Medicine and Health Sciences Commons^™

Implementing A Mentorship Program On A Medical/Oncology Unit, Nicole Frye, Stephanie Perreiah, Jenna Vansanford

Central Division Nurse Clinical Inquiry Conference

Abstract:

Title: Implementing a Mentorship Program on a Medical/Oncology Unit Background: New-to-specialty acute care nurses are generally assigned a preceptor to demonstrate complex competencies within 90 days of hire. However, providing inpatient nursing care presents psychosocial stressors not well-addressed by preceptors which can contribute to burnout and turnover. Participating in a mentorship program addressing psychosocial nursing stressors following competency-focused preceptorship may reduce burnout and turnover. A medical-oncology unit of a 200-bed urban hospital lacked a mentorship program and Unit-Based Council (UBC) members worked to implement and evaluate this resource. Purpose: To evaluate barriers and facilitators of participation in a new …

Liposome Synthesis And Evaluation In The Hek-293 Cell Line, Christine Skibinski

Harrisburg University Research Symposium: Highlighting Research, Innovation, & Creativity

Liposomes were synthesized using the thin film method. A lyophilized power of egg-derived phosphatidylcholine, stearylamine, and cholesterol were added to ethanol and dried under argon to form a lipid cake. The lipid cake was rehydrated with dPBS and sonicated at 60°C forming a heterogenous batch of liposomes. Our results revealed the average size of the liposomes, determined by Dynamic Light Scattering, was approximately 223.1nm, while demonstrating a weakly positive zeta-potential of 1.9± 8.07mv. Next, we tested the antitumor action of the liposomes in the HEK-293 cell line via an MTT assay. We observed that the liposomes were able to inhibit …

Outcomes Of Hypofractionated Radiation Therapy In Locally Advanced Non-Small Cell Carcinoma Lung : A Single Institutional Experience, Meenu Gupta, Shivani Mehra, Vipul Nautiyal, Sunil Saini, Mushtaq Ahmed

Research Symposium

Introduction: Radical treatment in locally advanced non small cell carcinoma lung presents a management dilemma in patients with compromised performance status. Hypofractionated EBRT resolves this by confering high efficacy while avoiding excessive early toxicity.

Objectives: To evaluate the efficacy and tolerance of hypofractionated radiotherapy in locally advanced lung cancer patients with compromised performance status.

Methods: From January 2019 to January 2020,62 patients were enrolled to receive hypofractionated radiotherapy with 40Gy in 16 fractions with 5 fractions per week (2.5Gy per fraction) because of compromised performance status. Follow-up was conducted at 6 weeks and 3 months for symptomatic and radiological response …

Moans, Palpable Groin, And Entrapment Of Bone: A Case Of Malignant Peripheral Nerve Sheath Tumor In An Otherwise Healthy Hispanic Male, Nelson D. Gonzalez, Christine E. Loftis, Rosa Guedez-White

Research Symposium

Background: Malignant peripheral nerve sheath tumors (MPNTs) are rare malignant soft tissue sarcomas that have an incidence of about 0.001 %. MPNTs typically occur in individuals who have neurofibromatosis or secondary to radiation therapy and rarely occur sporadically. We present a case of a previously healthy 56-year-old gentleman who was diagnosed with MPNTs.

Case: A healthy 56-year-old gentleman presented with worsening LLQ abdominal pain for 6 months. Associated symptoms included bloating, LLE swelling, early satiety for the past 2 months, and a 5-10lb unintentional weight loss. Patient denied recent cough, night sweats, dyspnea, fever, chills, melena or hematochezia. Vitals were …

Long Non-Coding Rna (Lncrna) As A New Biomarker For Hepatocellular Carcinoma (Hcc) Drug Resistance, Areeb Masood, Kyle Doxtater, Anupam Dhasmana, Subhash C. Chuahan, Sanjaya Satapathy, Manish Tripathi

Research Symposium

Background: Hepatocellular carcinoma (HCC) is the 4^th leading cause of cancer-related deaths worldwide and the 6^th most common cancer worldwide. When HCC progresses to advanced stages, drug resistance becomes a major hurdle and leaves clinicians with limited therapeutic options. Long non-coding RNAs (lncRNAs) have shown to promote drug resistance in various cancers. The goal of our research is to explain the molecular role of lncRNAs in HCC drug resistance and compile a comprehensive list of studied lncRNAs involved in HCC drug resistance.

