Medicine and Health Sciences Commons^™

Decreased Antibiotic Use In Well-Appearing Infants Exposed To Maternal Chorioamnionitis, Lauren E. Cummings

Research Days

No abstract provided.

Neuroblastoma In Adolescents And Children Older Than 10 Years: Unusual Clinicopathologic And Biologic Features, Laura Mccarthy

Research Days

No abstract provided.

Mismanagement Of A Cervical Spine Fracture By Multiple Healthcare Providers In A High School Football Player, Alvin Chi

Research Days

No abstract provided.

Improving Handoffs By Incorporating A Standardized Ipass Section Into The Written Handoff Document, Susamita Kesh, Kristin Streiler

Research Days

No abstract provided.

Challenges Of Encountering Infant Delirium On Ecmo, Karishma Rao

Research Days

No abstract provided.

When Parents Take Conflicts To Digital Media, Bryanna Moore

Research Days

No abstract provided.

Gonadotropin Releasing Hormone (Gnrh) Agonist Improves Hyperandrogenism In Adolescent With Novel Insulin Receptor Gene Mutation, Emily Paprocki

Research Days

No abstract provided.

Implementation Of Hpv Vaccination For Child And Adolescent Victims Of Non-Acute Sexual Assault/Abuse, Sara Kilbride

Research Days

No abstract provided.

A Review Of First Year Fellow Endoscopic Skills And Time To Proficiency, Dalya El Tawil, Antoinette Adjowa O. Walker

Research Days

No abstract provided.

The Management Of Perioperative Immunosuppressant Medications For Rheumatoid Arthritis During Elective Hand Surgery, Kevin M. Klifto, Brian H. Cho, Scott D. Lifchez

Research Day

Purpose: Rheumatoid arthritis (RA) is a destructive inflammatory disease that commonly involves joints of the hand and wrist. Different recommendations exist for continuing or discontinuing immunosuppressant medications during the perioperative time period. The purpose of our study was to determine if continuing steroids, non-biologic DMARDs, and/or biologic DMARDs were associated with an increased risk of postoperative complications.

Methods: We performed a single-centered, retrospective review of a consecutive cohort of RA patients who had elective hand surgery by a single surgeon. Patients were included if they had a documented diagnosis of seropositive RA by a rheumatologist, and had elective …

Alcohol Use Effects On Burn Related Reconstruction Patient Outcomes And Complications Following Hospital Admission: Systematic Review And Meta-Analysis, Kevin Klifto, Pragna Shetty, Ben Slavin, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Patients suffering from burn-related injuries admitted to the hospital concurrently consuming alcohol are believed to be at an increased risk of poor outcomes and the development of complications following burn reconstruction, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications from studies during the years 1958 to 2018 between 813 burn patients admitted to the hospital with alcohol use reported by a positive blood alcohol concentration (BAC), intoxication, or the patient on admission to 299543 burn patients admitted who were not consuming alcohol. The PubMed, EMBASE, Cochrane Library, and Web of …

Effects Of Pay For Performance On Performance Outcomes In Pennsylvania’S Medicaid Managed Care Program, Harry Zobel, David Kelley, Michele Robinson, Pauline Sanders, Jennifer Ibrahim

Research Day

Background and Purpose: A goal in healthcare is to reduce costs while improving quality of care, and population health. Pay for Performance (P4P) is one intervention being utilized by Medicaid programs to achieve this goal. While P4P has become a favorite among policymakers, its effectiveness in improving health outcomes is still under investigation. We assessed the role of P4P to improve provider performance by evaluating Pennsylvania’s Medicaid Managed Care (MMC) Program.

Methods: We conducted a retrospective longitudinal analysis of providers within the HealthChoices MMC Program in Pennsylvania. We examined annual provider performance outcomes for seven providers across six …

Illicit Substance Use Effects On Burn Related Reconstruction Patient Outcomes And Complications Following Hospital Admission: Systematic Review And Meta-Analysis, Kevin Klifto, Pragna N. Shetty, Benjamin R. Slavin, Caresse F. Gurno, Stella M. Seal, Mohammed Asif, Scott Hultman

Research Day

Patients suffering from burn-related injuries admitted to the hospital concurrent illicit substance use are believed to be at an increased risk of poor outcomes and the development of complications following burn reconstruction, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications from studies during the years 1986 to 2017 between 15653 burn patients admitted to the hospital with substance use alcohol use reported by a positive toxicology screen (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, codeine/morphine, PCP, LSD, inhalants, solvents, aerosols, legal highs), or the patient on hospital admission to 299543 burn …

