Medicine and Health Sciences Commons^™

Breast Cancer Screening, Nina Mingioni, Md, Facp

Clinical Education Teaching Tools

Learning Objectives:

• Assess patients for risk of breast cancer
• Name common breast cancer screening modalities
• Discuss the risks and benefits of breast cancer screening
• Recommend breast cancer screening in appropriate patients

Level 4 Visit, George Valco, Md

Department of Family & Community Medicine Presentations and Grand Rounds

• Medicare guidelines specifically with regard to PATH rules ( Physicians At Teaching Hospitals).
• Specific Documentation is a requirement for reimbursement under Medicare, Medicaid, and any 3rd party payers who refer to Medicare guidelines.
• Resident participation & documentation is incorporated by the Teaching Physicians (TP).

Mental Health Care Transitions From Incarceration, Graham Stratton, Md

Department of Family & Community Medicine Presentations and Grand Rounds

The scope of the problem of mental health and incarceration

• Case & Consideration 1: Severe Mental Illness ○ Brief history of de institutionalization and re institutionalization ○ Philadelphia’s jails at a glance
• Case & Consideration 2: Violence and trauma
• Consideration & Consideration 3: Addiction and substance use
• Models of transitions of care for reentry
• Community teams and resources
• Next steps for a Family Medicine physician

Brief Psychotherapy In Primary Care, Geoffrey Mills, Md, Phd

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Overview Case

Thread Goals

• Acknowledgement
• Rationale
• Background ‘theory’
• Framework(s) Practical applications

Osseous Changes Following Reverse Total Shoulder Arthroplasty Combined With Latissimus Dorsi Transfer: A Case Series, Jason S Klein, Peter S Johnston, Benjamin W Sears, Manan S Patel, Armodios M Hatzidakis, Mark D. Lazarus

Department of Orthopaedic Surgery Faculty Papers

Background: This is the first report on the incidence of proximal humerus osseous changes and associated clinical consequences in reverse total shoulder arthroplasty combined with a latissimus dorsi tendon transfer (RTSA+LDT).

Methods: A multicenter, retrospective review identified all patients who had undergone a primary RTSA+LDT and had at least 3-month radiographic follow-up between 2012 and 2017. Data collection included demographics, oral steroid use, repair technique for LDT fixation, radiographic humeral osseous changes, complications, and need for revision surgery.

Results: Twenty-four patients were included with an average age of 70.7 ± 7.9 years and follow-up of 16.3 (3-50) months. Ten patients …

Comparison Of Outcomes Of Hct In Blast Phase Of Bcr-Abl1- Mpn With De Novo Aml And With Aml Following Mds, Vikas Gupta, Soyoung Kim, Zhen-Huan Hu, Ying Liu, Mahmoud Aljurf, Ulrike Bacher, Amer Beitinjaneh, Jean-Yves Cahn, Jan Cerny, Edward Copelan, Shahinaz M Gadalla, Robert Peter Gale, Siddhartha Ganguly, Biju George, Aaron T Gerds, Usama Gergis, Betty K Hamilton, Shahrukh Hashmi, Gerhard C Hildebrandt, Rammurti T Kamble, Tamila Kindwall-Keller, Hillard M Lazarus, Jane L Liesveld, Mark Litzow, Richard T Maziarz, Taiga Nishihori, Richard F Olsson, David Rizzieri, Bipin N Savani, Sachiko Seo, Melhem Solh, Jeff Szer, Leo F Verdonck, Baldeep Wirk, Ann Woolfrey, Jean A Yared, Edwin P Alyea, Uday R Popat, Ronald M Sobecks, Bart L Scott, Ryotaro Nakamura, Wael Saber

Department of Medical Oncology Faculty Papers

Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL1- myeloproliferative neoplasms (MPNs) in blast phase (MPN-BP) vs de novo acute myeloid leukemia (AML), and AML with prior myelodysplastic syndromes (MDSs; post-MDS AML), are unknown. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we compared HCT outcomes in 177 MPN-BP patients with 4749 patients with de novo AML, and 1104 patients with post-MDS AML, using multivariate regression analysis in 2 separate comparisons. In a multivariate Cox model, no difference in overall survival (OS) or relapse was observed in patients with MPN-BP vs de novo AML with …

Feasibility Of Removable Balloon Implant For Simultaneous Magnetic Nanoparticle Heating And Hdr Brachytherapy Of Brain Tumor Resection Cavities., Paul R. Stauffer, Dario B. Rodrigues, Robert Goldstein, Thinh Nguyen, Yan Yu, Shuying Wan, Richard Woodward, Michael Gibbs, Ilya L. Vasilchenko, Alexey M. Osintsev, Voichita Bar-Ad, Dennis B. Leeper, Wenyin Shi, Kevin D. Judy, Mark D. Hurwitz