Methods: To compile a list of lncRNA involved in HCC drug resistance we performed an advanced …

Association Of Nutritional Status With Failure To Complete Planned Treatment In Patients With Hnscc- A Prospective Cohort Study In A Tertiary Cancer Centre In Northern India., Anshika Arora, Sunil Kumar Saini

Research Symposium

Background: To determine the association between Nutritional status of patient and the ability to complete all planned treatment in Head & Neck Squamous Cell Carcinoma(HNSCC).

Materials & Methods: This prospective cohort study was conducted at CRI India between 2018 and 2020. Patients diagnosed with HNSCC and planned for treatment were enrolled after written informed consent. Nutritional status was determined using- anthropometric measures and Subjective Global Assessment(SGA) scale before starting treatment. Patients were followed up for treatment details, complications and failure to complete planned treatment. Statistical analysis was performed using SPSS version 22. Data was analyzed using parametric and non-parametric …

A Survival Analysis Of High-Grade Gliomas In Sub-Himalayan Population Including The Times Of Lockdown During Covid 19 Pandemic: A Single Institutional Experience, Pooja Kalra, Meenu Gupta, Vipul Nautiyal, Ranjeet Kumar, Sanjeev Pandey, Nazia Shirazi, Brijesh Tiwari, Mushtaq Ahmad

Research Symposium

Background and Objectives: High Grade Gliomas are categorised as Grade III and IV and have high mortality rate with poor prognosis. How we should adopt clinical practice in neuro-oncology during Covid 19 Pandemic is another area of scientific exploration . Hypofractionated radiotherapy protocols can be easily utilised in high grade gliomas during Covid 19 pandemic .

Materials and Methods: Retrospective analysis of 147 patients with diagnosis of high-grade gliomas between January 2009 till December 2020 including Covid-19 pandemic lockdown time was done. Age , gender , KPS , symptoms , extent of surgery and use of concurrent temozolamide , were …

An Ngqd Based Diagnostic Tool For Pancreatic Cancer, Ryan Ketan Ajgaonkar, Bong Lee, Alina Valimukhametova, Anton Naumov, Giridhar Akkaraju

Research Symposium

Background: Pancreatic cancer remains difficult to detect at early stages which contributes to a poor five-yearsurvival rate. Therefore, early detection approaches based on novel technologies should be explored to address this critical health issue. Nanomaterials have recently emerged as frontrunners for diagnostic applications due to their small size in the 1-100 nm range, which facilitates one-on-one interactions with a variety of biomolecules like oligonucleotides and makes them suitable for a plethora of detection and delivery applications. In this work, the presence of specific pancreatic cancer miRNA (pre-miR-132) is detected utilizing the fluorescence properties of highly biocompatible nitrogen-doped graphene quantum dots …

Antigen Staining For Detection Of Muc13 And Mcu16 In Carcinoma Tissue, Jose A. Benitez

Research Symposium

MUC13 and MUC16 are mucosal epithelial expressed proteins associated with various carcinomas. Overexpression of these biomarkers appear to play a role in tumor growth; this discovery has paved a road for multiple studies discussing the potential of targeting mucin proteins and optimize immunotherapy approaches against carcinomas. Our study serves to investigate the level of expression of MUC13 and MUC16 in cancerous and normal tissue and to discuss the implications our findings may have for the utilization of these biomarkers for cancer therapy.

A Two State-Wide Population Based Analysis Of Hepatosplenic T-Cell Lymphoma In Hispanic Vs Non-Hispanic Patients In Texas And Florida, Christine E. Loftis, Rosa White, Joel Michalek, Liu Qianqian, Adolfo Diaz

Research Symposium

Introduction: Peripheral T-cell lymphomas (PTCLs) are a diverse, aggressive form of neoplasms that are rare and constitute % of all non-Hodgkin lymphoma cases (Am J Pathol, PMID:1698028). A sub-set of PTCLs is hepatosplenic T-cell Lymphoma (HSTCL) which is described as an extra-nodal T-cell lymphoma of mature gamma or delta T-cells (Am J Pathol, PMID:1698028). HSTCL is extremely rare accounting for less than 1% of all cases of NHL and because of this, epidemiological research is lacking (Blood PMID: 21300984). Hispanics (H) are one of the fastest growing races in the US but tend to have poorer …

