Medicine and Health Sciences Commons^™

The Impact Of Patellar Resurfacing In Two-Stage Revision Of The Infected Total Knee Arthroplasty., Aaron Glynn, Ronald Huang, Javad Mortazavi, Javad Parvizi Md

Rothman Institute Papers

Evidence for optimal management of the patellofemoral joint in revision surgery for the infected TKA is limited. We reviewed 69 infected TKAs undergoing two-stage revision. Fifty four patellae were resurfaced, 11 had patelloplasty performed, two were augmented with trabecular metal, one had impaction grafting, and one knee underwent patellectomy. Average follow-up was 4.5years. The patients that received patellar resurfacing at re-implantation experienced statistically significant improvements in KSS pain score, functional KSS, and patellar score (P

Safety Of Hexaminolevulinate For Blue Light Cystoscopy In Bladder Cancer. A Combined Analysis Of The Trials Used For Registration And Postmarketing Data., J Alfred Witjes, Leonard G. Gomella, Arnulf Stenzl, Sam S. Chang, Dirk Zaak, H Barton Grossman

Department of Urology Faculty Papers

OBJECTIVE: To detail and put into perspective, safety of hexaminolevulinate blue light cystoscopy (HAL-BLC), including repeated use, based on combined data of controlled trials used for registration of HAL and postmarketing experience.

METHODS: Safety data of 2 randomized comparative studies (group 1) and 4 within patient control studies (group 2) were combined. Postmarketing data from >200,000 patients were analyzed.

RESULTS: In group 1, 533 patients were examined with HAL-BLC and 499 with white light (WL) cystoscopy. In group 2, 791 patients were examined with both WL and HAL-BLC. Between 73% and 93% of these patients had concomitant diseases. Between 41% …

Posaconazole Tablet Pharmacokinetics: Lack Of Effect Of Concomitant Medications Altering Gastric Ph And Gastric Motility In Healthy Subjects., Walter K. Kraft, Peter S. Chang, Marlou L P S Van Iersel, Hetty Waskin, Gopal Krishna, Wendy M Kersemaekers

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Posaconazole oral suspension is an extended-spectrum triazole that should be taken with food to maximize absorption. A new posaconazole tablet formulation has demonstrated improved bioavailability over the oral suspension in healthy adults in a fasting state. This study evaluated the effects of concomitant medications altering gastric pH (antacid, ranitidine, and esomeprazole) and gastric motility (metoclopramide) on the pharmacokinetics of posaconazole tablets. This was a prospective open-label 5-way crossover study in 20 healthy volunteers. In each treatment period, a single 400-mg dose (4 100-mg tablets) of posaconazole was administered alone or with 20 ml antacid (2 g of aluminum hydroxide and …

Asa Section On Teaching Of Statistics In The Health Sciences: 25 Years Later, Constantine Daskalakis, Scd

Department of Pharmacology and Experimental Therapeutics Faculty Papers

ASA's Section on Teaching of Statistics in the Health Sciences was established as a subsection of the Section on Statistical Education in 1970, and became an independent section in 1991. Stephen Looney, Todd Nick, Ralph O'Brien, Bob Oster and others led the section's early growth in the mid-to-late 1990s. Sessions and continuing education courses were organized at JSM, the newsletter was modernized, and a first website was established. In the early-to-mid 2000s, Ruth Mickey, Walter Ambrosius, Cyndy Long, Ed Gracely, the late Patrick Arbogast, Jodi Lapidus, and Scott Evans added their own efforts in strengthening section activities. It was during …

Feasibility Of Diagnosis Of Postcardiotomy Tamponade By Miniaturized Transesophageal Echocardiography., Hitoshi Hirose, Md, Shreya Gupta, Bs, Harrsion Pitcher, Md, Joseph Miessau, Ms, Qiong Yang, Md, Jenny Yang, Md, Nicholas Cavarhocchi, Md

Department of Surgery Faculty Papers

BACKGROUND: Pericardial tamponade after cardiac surgery is a critical diagnosis that can be difficult to diagnose using conventional cardiac monitoring. Transesophageal echocardiography can provide comprehensive information to make the diagnosis but is not always available, whereas transthoracic echocardiography has its utility limited because of the body habitus or other surgical effects. New monitoring devices, miniaturized hemodynamic transesophageal echocardiography (hTEE), which allows point of care assessment of cardiac filling and functions, may aid in diagnosis of postcardiotomy tamponade.

