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Articles 31 - 60 of 68
Full-Text Articles in Medicine and Health Sciences
The Impact Of Community Use Of Novel Oral Anticoagulants On An Academic Medical Center, Luis Eraso, Md, Taki Galanis, Md, Kristina Kipp, Pharm.D., Walter K. Kraft, Md, Michael Palladino, Pharm.D., Cacp, Alejandro Perez, Md, Kimberle Ferebee-Spruill, Crnp, Geno Merli, Md, Brian G. Swift, Pharm.D., Mba, Lynda Thomson, Brittany Vining
The Impact Of Community Use Of Novel Oral Anticoagulants On An Academic Medical Center, Luis Eraso, Md, Taki Galanis, Md, Kristina Kipp, Pharm.D., Walter K. Kraft, Md, Michael Palladino, Pharm.D., Cacp, Alejandro Perez, Md, Kimberle Ferebee-Spruill, Crnp, Geno Merli, Md, Brian G. Swift, Pharm.D., Mba, Lynda Thomson, Brittany Vining
Department of Pharmacology and Experimental Therapeutics Faculty Papers
Warfarin has been a mainstay of therapy for treatment and prevention of venous thromboembolic disease (VTED) and prevention of stroke and systemic embolism for over 50 years. Recent FDA approval of several novel oral anticoagulants has offered more extensive treatment options for management of these disease states.
The availability of the novel anticoagulants offers an attractive alternative to warfarin therapy for patients due to their convenience of use. In comparison to warfarin, dabigatran, rivaroxaban and apixaban offer: - a fixed dosage regimen
- a relatively small potential drug interaction profile
- minimal laboratory monitoring
- little to no dietary restrictions. …
A Case Of Hemoglobinopathy-Thalassemia Syndrome, Michele C. Khurana, B.S., Gene Gulati, Ph.D
A Case Of Hemoglobinopathy-Thalassemia Syndrome, Michele C. Khurana, B.S., Gene Gulati, Ph.D
Department of Pathology Honors Program Student Research Symposium
Patient Presentation
- 43 year-old African American female presents with left lower extremity pain
- Physical exam: unremarkable
- Past medical history:
Anemic since childhood
Avascular necrosis of left hip
DVT
Chronic illnesses: asthma, depression
Surgical history: appendectomy, tubal ligation, splenectomy, cholecystectomy, L hip replacement
- Family history: mother has lupus
The Line Between Addiction And Medication: Alcohol, Anesthesia, And Analgesia, Priya Joshi, B.S., Emanual Rubin, Md
The Line Between Addiction And Medication: Alcohol, Anesthesia, And Analgesia, Priya Joshi, B.S., Emanual Rubin, Md
Department of Pathology Honors Program Student Research Symposium
Alcohol is a particularly dangerous addiction because its consumption is legal even in excess, despite its harmful effects. Because alcohol has a multitude of targets in the central nervous system that are modified during chronic exposure, medications with overlapping targets such as anesthetics and analgesics must be modified when given to alcoholics. Unfortunately, as relatively little is known about the mechanism of addiction, it is difficult to predict how medications will be affected by central adaptation to chronic alcohol exposure. This review summarizes the consequences of alcohol exposure with particular attention to the GABAAreceptor, and discusses the reasons …
Lumbar Chordoma: A Primary Bone Tumor, Andrew N. Fleischman, Bs, Brian O'Hara, Md
Lumbar Chordoma: A Primary Bone Tumor, Andrew N. Fleischman, Bs, Brian O'Hara, Md
Department of Pathology Honors Program Student Research Symposium
INTRODUCTION
- Primary malignant bone tumor of embryonic notochord remnants
- 1-4% of primary bone tumors, <0.1 per 100,000
- Location: Sacral (50%), Skull base (35%), Vertebral column (15%)
- Classic, chondroid (5-15%), and dedifferentiated (5%) variants
- Most commonly in late middle age (50s to 60s)
- Low-grade, slow growing tumor
- But locally aggressive, high rate of local recurrence (20% in 1st year)
- Local recurrence is most important predictor of mortality
- Metastasis only occurs very late in disease
