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Download Entire Bodine Journal Volume 1, Issue 1, 2008

Bodine Journal

No abstract provided.

Factors Associated With Severe Late Toxicity After Concurrent Chemoradiation For Locally Advanced Head And Neck Cancer: An Rtog Analysis, Mitchell Machtay, Md, Jennifer Moughan, Ms, Andrew Trotti, Md, Adam S. Garden, Md, Randal S. Weber, Md, Jay S. Cooper, Md, Arlene Forastiere, Md, K. Kian Ang, Md

Bodine Journal

Purpose

Concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN) increases both local tumor control and toxicity. This study evaluates clinical factors that are associated with and might predict severe late toxicity after CCRT.

Methods

Patients were analyzed from a subset of three previously reported RTOG trials of concurrent chemoradiotherapy for locally advanced SCCHN (RTOG 91-11; 97-03; and 99-14). Severe late toxicity was defined in this secondary analysis as chronic Grade 3-4 pharyngeal/laryngeal toxicity (RTOG/EORTC late toxicity scoring system) and/or requirement for a feeding tube ≥2 years after registration and/or potential treatment-related death (e.g. pneumonia) within …

Increasing Tumor Volume Is Predictive Of Poor Overall And Progression-Free Survival: Secondary Analysis Of The Radiation Therapy Oncology Group 93-11 Phase I-Ii Radiation Dose-Escalation Study In Patients With Inoperable Non-Small-Cell Lung Cancer, Maria Werner-Wasik, R. Suzanne Swann, Phd, Jeffrey Bradley, Md, Mary Graham, Md, Bahman Emani, Md, James Purdy, Phd, William Sause, Md

Bodine Journal

Purpose

Patients with non–small-cell lung cancer (NSCLC) in the Radiation Therapy Oncology Group (RTOG) 93-11 trial received radiation doses of 70.9, 77.4, 83.8, or 90.3 Gy. The locoregional control and survival rates were similar among the various dose levels.We investigated the effect of the gross tumor volume (GTV) on the outcome.

Methods and Materials

The GTV was defined as the sum of the volumes of the primary tumor and involved lymph nodes. The tumor response, median survival time (MST), and progression-free survival (PFS) were analyzed separately for smaller (≤45 cm3) vs. larger (>45 cm3) tumors.

Results

The distribution of …

Inhibition Of P73 Function By Pifithrin-Α As Revealed By Studies In Zebrafish Embryos, William R Davidson, Qing Ren, Gabor Kari, Ori Kashi, Adam Dicker Md, Phd, Ulrich Rodeck

Bodine Journal

The p53 family of proteins contains two members that have been implicated in sensitization of cells and organisms to genotoxic stress, i.e., p53 itself and p73. In vitro, lack of either p53 or p73 can protect certain cell types in the adult organism against death upon exposure to DNA damaging agents. The present study was designed to assess the relative contribution of p53 to radiation resistance of an emerging vertebrate model organism, i.e., zebrafish embryos. Consistent with previous reports, suppressing p53 protein expression using antisense morpholino oligonucleotides (MOs) increased survival and reduced gross morphological alterations in zebrafish embryos exposed to …

Vegf Trap In Combination With Radiotherapy Improves Tumor Control In U87 Glioblastoma, Phyllis Wachsberger, Phd, Randy Burd, Phd, Chris Cardi, Ms, Mathew L. Thakur, Constantine Daskalakis, Jocelyn Holash, Phd, George D. Yancopoulos, Phd, Adam Dicker Md, Phd

Bodine Journal

Purpose

To determine the effect of vascular endothelial growth factor VEGF Trap (Regeneron Pharmaceuticals, Tarrytown, NY), a humanized soluble vascular endothelial growth factor (VEGF) receptor protein, and radiation (RT) on tumor growth in U87 glioblastoma xenografts in nude mice.

Methods and Materials

U87 cell suspensions were implanted subcutaneously into hind limbs of nude mice. VEGF Trap (2.5–25 mg/kg) was administered every 3 days for 3 weeks alone or in combination with a single dose of 10 Gy or fractionated RT (3 x 5 Gy). In addition, three scheduling protocols for VEGF Trap plus fractionated RT were examined.

Results

Improved tumor …

A Cone Beam Ct-Based Study For Clinical Target Definition Using Pelvic Anatomy During Post-Prostatectomy Radiotherapy, Timothy Showalter Md, A. Omer Nawaz, Ma, Ying Xiao, James Galvin Phd, Richard K. Valicenti, Md

Bodine Journal

Introduction:

Radiation therapy (RT) is delivered after radical prostatectomy (RP) either as salvage treatment for an elevated prostate-specific antigen (PSA) level1-6 or as adjuvant therapy for patients with highrisk pathologic features7-8. Recent prospective data demonstrated a disease-free survival benefit of adjuvant RT for pathologic T3N0 prostate cancer9-10. Despite literature supporting the delivery of post-RP RT to the prostatic fossa (PF), no clear target definition guidelines exist for intensity modulated radiation therapy (IMRT) or image-guided RT (IGRT)11.