Tale Of Traveling In A Stealth Mode, Blesset Alexander, Priyasha Suri, Don Rajan, Praveen Vijhani

Research Symposium

Background: Melanoma is an aggressive malignancy that tends to form metastases in the brain. The nature of metastatic melanoma with unknown primary is poorly understood and has only theoretical assumptions. Less than 10% of melanoma cases present with an unknown primary tumor location.

Case presentation: A 68-year-old Caucasian male patient, Canadian citizen, presented to the hospital with left-sided weakness and deviation of right side of angle of mouth for three days. Pertinent positive physical signs were motor weakness of left upper and lower extremities. Labs were unremarkable. CT-scan of the brain showed right temporal lobe lobulated masses associated with vasogenic …

Epidemiología Del Cáncer De Colon En Un Plan De Salud De Un Hospital De Comunidad. Estudio De Cohorte Retrospectivo., Nora Fuentes Phd, Mariano Esperatti Phd, Juan Martín Alfonso Md, Marcos Flores Md

AMNET XX Conferencia Internacional

Epidemiología del cáncer de colon en un Plan de Salud de un Hospital de Comunidad. Estudio de cohorte retrospectivo.

Introducción: el CCR ocupa el 4to lugar en ambos sexos y todas las edades (19.5 casos por 100.000 habitantes) y ocupa el 2do lugar en luego del cáncer de pulmón.

Objetivo: Describir la incidencia y sobrevida del cáncer de colon en un hospital de comunidad con Plan de salud (PS)

Métodos: Estudio de cohorte retrospectivo (Aprobado por el comité de ética). Se incluyeron todos los afiliados al Plan de Salud (PS) de 20 años o más entre 2009-2019. Se identificaron los …

Epidemiología Del Cáncer De Pulmón En Un Plan De Salud De Un Hospital De Comunidad. Estudio De Cohorte Retrospectivo., Nora Fuentes Phd, Mariano Esperatti Md, Juan Martin Alfonso Md

AMNET XX Conferencia Internacional

Introducción: El cáncer de pulmón es de los tumores más frecuentes a nivel mundial. En Argentina es 1er causa de muerte por cáncer (15%), sobrevida a 5 años de un 10%.

Objetivo: Describir la incidencia y sobrevida del cáncer pulmón en un hospital de comunidad con Plan de salud (PS)

Métodos:Estudio de cohorte retrospectivo (Aprobado por el comité de ética). Se incluyeron todos los afiliados al Plan de Salud (PS) de 20 años o más entre 2016-2021. Se identificaron los casos por patología. Se calcularon las tasas de incidencia tasa cruda, sexo y estandarizada por población estándar OMS, usando …

Upper Urinary Tract Transitional Cell Carcinoma And Lymph Node Involvement: Pre And Post Operative Outcomes, Brittney Henderson, Son Young, Mark Quiring, Scott Serpico, Edward Wu, Emma Troyer, Ryan Moriarty, Thomas Mueller, Gordon Brown

Research Day

Background: Upper urinary tract transitional cell carcinomas (UUT-TCC) comprise any malignancy arising from the renal pelvis to distal ureter. These cancers account for approximately 5-10% of all urothelial tumors. Two-thirds of cases are invasive with an estimated 5-year survival rate less than 50%. Pathologic staging, invasion into local structures, and lymph node involvement influence the overall survival rate. Lymph node dissection (LND) is associated with higher overall survival rates in UUT-TCC patients, likely by decreasing regional lymph node metastasis. Current literature suggests that removing eight to ten regional lymph nodes may improve survival. The outcomes of upper urinary tract malignancies …

Modified Excisional Biopsy Technique For Confirmed Or Highly Suspected Melanomas, Batul Momin, Katrina Hansen

