Medicine and Health Sciences Commons^™

Felty Syndrome, Dorothea Frederick, Dnp, Fnp-C

College of Nursing Posters

Take home point: It is important to remember that the diagnosis of FS may be masked in patients who present with infection, since active bacterial infection raises the WBC count to normal or slightly elevated – the neutropenia reappears shortly after successful treatment (Kay, 2017).

Grfs And Crfs In Alternative Donor Hematopoietic Cell Transplantation For Pediatric Patients With Acute Leukemia., Rohtesh S. Mehta, Shernan G Holtan, Tao Wang, Michael T. Hemmer, Stephen R. Spellman, Mukta Arora, Daniel R. Couriel, Amin M. Alousi, Joseph Pidala, Hisham Abdel-Azim, Ibrahim Ahmed, Mahmoud Aljurf, Medhat Askar, Jeffery J. Auletta, Vijaya Bhatt, Christopher Bredeson, Saurabh Chhabra, Shahinaz Gadalla, James Gajewski, Robert Peter Gale, Usama Gergis, Peiman Hematti, Gerhard C. Hildebrandt, Yoshihiro Inamoto, Carrie Kitko, Pooja Khandelwal, Margaret L. Macmillan, Navneet Majhail, David I. Marks, Parinda Mehta, Taiga Nishihori, Richard F. Olsson, Attaphol Pawarode, Miguel Angel Diaz, Tim Prestidge, Muna Qayed, Hemalatha Rangarajan, Olle Ringden, Ayman Saad, Bipin N. Savani, Sachiko Seo, Ami Shah, Niketa Shah, Kirk R. Schultz, Melhem Solh, Thomas Spitzer, Jeffrey Szer, Takanori Teshima, Leo F Verdonck, Kirsten M. Williams, Baldeep Wirk, John Wagner, Jean A. Yared, Daniel J. Weisdorf

Department of Medical Oncology Faculty Papers

We report graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) (a composite end point of survival without grade III-IV acute GVHD [aGVHD], systemic therapy-requiring chronic GVHD [cGVHD], or relapse) and cGVHD-free relapse-free survival (CRFS) among pediatric patients with acute leukemia (n = 1613) who underwent transplantation with 1 antigen-mismatched (7/8) bone marrow (BM; n = 172) or umbilical cord blood (UCB; n = 1441). Multivariate analysis was performed using Cox proportional hazards models. To account for multiple testing, P < .01 for the donor/graft variable was considered statistically significant. Clinical characteristics were similar between UCB and 7/8 BM recipients, because most had acute lymphoblastic leukemia (62%), 64% received total body irradiation-based conditioning, and 60% received anti-thymocyte globulin or alemtuzumab. Methotrexate-based GVHD prophylaxis was more common with 7/8 BM (79%) than with UCB (15%), in which mycophenolate mofetil was commonly used. The univariate estimates of GRFS and CRFS were 22% (95% confidence interval [CI], 16-29) and 27% (95% CI, 20-34), respectively, with 7/8 BM and 33% (95% CI, 31-36) and 38% (95% CI, 35-40), respectively, with UCB (P < .001). In multivariate analysis, 7/8 BM vs UCB had similar GRFS (hazard ratio [HR], 1.12; 95% CI, 0.87-1.45; P = .39), CRFS (HR, 1.06; 95% CI, 0.82-1.38; P = .66), overall survival (HR, 1.07; 95% CI, 0.80-1.44; P = .66), and relapse (HR, 1.44; 95% CI, 1.03-2.02; P = .03). However, the 7/8 BM group had a significantly higher risk for grade III-IV aGVHD (HR, 1.70; 95% CI, 1.16-2.48; P = .006) compared with the UCB group. UCB and 7/8 BM groups had similar outcomes, as measured by GRFS and CRFS. However, given the higher risk for grade III-IV aGVHD, UCB might be preferred for patients lacking matched donors. © 2019 American Society of Hematology. All rights reserved.

