Medicine and Health Sciences Commons^™

Discoidin Domain Receptor 1 Functionally Interacts With The Igf-I System In Bladder Cancer, Simone Buraschi, Alaide Morcavallo, Thomas Neill, Manuela Stefanello, Chiara Palladino, Shi-Qiong Xu, Antonino Belfiore, Renato V. Iozzo, Andrea Morrione

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Characterization Of Adnexal Masses Using Contrast-Enhanced Subharmonic Imaging: A Pilot Study., Lauren J. Delaney, Priscilla Machado, Mehnoosh Torkzaban, Andrej Lyshchik, Corinne Wessner, Christine H. Kim, Md, Norman G Rosenblum, Scott D. Richard, Kirk Wallace, Flemming Forsberg

Department of Radiology Faculty Papers

OBJECTIVES: This pilot study evaluated whether contrast-enhanced subharmonic imaging (SHI) could be used to characterize adnexal masses before surgical intervention.

METHODS: Ten women (with 12 lesions) scheduled for surgery of an ovarian mass underwent an SHI examination of their adnexal region using a modified LOGIQ E9 scanner (GE Healthcare, Waukesha, WI) with an endocavitary transducer, in which digital clips were acquired by pulse destruction-replenishment SHI across the lesions. Time-intensity curves were created offline to quantitatively evaluate SHI parameters (fractional tumor perfusion, peak contrast intensity, time to peak contrast enhancement, and area under the time-intensity curve), which were compared to pathologic …

Small Extracellular Vesicles Modulated By Αvβ3 Integrin Induce Neuroendocrine Differentiation In Recipient Cancer Cells, Fabio Quaglia, Shiv Ram Krishn, George G. Daaboul, Srawasti Sarker, Raffaella Pippad, Josep Domingo-Domenech, Gaurav Kumar, Paolo Fortina, Peter Mccuee, William K. Kelly, Himisha Beltran, Qin Liu, Lucia R. Languinoa

Department of Biochemistry and Molecular Biology Faculty Papers

The ability of small extracellular vesicles (sEVs) to reprogram cancer cells is well established. However, the specific sEV components able to mediate aberrant effects in cancer cells have not been characterized. Integrins are major players in mediating sEV functions. We have previously reported that the αVβ3 integrin is detected in sEVs of prostate cancer (PαVβ3rCa) cells and transferred into recipient cells. Here, we investigate whether sEVs from -expressing cells affect tumour growth differently than sEVs from control cells that do not express αVβ3. We compared the ability of sEVs to stimulate tumour growth, using sEVs isolated from PrCa C4-2B cells …

Results Of The Adhere Upper Airway Stimulation Registry And Predictors Of Therapy Efficacy., Erica Thaler, Richard Schwab, Joachim Maurer, Ryan Soose, Christopher Larsen, Suzanne Stevens, Damien Stevens, Maurits Boon, Colin Huntley, Karl Doghramji, Tina Waters, Alan Kominsky, Armin Steffen, Eric Kezirian, Benedikt Hofauer, Ulrich Sommer, Kirk Withrow, Kingman Strohl, Clemens Heiser

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE/HYPOTHESIS: The ADHERE Registry is a multicenter prospective observational study following outcomes of upper airway stimulation (UAS) therapy in patients who have failed continuous positive airway pressure therapy for obstructive sleep apnea (OSA). The aim of this registry and purpose of this article were to examine the outcomes of patients receiving UAS for treatment of OSA.

STUDY DESIGN: Cohort Study.

METHODS: Demographic and sleep study data collection occurred at baseline, implantation visit, post-titration (6 months), and final visit (12 months). Patient and physician reported outcomes were also collected. Post hoc univariate and multivariate analysis was used to identify predictors of …

Dermatologists In The Wild West, 1870-1900: The Early Pioneers From The Mississippi River To The Pacific Coast., Leonard J Hoenig, Lawrence Charles Parish

Department of Dermatology and Cutaneous Biology Faculty Papers

During the Wild West era of American history (approximately 1870-1900), at least 53 dermatologists settled between the Mississippi River and the Pacific Coast. In 1870, two dermatologists began their practice in the city of St Louis, Missouri (William Augustus Hardaway and Solomon Claiborne Martin, Sr) and one dermatologist started his practice in San Francisco, California (George J. Bucknall). By 1900, 50 more dermatologists had settled in 19 cities located in the American West (Tables 1,2). There, they established practices, initiated academic programs, and pioneered dermatology as a medical specialty in the western United States. This contribution provides brief biographic profiles …

