Medicine and Health Sciences Commons^™

Exploring Political Awareness And Civic Engagement Among Women Utilizing Mater Services, Cathy Lu, Meghan Gannon, Phd, Msph

Phase 1

Introduction: High levels of civic engagement by United States citizens sustains the integrity of the democratic system. Health organizations, such as The Maternal Addiction Treatment Education and Research (MATER) program, are in a position to help marginalized voting-eligible individuals overcome barriers to voting.

Methods: The target population was women utilizing MATER services. The study design consisted of a survey collecting data including demographic information, political engagement, perceived barriers, and interest in future advocacy. Following the survey, participants were offered more voting resources.

Results: One hundred percent of participants reported utilizing public assistance. Forty-eight percent reported a social network as their …

Strategic Design Development For Malawian Public Health Center Labor & Delivery Suites, Kayla Holston, Mph, Meghan Gannon, Phd, Msph, Christopher Harnish, March, Zayithwa Fabiano, Mbbs, Luis Gadama, Mbbs, Mmed

Phase 1

Introduction: Maternity ward pre-, peri-, and postnatal room sharing creates concerns regarding maternal privacy (particularly confidentiality and dignity), paternal involvement in birthing process, and staff workflow efficiency. This study aimed to understand the current state of the aforementioned concerns and their impact on maternal child bonding and maternal mental health at Queen Elizabeth Central Hospital (QECH).

Methods: At discharge, mothers of birth (MOBs) were surveyed on pre-, peri-, and postnatal experience with regard to privacy and paternal involvement in the birthing process, and then assessed using the Mother to Infant Bonding Scale and Edinburg Depression Scale. Father of births (FOBs) …

Effect Of Patient Perspectives In Teaching Medical Students About Postpartum Depression, Laura Fiorini, Julia Switzer, Md

Phase 1

Purpose: Postpartum Depression (PPD) is frequently undiagnosed in the clinical setting. Barriers to correctly recognizing and diagnosing PPD include lack of specific education during medical school and prioritization of physical health over psychosocial health. Further, to better understand psychologic disorders, medical education should incorporate patient perspectives so that students can fully appreciate the individual impact.

Methods: This study was designed on Qualtrics and circulated to preclinical medical students (MS 1/2) at Thomas Jefferson University. Participants completed a T/F pretest and viewed the included slide deck. Half of the participants were randomized to watch a patient perspective. As a posttest, objective …

Rapid Decline In Telestroke Consults In The Setting Of Covid-19., Syed O. Shah., Robin Dharia, Jaime Stazi, Maureen Deprince, Robert H. Rosenwasswer

Farber Institute for Neuroscience Faculty Papers

Background and Purpose: As coronavirus disease 2019 (COVID-19) continues to be a global pandemic, there is a growing body of evidence suggesting that incidence of diseases that require emergent care, particularly myocardial infarction and ischemic stroke, has declined rapidly. The objective of this study is to quantify our experience of telestroke (TS) consults at a large tertiary comprehensive stroke center during the COVID-19 pandemic.

Methods: We retrospectively reviewed TS consults of patients presenting to our neuroscience network. Those with a confirmed diagnosis of acute ischemic stroke or transient ischemia attack were included. Data were compared from April 1, 2019, to …

The Role Of Mirnas, Mirna Clusters, And Isomirs In Development Of Cancer Stem Cell Populations In Colorectal Cancer., Victoria A Stark, Caroline O B Facey, Vignesh Viswanathan, Bruce M Boman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

MicroRNAs (miRNAs or miRs) have a critical role in regulating stem cells (SCs) duringdevelopment and altered expression can cause developmental defects and/or disease. Indeed,aberrant miRNA expression leads to wide-spread transcriptional dysregulation which has beenlinked to many cancers. Mounting evidence also indicates a role for miRNAs in the developmentof the cancer SC (CSC) phenotype. Our goal herein is to provide a review of: (i) current researchon miRNAs and their targets in colorectal cancer (CRC), and (ii) miRNAs that are differentiallyexpressed in colon CSCs. MicroRNAs can work in clusters or alone when targeting different SC genesto influence CSC phenotype. Accordingly, we discuss …

Impact Of Covid-19 On Individuals With Opioid Use Disorder’S Access To Services And Substance Use, Camryn Bernheimer, Lara Weinstein, Md

Phase 1

Introduction: The opioid epidemic has already devastated Philadelphia and COVID-19 has the potential to exacerbating this existing crisis. The goal of this study is to investigate how COVID-19 has impacted Medication Assisted Treatment (MAT) service utilization and substance use for individuals with opioid use disorder (OUD).