Hit And Run Versus Long-Term Activation Of Parp-1 By Its Different Domains Fine-Tunes Nuclear Processes., Colin Thomas, Md, Yingbiao Ji, Chao Wu, Haily Datz, Cody Boyle, Brett Macleod, Shri Patel, Michelle Ampofo, Michelle Currie, Jonathan Harbin, Kate Pechenkina, Niraj Lodhi, Sarah J. Johnson, Alexei V. Tulin

Department of Medicine Faculty Papers

Poly(ADP-ribose) polymerase 1 (PARP-1) is a multidomain multifunctional nuclear enzyme involved in the regulation of the chromatin structure and transcription. PARP-1 consists of three functional domains: the N-terminal DNA-binding domain (DBD) containing three zinc fingers, the automodification domain (A), and the C-terminal domain, which includes the protein interacting WGR domain (W) and the catalytic (Cat) subdomain responsible for the poly(ADP ribosyl)ating reaction. The mechanisms coordinating the functions of these domains and determining the positioning of PARP-1 in chromatin remain unknown. Using multiple deletional isoforms of PARP-1, lacking one or another of its three domains, as well as consisting of only …

Antibody-Based Ticagrelor Reversal Agent In Healthy Volunteers., Deepak L. Bhatt, Charles V. Pollack, Jeffrey I. Weitz, Lisa K. Jennings, Sherry Xu, Susan E. Arnold, Bret R. Umstead, Michael C. Mays, John S. Lee

Department of Emergency Medicine Faculty Papers

BACKGROUND: Ticagrelor is an oral P2Y₁₂ inhibitor that is used with aspirin to reduce the risk of ischemic events among patients with acute coronary syndromes or previous myocardial infarction. Spontaneous major bleeding and bleeding associated with urgent invasive procedures are concerns with ticagrelor, as with other antiplatelet drugs. The antiplatelet effects of ticagrelor cannot be reversed with platelet transfusion. A rapid-acting reversal agent would be useful.

METHODS: In this randomized, double-blind, placebo-controlled, phase 1 trial, we evaluated intravenous PB2452, a monoclonal antibody fragment that binds ticagrelor with high affinity, as a ticagrelor reversal agent. We assessed platelet function in …

Determining A Clinical Role For Digital Apps For Mental Health, Hephsibah Loeb, Md, Ann Chandy, Md

Department of Psychiatry and Human Behavior Posters

In 2017, the FDA approved the first app for treatment of alcohol, cocaine, marijuana and stimulant use disorders. In a preceding randomized controlled trial, mobile software Therapeutic Education System (TES) was found to reduce dropout from treatment and to increase patients’ rates of abstinence from substance abuse. Another study showed that PRIME-D, a mobile-based treatment for depression, positively affected symptoms of depression and disability. Many individuals seek out self-help apps for psychiatric complaints, although, in general, little evidence exists for evaluation of the most accessible mobile apps for self-help. What are the strengths and weaknesses of digital apps for treatment …

Erenumab In Chronic Migraine: Patient-Reported Outcomes In A Randomized Double-Blind Study., Richard B. Lipton, Stewart J. Tepper, Uwe Reuter, Stephen Silberstein, Walter F. Stewart, Jon Nilsen, Dean K. Leonardi, Pooja Desai, Sunfa Cheng, Daniel D. Mikol, Robert Lenz

Department of Neurology Faculty Papers

OBJECTIVE: To determine the effect of erenumab, a human monoclonal antibody targeting the calcitonin gene-related peptide receptor, on health-related quality of life (HRQoL), headache impact, and disability in patients with chronic migraine (CM).

METHODS: In this double-blind, placebo-controlled study, 667 adults with CM were randomized (3:2:2) to placebo or erenumab (70 or 140 mg monthly). Exploratory endpoints included migraine-specific HRQoL (Migraine-Specific Quality-of-Life Questionnaire [MSQ]), headache impact (Headache Impact Test-6 [HIT-6]), migraine-related disability (Migraine Disability Assessment [MIDAS] test), and pain interference (Patient-Reported Outcomes Measurement Information System [PROMIS] Pain Interference Scale short form 6b).

