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Full-Text Articles in Medicine and Health Sciences

What We Learned In The Development Of A Third-Year Medical Student Curricular Project., Maria Syl D. De La Cruz, Rashida S Smith, Alexis E Silverio, Allison R Casola, Erin L Kelly Jan 2021

What We Learned In The Development Of A Third-Year Medical Student Curricular Project., Maria Syl D. De La Cruz, Rashida S Smith, Alexis E Silverio, Allison R Casola, Erin L Kelly

Department of Family & Community Medicine Faculty Papers

The application of continuous systems improvement in medical education can provide actionable information for curriculum development, improvement, and future planning (as reported by Bowe and Armstrong, Acad Med 92:585-92, 2017). After receiving a medical education grant, we developed a curriculum to teach medical students how to use quality improvement (QI) to address health disparities in vulnerable populations. During the process of developing and implementing this curriculum, we learned several lessons.One of the major surprises was that our proposed project work took much longer to complete than anticipated. This was mainly because we did not have the right team assembled from …


Dysregulated Anti-Viral Innate Immune Cascade During Aging., Colby Stotesbury, Luis J. Sigal Jan 2021

Dysregulated Anti-Viral Innate Immune Cascade During Aging., Colby Stotesbury, Luis J. Sigal

Department of Microbiology and Immunology Faculty Papers

Aging predisposes to increased morbidity and lethality to infectious diseases, which becomes apparent with the high mortality rates suffered by older people when infected with influenza virus or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the root of this increased susceptibility to infections, is the wide-spread deterioration of the immune system.


Fructosamine Is A Valuable Marker For Glycemic Control And Predicting Adverse Outcomes Following Total Hip Arthroplasty: A Prospective Multi-Institutional Investigation, Noam Shohat, Karan Goswami, Leigham Breckenridge, Michael B Held, Arthur L Malkani, Roshan P Shah, Ran Schwarzkopf, Javad Parvizi Jan 2021

Fructosamine Is A Valuable Marker For Glycemic Control And Predicting Adverse Outcomes Following Total Hip Arthroplasty: A Prospective Multi-Institutional Investigation, Noam Shohat, Karan Goswami, Leigham Breckenridge, Michael B Held, Arthur L Malkani, Roshan P Shah, Ran Schwarzkopf, Javad Parvizi

Rothman Institute Papers

Recently, fructosamine has shown promising results in predicting adverse outcomes following total knee arthroplasty. The purpose of this study was to assess the utility of fructosamine to predict adverse outcomes following total hip arthroplasty (THA). A prospective multi-center study involving four institutions was conducted. All primary THA were evaluated for glycemic control using fructosamine levels prior to surgery. Adverse outcomes were assessed at a minimum 1 year from surgery. Primary outcome of interest was periprosthetic joint infection (PJI) based on the International Consensus Meeting (ICM) criteria. Secondary outcomes assessed were superficial infections, readmissions and death. Based on previous studies on …


Onchocerca Volvulus Bivalent Subunit Vaccine Induces Protective Immunity In Genetically Diverse Collaborative Cross Recombinant Inbred Intercross Mice, Nathan M Ryan, Jessica A. Hess Ligas, Fernando Pardo-Manuel De Villena, Benjamin E Leiby, Ayako Shimada, Lei Yu, Amir Yarmahmoodi, Nikolai Petrovsky, Bin Zhan, Maria Elena Bottazzi, Benjamin L Makepeace, Sara Lustigman, David Abraham Jan 2021

Onchocerca Volvulus Bivalent Subunit Vaccine Induces Protective Immunity In Genetically Diverse Collaborative Cross Recombinant Inbred Intercross Mice, Nathan M Ryan, Jessica A. Hess Ligas, Fernando Pardo-Manuel De Villena, Benjamin E Leiby, Ayako Shimada, Lei Yu, Amir Yarmahmoodi, Nikolai Petrovsky, Bin Zhan, Maria Elena Bottazzi, Benjamin L Makepeace, Sara Lustigman, David Abraham

Department of Microbiology and Immunology Faculty Papers

This study tests the hypothesis that an Onchocerca volvulus vaccine, consisting of two recombinant antigens (Ov-103 and Ov-RAL-2) formulated with the combination-adjuvant Advax-2, can induce protective immunity in genetically diverse Collaborative Cross recombinant inbred intercross mice (CC-RIX). CC-RIX lines were immunized with the O. volvulus vaccine and challenged with third-stage larvae. Equal and significant reductions in parasite survival were observed in 7 of 8 CC-RIX lines. Innate protective immunity was seen in the single CC-RIX line that did not demonstrate protective adaptive immunity. Analysis of a wide array of immune factors showed that each line of mice have a unique …


