Medicine and Health Sciences Commons^™

Acetate Causes Alcohol Hangover Headache In Rats, Christina R. Maxwell, Rebecca Jay Spangenberg, Jan B. Hoek, Stephen D. Silberstein, Michael L. Oshinsky

Department of Neurology Faculty Papers

Background

The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache.

Methods

We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats.

Results

Ethanol initially decreased sensitivity to mechanical stimuli on the face (analgesia), followed 4 to 6 hours later by inflammatory pain. Inhibiting alcohol dehydrogenase extended the analgesia whereas inhibiting aldehyde dehydrogenase decreased analgesia. Neither treatment had nociceptive effects. Direct administration of acetate …

Phosphorylation Meets Nuclear Import: A Review., Jonathan D Nardozzi, Kaylen Lott, Gino Cingolani

Department of Biochemistry and Molecular Biology Faculty Papers

Phosphorylation is the most common and pleiotropic modification in biology, which plays a vital role in regulating and finely tuning a multitude of biological pathways. Transport across the nuclear envelope is also an essential cellular function and is intimately linked to many degeneration processes that lead to disease. It is therefore not surprising that phosphorylation of cargos trafficking between the cytoplasm and nucleus is emerging as an important step to regulate nuclear availability, which directly affects gene expression, cell growth and proliferation. However, the literature on phosphorylation of nucleocytoplasmic trafficking cargos is often confusing. Phosphorylation, and its mirror process dephosphorylation, …

Psychiatric Comorbidity In Transformed Migraine: Presentation, Treatment, Impact And Outcome, Muhammad A. Abbas M.D, Haseeba Ismaiel, M.D, William B. Young M.D., Mary Hopkins, Stephen D. Silberstein, M.D

Jefferson Journal of Psychiatry

Transformed migraine is one of the subtypes of chronic daily headache (CDH), and is similar to chronic migraine, described in the new International Headache Society (IHS) classification 2004. The term CDH refers to the Headache disorders experienced 15 or more days a month and includes headaches associated with medication overuse. CDH can be divided into primary and secondary varieties. Primary CDH is not related to a structural or systemic illness. It includes diseases such as Transformed migraine (TM). Chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). Secondary CDH has an identifiable underlying cause, including post-traumatic …

Resident Teaching Expectations And Medical Student Feedback, Michael Ignatowski

Jefferson Journal of Psychiatry

Objective Much of resident teaching of medical students occurs in an informal manner, with bedside teaching a common focus. Hence, the ability to monitor such teaching is limited. Feedback about how students perceive the teaching is perhaps one way to more effectively monitor and influence resident teaching.

Ten Year Follow Up Of A Psychiatry Residency Program Merger, Alvi A. Azad, Julianne Flynn, Thomas Matthews, Kenneth Matthews, Joseph Chozinski

Jefferson Journal of Psychiatry

Objective: To report on the successful merger of a civilian and military psychiatry residency. Methods: The reasons for and the history of the merger between the University of Texas Health Science Center at San Antonio and Wilford Hall Air Force Medical Center psychiatry residencies is described. Results: After some false starts, a bottom-up approach was implemented by first merging seminars, then rotations. Conclusions: Combining two psychiatry residencies in order to capitalize on both their strengths can yield a product even greater than the sum of their two programs and the key to a lasting merger is to start with two …

Patient Perceptions Of Physician Empathy, Satisfaction With Physician, Interpersonal Trust, And Compliance, Mohammadreza Hojat, Daniel Z. Lewis, Kaye Maxwell, Fred Markham, Richard Wender, Joseph S. Gonnella

Department of Psychiatry and Human Behavior Faculty Papers

Objectives: This study was designed to investigate psychometric properties of the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and to examine correlations between its scores and measures of overall satisfaction with physicians, personal trust, and indicators of patient compliance.

Methods: Research participants included 535 out-patients (between 18-75 years old, 66% female). A survey was mailed to participants which included the JSPPPE (5-item), a scale for measuring overall satisfaction with the primary care physician (10-item), and demographic questions. Patients were also asked about compliance with their physician's recommendation for preventive tests (colonoscopy, mammogram, and PSA for age and gender …

Awake Vs. Asleep Placement Of Spinal Cord Stimulators: A Cohort Analysis Of Complications Associated With Placement, Steven M. Falowski, Md, Amanda Celii Md, Anthony K. Sestokas Phd, Daniel M. Schwartz Phd, Craig Matsumoto Mpas, Ashwini Sharan Md

Department of Neurosurgery Faculty Papers

Introduction: Patients will typically undergo awake surgery for permanent implantation of SCS in an attempt to optimize electrode placement using patient feedback about the distribution of stimulation-induced paresthesia. The present study compared efficacy of first-time electrode placement under awake conditions with that of neurophysiologically-guided placement under general anesthesia.