RESULTS: Improvements were observed for all endpoints in …

Centeringpregnancy® Increases The Likelihood Of Postpartum Visit And Contraceptive Use, Rei Yamada, Abigail Wolf

Department of Obstetrics and Gynecology Posters

AIMS

• Examine contraceptive use among patients in our CenteringPregnancy® program
• Measure postpartum visit attendance among the CenteringPregnancy® patients

Yeast Mitochondrial Protein Pet111p Binds Directly To Two Distinct Targets In Cox2 Mrna, Suggesting A Mechanism Of Translational Activation, Julia L Jones, Katharina B. Hofmann, Andrew T. Cowan, Dmitry Temiakov, Patrick Cramer, Michael Anikin

Department of Biochemistry and Molecular Biology Faculty Papers

The genes in mitochondrial DNA code for essential subunits of the respiratory chain complexes. In yeast, expression of mitochondrial genes is controlled by a group of gene-specific translational activators encoded in the nucleus. These factors appear to be part of a regulatory system that enables concerted expression of the necessary genes from both nuclear and mitochondrial genomes to produce functional respiratory complexes. Many of the translational activators are believed to act on the 5'-untranslated regions of target mRNAs, but the molecular mechanisms involved in this regulation remain obscure. In this study, we used a combination of in vivo and in …

Evidence Based Solutions: Creating Specialty Units, Jacqueline Adams, Msn, Rn, Corln, Ccctm, Megan Bagonis, Rn, Bsn, Michelle Lewandowski, Rn, Bsn, Mha

Department of Nursing Posters

Purpose

To describe how the development of a specialty Ear, Nose, and Throat (ENT) care unit staffed by experienced ENT nurses positively influences quality outcomes, patient experience, ICU admissions, and readmission and LOS rates in a large, urban, academic medical center.

Silencing The Guca2a-Gucy2c Tumor Suppressor Axis In Cin, Serrated, And Msi Colorectal Neoplasia., Babar Bashir, Dante J. Merlino, Jeff A. Rappaport, Esteban Gnass, Juan P. Palazzo, Ying Feng, Eric R R. Fearon, Adam E. Snook, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Colorectal cancers (CRCs) initiate through distinct mutations, including in APC pathway components leading to tubular adenomas (TAs); in BRAF, with epigenetic silencing of CDX2, leading to serrated adenomas (SAs); and in the DNA mismatch repair machinery driving microsatellite instability (MSI). Transformation through the APC pathway involves loss of the hormone GUCA2A that silences the tumor-suppressing receptor GUCY2C. Indeed, oral hormone replacement is an emerging strategy to reactivate GUCY2C and prevent CRC initiation and progression. Moreover, retained expression by tumors arising from TAs has established GUCY2C as a diagnostic and therapeutic target to prevent and treat metastatic CRC. Here, we defined …

The In Vivo Effects Of Alcohol In Lung And Liver Are At Least Partially Mediated Through The Alpha 4 Nicotinic Acetylcholine Receptor, J. Ritzenthaler, E. Torres-Gonzalez, G. E. Arteel, J. Roman

Division of Pulmonary, Allergy, and Critical Care Medicine Posters

Rational: Chronic alcohol abuse is a major risk factor for the development of acute lung injury, with 40% of annual cases in the U.S. linked to this disorder. Alcohol is not only associated with increased incidence of acute lung injury in at-risk individuals, but also increased mortality. The exact mechanisms by which alcohol abuse renders the host susceptible to acute lung injury remain poorly defined. We have reported that α4 nicotinic acetylcholine receptors (α4 nAChRs) may serve as potential sensors for alcohol in lung fibroblasts; however, we have not tested their role in vivo.

Methods: To test the role of …

Letter To The Editor: Ketamine For Pain Management: Let's Not Neglect Practical Concerns, Steven P. Cohen, Eric S. Schwenk, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

We read with interest the recent article on ketamine by Bell and Kalso.1 In recent years, the use of ketamine to treat chronic pain and depression has exploded, and this article represents an easy-to-follow overview of this often misunderstood medication.

Aospine—Spine Trauma Classification System: The Value Of Modifiers: A Narrative Review With Commentary On Evolving Descriptive Principles, Srikanth N. Divi, Md, Gregory D. Schroeder, Md, Cumhur Oner, Md, Phd, Frank Kandziora, Md, Phd, Klaus J. Schnake, Md, Marcel F. Dvorak, Md, Lorin M. Benneker, Md, Jens R. Chapman, Md, Alex R. Vaccaro, Md, Phd, Mba

Department of Orthopaedic Surgery Faculty Papers

Study Design: Narrative review.

