Medicine and Health Sciences Commons^™

Comparison Of Estimated Glomerular Filtration Rate Using Five Equations To Predict Acute Kidney Injury Following Total Joint Arthroplasty, Hunter Hayes, Kevin Mekkawy, Yash Chaudhry, Michael Raad, Raj Amin, Harpal Khanuja

Research Day

Introduction: Primary total joint arthroplasty (TJA) is one of the most common procedures in the United States, and as the incidence of this surgery increases, identifying methods for improving outcomes and reducing complications is essential. Acute kidney injury (AKI) following TJA is a potential source of morbidity and mortality. Estimated glomerular filtration rate (eGFR) is used as an indicator of renal function. Several equations are commonly used to calculate eGFR. The purpose of this study was 1) to evaluate the agreement between five equations in calculating eGFR, and 2) to confirm which equation can best predict AKI in patients undergoing …

Family History Of Acl Tears As Non-Modifiable Risk Factor In Acl Injury, Michael Valenzuela, Robert Roundy, Marshall Williams, Mathew Pombo

Research Day

Background: 100,000-200,000 anterior cruciate ligament (ACL) injuries occur each year in the United States. These injuries result in significant burden to the patient, and predisposition to ACL injuries is often multifactorial. Some researchers have looked into the genetic component to ACL injuries, both at the population and molecular level. We aim to study a large orthopaedic population in order to assess the association between personal and family history of an ACL injury.

Hypothesis/Purpose: We hypothesize that patients with a first-degree relative, who have a history of ACL injury, will have increased odds to sustain an ACL injury themselves.

Study Design: …

No Pain No Gain: Student Performance Over Time On The Revised Neurophysiology Of Pain Questionnaire, Ruth Maher, Jeanne P. Welch

Research Day

Purpose/Hypothesis: Core competencies in pain management for pre-licensure health professional education have been established. The purpose of this study was to assess the effect of 10-hours of pain neurophysiology education (PNE) on physical therapy students' understanding of pain and retention of key concepts.

Number of Subjects: Thirty-three second-year physical therapy students.

Materials and Methods: Ten hours of PNE was embedded in a clinical neuroscience course which included a 2-hour lab assignment called “The Matrix”. The content was guided by key principles recommended by the International Association for the study of Pain (IASP). The lab assignment included case studies that required …

A Computer-Based Intervention May Be Effective For Treating Bereavement As Measured By Scores Of Prolonged Grief, Anxiety, Depression, And Cognitive Distortions., Michael Kastelnik, Bradley Michael Rosenfield, Michael B. Roberts

Research Day

Many people suffer from complications due to grieving the death of a loved one, an experience known as bereavement. In addition to the emotional suffering, complications can lead to functional impairment, negatively impacting relationships, work, and health of those who grieve. Although there are evidence-based interventions for bereavements, there are barriers to treatment, including costs and accessibility. Computer-based interventions are empirically demonstrated to overcome these barriers. The present study aims to test the effectiveness of a computer-based single-session treatment for bereavement. It is hypothesized that individuals who complete a computer-based CBT intervention for bereavement will experience a significant decrease in …

Inventory Of Cognitive Distortions-Youth Version: The Development And Validation Of A Psychometric Test For The Measurement Of Cognitive Distortions, Kelsey Jones, Robert A. Ditomasso, Susan Panichelli Mindel, Michael B. Roberts

Research Day

Cognitive distortions are systematic biases in an individual’s thinking that maintain a person’s belief in their negative views of themselves or others, even in the presence of contradictory evidence. The Inventory of Cognitive Distortions (ICD), created by Yurica and DiTomasso, provided a template to measure distorted thinking in adults. Currently, there is not a youth measure of cognitive distortions that adequately encapsulates the range of distorted thinking that may be present in youth. Therefore, the purpose of this study is to create and validate a newly designed instrument of cognitive distortions, The Inventory of Cognitive Distortions-Youth Version (ICD-YV), with youth …

Social Media Use, Connectedness, And Depression In Graduate Students, Marisa Gretz, Stephen R. Poteau, Robert A. Ditomasso, Michael B. Roberts