"Trauma To The Eye"-A Low Fidelity Resident Teaching Module For Identifying And Treating A Retrobulbar Hematoma., Jared Raikin, R. Hall, Dimitrios Papanagnou, Md Jan 2021

"Trauma To The Eye"-A Low Fidelity Resident Teaching Module For Identifying And Treating A Retrobulbar Hematoma., Jared Raikin, R. Hall, Dimitrios Papanagnou, Md

Department of Emergency Medicine Faculty Papers

Introduction: A retrobulbar hematoma (RH) is a serious time-dependent diagnosis due to its potential for permanent damage of the optic nerve, resulting in blindness. Emergency medicine (EM) physicians face the challenge of recognizing this time-sensitive injury and treating it before irreversible damage occurs. Due to its relative infrequency in the emergency department, residents may not have adequate experience in recognizing and treating RH.

Methods: This educational intervention outlined a simulated scenario that we developed to educate EM residents to diagnose RH and perform an emergent lateral canthotomy and cantholysis (LCC). Participating residents were asked to obtain a history and perform …


Manganese Exposure In Juvenile C57bl/6 Mice Increases Glial Inflammatory Responses In The Substantia Nigra Following Infection With H1n1 Influenza Virus., Collin M Bantle, C Tenley French, Jason E Cummings, Shankar Sadasivan, Kevin Tran, Richard A Slayden, Richard Jay Smeyne, Ronald B Tjalkens Jan 2021

Manganese Exposure In Juvenile C57bl/6 Mice Increases Glial Inflammatory Responses In The Substantia Nigra Following Infection With H1n1 Influenza Virus., Collin M Bantle, C Tenley French, Jason E Cummings, Shankar Sadasivan, Kevin Tran, Richard A Slayden, Richard Jay Smeyne, Ronald B Tjalkens

Farber Institute for Neuroscience Faculty Papers

Infection with Influenza A virus can lead to the development of encephalitis and subsequent neurological deficits ranging from headaches to neurodegeneration. Post-encephalitic parkinsonism has been reported in surviving patients of H1N1 infections, but not all cases of encephalitic H1N1 infection present with these neurological symptoms, suggesting that interactions with an environmental neurotoxin could promote more severe neurological damage. The heavy metal, manganese (Mn), is a potential interacting factor with H1N1 because excessive exposure early in life can induce long-lasting effects on neurological function through inflammatory activation of glial cells. In the current study, we used a two-hit model of neurotoxin-pathogen …


Post-Partum Skin-To-Skin Care And Infant Safety: Results Of A State-Wide Hospital Survey, Eileen Tyrala, Md, Michael H. Goodstein, Md, Erich Batra, Md, Barbara Kelly, Md, Judy Bannon, Mba, Ted Bell, Ms Jan 2021

Post-Partum Skin-To-Skin Care And Infant Safety: Results Of A State-Wide Hospital Survey, Eileen Tyrala, Md, Michael H. Goodstein, Md, Erich Batra, Md, Barbara Kelly, Md, Judy Bannon, Mba, Ted Bell, Ms

Department of Medicine Faculty Papers

Objectives: Survey current experience with Skin to Skin care (SSC) in Pennsylvania Maternity Centers.

Study Design: The nursing director of each Maternity Center in PA (n = 95) was sent an on-line confidential survey querying SSC practices. Responses were compared by delivery size, location, and nature of affiliation. Statistics analyzed by chi-square and student t-test.

Results: Of these 64/95 MCs (67%) responded. All allowed SSC after vaginal deliveries, 55% after C-section, 73% mother’s room. Monitoring included delivery room nurse (94%) with support from other providers (61%), family members (37%), and electronic monitoring (5%). If SSC occurred in mother’s …


Opioids And Sickle Cell Disease: From Opium To The Opioid Epidemic., Samir K. Ballas Jan 2021

Opioids And Sickle Cell Disease: From Opium To The Opioid Epidemic., Samir K. Ballas

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is an inherited disorder of hemoglobin structure. The clinical effects of the sickle gene are pleiotropic in nature causing multiple phenotypic expressions associated with the various complications of the disease. The hallmark of the disease is pain that could be acute, chronic, nociceptive, or neuropathic that could occur singly or in various combinations. The acute vaso-occlusive painful crisis (VOC) is the most common cause of admissions to the Emergency Department and/or the hospital. Although progress has been made in understanding the pathophysiology of SCD as well as in developing preventive and curative therapies, effective pain management …


Differential Expression Of Αvβ3 And Αvβ6 Integrins In Prostate Cancer Progression, Fabio Quaglia, Shiv Ram Krishn, Yanqing Wang, David W Goodrich, Peter Mccue, Andrew Kossenkov, Amy C Mandigo, Karen Knudsen, Paul H Weinreb, Eva Corey, William Kevin Kelly, Lucia R Languino Jan 2021