Department of Radiation Oncology Faculty Papers

AIM: Hyperthermia (HT) has been shown to improve clinical response to radiation therapy (RT) for cancer. Synergism is dramatically enhanced if HT and RT are combined simultaneously, but appropriate technology to apply treatments together does not exist. This study investigates the feasibility of delivering HT with RT to a 5-10mm annular rim of at-risk tissue around a tumor resection cavity using a temporary thermobrachytherapy (TBT) balloon implant.

METHODS: A balloon catheter was designed to deliver radiation from High Dose Rate (HDR) brachytherapy concurrent with HT delivered by filling the balloon with magnetic nanoparticles (MNP) and immersing it in a radiofrequency …

A Community Assessment Of Rapid Response Team Events Preceding Cardiopulmonary Arrest: Does It Improve Outcomes?, Vincent Chan, Ahmad Raza, Qian Zhang, Artem Minalyan, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

An Unlikely Combination Of Neutrophilic Predominant Pleural Effusion With Acid-Fast Bacilli Positivity, Vincent Chan, Qian Zhang, Ahmad Raza, Artem Minalyan, William Ward

Abington Jefferson Health Papers

No abstract provided.

Rare Cause Of Fatal Liver Disease: A Case Of Acute Liver Failure In A Patient With Recently Diagnosed Metastatic Ovarian Carcinoma, Artem Minalyan, Qian Zhang, Vincent Chan

Abington Jefferson Health Papers

No abstract provided.

"Brain Dead" Donor: A Case Of Brain Death Mimic Due To Pentobarbital Overdose, Artem Minalyan, Vincent Chan, Qian Zhang

Abington Jefferson Health Papers

No abstract provided.

Survival Analysis Based On The Duration Of Cpr After In-Hospital Cardiac Arrest, Ahmad Raza, Nayab Nadeem, Ahmad Arslan, Zain Ali, Qian Zhang, Usama Sadiq, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

A Roller Coaster Ride Of Idiopathic Fibrosing Mediastinitis, Qian Zhang, Khine Shan

Abington Jefferson Health Papers

No abstract provided.

Identifying Treatments For Taste And Smell Disorders: Gaps And Opportunities., Joel D. Mainland, Linda A. Barlow, Steven D. Munger, Sarah E. Millar, M. Natalia Vergara, Peihua Jiang, James E. Schwob, Bradley J. Goldstein, Shannon E. Boye, Jeffrey R. Martens, Donald A. Leopold, Linda M. Bartoshuk, Richard L. Doty, Thomas Hummel, Jayant M. Pinto, Casey Trimmer, Christine Kelly, Edmund A. Pribitkin, Danielle R. Reed

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The chemical senses of taste and smell play a vital role in conveying information about ourselves and our environment. Tastes and smells can warn against danger and also contribute to the daily enjoyment of food, friends and family, and our surroundings. Over 12% of the US population is estimated to experience taste and smell (chemosensory) dysfunction. Yet, despite this high prevalence, long-term, effective treatments for these disorders have been largely elusive. Clinical successes in other sensory systems, including hearing and vision, have led to new hope for developments in the treatment of chemosensory disorders. To accelerate cures, we convened the …

Lgi1 Encephalitis With Squamous Lung-Cell Carcinoma: Resolution After Tumor Resection., Akash Virupakshaiah, Marinos Dalakas, Neeja Desai, Scott Mintzer, Jeffrey Ratliff

Department of Neurology Faculty Papers

Encephalitis with leucine-rich glioma-inactivated-1 (LGI1) immunoglobulin G (IgG) anti-bodies classically presents with cognitive impairment and characteristic faciobrachial dystonicseizures.1In a murine model, human LGI1 IgG caused reduction of Kv1.1 channels andα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor receptors resulting in neuro-nal hyperexcitability indicating probable pathogenicity of LGI1 antibodies.2LGI1 autoimmu-nity is associated with malignancy in less than 10% of cases, including small cell lung cancer,prostate and colon cancer, squamous cell skin carcinoma, and neuroendocrine pancreaticcancer.3,4We present a case of LGI1 encephalitis only partially responsive to immunotherapywith eventual complete resolution after resection of a squamous cell lung carcinoma.