- Median survival of about 6 years, less than 12 months with mets
- 5 year survival of 70%, 10 year survival of 40%
- Primary therapy- aggressive surgical resection (if possible) … 0.1>
Transfusion Related Acute Lung Injury, Nadia Abidi, Jay Herman, Md, Julie Karp, Md
Transfusion Related Acute Lung Injury, Nadia Abidi, Jay Herman, Md, Julie Karp, Md
Department of Pathology Honors Program Student Research Symposium
A 74 year old woman presented with hematemesis. Her medical history was significant for pulmonary embolism treated with warfarin anticoagulation, fibromyalgia treated with NSAIDs/steroids, and a prior bleeding event from a gastric ulcer. On admission she was stable with a hemoglobin of 8.7 g/dL and a therapeutic INR of 3.19. A type and screen determined a blood type of AB positive. In anticipation of endoscopy, the patient received one unit of red blood cells and four units of type AB plasma. Following transfusion, her INR was 1.83. The patient received an additional four units of type AB plasma to further …
Morphologic And Endoscopic Evaluation Of Collagenous Gastritis, Annie Ashok, Ashlie L. Burkart, Md, Cm
Morphologic And Endoscopic Evaluation Of Collagenous Gastritis, Annie Ashok, Ashlie L. Burkart, Md, Cm
Department of Pathology Honors Program Student Research Symposium
Collagenous gastritis (CG) is a rare gastrointestinal condition of unknown etiology and pathogenesis characterized by the presence of a gastric subepithelial collagen band of variable thickness. While little is known about the disease, children and young adults often present with anemia, abdominal pain, and nodular gastric mucosa on endoscopy. In contrast, adults often present with chronic watery diarrhea and normal gastric mucosa on endoscopy. Disease associations (usually in adult cases) include celiac disease, collagenous colitis, collagenous sprue, and lymphocytic colitis. This study aims to further characterize the clinical, endoscopic and morphologic spectrum of CG.
Thoracic Dissecting Aneurysm And The Importance Of Genetics, Dan Kramer, Ba, Anthony Prestipino, M.D.
Thoracic Dissecting Aneurysm And The Importance Of Genetics, Dan Kramer, Ba, Anthony Prestipino, M.D.
Department of Pathology Honors Program Student Research Symposium
Patient Presentation
- 28 year old white male with a past medical history significant for untreated hypertension
- Presents with 3 day history of chest discomfort, lower extremity weakness, bowel and bladder dysfunction, near-syncopal episodes
- Absent pulse in right femoral artery, weak pulse in left femoral artery
- Echosonography showed acute Type A dissecting aortic aneurysm
- Treatment
Immediately taken to surgery for repair of aorta with a graft and replacement of the aortic valve
- Outcome
Unstable after surgery
Biventricular heart failure
Persistent bleeding into mediastinum due to DIC
Required massive transfusion of RBCs, FFP, Cryoprecipitate, and Platelets
Became anuric and acidotic
Became fluid …
Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (Dipnech) To Carcinoid: Exploring The Link, Jacob D. Mcfadden Msii, Jeffrey P. Baliff Md
Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (Dipnech) To Carcinoid: Exploring The Link, Jacob D. Mcfadden Msii, Jeffrey P. Baliff Md
Department of Pathology Honors Program Student Research Symposium
Neuroendocrine cells (NECs) play important roles in normal lung development, autonomic regulation of lung function, and response to hypoxia or injury. They are located between the respiratory epithelium and the basement membrane of bronchi and bronchioles (below), often as single cells or small clusters.
NEC proliferation is a common pathologic occurrence, well established as a reactive response to chronic lung injury. Much less commonly, NEC proliferation is observed in the absence of apparent inciting factors. This neoplastic phenomenon is termed “diffuse idiopathic pulmonary neuroendocrine cell hyperplasia” (DIPNECH).