Methods: 170 participants with OUD in group-based MAT programs in Philadelphia were analyzed three months prior to and after COVID-19. The data provided participant age, gender, race/ethnicity, MAT visits, primary care physician (PCP) visits, behavioral health consult visits (BHC), and urine drug screen (UDS) results from health records. Pre-post COVID-19 relationships were examined …

Infection And Risk Of Parkinson's Disease, Richard Jay Smeyne, Alastair J Noyce, Matthew D. Byrne, Rodolfo Savica, Connie Marras

Department of Neuroscience Faculty Papers

Parkinson's disease (PD) is thought to be caused by a combination of genetic and environmental factors. Bacterial or viral infection has been proposed as a potential risk factor, and there is supporting although not entirely consistent epidemiologic and basic science evidence to support its role. Encephalitis caused by influenza has included parkinsonian features. Epidemiological evidence is most compelling for an association between PD and hepatitis C virus. Infection with Helicobacter pylori may be associated not only with PD risk but also response to levodopa. Rapidly evolving knowledge regarding the role of the microbiome also suggests a role of resident bacteria …

Conexo, Joseph Leone, Anjali Patel, Heli Patel, Gigi Geary, Lauren Huggler, Stephanie Szymanski, J. Matthew Fields

Phase 1

Helping healthcare workers keep IV lines clean in order to reduce preventable bloodstream infections.

Impact Of Medical Nutrition Therapy On Blood Pressure, Connor Mcelwee, Jessica Vitale, Cynthia Cheng, Md, Phd

Phase 1

Introduction:

We are studying how Jefferson’s Medical Nutrition Therapy (MNT) program has impacted biometric variables in program participants. These variables include body weight, HgA1C, lipids, and blood pressure (BP). My poster will focus on the impact of Jefferson’s MNT on blood pressure. My hypothesis is that participation in MNT will result in reduced blood pressure.

Methods:

The target population is patients who have participated in Jefferson’s MNT program. Study exclusion criteria included history of gastric bypass surgery, medical conditions or medication usage that might impact weight loss and other dependent variables. Data was abstracted from patients’ medical records, as …

Ifn-Γ/Il-27 Axis Induces Pd-L1 Expression In Monocyte-Derived Dendritic Cells And Restores Immune Tolerance In Cns Autoimmunity, Asrita Vattikonda, Giacomo Casella, Javad Rasouli, Rodolfo Thome, Hélène C. Descamps, Larissa Ishikawa, Alexandra Boehm, Daniel Hwang, Weifeng Zhang, Dan Xiao, Jeongho Park, Guang-Xian Zhang, Jorge I. Alvarez, Abdolmohamad Rostami, Bogoljub Ciric

Phase 1

Antigen (Ag)-specific tolerance induction by intravenous (i.v.) injection of high-dose auto-Ags has been explored for therapy of autoimmune diseases, including multiple sclerosis (MS). It is thought that the advantage of such Ag-specific therapy over non-specific immunomodulatory treatments would be selective suppression of a pathogenic immune response without impairing systemic immunity, thus avoiding adverse effects of immunosuppression. Auto-Ag i.v. tolerance induction has been extensively studied in experimental autoimmune encephalomyelitis (EAE), an animal model of MS, and limited clinical trials demonstrated that it is safe and beneficial to a subset of MS patients. Nonetheless, mechanisms of i.v. tolerance induction are incompletely understood, …

Acute Depression And Anxiety Symptoms Following Concussion In An Adolescent Outpatient Population, Ari M. Fish, Julia Vanni, Kristy Arbogast, Phd, Catherine C. Mcdonald, Phd, Rn, Christina Master, Md, Caqsm

Phase 1

Introduction: Research has shown that concussed youth are at increased risk of developing psychiatric symptoms as compared to non-concussed youth. Few studies, however, have detailed the presence and severity of acute depression and anxiety symptoms following a concussion in adolescents, specifically. Thus, the current study aims to describe depression and anxiety symptoms in concussed and non-concussed adolescents using validated measures of depression and anxiety.

