Medicine and Health Sciences Commons^™

Progression-Free But No Overall Survival Benefit For Adult Patients With Bevacizumab Therapy For The Treatment Of Newly Diagnosed Glioblastoma: A Systematic Review And Meta-Analysis., Nagham Kaka, Karim Hafazalla, Haider Samawi, Andrew Simpkin, James Perry, Arjun Sahgal, Sunit Das

Department of Neurosurgery Faculty Papers

Glioblastoma (GBM) is the most common high-grade primary brain tumor in adults. Standard multi-modality treatment of glioblastoma with surgery, temozolomide chemotherapy, and radiation results in transient tumor control but inevitably gives way to disease progression. The need for additional therapeutic avenues for patients with GBM led to interest in anti-angiogenic therapies, and in particular, bevacizumab. We sought to determine the efficacy of bevacizumab as a treatment for newly diagnosed GBM. We conducted a literature search using the PubMed database and Google Scholar to identify randomized controlled trials (RCTs) since 2014 investigating the safety and efficacy of bevacizumab in the treatment …

Connecting Health Plan Care Managers With A Network Of Enhanced Services Community Pharmacies: A Pennsylvania Case Study, Nicholas Leon, Pharmd, Stephanie Mcgrath, Pharmd, Kim Coley, Pharmd, David Pope, Pharmd, Elizabeth Grassmyer, Melissa A. Mcgivney, Pharmd, Patricia Epple

College of Pharmacy Posters

PPCN pharmacies have been able to successfully collaborate, bi-directionally, with health plan care managers to improve patient health and enable appropriate utilization of healthcare resources

To build off of our early success, additional systems and tracking capabilities are being explored related to the following:

• Bi-directional tracking of referrals
• Care managers to pharmacists
• Pharmacists to care managers
• Delivery drivers as community health workers
• Drug class specific interventions (ex. a focus on opioids)
• Disease state specific interventions (ex. a focus on asthma or type 2 diabetes)
• Formal interventions focused on dialing patients back into the services/resources offered by health plans

PPCN is …

Jcph Presentations At The American Public Health Association Annual Conference 2019

JCPH at APHA 2019

No abstract provided.

Pediatric Moyamoya Presenting As A Subarachnoid Hemorrhage From A Ruptured Anterior Cerebral Artery Aneurysm., Mohammad Hassan A. Noureldine, Ibrahim Saikali, Anis Nassif, Rita Chahinian, Ahmad Sweid, Raghid Kikano, Michel Mawad

Department of Neurosurgery Faculty Papers

BACKGROUND: The incidence of Moyamoya disease (MMD)-associated intracranial aneurysms ranges from 3% to 14% in adult patients, whereas this complication has rarely been reported in children.

CASE DESCRIPTION: We herein report the first case, to our knowledge, of an extremely rare subarachnoid hemorrhage presentation of a child with a ruptured anterior cerebral artery dissecting aneurysm secondary to a newly discovered, unilateral Moyamoya-like pathology.

CONCLUSIONS: MMD-associated aneurysms are extremely rare in children, and hemorrhage may be the initial presentation of the disease. Prompt intervention is essential to exclude the ruptured aneurysm that is at risk of rebleeding because of persistent hemodynamic …

Thyrotoxicosis Factitia: A Rare Cause Of Junctional Rhythm And Cardiac Arrest, Iqra Iqbal, Muhammad Atique Alam Khan, Waqas Ullah, Dina Nabwani

Abington Jefferson Health Posters

Introduction

Little is known about the types of arrhythmias due to exogenous thyroxine. We present an unusual set of cardiac arrhythmias in a fairly healthy athlete who succumbed to the severe complications of exogenous thyroxine.