DIPNECH is recognized as a precursor lesion for carcinoid tumors. While the progression …
Correlations Between Gene Amplification And Protein Expression Of Topoisomerase 2a (Top2a) In Squamous Cell Carcinoma Of The Lung, Anita Modi, Msii, Charalambos C. Solomides, Md
Correlations Between Gene Amplification And Protein Expression Of Topoisomerase 2a (Top2a) In Squamous Cell Carcinoma Of The Lung, Anita Modi, Msii, Charalambos C. Solomides, Md
Department of Pathology Honors Program Student Research Symposium
Background: While DNA topoisomerase 2A (TOP2A) plays an essential role in maintaining the structural integrity of the double helix during replication and recombination, excessive expression of this enzyme may promote malignant cell transformations. In fact, increased levels of TOP2A have been observed in various cancer cell lines including squamous cell carcinoma of the lung. This study sought to identify correlations between genotypic and phenotypic evidence of TOP2A obtained via in situ hybridization (ISH) and immunohistochemistry (IHC) techniques.
Methods Tissue microarrays created from 29 samples of Stage I Squamous Cell Carcinoma of the lung were stained with VENTANA BenchMark ULTRA platform …
Temporal Lobe Ganglioglioma In An Epilepsy Patient With Worsening Seizures: Case Study And Future Directions, Adam M. Olszewski, Mark Curtis, Md Phd.
Temporal Lobe Ganglioglioma In An Epilepsy Patient With Worsening Seizures: Case Study And Future Directions, Adam M. Olszewski, Mark Curtis, Md Phd.
Department of Pathology Honors Program Student Research Symposium
Gangliogliomas are rare brain tumors that have both neuronal and glial components. They hold a better prognosis than other infiltrative glial tumors, but differentiating between them can be challenging. While molecular markers are being studied, it is currently a histologic diagnosis.
In this case, the patient presented with epilepsy and worsening seizures secondary to a medial temporal lobe mass. Radiology report was inconclusive. Surgical resection was achieved and based on histologic examination the lesion was diagnosed as ganglioglioma, WHO grade I.
In this patient, pathological diagnosis of ganglioglioma offers a favorable prognosis and low risk of recurrence. In the future, …
An Unexpected Immunohistochemical Profile In An Ovarian Lesion, Kate Fritton, Joanna Chan, Md
An Unexpected Immunohistochemical Profile In An Ovarian Lesion, Kate Fritton, Joanna Chan, Md
Department of Pathology Honors Program Student Research Symposium
A 27 year old female presented with pelvic pain and a palpable pelvic mass. Upon histological examination, the cystic mass contained a multi-cellular lining with nuclear grooves. Negative inhibin staining ruled out a follicular cyst and granulosa cell tumor while pan-cytokeratin positivity suggested an epithelial lesion. The lesion stained positive for thrombomodulin, ultimately suggesting a diagnosis of a Brenner cell tumor, although CD56 positivity in the tumor questions the known immunohistochemical profile of Brenner cell tumors. This unusual result opens the door to future research into the role CD56 in the diagnosis of ovarian neoplasms.
Myeloid Sarcoma: Extramedullary Relapse After Allogeneic Bone Marrow Transplant For Chronic Myelogenous Leukemia, Maria Gubbiotti, Alina Dulau Florea, Md, Renu Bajaj, Phd
Myeloid Sarcoma: Extramedullary Relapse After Allogeneic Bone Marrow Transplant For Chronic Myelogenous Leukemia, Maria Gubbiotti, Alina Dulau Florea, Md, Renu Bajaj, Phd
Department of Pathology Honors Program Student Research Symposium
Myeloid sarcoma (MS) is an extramedullary tumor of myeloid precursor cells, which can precede or occur concomitantly with acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms. Although MS can involve any organ, it is more common in the central nervous system (CNS) and gonads, sites known as “pharmacologic sanctuaries” where leukemic cells can survive despite systemic chemotherapy. Less often, this tumor can be the manner of relapse after allogeneic bone marrow transplantation.
