Medicine and Health Sciences Commons^™

Small Cell Carcinoma Of The Breast, Victor Carlson, Paolo Cotzia, Md, Juan P. Palazzo, Md

Department of Pathology Honors Program Student Research Symposium

INTRODUCTION

Small cell carcinoma of the breast (SCCB) is a rare, highly aggressive neoplasm first reported in 1983. With striking histologic similarity to small cell carcinoma of the lung, it is comprised of small cells with relatively large, hyperchromatic nuclei and scanty cytoplasm. While capable of hormone secretion, this is a rare occurrence in this variant of small cell carcinoma. Patients typically present with a suspicious breast mass confirmed on imaging, with variable lymph node invasion.

Fibrosing Cholestatic Hepatitis C Post-Liver Transplantation: A Case Study, Layla Hatem, Wei Jiang, Md, Phd

Department of Pathology Honors Program Student Research Symposium

Introduction:

Liver Transplantation:

• Hepatitis C infection is the most common indication for liver transplantation in the US
• HCV infection of the liver allograft occurs within hours from circulating virions.

-Serum RNA levels are observed in the first several weeks.

-Acute hepatitis occurs in 2-6 months

-Chronic hepatitis occurs in 3-9 months

***Persistence of HCV infection is the rule after transplantation due to immune suppression

Chronic recurrent HCV infection post transplantation

• There are four distinct patterns of recurrent chronic HCV in the liver allograft.

-Usual chronic HCV (>70%)

-Fibrosing Cholestatic Hepatitis C (5-10%)

-Plasma cell-rich HCV

-HCV overlapping with rejection …

Evaluation Of Echogenic Material On Transvenous Leads By Transesophageal Echocardiography In Patients With And Without Lead-Associated Endocarditis, Toshimasa Okabe, Md, Praveen Mehrotra, Md, Henry Siu, Md, Arnold J. Greenspon, Md

Division of Cardiology Faculty Papers

Echogenic material (EM) on non-infected leads in patients with cardiac implantable device is common on transesophageal echocardiography (TEE). Although several morphologic characteristics of EM are more commonly seen in transvenous lead-associated endocarditis, these characteristics alone are not diagnostic for lead-associated endocardiatis. Lead-associated EM on TEE should be interpreted within the overall clinical context.

Avoid, Accommodate, Confront Or Collaborate: Using Simulation To Teach Conflict Resolution Skills, E. Adel Herge, Otd, Otr/L, Deborah A. Hopkins, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Objective:

• Interprofessional education competencies include understanding roles & responsibilities of team members, and demonstrating effective communication and team building skills (Pardue, 2013).
• Team conflict impacts patient safety and outcomes (Knickle & McNaughton, 2009; Wagner, Liston & Miller, 2011) so effective team communication and conflict resolution in an important skill for students to develop (Greer et al., 2012; Levi, 2014).
• Simulation is effective in teaching interprofessional communication skills to health profession students (Velde, 2009).

Revisiting Our Roots: Innovative Community-Based Psychosocial Fieldwork Programs: Classroom To Clinic, Susan Santalucia, Ms, Otr/L, Kimberly S. Mollo, Ms, Otr/L, Tina Angelis, Edd, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives:

1. Understand the core components of a community-based level 1 psychosocial experience that bridge and enhance student classroom learning.

2. Examine strategies to identify, create, and maintain partnerships with community based sites.

3. Explore 2-3 learning activities and/or strategies that facilitate student learning during the Level 1 experience in a community based psychosocial setting.

Evaluating The Effects Of Grasp Patterns And Grip Strength On Handwriting Skills, Jennifer Bebey, Ots, Kelsey Engelstad, Ots, Audrey Zapletal, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background Information

• Handwriting is a critical and complex skill that school aged children acquire over time.
• When a child demonstrates handwriting difficulties, he or she may have challenges with:

Completing written school assignments in a timely fashion,

Taking notes,

Finishing homework,

Completing exams, especially short answer.

• 80% to 85% of occupational therapy referrals in schools are due to atypical grasp pattern, fine motor and handwriting concerns that affect a child’s educational performance.

Interleukin-7-Dependent B Lymphocytes Are Required For The Anti-Pneumococcal Polysaccharide Response And Protective Immunity To Streptococcus Pneumoniae, Gregory S. Dickinson, Phd, Raja Vuyyuru, Timothy L. Manser, Phd, John F. Kerney, Kishore Alugupalli, Phd

Department of Microbiology and Immunology Faculty Papers

Unlike human adults or adult mice, young children or young mice respond poorly to pneumococcal polysaccharides (PPS). In mice, B1b lymphocytes are the major responders to a variety of bacterial polysaccharides including PPS. Despite having B1b cells, young mice are severely impaired in responding to PPS, suggesting that B cells in the young are distinct from those in adults. Since B lymphopoeisis early in life is largely Interleukin-7 (IL-7)-independent, while in adults it is IL-7-dependent, we hypothesize that B cells developed in the presence of IL-7 are required for generating anti-PPS antibody responses. In support of this, we found that …

Implementation Of A Four Year Rehabilitation Curriculum For Medical Students, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Faculty Papers

In 2009 the Vice-Dean of Undergraduate Medical Education modified the 4th year curriculum by eliminating the required clerkship in Rehabilitation Medicine, and the Department was tasked with the creation of a four year curricular thread. While disappointing, this was a blessing in disguise. For years, we attempted to fit a great deal of content into an ever decreasing timespan, to increasingly disinterested students. Our teachers were also burned out with the sheer volume of students.

