Medicine and Health Sciences Commons^™

Collagen Fibrils And Proteoglycans Of Peripheral And Central Stroma Of The Keratoconus Cornea - Ultrastructure And 3d Transmission Electron Tomography, Aljoharah Alkanaan, Robert J. Barsotti, Omar Kirat, Adnan Khan, Turki Almubrad, Saeed Akhtar

PCOM Scholarly Papers

Keratoconus (KC) is a progressive corneal disorder in which vision gradually deteriorates as a result of continuous conical protrusion and the consequent altered corneal curvature. While the majority of the literature focus on assessing the center of this diseased cornea, there is growing evidence of peripheral involvement in the disease process. Thus, we investigated the organization of collagen fibrils (CFs) and proteoglycans (PGs) in the periphery and center of KC corneal stroma. Three-dimensional transmission electron tomography on four KC corneas showed the degeneration of microfibrils within the CFs and disturbance in the attachment of the PGs. Within the KC corneas, …

Mta3 Represses Cancer Stemness By Targeting The Sox2ot/Sox2 Axis, Liang Du, Lu Wang, Jinfeng Gan, Zhimeng Yao, Wan Lin, Junkuo Li, Yi Guo, Yuping Chen, Fuyou Zhou, Sai-Ching Jim Yeung, Robert P Coppes, Dianzheng Zhang, Hao Zhang

PCOM Scholarly Papers

Cancer cell stemness (CCS) plays critical roles in both malignancy maintenance and metastasis, yet the underlying molecular mechanisms are far from complete. Although the importance of SOX2 in cancer development and CCS are well recognized, the role of MTA3 in these processes is unknown. In this study, we used esophageal squamous cell carcinoma (ESCC) as a model system to demonstrate that MTA3 can repress both CCS and metastasis in vitro and in vivo. Mechanistically, by forming a repressive complex with GATA3, MTA3 downregulates SOX2OT, subsequently suppresses the SOX2OT/SOX2 axis, and ultimately represses CCS and metastasis. More importantly, MTA3

Validation Of A 5-Item Tool To Measure Patient Assessment Of Clinician Compassion In The Emergency Department., Praveen Sabapathi, Michael B. Roberts, Brian M Fuller, Michael A Puskarich, Christopher W Jones, J Hope Kilgannon, Valerie Braz, Christina Creel-Bulos, Nathaniel Scott, Kristina L Tester, Anthony Mazzarelli, Stephen Trzeciak, Brian W Roberts

PCOM Scholarly Papers

BACKGROUND: To test if the 5-item compassion measure (a tool previously validated in the outpatient setting to measure patient assessment of clinician compassion) is a valid and reliable tool to quantify a distinct construct (i.e. clinical compassion) among patients evaluated in the emergency department (ED).

METHODS: Cross-sectional study conducted in three academic emergency departments in the U.S. between November 2018 and April 2019. We enrolled adult patients who were evaluated in the EDs of the participating institutions and administered the 5-item compassion measure after completion of care in the ED. Validity testing was performed using confirmatory factor analysis. Cronbach's alpha …

Pcom Georgia Do Class Of 2024 Composite Sheet, Philadelphia College Of Osteopathic Medicine

Class Composite Sheets

PCOM Georgia DO Class of 2022 student portraits, matriculating Fall 2019.

Use Of Integra For Reconstruction After Nevi Resection: A Systematic Review And Pooled Analysis Of Reported Cases, Jude Opoku-Agyeman, Kayla Humenansky, Wellington Davis Iii, Paul Glat

Plastic Surgery Resident Research

BACKGROUND:

The use of Integra Dermal Reconstruction Template has emerged as an option for wound reconstruction, after resection of congenital nevi, especially giant congenital nevi. There have been many reports on Integra use in the literature for this purpose. This systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes.

METHODS:

Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Studies were analyzed if they met the inclusion criteria. Pooled …

Pcom Georgia Do Class Of 2023 Composite Sheet, Philadelphia College Of Osteopathic Medicine

Class Composite Sheets

PCOM Georgia DO Class of 2023 student portraits, matriculating Fall 2019.