The diagnosis is based on morphology and immunophenotype by either flow cytometry or immunohistochemistry of paraffin-embedded tissue, and confirmed by FISH or molecular studies. Myeloid sarcomas usually express …
Adenoid Cystic Carcinoma In Unusual Locations – Differential Diagnosis Difficulties, Heather A. Mcmahon, B.S., Madalina Tuluc, Md
Adenoid Cystic Carcinoma In Unusual Locations – Differential Diagnosis Difficulties, Heather A. Mcmahon, B.S., Madalina Tuluc, Md
Department of Pathology Honors Program Student Research Symposium
Adenoid Cystic Carcinoma (ACC) is an uncommon malignant salivary gland tumor, representing 1% of all malignant tumors of the oral and maxillofacial region and 22% of all salivary gland malignancies. Although in the majority of cases ACC manifests in the major salivary glands, in rare instances it can be found in locations such as the esophagus, larynx, trachea, lacrimal gland, breast, prostate, lungs, or auditory canal. These unusual locations of ACC often pose a diagnostic challenge to the clinician and are associated with poorer outcomes for patients as compared to those ACC of a more typical presentation. In this study …
Ocular Manifestations Of Rosai-Dorfman Disease, Phoebe L. Mellen, B.S., Ralph C. Eagle Jr., M.D.
Ocular Manifestations Of Rosai-Dorfman Disease, Phoebe L. Mellen, B.S., Ralph C. Eagle Jr., M.D.
Department of Pathology Honors Program Student Research Symposium
History of Rosai-Dorfman Disease
In 1969, Dr. Juan Rosai and Dr. Ronald F. Dorfman reported four cases of an entity that previously had puzzled pathologists and clinicians. The four cases had failed to fit under any diagnosis, but shared a few common characteristics. Each patient presented with painless, massive lymphadenopathy, most commonly of the cervical lymph nodes1. Other locations included the inguinal, intra-parotid, and axillary lymph nodes. The patients all presented with fever and leukocytosis1. The differential diagnosis included malignant lymphoma, malignant histiocytosis, reticuloendotheliosis, and chronic inflammation. However, the histopathological characteristics of the cases did not …
Diagnostic Yield Of Endobronchial Ultrasound-Guided Fine Needle Aspiration (Ebus-Fna) In Lung Cancer Staging, Subtyping And Diagnosis Of Unexplained Mediastinal Lymphadenopathy, Rino Sato, Rossitza Draganova-Tacheva, Md
Diagnostic Yield Of Endobronchial Ultrasound-Guided Fine Needle Aspiration (Ebus-Fna) In Lung Cancer Staging, Subtyping And Diagnosis Of Unexplained Mediastinal Lymphadenopathy, Rino Sato, Rossitza Draganova-Tacheva, Md
Department of Pathology Honors Program Student Research Symposium
INTRODUCTION
- Lung cancer (LC) is the most commonly diagnosed cancer worldwide and the most frequent cause of cancer death in both men and women in the US (more deaths than the next three most common cancers combined)1
- Clinical staging of LC is an integral part of patient care because it directs therapy and has prognostic value
Patients are routinely investigated with a conventional workup (medical history, PE, lab tests, bronchoscopy), CT and integrated whole-body PET-CT, followed by mediastinal tissue staging for enlarged or PET-positive intrathoracic nodes2
- Mediastinal tissue staging has been classically performed by mediastinoscopy, but they can …
Melanocytoma Of The Cerebellopontine Angle, Pranay Soni, M.D, Lawrence C. Kenyon, Md, Phd
Melanocytoma Of The Cerebellopontine Angle, Pranay Soni, M.D, Lawrence C. Kenyon, Md, Phd
Department of Pathology Honors Program Student Research Symposium
Ms. M.G. is a 46-year-old woman with a history of hypertension and prior bilateral laser eye surgery. In 2009, she presented with vertigo, tinnitus, and decreased hearing in the left ear. An MRI scan revealed an enhancing mass in the posterior fossa that was thought to be an acoustic neuroma. In May of 2009, she underwent gamma-knife radiotherapy for the 2.7 cm mass.