Incorporating B Cell Activating Factor (Baff) Into The Membrane Of Rabies Virus (Rabv) Particles Improves The Speed And Magnitude Of Vaccine-Induced Antibody Responses., Joseph R Plummer, James P Mcgettigan

Department of Microbiology and Immunology Faculty Papers

B cell activating factor (BAFF) is a member of the tumor necrosis factor (TNF) superfamily of cytokines that links innate with adaptive immunity. BAFF signals through receptors on B cells, making it an attractive molecule to potentiate vaccine-induced B cell responses. We hypothesized that a rabies virus (RABV)-based vaccine displaying both antigen and BAFF on the surface of the same virus particle would target antigen-specific B cells for activation and improve RABV-specific antibody responses. To test this hypothesis, we constructed a recombinant RABV-based vector expressing virus membrane-anchored murine BAFF (RABV-ED51-mBAFF). BAFF was incorporated into the RABV particle and determined to …

Developing A Community-Based Research Project Proposal To Build Public Health Educator Capacity: A Graduate Student Perspective., Alexander J. Baukus

Student Papers, Posters & Projects

This article is the author's first-person perspective of completing an Applied Practice Experience (APE) at an accredited public health program. Graduate-level public health students in the United States are mandated by the Council on Education for Public Health to complete this supervised field experience to apply knowledge and concepts to real-world public health practice. For his APE, the author worked with a faculty advisor and two community groups to facilitate and submit a community-based participatory research grant proposal. This article discusses the author's experiences before, during, and after the APE. The author outlines challenges and success of working on this …

Twenty Novel Disease Group-Specific And 12 New Shared Macrophage Pathways In Eight Groups Of 34 Diseases Including 24 Inflammatory Organ Diseases And 10 Types Of Tumors., Bin Lai, Jiwei Wang, Alexander Fagenson, Yu Sun, Jason Saredy, Yifan Lu, Gayani Nanayakkara, William Y Yang, Daohai Yu, Ying Shao, Charles Drummer, Candice Johnson, Fatma Saaoud, Ruijing Zhang, Qian Yang, Keman Xu, Kevin Mastascusa, Ramon Cueto, Hangfei Fu, Susu Wu, Lizhe Sun, Peiqian Zhu, Xuebin Qin, Jun Yu, Daping Fan, Ying H Shen, Jianxin Sun, Thomas Rogers, Eric T Choi, Hong Wang, Xiaofeng Yang

Center for Translational Medicine Faculty Papers

The mechanisms underlying pathophysiological regulation of tissue macrophage (Mφ) subsets remain poorly understood. From the expression of 207 Mφ genes comprising 31 markers for 10 subsets, 45 transcription factors (TFs), 56 immunometabolism enzymes, 23 trained immunity (innate immune memory) enzymes, and 52 other genes in microarray data, we made the following findings. (1) When 34 inflammation diseases and tumor types were grouped into eight categories, there was differential expression of the 31 Mφ markers and 45 Mφ TFs, highlighted by 12 shared and 20 group-specific disease pathways. (2) Mφ in lung, liver, spleen, and intestine (LLSI-Mφ) express higher M1 Mφ …

Why Medical (And Dermatologic) Practice Has Become So Convoluted: The Complexity/Convolutional/Obfuscatory Kleptocracies., W. Clark Lambert, Jennifer L. Parish, Lawrence Charles Parish, Shreya Patel, Loka Thangamathesvaran, Amer Ali Almosshen

Department of Dermatology and Cutaneous Biology Faculty Papers

Consider dermatology (or medical) practice from the aspect of those who manage, and seek to glean a profit from, medical management corporations, including but not limited to third party payers. Although much of the complexity burden thrust upon doctors’ offices is borne by the offices and doctors, there is also much that is borne by the companies, and the entire process appears to make no sense whatsoever. How can the business professionals who run these outfits make such blunders? Let us approach this question by examining another industry: fast food franchising.

Care Coordination: Roles Of Registered Nurses Across The Care Continuum, Beth Ann Swan, Sheila Haas, Anne T. Jessie

College of Nursing Faculty Papers & Presentations

Lack of coordination leads to health care that is fragmented, inconsistent, and poorly planned. Conversely, effective care coordination supports achieving the Quadruple Aim. Care coordination, roles of RNs in care coordination, and implications for healthcare delivery are explored.