Methods: A retrospective review was performed of 387 SCS surgeries among 259 patients which included 167 new stimulator implantation to determine whether first time awake surgery for placement of spinal cord stimulators is preferable to non-awake placement.

Results: The incidence of device failure for patients implanted using neurophysiologically-guided placement under general anesthesia …

Finding High Quality Hospitals In Philadelphia., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Guest lecture for PBH609 GIS Mapping. Fall, 2010 session. Philadelphia, PA.

15 PowerPoint slides.

Stage Of Diagnosis Of Breast Cancer And Socioeconomic Status In A Universal Healthcare System: A Population-Based Study In Emilia-Romagna, Italy., Daniel Friedberg

Master of Public Health Capstone Presentations

Research has shown that lower socioeconomic status (SES) is associated with later stage of diagnosis of breast cancer in the United States healthcare system, where access to services may be an issue. However, limited data exists as to whether this effect is present in a universal healthcare system, without financial barriers to services. We sought to determine the association between stage of diagnosis of breast cancer and SES using data from Emilia-Romagna, a large region in northern Italy. We identified a population of women with incident breast cancer from 2002-2003 regional cancer registries, including information on cancer stage based on …

Jefferson Kimmel Cancer Center Support Groups

Bodine Journal

Listing of Jefferson Kimmel Cancer Center Support Groups.

Research Department Of Radiation Oncology

Bodine Journal

Listing of Basic Research Studies/Grants and Clinical Research Studies/Grants.

Young Investigator Awards

Bodine Journal

Robert Den, MD, Laura Doyle, MS, Nitin Ohri, MD and Evan Wuthrick, MD

New Faculty Members

Bodine Journal

New faculty members: Voichita (Voika) Bar Ad, MD and Wenyin Shi, MD, PhD.

The Gucy2c Tumor Suppressor Is The Nexus Of A Paracrine Hormone Axis Preventing Radiotherapy-Induced Gastrointestinal (Gi) Toxicity, E. J. Wuthrick, P. Li, J. E. Lin, A. P. Dicker, D. Leeper, S. A. Waldman

Bodine Journal

Purpose/Objective: Radiation-induced GI toxicity is the primary dose limitation compromising therapy in cancer patients treated with radiation therapy. GUCY2C is the intestinal receptor for diarrheagenic bacterial enterotoxins and the endogenous paracrine hormones guanylin and uroguanylin. Following genomic insult, cyclic (c)GMP produced by ligand activation of GUCY2C enhances DNA damage sensing and repair in intestinal cells. Here, we show that the GUCY2C-cGMP axis mediates p53-dependent radioprotection of intestinal epithelial cells.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Departmental Information-Thomas Jefferson University, Jefferson Medical College, Department Of Radiation Oncology

Bodine Journal

Directory of Attending Physicians, Division of Molecular Radiology, Division of Medical Physics, Radiation Oncology Residents, Medical Physics Residents/Research Staff and Administration.

Chart Rounds In The Digital Age: A Survey Of North American Institutions, M. A. Whiton, A. P. Dicker, E. J. Wuthrick, L. Doyle, A. S. Harrison, Y. R. Lawrence

Bodine Journal

Purpose/Objective(s): In light of public concerns regarding the quality of radiation treatment delivery, we surveyed the utilization of “chart rounds” or peer-review quality assurance meetings, within North American academic institutions.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Potential For Dose-Escalation In The Post-Prostatectomy Setting With Intensitymodulated Radiation Therapy: A Dosimetric Study Using Eortc Consensus Guidelines For Target Volume Contours, M. Studenski, A. Harrison, S. Anamalayil, A. Harvey, E. Trabulsi, Y. Xiao, Y. Yu, A. P. Dicker, T. N. Showalter

Bodine Journal

Purpose: Radiation therapy (RT) is delivered after radical prostatectomy (RP) for prostate cancer (PC). Although intensity modulated radiation therapy (IMRT) has become standard in definitive RT for PC, dosimetric data in support of post-RP IMRT are limited. This study was designed to quantify benefits of IMRT versus 3D conformal RT (3DCRT) with respect to dose sparing of rectum and bladder and target volume coverage. Motivated by the desire to deliver higher radiation doses and to quantify the dosimetric impact of IMRT, we retrospectively analyzed images in order to: 1) identify a preferred IMRT beam arrangement; 2) evaluate the dosimetric advantages …