In September of 2012, M.G. noted progressive change in her voice quality as well as a swallowing disturbance and left facial spasms. A subsequent MRI showed significant enlargement of the tumor to a maximal size of 3.7 …
Promoting Health Literacy Through Leading Edge Occupational Therapy Education, Susan Toth-Cohen, Phd, Otr/L, Annalisa Synnestvedt, Ba, Ots, Alyssa Frey Peachey, Ots
Promoting Health Literacy Through Leading Edge Occupational Therapy Education, Susan Toth-Cohen, Phd, Otr/L, Annalisa Synnestvedt, Ba, Ots, Alyssa Frey Peachey, Ots
Department of Occupational Therapy Posters and Presentations
Synopsis:
Health literacy has become a vital focus of U.S. healthcare. By incorporating health literacy knowledge, attitudes, and skills into entry-‐level education, occupational therapy professionals can enact a leading role in health and human services teams to address our national healthcare goals.
Poster presentation at the American Occupational Therapy Association Annual Conference, San Diego, CA, April 2013.
Patient-Centered Cardiac Risk Communication, Roma Amin, Mark Berguson, Marianna Lanoue, Phd, Geoffrey Mills, Md, Phd, Manisha Verma, Md, Mph
Patient-Centered Cardiac Risk Communication, Roma Amin, Mark Berguson, Marianna Lanoue, Phd, Geoffrey Mills, Md, Phd, Manisha Verma, Md, Mph
CwiC-PH
More than a third of cardiovascular disease (CVD) in America is primarily due to modifiable risk factors. This reflects the significant impact that patient behavior could have on health outcomes. Our solution is to develop a tool that would convert Framingham Risk Score (FRS) – the gold standard of cardiac risk assessment – into a personalized mode that best incorporates patient’s desires and abilities, and that ultimately elicits behavior change. The first phase in this project was to understand how physicians are currently assessing cardiac risk.
The Contribution Of Schizophrenia To Homelessness: Analysis Of The Housing First Model And Possible Prevention Of Serious Mental Illness, Elijah Grillo
CwiC-PH
The Problem
- 2.6 million schizophrenics in the US accounting for more inpatient treatment days than any other medical illness (national cost: $62 billion/year).
- 6% (~160,000) are homeless or live in shelters
- Make up 36% of the 700,000 homeless individuals in the US.
Asthma Questionnaire For An Immigrant Chinese Population, Ho-Hin Choy, Whitney Shiau, Md, Audrey Lung Md, Faap
Asthma Questionnaire For An Immigrant Chinese Population, Ho-Hin Choy, Whitney Shiau, Md, Audrey Lung Md, Faap
CwiC-PH
Asthma is a key public health problem for the pediatric population of the United States. 7 million children in the United States have been diagnosed with asthma at some point in their lives (1). Asthma remains a disease that occurs in higher rates among minority populations. Those living in inner-city environments are most at risk. A study performed in an inner-city area of Boston, MA showed that 16% of an Asian American school age population had previously diagnosed asthma with an additional 3% having possible undiagnosed asthma (2). Northeast Medical Services (NEMS), a federally qualified community health center (FQHC), serves …
Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox
Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox
CwiC-PH
- Assessed needs and looked for solutions that are
- Executed and maintained locally Income-generating
- Provided skills trainings to CHWs on these topics
- Help initiate projects using these skills
- These projects show some modest continuing success
Helping Refugees Navigate The Health Care Maze, Jenna Fox, Andy Kay
Helping Refugees Navigate The Health Care Maze, Jenna Fox, Andy Kay
CwiC-PH
Jenna’s main focus during her Bridging the Gaps assignment at NSC was an outcomes assessment for use in grant applications. Her side projects included client service and education development
Health Care Delivery And Community Development In Rural Nepal, Abdul-Razaq Adeniyi
Health Care Delivery And Community Development In Rural Nepal, Abdul-Razaq Adeniyi
CwiC-PH
The barriers to health delivery and access to care in the developing world have numerous origins. From poverty and education, to environmental and cultural factors, the immense complexity of the problem demands innovative, dynamic, and comprehensive treatment models. Through a 5 week research and observational internship at Dhulikhel Hospital, in Dhulikhel Nepal, I was able to observe how the public health and community outreach arm or the hospital engaged in an effective model of delivery incorporating community participation, economic development, an innovative collaboration.