METHODS: From May 2011 to July 2013, 21 patients underwent hTEE to rule out pericardial tamponade for clinical suspicion of tamponade after open …

Small-Molecule Probes Targeting The Viral Ppxy-Host Nedd4 Interface Block Egress Of A Broad Range Of Rna Viruses., Ziying Han, Jianhong Lu, Yuliang Liu, Benjamin Davis, Michael S Lee, Mark A Olson, Gordon Ruthel, Bruce D Freedman, Matthias J. Schnell, Jay E Wrobel, Allen B Reitz, Ronald N Harty

Department of Microbiology and Immunology Faculty Papers

Budding of filoviruses, arenaviruses, and rhabdoviruses is facilitated by subversion of host proteins, such as Nedd4 E3 ubiquitin ligase, by viral PPxY late (L) budding domains expressed within the matrix proteins of these RNA viruses. As L domains are important for budding and are highly conserved in a wide array of RNA viruses, they represent potential broad-spectrum targets for the development of antiviral drugs. To identify potential competitive blockers, we used the known Nedd4 WW domain-PPxY interaction interface as the basis of an in silico screen. Using PPxY-dependent budding of Marburg (MARV) VP40 virus-like particles (VLPs) as our model system, …

Systemic Hematogenous Maintenance Of Memory Inflation By Mcmv Infection., Corinne J Smith, Holly Turula, Christopher M. Snyder

Department of Microbiology and Immunology Faculty Papers

Several low-grade persistent viral infections induce and sustain very large numbers of virus-specific effector T cells. This was first described as a response to cytomegalovirus (CMV), a herpesvirus that establishes a life-long persistent/latent infection, and sustains the largest known effector T cell populations in healthy people. These T cells remain functional and traffic systemically, which has led to the recent exploration of CMV as a persistent vaccine vector. However, the maintenance of this remarkable response is not understood. Current models propose that reservoirs of viral antigen and/or latently infected cells in lymph nodes stimulate T cell proliferation and effector differentiation, …

Inflammation In The Pain Pathway In A Model Of Mild Closed Head Injury: Implications For Post-Concussion Headache, Cm Macolino, Bv Daiutolo, Al Tyburski, Mb Elliot

Department of Neurosurgery Faculty Papers

Introduction

Headache is a hallmark feature of post-concussion syndrome. Post-concussion headache (PCH) is highly prevalent in the military with as high as 97.8% reporting having headaches¹ occurring in up to 85% of athletes following ^2-4 concussion or mTBI. In the Military and sports, return to duty or play guidelines state that a soldier/player should be asymptomatic before returning to physical activity⁴. However, headache following concussion is commonly dismissed.

PCH can be a new headache resulting from head trauma or worsening of pre-existing headache disorder. Incidence rates for concussion will continue to grow along with the increasing awareness …

Cortical Injury Modulates The Pain Pathway Partially Through Inducible Nitric Oxide Synthase, Bv Daiutolo, Cm Macolino, Al Tyburski, Mb Elliot

Department of Neurosurgery Faculty Papers

Introduction

Headache is a highly prevalent symptom in all severities of traumatic brain injury (TBI), and it is one of the most common symptoms of post-traumatic headache. Post-traumatic headache (PTH) remains the most common chronic pain syndrome within the TBI patient population¹. Mild and moderate forms of TBI are more prevalent than severe forms, but it is currently believed that PTH occurrence is not related to the severity of TBI¹. Despite being a common symptom following injury, little is known about the pathogenesis of post-traumatic headache. This is partly due to a lack in preclinical animal …

Outcomes Of Third-Year Pharmacy Students Using Technology For Instruction In An Infectious Diseases Elective Course, Joanna Headley, Pharmd, Candidate 2015, Bhavik Shah, Pharmd, Bcps, Aahivp, Jason J. Schafer, Pharmd, Mph, Bcps, Aahivp

College of Pharmacy Faculty Papers

BACKGROUND

• The use of technology both inside and outside the classroom is integral to the facilitation of pharmacy students’ learning.¹

• Technology is allowing education to restructure classroom time for something other than simple transmission of factual information and to adopt an evidence-based approach to instructional innovation and reform.¹

• Pharmacy colleges and schools should incorporate technologies that students frequently use and that positively impact learning.²

• Limited assessment of the impact of technology on student performance is available including teaching and learning from peers.^1,2

• An infectious diseases elective course developed at the Jefferson School of Pharmacy incorporated the …

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The Regulator Of G Protein Signaling (Rgs) Domain Of G Protein-Coupled Receptor Kinase 5 (Grk5) Regulates Plasma Membrane Localization And Function., Hua Xu, Xiaoshan Jiang, Ke Shen, Christopher C. Fischer, Philip B Wedegaertner