Using Emr To Implement And Track Compliance Of A Unique Colon Bundle That Reduced Surgical Site Infection In Colorectal Surgery: A Single Institution Review, Leigh Gerson, Jessica Barton, Christina Monaco, Lisa Baro

Research Day

Background: Surgical site infections (SSI) remain a common complication of colorectal surgery and are associated with an increase in cost, hospital LOS and an increased risk of postoperative morbidity and mortality. It is well studied that surgical care bundles reduce infection, there is no established consensus on the optimal amalgamation of variables. Increasing the number of measures within the bundle is associated with a stepwise reduction in SSI. This review presents the efficacy and implementation of a detailed surgical bundle to reduce SSIs in patients undergoing colorectal surgery. We illustrate how the use of EMR aids in implementation and …

Characterization Of Ppar-Gamma 1 And Ppar-Gamma 2 In Knockin And Knockout Mouse Models, Arielle N. Roberts, Wenxiang Hu, Mitchell A. Lazar

Research Day

The global epidemic of obesity and type II diabetes has led to a growing interest in the underlying mechanisms of metabolic diseases. The peroxisome proliferator-activated receptor gamma (PPARγ) is a member of the nuclear receptor superfamily, and is vital for the transcriptional regulation of adipogenesis, insulin sensitivity and lipid metabolism. In the mouse model, it has been demonstrated that global knockout of PPARγ leads to severe metabolic disturbance, resulting in embryonic lethality. However, the specific regulatory roles of its two protein isoforms, PPARγ1 and PPARγ2, remain uncertain, due to limitations of reagents and appropriate mouse models. To investigate the hypothesis …

Understanding The Comorbidity Of Asthma And Anxiety In Childhood: Characteristics, Vulnerabilities, And Treatment Implications, Nicole Fleischer, Elizabeth Gosch, Phil Kendall

Research Day

Introduction: Given the high incidence of asthma and anxiety comorbidity, clinicians should be informed of the unique presentation of these clients in clinical practice. Although much is known about the development and characteristics of childhood anxiety, less is known about children with anxiety and comorbid asthma.

Methods: This study, using archival data, examined the potential differences in children with comorbid asthma and anxiety compared to children with anxiety from a random controlled trial. These two groups were compared on negative self-talk, number of physical symptoms, parent anxiety, content of their worries, and presence of panic, generalized anxiety, and …

Sleep, Communicative Ability, And Dietary Intervention As Predictors Of Aggression In Children With Autism Spectrum Disorder, Rafat Omar, Elizabeth Gosch, Susan Panichelli Mindel, Johnathan Roberds

Research Day

Aggression is a common behavioral issue in children with Autism Spectrum Disorder (ASD). Aggression is often treated with evidence-based behavioral treatments such as applied behavioral analysis and functional communication training. One form of intervention that has grown in popularity is to alter the child’s diet. The most popular dietary intervention, the Autism Diet, has been utilized as a form of behavior management by parents and guardians for children diagnosed with ASD to address aggressive behavior, however its use has not been strongly supported by research. We propose that a more beneficial way of understanding aggression in ASD is to understand …

The Efficacy Of Applied Behavior Analysis On The Quality Of Critical Life Skills In Autistic Youth, Olukayode A. Akinsola Jr, Denah Appelt

Research Day

Autism spectrum disorder (ASD) is a developmental disorder characterized by difficulties in social interaction, social communication, restricted and repetitive patterns of behavior, and interest or activities. As of 2013, ASD is no longer an individual entity but rather an umbrella term encompassing other distinctive developmental disorders. Signs and symptoms of ASD can appear anywhere from birth to three years of life. Various behavioral modalities exist for the treatment of ASD, which is considered to be the gold standard of care. One of the newest behavioral modalities is applied behavior analysis (ABA) therapy. The general purpose of ABA therapy is the …

Nicotine And Smoking Effects On Burn Related Reconstruction Patient Outcomes And Complications Following Hospital Admission: Systematic Review And Meta-Analysis, Kevin Klifto, Pragna Shetty, Ben Slavin, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Patients suffering from burn-related injuries admitted to the hospital concurrently using nicotine and/or smoke are believed to be at an increased risk of poor outcomes and the development of complications following burn reconstruction, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications from studies during the years 1986 to 2018 between 8568 burn patients admitted to the hospital who use nicotine and/or smoke to 299543 burn patients admitted who do not use nicotine and/or smoke. The PubMed, EMBASE, Cochrane Library, and Web of Science databases were systematically and independently searched. Clinical …