Research Day

This study will examine the relationship between social media use, sense of connectedness, and depression among graduate students. Graduate students are often disconnected from their social supports due to their program's demands; additionally, the risk of depression in this population has been established in the literature. The impact of social media on depression has been investigated, and the results are discrepant. The relationship between a sense of connection, the use of social media, and depression in a graduate student population has not yet been explored. Graduate students at The Philadelphia College of Osteopathic Medicine (PCOM) and other universities studying psychology, …

Benefits Of Preclinical Osteopathic Medical Students' Joining Interprofessional Research Teams, Alexander Rembalsky, Stephanie H. Felgoise

Research Day

Challenge/ Issues: There are few options for interprofessional research experiences that offer medical students the ability to collaborate with clinical psychology doctoral (PsyD) students. While a core principle of osteopathic medicine is holistic care, exposure to psychosocial aspects of medical conditions is limited or unrepresented in the preclinical education years. As an example, the psychosocial aspects and quality of life issues related to kidney dialysis are not discussed in the classroom.

Objectives: The objectives for integrating medical students into a research study on quality of life and psychosocial aspects in persons undergoing kidney dialysis are to: a) have psychology and …

Meta-Analysis Of Antiganglioside Antibodies In Peripheral Neuropathies: A Potenital Diagnostic Indicator In Cidp, Gbs, And Mmn, Morgan Ilgenfritz, Shafik Habal

Research Day

Introduction: Autoimmune diseases that attack the peripheral nervous system are rare and difficult to precisely diagnose. Current diagnostic techniques rely heavily on patient symptomatology which prove problematic considering the varying presentations and the interchangeability of symptomatology among many peripheral neuropathies. Little is understood about the precise mechanism of pathogenesis which makes obtaining a biomarker challenging, but the presence of autoantibodies which target myelin proteins suggest a humoral component. In previous studies antiganglioside IgG and IgM antibodies that attack myelin have been reported in up to 60% of cases of Guillain-Barre syndrome (GBS) and 50% of cases of multifocal motor neuropathy …

Surgical Techniques For Lymphedema Management, Matthew Kayal, Shelley Dicecco

Research Day

Introduction: Lymphedema is known as a debilitating disease where the management plan can require a combination of surgical and conservative treatments. Worldwide, greater than 300 million people suffer from lymphedema. The lymphatic system is responsible for the drainage of fluid from the interstitial tissues and organ systems and is the body’s primary way of managing edema. The aim of this review was to investigate the efficacy of the procedures and the multiple surgical options that exist for the treatment of lymphedema, including the Charles procedure, liposuction or suction-assisted protein lipectomy (SAPL), lymphovenous anastomosis (LVA), and vascularized lymph node transfer (VLNT). …

Pretreatment With Naltrindole Exhibits Robust Cardioprotection In An Isolated Rat Heart Model Of Ischemia-Reperfusion Injury, Alexis Verwoert, Arjun Nair, Michael Bamimore, Tameka Dean, Sunit Singh, Melinda Beale, Kayla Harrell, Cameron Stinson, Qian Chen, Robert J. Barsotti, Lindon H. Young

Research Day

Previously, a novel three-amino acid peptide (tripeptide) that is structurally similar to other amino acid-based delta and kappa-opioid receptor agonists (the predominant opioid receptor subtypes in heart tissue) demonstrated a significant reduction in infarct size and improved cardiac function when administered during preconditioning in isolated rat hearts using the Langendorf model. The cardioprotective effects of tripeptide were blocked by naloxone (NX, broad-spectrum opioid antagonist) and nor-binaltorphine (BNI, kappa-opioid receptor antagonist), whereas naltrindole (NTI, delta-opioid receptor antagonist) seemed to augment the effects of tripeptide. To determine whether the cardioprotective effects of the combination were due to tripeptide or NTI, the effects …

A 37-Year-Old Female With Low Back Pain And Acute Lower Extremity Weakness, Kelci Beardsley, Ronald Lincow

Research Day

Setting: Outpatient Pain Management

Patient: A 37-year-old female with no significant past medical history presents with low back pain and unilateral lower extremity weakness two weeks after a motor vehicle accident.