Differential Expression Of Αvβ3 And Αvβ6 Integrins In Prostate Cancer Progression, Fabio Quaglia, Shiv Ram Krishn, Yanqing Wang, David W Goodrich, Peter Mccue, Andrew Kossenkov, Amy C Mandigo, Karen Knudsen, Paul H Weinreb, Eva Corey, William Kevin Kelly, Lucia R Languino

Department of Cancer Biology Faculty Papers

Neuroendocrine prostate cancer (NEPrCa) arises de novo or after accumulation of genomic alterations in pre-existing adenocarcinoma tumors in response to androgen deprivation therapies. We have provided evidence that small extracellular vesicles released by PrCa cells and containing the αVβ3 integrin promote neuroendocrine differentiation of PrCa in vivo and in vitro. Here, we examined αVβ3 integrin expression in three murine models carrying a deletion of PTEN (SKO), PTEN and RB1 (DKO), or PTEN, RB1 and TRP53 (TKO) genes in the prostatic epithelium; of these three models, the DKO and TKO tumors develop NEPrCa with a gene signature comparable to those of …


Ashp Guidelines On Emergency Medicine Pharmacist Services., Melinda J. Ortmann, Elizabeth Giesler Johnson, Daniel H. Jarrell, Matt Bilhimer, Bryan D. Hayes, Aimee Mishler, Robert S. Pugliese, Taylor A. Roberson, Giles Slocum, Andrew P. Smith, Katie Yabut, David E. Zimmerman Jan 2021

Ashp Guidelines On Emergency Medicine Pharmacist Services., Melinda J. Ortmann, Elizabeth Giesler Johnson, Daniel H. Jarrell, Matt Bilhimer, Bryan D. Hayes, Aimee Mishler, Robert S. Pugliese, Taylor A. Roberson, Giles Slocum, Andrew P. Smith, Katie Yabut, David E. Zimmerman

Jefferson Hospital Staff Papers and Presentations

No abstract provided.


Early Stages Of Alzheimer's Disease: Evolving The Care Team For Optimal Patient Management., James E Galvin, Paul Aisen, Jessica B Langbaum, Eric Rodriguez, Marwan Sabbagh, Richard G. Stefanacci Do,Mgh,Mba,Agsf,Cmd, Robert A Stern, Elizabeth A Vassey, Arno De Wilde, Neva West, Ivana Rubino Jan 2021

Early Stages Of Alzheimer's Disease: Evolving The Care Team For Optimal Patient Management., James E Galvin, Paul Aisen, Jessica B Langbaum, Eric Rodriguez, Marwan Sabbagh, Richard G. Stefanacci Do,Mgh,Mba,Agsf,Cmd, Robert A Stern, Elizabeth A Vassey, Arno De Wilde, Neva West, Ivana Rubino

College of Population Health Faculty Papers

Alzheimer's disease (AD) is a progressive, neurodegenerative disease that creates complex challenges and a significant burden for patients and caregivers. Although underlying pathological changes due to AD may be detected in research studies decades prior to symptom onset, many patients in the early stages of AD remain undiagnosed in clinical practice. Increasing evidence points to the importance of an early and accurate AD diagnosis to optimize outcomes for patients and their families, yet many barriers remain along the diagnostic journey. Through a series of international working group meetings, a diverse group of experts contributed their perspectives to create a blueprint …


Development Of Optically Controlled "Living Electrodes" With Long-Projecting Axon Tracts For A Synaptic Brain-Machine Interface., Dayo O. Adewole, Laura A. Struzyna, Justin C. Burrell, James P. Harris, Ashley D. Nemes, Dmitriy Petrov, Reuben H. Kraft, H. Isaac Chen, Mijail D. Serruya, John A. Wolf, D. Kacy Cullen Jan 2021

Development Of Optically Controlled "Living Electrodes" With Long-Projecting Axon Tracts For A Synaptic Brain-Machine Interface., Dayo O. Adewole, Laura A. Struzyna, Justin C. Burrell, James P. Harris, Ashley D. Nemes, Dmitriy Petrov, Reuben H. Kraft, H. Isaac Chen, Mijail D. Serruya, John A. Wolf, D. Kacy Cullen

Department of Neurology Faculty Papers

For implantable neural interfaces, functional/clinical outcomes are challenged by limitations in specificity and stability of inorganic microelectrodes. A biological intermediary between microelectrical devices and the brain may improve specificity and longevity through (i) natural synaptic integration with deep neural circuitry, (ii) accessibility on the brain surface, and (iii) optogenetic manipulation for targeted, light-based readout/control. Accordingly, we have developed implantable "living electrodes," living cortical neurons, and axonal tracts protected within soft hydrogel cylinders, for optobiological monitoring/modulation of brain activity. Here, we demonstrate fabrication, rapid axonal outgrowth, reproducible cytoarchitecture, and simultaneous optical stimulation and recording of these tissue engineered constructs in vitro. …