Methods: The current study includes 284 adolescents (114 cases, 170 controls), 13-18 years of age. Cases included concussed patients at the Children’s Hospital of Philadelphia, and controls were recruited from a local, Philadelphia high school. …

Nccn Intermediate Risk Prostate Cancer- Long-Term Outcomes Of Active Surveillance Compared To Active Treatment, A Population-Based Analysis, Adam Schneider, Thenappan Chandrasekar, Nicholas Bowler, Hanan Goldberg, James R. Mark, Edouard J. Trabulsi, Costas D. Lallas, Leonard G. Gomella

Phase 1

Background: While active surveillance (AS) is an established standard of care for low-risk (LR) prostate cancer (PCa), its utility for intermediate risk (IR) PCa is less evident. Prior studies were limited by the inability to differentiate between AS and watchful waiting (WW). Using a recent update in the Surveillance, Epidemiology and End Results (SEER) Database that allows for enhanced distinction between AS and WW, we aimed to compare survival outcomes of men with LR and IR PCa treated with either AS, WW or active treatment (AT).

Methods: 166,244 men were initially identified by biopsy Gleason Grade Group (GG) alone – …

Investigation Of The Reciprocal Relationship Between C7, Tsp1, And Tgf-Β Activation In Normal Fibroblasts, Alicia Kenyon, Andrew South, Phd

Phase 1

Introduction: Recessive dystrophic epidermolysis bullosa (RDEB) is a rare skin blistering disorder due to a loss of function mutation in the collagen 7 (C7) gene. C7 activity loss upregulates thrombospondin-1 (TSP1), stimulating tissue growth factor-ß (TGF-ß), which promotes the development of cutaneous squamous cell carcinoma (cSCC) in RDEB patients. This C7-TSP1 interaction has not been described in normal fibroblasts; therefore, in this study, we tested the hypothesis that the level of intracellular C7 negatively correlates with TSP1 expression in normal fibroblasts.

Methods: In this basic research cell study, C7, TSP1, and pSMAD3 (phosphorylated SMAD3), a marker of TGF-ß activation, were …

Endovascular Intervention For Tracheo-Innominate Fistula: A Systematic Review And Meta-Analysis, Andrew M. Jordan, Thomas J. O'Malley, Kyle W. Prochno, Abhiraj Saxena, Elizabeth Maynes, Brandon Ferrell, T. Sloane Guy, John W. Entwistle, H. Todd Massey, Rohinton J. Morris, Babak Abai, Vakhtang Tchantchaleishvili

Phase 1

Introduction: Fistula formation between the trachea and the innominate artery is a life-threatening complication rarely seen with existing or previous tracheostomy. Fatal upon rupture, swift diagnosis and immediate intervention are paramount for survival. We aim to identify feasibility and outcomes of endovascular intervention for trachea-innominate fistula (TIF).

Methods: Patient-level data of reported individuals above the age of 14 that underwent endovascular intervention for TIF was extracted and analyzed. Identification of 25 patients from 27 studies was accomplished by electronic database search of Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Ovid Medline, …

Effects Of Continuous Positive Airway Pressure On Blood Pressure In Obstructive Sleep Apnea, Amy He, Dani Yellanki, Grace Severance, Peter Zhang, Zachary Feuer, Natali Salinas, Cynthia Cheng, Md, Phd

Phase 1

Introduction:

Obstructive sleep apnea (OSA) has been previously linked to the development of hypertension, possibly through the proposed mechanism of recurrent episodes of intermittent hypoxia leading to endothelial dysfunction, inflammation, and metabolic dysregulation. This study aims to investigate continuous positive airway pressure (CPAP) therapy, a first-line therapy for OSA, and its effects on blood pressure in patients with moderate to severe OSA. We hypothesize that compliance to CPAP leads to a decrease in average annual systolic and diastolic blood pressure, compared to noncompliant and non-CPAP use.