Visualization of the PF is limited on standard CT images, with significant interobserver variability and uncertainty in CTV definition12. Efforts to incorporate complementary imaging …

Toxicity Of Radiotherapy In Patients With Collagen Vascular Disease, Alexander Lin, Md, Eyad Abu-Isa, Md, Kent A. Griffith, Mph, Ms, Edgar Ben-Josef, Md

Bodine Journal

Background

A diagnosis of collagen vascular disease (CVD) may predispose to radiotherapy (RT) toxicity. The objective of the current study was to identify factors that influence RT toxicity in the setting of CVD.

Methods

A total of 86 RT courses for 73 patients with CVD were delivered between 1985 and 2005. CVD subtypes include rheumatoid arthritis (RA; 33 patients), systemic lupus erythematosus (SLE; 13 patients), scleroderma (9 patients), dermatomyositis/polymyositis (5 patients), ankylosing spondylitis (4 patients), polymyalgia rheumatica/temporal arteritis (4 patients), Wegener granulomatosis (3 patients), and mixed connective tissue disorders (MCTD)/other (2 patients). Each patient with CVD was matched to 1 …

Table Of Contents: Bodine Journal Volume 1, Issue 1, Fall 2008

Bodine Journal

No abstract provided.

Download Entire Bodine Journal Volume 2, Issue 1, 2009

Bodine Journal

No abstract provided.

Flexible Needle-Tissue Interaction Modeling With Depth-Varying Mean Parameter: Preliminary Study, Kai Guo Yan, Tarun Podder, Yan Yu, Tien-I Liu, Christopher W.S. Cheng, Wan Sing Ng

Bodine Journal

Flexible needle steering has aroused a lot of research interest in recent years. It has the potential to correct targeting errors, which may be caused by needle bending, tissue deformation, or error in insertion angle. In addition, control and planning based on a steering model can guide the needle to some areas that are currently not amenable to needles because of obstacles, such as bone or sensitive tissues. Thus, there is a clear motivation for needle steering. In this paper, a spring–beam– damper model is proposed to describe the dynamics during the needle–tissue contact procedure. Considering tissue inhomogeneity, depth-varying mean …

Does Intraoperative Radiation Therapy Improve Local Tumor Control In Patients Undergoing Pancreaticoduodenectomy For Pancreatic Adenocarcinoma? A Propensity Score Analysis, Timothy Showalter Md, Atul Rao, Rani Anne Md, Francis E. Rosato, Ernest L Rosato, Jocelyn Andrel, Terry Hyslop, Xia Xu, Adam C. Berger

Bodine Journal

Background:

Locoregional recurrence (LRR) is an important factor after pancreaticoduodenectomy (PD) for pancreatic cancer. IORT administered to the resection bed may improve local tumor control.

Methods:

We performed a retrospective analysis of patients who underwent PD at Thomas Jefferson University Hospital (TJUH) between 1995 and 2005 to identify patients who underwent resection with and without intraoperative radiation therapy (IORT). Data collected included age, gender, complications, margin status, stage, survival, and recurrence. Unadjusted analyses of the IORT and non-IORT groups were performed using Fisher’s chi-square method for discrete variables and Wilcoxon Rank Sum test for continuous variables. To account for biases …

Combination Of Vandetanib, Radiotherapy, And Irinotecan In The Lovo Human Colorectal Cancer Xenograft Model, Phyllis Wachsberger, Phd, Randy Burd, Phd, Anderson Ryan, Phd, Constantine Daskalakis, Phd, Adam Dicker Md, Phd

Bodine Journal

Purpose:

The tumor growth kinetics of the human LoVo colorectal xenograft model was assessed in response to vandetanib, an orally available receptor tyrosine kinase inhibitor, radiotherapy (RT), or irinotecan (CPT-11), as single therapies and in combination.