Costs Of Early Adjuvant Radiation Therapy After Radical Prostatectomy: A Decision Analysis, T. N. Showalter, K. A. Foley, E. Jutkowitz, C. Lallas, A. J. Harvey, E. J. Trabulsi, L. G. Gomella, A. P. Dicker, L. T. Pizzi

Bodine Journal

Purpose/Objective(s): Prospective, randomized trials support adjuvant radiation therapy (RT) for adverse pathologic features after radical prostatectomy (RP). However, adjuvant RT is not universally delivered in this setting. Criticisms of adjuvant RT include toxicity, financial costs, potential overtreatment, and effectiveness of salvage RT. The objective of this study was to construct a decision analytic model to estimate real world cost of RT vs. no RT within the context of the effectiveness of early adjuvant RT for prostate patients based on published clinical results of the Southwest Oncology Group prospective trial of adjuvant RT (SWOG 8794).

American Society for Therapeutic Radiation Oncology …

Mirab: An Image-Guided Multichannel Robot For Prostate Brachytherapy, T. Podder, I. Buzurovic, K. Huang, Y. Yu

Bodine Journal

Purpose: To date, twelve robotic systems have been developed worldwide for brachytherapy, especially for seed implantation. However, the only system that has provision for simultaneous insertion of multiple needles is the MIRAB system. This article reports the feasibility and efficacy of the MIRAB robot as ultrasound image-guided autonomous delivery of radioactive seeds for treating prostate cancers.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Intensity Modulated Radiation Therapy Compared With 3d Conformal Radiotherapy For Craniospinal Irradiation In Adults – Do We Gain Anything?, X. Shen, M. Studenski, A. Harrison, Y. Xiao, T. Biswas

Bodine Journal

Purpose: Craniospinal irradiation (CSI) remains one of the most technically challenging planning processes in radiation oncology due to its long shape especially in adults and complex target volume. In addition, CSI is associated with significant acute and late morbidities. We undertook a dosimetric analysis to determine if intensity modulated radiation therapy (IMRT) could improve target coverage while sparing normal tissue structures compared to classic 3D conformal radiation (3D‐CRT) planning.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Reirradiation For Recurrent Meningioma, N. Ohri, A. Wojcieszynski, J. J. Evans, D. W. Andrews, M. Werner-Wasik

Bodine Journal

Purpose/Objective(s): Management options for meningioma include observation, surgical resection, and radiation therapy (RT). In cases of progressive or recurrent disease after RT, similar options exist. The control rate following a second course of RT is unknown.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Prophylactic Radiation Therapy Is Safe And Effective Treatment For The Prevention Of Recurrent Heterotopic Ossification In Elbow And Knee Joints, M. V. Mishra, L. Austin, J. Parvisi, M. Ramsey, T. N. Showalter

Bodine Journal

Background: Background Prophylactic radiation therapy (RT) is an established adjuvant therapy for heterotopic ossification (HO) of the hip when delivered in the immediate pre- or post-operative setting. Its role in prevention of recurrence after excision of HO is supported by randomized trials for HO of the hip, but there is scant evidence to support a similar approach in non-hip joints. In the current study, we evaluate radiologic and functional outcomes after prophylactic radiation therapy (RT) for prevention of HO of the knee and upper extremity [elbow and metacarpophalangeal (MCP) joints].

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting …

Evolving Role Of Vorinostat Combined With Radiation Therapy In The Treatment Of Brain Tumors, From The Lab To The Clinic, Y. R. Lawrence, P. Wachsberger, Y. Liu, B. Andersen, A. P. Dicker

Bodine Journal

Purpose/Objective(s): Radiation therapy (RT) is a critical element in the treatment of both brain metastases and glioblastoma (GBM). Temozolomide (TMZ) has an established role in the upfront treatment of GBM. Down-regulated mismatch repair (MMR) is a known mechanism of resistance to TMZ. Vorinostat (SAHA), an HDAC inhibitor, has successfully been combined with a number of cytotoxic agents, including ionizing radiation (IR). We performed a series of preclinical and clinical studies to examine the role of SAHA in the treatment of brain tumors.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Early Stage Testicular Seminoma: A Multicenter Review Of Treatment Outcomes And Patterns Of Recurrence, M. Kim, E. Wuthrick, A. Lin