Analysis Of The Gut-Brain Axis In Aging: Implications In Alzheimer Disease, Molly Martin, Mary Austin, Denah Appelt

Research Day

The gut microbiome is comprised of the shared genome of the trillions of microorganisms residing in the gastrointestinal ecosystem. The interaction between the host and its gut microbiome, the Gut-Bran Axis (GBA), is a complex relationship whose management could prove critical to preventing or treating not only various gut disorders, like irritable bowel syndrome (IBS) or behavioral health disorders such as general depression and anxiety, but also central nervous system (CNS) disorders, such as Alzheimer's (AD) and Parkinson's (PD) diseases. The purpose of this review is to summarize what is currently known about the gut microbiome, how it is connected …

Restoration Of Penile Sensation After Dorsal Nerve Trauma In Cismen, Kevin M. Klifto, A. Lee Dellon

Research Day

Purpose: Loss of penis sensation or development of a painful penis can occur after injury to the dorsal branch of the pudendal nerve. Attempted relief of this problem through neurolysis of the dorsal nerve in the inferior pubic ramus canal has been reported rarely. While recovery of genital sensibility has been discussed frequently in transmen, this subject has been reported rarely in cismen. The purpose of this report is to review our experience with recovery of sensation after decompression of the dorsal branch of the pudendal nerve.

Methods: A retrospective chart review was carried out from 2014 to …

Persistent Genital Arousal Disorder (Pgad): Treatment By Neurolysis Of Dorsal Branch Of Pudendal Nerve, Kevin M. Klifto, A Lee Dellon

Research Day

Introduction: Persistent genital arousal disorder (PGAD) is the female perception that they are in a state of sexual arousal, without the ability of the arousal to be satisfied by orgasm.

Aims: It is the hypothesis of this study that PGAD results from a minimal degree of nerve compression of the dorsal branch of the pudendal nerve. If this hypothesis were true, then PGAD could be treated by neurolysis of the dorsal branch of the pudendal nerve.

Methods: A retrospective chart review was carried out from 2010 through 2018, of those women having neurolysis of the dorsal branch of the pudendal …

A Feather In Our Research Cap: Implementing Redcap In The Library, Jackie Werner, Meghan Dirito, Pj Grier, Skye Bickett

Research Day

The PCOM Library works to facilitate and support research across all disciplines. One method in which the Library incorporates this concept is by implementing, promoting, and teaching REDCap, a tool for data capture and for building and managing online surveys and databases. This poster presents the PCOM Library’s experiences with all steps of planning and implementing REDCap, along with lessons learned and future steps.

The Barriers That Deter The Geriatric Population From Receiving Healthcare, Jacquelyn Smith, Anne Egan, Denah Appelt

Research Day

In the United States, the geriatric population is considered to include individuals that are 65 years or older. In 2016, there was an estimated 49.2 million elderly Americans (Roberts, Ogunwole, Blakeslee, & Rabe 2018). Since the advances of modern medicine are prospering, this number is expected to increase drastically.

Furthermore, the geriatric population is projected to double, from 2010 to 2030, to 20% or 72 million Americans (Horton and Johnson 2010). Looking further into the future, the American geriatric population is expected to be 83.7 million in 2050 (Ortman, Velkoff, & Hogan 2014). In a 2016 Center for Disease Control …

Community Paramedicine To Proactively Combat Opioid Overdoses, Jeffrey Kalczynski, Justin Canakis, Novneet Sahu

Research Day

The growing problem of opioid overdoses has traditionally been combated with a reactive approach. In New Castle County, DE, a Community Paramedicine program has been implemented to make an attempt at stopping overdoses before they happen. Community Paramedicine is a mobile integrated health program that trains paramedics to visit and treat high risk patients at their homes on a non emergent basis. The aim is to prevent acute exacerbation of chronic disease. In other jurisdictions, this model has been used in an effort to reduce abuse of the 911 system and Emergency Department by "high utilizers" of the 911 system. …

Renal Epithelioid Angiomyolipoma: Genomic Characterization And Malignant Potential, Alan Wang, Kyle A. Blum, Jonathan Coleman, Paul Russo, A. Ari Hakimi