Through collaboration with other course directors, we inserted content where it fit the developmental needs of the students. We were also able to introduce students …

Implementation Of A Residency Twitter Account To Provide Curricular Enrichment, Bryan Lebude, Md, Subhashini Appulingam Sellers, Md, Gretchen Diemer, Md, Facp

Department of Medicine Faculty Papers

Background

_{The Problem}

_{With the goals of improving patient safety and resident well-being, the ACGME’s 2011 revision of duty-hour requirements included a 16-hour limit on continuous duty hours for postgraduate year 1 (PGY-1) trainees, increased supervision for junior trainees, as well as mandated rest periods between duty hours.1 These rules place limitations on the ability of trainees to attend scheduled educational activities during standard work hours; a recent study showed a decrease in resident availability for teaching conferences compared with the 2003 duty hour regulations.2 Residency training programs must develop alternative avenues for education and encouraging inquiry outside of traditional …}

The Effect Of Breathable Under Pads To Decrease Hospital Acquired Pressure Ulcers: A Nurse Resident Project, Sara Meshino, Bsn, Rn, Bridget Trefz, Bsn, Rn

Department of Nursing papers and presentations

PURPOSE

To reduce the rate of hospital acquired pressure ulcers (HAPU), in June 2013, a large urban academic medical center switched from non-breathable to breathable under pads for incontinent patients lying on either a standard bed (low risk patients) or low-air-loss mattress (high risk patients). Standard pressure ulcer prevention measures were maintained. Staff on two oncology units sought to determine the effectiveness of breathable vs. non-breathable under pads in reducing the rate of HAPU and UAPU.

Bridging The Evidence Gap: The Role Of Fieldwork Students, Tracey Vause-Earland, Ms, Otr/L, E. Adel Herge, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Introduction

Understanding and using evidence in practice improves health care delivery (Lugtenberg, Burgers, & Westert, 2009), reduces errors, and increases professional identity. Despite the call for increased use of evidence in occupational therapy decision making and positive attitudes of therapists toward use of evidence in practice), evidence based practice (EBP) is perceived by clinicians as time consuming and difficult due to lack of knowledge and/or resources (Humphries, et al, 2000; Bennett et al, 2003).

Hematopoietic Cell Transplant Co-Morbidity Index (Hct-Ci): Ability To Predict Outcomes In Haploidentical (Hi) Hematopoietic Stem Cell Transplantation (Hsct), Neil D. Palmisiano, Md, Sameh Gaballa, Md, Onder Alpdogan, Matthew Carabasi, Md, Joanne Filicko-O'Hara, Md, Margaret Kasner, Md, Ubaldo E. Martinez-Outshoorn, Md, John L. Wagner, Md, Mark Weiss, Md, Neal Flomenberg, Md, Dolores Grosso, Dnp

Department of Medical Oncology Faculty Papers

Introduction

We developed a 2 step approach to HI HSCT in which a fixed dose of allogeneic T cells are infused after reduced intensity (RIC) or myeloablative conditioning (HSCT step 1). After 2-3 days, cyclophosphamide (CY) 60 mg/kg/d x 2 is given to establish bidirectional tolerance. One day after the CY, a CD 34 selected stem cell product is infused (HSCT step 2).

This approach has been associated with a low incidence of non-relapse mortality (NRM) resulting in a significant improvement in overall survival (OS) in patients (pts) undergoing HI HSCT at our institution. This abstract examined the predictability of …

Outcomes Of Older Patients Undergoing 2-Step Approach To Haploidentical And Matched Related Peripheral Blood Hematopoietic Stem Cell Transplantation (Hsct): A Single Institutional Experience, Sameh Gaballa, Md, Seyfettin Onder Alpdogan, Md, Matthew Carabasi, Md, Joanne Filicko-O'Hara, Md, Margaret Kasner, Md, Benjamin E Leiby, Phd, Ubaldo E. Martinez-Outshoorn, Md, Edward C Pequignot, Md, Sarah Rosado, Shannon Rudolph, Ms, John L Wagner, Md, Mark Weiss, Md, Neal Flomenberg, Md, Dolores Grosso, Dnp

Department of Medical Oncology Faculty Papers

Introduction:

HSCT is a curative option for many patients (pts) with hematological malignancies.