Methods:

Our study is a combined retrospective and prospective EPIC chart review study. Moderate …

Cardiac Arrest Clinical Outcomes In Patients Presenting With Opioid Overdose, Andrew Toron, Morgan Hutchinson, Md, David Gaieski

Phase 1

Introduction: Understanding opioids and their potential to cause cardiac arrests is integral in learning how to lower mortality rates in patients who overdose on them. Few studies have specifically examined the association of out-of-hospital cardiac arrests with opioid overdoses. We hypothesized that cardiac arrests caused by opioid overdoses will result in longer hospital stays and a higher mortality rate than other cardiac arrests.

Methods: This study is a secondary analysis of data from the Cardiac Arrest Registry to Enhance Survival. Data regarding 35 patients who presented to Jefferson and Methodist hospitals with out-of-hospital cardiac arrests due to opioid overdose …

Deep Supratentorial Extension Is Associated With Poor Clinical Outcomes After Glioblastoma Resection, Adam Barsouk, Michael P. Baldassari, Omaditya Khanna, Donald Ye, Erica Cunningham, Christopher Farrell, David Andrews, James Evans, Kevin Judy

Phase 1

Introduction: Glioblastoma (GBM) often extends to deep supratentorial locations, which limits the extent of maximal safe resection. Deep supratentorial extension (DSE) may be a clinically convenient prognostic indicator following GBM resection.

Methods: 582 GBM resections from 2012-2018 were retrospectively reviewed. DSE was defined as tumoral extension to the basal ganglia, thalamus, corpus callosum, internal capsule, hypothalamus, caudate, or putamen as identified on preoperative imaging.

Results: DSE was identified in 32.9% cases (192), while 52.5% (306) involved only superficial supratentorial locations (frontal, parietal, temporal and occipital lobes). Within the DSE cohort, the most commonly affected anatomical locations were the corpus …

Angiogram Negative Subarachnoid Hemorrhage: Incidence, Outcomes, And Predisposition, Victoria Coaxum, Ahmad Sweid, Md, Julie Barbera, Nicolas Nelson, Grace Severance, Angelo D'Antonio-Bertagnolli, Manan Parekh

Phase 1

Introduction: Subarachnoid hemorrhage (SAH) is a medical emergency that may lead to deleterious outcomes unless the underlying cause is determined and managed promptly to prevent further rebleed. Though a significant percentage of cases of SAH have no identifiable pathology, there is a lack of data related to outcomes, predispositions, and whether there has been an increase in the incidence of angiogram negative SAH (anSAH). This study aimed to assess the current incidence of anSAH and factors that are associated with outcomes and predisposition among patients diagnosed with anSAH.

Methods: A retrospective chart review was performed. Medical records of patients …

Procedural And Clinical Outcomes Of Transitioning To High Power Short Duration Guided Ablation For Atrial Fibrillation, Zachary Pang, Sean J. Dikdan, Joey Junarta, Sairamya Bodempudi, Naman Upadhyay, Md, Daniel R. Frisch

Phase 1

Introduction: High-power short-duration (HPSD; 50W for up to 15s) ablation is a novel way to use a contact force-sensing catheter optimized for power-controlled radiofrequency ablation of atrial fibrillation (AF). Our goal was to compare the procedural and clinical outcomes of AF ablation with HPSD to previous ablation methods used, including standard-power standard duration (SPSD; 20-25W, up to 60s) and temperature-controlled non-contact (TCNC; 20-40W, up to 60s).

Methods: Procedural and clinical data was from consecutive cases of patients with paroxysmal or persistent AF undergoing pulmonary vein isolation with HPSD, TCNC and SPSD between 7/1/13 to 11/1/19. A total of 171 patients …

Expanding The Whipple Accelerated Recovery Pathway (Warp) To All Patients Undergoing Pancreaticoduodenectomy (Pd), Taylor R. Kavanagh, Clifford Yudkoff, Ava Torjani, Geoffrey W. Krampitz, Wilbur Bowne, Hamza Rshaidat, Cyrus J. Sholevar, Alexandra C. Leto, William Preston, Elwin Tham, Mandeep Shergill, Shawnna Cannaday, Theresa Yeo, Harish Lavu, Charles J. Yeo

Phase 1

Introduction:

Pancreaticoduodenectomy (PD) is a complex abdominal procedure with high rates of perioperative morbidity. The Whipple Accelerated Recovery Pathway (WARP) was developed for highly selected patients undergoing PD to reduce hospital length of stay (LOS) and time to adjuvant therapy (TTAT), without increasing post-operative complications (POC) or readmission rates (RR). The purpose of this study was to determine if WARP could be implemented for all-risk patients undergoing PD.