Revisiting The Expanded Use Of Hyperbaric Oxygen Therapy For Treatment Of Resistant Migraines, David V Matera, Brian Smith, Benjamin Lam

PCOM Scholarly Papers

There are currently 13 indications approved by the U.S. Food and Drug Administration for use of hyperbaric oxygen therapy. The European Consensus Conference on Hyperbaric Medicine has 28 indications approved for its use. However, neither includes the use of hyperbaric oxygen therapy for neurological conditions such as migraines with aura. Recent research has made the attempt to fully understand the use of hyperbaric therapy in treatment of neurological conditions, but results have so far been inconclusive. We report a 23-year-old female with an 11-year history of migraines with aura who has received inadequate pharmacological treatment for her migraines since she …

Surgical Configurations Of The Pectoralis Major Flap For Reconstruction Of Sternoclavicular Defects: A Systematic Review And New Classification Of Described Techniques, Jude Opoku-Agyeman, David Matera, Jamee Simone

Plastic Surgery Resident Research

The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. We also provide an algorithm for the selection of these flap variants for sternoclavicular defect reconstruction.

METHODS:

EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to August …

An Unusual Presentation Of Subglottic Stenosis Necessitating Urgent Tracheostomy, Jacob Burdett, Alexander Manteghi

Otolaryngology (ENT) Resident Research

By definition, the subglottis is the area of the larynx immediately below the vocal folds extending to the level of the inferior border of the cricoid cartilage. This area represents the narrowest portion of the pediatric airway and is the most common site of iatrogenic stenosis. This stenosis is generally secondary to increased rates of intubation in infants of prematurity. Evaluation and treatment for subglottic stenosis represents one of the most common airway consultations within pediatric otolaryngology. Goals of therapy include securing a safe airway and restoring subglottic patency. In this clinical case, we present a unique pattern and presentation …

An Interesting Secondary Airway Lesion In An Infant With Laryngomalacia, William L. Valentino, David Lafferty, Alexander Manteghi

Otolaryngology (ENT) Resident Research

A 2-month-old male with a prior diagnosis of laryngomalacia (LM) presented to the emergency department in respiratory distress with worsening inspiratory stridor, suprasternal retractions, and a dry cough. A chest X-ray and lateral neck radiograph were performed and demonstrated no abnormalities. Flexible laryngoscopy revealed the same, previously observed moderately prolapsed arytenoids and an omega-shaped epiglottis with shortened aryepiglottic (AE) folds. He also had a right lower neck mass. He was scheduled for a direct laryngoscopy and bronchoscopy (DLB) and supraglottoplasty. During the DLB, LM and anterior compression of the midtrachea was noted. Lysis of the AE folds was performed in …

A Renal Cell Carcinoma With Biallelic Somatic Tsc2 Mutation: Clinical Study And Literature Review., Jian Pang, Linang Wang, Jing Xu, Qiubo Xie, Qiuli Liu, Dali Tong, Gaolei Liu, Yiqiang Huang, Xingxia Yang, Jinhong Pan, Xiaochu Yan, Qiang Ma, Dianzheng Zhang, Jun Jiang

PCOM Scholarly Papers

OBJECTIVES: To elucidate the effect of the biallelic somatic TSC2 mutations, identified in one adolescent patient, in renal cell carcinoma (RCC).

METHODS: Mutation analyses, immunohistochemistry and real-time polymerase chain reaction (PCR) were conducted.

RESULTS: Two novel somatic mutations of TSC2 in unilateral and solitary RCC samples from a 14-year-old female were identified. The pathological features suggest the tumor as a clear-cell renal cell carcinoma. In addition, immunohistochemistry revealed elevated levels of phosphorylated S6K1. Results from in vitro cellular experiments suggest that the mutant TSC2 proteins were quickly degraded and they failed to repress the phosphorylation of S6K1 and STAT3, which …

Depletion Of Myo/Nog Cells In The Lens Mitigates Posterior Capsule Opacification In Rabbits., Jacquelyn Gerhart, Liliana Werner, Nick Mamalis, Joseph Infanti, Colleen Withers, Fathma Abdalla, Colby Gerhart, Arturo Bravo Nuevo, Olivia Gerhart, Lori Getts, Kelly Rhodes, Jessica Bowers, Robert Getts, Mindy George-Weinstein

PCOM Scholarly Papers

Purpose: Posterior capsule opacification (PCO) is a vision-impairing disease that occurs in some adults and most children after cataract surgery. Contractile myofibroblasts contribute to PCO by producing wrinkles in the lens capsule that scatter light. Myofibroblasts in the lens originate from Myo/Nog cells named for their expression of the MyoD transcription factor and bone morphogenetic protein inhibitor noggin. In this study we tested the effects of depleting Myo/Nog cells on development of PCO.