Robotic Adrenalectomy For Functional Adenoma In Second Trimester Treats Worsening Hypertension., Courtney E. Capella, Thenappan Chandrasekar, May Jean Counsilman, Christopher Sebastiano, Costas D. Lallas, Huda B. Al-Kouatly

Department of Urology Faculty Papers

A 33-year-old G6P3023 was found to have a 4.2 cm right adrenal incidentaloma during an admission for right pyelonephritis. Computed tomography (CT) was performed to rule out perinephric abscess in the setting of worsening leukocytosis while on antibiotics ( Fig. 1). Initial differential diagnosis from endocrinology included pheochromocytoma and primary aldosteronism. Due to the lack of typical physical exam stigmata, Cushing syndrome was initially of low concern. Of note, her past medical history included hypertension treated with amlodipine 10 mg and hydrochlorothiazide 12.5 mg. During admission, extensive endocrine laboratory workup demonstrated an elevated aldosterone:plasma renin activity, suppressed dehydroepiandrosterone (DHEA), normal …

Empiric Treatment For Suspected Malaria In The United States: A Case Report., Jonathan C. Li, Emma Lundsmith

Division of Internal Medicine Faculty Papers & Presentations

Malaria in the United States is rare and most commonly presents among returning travelers from endemic areas. Diagnosis is classically dependent on a positive blood smear or polymerase chain reaction (PCR) test. The objective of this case report is to highlight a case of suspected malaria in a high-risk individual with negative diagnostic testing where a trial of empiric treatment was initiated based on clinical presentation after a thorough discussion of risks and benefits. However, empiric treatment based on a single case is limiting. We present a case of a 56-year-old man with extensive travel history throughout Asia, who presented …

Sti & Prep Updates, Marshal Miller, Md, Aahivs, Sunny Lai, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Apply key findings from the DISCOVER trial to PrEP clinical decision-making
• Understand the gaps in PrEP research for cisgender women and adolescents
• Understand the use of on-demand pre-exposure prophylaxis
• Review Current treatment recs and emerging data on Gonococcal and Chlamydial infection
• Discuss diagnostic and management options for non-gonococcal urethritis

Iron Deficiency Anemia: An Unexpected Cause Of An Acute Occipital Lobe Stroke In An Otherwise Healthy Young Woman, Qian Zhang, Khine S. Shan, Conor O'Sullivan, Travis C. Nace

Abington Jefferson Health Papers

A 29-year-old caucasian woman who presented to the hospital with an acute onset of right eye visual disturbance and headache was found to have an acute left occipital lobe infarction. Past medical history was significant for iron deficiency anemia (IDA) secondary to menorrhagia. Her initial hemoglobin level was 7.8 G/DL, and her symptoms improved after iron and blood transfusions. Hypercoagulable studies were completed in the outpatient setting, and the results were unremarkable. Her acute stroke was most likely related to IDA as she had low cardiovascular risk factors along with a negative complete stroke workup.

Critical Care Ultrasonography And Its Application For Covid-19, Xi Liu, Md, Yang Hai, Md, Bin Ma, Md, Weelic Chong, Md, Ji-Bin Liu, Md

Department of Radiology Faculty Papers

Ultrasound has developed as an invaluable tool in diagnosis and proper management in the intensive care unit (ICU). Application of critical care ultrasonography is quite distinct from the routine comprehensive diagnostic ultrasound exam, because the urgent setting mandates a goal-directed approach. Performing accurate and efficient critical care ultrasound requires ultrasound providers to first understand the pathophysiology of the disease and related imaging findings, and then follow the protocols to perform a focused ultrasound exam. In the ongoing coronavirus disease 2019 (COVID-19) pandemic, ultrasound plays an essential role in diagnosing and monitoring critically ill COVID-19 patients in the ICU. Our review …

Chinese Expert Consensus On Critical Care Ultrasound Applications At Covid-19 Pandemic, Faqin Lv, Md, Jinrui Wang, Md, Xing Yu, Md, Aiping Yang, Md, Ji-Bin Liu, Md, Linxue Qian, Md, Huixiong Xu, Md, Ligang Cui, Md, Mingxing Xie, Md, Xi Liu, Md, Chengzhong Peng, Md, Yi Huang, Md, Haiyan Kou, Md, Shengzheng Wu, Md, Xi Yang, Md, Bin Tu, Md, Huaping Jia, Md, Qingyi Meng, Md, Je Liu, Md, Ruizhong Ye, Md