Department of Biochemistry and Molecular Biology Faculty Papers

The G protein-coupled receptor (GPCR) kinases (GRKs) phosphorylate activated GPCRs at the plasma membrane (PM). Here GRK5/GRK4 chimeras and point mutations in GRK5 identify a short sequence within the regulator of G protein signaling (RGS) domain in GRK5 that is critical for GRK5 PM localization. This region of the RGS domain of GRK5 coincides with a region of GRK6 and GRK1 shown to form a hydrophobic dimeric interface (HDI) in crystal structures. Coimmunoprecipitation (coIP) and acceptor photobleaching fluorescence resonance energy transfer assays show that expressed GRK5 self-associates in cells, whereas GRK5-M165E/F166E (GRK5-EE), containing hydrophilic mutations in the HDI region of …

Definition Of Periprosthetic Joint Infection, Javad Parvizi, Md, Frcs, Thorsten Gehrke, Md

Rothman Institute Papers

Diagnosis of periprosthetic joint infection (PJI) remains challenging as no “gold standard” for diagnosis exists [3]. The challenge is then what test(s) or criterion (ia) can be used to define PJI. In an effort to standardize the definition of PJI, Musculoskeletal Infection Society (MSIS) convened a workgroup in 2011 to issue diagnostic criteria for PJI [1]. The MSIS definition of PJI consists of two major criteria, when the presence of either criterion would indicate PJI, and six minor criteria, when the presence of four or more would indicate PJI.

Unique Interdisciplinary Public Health Model Doubles Latent Tuberculosis Infection Treatment Completion Of Refugee Patients In A Large Metropolitan Area, Christine O'Leary, Pharmd, Kevin Scott, Md, Marc Altshuler, Md, Karen Kitagawa-James, Rn, Bsn, Maria Hervada-Paige, Mss

Department of Family & Community Medicine Presentations and Grand Rounds

Background and Purpose:

The Jefferson Center for Refugee Health (JCRH), a component of Jefferson Family Medicine Associates (JFMA), is the first and largest single provider of refugee health in Philadelphia; over 1,000 refugee primary care visits are provided annually. Refugee patients are disproportionately affected by latent tuberculosis infection (LTBI) compared to the general population of the United States; and though treatment of LTBI is highly effective at reducing conversion to active tuberculosis (TB), completion rates among the foreign-born are reported to be less than 50%. To establish baseline LTBI incidence and treatment completion rates for our refugee population, the JCRH …

Neonatal Abstinence Syndrome In Methadone Exposed Infants: Role Of Genetic Variability, Andrea L. Fielder, J. K. Coller, M. R. Hutchinson, Ross R. Haslam, Nona Lu, Susan C. Adeniyi-Jones, Michelle Ehrlich, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Posters

Poster presented at: CPDD Scientific Meeting, San Juan, PR.

Aims: NAS incidence & severity in infants exposed to methadone during gestation is independent of maternal methadone dose. The incidence & severity of NAS could be in part due to genetic variability of key genetic loci related to opioid response; the interleukin-1beta (IL-1B) & mu opioid receptor (OPRM1) genes. This study aimed to investigate the impact of genetic variability in IL-1B -31 or OPRM1 A118G on NAS incidence (treatment required) & severity (dose of morphine).

Methods: This pilot study collected cheek cells from 71 methadone exposed infants; 46 …

What's New In Spine Surgery., Keith H Bridwell, Paul A Anderson, Scott D Boden, Han Jo Kim, Alexander Vaccaro, Md, Phd, Jeffrey C Wang

Rothman Institute Papers

No abstract provided.

The Tumor Suppressive Role Of Camk2n1 In Castration-Resistant Prostate Cancer., Tao Wang, Zhuo Liu, Shuiming Guo, Licheng Wu, Mingchao Li, Jun Yang, Ruibao Chen, Hua Xu, Shaoxin Cai, Hui Chen, Weiyong Li, Liang Wang, Zhiquan Hu, Qianyuan Zhuang, Shaohua Xu, Liping Wang, Jihong Liu, Zhangqun Ye, Jun-Yuan Ji, Chenguang Wang, Ke Chen