Pregnant Smokers Receiving Opioid Agonist Therapy Have An Elevated Nicotine Metabolite Ratio: A Replication Study., Henry R Kranzler, Yukiko Washio, Leah R Zindel, Kevin G Lynch, Dennis J. Hand, Rachel F Tyndale, Cheryl Oncken, Robert Schnoll

Department of Obstetrics and Gynecology Faculty Papers

INTRODUCTION: Pregnant women exposed chronically to opioids smoked more cigarettes per day (CPD) and had a higher nicotine metabolite ratio (NMR), 3-hydroxycotinine/cotinine, a biomarker of nicotine metabolism and clearance, than those not receiving opioids. We examined CPD and NMR in a group of pregnant smokers, a quarter of whom were receiving opioid agonist therapy (OAT).

AIMS AND METHODS: Pregnant smokers recruited to participate in a placebo-controlled trial of bupropion for smoking cessation provided a blood sample for measurement of NMR.

RESULTS: Half (52.4%) of the 124 women with NMR data were African American. OAT-treated women (n = 34, 27.4%; 27 …

A Survey Of Internal And Family Medicine Residents: Assessment Of Disability-Specific Education And Knowledge., Michael D Stillman, Nethra Ankam, Michael Mallow, Maclain Capron, Steve Williams

Department of Rehabilitation Medicine Faculty Papers

BACKGROUND: The literature suggests that primary care physicians are inadequately educated in the care of people with disabilities. No study to date has evaluated whether internal medicine (IM) and family medicine (FM) residents have received disability-specific education or their level of comfort in caring for people with physical disabilities.

OBJECTIVES: To assess IM and FM residents' receipt of disability-specific education during medical school and residency; to evaluate their self-reported comfort in managing secondary conditions associated with physical disabilities and in coordinating therapies and services for individuals with disabilities; to gauge their interest in receiving disability-specific education.

METHODS: An on-line survey …

Empathy Of Medical Students And Compassionate Care For Dying Patients: An Assessment Of “No One Dies Alone” Program, Mohammadreza Hojat, Jennifer Desantis, David Ney, Hannah Decleene-Do

CRMEHC Faculty Papers

The “No One Dies Alone” (NODA) program was initiated to provide compassionate companions to the bedside of dying patients. This study was designed to test the following hypotheses: (1) Empathy scores would be higher among medical students who volunteered to participate in the NODA program than nonvolunteers; (2) Spending time with dying patients would enhance empathy in medical students. Study sample included 525 first- and second-year medical students, 54 of whom volunteered to participate in the NODA program. Of these volunteers, 26 had the opportunity to visit a dying patient (experimental group), and 28 did not, due to scheduling conflicts …

Early General Hypothermia Improves Motor Function After Spinal Cord Injury In Rats; A Systematic Review And Meta-Analysis., Mahmoud Yousefifard, Mohammad Hossein Vazirizadeh-Mahabadi, Leila Haghani, Farhad Shokraneh, Alex R. Vaccaro, Vafa Rahimi-Movaghar, Mostafa Hosseini

Rothman Institute Papers

Introduction: There is still controversy about the effect of early hypothermia on the outcome of spinal cord injury (SCI). The aim of this review article is to investigate the effect of local or general hypothermia on improving the locomotion after traumatic SCI.

Methods: Electronic databases (Medline and Embase) were searched from inception until May 7, 2018. Two independent reviewers screened and summarized the relevant experimental studies on hypothermia efficacy in traumatic SCI. The data were analyzed and the findings were presented as pooled standardized mean difference (SMD) and 95% confidence interval (95% CI).

Results: 20 papers contain-ing 30 separate experiments …

Eptinezumab For The Prevention Of Chronic Migraine: Efficacy And Safety Through 24 Weeks Of Treatment In The Phase 3 Promise-2 (Prevention Of Migraine Via Intravenous Ald403 Safety And Efficacy-2) Study., Stephen Silberstein, Merle Diamond, Nada A. Hindiyeh, David M. Biondi, Roger Cady, Joe Hirman, Brent Allan, Susan Pederson, Barbara Schaeffler, Jeff Smith

Department of Neurology Faculty Papers

BACKGROUND: PROMISE-2 was a phase 3, randomized, double-blind, placebo-controlled study that evaluated the efficacy and safety of repeat intravenous (IV) doses of the calcitonin gene-related peptide-targeted monoclonal antibody eptinezumab (ALD403) for migraine prevention in adults with chronic migraine. This report describes the results of PROMISE-2 through 24 weeks of treatment.

