Medicine and Health Sciences Commons^™

Aquacel Surgical Dressing Reduces The Rate Of Acute Pji Following Total Joint Arthroplasty: A Case-Control Study., Jenny Cai, Joseph A Karam, Javad Parvizi, Eric B Smith, Peter F. Sharkey

Rothman Institute Papers

An effort to prevent PJI has led to the development of antimicrobial dressings that support wound healing. We sought to determine whether Aquacel Surgical dressing independently reduces the rate of acute PJI following TJA. A single institution retrospective chart review of 903 consecutive cases who received the Aquacel Surgical dressing and 875 consecutive cases who received standard gauze dressing was conducted to determine the incidence of acute PJI (within 3months). The incidence of acute PJI is 0.44% in the Aquacel dressing group compared to 1.7% in the standard gauze dressing group (P=0.005). Multivariate analysis revealed that use of Aquacel dressing …

Azd8931, An Equipotent, Reversible Inhibitor Of Signaling By Epidermal Growth Factor Receptor (Egfr), Her2, And Her3: Preclinical Activity In Her2 Non-Amplified Inflammatory Breast Cancer Models., Zhaomei Mu, Teresa Klinowska, Xiaoshen Dong, Emily Foster, Chris Womack, Sandra V Fernandez, Massimo Cristofanilli

Department of Medical Oncology Faculty Papers

INTRODUCTION: Epidermal growth factor receptor (EGFR) overexpression has been associated with prognostic and predictive value in inflammatory breast cancer (IBC). Epidermal growth factor receptor 2 (HER2) overexpression is observed at a higher rate in IBC compared with noninflammatory breast cancer. Current clinically available anti-HER2 therapies are effective only in patients with HER2 amplified breast cancer, including IBC. AZD8931 is a novel small-molecule equipotent inhibitor of EGFR, HER2, and HER3 signaling. In this study, we investigated the antitumor activity of AZD8931 alone or in combination with paclitaxel using preclinical models of EGFR-overexpressed and HER2 non-amplified IBC cells.

METHODS: Two IBC cell …

2014 Commencement For Jefferson School Of Health Professions, Jefferson School Of Pharmacy, And Jefferson School Of Nursing

Jefferson College of Nursing Commencements

No abstract provided.

Overexpression Of The Astrocyte Glutamate Transporter Glt1 Exacerbates Phrenic Motor Neuron Degeneration, Diaphragm Compromise, And Forelimb Motor Dysfunction Following Cervical Contusion Spinal Cord Injury., Ke Li, Charles Nicaise, Daniel Sannie, Tamara J Hala, Elham Javed, Jessica L Parker, Rajarshi Putatunda, Kathleen A Regan, Valérie Suain, Jean-Pierre Brion, Fred Rhoderick, Megan C Wright, David J Poulsen, Angelo C Lepore

Farber Institute for Neuroscience Faculty Papers

A major portion of spinal cord injury (SCI) cases affect midcervical levels, the location of the phrenic motor neuron (PhMN) pool that innervates the diaphragm. While initial trauma is uncontrollable, a valuable opportunity exists in the hours to days following SCI for preventing PhMN loss and consequent respiratory dysfunction that occurs during secondary degeneration. One of the primary causes of secondary injury is excitotoxic cell death due to dysregulation of extracellular glutamate homeostasis. GLT1, mainly expressed by astrocytes, is responsible for the vast majority of functional uptake of extracellular glutamate in the CNS, particularly in spinal cord. We found that, …

The Relative Efficacy Of Antifibrinolytics In Adolescent Idiopathic Scoliosis: A Prospective Randomized Trial., Kushagra Verma, Md, Thomas Errico, Chris Diefenbach, Christian Hoelscher, Austin Peters, Joseph Dryer, Tessa Huncke, Kirstin Boenigk, Baron S Lonner

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Antifibrinolytics can reduce intraoperative blood loss. The primary aim of this study was to determine the efficacy of intraoperative tranexamic acid, epsilon-aminocaproic acid, and placebo at reducing perioperative blood loss and the transfusion rate in patients with adolescent idiopathic scoliosis undergoing posterior spinal arthrodesis.