Department of Cancer Biology Faculty Papers

Prostate cancer at advanced stages including metastatic and castration-resistant cancer remains incurable due to the lack of effective therapies. The CAMK2N1 gene, cloned and characterized as an inhibitor of CaMKII (calcium/calmodulin-dependent protein kinase II), has been shown to affect tumorigenesis and tumor growth. However, it is still unknown whether CAMK2N1 plays a role in prostate cancer development. We first examined the protein and mRNA levels of CAMK2N1 and observed a significant decrease in human prostate cancers comparing to normal prostate tissues. Re-expression of CAMK2N1 in prostate cancer cells reduced cellular proliferation, arrested cells in G0/G1 phases, and induced apoptotic cell …

Multisite Phosphorylation Of The Sum1 Transcriptional Repressor By S-Phase Kinases Controls Exit From Meiotic Prophase In Yeast., Daniel Corbi, Sham Sunder, Michael Weinreich, Aikaterini Skokotas, Erica S Johnson, Edward Winter

Department of Biochemistry and Molecular Biology Faculty Papers

Activation of the meiotic transcription factor Ndt80 is a key regulatory transition in the life cycle of Saccharomyces cerevisiae because it triggers exit from pachytene and entry into meiosis. The NDT80 promoter is held inactive by a complex containing the DNA-binding protein Sum1 and the histone deacetylase Hst1. Meiosis-specific phosphorylation of Sum1 by the protein kinases Cdk1, Ime2, and Cdc7 is required for NDT80 expression. Here, we show that the S-phase-promoting cyclin Clb5 activates Cdk1 to phosphorylate most, and perhaps all, of the 11 minimal cyclin-dependent kinase (CDK) phospho-consensus sites (S/T-P) in Sum1. Nine of these sites can individually promote …

Designing Your Research Poster: Tips And Best Practices, Medical Media Services

Electronic Handouts

One page handout on designing your research poster including tips and best practices from Medical Media Services at Thomas Jefferson University.

6th Annual Faculty Days Presentations Now In The Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Check out the innovative teaching methods and ideas your colleagues are using in their courses. Access all 14 presentations from the recent 6th Annual Faculty Days in the Jefferson Digital Commons.

Another Milestone For The Jefferson Digital Commons, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

On June 6, 2014 the Jefferson Digital Commons surpassed 9,000 total deposited assets. Recent additions include the Pathology Honors Program Student Research Symposium posters and Jefferson Medical College yearbooks from 1950 to 1960.

An Interprofessional Falls Assessment Clinic Model To Develop Collaborative Team Skills Among Health Professional Students, Tracey Vause-Earland, Ms, Otr/L, Leigh Ann Hewston, Pt, Med, Cecilia Borden, Edd, Msn, Brooke Salzman, Md, Emily Hajjar, Pharmd, Ellen Furman, Msw, Christine Hsieh, Md, Susan Parks, Md

Department of Occupational Therapy Posters and Presentations

BACKGROUND

• Older adults are at increased risk for falls and fall related injuries, leading to loss of independence, disability, and increased mortality.
• Preventing injury and falls is a national Healthy People 2010 objective. However, physicians and other health professionals frequently fail to incorporate known evidence into usual care. Screening for falls is not consistently performed as an essential assessment in older adults by primary care providers.
• Multidisciplinary assessment can be an important component in preventing falls in community dwelling adults.
• In new practice models, such as the Chronic Care Model, there is an emphasis on interdisciplinary collaboration, however health professions …

Advances In Neurovascular Treatments., Robert M Starke, Stephen J Monteith, Nohra Chalouhi, Dale Ding, Ricky Medel, David Hasan, Aaron S Dumont

Department of Neurosurgery Faculty Papers

No abstract provided.

Micrornas: The Short Link Between Cancer And Rt-Induced Dna Damage Response., Christopher M Wright, Tu Dan, Adam Dicker Md, Phd, Nicole L Simone

Department of Radiation Oncology Faculty Papers

No abstract provided.

Sphingosine-1-Phosphate Promotes The Differentiation Of Adipose-Derived Stem Cells Into Endothelial Nitric Oxide Synthase (Enos) Expressing Endothelial-Like Cells., Divya Arya, Shaohua Chang, Paul J Dimuzio, Jeffrey Carpenter, Thomas N Tulenko

Department of Surgery Faculty Papers

BACKGROUND: Adipose tissue provides a readily available source of autologous stem cells. Adipose-derived stem cells (ASCs) have been proposed as a source for endothelial cell substitutes for lining the luminal surface of tissue engineered bypass grafts. Endothelial nitric oxide synthase (eNOS) is a key protein in endothelial cell function. Currently, endothelial differentiation from ASCs is limited by poor eNOS expression. The goal of this study was to investigate the role of three molecules, sphingosine-1-phosphate (S1P), bradykinin, and prostaglandin-E1 (PGE1) in ASC endothelial differentiation. Endothelial differentiation markers (CD31, vWF and eNOS) were used to evaluate the level of ASCs differentiation capability. …