Methods: Myo/Nog cells were eliminated by injecting the G8 antibody conjugated to 3DNA nanocarriers for the cytotoxin doxorubicin (G8:3DNA:Dox) during cataract surgery in rabbits. The severity of …

Reconstruction Of Sternoclavicular Defect With Completely Detached Pectoralis Major Flap, Jude Opoku-Agyeman, Sergio Perez, Amir Behnam, David Matera

Plastic Surgery Resident Research

Sternoclavicular joint infection is very rare. Osteomyelitis is a known complication of septic sternoclavicular joint. Once this condition is diagnosed, aggressive management including antibiotic and surgical debridement is warranted. Patients are often left with sizeable sternoclavicular defects that may need surgical reconstruction. In this report, we describe the use of a completely detached pectoralis major flap for the reconstruction of a large sternoclavicular defect after resection for osteomyelitis. Briefly, after the debridement of the infected sternoclavicular joint, the pectoralis major was detached from its sternoclavicular attachments and further detached from the humeral attachments rendering it completely detached on a vascular …

Multilevel Sleep Surgery Including The Palate In Nonsyndromic, Neurologically Intact Children With Obstructive Sleep Apnea, Jason E. Cohn, George E. Relyea, Srihari Daggumati, Brian J. Mckinnon

Otolaryngology (ENT) Resident Research

OBJECTIVE:

To examine the effects of multilevel sleep surgery, including palate procedures, on obstructive sleep apnea parameters in the pediatric population.

STUDY DESIGN:

A case series with chart review was conducted to identify nonsyndromic, neurologically intact pediatric patients who underwent either uvulectomy or uvulopalatopharyngoplasty as part of multilevel sleep surgery from 2011 through 2017.

SETTING:

A tertiary care, university children's hospital.

SUBJECTS AND METHODS:

Unpaired Student t test was used to compare average pre- and postsurgical apnea-hypopnea index (AHI) and oxygen saturation nadir (OSN). Paired Student t test was used to compare the mean pre- and postsurgical AHI and OSN …

Epithelioid Glioblastoma Presenting As Aphasia In A Young Adult With Ovarian Cancer: A Case Report, Megan M. Finneran, Joseph Georges, Michael Kakareka, Ryan Moncman, Miriam Enriquez, Todd Siegal, Gregory Kubicek, Alan Turtz, Steven S. Yocom, H Warren Goldman

PCOM Scholarly Papers

Our patient's clinical history and preoperative radiographic evaluation suggested central nervous system (CNS) metastatic disease. Ultimately, final pathology revealed epithelioid glioblastoma (eGBM), a newly classified CNS primary tumor. This reinforces the importance of direct tissue sampling and including eGBM on the differential for young patients with histories of systemic cancer presenting with new CNS lesions.

Astrocytes Infected With Chlamydia Pneumoniae Demonstrate Altered Expression And Activity Of Secretases Involved In The Generation Of Β-Amyloid Found In Alzheimer Disease, Zein Al-Atrache, Danielle B Lopez, Susan Hingley, Denah Appelt

PCOM Scholarly Papers

BACKGROUND: Epidemiologic studies strongly suggest that the pathophysiology of late-onset Alzheimer disease (AD) versus early-onset AD has environmental rather than genetic causes, thus revealing potentially novel therapeutic targets to limit disease progression. Several studies supporting the "pathogen hypothesis" of AD demonstrate a strong association between pathogens and the production of β-amyloid, the pathologic hallmark of AD. Although the mechanism of pathogen-induced neurodegeneration of AD remains unclear, astrocytes, a key player of the CNS innate immune response and producer/metabolizer of β-amyloid, have been implicated. We hypothesized that Chlamydia pneumoniae infection of human astrocytes alters the expression of the amyloid precursor protein …

Speech And Language Outcomes In Patients With Ankyloglossia Undergoing Frenulectomy: A Retrospective Pilot Study, Srihari Daggumati, Jason E. Cohn, Matthew J. Brennan, Marissa Evarts, Brian J. Mckinnon, Alyssa R. Terk

Otolaryngology (ENT) Resident Research

Ankyloglossia is a controversial topic with no standardized treatment guidelines. A retrospective chart review was conducted to identify children who underwent lingual frenulectomy for speech and language impairment. Impairment severity was recorded pre- and postoperatively as mild, mild to moderate, moderate, moderate to severe, or severe. Variables were tested with chi-square analysis for their statistical relationship to improvements in speech and language. Children with preoperative moderate and moderate-to-severe speech and language impairment attained better speech and language outcomes after frenulectomy as compared with children with mild and mild-to-moderate impairment (100% vs 82%, P = .015). Sutured closure after frenulectomy was …