Methods:

A single-institution, retrospective analysis of 281 patients implemented on the WARP between 2017-2020 was performed. 119 patients were categorized as WARP-eligible (WEPs) according to original inclusion criteria, and 162 were …

Efficacy Of An Appointment Specialist In Reducing Loss To Follow Up In A Retina Practice, Turner D. Wibbelsman, Michael Ammar, Md, Anthony Obeid, Md, Mph, Jason Hsu, Md

Phase 1

Introduction:

Although a new armamentarium has greatly benefitted patients with retinal disease, novel therapeutic approaches require more frequent clinic visits, which may lead to missed treatments and vision loss. This study characterizes patient-reported reasons for missed visits and assesses the efficacy of calling patients for rescheduling missed visits.

Methods:

This retrospective cohort study included patients who missed an appointment for an intravitreal injection between January 2018 and February 2020 at the Retina Service of Wills Eye Hospital. Two calls were made to each patient by an appointment specialist to reschedule the visit and record a reason for the …

Anatomic Location And Mortality Of Pancreatic Adenocarcinoma: A Single Institution Study, Sophia Lam, Randi Zukas, Ida Micaily, Atrayee Basu Mallick

Phase 1

In pancreatic adenocarcinoma, it is believed that patients with proximal tumors (head) have earlier diagnosis and higher survival due to anatomic location compared to patients with distal tumors (body/tail). We hypothesized that differences in tumor biology would contribute to poorer survival in body/tail tumors compared to head tumors when diagnosed at the same stage.

We performed a retrospective chart review on 324 patients with pancreatic adenocarcinoma (236 head and 88 body/tail) diagnosed from 2011-2017. We gathered electronic health records from a single center with a high volume of pancreatic cancer directed surgery. We compared median patient survival from onset of …

Factors Influencing Efficacy And Satisfaction In Prenatal Counseling For Families With Single Ventricle Heart Disease, Taylor Hartzel Houlihan, Jack Rychik, Md

Phase 1

Introduction: The Fetal Heart Program at Children’s Hospital of Philadelphia offers prenatal counseling to families with congenital heart disease diagnoses. This center has yet to examine family satisfaction with counseling, especially those with complicated single ventricle diagnoses. While families may receive sufficient education about their child’s condition, better communication may be needed to prepare them for potential neurological and behavioral complications.

Methods: Through chart review, 355 patient families with single ventricle diagnoses who utilized CHOP prenatal counseling within the past 10 years were identified. Retrospective surveys including Likert scales and open-ended questions were distributed by email. 65 responses were …

Treatment Of Distal Radius Fractures In Patients Over 80 Years Of Age: Functional Outcomes After Open Reduction And Internal Fixation Versus Nonoperative Treatment, Robert Gallivan, Lili E. Schindelar, Md, Mph, Richard Mcentee, Pedro K. Beredjiklian, Md

Phase 1

INTRODUCTION

Distal radius fractures are one of the most common fractures seen in the elderly. With the younger physiological age of patients over 60 years, the expectation of functional outcomes is changing. The management of distal radius fractures in the elderly patient, especially those over the age of 80, has not been well defined. The purpose of this study was to compare operative to nonoperative treatment of distal radius fractures in patients older than 80 years to determine if there is any difference in functional outcomes or complications.

METHODS

A retrospective review was performed to identify patients 80 years or …

Coronary Artery Disease And Nonalcoholic Fatty Liver Disease: Clinical Correlation Using Ct Coronary Calcium Scans, Richard S. Kirby, Dina Halegoua-De Marzio

Phase 1

Introduction: Nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) have been explored with coronary angiography which showed a link between severe NAFLD and CVD risk. This study’s aim is to determine if CT coronary artery calcium (CAC) scores used to determine CAD severity in asymptomatic populations can help predict presence of NAFLD.