Department of Radiology Faculty Papers

The spread of new coronavirus (SARS-Cov-2) follows a different pattern than previous respiratory viruses, posing a serious public health risk worldwide. World Health Organization (WHO) named the disease as COVID-19 and declared it a pandemic. COVID-19 is characterized by highly contagious nature, rapid transmission, swift clinical course, profound worldwide impact, and high mortality among critically ill patients. Chest X-ray, computerized tomography (CT), and ultrasound are commonly used imaging modalities. Among them, ultrasound, due to its portability and non-invasiveness, can be easily moved to the bedside for examination at any time. In addition, with use of 4G or 5G networks, remote …

Insights From Immuno-Oncology: The Society For Immunotherapy Of Cancer Statement On Access To Il-6-Targeting Therapies For Covid-19., Paolo Antonio Ascierto, Bernard Fox, Walter Urba, Ana Carrizosa Anderson, Michael B Atkins, Ernest C Borden, Julie Brahmer, Lisa H Butterfield, Alessandra Cesano, Daniel Chen, Tanja De Gruijl, Robert O Dillman, Charles G Drake, Leisha A Emens, Thomas F Gajewski, James L Gulley, F Stephen Hodi, Patrick Hwu, David Kaufman, Howard Kaufman, Michael Lotze, Douglas G Mcneel, Kim Margolin, Francesco Marincola, Michael J Mastrangelo, Marcela V Maus, David R Parkinson, Pedro J Romero, Paul M Sondel, Stefani Spranger, Mario Sznol, George J Weiner, Jon M Wiggington, Jeffrey S Weber

Department of Microbiology and Immunology Faculty Papers

No abstract provided.

Diagnosis And Management Of Common Hand Infections., Vivek K. Bilolikar, Daniel A Seigerman, Asif M. Ilyas

Rothman Institute Papers

• While many hand infections are superficial, diligent evaluation, diagnosis, and treatment of these infections are central for preventing disability and morbidity.
• Maintaining a wide differential diagnosis is important as some hand infections may mimic others.
• In geographic areas with more than a 10% to 15% prevalence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) hand infections, empiric antibiotics should adequately cover MRSA.
• Once culture results are available, antibiotic regimens should be narrowed to reduce the development of resistant pathogens.

Epigenomic Profiling Of Neuroblastoma Cell Lines., Kristen Upton, Apexa Modi, Khushbu Patel, Nathan M Kendsersky, Karina L Conkrite, Robyn T Sussman, Gregory P Way, Rebecca N Adams, Gregory I Sacks, Paolo Fortina, Sharon J Diskin, John M Maris, Jo Lynne Rokita

Kimmel Cancer Center Faculty Papers

Understanding the aberrant transcriptional landscape of neuroblastoma is necessary to provide insight to the underlying influences of the initiation, progression and persistence of this developmental cancer. Here, we present chromatin immunoprecipitation sequencing (ChIP-Seq) data for the oncogenic transcription factors, MYCN and MYC, as well as regulatory histone marks H3K4me1, H3K4me3, H3K27Ac, and H3K27me3 in ten commonly used human neuroblastoma-derived cell line models. In addition, for all of the profiled cell lines we provide ATAC-Seq as a measure of open chromatin. We validate specificity of global MYCN occupancy in MYCN amplified cell lines and functional redundancy of MYC occupancy in MYCN …

Efficacy Of Ultrasound-Guided Radiofrequency Ablation Of Parathyroid Hyperplasia: Single Session Vs. Two-Session For Effect On Hypocalcemia, Zeng Zeng, Cheng-Zhong Peng, Ji-Bin Liu, Yi-Wen Li, Hong-Feng He, Qiao-Hong Hu, Bo Lin, Xiao-Gang Shen

Department of Radiology Faculty Papers

To evaluate safety and efficacy of one- vs. two-session radiofrequency ablation (RFA) of parathyroid hyperplasia for patients with secondary hyperparathyroidism (SHPT) and to compare the outcome of both methods on hypocalcemia. Patients with secondary hyperparathyroidism underwent ultrasound guided RFA of parathyroid hyperplasia. Patients were alternately assigned to either group 1 (n = 28) with RFA of all 4 glands in one session or group 2 (n = 28) with RFA of 2 glands in a first session and other 2 glands in a second session. Serum parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) values were measured at a …

How Do Counselors Support Clients During The Coronavirus Pandemic?, Yoon Suh Moh, Katharine Sperandio

Counseling and Behavioral Health Faculty Papers

It is impossible to deny the extraordinary societal impact of the outbreak of the novel coronavirus, severe acute respiratory syndrome 2 (SARS-Cov-2). All of us are bombarded daily with messages and information related to the pandemic. As this virus garners heightened attention from the media, individuals may have difficulty delineating between misinformation and accurate information about the illness.