Case Description: This patient presented to the office with a chief complaint of new right sided low back pain and right lower extremity weakness. History revealed that the patient was involved in a motor vehicle accident (MVA) several weeks prior to presentation. She was the restrained driver and was hit from behind by another motorist. The patient noted that she immediately felt stiffness in her low back, but did …

Lumbar Sympathetic Block As A Treatment Modality For Complex Regional Pain Syndrome, Kelci Beardsley, Ronald Lincow

Research Day

Setting: Outpatient Pain Management

Patient: A 28-year-old male with a history of cryptogenic stroke, bilateral lower extremity compartment syndrome, and severe left foot pain secondary to emergent fasciotomy.

Case Description: This patient presented to the office with a chief complaint of left foot pain. Past medical history was significant for cryptogenic stroke and bilateral lower extremity compartment syndrome, status post emergent fasciotomy. Severe left foot pain began after emergent fasciotomy, and he required a walker for ambulation. While hospitalized, several different treatment modalities were utilized in an attempt to alleviate the pain. Previous treatments included tricyclic antidepressants, gabapentin, and saphenous …

Extensor Medii Proprius: A Cadaveric Case Study, Christopher Baker, Gabrielle Swartz, Jeanine Garcia, Perez Felix Hernandez, Leslie Mcintosh

Research Day

Abstract:

During routine dissection of 11 cadavers that originated with the Body Donor Program at PCOM Georgia, a 69-year-old male with bilateral extensor anomalies in the dorsal forearm compartment was encountered. The distinct muscle belly, identified as the extensor medii proprius, originated from the distal ulna and inserted into the dorsal aponeurosis of the third digit. Manual traction of the right tendon resulted in extension of the third digit, suggesting functional significance of the anomalous muscle. This case study analyzes the extensor medii proprius found during dissection, its prevalence, embryologic origins, and clinical significance. The presence of the extensor medii …

Trauma As A Predictor Of Exposure And Response Prevention (Ex/Rp) Treatment Outcomes For Patients With Obsessive-Compulsive Disorder (Ocd) In A Clinical Setting, Lindsey Salerno, Elizabeth Gosch, Stephen R. Poteau, Jeremy Tyler

Research Day

Background: Trauma has been found to be highly prevalent among individuals diagnosed with obsessive-compulsive disorder (OCD) and to impact the onset, maintenance, and severity of OCD symptoms. Little is known, however, about how trauma might affect outcomes for individuals engaging in exposure and response prevention (Ex/RP). Despite Ex/RP being the most widely implemented treatment for OCD, lack of consideration for psychosocial factors, like experienced trauma, has been cited as a possible limitation of the treatment. Furthermore, intolerance of uncertainty (IU), anxiety sensitivity (AS), and emotion regulation (ER) are transdiagnostic variables most commonly associated with the presence of posttraumatic stress and …

Investigating The Potential Cardioprotective Properties Of Two Novel Microbiome Derived Compounds Urolithin A And Urolithin B Against Methylglyoxal Induced Cellular Damage, Alhussain Yasin, Qian Chen

Research Day

Introduction: Diabetes puts patients at higher risk to develop cardiac, vascular, and neuronal complications due to accumulation of advanced glycation end products. Methylglyoxal (MG) is found raised in diabetic plasma and serves as a precursor of advanced glycation end products. There still is a lack of strategy to mitigate MG’s deleterious effects. Urolithin A (URO A) and Urolithin B (URO B) are two novel microbiome derived compounds that can be found plentiful in such sources as pomegranates, raspberries, and strawberries. There has been recent interest in their ability to provide protection against cellular damage. Their activity against MG induced cellular …

De Novo Sox6 Variants Cause A Neurodevelopmental Syndrome Associated With Adhd, Craniosynostosis, And Osteochondromas, Dara Tolchin, Jessica P. Yeager, Abdul Haseeb, Marco Angelozzi, Véronique Lefebvre, Cédric Le Caignec

