle weakness, alterations in muscle tone, balance deficits, and loss of selective motor control. These impairments and activity limitations are thought to contribute to lower levels of participation. Studies examining participation of children with CP have found that participation is positively correlated with increased physical activity and have concluded that environment is a significant predictor of participation. However, research examining participation across specific environments is lacking. Additionally, research investigating the influence of various …