We are not writing this article to perpetuate increased fear among the counseling community regarding the spread of the novel coronavirus, but rather to:

• Provide resources helpful for staying informed about the impact of COVID-19, which is a disease caused by SARS-Cov-2 …

A Crisis Is A Terrible Thing To Waste: Recovering A Sense Of Agency In Coronavirus Times, Steven F. Freeman

School of Continuing and Professional Studies Coronavirus Papers

No abstract provided.

The Lysosomal Diseases Testing Laboratory: A Review Of The Past 47 Years., David A. Wenger, Paola Luzi

Department of Neurology Faculty Papers

Lysosomal disorders are diseases that involve mutations in genes responsible for the coding of lysosomal enzymes, transport proteins, activator proteins and protein processing enzymes. These defects lead to the storage of specific metabolites within lysosomes resulting in a great variety of clinical features depending on the tissues with the storage, the storage products and the extent of the storage. The methods for rapidly diagnosing patients started in the late 1960's when the enzyme defects were identified eliminating the need for tissue biopsies. The first requests for diagnostic help in this laboratory came in 1973. In that year, patients with Krabbe …

Novel Coronavirus (2019-Ncov) In Disguise, Qian Zhang, Annyella Douglas, Zain U. Abideen, Shristi Khanal, Stephanie Tzarnas

Abington Jefferson Health Papers

Novel coronavirus (2019-nCoV) pandemic is currently one of the most influential topics as it not only impacts the field of medicine but most importantly, it affects the lives of many individuals throughout the world. We report an interesting 2019-nCoV case in a tertiary community hospital with the initial concern of acute pyelonephritis without respiratory symptoms that ultimately led to the quarantine of a number of healthcare providers. This case emphasizes the importance of radiological evidence in diagnosing 2019-nCoV in the setting of an initial atypical presentation. It also serves as an example of how healthcare providers may need to increase …

Spider Venom Administration Impairs Glioblastoma Growth And Modulates Immune Response In A Non-Clinical Model., Amanda Pires Bonfanti, Natália Barreto, Jaqueline Munhoz, Marcus Caballero, Gabriel Cordeiro, Thomaz Rocha-E-Silva, Rafael Sutti, Fernanda Moura, Sérgio Brunetto, Celso Dario Ramos, Rodolfo Thome, Liana Verinaud, Catarina Rapôso

Department of Neurology Faculty Papers

Molecules from animal venoms are promising candidates for the development of new drugs. Previous in vitro studies have shown that the venom of the spider Phoneutria nigriventer (PnV) is a potential source of antineoplastic components with activity in glioblastoma (GB) cell lines. In the present work, the effects of PnV on tumor development were established in vivo using a xenogeneic model. Human GB (NG97, the most responsive line in the previous study) cells were inoculated (s.c.) on the back of RAG-/- mice. PnV (100 µg/Kg) was administrated every 48 h (i.p.) for 14 days and several endpoints were evaluated: tumor …

Fatigue In Primary Care: Doctor, Why Am I So Tired?, Nina Mingioni, Md

Clinical Education Teaching Tools

Learning Objectives:

1. Identify top causes of fatigue in women
2. Develop an evidence-based approach to assessing a patient with fatigue
3. Reflect on the evidence for available screening tools for fatigue

Occupational Therapy: Breaking The Barriers With Survivors Of Human Trafficking, Leanne Bahn, Ots, Sierra Wells, Ots, Stacey Wisniewski, Ots

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

PICO Question

• What occupational therapy interventions enhance the occupational engagement for survivors of human trafficking?

Objectives

• Recognize the occupational injustices experienced by survivors of human trafficking and the effect on occupational participation
• Describe the role of the occupational therapy practitioner in enhancing occupational participation of survivors of human trafficking
• Discuss evidence-based interventions within the scope of occupational therapy practice for survivors of human trafficking

Trauma-Informed Care In A School Setting: Occupational Therapy Interventions To Promote Emotional Regulation, Sarah Blaise, Ots, Sara Cohen, Ots, Maria Marcum, Ots

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

PICO Question

• What trauma-informed occupational therapy interventions improve emotional regulation and participation in school-based tasks for students?