Objectives: To describe the current AOSpine Trauma Classification system for spinal trauma and highlight the value of patient-specific modifiers for facilitating communication and nuances in treatment.

Methods: The classification for spine trauma previously developed by The AOSpine Knowledge Forum is reviewed and the importance of case modifiers in this system is discussed.

Results: A successful classification system facilitates communication and agreement between physicians while also determining injury severity and provides guidance on prognosis and treatment. As each injury may be unique among different patients, the importance of considering patient-specific characteristics is highlighted in this review. In …

Management Of Acute Traumatic Central Cord Syndrome: A Narrative Review, Srikanth N. Divi, Gregory D. Schroeder, John J. Mangan, Madeline Tadley, Wyatt L. Ramey, Jetan H. Badhiwala, Michael G. Fehlings, F. Cumhur Oner, Frank Kandziora, Lorin M. Benneker, Emiliano N. Vialle, Shanmuganathan Rajasekaran, Jens R. Chapman, Alexander R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

Study Design: Narrative review.Objectives:To provide an updated overview of the management of acute traumatic central cord syndrome (ATCCS).

Methods: A comprehensive narrative review of the literature was done to identify evidence-based treatment strategies forpatients diagnosed with ATCCS.

Results: ATCCS is the most commonly encountered subtype of incomplete spinal cord injury and is characterized by worsesensory and motor function in the upper extremities compared with the lower extremities. It is most commonly seen in thesetting of trauma such as motor vehicles or falls in elderly patients. The operative management of this injury has been historicallyvariable as it can be seen in …

Downregulation Of Thromboxane A2 And Angiotensin Ii Type 1 Receptors Associated With Aging-Related Decrease In Internal Anal Sphincter Tone., Ipsita Mohanty, Jagmohan Singh, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

Aging-associated decrease in internal anal sphincter (IAS) tone (AADI) is a major contributor in the rectoanal incontinence (RI). To determine the pathogenesis of AADI, we investigated the effect of aging on GPCR activation and related downstream signaling. We particularly investigated two GPCRs that characterize IAS smooth muscle cells (SMCs): thromboxane A ₂ and angiotensin II type 1. Two groups of Fischer 344 rats (6-month-old [young group] and 26-month-old [old group]) were employed to determine the GPCR function by isometric contraction, the expressions of GPCRs, and their downstream regulatory signaling proteins (regulator of G-protein signaling 2, RGS2; GPCR Kinase 5, GRK5; …

Discontinuation Of Proton Pump Inhibitor Use Reduces The Number Of Endoscopic Procedures Required For Resolution Of Walled-Off Pancreatic Necrosis., Patrick C. Powers, Ali Siddiqui, Reem Z. Sharaiha, Grace Yang, Enad Dawod, Aleksey A. Novikov, Amy Javia, Cynthia Edirisuriya, Arish Noor, Tayebah Mumtaz, Usama Iqbal, David .E Loren, Thomas E. Kowalski, Natalie Cosgrove, Yordano Alicea, Amy Tyberg, Iman Andalib, Michel Kahaleh, Douglas G. Adler

Division of Gastroenterology and Hepatology Faculty Papers

Background and Objectives: Endoscopic drainage/debridement of symptomatic walled off necrosis (WON) using lumen-apposing metal stents (LAMS) is both safe and effective. While endoscopic management of WON is the standard approach to treatment, the ideal concomitant medical therapy remains unclear. The purpose of this study was to further elucidate the effect of proton pump inhibitor (PPIs) therapy on the technical and clinical success of endoscopic treatment of WON.