Guggulsterone Activates Adipocyte Beiging Through Direct Effects On 3t3-L1 Adipocytes And Indirect Effects Mediated Through Raw264.7 Macrophages., Colette N Miller, Janaiya S Samuels, Yusra Azhar, Ashish Parmar, Rangaiah Shashidharamurthy, Srujana Rayalam

PCOM Scholarly Papers

Background: Plant-derived phytochemicals have been of emerging interest as anti-obesity compounds due to their apparent effects on promoting reduced lipid accumulation in adipocytes. Despite such promising evidence, little is known about the potential mechanisms behind their anti-obesity effects. The aim of this study is to establish potential anti-obesity effects of the phytochemical guggulsterone (GS). Methods: Mature 3T3-L1 adipocytes were treated with GS, derived from the guggul plant native in northern India, to investigate its effects on mitochondrial biogenesis and adipocyte "beiging." Further, to explore the relationship between macrophages and adipocytes, 3T3-L1s were treated with conditioned media from GS-treated RAW264.7 macrophages. …

The Use Of Dietary Interventions In Pediatric Patients, Shirin Madzhidova, Lusine Sedrakyan

PCOM Scholarly Papers

Complementary and alternative treatment approaches are becoming more common among children with chronic conditions. The prevalence of CAM use among US adults was estimated to be around 42% in 2015 and around 44% to 50% among adults with neurologic disorders. Studies demonstrate that children with certain chronic illnesses such as asthma, cancer, genetic disorders, attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental disorders are treated with complementary and alternative treatments at higher rates. Dietary therapies are gaining increasing popularity in the mainstream population. Although the majority of "fad" diets do not have enough supporting evidence, some dietary therapies have been utilized for …

Synapsis: Philadelphia Campus (2019), Philadelphia College Of Osteopathic Medicine

All Yearbooks

The 2019 Philadelphia Campus Synapsis includes Orientation, White Coat, Gala, Life at PCOM, Anatomy Groups, Radiology, Family Medicine, Match.

Analysis Of Gene Transcription Changes Following Chlamydia Pneumoniae Infection Of Thpl Monocytes May Have Relevance To Alzheimer's Disease, Desiré Guthier

PCOM Biomedical Studies Student Scholarship

There is increasing evidence that neuroinflammation caused by infectious agents is an important etiologic factor in neurodegenerative diseases including Alzheimer's disease (AD). One infectious agent that has been associated with AD is Chlamydia pneumoniae (Cpn). Cpn DNA can be detected within peripherally circulating mononuclear cells and there is evidence that infected mononuclear cells could be involved in chronic infection and contribute to inflammation at numerous anatomical sites, including the brain. Understanding Cpn genetic changes progressing from an acute to a chronic infection within monocytes may help to further elucidate. the role of Cpn infected monocytes with regard to …

The Effects Of Resveratrol On Dbc1 & Cadherin Expression In Prostate Cancer, Micah Bower-Kaiser

PCOM Biomedical Studies Student Scholarship

Prostate cancer (PCa) is an incredibly common disease in the United States, with approximately 170,000 new diagnoses and 30,000 deaths occurring on an annual basis. The current mainstay of treatment for PCa is known as androgen deprivation therapy (ADT), which has proven to be an effective short-term option in earlier stages of the disease. Unfortunately, longer periods of ADT risk accelerating progression of the cancer to the point where 25% of all treated patients relapse to an incurable, metastatic, and highly lethal form known as castration-resistant prostate cancer (CRPC). In approximately 60% of CRPC cases, a splice variant of androgen …

Does Light Therapy Improve The Quality Of Life For People With Acne?, Montana W. Banks

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does light therapy improve the quality of life for people with acne?”

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between the years of 2016 and 2018. All articles were published in the English language and in peer-reviewed journals.

DATA SOURCES: One pilot study, one multicenter, randomized, split-face control study and one single-blind, randomized, split-face study evaluating if light therapy can improve the quality of life (QOL) of people with acne. Sources were selected from PubMed and Cochrane based off of the relevance …

Does Stem Cell Injection Improve Quality Of Life In Patients With Cardiopathy Patients?, Shoua Shue Casillas

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not stem cell injections improve the quality of life in patients with cardiopathy.