Objectives

• Define trauma and note its prevalence among school-aged children
• Describe principles of Trauma-Informed Care and its importance in a school setting.
• Describe current research to determine best practice using a Trauma-Informed Care (TIC) approach in schools for OT practitioners

The Splashing Effects Of Aquatic Therapy For Children With Developmental Disabilities, Eric Bradway, Ots, Mikaela Mcgraw, Ots, Katie Boshoven, Ots

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

PICO Question

• What are the effects of aquatic therapy on participation in childhood occupations for children with developmental disabilities?

Objectives

• Define aquatic therapy within the scope of occupational therapy practice for children with developmental disabilities
• Discuss the current evidence on effective aquatic based interventions to facilitate participation in childhood occupations in children with developmental disabilities
• Discuss ways to apply this information to practitioners’ own clinical setting

Promoting Independence Through Effective Interventions For Adults With Als, Renee Gluchowski, Ots, Hannah Harris, Ots, Jaclyn Heineman, Ots, Kimberly Kendro, Ots, Heather Malosky, Ots

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

PICO Question

What are effective occupational therapy interventions for adults with ALS to improve participation in ADLs/IADLs?

Objectives

• Define amyotrophic lateral sclerosis (ALS) and recognize the prevalence
• Identify and describe evidence-based interventions to promote independence for individuals with ALS in activities of daily living (ADLs) and instrumental activities of daily living (IADLs)
• Discuss how the current literature on the effective interventions impacts occupational performance and treatment of adults with ALS

Jefferson Digital Commons Quarterly Report: January-March 2020, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• New Look for the Jefferson Digital Commons
• Articles
• COVID-19 Working Papers
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• JeffMD Scholarly Inquiry Abstracts
• Journals and Newsletters
• Master of Public Health Capstones
• Oral Histories
• Posters and Conference Presentations
• What People are Saying About the Jefferson the Digital Commons

Sustaining The National Spinal Cord Injury Registry Of Iran (Nscir-Ir) In A Regional Center: Challenges And Solutions, Zahra Azadmanjir, Zahra Mohtasham-Amiri, Seyed-Mahdi Ziabari, Leila Kochakinejad, Hamid Haidari, Guilan University Of Medical Sciences, Hadis Sabour, Zahra Khazaeipour, Mahdi Sharif-Alhoseini, Zahra Ghodsi, Abbas Amirjamshidi, Farshad Akbarzadeh, Kazem Zendehdel, Amir Azarhomayouon, Khatereh Naghdi, Gerard Oreilly, Ellen Merete, Alexander Vaccaro, Edward C. Benzel, Seyed Behzad Jazayeri, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Background: The National Traumatic Spinal Cord Injury Registry in Iran (NSCIR-IR), was implemented initially in three hospitals as a pilot phase from 11 Oct 2015 to 19 Jun 2016 and has been active in eight centers from 19 Jun 2016. Poursina Hospital, a trauma care referral center in Rasht, Guilan Province of Iran is one of the registry sites, and has been involved in registering eligible patients since 1 Jan 2016. This study aimed to identify the challenges and solutions for sustaining the NSCIR-IR in a regional center.

Methods: This was a mixed-methods study. For the quantitative analysis, a retrospective …

Japanese Immigrant Families' Experiences Of Accessing Healthcare In The Us, Rei Yamada, Maki Kano-Lueckerath, Md, Walter K. Kraft, Md

Student Papers, Posters & Projects

No abstract provided.

Current Strategies In Prevention Of Postoperative Infections In Spine Surgery., Kivanc Atesok, Efstathios Papavassiliou, Michael J Heffernan, Danny Tunmire, Irina Sitnikov, Nobuhiro Tanaka, Sakthivel Rajaram, Jason Pittman, Ziya L Gokaslan, Alexander Vaccaro, Steven Theiss

Rothman Institute Papers

Study Design: Narrative review.

Objectives: Postoperative surgical site infections (SSIs) are among the most common acute complications in spine surgery and have a devastating impact on outcomes. They can lead to increased morbidity and mortality as well as greater economic burden. Hence, preventive strategies to reduce the rate of SSIs after spine surgery have become vitally important. The purpose of this article was to summarize and critically analyze the available evidence related to current strategies in the prevention of SSIs after spine surgery.

Methods: A literature search utilizing Medline database was performed. Relevant studies from all the evidence levels have …

Our Multi-Pandemic, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

Application of systems thinking to identify and understand complex problems and to discover innovative ways to intervene has been advocated separately within public health, education, finance, and many other spheres of society. We need it now for the multi-pandemic.