Methods: Two hundred and seventy-two patients in 8 centers with WON managed by endoscopic drainage using LAMS were evaluated. Patients were followed for at least 6 months following treatment. The patients were divided …

Trust And Glycemic Control In Black Patients With Diabetic Retinopathy: A Pilot Study, Barry W. Rovner, Robin J. Casten

Department of Psychiatry and Human Behavior Faculty Papers

Diabetic retinopathy (DR) is more prevalent in blacks than whites because, compared to whites, blacks on average have worse glycemic control. Both of these racial disparities reflect differences in sociocultural determinants of health, including physician mistrust. This randomized, controlled 6-month pilot trial compared the efficacy of a culturally tailored behavioral health/ophthalmologic intervention called Collaborative Care for Depression and Diabetic Retinopathy (CC-DDR) to enhanced usual care (EUC) for improving glycemic control in black patients with DR (n = 33). The mean age of participants was 68 years (SD 6.1 years), 76% were women, and the mean A1C was 8.7% (SD 1.5%). …

Developing A Business Case For The Care Coordination And Transition Management Model: Need, Metrics, And Measures, Sheila Haas, Phd, Rn, Faan, Regina Conway-Phillips, Phd, Rn, Beth Ann Swan, Phd, Crnp, Faan, Laura De La Pena, Msn, Rnc, C-Efm, Rachel Start, Msn, Rn, Ne-Bc, Diane Storer Brown, Phd, Rn, Cphq, Fnahq, Faan

College of Nursing Faculty Papers & Presentations

In this descriptive qualitative study, nurse and healthcare leaders' experiences, perceptions of care coordination and transition management (CCTM®), and insights as to how to foster adoption of the CCTM RN role in nursing education, practice across the continuum, and policy were explored. Twenty-five barriers to recognition and adoption of CCTM RN practice across the continuum were identified and categorized. Implications of these findings, recommendations for adoption of CCTM RN practice across the care continuum, and strategies for reimbursement policies are discussed.

Re-Visioning Interprofessional Education In Virtual Worlds, Susan Toth-Cohen, Anne C. Smith

Department of Occupational Therapy Faculty Papers

From their inception, virtual worlds have attracted educators from many disciplines, and benefits for both students and educators for networking and immersive experience have been well documented. But, while virtual world education has engaged multiple disciplines to learn with, from, and about each other, the potential for innovation in interprofessional education (IPE) has not been fully realized. This paper outlines ways to re-vision IPE using a flexible learning framework to develop, implement, and enhance virtual world training programs.

Cervical Posterior Longitudinal Ligament Ossification : Microscopy-Assisted Anterior Corpectomy And Fusion., Wanyi Wang, Tao Ding, James Harrop, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Yuntao Xue, Miao Lu, Chao Wu

Department of Neurosurgery Faculty Papers

OBJECTIVE: To explore the clinical efficacy and safety of microscopy-assisted anterior corpectomy and fusion for cervical ossification of the posterior longitudinal ligament (OPLL).

METHODS: A retrospective review of 32 cervical OPLL patients who underwent microscopy-assisted anterior corpectomy and fusion from June 2012 to March 2017 was carried out. Patients were evaluated with outcome metrics: Japanese Orthopaedic Association (JOA) scores (17 points method), visual analog scale (VAS), and radiographic parameters of the lordotic angle. The complications during treatment and follow-up were recorded.

RESULTS: This study included 32 patients (15 males and 17 females) with a mean age of 58.3 ± 2.9 …

The Fibrosis Across Organs Symposium: A Roadmap For Future Research Priorities., Jesse Roman, Teresa R. Barnes, Dolly J. Kervitsky, Gregory P. Cosgrove, Dennis E. Doherty, Andrew M. Tager, Luca Richeldi, Eric S. White, David A. Brenner, Lynn M. Schnapp, Timothy D. Hewitson, Bodh I. Jugdutt, Timothy A. Mckinsey, John D. Tosi, Stephen Crane, Kevin K. Brown

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

No abstract provided.

Comparative Effectiveness Of Intensity Modulated Radiation Therapy To 3-Dimensional Conformal Radiation In Locally Advanced Lung Cancer: Pathological And Clinical Outcomes., Sarit Appel, Jair Bar, Alon Ben-Nun, Marina Perelman, Dror Alezra, Damien Urban, Maoz Ben-Ayun, Nir Honig, Efrat Ofek, Tamar Katzman, Amir Onn, Sumit Chatterji, Sergey Dubinski, Lev Tsvang, Shira Felder, Judith Kraitman, Ory Haisraely, Tatiana Rabin Alezra, Sivan Lieberman, Edith M. Marom, Nir Golan, David Simansky, Zvi Symon, Yaacov Richard Lawrence

Department of Radiation Oncology Faculty Papers

OBJECTIVE: Intensity-modulated radiotherapy (IMRT) has better normal-tissue sparing compared with 3-dimensional conformal radiation (3DCRT). We sought to assess the impact of radiation technique on pathological and clinical outcomes in locally advanced non-small cell lung cancer (LANSCLC) treated with a trimodality strategy.