Research Day

Introduction: The SOX gene family consists of twenty transcription factors that play a pivotal role in cell fate and differentiation during the development of many organ systems. Within these SRY-related (SOX) genes is a highly conserved high mobility group (HMG) domain that has been shown to be critical for DNA binding and bending, nuclear trafficking, and protein-protein interactions. Mutations within this transcription factor family have been associated with rare congenital disorders, known as SOXopathies. These mutations are commonly de novo, heterozygous and inactivating, and exhibit gene haploinsufficiency. Of these twenty transcription factors, SOX6 is known to be involved in chondrocyte …

Adapting To Challenges Presented In Training New Students In Laboratory Techniques During Covid-19, E-Jine Tsai, Rushil Brahmbhatt, Jessica Kim, Troy Hillanbrand, Grzegorz Gorski, Arturo Bravo Nuevo

Research Day

Introduction: In early 2020, COVID-19 entered the United States, and by the end of March 2020, the city had mandated schools shut down to slow the spread and flatten the curve. Beginning in the fall, PCOM started slowly opening up research labs again to students with restrictions in capacity and returning onto campus. The new standards affected the normal timeline of introducing new students into the lab. The Bravo research laboratory takes an average of 20 students in each year, with a limited number of students allowed to be trained at the time, the lab management personnel had to adapt …

Predictors Of Hospice Discharge Following Surgical Fixation Of Hip Fracture, Efstratios A. Papadelis, Kevin L. Mekkawy, Yash P. Chaudhry, Sandesh S. Rao, Kawsu Barry, Varun Puvanesarajah, Raj M. Amin, Aoife Macmagon, Harpal S. Khanuja

Research Day

Introduction: Each year, over 300,000 people over the age of 65 are hospitalized for hip fractures, and even with co-management of patients perioperatively with a geriatric team, hip fractures in the elderly are associated with significant morbidity and mortality. Given the extreme morbidity and mortality faced by elderly patients in the post-injury period, recommendations have been put forth for the integration of palliative and even hospice care, to help improve patients’ quality of life. Our objectives were to 1) determine the proportion of patients discharged to hospice following hip fracture surgery and their 30-day mortality rates of these patients, and …

Exploring The Relationship Between Mild, Repetitive Traumatic Brain Injury And Post-Traumatic Epilepsy: A Review, Alayna Nelson, Denah Appelt

Research Day

Objective: The objective of this review is to explore the relationship between traumatic brain injury and the development of post-traumatic epilepsy.

Background: According to the Centers for Disease Control and Prevention, traumatic brain injury (TBI) is considered a major public health problem in the United States. Each year, 2.53 million Americans, including 812,000 children, document a TBI-related emergency room visit. TBI is a disruption in the brain’s normal function, caused by a bump or blow to the head or by penetrating head injury. These injuries range in severity and can cause damage to one area of the brain, as in …

Addressing Mental Health In The Medical School Setting Using A Peer Forum, Erica Stagliano, Christina Bascara, Bliss Rogers, Ruth Conboy, Denah Appelt

Research Day

Background: Medical students have a particularly higher incidence of depression, anxiety, and suicidal ideation compared to the general population. Consequently, there is a need to address students’ mental health as a component of professional development. At a medical school in the northeastern United States, we utilize a student-led, medical student-only forum that focuses on mental health topics and experiences. The intent is to educate and advocate for mental health acceptance and treatment through open discussion among peers. It is anticipated that this forum results in professional help-seeking behaviors and continued mental health discussions both inside and outside of the school …

Pediatric Bladder Teratoma Case Report, Michael Caro, Médina Ndoye, Lissoune Cissé, Shana Santarelli, Clayton Bunting, Mohamed Jalloh, Mouhamadou Mbodji, Serigne Gueye

Research Day

Background: Limited cases of bladder teratomas in the pediatric population have been published. Often, these tumors will present as hematuria, which is regarded as benign. Because of this presentation, pediatric patients often are not diagnosed until years after their initial presentation. We present a 4 year-old female patient who presented initially at 6 months with progressive hematuria that ultimately ended up being diagnosed with a bladder teratoma. In conclusion, bladder teratomas should be included in the initial work-up when presenting with hematuria.