Research Day

Introduction:

Renal angiomyolipoma (AML) is one of the most common benign kidney tumors diagnosed. Epithelioid angiomyolipoma (eAML) is a rare variant of these kind of masses that have been classified by the World Health Organization as a potentially malignant mesenchymal neoplasm that metastasizes in one-third of cases. However, conflicting reports have brought in to question the true malignant potential of eAML. Due to eAMLs overall rarity, few studies have characterized this entity. In this study, we further define eAML by describing its genomic alterations and malignant potential by comparing it to a cohort of AML patients at a large-volume cancer …

Acute Surgical Vs. Non-Surgical Management For Ocular And Peri-Ocular Burns: Oculoplastic Systematic Review And Meta-Analysis, Kevin Klifto, Ala Elhelali, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Burn related injury to the face involving the structures of the eyes, eyelids, eyelashes, and/or eyebrows could result in multiple reconstructive procedures to improve functional and cosmetic outcomes, and correct complications following poor acute phase management. This systematic review and meta-analysis compared 272 surgical to 535 non-surgical interventions within one month of patients suffering burn-related injuries to 465 eyes, 253 eyelids, 90 eyelashes, and 0 eyebrows and evaluated associated outcomes and complications. The PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases were systematically and independently searched. Patient and clinical characteristics, surgical and medical interventions, outcomes and complications were …

The Effects Of Protein Kinase C Beta Ii Peptide Modulation On Superoxide Release In Rat Polymorphonuclear Leukocytes, Christina Lipscombe, Chinyere Ebo, Daphne Metellus, Jennifer Dang, Annam Humayun, Arjun Nair, Harsh Patel, Megan Michaels, Matthew Finnegan, Lucy Checchio, Faosat Muftau-Lediju, Faosat Martorana, Qian Chen, Robert J. Barsotti, Lindon H. Young

Research Day

Phorbol 12-myristate 13-acetate (PMA; a diacylglycerol mimetic) is known to augment polymorphonuclear leukocyte (PMN) superoxide (SO) release via protein kinase C (PKC) activation. However, the role of PKC beta II (βII) mediating this response is not known. It’s known that myristic acid (myr-) conjugation facilitates intracellular delivery of the cargo sequence, and that putative PKCβII activator and inhibitor peptides work by augmenting or attenuating PKCβII translocation to cell membrane substrates (e.g. NOX-2). Therefore, we hypothesize that myr- conjugated PKCβII peptide-activator (N-myr-SVEIWD; myr-PKCβ+) would increase PMA-induced rat PMN SO release, whereas, myr-PKCβII peptide-inhibitor (N-myr-SLNPEWNET; myr-PKCβ-) would attenuate this response compared to …

A Case Report: The Myxomatous Mystery, Joseph Kim, Nicole P. Pantle, Jacquelyn E. Fisher

Research Day

Introduction: Primary cardiac tumors are rare with an incidence rate of 1.38 new cases per 100,000 individuals per year. Of these tumors, 75% are benign in origin and the most common type is a myxoma with a frequency of over 50%. Myxomas most commonly arise from the left atrium followed by the right atrium. Clinical presentation of a myxoma varies depending on the location, size, and shape of the tumor. For example, a patient diagnosed with a myxoma may have constitutional symptoms, cardiovascular symptoms, pulmonary symptoms etc. or may be entirely asymptomatic. Since there is no specific symptoms presented …

The Effects Of Metformin, Aminoguanidine, And Pyridoxamine On Methylglyoxal Induced Cardiac Myocyte Injury, Amanda Harvey, Rose Martorana, Julia Colangeli, Hafsa Ahmed, Dean Delgado, Alisa Kim, Robinderpaul Sandhu, Robert J. Barsotti, Lindon H. Young, Qian Chen

Research Day

Advanced glycation end (AGE) products have been under investigation for their role in cardiovascular disease in complications. Methylglyoxal, a byproduct of glucose metabolism, is elevated in the blood of diabetic patients and has shown to be an important intermediate in the production of AGEs. Due to the highly reactive structure of methylglyoxal, it can produce high levels of reactive oxygen species (ROS) within the cell via mitochondrial modification which results in a loss of cell membrane potential and possible cell death. The role of methylglyoxal in cardiac cells is not well known; in this study methylglyoxal induced cell injury and …