Research Day

There are a variety of biopsy techniques for sampling confirmed or highly suspicious melanomas, including excisional, scoop-shave or “saucerization”, shave, and punch biopsy. Herein, we present a case in which a combination approach of saucerization and excisional biopsy was used for a patient with an inadequately sampled melanoma. In the literature, excisional biopsy remains the gold standard for diagnosing melanoma. This technique is accomplished with a full-thickness, fusiform removal of the lesion with a scalpel to the level of adipose tissue (2). The drawback to this technique is the slightly distorted anatomy that can occur during wound closure. Albeit rare, …

A Seemingly Low Risk Patient Develops Urosepsis As A Complication Of Transrectal Prostate Biopsy: A Case Study, Nicole Peritz, Gabrielle Oquendo, Yuhyun Kang, Elijah Humphries, Joy Zarandy

Research Day

Background:

Prostate cancer (PCa) is the most common cancer in men, and the second most common cause of cancer deaths in the United States. Approximately 1 million Americans undergo prostate biopsies annually, with 97% undergoing the transrectal prostate biopsy (TRPB). While TRPB is reliable and relatively low risk, nearly 7% of patients develop infectious complications, with 3% requiring hospitalization due to sepsis. Risk factors for developing infection post-TRPB include antibiotic resistance, >10 biopsy cores, diabetes mellitus, indwelling catheter, and African-American ethnicity. Identifying risk factors, considering a transperineal biopsy approach, and utilizing pre-procedural practices like rectal sterilization, screening urinalysis, prophylactic antibiotics, …

Rare Presentation Of Metastatic Hepatocellular Carcinoma In The Finger: Case Report And Review Of Literature, F. Rhana Mousavi, Bassem Bekheit, Emon Alavi, Nick A. Hirad, Abanoub Gabra

Research Day

Hepatocellular carcinoma (HCC) is a primary tumor of the liver that primarily develops in the setting of chronic liver disease. HCC is difficult to diagnose due to it requiring the use of multiple imaging modalities with the goal to detect tumors when they are less than or equal to 2 cm in size to allow all possible treatment options to be used. Herein, we discuss a 69-year-old male with stage IV liver cancer residing in hospice presenting with left middle finger osteomyelitis and extreme pain. Radiology revealed a destructive lesion but pathology provided the diagnosis of metastatic hepatocellular carcinoma in …

A Cadaveric Case Study On Lung Cancer Pathology, Anna Beth Boyette, Sarah Kate Boyette, Haley Garrett, Janai Groves, Perry Chandler Mullis, Sofia Sirocchi, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Lung cancer is the most commonly diagnosed cancer amongst both genders, currently accounting for about 18% of all cancer deaths.

OBJECTIVES: The overall purpose of this study was to evaluate the pathology associated with the patient’s cause of death, cardiorespiratory failure and lung cancer. The secondary aims of this study were to confirm the presence of malignant neoplasms within a human cadaver, determine the type of cancer present, and take specimens for histological examination to evaluate the patient’s cause of death.

METHODS: This is a case report from one of the cadavers in the Gross Anatomy laboratory at the …

A Cadaveric Case Study On Metastatic Breast Cancer Pathology, Janai L. Groves, Haley B. Garrett, Savannah J. Finley, Jada M. Glenn, Itza M. Garcia, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Breast cancer is the second most common cancer among women in the United States. The exact etiology of breast cancer is unknown, but over 70% of breast cancer cases involve only two risk factors: being a woman and being over the age of 50. Women with a family history of breast cancer, as well as women who experience early menopause, have an even greater risk of developing this disease. When considering racial demographics, African-American women have a 4-8% lower incidence rate of breast cancer than Caucasian women but are 40% more likely to die from the disease. Breast cancer …

Cadaveric Study: Sign Of Leser-Trélat Associated With Breast Cancer, Brigitte L. Cochran, Shiv Dhiman, Savita Arya

Research Day

INTRODUCTION: Seborrheic keratoses (SK) is considered the most common benign skin lesions found in individuals that are middle aged and older. In dermatology practice, these lesions pose no threat to the individual but can be concerning for cosmetic and underlying malignancy reasons when they cover most of the skin surface. Of specific concern is the sign of Leser-Trélat, which has been documented as a cutaneous harbinger of underlying malignancy associated with proliferation of the size and/or number seborrheic keratoses. This rare sign is usually caused by malignancies such as gastrointestinal adenocarcinoma and lung, kidney, liver, pancreatic cancer or malignant melanoma. …