Significant advances in supportive care and conditioning regimens over the past decade have allowed the extension of this therapy to older individuals.

Information regarding the outcomes of this older subset of pts undergoing HSCT is limited, especially those undergoing haploidential (HI) HSCT.

Objectives:

To describe the outcomes of patients 60 years of age or older undergoing haploidential and matched related (MR) HSCT using the 2-step approach.

Integrating The Classroom, Clinic, And Use Of Simulation To Prepare Students For Working With Individuals With Sci, Audrey Zapletal, Ms, Otr/L, Rob Hargraves, Ba, Gina Cooke, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background Information

• Students learn best through active engagement. Although experiences vary, practicing skills in clinical situations have proven to be an effective method.
• Practicing skills in a simulated controlled environment provides opportunities for students to receive feedback on their skills.
• Standardized patient experiences provide students a safe environment to practice clinical skills in challenging situations. These experiences have been shown to have a positive impact on learning.

Patient Characteristics And Predictors Of Mortality Associated With Pericardial Decompression Syndrome, Rajesh Pradhan, Md, Toshimasa Okabe, Md, Kazuki Yoshida, Md, Dimitrios Angouras, Md, Matthew Decaro, Md, Gregary D. Marhefka, Md

Division of Cardiology Faculty Papers

Pericardial decompression syndrome is a rare complication of pericardiocentesis and surgical drainage of pericardial effusion with a high morality rate. The minimum amount of drained effusion in our serious was 450 ml. Surgical drainage was associated with a higher mortality rate.

Threshold For Synovial Cell Count And Neutrophil Differential In Diagnosis Of Periprosthetic Knee Infection: A Multi-Institutional Study, Benjamin Zmistowski, Bs, Carlos Higuera, Md, Jane Liu, Ba, Wael Barsoum, Md, Joseph Mendelis, Ba, Craig Della Valle, Md, Javad Parvizi, Md

Rothman Institute Conference Posters

Introduction:

Synovial fl­uid analysis is an important tool in the work-up of suspected periprosthetic joint infection (PJI). Yet, there is confl­icting guidance for the analysis of synovial fl­uid aspiration, including a lack of uniform thresholds for white blood cell (WBC) count and neutrophil percentage (PMN%)1-3. Therefore, a multi-institutional study was undertaken to reassess these thresholds, compare preoperative versus intraoperative sample collection, and assess variation in results between institutions.

Is Further Treatment Necessary For Patellar Crepitus After Total Knee Arthroplasty?, Bo-Hyun Hwang, Md, Chang-Hyun Nam, Md, Kwang-Am Jung, Md, Alvin Ong, Md, Su-Chan Lee, Md

Rothman Institute Conference Posters

Introduction:

• Posterior-stabilized (PS) TKA that sacrifice the cruciate ligaments improves pain and function in patients with advanced osteoarthritis.
• Patellar crepitus appears to be due to a spectrum of peripatellar fibrosynovial formations and is usually encountered after PS-TKA, which uniquely has an intercondylar box to accept the tibial post.
• Symptoms of patellar crepitus occur most commonly during terminal knee extension and occur usually from 3 to 9 months after PS-TKA, and in some cases, this phenomenon is symptomatic enough to warrant an arthroscopic procedure or open arthrotomy.
• The development of patellar crepitus after PS-TKA appears related to many factors such as …

Risk Factors For Surgical Site Infection Following Total Joint Arthroplasty, Mohammad Rasouli, Md, Camilo Restrepo, Md, Mitchell Maltenfort, Phd, James J. Purtill, Md, Javad Parvizi, Md

Rothman Institute Conference Posters

Surgical Site Infection (SSI) after total joint arthroplasty (TJA) is a rare but devastating complication1. In spite of improvement in the prevention of SSI, these infections are still a signi­ficant cause of morbidity in surgical patients2. Management of Hospital Acquired infections (HAI) including SSI poses a huge economic burden on healthcare3. As part of the mission to reduce the burden of HAI, the Centers for Disease Control and Prevention (CDC) has issued guidelines for the prevention of SSI that are currently being updated4. In addition, CDC requires all hospitals to report HAI through the National Healthcare Safety Network (NHSN) surveillance …

Measuring Patient Satisfaction In Multidisciplinary Cancer Centers: Optimize Use Of Results To Effect Change And Improve Processes, Mary-Kate Cellmer, Bs

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Jefferson¹s Kimmel Cancer Center¹s multidisciplinary centers were established in 1994. The centers are a collaborative effort among radiation oncologists, medical oncologists, surgeons and other specialists involved in leading-edge cancer treatments.

The multidisciplinary center sees patients on the following days:

• Monday: Brain and Metastatic Uveal Melanoma
• Tuesday: Thoracic/Aerodigestive and Senior Adult Oncology
• Wednesday: Genitourinary and Liver
• Thursday: Small Renal Mass
• Friday: Senior Adult Oncology