Hyperthermia And Immunotherapy: Clinical Opportunities., Mark D Hurwitz

Department of Radiation Oncology Faculty Papers

Hyperthermia holds great promise to advance immunotherapy in the treatment of cancer. Multiple trials have demonstrated benefit with the addition of hyperthermia to radiation or chemotherapy in the treatment of wide-ranging malignancies. Similarly, pre-clinical studies have demonstrated the ability of hyperthermia to enhance each of the 8 steps in the cancer-immunotherapy cycle including stimulation of tumor-specific immunity. While there has been an extensive recent focus on augmenting immunotherapy with radiation, surprisingly to date, there have been no clinical trials assessing the combination of hyperthermia with immunotherapy. The study of hyperthermia with immunotherapy is particularly compelling when considered in the context …

False In Name Only-Gastroduodenal Artery Pseudoaneurysm In A Recurrently Bleeding Patient: Case Report And Literature Review., M. Binetti, A. Lauro, R. Golfieri, S Vaccari, V D'Andrea, I. R. Marino, M. Cervellera, M. Renzulli, V. Tonini

Department of Surgery Faculty Papers

INTRODUCTION: Although the diagnosis of visceral pseudoaneurysm is unusual, it requires emergent attention due to the risk of rupture. We describe a 70-year old man with a gastroduodenal artery (GDA) pseudoaneurysm manifest as recurrent hæmorrhage.

AREAS COVERED: We highlight the possible ætiologies, clinical presentations, diagnostic tools and treatment options for this condition. In this instance, the patient was successfully treated by selective angio-embolization.

EXPERT COMMENTARY: A visceral pseudoaneurysm should be considered in patients with abdominal pain and GI hæmorrhage. At present, angio-embolization is first-line therapy.

Hypotrichosis With Juvenile Macular Dystrophy: Combination Of Whole-Genome Sequencing And Genome-Wide Homozygosity Mapping Identifies A Large Deletion In Cdh3 Initially Undetected By Whole-Exome Sequencing-A Lesson From Next-Generation Sequencing., Amir Hossein Saeidian, Hassan Vahidnezhad, Leila Youssefian, Soheila Sotudeh, Meisam Sargazi, Sirous Zeinali, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Hypotrichosis with juvenile macular dystrophy (HJMD) is an autosomal recessive disorder characterized by abnormal growth of scalp hair and juvenile macular degeneration leading to blindness. We have explored the genetic basis of HJMD in a large consanguineous family with 12 affected patients, 1-76 years of age, with characteristic phenotypes.

METHODS: We first applied genome-wide homozygosity mapping to 10 affected individuals for linkage analysis to identify the genomic region of the defective gene. All affected individuals shared a 7.2 Mb region of homozygosity on chromosome 16q21-22.3, which harbored 298 genes, including CDH3, previously associated with HJMD. However, whole-exome sequencing (WES) …

A Physiologically-Based Pharmacokinetic Model For Targeting Calcitriol-Conjugated Quantum Dots To Inflammatory Breast Cancer Cells., James Forder, Mallory Smith, Margot Wagner, Rachel J. Schaefer, Jonathan Gorky, Kenneth L. Van Golen, Anja Nohe, Prasad Dhurjati

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Quantum dots (QDs) conjugated with 1,25 dihydroxyvitamin D3 (calcitriol) and Mucin-1 (MUC-1) antibodies (SM3) have been found to target inflammatory breast cancer (IBC) tumors and reduce proliferation, migration, and differentiation of these tumors in mice. A physiologically-based pharmacokinetic model has been constructed and optimized to match experimental data for multiple QDs: control QDs, QDs conjugated with calcitriol, and QDs conjugated with both calcitriol and SM3 MUC1 antibodies. The model predicts continuous QD concentration for key tissues in mice distinguished by IBC stage (healthy, early-stage, and late-stage). Experimental and clinical efforts in QD treatment of IBC can be augmented by in …