Clinical Performance Of The Point-Of-Care Cobas Liat For Detection Of Sars-Cov-2 In 20 Minutes: A Multicenter Study., Glen Hansen, Jamie Marino, Zi-Xuan Wang, Kathleen G Beavis, John Rodrigo, Kylie Labog, Lars F Westblade, Run Jin, Nedra Love, Karen Ding, Sachin Garg, Alan Huang, Joanna Sickler, Nam K Tran Jan 2021

Clinical Performance Of The Point-Of-Care Cobas Liat For Detection Of Sars-Cov-2 In 20 Minutes: A Multicenter Study., Glen Hansen, Jamie Marino, Zi-Xuan Wang, Kathleen G Beavis, John Rodrigo, Kylie Labog, Lars F Westblade, Run Jin, Nedra Love, Karen Ding, Sachin Garg, Alan Huang, Joanna Sickler, Nam K Tran

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Highly accurate testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the point of care (POC) is an unmet diagnostic need in emergency care and time-sensitive outpatient care settings. Reverse transcription-PCR (RT-PCR) technology is the gold standard for SARS-CoV-2 diagnostics. We performed a multisite U.S. study comparing the clinical performance of the first U.S. Food and Drug Administration (FDA)-authorized POC RT-PCR for detection of SARS-CoV-2 in 20 min, the cobas Liat SARS-CoV-2 and influenza A/B nucleic acid test, to the most widely used RT-PCR laboratory test, the cobas 68/8800 SARS-CoV-2 test. Clinical nasopharyngeal swab specimens from 444 patients with …


Distinct Mechanisms Control Genome Recognition By P53 At Its Target Genes Linked To Different Cell Fates., Marina Farkas, Hideharu Hashimoto, Yingtao Bi, Ramana V Davuluri, Lois Resnick-Silverman, James J. Manfredi, Erik W. Debler, Steven B. Mcmahon Jan 2021

Distinct Mechanisms Control Genome Recognition By P53 At Its Target Genes Linked To Different Cell Fates., Marina Farkas, Hideharu Hashimoto, Yingtao Bi, Ramana V Davuluri, Lois Resnick-Silverman, James J. Manfredi, Erik W. Debler, Steven B. Mcmahon

Department of Biochemistry and Molecular Biology Faculty Papers

The tumor suppressor p53 integrates stress response pathways by selectively engaging one of several potential transcriptomes, thereby triggering cell fate decisions (e.g., cell cycle arrest, apoptosis). Foundational to this process is the binding of tetrameric p53 to 20-bp response elements (REs) in the genome (RRRCWWGYYYN0-13RRRCWWGYYY). In general, REs at cell cycle arrest targets (e.g. p21) are of higher affinity than those at apoptosis targets (e.g., BAX). However, the RE sequence code underlying selectivity remains undeciphered. Here, we identify molecular mechanisms mediating p53 binding to high- and low-affinity REs by showing that key determinants of the code are embedded …


A Systematic Review On Three Major Types Of Scleral-Fixated Intraocular Lens Implantation, Ho Ming Wong, Ka Wai Kam, Christopher J Rapuano, Alvin L Young Jan 2021

A Systematic Review On Three Major Types Of Scleral-Fixated Intraocular Lens Implantation, Ho Ming Wong, Ka Wai Kam, Christopher J Rapuano, Alvin L Young

Wills Eye Hospital Papers

PURPOSE: We performed a systematic review on 3 major types of scleral-fixated intraocular lens (SFIOL) implantations and conducted subgroup analyses on pediatric population and subjects with Marfan syndrome.

DESIGN: Systematic review.

METHODS: We performed a search in PubMed, Ovid MEDLINE, and Embase for English language articles with keywords "(sutured intraocular lens) OR (SFIOL) OR (sutureless intraocular lens) OR (glued intraocular lens) OR (intrascleral intraocular lens) OR (SFIOL)" through October 16, 2019. Articles reporting individual outcomes after SFIOL were included in this systematic review. Recorded outcome measures included intraoperative and postoperative complications, endothelial cell changes, and intraocular lens-related outcomes.

