Medicine and Health Sciences Commons^™

Endolymphatic Sac Tumor, Tanner P. Lyons, Laura Barry, Robert T Sataloff

Otolaryngology (ENT) Resident Research

Masses occupying the retrolabyrinthine space are uncommon and most often represent paragangliomas, choroid plexus papilloma, endolymphatic sac tumors (ELSTs) or distant metastasis. ELSTs are rare, locally invasive tumors of the inner ear, with less than 300 cases reported in the literature. ELSTs are associated with von-Hippel Lindau (VHL) disease. Patients diagnosed with an ELST should undergo genetic testing for VHL disease, and individuals with confirmed VHL disease should be screened for ELST(s).

Antineutrophil Cytoplasmic Autoantibody-Associated Glomerulonephritis As A Possible Side Effect Of Covid-19 Vaccination., Edva Noel, Urmiya Rashid, Rizwan Rabbani, Waqas Ahmad Khan, Yves-Smith Benjamin, Iris Lee

Internal Medicine Resident Research

Vaccination is the principal tool aimed at curbing the COVID-19 pandemic that has, so far, affected tens of millions of individuals in the United States. The two available mRNA vaccines developed by Pfizer-BioNTech and Moderna possess high efficacy in preventing infection and illness severity. However, there are multiple side effects associated with these vaccines, some impacting different organs. Renal pathology is variable, with increasing cases of glomerulonephritis being observed. We report a rare acute kidney injury case due to antineutrophil cytoplasmic autoantibody (ANCA)-mediated glomerulonephritis after administering a second dose of the Pfizer-BioNTech mRNA SARS-CoV-2 vaccine. Aggravation and/or development of autoimmunity …

An Update And Report Failure Of Surgical Syndactyly Repair In Harlequin Ichthyosis., Elias H Kahan, Brian Temple, Logan Carr, Elizabeth Zellner

Plastic Surgery Resident Research

Harlequin ichthyosis (HI) is a rare congenital skin disorder caused by irregular epidermal differentiation. Syndactyly in HI is associated with thick hyperkeratotic skin flexion and angulation deformity of the hand and fingers resulting in limited function of the upper extremity. Traditional syndactyly release is limited as full-thickness skin grafts typically used in reconstruction are composed of diseased skin and require donor sites in a patient predisposed for adverse wound healing. This case report is a follow-up to a previous viewpoint written about digital escharotomies in a newborn with HI and outlines a second and fourth webspace syndactyly release with a …

Oncocytic Papillary Cystadenoma Of The Larynx: A Rare And Masquerading Entity., Samuel Bosco, James Ding, Christopher Fundakowski

Otolaryngology (ENT) Resident Research

We cared for a 59-year-old female smoker who presented with a supraglottic lesion mimicking a laryngeal saccular cyst. The lesion was found to be a oncocytic papillary cystadenoma. This is a rare, benign neoplasm that accounts for 2–4.7% of minor salivary gland neoplasms. Oncocytic papillary cystadenoma of the larynx is even more rare, compromising less than 1% of all benign laryngeal neoplasms. This case highlights the importance of comprehensive differential diagnosis for cystic laryngeal lesions.

Arthroscopic Suprapectoral Biceps Tenodesis: The Best Of Both Worlds, Tyler Pratte, Tyler Smith, Alfonso Arevalo, Joseph Wazen, David Rubenstein

Orthopedic Surgery Resident Research

Biceps tendinopathy and superior labrum anterior posterior lesions are a common source of shoulder pain and disability and can be effectively treated with biceps tenodesis. There are a variety of open and arthroscopic tenodesis techniques, but no one technique has demonstrated superiority. Arthroscopic techniques often disregard the extra-articular portions of the biceps tendon as a potential source of pain. Open techniques address this concern; however, they can be associated with wound complications, increased blood loss, nerve injury, and disruptions to surgical workflow. Here, we describe an all arthroscopic tenodesis technique at the suprapectoral zone of the tendon. This method addresses …

Unsupervised Home Exercises Versus Formal Physical Therapy After Primary Total Hip Arthroplasty: A Systematic Review, Yash P. Chaudhry, Hunter Hayes, Zachary Wells, Efstratios Papadelis, Alfonso Arevalo, Timothy Horan, Harpal S Khanuja, Carl Deirmengian

Orthopedic Surgery Resident Research

Historically, postoperative exercise and physical therapy (PT) have been viewed as crucial to a successful outcome following primary total hip arthroplasty (THA). This systematic review and meta-analysis aimed to assess differences in both short- and long-term objective and self-reported measures between primary THA patients with formal supervised physical therapy versus unsupervised home exercises after discharge. A search was conducted of six electronic databases from inception to December 14, 2020, for randomized controlled trials (RCTs) comparing changes from baseline in lower extremity strength (LES), aerobic capacity, and self-reported physical function and quality of life (QoL) between supervised and unsupervised physical therapy/exercise …

Gunshot Wound To The Chest With Retained Epicardial Bullet., Toba Bolaji, Abuoma C Ekpendu, Frederick Giberson