Mural Painting In South Philadelphia: A Means Of Addressing Racism Directed Against Bhutanese And Burmese Refugees, And Improving Health Outcomes, Meera Bhardwaj
CwiC-PH
INTRODUCTION
- Acculturation is the process of adjusting personal behavior patterns in response to prolonged interaction with another culture [1, 2].
- Discrimination in the host country significantly affects the acculturation process. Refugees have an extremely high risk for discrimination [3]. Discrimination exacerbates existing mental health conditions and activates the HPA [4].
- In the South Philadelphia refugees from Bhutan and Myanmar have been resettled into the neighborhood of East Passyunk/Moymensing. This demographic change has unfortunately resulted in acts of discrimination by the local community against the refugees.
- Mural Arts is painting a mural in the heart of this neighborhood. This mural will …
Growing Green Communities Through Urban Gardening In Haddington, Allison Rague, Zach Goldstein
Growing Green Communities Through Urban Gardening In Haddington, Allison Rague, Zach Goldstein
CwiC-PH
Allison, Krista, and Zach worked on a farm and surrounding community gardens with high school students from Philadelphia Youth Network (PYN). The 25 PYN youths were divided into groups and focused on different projects related to urban gardening. The groups included social media, marketing, garden/landscape design, environmental education, and construction/ farm maintenance. Each youth was given the opportunity to explore his or her own interests within the realm of farming.
The Current State Of Health Care In China, Jonathan Yadlosky
The Current State Of Health Care In China, Jonathan Yadlosky
CwiC-PH
After decentralizing health management in the early 1980s, China’s health care system developed many of the problems that we in the United States are currently working to solve. Though China is literally on the other side of the world, I think we might learn a few very important lessons from a close look at their successes, failures, trends, and goals in health care administration and delivery.
Wellbody Alliance, Sierra Leone, Kevin Rurak
Wellbody Alliance, Sierra Leone, Kevin Rurak
CwiC-PH
Pharmacy Project:
Inventory database development
- Streamlined tracking of daily and monthly drug dispensing
- New database to plan requisitions based on trends
Jeffhealth Soil-Transmitted Helminths, David Maniscalco
Jeffhealth Soil-Transmitted Helminths, David Maniscalco
CwiC-PH
Soil-transmitted helminth (STH) infections are known to be a significant problem in Rwanda. The Ministry of Health and individual villages are aware of its impact on people’s health and well-being as well as its impact on the country’s economy. The goal of the JeffHEALTH project is to educate poor, rural villages in Rwanda so that village members can take the knowledge they gain, put it into practice and share this knowledge with generations to come.
Assessing The Health Needs Of The Burmese And Bhutanese Refugees In South Philadelphia, Patricia Tolu-Ajayi
Assessing The Health Needs Of The Burmese And Bhutanese Refugees In South Philadelphia, Patricia Tolu-Ajayi
CwiC-PH
While refugees initially receive government aid (eg, Refugee Medical Assistance) upon arrival to the US, they often have unresolved medical concerns that persist beyond their initial period of government assistance (8 Months). To address these unmet health needs, Refugee Health Partners at Thomas Jefferson University started a free clinic targeting refugees from Bhutan and Burma living in South Philadelphia. An important finding from this clinic was that many refugees do not utilize the health care system, regardless of insurance status. Consequently, it is not known what health and social issues are most prevalent.
Integrated Medical Pluralism To Sustain Health Care In The Indian Trans-Himalayas, Jane Babiarz
Integrated Medical Pluralism To Sustain Health Care In The Indian Trans-Himalayas, Jane Babiarz
CwiC-PH
Inadequate health care delivery in the Indian trans-Himalayas arises from the harsh landscape and climate, poverty, the inaccessibility of health care centers, and a burden of chronic diseases and preventable acute illnesses that exceeds the number of traditional healers in the region. Systematizing a pluralistic healer network that integrates NGOs, international health organizations, mobile camps, district clinics, and traditional healers could address the issue of sustaining health care in this region. The backbone of this strategy would be a pre-existing resource relied upon by public and private health organizations: community health workers.