METHODS: This is a prospective, randomized, double-blind comparison of tranexamic acid, epsilon-aminocaproic acid, and placebo used intraoperatively in patients with adolescent idiopathic scoliosis. One hundred and twenty-five patients with adolescent idiopathic scoliosis were randomly assigned to the tranexamic acid, epsilon-aminocaproic acid, or control groups. Parameters recorded included estimated blood loss, hematocrit, blood product usage, drain …

Einstein's Medication Reach Program Enhances Patient Care, Deborah Hauser Rph, Mha

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Einstein's Comprehensive Unit-Based Safety Program, Beth Lapiene Msph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Data Analytics In Population Health, Harm Scherpbier Md, Ms

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Technology Improving Spinal Cord Injured Outlook: Our Experience With The Diaphragmatic Pacing System, Amanda Morina, Pt, Dpt, Ncs, Catharine Farnan-Kennedy, Ms, Crrn, Onc, Cbis

Department of Rehabilitation Medicine Faculty Papers

Introduction

Technology is always changing and that is a certainty. Integrating it into a population in a cost effective manner is always a challenge. One of the benefits of technology is the power to improve quality of life for those who are spinal cord injured. Five years ago in 2009, our rehabilitation team had the opportunity to partner with a young spinal cord injured patient with a newly implanted diaphragmatic pacer device (DPS). Since then we have had several patients with chronic spinal cord injury with this technology. The following poster will review the literature related to this device in …

Letter To Alliance For Headache Disorders Advocacy, William B. Young, Md

Department of Jefferson Headache Center Papers and Presentations

Several years ago the Centers for Medicare and Medicare Services (CMS) decided it would not pay for oxygen for the treatment of cluster headache. This is a serious hardship for many people with cluster headache. The American Headache Society and the Alliance for Headache Disorders Advocacy appealed to CMS to reverse this decision but they refused.

In February, we went to Congress, asking them to encourage CMS to reconsider this appeal. As a result of these efforts, Nebraska Senator Johanns and Delaware Senator Coons are circulating a letter for all Senators to sign urging CMS to re-evaluate this situation. To …

Talking To Insomniacs: Integrative Medicine Grand Rounds, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Please join us for Integrative Medicine Grand Rounds on Tuesday, June 3, 2014 in 925 Chestnut Street, 2nd floor conference room from 8:00-9:00 am. Please note the venue for this exciting program. Dimitri Markov, M.D., FAPA is presenting and the title of his presentation is: “Talking to Insomniacs.”Dr. Dimitri Markov is an attending physician in the Jefferson Sleep Disorders Center and the Division of Consultation-Liason Psychiatry here at Jefferson. Dr. Markov received his undergraduate degree in pharmacy from Temple University School of Pharmacy and his medical degree from the MCP-Hahnemann University School of Medicine. He completed the Adult Psychiatry …

Access To Therapy For Children With Autism: A Population-Based Analysis, Teal W. Benevides, Phd, Otr/L, Henry J. Carretta, Mph, Phd, Shelly J. Lane, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

1. Objective: Examine population-based trends in access to needed therapy services for children with ASD under the age of 18 years
2. Compare differences in access to needed therapy services between children with ASD and children with other special health care needs (CSHCN)
3. Identify individual, family enabling, and child need characteristics that contribute to reduced access to therapy services

Cesarean Sections, Buprenorphine, Intrathecal Opioids & Pain Control – What To Do?, Madeel A. Abdullah, Md, Michelle Beam, D.O., H. Jane Huffnagle, D.O., Suzanne Huffnagle, D.O., Michelle Mele, Md, Eugene R. Viscusi, Md

Department of Anesthesiology Faculty Papers

Introduction

Suboxone^® is becoming a popular alternative to methadone maintenance in opioid abstinence. This population will likely expand in the future presenting a challenge for perioperative analgesia. Conventional pharmacology suggests that buprenorphine has a high binding affinity for the mu-opioid receptor (MOR), displacing any other opioid; and, only overcome by extremely high opioid doses. Hence recommendations are usually that buprenorphine should be discontinued before surgery so the MOR is available perioperatively. Buprenorphine is considered to have a “ceiling” analgesic effect rather than a classic opioid dose-response curve; it should not be effective for postoperative analgesia. This case supports an …

Burkitt Lymphoma In A Pediatric Patient With Hereditary Multiple Exostose, Sara D. Prince, Portia A. Krieger, Md, Andrew W. Walter, Ms, Md

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Introduction

Hereditary multiple exostoses (HME) is an autosomal dominant disorder characterized by the growth of multiple bony tumors. These tumors include benign osteochondromas and less commonly, malignant tumors that arise from transformation of exostoses into secondary osteosarcomas and chondrosarcomas [1,3]. There have been no reported cases of lymphoma in the pediatric HME population. We report a case of a 10 year old boy with HME who developed Burkitt lymphoma of the abdomen.