RESULTS: Our …


The Health-Related Quality Of Life, Work Productivity, Healthcare Resource Utilization, And Economic Burden Associated With Levels Of Suicidal Ideation Among Patients Self-Reporting Moderately Severe Or Severe Major Depressive Disorder In A National Survey., Carmela Benson, David Singer, Colleen M Carpinella, May Shawi, Larry Alphs Jan 2021

The Health-Related Quality Of Life, Work Productivity, Healthcare Resource Utilization, And Economic Burden Associated With Levels Of Suicidal Ideation Among Patients Self-Reporting Moderately Severe Or Severe Major Depressive Disorder In A National Survey., Carmela Benson, David Singer, Colleen M Carpinella, May Shawi, Larry Alphs

College of Population Health Faculty Papers

Background: Suicidal ideation (SI) is a cardinal aspect of major depressive disorder (MDD); however, patient-reported outcomes data from large-scale surveys are limited concerning SI in the context of MDD. This study aims to understand the association between varying levels of SI and health-related quality of life (HRQoL), work productivity, healthcare resource utilization (HRU), and associated costs in patients with moderately severe/severe MDD.

Methods: This was a retrospective, cross-sectional analysis of 2013 national survey data. Patients who self-reported moderately severe or severe MDD and completed the Short Form Survey Version 2 (SF-36v2), Work Productivity Loss and Activity Impairment questionnaire (WPAI), and …


Prevalence Of Malaria Parasite Infections Among U.S.-Bound Congolese Refugees With And Without Splenomegaly., Moses Mwesigwa, Jessica L. Webster, Sam Lubwama Nsobya, Alexander Rowan, Mukunda Singh Basnet, Christina R. Phares, Michelle Weinberg, Alexander Klosovsky, Marwan Naoum, Philip J. Rosenthal, William Stauffer Jan 2021

Prevalence Of Malaria Parasite Infections Among U.S.-Bound Congolese Refugees With And Without Splenomegaly., Moses Mwesigwa, Jessica L. Webster, Sam Lubwama Nsobya, Alexander Rowan, Mukunda Singh Basnet, Christina R. Phares, Michelle Weinberg, Alexander Klosovsky, Marwan Naoum, Philip J. Rosenthal, William Stauffer

Student Papers, Posters & Projects

All U.S.-bound refugees from sub-Saharan Africa receive presumptive antimalarial treatment before departing for the United States. Among U.S.-bound Congolese refugees, breakthrough malaria cases and persistent splenomegaly have been reported. In response, an enhanced malaria diagnostic program was instituted. Here, we report the prevalence of plasmodial infection among 803 U.S.-bound Congolese refugees who received enhanced diagnostics. Infections by either rapid diagnostic test (RDT) or PCR were detected in 187 (23%) refugees, with 78 (10%) by RDT only, 35 (4%) by PCR only, and 74 (9%) by both. Infections identified by PCR included 103 monoinfections (87 Plasmodium falciparum, eight Plasmodium ovale, seven …


A High Affinity, Partial Antagonist Effect Of 3,4-Diaminopyridine Mediates Action Potential Broadening And Enhancement Of Transmitter Release At Nmjs, Kristine S Ojala, Scott P Ginebaugh, Man Wu, Evan W Miller, Gloria Ortiz, Manuel Covarrubias, Stephen D Meriney Jan 2021

A High Affinity, Partial Antagonist Effect Of 3,4-Diaminopyridine Mediates Action Potential Broadening And Enhancement Of Transmitter Release At Nmjs, Kristine S Ojala, Scott P Ginebaugh, Man Wu, Evan W Miller, Gloria Ortiz, Manuel Covarrubias, Stephen D Meriney

Department of Neuroscience Faculty Papers

3,4-Diaminopyridine (3,4-DAP) increases transmitter release from neuromuscular junctions (NMJs), and low doses of 3,4-DAP (estimated to reach ∼1 μM in serum) are the Food and Drug Administration (FDA)-Approved treatment for neuro muscular weakness caused by Lambert-Eaton myasthenic syn drome. Canonically, 3,4-DAP is thought to block voltage-gated potassium (Kv) channels, resulting in prolongation of the pre synaptic action potential (AP). However, recent reports have shown that low millimolar concentrations of 3,4-DAP have an off-Target agonist effect on the Cav1 subtype ("L-Type") of voltage-gated calcium (Cav) channels and have speculated that this agonist effect might contribute to 3,4-DAP effects on transmitter release …


The Circadian Cryptochrome, Cry1, Is A Pro-Tumorigenic Factor That Rhythmically Modulates Dna Repair., Ayesha A Shafi, Chris M Mcnair, Jennifer J Mccann, Mohammed Alshalalfa, Anton Shostak, Tesa M Severson, Yanyun Zhu, Andre Bergman, Nicolas Gordon, Amy C Mandigo, Saswati N Chand, Peter Gallagher, Emanuela Dylgjeri, Talya S Laufer, Irina A Vasilevskaya, Matthew J Schiewer, Michael Brunner, Felix Y Feng, Wilbert Zwart, Karen E Knudsen Jan 2021