STUDY DESIGN: Review of three randomized controlled trial (RCT) articles. All articles were published between 2012 – 2017 and were all printed in the English language.

DATA SOURCES: All three RCT articles were found through PubMed.

OUTCOMES MEASURED: One of the outcomes measured in each of the articles were improvement in quality of life in patients with cardiopathy. Among the three review articles, quality of life was measured using either the Kansas City Cardiomyopathy …

Is Apremilast 30mg Effective In Lowering Dlgi Scores In Patients With Plaque Psoriasis In 16 Weeks Of Therapy?, Hunter N. Dennard

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is Apremilast 30 mg effective in lowering DLQI scores in patients with plaque psoriasis in 16 weeks of therapy?”

Study Design: Review of three randomized, blind, placebo-controlled clinical trials published between the years 2013 and 2016.

Data Sources: All studies were published in peer-reviewed journals that were located using PubMed database searches.

Outcome Measured: The DLQI is a 10-item questionnaire that assesses the impact of skin disease on health-related quality of life (HRQOL) over the previous week. Scores for each item range from 0 (not at …

Does Adalimumab Improve Symptoms In Patients With Moderate To Severe Hidradenitis Suppurativa?, Eric A. Eck

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does Adalimumab improve symptoms in patients with moderate to severe Hidradenitis Suppurativa?”

STUDY DESIGN: A systematic review of three peer-reviewed articles published between 2011 and 2016 which present patient oriented evidence.

DATA SOURCES: Review incorporated analysis of two randomized controlled trials (RCTs) and one open label prospective trial. Studies were selected based upon the relevance to the clinical question, does adalimumab usage improve symptoms in individuals with moderate to severe hidradenitis suppurativa.

OUTCOMES MEASURED: The outcomes measured focused on patient reported reduction in hidradenitis suppurativa symptoms. …

Does The Ligasure Vessel Sealing System Provide Benefit In Mortality In Regards To Hepatic Resections?, Samantha M. Kleiber

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not using the LigaSure device provides any benefit in morality in patients undergoing hepatic resection surgery.

STUDY DESIGN: Review of three English language randomized control trials published in 2007, 2009 and 2012.

DATA SOURCES: Data sources obtained for this review primary studies published in peerreviewed journals, found using PubMed.

OUTCOMES MEASURED: Patient mortality, defined as death within 30 days of the surgical procedure.

RESULTS: The study done by Doklestic and et al had 3 patient mortalities occur. The deaths occurred on post op days three, four and …

Is Music Therapy Intervention Effective In Decreasing Pain After Standard Wound Care In Hospitalized Burn Patients?, Lindsay King

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not music therapy intervention is effective in decreasing pain after standard wound care in hospitalized burn patients.

STUDY DESIGN: Systematic review compiling data from three randomized controlled trials in 2016, all in the English language.

DATA SOURCES: After a thorough search of PubMed and Cochrane, three pertinent studies were found to include in this review. The selected studies were evaluated to assess the effectiveness of music therapy in decreasing pain after wound care in hospitalized burn patients.

OUTCOMES MEASURED: Decrease in pain symptoms were measured …

Is Electroacupuncture Effective In Improving Quality Of Life For Women With Urinary Incontinence?, Shelby Kaminsky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not “Is electroacupuncture effective in improving quality of life for women with urinary incontinence?”

STUDY DESIGN: A systematic review of 3 peer-reviewed studies published between the years of 2014 and 2017.

DATA SOURCES: Two randomized placebo-controlled studies and one comparative study evaluating if electroacupuncture (EA) and/or the use of tolterodine improves the quality of life and therapeutic effects of those with urinary incontinence (UI). Sources were selected from PubMed and Cochrane Library based off of their relevance to the clinical question and the outcomes …

Is Cannabis Effective In Reducing Muscle Spasticity And Body Pain Amongst Patients With Multiple Sclerosis?, William E. Johnson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not cannabis is effective in reducing muscle spasticity and body pain amongst patients with Multiple Sclerosis (MS).

STUDY DESIGN: A systematic review of three peer-reviewed studies published between the years of 2003 and 2012.

DATA SOURCES: Three randomized control trials (RCTs) evaluating if cannabis can reduce muscle spasticity and body pain for patients diagnosed with Multiple Sclerosis. All three sources were selected from PubMed and examined for outcomes that were patient oriented.

OUTCOMES MEASURED: The two primary outcomes measured include: muscle spasticity measured by the Ashworth scale, …