Postoperative Non-Steroidal Anti-Inflammatory Drugs And Risk Of Bleeding In Pediatric Intracapsular Tonsillectomy, Jill N. D'Souza, Md, Julie P. Adelman, Bs, Richard J. Schmidt, Md, Heather C. Nardone, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Tonsillectomy with or without adenoidectomy is one of the most frequently performed surgeries in the United States, with over 500,000 performed annually. Post-tonsillectomy hemorrhage is one of the most feared complications; thus, medications that could increase the risk of postoperative bleeding traditionally have been avoided. With recent FDA guidelines encouraging a departure from codeine-based medications in pediatric patients undergoing tonsillectomy, we examined the use of ibuprofen for post-tonsillectomy pain control. The records of 449 children who underwent tonsillectomy and received ibuprofen for postoperative pain control were reviewed and compared to a cohort of 1731 children who received codeine for pain …

The P53-Induced Factor Ei24 Inhibits Nuclear Import Through An Importin Β-Binding-Like Domain., Kim G Lieu, Eun-Hee Shim, Jinling Wang, Ravi K Lokareddy, Tao Tao, Gino Cingolani, Gerard P Zambetti, David A Jans

Department of Biochemistry and Molecular Biology Faculty Papers

The etoposide-induced protein Ei24 was initially identified as a p53-responsive, proapoptotic factor, but no clear function has been described. Here, we use a nonbiased proteomics approach to identify members of the importin (IMP) family of nuclear transporters as interactors of Ei24 and characterize an IMPβ-binding-like (IBBL) domain within Ei24. We show that Ei24 can bind specifically to IMPβ1 and IMPα2, but not other IMPs, and use a mutated IMPβ1 derivative to show that Ei24 binds to the same site on IMPβ1 as the IMPα IBB. Ectopic expression of Ei24 reduced the extent of IMPβ1- or IMPα/β1-dependent nuclear protein import specifically, …

Experiential Global Health Education For The Health Professions: Lessons Learned From Experience-Based Learning For Students, Residents And Healthcare And Population Health Professionals, Rob Simmons, James D. Plumb, John Donnelly, Pilar Martin, Carinne Brody, Tricia Todd

College of Population Health Lectures, Presentations, Workshops

Experiential Education/Learning Perspectives

• “For the things we have to learn before we can do them, we learn by doing them” - Aristotle

• “Education is lifelong through: auditory (instruction), visual (observation), and kinesthetic (hands-on activities, learning modalities)” - John Dewey

• “Behavior is a function of a person in their environment” - Kurt Lewin

• “Learner creates knowledge through direct experience that is meaningful to the student with guided reflection and analysis” - David Kolb

• Building learning experiences, discussing experiences via problem-based learning, case studies changes teacher’s role as a facilitator and mentor

Psychometric Evaluation Of The Functional Capacity Card Sort: Measuring Caregiver Appraisal Of Functional Capacity In Persons With Dementia, Catherine V. Piersol, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Background

Caregivers play a vital role in the safety and well-being of people with dementia

• Majority of people with dementia live at home, are cared for by families or close friends/neighbors, and require supervision or assistance with daily activities

• 80% of care provided in the home is delivered by unpaid caregivers (Alzheimer’s Association, 2013, Family Caregiver Alliance, 2006)

  Functional capacity in the person with dementia is usually assessed by caregiver interview

• Caregiver report is an important proxy measure in dementia care as the person with the cognitive impairment tends to overestimate function (Karagiozis et al., 1998; Kiyak, et al., 1994) …

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Importance Of Cbct Setup Verification For Optical-Guided Frameless Radiosurgery., Lei Fu, Harold Perera, Xiao Ying, Yan Yu

Department of Medical Genetics Faculty Papers

The purpose of this study is to quantify the discrepancy between optical guidance platform (OGP) frameless localization system (Varian) and Trilogy on-board imaging (OBI) system (Varian) for setting up phantom and stereotactic radiosurgery (SRS) patient; and to determine whether cone-beam CT (CBCT) is necessary for OGP patient setup, and compare CBCT and orthogonal kV-kV in term of their verification capability. Three different phantoms were used in the study: a custom-made phantom, a Penta-Guide phantom, and a RANDO phantom. Five patients using both OGP and CBCT setup and 14 patients using CBCT setup alone were analyzed. One patient who had big …

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.