Gilteritinib Or Chemotherapy For Relapsed Or Refractory Flt3-Mutated Aml, Alexander E. Perl, Giovanni Martinelli, Jorge E. Cortes, Andreas Neubauer, Ellin Berman, Stefania Paolini, Pau Montesinos, Maria R. Baer, Richard A. Larson, Celalettin Ustun, Francesco Fabbiano, Harry P. Erba, Antonio Di Stasi, Robert Stuart, Rebecca Olin, Margaret Kasner, Fabio Ciceri, Wen-Chien Chou, Nikolai Podoltsev, Christian Recher, Hisayuki Yokoyama, Naoko Hosono, Sung-Soo Yoon, Je-Hwan Lee, Timothy Pardee, Amir T. Fathi, Chaofeng Liu, Nahla Hasabou, Xuan Liu, Erkut Bahceci, Mark J. Levis

Department of Medical Oncology Faculty Papers

BACKGROUND: Patients with relapsed or refractory acute myeloid leukemia (AML) with mutations in the FMS-like tyrosine kinase 3 gene (FLT3) infrequently have a response to salvage chemotherapy. Gilteritinib is an oral, potent, selective FLT3 inhibitor with single-agent activity in relapsed or refractory FLT3-mutated AML.

METHODS: In a phase 3 trial, we randomly assigned adults with relapsed or refractory FLT3-mutated AML in a 2:1 ratio to receive either gilteritinib (at a dose of 120 mg per day) or salvage chemotherapy. The two primary end points were overall survival and the percentage of patients who had complete remission …

Worldwide Inequality In Access To Full Text Scientific Articles: The Example Of Ophthalmology., Christophe Boudry, Patricio Alvarez-Muñoz, Ricardo Arencibia-Jorge, Didier Ayena, Niels J Brouwer, Zia Chaudhuri, Brenda Chawner, Emilienne Epee, Khalil Erraïs, Akbar Fotouhi, Almutez M Gharaibeh, Dina H Hassanein, Martina C Herwig-Carl, Katherine Howard, Dieudonne Kaimbo Wa Kaimbo, Patricia-Ann Laughrea, Fernando A Lopez, Juan D Machin-Mastromatteo, Fernando K Malerbi, Papa Amadou Ndiaye, Nina A Noor, Josmel Pacheco-Mendoza, Vasilios P Papastefanou, Mufarriq Shah, Carol L Shields, Ya Xing Wang, Vasily Yartsev, Frederic Mouriaux

Wills Eye Hospital Papers

Background: The problem of access to medical information, particularly in low-income countries, has been under discussion for many years. Although a number of developments have occurred in the last decade (e.g., the open access (OA) movement and the website Sci-Hub), everyone agrees that these difficulties still persist very widely, mainly due to the fact that paywalls still limit access to approximately 75% of scholarly documents. In this study, we compare the accessibility of recent full text articles in the field of ophthalmology in 27 established institutions located worldwide.

Methods: A total of 200 references from articles were retrieved using the …

Case-Based Asynchronous Interactive Modules In Undergraduate Medical Education., Tatiana Villatoro, Katherine Lackritz, Joanna S Y Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Undergraduate medical education traditionally consists of 2 years of lecture-based courses followed by 2 years of clinical clerkships. However, over the past couple decades, undergraduate medical education has been evolving toward non-lecture-based integrated curriculums, requiring a collaborative curriculum. Additionally, e-learning platforms have become efficacious and essential to delivering education asynchronously to students. At Thomas Jefferson University, the Pathology and Obstetrics and Gynecology departments collaborated to create a pilot series of case-based asynchronous interactive modules to teach gynecologic pathology in a clinical context, while interweaving other educational components, such as evidence-based medicine, clinical skills, and basic sciences. The case-based asynchronous interactive …

Relationships Among Patient Diabetes Self-Care Behaviors, Depression And Self-Reported Medication Adherence In African Americans With Diabetes, Shu Xiao, Phd, Pharmd Candidate, Monica Woloshin, Bs, Pharmd Candidate, Robin Casten, Phd, Barry Rovner, Md, Ginah Nightingale, Pharmd, Bcop

College of Pharmacy Posters

Objectives

To determine the extent to which self-care behaviors and self-reported medication adherence are related to depression in older African Americans with diabetes who presented to the ED.