Transitional Year

Gunshot wounds remain the most common cause of penetrating injuries in children and adolescents and the second leading cause of death among youth in the United States. Penetrating cardiac injuries carry a significantly increased mortality rate. The extent of damage caused depends on the type of firearm, the bullet used, the velocityand the trajectory. Therefore, rapid diagnosis and treatment is of the utmost importance. We report a case of a 19-year-old boy who presented to ouremergency department (ED) after sustaining a gunshot wound (GSW) to the right chest. In the ED, the patient was stabilized and a large hematoma was …

Unresectable Primary Tracheal Synovial Sarcoma, Joann M. Butkus, Mackenzie Kramer, Daniel Eichorn, Ali Raza R. Shaikh, Rajesh R. Patel

Otolaryngology (ENT) Resident Research

Synovial sarcoma (SS) comprises less than 1% of head and neck cancers, and less than five cases of adult primary tracheal SS have been described. This case describes a patient encountered at a community-based academic hospital, and retrospective chart review was performed for data collection. A woman in her forties presented with shortness of breath due to a superior mediastinal mass found to be an unresectable primary tracheal SS. Primary treatment resorted to curative-intent radiation therapy. Subsequent metastasis required systemic chemotherapy with pazopanib. To the best of our knowledge, this is the first reported case of this nature and adds …

Early Colonoscopy In Hospitalized Patients With Acute Lower Gastrointestinal Bleeding: A Nationwide Analysis., Kuldeepsinh P Atodaria, Samyak Dhruv, Joseph M Bruno, Brisha Bhikadiya, Shravya R Ginnaram, Shreeja Shah

Internal Medicine Resident Research

Background: Performing colonoscopy within 24 h of presentation to the hospital is the accepted standard of care for patients with an acute lower gastrointestinal bleed (LGIB). Previous studies have failed to demonstrate the benefit of early colonoscopy (EC) on mortality. In this study, we wanted to see if there was a change in inpatient deaths (primary outcome), length of stay (LOS), and hospitalization charges (TOTCHG) (secondary outcomes) with EC compared to previous studies.

Methods: Adults diagnosed with LGIB were identified using the International Classification of Disease 10th Revision codes from the National Inpatient Sample database for 2016 to 2019. EC …

Laboratory-Reported Normal Value Ranges Should Not Be Used To Diagnose Periprosthetic Joint Infection., Salvador A. Forte, Joseph A. D'Alonzo, Zachary Wells, Brett Levine, Stephen Sizer, Carl Deirmengian

Orthopedic Surgery Resident Research

INTRODUCTION: Clinical laboratories offer several multipurpose tests, such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are not intended to diagnose any specific disease but are used by clinicians in multiple fields. The results and laboratory interpretation (normal/abnormal) of these multipurpose tests are based on laboratory-reported normal thresholds, which vary across clinical laboratories. In 2018, the International Consensus Meeting on Musculoskeletal Infection (2018 ICM) provided a gold-standard definition to diagnose periprosthetic joint infection (PJI) which included many multipurpose laboratory tests, along with thresholds optimized to diagnose PJI. The discrepancy between laboratory-reported normal thresholds and 2018 ICM-recommended PJI-optimized …

Systematic Review Of Prevalence, Risk Factors, And Management Of Instability Following Reverse Shoulder Arthroplasty, Jeffrey J. Olson, Michael D. Galetta, Rachel E. Keller, Luke S. Oh, Evan A. O'Donnell

Orthopedic Surgery Resident Research

Background

Since its approval for use, reverse shoulder arthroplasty (RSA) has become the primary treatment for cuff tear arthropathy, with indications expanding more recently to include revision fracture, osteoarthritis with significant glenoid bone loss, tumor, and chronic instability. Instability is a well-described postoperative complication, occurring in 1to 31% of relatively small cohorts and case series. Given the relative infrequency of instability, there remains a need for a comprehensive review of instability with a focus on risk factors and management. Our goal of this systematic review is to describe the prevalence, risk factors, and management strategies for instability …

Identification Of Novel Somatic Fusions Of Erg-Vegfa, Tmprss2-Erg, And Vegfa-Tmprss2 In Prostate Cancer Treated With Anlotinib And Androgen Deprivation Therapy: A Case Report, Qiuli Liu, Shuo Wang, Ze Wang, Peng Tang, Dianzheng Zhang, Weihua Lan, Jun Jiang

PCOM Scholarly Papers

The TMPRSS2-ERG fusion gene has frequently been found in prostate cancer and is associated with malignancy. Identifying novel fusions will help to stratify patients and establish patient-tailored therapies. A 78-year-old man presented to our hospital with severe symptoms of urinary urgency and frequency for 2 years, as well as severe bone pain for 1 year. He was diagnosed with metastatic prostate cancer with a Gleason score of 5 + 5. Three gene fusions, ERG_VEGFA, TMPRSS2_ERG, and VEGFA_TMPRSS2, were identified in the patient's prostate cancer tissue. Notably, administration of the tyrosine kinase inhibitor, anlotinib, in combination with a gonadotropin-releasing hormone agonist …

A Scoping Review Of Injuries In Amateur And Professional Men's Ice Hockey, Patrick F Szukics, Peters T Otlans, Alfonso Arevalo, Matthew Meade, Peter Deluca, John P Salvo

Orthopedic Surgery Resident Research

Background: Orthopaedic injuries are common in ice hockey at all levels and can result in physical and psychological adverse effects on these athletes.