Methods and Materials:

LoVo cells were injected subcutaneously into the right hind limb (5x106 cells in 100μL phosphate-buffered saline) of athymic NCR NUM mice and tumors were grown to a volume of 200–300mm3 before treatment. Vandetanib was administered at 50 mg/kg daily orally for 14 days starting on Day 1. RT was given as three fractions (3x3 Gy) on Days 1, 2, and 3. …

Nuclear Factor Κb Inhibitors Alleviate And The Proteasome Inhibitor Ps-341 Exacerbates Radiation Toxicity In Zebrafish Embryos, Borbala Daroczi, Gabor Kari, Qing Ren, Adam Dicker Md, Phd, Ulrich Rodeck

Bodine Journal

Inflammatory changes are a major component of the normal tissue response to ionizing radiation, and increased nuclear factor κB (NF-κB) activity is an important mediator of inflammatory responses. Here, we used zebrafish embryos to assess the capacity of two different classes of pharmacologic agents known to target NF-κB to modify radiation toxicity in the vertebrate organism. These were proteasome inhibitors, including lactacystin, MG132, and PS-341 (Bortezomib/VELCADE), and direct inhibitors of NF-κB activity, including ethyl pyruvate (EP) and the synthetic triterpenoid CDDO-TFEA (RTA401), among others. The proteasome inhibitors either did not significantly affect radiation sensitivity of zebrafish embryos (MG132, lactacystin) or …

Bodine Journal, Table Of Contents, Volume 2, Issue 1, Fall 2009

Bodine Journal

No abstract provided.

Jeffhope News-Fall 2016

JeffHOPE News

This issue includes:

• Updates: HCV Testing
• From the Project Director
• New Position: Triage Director
• Clinic at a Glance
• Advocacy Spotlight
• Research at JEFFHope
• Eye screening in an urban homeless shelter
• Contraception
• Self-Reported Indicators for Hepatitis C Virus Screening in JEFFHope Patients
• EKG Study
• Assessing the Need for Dermatological Care and Prevalence of Dermatologic conditions in an urban homeless shelter
• Spotlight on the John Bell Center
• If you had to describe JEFFHope in one word...
• Reflections by Committee Members and Directors
• 2016-2017 JEFFHope Volunteers

Planetary Health: Report On The 7th Annual Global Health Conference, Lucille B. Pilling Edd,Mph,Rn

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Triple Aim Forces Drive Academic Health Systems Growth, Richard G. Stefanacci Do,Mgh,Mba,Agsf,Cmd, Terri Schieder Rn, Mba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Telehealth At Jefferson: The Future Of Medicine, Danica Stone

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Mater: Innovative Programs For Maternal Addiction Education Treatment And Research, Meghan Gannon Phd Msph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Specialized Medical Home For Patients With Spinal Cord Injury, Mendel Kupfer Md, Marci Ruediger Pt, Ms, Norah V. Dixon Ma

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

From The Editors, Anusha Govind, Md, Loheetha Ragupathi, Md, Jad Al Danaf, Md, Mph, Shuwei Wang, Md

The Medicine Forum

Dear Students, Residents, Faculty, and Friends of the Forum,

We are excited to present you with the 17th annual edition of The Medicine Forum. This work reflects the talent, passion, creativity, and scientific inquisitiveness of Jefferson medical students, residents, fellows and faculty. It also celebrates the diverse patients who serve as the centerpiece for each story.

Unique to this issue is the initiation of Grand Rounds Discussions focusing on controversial medical topics with inputs from an array of experts. This year we discussed perioperative management of anticoagulation and antiplatelet agents, and we had exciting viewpoints from experienced cardiologists, a hematologist, …

A Difficult Conversation, Shuwei Wang, Md

The Medicine Forum

I put on my isolation gown, knocked on his hospital room door, and entered to initiate the family meeting. I had been dreading this meeting all morning. It is never easy telling the loved ones of a thirty-seven year old that his disease is terminal, and he is actively dying.

I greeted Mr. M, his girlfriend and sister with the help of a Spanish translator. He smiled and had a twinkle in his jaundiced eyes. He was debilitated, bed bound with anasarca, his right thigh tightly bound by multiple blood stained pressure dressings. "Hola", I greeted them with the little …

A Tribute To Our Nurses, Anusha Govind, Md

The Medicine Forum

I turned faint and weary as the page came through "Your patients heart rate is one hundred eighty" My legs shook as I ran up the stairs Thoughts racing a mile a minute, hoping someone more knowledgeable might be there first As I turned a corner, color draining from my face Then I spot my savior, the nurse, holding a syringe filled with the medication I knew now my patient and I were in good hands.

Grand Rounds Panel Discussion: Blood Thinners Peri-Operatively: What To Do?, Jad Al Danaf, Md, Anusha Govind, Md, Loheetha Ragupathi, Md, Shuwei Wang, Md

The Medicine Forum

PANELISTS

Mathew DeCaro, MD: Associate Professor of Cardiology, Director of the Coronary Cardiac Unit, Cardiology fellowship program director

John Doherty, MD: Professor of Cardiology

Gregary Markefka, MD: Associate Professor of Cardiology, Associate Director of the Coronary Cardiac Unit, Cardiology fellowship assistant program director

Geno Merli, MD: Professor of Vascular Medicine, Co-director of Jefferson Vascular Center