Introduction: Bladder tumors are uncommon in children with an incidence of 0.1%-0.4% during the first two decades of …

Ensuring Internet Access During A Pandemic: Piloting A Wifi Hotspot Lending Program, Pj Grier, Barbara Wood, Erica Rosalle, Jackie Werner, Matt Mcnelis

Research Day

With the onset of the COVID-19 pandemic in March 2020 many students experienced sudden lifestyle adjustments. These adjustments included not having reliable access to an internet source to complete their coursework. In an effort to soften the pandemic’s blow the library secured a grant to purchase, manage, and circulate mobile wifi hotspots to students in need. For the pilot eleven hotspots were purchased for one campus, and due to the success of the pilot now all three campuses of PCOM are loaning out a total of twenty-eight hotspots.

Blood Transfusions In Revision Surgery For Prosthetic Hip And Knee Infection, Yash Chaudhry, Kevin Mekkawy, Syed A. Hasan, Sandesh S. Rao, Raj Amin, Julius K. Oni, Robert S. Sterling, Harpal S. Khanuja

Research Day

Background: Surgery for prosthetic joint infection (PJI) can often have significant blood loss necessitating allogeneic blood transfusion (ABT). ABT is associated with higher rates of morbidity and death in revision TJA, particularly in the treatment of PJI. It is important to understand how the rates of ABT differ among the various surgical treatments of PJI. We compared ABT rates by procedure type among patients treated for PJI a multimodal blood conservation protocol.

Methods: We retrospectively reviewed 143 operative cases of revision arthroplasty for hip and knee PJI involving 102 patients at a single institution between 2016 and 2018. Procedures were …

Preoperative International Normalized Ratio Thresholds In Hip Fracture: An Analysis Of The National Surgical Quality Improvement Program, Yash Chaudhry, Kevin Mekkawy, John Mawn, Aoife Macmahon, Julius K. Oni, Robert S. Sterling, Rachel B. Sotsky, Harpal S. Khanuja

Research Day

Background: Hip fractures are one of the most common orthopaedic injuries among the elderly, and as life expectancy continues to rise, the incidence of hip fractures has increased. The international normalized ratio (INR) is routinely obtained preoperatively to assess a patient’s readiness for surgery to evaluate bleeding risk. We aimed to 1) assess the relationship between preoperative INR in hip fracture patients and postoperative complication rates and 2) establish an INR threshold under which patients would be safe to proceed to surgery without INR correction.

Methods: We retrospectively reviewed cases of hip fracture surgical stabilization in the American College of …

A Review Of Applicable Materials For 3d Printing A Biomechanically Accurate Cervical Spine Model For Surgical Education & Case Preparation, Nathaniel Neavling, Mashaal Syed, Adedayo Adetunji, Brandon L. Mariotti, Slah Khan, Jennifer J. Mao, Jeffrey Mullin

Research Day

Objectives: The authors review the literature to compare biomechanical properties of the human cervical spine as determined by cadaveric and finite elemental model (FEM) studies, with commercially available three-dimensional (3D) printing materials to aid in the development of 3D-printed cervical spines that can be used as biomechanically accurate educational tools. Specifically, 3D printing materials for fused deposition modeling (FDM) printers were explored.

Methods: A literature review of biomechanical specifications such as Young’s Modulus and Poisson’s ratio of certain anatomical aspects of the cervical spine was performed by searching the databases PubMed, MEDLINE via Ovid, Wolters Kluwer, ClinicalKey, and EMBASE via …

Comparison Of Estimated Glomerular Filtration Rate Using Five Equations To Predict Acute Kidney Injury Following Hip Fracture Surgery, Efstratios A. Papadelis, Kevin L. Mekkawy, Yash P. Chaudhry, Micheal Raad, Raj M. Amin, Harpal S. Khanuja

Research Day

Introduction: Hip fractures are a common injury and a source of disability and mortality in the aging population. Acute kidney injury (AKI) is a common and potentially serious complication following hip fracture surgery. Estimated glomerular filtration rate (eGFR) is used as an indicator of renal function. Several equations are commonly used to calculate eGFR. The purpose of this study was 1) to evaluate the agreement between five equations in calculating eGFR, and 2) to confirm which equation can best predict AKI in patients undergoing hip fracture surgery.