A Unique Case Of Atrial Fibrillation Secondary To Squamous Cell Lung Carcinoma, Mohammad J. Malik, Emily K. Wilson, Vijay Bandhakavi

Research Day

Atrial fibrillation (AF) is widely considered to be the most prevalent cardiac arrhythmia with an incidence of roughly 1-2% in the United States alone. The incidence of AF has been known to increase with advancing age and thus presents a significant burden on healthcare systems across the globe. AF arises as a result of several mechanisms including structural changes that occur to the heart overtime. Here we present a case in which a 63-year-old male with no past medical history except heavy tobacco use presented to the emergency department complaining of shortness of breath. He also endorsed having palpitations and …

A Combined Radio-Immunotherapy Regimen Eradicates Late-Stage Melanoma In Mice., Sritha Moram, Alexander Rakhmilevich, Noah Tsarovsky, Mildred Felder, Amy Erbe, Alex Pieper, Jen Zaborek, Emily Cheng, Cole Witt, Paul Sondel

Research Day

Advanced cancers are typically resistant to treatment, which leads to most experimental cancer immunotherapy approaches being tested against smaller tumors. In this study, we show that even late-stage, weakly immunogenic mouse B78 melanomas, with tumor volumes of 1500-2000 mm3, can be eradicated by a combined radio-immunotherapy regimen (CRIR) which includes local radiotherapy, intratumoral interleukin 12, slow-release systemic interleukin 2 and checkpoint blockade with anti-CTLA-4 antibody. Flow analysis of the tumors revealed a reduction in T regulatory (Treg) cells and an increase in CD8/Treg ratios following CRIR. T cell depletion did not prevent the rapid shrinkage of treated tumors, but suppressed …

A Novel Therapy For Refractory Cbfa2t3::Glis2-Associated Amkl Using Stro-002 And Plerixafor, Amy Johnson Md, Mba, Alan S. Gamis, Arturo Molina, Soheil Meshinchi, Karen Lewing

Research Days

Background: CBFA2T3::GLIS2-associated AML (CBF/GLIS AML) is an aggressive form of AML often associated with AMKL and recognized by its unique RAM phenotype by flow. It has a very poor prognosis, frequently refractory to standard of care regimens, with extreme marrow localization of leukemic blasts likely mediated by high CXCR4 (CD184) expression. The CBFA2T3::GLIS2 fusion gene is the most common oncogenic transcript in pediatric AMKL and universally results in high expression of FOLR1 surface antigen. STRO-002, an antibody drug conjugate targeting FOLR1, is currently in Phase I clinical trials for adults with refractory ovarian and endometrial malignancies A summary of 17 …

Bone Marrow Transplant For Macrophage Activation Syndrome In Systemic Juvenile Idiopathic Arthritis, Shailly Gaur, Michael J. Holland, J Allyson Hays, Ibrahim A. Ahmed

Research Days

Background

The recognition of macrophage-activation-syndrome (MAS) in the setting of systemic-juvenileidiopathic-arthritis (sJIA) is complex, but a necessary distinction given emerging treatment options. With overlapping clinical manifestations including fever, end-organ involvement and lymphadenopathy, there is a focus on laboratory values to differentiate MAS from a sJIA flare. Once parameters are met, multiple treatment modalities can be considered, as monotherapy or in combination, including steroids, immunosuppression, chemotherapy, intravenous immunoglobulin, and cytokine-directed biologics. Given the long-term morbidity and mortality associated with progressive inflammation and immune dysregulation due to MAS with sJIA, it is imperative to regain control over this complication. However, these treatments …

The Clinical Definition And Characterization Of Field Of Cancerization In Patients With Actinic Keratoses, Stuti Prajapati, Christina Kontzias, Mallory Zaino, Steven Feldman

Rowan-Virtua Research Day

Introduction: Chronic UV radiation affects the entire area of skin exposed, leading to visible actinic keratoses (AK) and subclinical changes in the surrounding skin. AKs are hyperkeratotic lesions, with a 0.025-16% risk of transforming into squamous cell carcinoma (SCC).1 Cellular atypia around AKs is the field of cancerization (FOC). Topical AK therapies can treat the FOC, while destructive treatments address visible lesions. FDA-approved products may be approved for field sizes up to 25 cm2.1,2

Objective: To characterize the FOC and assess the correlation between the FOC and number of AKs.