Srikanth Nagalla, MD, MS: Associate Professor of Medicine, Director, Clinical Hematology

Eric Schwenk, MD: Assistant Professor of Anesthesiology, Director of orthopedic anesthesia

Barry Ziring, MD: Clinical Associate Professor of Internal Medicine / Primary Care, Director of the division …

The Financial Dialogue In The Development Of Medical Treatment Plans, Christopher D. Busack, Ms3, Bethany Fox, Ms3

The Medicine Forum

As patients face increasingly high out-of-pocket costs and difficulties navigating the healthcare system, failing to discuss available treatment options in financial terms can lead to grave consequences for patients. Medical bills are responsible for the majority of bankruptcies in the United States. Given the severe financial implications of medical bills, it is imperative that patients become more involved in discussions of their treatment plans and become aware of the costs of their decisions up front. Counseling about costs ensures that physicians avoid placing a debilitating financial burden on patients and maintain adherence to the ethical principle of non-maleficence. Various studies …

Pemphigoid Gestationis: A Rare Dermatosis Of Pregnancy, Victoria Tran, Ms3, Meghan Belamorich, Md

The Medicine Forum

INTRODUCTION

Pemphigoid gestationis is a rare dermatosis of pregnancy that often goes unrecognized or misdiagnosed. It can lead to adverse fetal outcomes including preterm delivery, low fetal birth weight, and even neonatal pemphigoid gestationis1. As such, proper diagnosis and management is critical in reducing fetal risk.

Identification And Management Of Cobalt Toxicity: A Case Report Of Rapidly Progressing Toxicity After Hip Arthroplasty Revision, Neena Mohan, Md, Eric Kasprowicz, Md

The Medicine Forum

INTRODUCTION

Patients undergoing total hip arthroplasty represent a growing portion of the population. More than 330,000 hip replacements are performed annually1, and more than 2.5 million Americans are living with a hip prosthesis2. Many hardware configurations utilize metal alloys for the femoral head and/or acetabulum. Although their use is decreasing due to safety concerns, cobalt-chromium femoral heads were still used in 51% of total hip arthroplasties in 20143. There is rising concern about the adverse effects of metal ions released from these joint replacements. However, little published evidence is available supporting specific interventions for the management of cobalt toxicity.

Given …

Kikuchi Disease: Recognizing A Common Presentation Of An Uncommon Condition, Ramya Punati, Md

The Medicine Forum

INTRODUCTION

Kikuchi disease, also known as histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease, is a rare condition that typically presents with fever and cervical lymphadenopathy in previously healthy young women. First described by Dr. Kikuchi and independently by Dr. Fujimoto in Japan in 1972, the disease is benign and usually self-limited. However, because it can present dramatically and mimic more serious conditions such as lymphoma and tuberculous adenitis, recognizing Kikuchi disease is crucial to avoid misdiagnosis and inappropriate treatment. This case describes a patient who presented with severe manifestations of Kikuchi disease that generated an extensive workup and differential diagnosis prior …

A Case Report Of Multiple Aseptic Facial And Spinal Abscesses In A 45-Year-Old With Inflammatory Bowel Disease, Matthew Zheng, Md, Kristen Jackson, Md, Gloria Francis, Md, Bolin Niu, Md

The Medicine Forum

INTRODUCTION

Sterile abscess syndrome is a rarely described entity that is often associated with auto-inflammatory disorders. Although clinically similar to septic abscesses, sterile abscesses are known to be unaffected by antibiotic regimens and instead highly sensitive to steroids. The association of sterile abscesses with inflammatory bowel disease has been well-described. The majority of sterile abscess syndromes described in the literature are intraabdominal abscesses related to a primary gastrointestinal inflammatory disease. We describe a unique case of extra-abdominal sterile abscess syndrome associated with inflammatory bowel disease presenting as facial and paraspinal lesions.

Distal Renal Tubular Acidosis And Diabetes Insipidus Leading To The Diagnosis Of Sjögren's Syndrome, Loheetha Ragupathi, Md, Elijah Grillo, Md, Jonathan Yadlosky, Md, Ravi Sunderkrishnan, Md

The Medicine Forum

INTRODUCTION

Sjögren's syndrome is a chronic inflammatory disease characterized by the infiltration and progressive destruction of salivary and lacrimal glands. A common presentation involves the complaints of dry eyes and dry mouth, known as the “sicca complex.” Extra-glandular involvement is not uncommon, and is known to involve the lungs, vascular and peripheral nervous system, and kidney.1 The reported renal involvement ranges broadly from 2 – 67%,and is variably defined: the most commonly reported renal pathology is an a tubulo- interstitial nephritis resulting in tubular dysfunction and immune-mediated glomerular disease; however distal renal tubular acidosis (RTA) in particular can be present …