Methods: 146,702 cases of surgical stabilization of hip fracture were queried from the …

Stroke Centers Of Excellence In The United States: Certification, Access And Outcomes, Evan Kolesnick, Joshua Weinberg, Shyam Majmundar, Ahmad Sweid, Jane Khalife, Satish Gaddam, Zubin Hussain, Robin D'Ambrosio, Maureen Deprince, Pascal Jabbour, Stavropoula Tjoumakaris, M. Reid Gooch, Robert Rosenwasser, Nabeel Herial

Research Day

Introduction: Stroke is a leading cause of morbidity, mortality and healthcare costs in the United States. Evidence suggests that certified stroke centers have improved patient outcomes relative to non-certified hospitals. Our study explains the process, associated cost, quality and geographic proclivities of different certifying organizations.

Methods: Data was collected from published literature, information on certifying organizations’ websites and through direct communication with representatives of The Joint Commission (TJC), Det Norske Veritas and Germanischer Lloyd (DNV-GL), and Healthcare Facilities Accreditation Program (HFAP). Geographic mapping of thrombectomy capable centers and comprehensive stroke centers was performed with the ArcGIS online tool.

Results: Among …

Inhibiting Ror1 Expression In Androgen-Independent Prostate Cancer Reduces Aggressive Cancer Phenotypes By Modulation Of Akt-Gsk3Ꞵ Pathway, Vignesh Sivaganesh, Nazifa Promi, Salma Maher, Bela Peethambaran

Research Day

Prostate cancer is a disease that has a high prevalence and mortality amongst men. The severity of the cancer is stratified by risk, which is based on the Gleason grade, prostate-specific antigen (PSA) level, and clinical staging. Unlike breast cancer which can be classified into subtypes based on molecular heterogeneity, prostate cancer has no such classification and is treated with observation, prostatectomy, or radiation if local, and non-specific chemotherapy and androgen deprivation therapy (ADT) if metastatic. It is of the utmost importance to investigate molecular targets that can specifically eradicate prostate cancer while retaining the functions of normal tissue. Receptor …

30-90 Day Benefit Of Using Interreality Care To Reduce Unnecessary Hospital Admissions Among High-Risk Patients, Kaelin Demuth, Julio Llanga, Will Brewster, Michael Shen, Marla Golden

Research Day

Background: Reducing unnecessary hospital admission/ER visits on HMO/MSO/ACO patients is very challenging beyond traditional 30-90 day readmission threshold. Our study focused on expanding an Interreality (On-Site & On-Line) Care (IC) model (EHJ 2018;39:S225) in high-risk patients in an HMO setting.

Methods: IC model was created by integrating: 1. On-Site Care: ARNP & testing at patients’ residency; 2. On-Line Care: 24/7 monitoring & specialty cardiology/pulmonary intervention; and 3. A new high-risk care system with telemedicine, device, monitoring, protocols & management. A group of 57 Medicare Advantage patients with multiple admission/ER visits from 3 different healthcare organizations were referred to a MSO …

Resveratrol's Effect On The Androgen Receptor Pathway As A Target For Decreasing Growth And Invasion Of Melanoma And Methods Of Application, Anthony Concilla, Tala Mourabet, Natalie Silk, Kyla Geary, Dianzheng Zhang

Research Day

Introduction: Melanoma is predicted to be the fifth most common cause of cancer mortality in the U.S. in 2021. Although melanoma affects both sexes, current literature shows it is more prevalent and more deadly in men. Several potential reasons for this difference have been proposed, but most literature describes a gap in male knowledge concerning skin cancer and unwillingness to go to the dermatologist as an explanation. That said, the androgen receptor has been proven to play a role in melanoma growth and metastasis, and may play a part in the difference in incidence and mortality rates between sexes. Resveratrol, …