METHODS: Retrospective review of LANSCLC patients treated from August 2012 to August 2018 at Sheba Medical Center, Israel. The trimodality strategy consisted of concomitant chemoradiation to 60 Gray (Gy) followed by completion surgery. The planning target volume (PTV) was defined by co-registered PET/CT. Here we compare the pathological regression, surgical margin status, local control rates (LC), disease free (DFS) …

The Practice Of Dermatology Ain't What It Used To Be: The Preauthorization Catastrophe., Lawrence Charles Parish, Jennifer L. Parish, W. Clark Lambert, Carmela Ciferni

Department of Dermatology and Cutaneous Biology Faculty Papers

Many of us remember when a dermatology practice was cash only, and $5 cash was considered appropriate for a specialist. The general practitioner received $2 for an office visit and $4 for a home call. If you recall those days, “dearie you are much older than I.” 1

Not so long ago, the practitioner was confronted with obtaining a referral from the Health Maintenance Organization (HMO) in order to see the patient. Some plans permitted only four such referrals for specialists, annually, so the patient, who might have had a visit or two for gastritis and a similar number of …

Automation, Regulation, And Collaboration: Threats And Opportunities For Clinical Medical Physics Careers In Diagnostic Imaging And Nuclear Medicine., David W. Jordan, Eric L. Gingold, Ehsan Samei

Department of Radiology Faculty Papers

No abstract provided.

Re-Code Dcm (Research Objectives And Common Data Elements For Degenerative Cervical Myelopathy): A Consensus Process To Improve Research Efficiency In Dcm, Through Establishment Of A Standardized Dataset For Clinical Research And The Definition Of The Research Priorities, Benjamin M. Davies, Danyal Z. Khan, Oliver D. Mowforth, Angus G.K. Mcnair, Toto Gronlund, Angelos G. Kolias, Lindsay Tetreault, Michelle L. Starkey, Iwan Sadler, Ellen Sarewitz, Delphine Houlton, Julia Carter, Sukhvinder Kalsi-Ryan, Bizhan Aarabi, Brian K. Kwon, Shekar N. Kurpad, James Harrop, Jefferson R. Wilson, Robert Grossman, Armin Curt, Michael G. Fehlings, Mark R.N. Kotter

Department of Neurosurgery Faculty Papers

Study Design: Mixed-method consensus process.

Objectives: Degenerative cervical myelopathy (DCM) is a common and disabling condition that arises when mechanical stress damages the spinal cord as a result of degenerative changes in the surrounding spinal structures. RECODE-DCM (REsearch Objectives and Common Data Elements for Degenerative Cervical Myelopathy) aims to improve efficient use of health care resources within the field of DCM by using a multi-stakeholder partnership to define the DCM research priorities, to develop a minimum dataset for DCM clinical studies, and confirm a definition of DCM.

Methods: This requires a multi-stakeholder partnership and multiple parallel consensus development processes. It …

Cuff-Less Methods For Blood Pressure Telemonitoring., Dylan M. Bard, Jeffrey I. Joseph, Noud Van Helmond

Department of Anesthesiology Faculty Papers

Blood pressure telemonitoring (BPT) is a telemedicine strategy that uses a patient's self-measured blood pressure (BP) and transmits this information to healthcare providers, typically over the internet. BPT has been shown to improve BP control compared to usual care without remote monitoring. Traditionally, a cuff-based monitor with data communication capabilities has been used for BPT; however, cuff-based measurements are inconvenient and cause discomfort, which has prevented the widespread use of cuff-based monitors for BPT. The development of new technologies which allow for remote BP monitoring without the use of a cuff may aid in more extensive adoption of BPT. This …