The Circadian Cryptochrome, Cry1, Is A Pro-Tumorigenic Factor That Rhythmically Modulates Dna Repair., Ayesha A Shafi, Chris M Mcnair, Jennifer J Mccann, Mohammed Alshalalfa, Anton Shostak, Tesa M Severson, Yanyun Zhu, Andre Bergman, Nicolas Gordon, Amy C Mandigo, Saswati N Chand, Peter Gallagher, Emanuela Dylgjeri, Talya S Laufer, Irina A Vasilevskaya, Matthew J Schiewer, Michael Brunner, Felix Y Feng, Wilbert Zwart, Karen E Knudsen

Department of Cancer Biology Faculty Papers

Mechanisms regulating DNA repair processes remain incompletely defined. Here, the circadian factor CRY1, an evolutionally conserved transcriptional coregulator, is identified as a tumor specific regulator of DNA repair. Key findings demonstrate that CRY1 expression is androgen-responsive and associates with poor outcome in prostate cancer. Functional studies and first-in-field mapping of the CRY1 cistrome and transcriptome reveal that CRY1 regulates DNA repair and the G2/M transition. DNA damage stabilizes CRY1 in cancer (in vitro, in vivo, and human tumors ex vivo), which proves critical for efficient DNA repair. Further mechanistic investigation shows that stabilized CRY1 temporally regulates expression of genes required …


Myeloid-Derived Suppressor Cells In Gastrointestinal Cancers: A Systemic Review., Maham Farshidpour, Monjur Ahmed, Shilpa Junna, Juanita L. Merchant Jan 2021

Myeloid-Derived Suppressor Cells In Gastrointestinal Cancers: A Systemic Review., Maham Farshidpour, Monjur Ahmed, Shilpa Junna, Juanita L. Merchant

Division of Internal Medicine Faculty Papers & Presentations

Gastrointestinal (GI) cancers are one of the most common malignancies worldwide, with high rates of morbidity and mortality. Myeloid-derived suppressor cells (MDSCs) are major components of the tumor microenvironment (TME). MDSCs facilitate the transformation of premalignant cells and play roles in tumor growth and metastasis. Moreover, in patients with GI malignancies, MDSCs can lead to the suppression of T cells and natural killer cells. Accordingly, a better understanding of the role and mechanism of action of MDSCs in the TME will aid in the development of novel immune-targeted therapies.


Practical Guidance For Studies Using Freelisting Interviews., Shimrit Keddem, Frances K. Barg, Rosemary Frasso Jan 2021

Practical Guidance For Studies Using Freelisting Interviews., Shimrit Keddem, Frances K. Barg, Rosemary Frasso

College of Population Health Faculty Papers

Freelisting is a qualitative interviewing technique that has recently grown in popularity. It is an excellent tool for rapidly exploring how groups of people think about and define a particular health-related domain and is well suited for engaging communities and identifying shared priorities. In this article, we outline 7 practical considerations for conducting freelisting studies summarized from 16 articles conducted by the authors at the University of Pennsylvania and Thomas Jefferson University in partnership with community-based organizations and students. Our recommendations can inform study design, data collection, and data analysis for investigators who are interested in using freelisting interviews in …


Biomolecules As Model Indicators Of In Vitro And In Vivo Cold Plasma Safety, Caitlin Heslin, Daniela Boehm, Julianne Megaw, Brendan F. Gilmore, Theresa A. Freeman, Noreen J. Hickok, P. J. Cullen, Paula Bourke Jan 2021

Biomolecules As Model Indicators Of In Vitro And In Vivo Cold Plasma Safety, Caitlin Heslin, Daniela Boehm, Julianne Megaw, Brendan F. Gilmore, Theresa A. Freeman, Noreen J. Hickok, P. J. Cullen, Paula Bourke

Department of Medicine Faculty Papers

No abstract provided.


Caesarean Birth By Maternal Request: A Poorly Understood Phenomenon In Low- And Middle-Income Countries., Margo S. Harrison, Ana Garces, Lester Figueroa, Fabian Esamai, Sherri Bucher, Carl Bose, Shivaprasad Goudar, Richard Derman, Archana Patel, Patricia L. Hibberd, Elwyn Chomba, Miusaku Mwenechanya, Michael Hambidge, Nancy F. Krebs Jan 2021

Caesarean Birth By Maternal Request: A Poorly Understood Phenomenon In Low- And Middle-Income Countries., Margo S. Harrison, Ana Garces, Lester Figueroa, Fabian Esamai, Sherri Bucher, Carl Bose, Shivaprasad Goudar, Richard Derman, Archana Patel, Patricia L. Hibberd, Elwyn Chomba, Miusaku Mwenechanya, Michael Hambidge, Nancy F. Krebs

Global Health Articles

BACKGROUND: While trends in caesarean birth by maternal request in low- and middle-income countries are unclear, age, education, multiple gestation and hypertensive disease appear associated with the indication when compared with caesarean birth performed for medical indications.