Anti-Mitogenic Effects Of Bitter Taste Receptor (Btr) Agonists On Human Airway Smooth Muscle Cells, Deepak A. Deshpande, Phd

Center for Translational Medicine Faculty Papers

Abstract

Rationale: Obstructive diseases of airways such as asthma and COPD are characterized by airway remodeling. Clinical studies and animal models have demonstrated that ASM mass is increased in asthma, and ASM thickness is correlated with severity of the disease. Current asthma medications control inflammation and reverse airway obstruction effectively, yet have very limited effects in deterring airway remodeling. Recently we identified the expression of BTRs on human ASM cells. Activation with known BTR agonists resulted in elevation of intracellular calcium, membrane hyperpolarization and ASM relaxation. Aerosol challenge in normal and allergen sensitized- and challenged- mice resulted in a robust …

Adrenergic Signaling Regulates Mitochondrial Ca(2+) Uptake Through Pyk2-Dependent Tyrosine Phosphorylation Of The Mitochondrial Ca(2+) Uniporter., Jin O-Uchi, Bong Sook Jhun, Shangcheng Xu, Stephen Hurst, Anna Raffaello, Xiaoyun Liu, Bing Yi, Huiliang Zhang, Polina Gross, Jyotsna Mishra, Alina Ainbinder, Sarah Kettlewell, Godfrey L Smith, Robert T Dirksen, Wang Wang, Rosario Rizzuto, Shey-Shing Sheu

Center for Translational Medicine Faculty Papers

Abstract Aims: Mitochondrial Ca(2+) homeostasis is crucial for balancing cell survival and death. The recent discovery of the molecular identity of the mitochondrial Ca(2+) uniporter pore (MCU) opens new possibilities for applying genetic approaches to study mitochondrial Ca(2+) regulation in various cell types, including cardiac myocytes. Basal tyrosine phosphorylation of MCU was reported from mass spectroscopy of human and mouse tissues, but the signaling pathways that regulate mitochondrial Ca(2+) entry through posttranslational modifications of MCU are completely unknown. Therefore, we investigated α1-adrenergic-mediated signal transduction of MCU posttranslational modification and function in cardiac cells. Results: α1-adrenoceptor (α1-AR) signaling translocated activated proline-rich …

Prospective Unmasked Randomized Evaluation Of The Istent Inject (®) Versus Two Ocular Hypotensive Agents In Patients With Primary Open-Angle Glaucoma., Antonio M Fea, Jose I Belda, Marek Rękas, Anselm Jünemann, Lydia Chang, Luis Pablo, Lilit Voskanyan, L Jay Katz

Wills Eye Hospital Papers

PURPOSE: The purpose of this study was to compare outcomes of subjects with open-angle glaucoma (OAG) not controlled on one medication who underwent either implantation of two iStent inject (®) trabecular micro-bypass devices or received medical therapy consisting of a fixed combination of latanoprost/timolol.

PATIENTS AND METHODS: Of 192 subjects who qualified for the study and were enrolled, 94 were randomized to surgery with implantation of two iStent inject(®) devices in the treated eye and 98 to receive medical therapy.

RESULTS: At the month 12 visit, 94.7% of eyes (89/94) in the stent group reported an unmedicated intraocular pressure (IOP) …

Nutritional Counseling At Jeffhope, Cara Siegel, Msii, Anita Modi, Msiii, Amy Tressan, Msi

CwiC-PH

INTRODUCTION

Obesity is a major national public health concern and is strongly associated with increased morbidity and mortality.¹ Specifically, obesity is correlated to increased frequency in coronary artery disease², type two diabetes³, some cancers⁴, and other serious health conditions⁵. An epidemiological study of 21 developed countries found that increased waist size, weight, and BMI were all associated with low income.⁷ Importantly, obesity has a high prevalence among the homeless population, one study finding 42.8% of homeless women obese.¹⁷ It has been reported that 39% of sheltered homeless Americans are …

Digitized! Ten Years Of Jefferson Medical College Yearbooks Added To The Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Scott Memorial Library and University Archives and Special Collections have just digitized and uploaded ten years (1950 to 1960) of Jefferson Medical College yearbooks to the Jefferson Digital Commons. To date, JMC yearbooks from 1899 to 1960 have been digitized. Relive the glory, the tradition, and the history of Jefferson.