Purpose: Primarily, to summarize published data on orthopaedic hockey injuries at the junior through professional level. Secondarily, to characterize the literature based on anatomic site injured, return-to-play rates, cause/mechanism of injury, time lost, and treatments used.

Study Design: Scoping review; Level of evidence, 4.

Methods: PubMed, EMBASE, Cochrane library, and SCOPUS were searched using the terms "hockey" and "injuries" using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and 4163 studies involving orthopaedic injuries were …

A Scoping Review Of Injuries In Amateur And Professional Men's Ice Hockey., Patrick F Szukics, Peters T Otlans, Alfonso Arevalo, Matthew Meade, Peter Deluca, John P Salvo

Orthopedic Surgery Resident Research

Background: Orthopaedic injuries are common in ice hockey at all levels and can result in physical and psychological adverse effects on these athletes.

Purpose: Primarily, to summarize published data on orthopaedic hockey injuries at the junior through professional level. Secondarily, to characterize the literature based on anatomic site injured, return-to-play rates, cause/mechanism of injury, time lost, and treatments used.

Study Design: Scoping review; Level of evidence, 4.

Methods: PubMed, EMBASE, Cochrane library, and SCOPUS were searched using the terms "hockey" and "injuries" using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and 4163 studies involving orthopaedic injuries were …

A Unique Case Of Metastatic Prostate Carcinoma To The Subglottis, Samuel Bosco, Kristen Prijs, Jordan Licata, Sandra A Schwartz, Raymond Lesser

Otolaryngology (ENT) Resident Research

An 85-year-old male presented to an otolaryngology office with hoarseness, stridor, and shortness of breath. He had been evaluated by 2 outside otolaryngologists for a 4-year history of hoarseness. He was referred for consideration for speech therapy regarding hoarseness, vocal fold edema, and a questionable right vocal fold polyp. The patient reported that his symptoms had worsened progressively over the prior 6-12 months. He had no history of head and neck cancer, recent intubation, autoimmune conditions, head and neck trauma, or smoking. The patient had a history of prostate carcinoma treated with radical prostatectomy, radiation therapy, and hormone therapy 18 …

Examination Of Care Processes And Treatment Optimization For Head And Neck Cancer Patients In A Community Setting “Hub And Hub” Model, Harleen K. Sethi, Elijah Walker, Travis Weinsheim, Matthew J. Brennan, Christopher E. Fundakowski

Otolaryngology (ENT) Resident Research

Objective

To examine referral pattern, the timing of diagnostic/staging processes, and treatment initiation for new head and neck cancer patients in a community setting.

Methods

Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020. Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation.

Results

One hundred and five patients were included in the study. The primary referral sources were external general otolaryngology (56.3%). Oral surgery and dermatology obtained tissue …

A Signature Of Saliva-Derived Exosomal Small Rnas As Predicting Biomarker For Esophageal Carcinoma: A Multicenter Prospective Study, Kai Li, Yusheng Lin, Yichen Luo, Xiao Xiong, Lu Wang, Kameron Durante, Junkuo Li, Fuyou Zhou, Yi Guo, Shaobin Chen, Yuping Chen, Dianzheng Zhang, Sai-Ching Jim Yeung, Hao Zhang

PCOM Scholarly Papers

BACKGROUND: The tRNA-derived small RNAs (tsRNAs) are produced in a nuclease-dependent manner in responses to variety of stresses that are common in cancers. We focus on a cancer-enriched tsRNA signature to develop a salivary exosome-based non-invasive biomarker for human esophageal squamous cell carcinoma (ESCC).

METHODS: Cancer-enriched small RNAs were identified by RNA sequencing of salivary exosomes obtained from ESCC patients (n = 3) and healthy controls (n = 3) in a pilot study and further validated in discovery cohort (n = 66). A multicenter prospective observational study was conducted in two ESCC high-incidence regions (n = 320 and 200, respectively) …

Editorial: Infection, Inflammation, And Neurodegeneration: A Critical Path To Alzheimer's Disease, Volume Ii., Roberta Mancuso, Simone Agostini, Denah Appelt, Brian J. Balin

PCOM Scholarly Papers

No abstract available

Digest Of The Philadelphia College Of Osteopathic Medicine (2022 No. 1), Philadelphia College Of Osteopathic Medicine

PCOM Digest 2020s

The 2022 Vol 1 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Updates
• Advancing Alumni
• PCOM Board of Trustees Elects New Chairman Thomas J. Gravina
• Past PCOM Chairman John P. Kearney’s Legacy
• 125 Years Through 125 Stories: Six Reflections of Legendary PCOM Professors
• Edna K. Williams DO 1926: The Diminutive Osteopath with Mighty Hands and Spirit
• A Humble Genius: David A. Festinger, PhD
• Class Notes