METHODS: We performed a secondary analysis of a prospectively collected population-based study of home and facility births using descriptive statistics, bivariate comparisons and multilevel mixed-effects logistic regression.

RESULTS: Of 28 751 patients who underwent caesarean birth and had a documented primary indication for the surgery, 655 (2%) were attributed to caesarean birth by maternal request. The remaining 98% were attributed to maternal and …


Medical Oncology Professionals’ Perceptions Of Telehealth Video Visits, Arianna Heyer, Rachel E. Granberg, Kristin L. Rising, Adam F. Binder, Alexzandra T. Gentsch, Nathan R. Handley Jan 2021

Medical Oncology Professionals’ Perceptions Of Telehealth Video Visits, Arianna Heyer, Rachel E. Granberg, Kristin L. Rising, Adam F. Binder, Alexzandra T. Gentsch, Nathan R. Handley

Department of Medical Oncology Faculty Papers

IMPORTANCE: Telehealth has emerged as a means of improving access and reducing cost for medical oncology care; however, use by specialists prior to the coronavirus disease 2019 (COVID-19) pandemic still remained low. Medical oncology professionals’ perceptions of telehealth for cancer care are largely unknown, but are critical to telehealth utilization and expansion efforts.

OBJECTIVE: To identify medical oncology health professionals’ perceptions of the barriers to and benefits of telehealth video visits.

DESIGN, SETTING, AND PARTICIPANTS: This qualitative study used interviews conducted from October 30, 2019, to March 5, 2020, of medical oncology health professionals at the Thomas Jefferson University Hospital, …


Approach To Ruq Pain, Jose Medina, Md, Msw Jan 2021

Approach To Ruq Pain, Jose Medina, Md, Msw

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

  • Highlight the prevalence of RUQ pain
  • Review the anatomy relevant to RUQ pain
  • Discuss the broad differential associated
  • Walk through important history, physical exam, and lab work components of the work up for RUQ pain
  • Review the appropriateness/clinical utility of different imaging modalities
  • Highlight common US findings associated with RUQ pain
  • Case review and management of common RUQ diagnoses


Feasibility And Initial Experience Of Left Radial Approach For Diagnostic Neuroangiography., Nohra Chalouhi, Ahmad Sweid, Fadi Al Saiegh, Kalyan C Sajja, Richard F. Schmidt, Michael B Avery, Nikolaos Mouchtouris, Omaditya Khanna, Joshua H Weinberg, Victor Romo, Stavropoula Tjoumakaris, Michael Reid Gooch, Nabeel Herial, Robert H Rosenwasser, Pascal Jabbour Jan 2021

Feasibility And Initial Experience Of Left Radial Approach For Diagnostic Neuroangiography., Nohra Chalouhi, Ahmad Sweid, Fadi Al Saiegh, Kalyan C Sajja, Richard F. Schmidt, Michael B Avery, Nikolaos Mouchtouris, Omaditya Khanna, Joshua H Weinberg, Victor Romo, Stavropoula Tjoumakaris, Michael Reid Gooch, Nabeel Herial, Robert H Rosenwasser, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Neuroangiography has seen a recent shift from transfemoral to transradial access. In transradial neuroangiography, the right dominant hand is the main access used. However, the left side may be used specifically for left posterior circulation pathologies and when right access cannot be used. This study describes our initial experience with left radial access for diagnostic neuroangiography and assesses the feasibility and safety of this technique. We performed a retrospective review of a prospective database of consecutive patients between April 2018 and January 2020, and identified 20 patients whom a left radial access was used for neurovascular procedures. Left transradial neuroangiography …


Improved Prognostic Stratification Using Circulating Tumor Cell Clusters In Patients With Metastatic Castration-Resistant Prostate Cancer., Chun Wang, Zhenchao Zhang, Weelic Chong, Rui Luo, Ronald E Myers, Jian Gu, Jianqing Lin, Qiang Wei, Bingshan Li, Timothy R Rebbeck, Grace Lu-Yao, William K Kelly, Hushan Yang Jan 2021

Improved Prognostic Stratification Using Circulating Tumor Cell Clusters In Patients With Metastatic Castration-Resistant Prostate Cancer., Chun Wang, Zhenchao Zhang, Weelic Chong, Rui Luo, Ronald E Myers, Jian Gu, Jianqing Lin, Qiang Wei, Bingshan Li, Timothy R Rebbeck, Grace Lu-Yao, William K Kelly, Hushan Yang