Bodine Journal

Purpose/Objective(s): Although overall survival for early stage testicular seminoma is generally excellent, certain pathologic factors can increase recurrence risk for those undergoing observation, while radiation therapy (RT) can be associated with long-term morbidity. We sought to identify disease-related and treatment-related factors that influenced the outcomes, with particular emphasis on recurrence risk, patterns and timing of recurrence, as well as RT-induced malignancy.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Substantial Dose-Response Relationship With Clinical Outcome For Lung Stereotactic Body Radiotherapy (Sbrt) Delivered Via Online Image Guidance, L. Kestin, I. Grills, M. Guckenberger, J. Belderbos, A. J. Hope, M. Werner-Wasik, J. J. Sonke, J. P. Bissonnette, Y. Xiao, D. Yan

Bodine Journal

Purpose: To examine potential tumor dose-response relationships with various non-small cell lung cancer (NSCLC) SBRT fractionation regimens delivered with online CT-based image guidance.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Poor Pulmonary Function Is Not Associated With Increased Rates Of Toxicity Or Decreased Overall Survival After Stereotactic Body Radiotherapy For Early Stage Non-Small Cell Lung Cancer: Results Of A Multi-Institutional Analysis, M. Guckenberger, J. Belderbos, A. Hope, L. L. Kestin, M. Werner-Wasik, J. J. Sonke, Y. Xiao, D. Yan, J. Wilbert, I. S. Grills

Bodine Journal

Purpose/Objective(s): Stereotactic body radiotherapy (SBRT) is considered as the treatment of choice for stage I non-small cell lung cancer (NSCLC) in medically inoperable patients. It was the purpose of this study to evaluate whether pretreatment pulmonary function is predictive for survival and toxicity after SBRT.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

A Multi-National Pooled Analysis Of 434 Cases Of Stage I Non-Small Cell Lung Cancer (Nsclc) Treated With Volumetrically Image-Guided Stereotactic Lung Radiotherapy: Results From The Elekta Collaborative Lung Research Group, I. S. Grills, A. J. Hope, M. Guckenberger, L. L. Kestin, M. Werner-Wasik, D. Yan, J. J. Sonke, J. P. Bissonnette, Y. Xiao, J. Belderbos

Bodine Journal

Background: Published lung SBRT outcomes/dose response data for inoperable NSCLC come from small phase I-II studies or larger datasets not requiring image-guided radiotherapy (IGRT) or volumetric prescriptions. This entire cohort of SBRT patients had daily online cone-beam CT.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Toxicity Of Phase I Radiation Oncology Trials: Worldwide Experience, C. Glass, R. B. Den, A. P. Dicker, Y. R. Lawrence

Bodine Journal

Introduction: Informed consent involves understanding the risks and benefits of trial enrollment. This is challenging in the phase I setting since true quantitative information is never known. We therefore performed an analysis of published radiation oncology (RO) phase I trials emphasizing patient outcomes. To our knowledge, no such systemic analysis has previously been published.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA

Pathologic Correlation Of Pet-Ct Based Auto Contouring For Radiation Planning In Lung Cancer, S. E. Fogh, A. Farach, C. Intenzo, R. Axelrod, P. Mccue, A. Harper, A. Nelson, M Werner-Wasik

Bodine Journal

Purpose/Objective(s): Radiation therapy in lung cancer relies on CT and functional imaging (FDG-PET) to delineate tumor volumes. Semi-automatic contouring tools have been developed for PET to improve on the inter-observer bias of manual contouring and intrinsic differences in imaging equipment. A common method involves using a threshold at a given percentage of the max activity, which may be less accurate with smaller tumors and tumors with low source to background ratio. To overcome this deficiency, a gradient algorithm, which detects changes in image counts at the border of the tumor, has been developed. Few studies have correlated these methods to …

Igrt After Prostatectomy: Evaluation Of Corrective Shifts And Toxicity Using Online Cone Beam Ct Vs. Weekly Port Films For Target Localization, H. B. Eldredge, M. Studenski, S. Keith, E. J. Trabulsi, A. Harvey, C. Lallas, L. Gomella, A. P. Dicker, T. N. Showalter

Bodine Journal

Purpose/Objective(s): Image guidance (IG) may permit higher radiotherapy (RT) doses (>65 Gy) after radical prostatectomy (RP) without increased toxicity, with improved accuracy and smaller margins. Conebeam (CBCT) allows IGRT with volumetric images. This study evaluated CBCT shifts and toxicity after conformal IGRT, compared to RT with port films.

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, CA