METHODS: Patients received up to two 30-min IV administrations of eptinezumab 100 mg, 300 mg, or placebo separated by 12 weeks. Patients recorded migraine and headache endpoints in a daily eDiary. Additional assessments, including patient-reported outcomes, were performed at regularly scheduled clinic visits throughout the 32-week study period (screening, day …

Absence-To-Bilateral-Tonic-Clonic Seizure: A Generalized Seizure Type., Sándor Beniczky, Guido Rubboli, Athanasios Covanis, Michael R Sperling

Department of Neurology Faculty Papers

OBJECTIVE: To test the hypothesis that absence seizures can evolve to generalized tonic-clonic seizures, we documented electroclinical features of this novel seizure type.

METHODS: In 4 large video-EEG databases, we identified recordings of seizures starting with impaired awareness that, without returning to baseline interictal state, evolved to generalized tonic-clonic seizures. We extracted the detailed semiologic and electrographic characteristics of these seizures, and we documented the clinical background, diagnoses, and therapeutic responses in these patients.

RESULTS: We identified 12 seizures from 12 patients. All seizures started with a period of impaired awareness and bursts of generalized spike or polyspike and slow-wave …

Population Health And The Pandemic: Emerging Stronger Next Time., David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Variation In Early Number Skills And Mathematics Achievement: Implications From Cognitive Profiles Of Children With Or Without Turner Syndrome, Sarah L Lukowski, Emily R Padrutt, Kyriakie Sarafoglou, Judith L. Ross, Jennifer R Law, Rachel E Olson, Michèle M M Mazzocco

Department of Pediatrics Faculty Papers

Individuals with Mathematics Learning Disabilities have persistent mathematics underperformance but vary with respect to their cognitive profiles. The present study examined mathematics ability and achievement, and associated mathematics-specific numerical skills and domain-general cognitive abilities, in young children with Turner syndrome compared to their matched peers. We utilized two independent peer groups so that group comparisons would account for verbal skills, a hypothesized strength of girls with Turner syndrome, and nonsymbolic magnitude comparison skills, a hypothesized difference of girls with Turner syndrome. This individual matching approach afforded characterization of mathematics profiles of girls with Turner syndrome and girls without Turner syndrome …

Early Evidence Of Dose-Dependent Pharmacodynamic Activity Following Treatment With Sy-5609, A Highly Selective And Potent Oral Cdk7 Inhibitor, In Patients With Advanced Solid Tumors, Kyriakos P. Papadopoulos, Manish R. Sharma, Erika Hamilton, Debra Richardson, Babar Bashir, Dejan Juric, Geoffrey Shapiro, Graeme Hodgson, Nan Ke, Anthony D'Ippolito, Liv Johannessen, Qing Kang-Fortner, Li Zhou, Maria Rosario, William Zamboni, Hina A. Jolin, Catherine Madigan, Michael J. Kelly, David A. Roth

Department of Medical Oncology Posters

No abstract provided.

Jefferson Digital Commons Quarterly Report: July-September 2020, Kelsey Duinkerken, Msi, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

Included in this Report

• Abington Health Articles
• Articles
• Collaborative Healthcare: Interprofessional Practice, Education, and Evaluation (JCIPE)
• Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)
• Covid 19-: Spread the Science, Not the Virus
• Department of Family and Community Medicine Presentations and Grand Rounds
• Master of Population Health Program Thesis and Capstone Presentations
• Master of Public Health Thesis and Capstone Presentations
• Jefferson Surgical Solutions
• The Medicine Forum
• Sex and Gender Health Education Summit 2020
• Student Papers and Posters
• Misc. Uploads
• What people are saying about the Jefferson Digital Repository

Modulation Of Sleep-Courtship Balance By Nutritional Status In Drosophila, José M Duhart, Victoria Baccini, Yanan Zhang, Daniel R Machado, Kyunghee Koh

Farber Institute for Neuroscience Faculty Papers

Sleep is essential but incompatible with other behaviors, and thus sleep drive competes with other motivations. We previously showed Drosophila males balance sleep and courtship via octopaminergic neurons that act upstream of courtship-regulating P1 neurons (Machado et al., 2017). Here, we show nutrition modulates the sleep-courtship balance and identify sleep-regulatory neurons downstream of P1 neurons. Yeast-deprived males exhibited attenuated female-induced nighttime sleep loss yet normal daytime courtship, which suggests male flies consider nutritional status in deciding whether the potential benefit of pursuing female partners outweighs the cost of losing sleep. Trans-synaptic tracing and calcium imaging identified dopaminergic neurons projecting to …