Methods: Retrospective cross-sectional study of positive CT CAC scores and liver imaging with either CT, ultrasound, or MRI of the abdomen or CT of the chest. Drinking 7 or 14 drinks per week for a woman or man respectively and chronic viral hepatitis diagnosis …

Abcd Progression Post Crosslinking For Keratoconus, Sonali Patel, Neil Vadhar, Zeba Syed

Phase 1

Introduction:

Keratoconus is a corneal disease that leads to various ocular illnesses such as scarring and thinning and the most common treatment for this disease at this time is Cross Linking. Previously, post-surgical outcomes of cross linking were analyzed using the AK (Amsler- Krumeich) system which didn’t account for posterior corneal surface and corneal thickness. In order to overcome these shortcomings, a new ABCD classification was developed which accounts for anterior (A) and posterior (B) radius of curvature, thinnest corneal pachymetry (C) and distance for best corrected vision (D).

Methods:

A retrospective study was done using 104 patients who …

Does Prior Acromioplasty Increase The Incidence Of Acromial Fracture Following Reverse Total Shoulder Arthroplasty? A Retrospective Matched Cohort Analysis, Olivia Blaber, Brandon J. Erickson, Md, Christopher Hadley

Phase 1

Introduction: Reverse total shoulder arthroplasty (RTSA) is an effective treatment option for multiple shoulder pathologies. Arthroscopic acromioplasty is a treatment for subacromial impingement. RTSA can place excess stress on the acromion. No studies have evaluated outcomes following RTSA among patients with prior acromioplasty. The purpose of this study was to report outcomes in patients following RTSA who have had a prior acromioplasty. The authors hypothesized patients with prior acromioplasty who undergo RTSA will have significant improvements in clinical outcomes with no increased risk of acromial fracture.

Methods: Patients from a single institution who underwent RTSA with a history of acromioplasty …

Assessment Of Treatment Response Of Keloid Patients, Rachel Zachian, Mary Metkus, John Bruckbauer, Neda Nikbakht

Phase 1

Introduction: Keloids are benign exophytic scars ranging from asymptomatic, small papules to large symptomatic plaques that affect patients’ quality of life. The most effective treatment for this troublesome condition has yet to be determined. This study aims to demonstrate that intralesional Kenalog injections produce better keloid outcomes than surgical excision.

Methods: Researchers called 504 Jefferson keloid patients to determine their keloid outcomes post-treatment. Patients were asked to confirm their last treatment method, describe the percent change in size of their lesion(s), and rate their symptoms (pruritis and pain) on a scale of 0-10 before and after treatment. Excision and …

Return To Play Criteria Following Operative Management Of Acromioclavicular Joint Separation: A Systematic Review, Richard J. Gawel, Taylor D'Amore, Md, Peters Otlans, Md, Somnath Rao, Steven B. Cohen, Md, Michael G. Ciccotti, Md

Phase 1

Introduction: Acromioclavicular (AC) joint separation is a leading cause of shoulder injury among athletes. High grade injuries may require operative fixation, and comprehensive return to play guidelines have not yet been established. The purpose of this investigation is to summarize return to play criteria following operative management of AC joint separation.

Methods: A systematic review of the literature was performed to evaluate clinical evidence regarding return to play following operative management of isolated AC joint separation. Studies satisfying inclusion criteria were analyzed for return to play timeline and other factors used to guide return to play following surgery.

Results: Sixty-three …

Real-Time Baseline Coagulation Profiles Using Rotem In Patients Undergoing Liver Transplantation, Paul Del Prato, Uzung Yoon, Md

Phase 1

Real-time monitoring of blood coagulation during invasive surgeries is an important component of ensuring patient safety and effective treatment. Rotational thromboelastometry (ROTEM) is a viscoelastic monitoring system of hemostasis in blood that allows for ongoing measurement of global markers of coagulation. This study compares coagulation in a population of hepatocellular carcinoma liver-transplant patients (HCC) with a transplant population of other etiologies (non-HCC). A database of ROTEM measurements acquired peri-operatively during liver transplantation was compiled from over 400 Jefferson patients. A baseline profile was developed comprised of ROTEM measurements of clot initiation/stability that can be used as a methodological standard. Analysis …