Nucleus Pulposus Primary Cilia Alter Their Length In Response To Changes In Extracellular Osmolarity But Do Not Control Tonebp-Mediated Osmoregulation., Hyowon Choi, Vedavathi Madhu, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

The nucleus pulposus (NP) cells adapt to their physiologically hyperosmotic microenvironment through Tonicity-responsive enhancer binding protein (TonEBP/nuclear factor of activated T-cell5 [NFAT5])-mediated osmoregulation. Primary cilia in different organs serve diverse roles including osmosensing, but its contribution to NP cell osmoadaptive response is unknown. A high percentage of cultured primary NP cells possessed primary cilia that changed length in response to osmotic stimuli. Stable silencing of Intraflagellar Transport 88 (Ift88) or Kinesin Family Member 3 A (Kif3a) to inhibit the formation of primary cilia did not affect hyperosmotic upregulation of TonEBP. While ShKif3a blocked hyperosmotic increase of TonEBP-Transactivation Domain (TAD) activity, …

Dysregulation Of Mitochondrial Ca2+ Uptake And Sarcolemma Repair Underlie Muscle Weakness And Wasting In Patients And Mice Lacking Micu1, Valentina Debattisti, Adam Horn, Raghavendra Singh, Erin L. Seifert, Marshall W. Hogarth, Davi A. Mazala, Kai Ting Huang, Rita Horvath, Jyoti K. Jaiswal, György Hajnóczky

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Muscle function is regulated by Ca²⁺, which mediates excitation-contraction coupling, energy metabolism, adaptation to exercise, and sarcolemmal repair. Several of these actions rely on Ca²⁺ delivery to the mitochondrial matrix via the mitochondrial Ca²⁺ uniporter, the pore of which is formed by mitochondrial calcium uniporter (MCU). MCU's gatekeeping and cooperative activation are controlled by MICU1. Loss-of-protein mutation in MICU1 causes a neuromuscular disease. To determine the mechanisms underlying the muscle impairments, we used MICU1 patient cells and skeletal muscle-specific MICU1 knockout mice. Both these models show a lower threshold for MCU-mediated Ca²⁺ uptake. Lack of …

Poem Perceptions: A Survey Of Gastroenterologists And The Treatment Of Achalasia In The Philadelphia Region, Rebecca Loh, Md, Alexander Schlachterman, Md

Department of Medicine Posters

Introduction

Peroral endoscopic myotomy (POEM) is a relatively new innovate technique that has been shown to be an effective treatment for achalasia. Despite studies demonstrating its effectiveness as a less invasive therapy, POEM is still not as widely implemented as the traditional Heller myotomy for the treatment of achalasia. We aimed to explore the barriers that may impact implementation of POEM and to assess the regional perception of POEM amongst gastroenterologists in an urban setting.

The Utility Of Impedance Cardiography In Hemodynamic Monitoring Of Patients With Sepsis, James Butz, Yizhi Shan, Andres Samayoa, Orlando C. Kirton, Thai Vu

Abington Jefferson Health Papers

BACKGROUND: Commonly used biochemical indicators and hemodynamic and physiologic parameters of sepsis vary with regard to their sensitivity and specificity to the diagnosis. The aim of this preliminary study was to evaluate non-invasive impedance cardiography as a monitoring tool of the hemodynamic status of patients with sepsis throughout their initial volume resuscitation to explore the possibility of identifying additional measurements to be used in the future treatment of sepsis.