Interleukin 35 Delays Hindlimb Ischemia-Induced Angiogenesis Through Regulating Ros-Extracellular Matrix But Spares Later Regenerative Angiogenesis., Hangfei Fu, Yu Sun, Ying Shao, Jason Saredy, Ramon Cueto, Lu Liu, Charles Drummer, Candice Johnson, Keman Xu, Yifan Lu, Xinyuan Li, Shu Meng, Eric R Xue, Judy Tan, Nirag C Jhala, Daohai Yu, Yan Zhou, Kayla J Bayless, Jun Yu, Thomas J Rogers, Wenhui Hu, Nathaniel W Snyder, Jianxin Sun, Xuebin Qin, Xiaohua Jiang, Hong Wang, Xiaofeng Yang

Center for Translational Medicine Faculty Papers

Interleukin (IL) 35 is a novel immunosuppressive heterodimeric cytokine in IL-12 family. Whether and how IL-35 regulates ischemia-induced angiogenesis in peripheral artery diseases are unrevealed. To fill this important knowledge gap, we used loss-of-function, gain-of-function, omics data analysis, RNA-Seq, in vivo and in vitro experiments, and we have made the following significant findings: i) IL-35 and its receptor subunit IL-12RB2, but not IL-6ST, are induced in the muscle after hindlimb ischemia (HLI); ii) HLI-induced angiogenesis is improved in Il12rb2-/- mice, in ApoE-/-/Il12rb2-/- mice compared to WT and ApoE-/- controls, respectively, where hyperlipidemia inhibits angiogenesis in vivo and in …

Rabies Virus-Based Covid-19 Vaccine Coravax™ Induces High Levels Of Neutralizing Antibodies Against Sars-Cov-2., Drishya Kurup, Christoph Wirblich, Holly Ramage, Matthias J Schnell

Department of Microbiology and Immunology Faculty Papers

The recently emerged coronavirus SARS-CoV-2, the causative agent of COVID-19, is rapidly spreading in the world. The exponentially expanding threat of SARS-CoV-2 to global health highlights the urgent need for a vaccine. Herein we show the rapid development of a novel, highly efficient, and safe COVID-19 vaccine using a rabies virus-based vector that has proven to be an efficient vaccine against several emerging infectious diseases. This study reports that both a live and an inactivated rabies virus containing the SARS-CoV-2 spike S1 protein induces potent virus-neutralizing antibodies at much higher levels than seen in the sera of convalescent patients. In …

Stxbp2-R190c Variant In A Patient With Neonatal Hemophagocytic Lymphohistiocytosis (Hlh) And G6pd Deficiency Reveals A Critical Role Of Stxbp2 Domain 2 On Granule Exocytosis, Nathalia Benavides, Waldo A Spessott, Maria L Sanmillan, Marcelo Vargas, Mylynda S Livingston, Nissa Erickson, Tamara C Pozos, Margaret E Mccormick, Emilia Scharrig, Yoav H Messinger, Claudio G. Giraudo

Department of Microbiology and Immunology Faculty Papers

Neonatal hemophagocytic lymphohistiocytosis (HLH) is a medical emergency that can be associated with significant morbidity and mortality. Often these patients present with familial HLH (f-HLH), which is caused by gene mutations interfering with the cytolytic pathway of cytotoxic T-lymphocytes (CTLs) and natural killer cells. Here we describe a male newborn who met the HLH diagnostic criteria, presented with profound cholestasis, and carried a maternally inherited heterozygous mutation in syntaxin-binding protein-2 [STXBP2, c.568C>T (p.Arg190Cys)] in addition to a severe pathogenic variant in glucose 6-phosphate dehydrogenase [G6PD, hemizygous c.1153T>C (Cys385Arg)]. Although mutations in STXBP2 gene are …

Nipple Sparing Mastectomy: A Review Of Outcomes At A 1 Single Institution, Steven Woodward, Md, Alliric Willis, Melissa Lazar, Adam C. Berger, Theodore Tsangaris

Department of Surgery Faculty Papers

Introduction

Nipple sparing mastectomy (NSM) offers patients who are not candidates for breast conserving treatment an aesthetically pleasing alternative to traditional mastectomy. Some studies have demonstrated its oncologic safety while others have demonstrated residual occult tumor cells at the nipple areolar complex (NAC). These data prompt further review of oncologic outcomes after NSM.

Methods

A single institution retrospective chart review of all NSMs performed by 4 breast surgeons at Thomas Jefferson University Hospital over a span of 2012-2019. In this cohort we review the reconstruction performed, axillary lymph node status, surgical margins, final pathology, loss of the NAC, recurrence rates, …