Methods: 100 patients with AKs were recruited. FOC was defined …

Barriers To Colorectal Cancer Screening For Low-Income Hispanic Men In Urban Areas Between 50-75, Alex Vega

Rowan-Virtua Research Day

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Although CRC screening rates have improved in non-Hispanic whites (NHW), Hispanic adult males (HAM) aged 50-75 in urban areas continue to experience low screening rates and higher CRC morbidity and mortality. This review aims to identify the barriers to CRC screening among HAM and propose targeted interventions to increase screening rates. A comprehensive literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Key search terms included "colorectal cancer", "screening", "Hispanic adult males", "urban", "barriers", and "interventions". Factors identified include poverty, language …

Cellular Metabolism Therapy Slowing Growth Rate Of Glioblastomas, Heet Patel

Rowan-Virtua Research Day

Glioblastoma Multiforme (GBM), more commonly known as glioblastomas, are a form of specialized brain tumors called gliomas. Glioblastomas most commonly occur in glial cells of the central nervous system and the average age of diagnosis is 64. Treatment methods implemented currently are surgery of the removable masses followed by courses of chemotherapy and radiotherapy. These methods can only prolong the life span by a few months and as such, new research focused on tumor cell metabolism is being conducted to determine its impact on the progression of this tumor. Tumor masses, such as Glioblastomas, modify their metabolism via the Warburg …

Evaluating The Effect Of A Taxane-Based Anti-Cancer Drug On The Adult Taste Organ Using A Mouse Model, Archana Kumari, Lucre'ce Estropia

Rowan-Virtua Research Day

Chemosensory alteration is one of the major side effects of chemotherapy that can negatively impact the quality of life of cancer patients. Decreased appetite and food aversions can consequently lead to substantial reductions in food intake and thereby malnutrition and poor patient outcomes. The chemotherapeutic agent, taxane (docetaxel), is an effective choice of treatment for breast cancer, gastric cancer, or prostate cancer. Despite its major effects as an anti-cancer medication, patients under taxane treatments have reported taste alterations. Essentially, the drug disrupts normal microtubule growth by inhibiting microtubule depolymerization. By binding to ß-tubulin, a major component of mitotic spindles, docetaxel …

Perioperative Ketamine Use For Post Mastectomy Pain, Alessia Cooney, Jaylyn Thompson, Naomi Watkins-Granville

Rowan-Virtua Research Day

PMPS is defined as chronic neuropathic pain following breast cancer procedures in the ipsilateral arm, chest wall, axilla or shoulder.1-3 Approximately 20 to 50% of post mastectomy patients suffer from Post Mastectomy Pain Syndrome (PMPS).1 With more than 3.8 million breast cancer survivors, due to advances in treatment, there is increased importance in findings ways to better manage the quality of life of breast cancer survivors.1,4 Ketamine induces analgesic effects through its non-competitive antagonism of NDMA receptors.5 Low doses of ketamine infusion (20–30 mg x h−1) have been shown to produce analgesia in neuropathic pain states with benefits lasting up …

Mcl-1 Inhibition Modulates Erk-Mediated Resistance In Multiple Myeloma, Omar Al-Odat, Krishne Gowda, Shantu Amin, Tulin Budak-Alpdogan, Subash Jonnalagadda, Manoj Pandey

Rowan-Virtua Research Day

Novel multiple myeloma (MM) treatments have significantly improved over the previous several decades, primarily on account of targeting bone marrow microenvironment (BMM) pathways. However, drug resistance and patient relapse remain major clinical problems. The role of BMM in the upregulation of anti-apoptotic protein Mcl-1 is well documented. The Mcl-1 protein plays a critical role in the progression and acquired drug resistance in MM. The regulation of Mcl-1, a protein characterized by a short half-life, from transcription to degradation is crucial for understanding its role in cell survival. The GSK3β and Erk play important role in the stability of Mcl-1. Also, …