Department of Medical Oncology Faculty Papers

Liquid biopsy-based biomarkers have advantages in monitoring the dynamics of metastatic castration-resistant prostate cancer (mCRPC), a bone-predominant metastatic disease. Previous studies have demonstrated associations between circulating tumor cells (CTCs) and clinical outcomes of mCRPC patients, but little is known about the prognostic value of CTC-clusters. In 227 longitudinally collected blood samples from 64 mCRPC patients, CTCs and CTC-clusters were enumerated using the CellSearch platform. The associations of CTC and CTC-cluster counts with progression-free survival (PFS) and overall survival (OS), individually and jointly, were evaluated by Cox models. CTCs and CTC-clusters were detected in 24 (37.5%) and 8 (12.5%) of 64 …


'Educated' Osteoblasts Reduce Osteoclastogenesis In A Bone-Tumor Mimetic Microenvironment., Alexus D. Kolb, Jinlu Dai, Evan T. Keller, Karen M. Bussard Jan 2021

'Educated' Osteoblasts Reduce Osteoclastogenesis In A Bone-Tumor Mimetic Microenvironment., Alexus D. Kolb, Jinlu Dai, Evan T. Keller, Karen M. Bussard

Department of Cancer Biology Faculty Papers

Breast cancer (BC) metastases to bone disrupt the balance between osteoblasts and osteoclasts, leading to excessive bone resorption. We identified a novel subpopulation of osteoblasts with tumor-inhibitory properties, called educated osteoblasts (EOs). Here we sought to examine the effect of EOs on osteoclastogenesis during tumor progression. We hypothesized that EOs affect osteoclast development in the bone-tumor niche, leading to suppressed pre-osteoclast fusion and bone resorption. Conditioned media (CM) was analyzed for protein expression of osteoclast factors receptor activator of nuclear factor kappa-β ligand (RANKL), osteoprotegerin (OPG), and tumor necrosis factor alpha (TNFα) via ELISA. EOs were co-cultured with pre-osteoclasts on …


Contemporary Incidence And Risk Factors Of Post Transplant Erythrocytosis In Deceased Donor Kidney Transplantation., Sami Alasfar, Isaac E Hall, Sherry G Mansour, Yaqi Jia, Heather R Thiessen-Philbrook, Francis L Weng, Pooja Singh, Bernd Schröppel, Thangamani Muthukumar, Sumit Mohan, Rubab F Malik, Meera N Harhay, Mona D Doshi, Enver Akalin, Jonathan S Bromberg, Daniel C Brennan, Peter P Reese, Chirag R Parikh Jan 2021

Contemporary Incidence And Risk Factors Of Post Transplant Erythrocytosis In Deceased Donor Kidney Transplantation., Sami Alasfar, Isaac E Hall, Sherry G Mansour, Yaqi Jia, Heather R Thiessen-Philbrook, Francis L Weng, Pooja Singh, Bernd Schröppel, Thangamani Muthukumar, Sumit Mohan, Rubab F Malik, Meera N Harhay, Mona D Doshi, Enver Akalin, Jonathan S Bromberg, Daniel C Brennan, Peter P Reese, Chirag R Parikh

Department of Medicine Faculty Papers

BACKGROUND: Post-Transplant erythrocytosis (PTE) has not been studied in large recent cohorts. In this study, we evaluated the incidence, risk factors, and outcome of PTE with current transplant practices using the present World Health Organization criteria to define erythrocytosis. We also tested the hypothesis that the risk of PTE is greater with higher-quality kidneys.

METHODS: We utilized the Deceased Donor Study which is an ongoing, multicenter, observational study of deceased donors and their kidney recipients that were transplanted between 2010 and 2013 across 13 centers. Eryrthocytosis is defined by hemoglobin> 16.5 g/dL in men and> 16 g/dL in women. Kidney …


Genetic Murine Models Of Spinal Development And Degeneration Provide Valuable Insights Into Intervertebral Disc Pathobiology., J. Melrose, S. Tessier, M. V. Risbud Jan 2021

Genetic Murine Models Of Spinal Development And Degeneration Provide Valuable Insights Into Intervertebral Disc Pathobiology., J. Melrose, S. Tessier, M. V. Risbud

Department of Orthopaedic Surgery Faculty Papers

Disc degeneration and associated back and neck pain elicits a substantial burden on healthcare systems and the individuals affected, necessitating the development of novel therapeutic strategies. This goal can only be achieved by a better understanding of intervertebral disc development, homeostasis and pathogenesis. A number of genetic and in-bred murine models are reviewed to underscore the importance of the mouse as an animal model of choice for the assessment of intervertebral disc pathobiology. Appraisals of the differences between mouse and human musculoskeletal systems and proteoglycan structures are also included. A number of important target pathways and molecules have been identified, …