METHODS: Nine patients who presented to the emergency room and received a surgical consultation during a 3-month period in 2016, meeting the clinical criteria of sepsis defined by systemic inflammatory response …

Effect Of Nutritional Intervention On Patients With Gastroparesis, Emily Rubin, Rd, Melissa Viscuso, Rd, Kamal Amer, Md, Joseph Yoo, Md, Anthony Dimarino, Md, Stephanie Moleski, Md

Division of Gastroenterology and Hepatology Posters

Study Aims

• Utilize the PAGI-SYM survey as an assessment tool in following clinical symptoms of patients with GP.
• Determine if a formal consultation with a Registered Dietitian (RD) provided benefit to patients documented gastroparesis.

Hypercalcemia Related To Ectopic Vitamin D Production From A Dysgerminoma, Iqra Iqbal, Muhammad Atique Alam Khan, Puneet Dhillon, Samavia Munir, Dina Nabwani

Abington Jefferson Health Posters

Introduction

While malignancy associated hypercalcemia is a common finding among 20% to 30% of adult patients with breast cancer, lung cancer and multiple myeloma, it happens in less than 5% of female genital tract malignancies. [1] The three most common mechanisms associated with hypercalcemia are: local osteolytic hypercalcemia, humoral hypercalcemia of malignancy (HHM) caused by the parathyroid hormone-related peptide (PTHrP), and other humoral factors including prostaglandin, tumor necrosis factor (TNF), osteoclast activating factor and transforming growth factor (TGF). PTHrP and 1, 25 dihydroxy vitamin D (1, 25 Vit D) have been reported as humoral factors for dysgermininoma. [2] Humoral hypercalcemia …

Post-Stroke Recrudescence In The Setting Of Tramadol Overuse: A Case Report, Richard S. Zhang, Bs, Benjamin Larson, Md

Student Papers, Posters & Projects

This report promotes greater awareness of opioid-induced PSR, especially considering the tragic opioid crisis that has afflicted the US since the 1990s, and the contribution of synthetic prescription opioids to the crisis. This report also supports the establishment of care guidelines to limit PSR risk in people with major risk factors, such as MCA infarcts.

Evanescent - Issue 1

Evanescent

1 - My first 24-hour shift, Marnie Abehouse

3 - Unprepared, Daniel Bahat

5 - #1, Douglas Gouchoe

7 - Harrowing Halloween, Nick Siena

11 - Where do we go from here?, Robert Wilson

15 - Lucky, Marina Heskel

Electronic Health Record Skills Workshop For Medical Students., Jillian Zavodnick, Tasha Kouvatsos

Department of Medicine Faculty Papers

Introduction: The adoption of electronic health records (EHRs) presents new challenges for information gathering, documentation, and patient care. Medical students spend a significant amount of time using the EHR during their clerkship experiences and will continue to do so as they progress to residency. However, formal training varies between institutions and leaves gaps in data-gathering skills, documentation skills, and order entry-these three skills formed the basis for our learning objectives. We designed a workshop using a simulated EHR to teach these skills.

Methods: We offered the workshop during a class-wide transition-to-internship course for senior medical students. After a brief didactic, …

50th Anniversary: Leading The Way In Rehabilitation Medicine (1969-2019), Carol Abbott

Department of Rehabilitation Medicine Posters

No abstract provided.

Case 22-2019: A 65-Year-Old Woman With Myopathy., Marinos C. Dalakas

Department of Neurology Faculty Papers

No abstract provided.

Identifying Emergency Department Symptom-Based Diagnoses With The Unified Medical Language System., Benjamin H. Slovis, Danielle M. Mccarthy, Garrison Nord, Amanda Doty, Katherine Piserchia, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Many patients who are discharged from the emergency department (ED) with a symptom-based discharge diagnosis (SBD) have post-discharge challenges related to lack of a definitive discharge diagnosis and follow-up plan. There is no well-defined method for identifying patients with a SBD without individual chart review. We describe a method for automated identification of SBDs from ICD-10 codes using the Unified Medical Language System (UMLS) Metathesaurus.

METHODS: We mapped discharge diagnosis, with use of ICD-10 codes from a one-month period of ED discharges at an urban, academic ED to UMLS concepts and semantic types. Two physician reviewers independently manually identified …