Permeation Redux: Thermodynamics And Kinetics Of Ion Movement Through Potassium Channels., Richard Horn, Benoît Roux, Johan Aqvist

Department of Molecular Physiology and Biophysics Faculty Papers

The fundamental biophysics underlying the selective movement of ions through ion channels was launched by George Eisenman in the 1960s, using glass electrodes. This minireview examines the insights from these early studies and the explosive progress made since then.

Systematic Review: Occupational Therapy And Chronic Conditions In Primary Care, John Flood, Jillian Petty, Noreen Reidy, Shannon Whyte

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Learning Objectives:

• Define occupational therapy’s role in the primary care setting with a focus on those with chronic conditions using Occupational Therapy Practice Framework terminology.
• Describe the current evidence on occupational performance related to occupational therapy services in primary care.
• Discuss the future implications for occupational therapists working in primary care.

Cd27high/Klrg1low Cd8+ T Cells That Persist Throughout Mcmv Infection Are Highly Expansive And Have The Ability To Reestablish Mcmv Immunity, Michael Quinn, Holly Turula, Christopher M. Snyder

Department of Microbiology and Immunology Faculty Papers

Abstract

Cytomegalovirus (CMV) is a herpesvirus that establishes life-long latency in 60-80% of Americans. Constant immune surveillance is necessary to prevent viral reactivation from latency and results in the accumulation of functional CMV-specific CD8+ T cells (CD8s) over time, a process termed memory inflation. As such, CMV reactivations remain a clinical concern for immunosuppressed patients and reconstituting CMV immunity is critical for the long-term prevention of CMV disease. Understanding the maintenance of memory inflation may reveal novel approaches to restore CMV immunity.

Previous work has shown that the majority of inflationary CD8s express a terminally-differentiated “effector” (T_EFF) phenotype, …

Teens 4 Good: Positive Youth Development Through Urban Community Gardening, Katelyn Hurley, Mph, Nancy L. Chernett, Ma, Mph, Colleen Payton, Mph, Ches, Diane Cornman-Levy, Ms Pt

College of Population Health Lectures, Presentations, Workshops

Background and Rationale

• Teens that grow up in poor, blighted neighborhoods are at risk for a variety of negative outcomes, including poor health.¹

• In Philadelphia and many other urban communities, disparities in race, income, and education impact access to and consumption of fresh, healthy foods.²

• Youth development programs (YDP) have grown as a viable solution to ameliorate negative outcomes among at-risk youth.³

• Community gardens have been introduced in many urban environments to address issues of food insecurity.⁴

Teens 4 Good (T4G) is a youth-led entrepreneurial program that converts vacant city lots into community gardens.

• T4G was …

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The Potential Role Of Magnetic Resonance Spectroscopy In Image-Guided Radiotherapy., Mai Lin Nguyen, Brooke Willows, Rihan Khan, Alexander Chi, Lyndon Kim, Sherif G Nour, Thomas Sroka, Christine Kerr, Juan Godinez, Melissa Mills, Ulf Karlsson, Gabor Altdorfer, Nam Phong Nguyen, Gordon Jendrasiak

Department of Medical Oncology Faculty Papers

Magnetic resonance spectroscopy (MRS) is a non-invasive technique to detect metabolites within the normal and tumoral tissues. The ability of MRS to diagnose areas of high metabolic activity linked to tumor cell proliferation is particularly useful for radiotherapy treatment planning because of better gross tumor volume (GTV) delineation. The GTV may be targeted with higher radiation dose, potentially improving local control without excessive irradiation to the normal adjacent tissues. Prostate cancer and glioblastoma multiforme (GBM) are two tumor models that are associated with a heterogeneous tumor distribution. Preliminary studies suggest that the integration of MRS into radiotherapy planning for these …