Tumor-Derived Extracellular Vesicles Require Β1 Integrins To Promote Anchorage-Independent Growth., Rachel M. Derita, Aejaz Sayeed, Vaughn Garcia, Shiv Ram Krishn, Christopher D. Shields, Srawasti Sarker, Andrea Friedman, Peter Mccue, Sudheer Kumar Molugu, Ulrich Rodeck, Adam P. Dicker, Lucia R. Languino

Department of Cancer Biology Faculty Papers

The β1 integrins, known to promote cancer progression, are abundant in extracellular vesicles (EVs). We investigated whether prostate cancer (PrCa) EVs affect anchorage-independent growth and whether β1 integrins are required for this effect. Specifically using a cell-line-based genetic rescue and an in vivo PrCa model, we show that gradient-purified small EVs (sEVs) from either cancer cells or blood from tumor-bearing TRAMP (transgenic adenocarcinoma of the mouse prostate) mice promote anchorage-independent growth of PrCa cells. In contrast, sEVs from cultured PrCa cells harboring a short hairpin RNA to β1, from wild-type mice or from TRAMP mice carrying a β1 conditional ablation …

Routine Patellar Resurfacing During Total Knee Arthroplasty Is Not Cost-Effective In Patients Without Patellar Arthritis, Harold I. Salmons, Bs, Benjamin Zmistowski, Md, Yale A. Fillingham, Md, Derek Ward, Md, Robert P. Good, Md, Jess H. Lonner, Md

Department of Orthopaedic Surgery Posters

• During total knee arthroplasty (TKA), whether or not one should routinely resurface the patella is controversial.
• Leaving an unresurfaced patella following index TKA may lead to anterior knee pain (AKP), patellofemoral crepitus, and future secondary resurfacing operations.
• However, routinely resurfacing the patella (PR) may lead to patellar fracture, aseptic loosening, patellar instability, avascular necrosis, and patellar clunk.
• The purpose of the present study is to utilize the existing level one evidence to assess the cost-utility of routine patella resurfacing during primary TKA.
• Hypothesis: Selective resurfacing of the patella is more cost effective than routine patellar resurfacing during primary TKA.

Patients With Refractory Out-Of-Cardiac Arrest And Sustained Ventricular Fibrillation As Candidates For Extracorporeal Cardiopulmonary Resuscitation - Prospective Multi-Center Observational Study., Takahiro Nakashima, Teruo Noguchi, Yoshio Tahara, Kunihiro Nishimura, Soshiro Ogata, Satoshi Yasuda, Daisuke Onozuka, Naoto Morimura, Ken Nagao, David F. Gaieski, Yasufumi Asai, Hiroyuki Yokota, Satoshi Nara, Mamoru Hase, Takahiro Atsumi, Tetsuya Sakamoto

Department of Emergency Medicine Faculty Papers

BACKGROUND: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) and sustained ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) or conversion to pulseless electrical activity/asystole (PEA/asystole) benefit more from extracorporeal cardiopulmonary resuscitation (ECPR). Methods and Results: We analyzed data from the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan, which was a prospective, multicenter, observational study with 22 institutions in the ECPR group and 17 institutions in the conventional CPR (CCPR) group. Patients were divided into 4 groups by cardiac rhythm and CPR group. The primary endpoint was favorable neurological outcome, defined as Cerebral Performance Category 1 …

Process Improvement For Follow-Up Radiology Report Recommendations Of Lung Nodules., Philip S. Lim, Doron Schneider, Jonathan Sternlieb, Michel Taupin, Nicholas Sich, Joan Diaz, Eileen Jameson, Bryan Frambes, Sharon Taylor

Abington Jefferson Health Papers

In the modern healthcare system, there are still wide gaps of communication of imaging results to physician and patient stakeholders and tracking of whether follow-up has occurred. Patients are also unaware of the significance of findings in radiology reports. With the increase in use of cross-sectional imaging such as CT, patients are not only being diagnosed with primary urgent findings but also with incidental findings such as lung nodules; however, they are not being told of their imaging findings nor what actions to take to mitigate their risks. In addition, patients at high risk for developing lung cancer often obtain …