Download Entire Issue- Jefferson Interprofessional Education And Care Newsletter, Spring, 2014, Volume 5, Issue 1

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download entire issue- Jefferson Interprofessional Education and Care Newsletter, Spring, 2014, Volume 5, Issue 1

Jcipe To Host Fourth Biennial Conference On Interprofessional Education And Care, Kevin Lyons, Phd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The Jefferson Center for Interprofessional Education (JCIPE) will host its’ fourth biennial conference on interprofessional education and care from Friday, October 10^th through Sunday, October 12^th. Entitled “Interprofessional Care for the 21^st Century: Redefining Education and Practice,” the conference will bring individuals involved in interprofessional education and care together to share ideas, innovative programs and the latest research to help advance interprofessional approaches to education and care (IPE/C) across the country.

Ipads, Ibooks, Apps! What's All The Ifuss About?, Martha L. Ankeny, M.Ed., Lauren Collins, Md, Kathryn M. Shaffer, Rn, Msn, Cne, Sokha Koeuth, Mph, Ba

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The iVolution is here. It is iThis and iThat every way you turn. Is this just another iFad, or is it truly revolutionizing education? In a recent survey conducted by EDUCAUSE Center for Analysis and Research on undergraduates and technology, 31% of students reported owning tablet technology a 15% increase from the previous year and 76% of students reported owning smart phones. This finding was a 14% increase from the previous year. Students also reported using smart devices in class to access material, participate in activities, look up information and photograph material as learning strategies. Thomas Jefferson University is riding …

Using Technology To Enhance Interprofessional Collaborative Practice: Creating Virtual Clinical Opportunities By Implementing Google Doc And Google Hangout In Clinical Rounding, Kathryn Shaffer, Msn, Rn, Cne, Elizabeth Speakman, Edd, Rn, Anef, Fnap

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The delivery of quality care is best done by a group of practitioners who can effectively communicate and utilize the ‘team decision making approach’ to solve patient/client/person care issues. Organizations such as the WHO advise us that “after almost 50 years of inquiry, there is now sufficient evidence to indicate that interprofessional education enables effective collaborative practice which in turn optimizes health-services, strengthens health systems and improves health outcomes” (2010, p18). The need to implement interprofessional team based approaches to patient care is important. What is also essential is the need to provide interprofessional learning opportunities for today’s health care …

From The Editors, Lauren Collins, Md, Elizabeth Speakman, Edd, Rn, Anef, Fnap, Christine A. Arenson, Md

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Welcome to the Spring 2014 edition of the Jefferson Center for Interprofessional Education (JCIPE) newsletter. In this edition of our newsletter, you will have a chance to read about two new innovations in technology designed to enhance interprofessional education and collaborative practice. We believe that integrating technology into IPE will be central to aligning health care education reforms with changes in healthcare delivery. This Spring also marks the graduation of our 6^th cohort of JHMP students at TJU. Now, over 4,100 students have completed this longitudinal IPE curriculum; feedback from graduates has been highly positive, detailing the impact of …

Results Of A Phase I Study Of Bendamustine In Combination With Ofatumumab, Carboplatin And Etoposide (Boce) For Refractory Of Relapsed Aggressive B-Cell Non Hodgkin's Lymphomas (Nhl), Sameh Gaballa, Md, Neil D. Palmisiano, Md, Aakanksha Asija, Md, Andrew Chapman, Do, Jennifer K. Cloud, Bs, Joanne Filicko-O'Hara, Md, Lewis Rose, Md, Michael Ramirez, Md, Onder Alpdogan, Md, Neal Flomenberg, Md, Barbara Pro, Md, Elena Gitelson, Md, Phd, Mark Weiss, Md

Department of Medical Oncology Faculty Papers

Introduction:

• There are a number of regimens used to treat relapsed/refractory aggressive lymphomas and little consensus exists on the best salvage treatment.
• No regimen has shown clear superiority but uniformly there was an inferior outcome among patients who had relapsed after a prior rituximab containing regimen.
• Ofatumumab is a fully human IgG1k monoclonal anti-CD20 antibody. It recognizes a distinct epitope on the human CD20 molecule. In vitro studies with ofatumumab have shown more complement dependent cytotoxicity than rituximab.
• Bendamustine has single agent activity in relapsed aggressive lymphomas and has a favorable safety profile.

Objectives:

• We conducted a phase I trial …