Medicine and Health Sciences Commons^™

Calibration And Optimization Of 3d Digital Breast Tomosynthesis Guided Near Infrared Spectral Tomography, Kelly E. Michaelsen, Venkataramanan Krishnaswamy, Linxi Shi, Srinivasan Vedantham, Steven Poplack, Andrew Karellas, Brian Pogue, Keith Paulsen

Dartmouth Scholarship

Calibration of a three-dimensional multimodal digital breast tomosynthesis (DBT) x-ray and non-fiber based near infrared spectral tomography (NIRST) system is challenging but essential for clinical studies. Phantom imaging results yielded linear contrast recovery of total hemoglobin (HbT) concentration for cylindrical inclusions of 15 mm, 10 mm and 7 mm with a 3.5% decrease in the HbT estimate for each 1 cm increase in inclusion depth. A clinical exam of a patient's breast containing both benign and malignant lesions was successfully imaged, with greater HbT was found in the malignancy relative to the benign abnormality and fibroglandular regions (11 μM vs. …

Yeast Vacuolar Hops, Regulated By Its Kinase, Exploits Affinities For Acidic Lipids And Rab:Gtp For Membrane Binding And To Catalyze Tethering And Fusion, Amy Orr, William Wickner, Scott F. Rusin, Arminja N. Kettenbach, Michael Zick

Dartmouth Scholarship

Fusion of yeast vacuoles requires the Rab GTPase Ypt7p, four SNAREs (soluble N-ethylmaleimide–sensitive factor attachment protein receptors), the SNARE disassembly chaperones Sec17p/Sec18p, vacuolar lipids, and the Rab-effector complex HOPS (homotypic fusion and vacuole protein sorting). Two HOPS subunits have direct affinity for Ypt7p. Although vacuolar fusion has been reconstituted with purified components, the functional relationships between individual lipids and Ypt7p:GTP have remained unclear. We now report that acidic lipids function with Ypt7p as coreceptors for HOPS, supporting membrane tethering and fusion. After phosphorylation by the vacuolar kinase Yck3p, phospho-HOPS needs both Ypt7p:GTP and acidic lipids to support fusion.

Regulated Internalization Of Nmda Receptors Drives Pkd1-Mediated Suppression Of The Activity Of Residual Cell-Surface Nmda Receptors, Xiaoqian Fang, Haifa Qiao, Bradley R. Groveman, Shuang Feng, Melissa Pflueger, Wen-Kuan Xin, Mohammad K. Ali, Shuang-Xiu Lin, Jindong Xu, Florian Duclot, Mohamed Kabbaj, Wei Wang, Teresa Santiago-Sim

School of Medicine Publications

Background

Constitutive and regulated internalization of cell surface proteins has been extensively investigated. The regulated internalization has been characterized as a principal mechanism for removing cell-surface receptors from the plasma membrane, and signaling to downstream targets of receptors. However, so far it is still not known whether the functional properties of remaining (non-internalized) receptor/channels may be regulated by internalization of the same class of receptor/channels. The N-methyl-D-aspartate receptor (NMDAR) is a principal subtype of glutamate-gated ion channel and plays key roles in neuronal plasticity and memory functions. NMDARs are well-known to undergo two types of regulated internalization – homologous and …

The Use Of Manual Therapy And Strengthening Exercises To Improve Plantarflexion Strength And Mobility Following Achilles Tendon Repair: A Case Report, Jason Glikman

Case Report Posters

An Achilles tendon rupture is classified as ‘chronic’ or ‘neglected’ if it has been untreated for four or more weeks. PT management for all Achilles ruptures is to gain Plantarflexion (PF) strength, ankle ROM, and decrease scar tissue. Neglected ruptures increase scar tissue formation, causing delay in regaining functional strength and mobility. Decreased strength and mobility can lead to gait impairments, activity limitations, and participation restrictions. Literature is limited on best therapy for neglected Achilles tendon ruptures. The purpose of this case report was to add to the literature pertaining to neglected Achilles tendon ruptures and to report upon the …

Multimodal Physical Therapy Management Of A Patient With Unilateral Neglect Post-Stroke In An Outpatient Setting: A Case Report, Meghan Riley

Case Report Posters

A common behavioral syndrome of stroke is unilateral neglect (ULN) which is defined as the failure to report, respond, or orient to stimuli presented contralateral to the brain lesion. ULN has a negative influence on functional recovery and is associated with a poor functional outcome following a stroke, therefore several rehabilitative approaches have been proposed and implemented to decrease neglect and improve patient recovery. There are currently limitations within the research regarding the efficacy of PT interventions to decrease ULN symptoms. In addition, the optimal PT interventions and treatment strategies is unclear. The purpose of this case report is to …

Hip Muscle Strengthening And Balance For A Patient With Bipolar Disorder Following Hip Fracture: A Case Report, Allison Kaplan

Case Report Posters

Hip fractures result in more than 258,000 hospital admissions annually for those aged 65 and older. Mortality rate following hip fracture is 10-20%. Among survivors, half will have longstanding disability, only 1/3 will return home, and 19-27% will remain in long term care. Six percent will experience a second fracture within four years. Cost for treatment for hip fractures in the US: $10.3-15.2 billion/year. Over 95% of hip fractures occur as a result of a fall. Direct medical costs for falls in 2013 reached $34 billion. Average hospital cost for a fall injury is $35,000. Neuropsychiatric symptoms negatively affect functional …

Agility Outcome Measures And Gait Analysis In The Physical Therapy Rehabilitation Of An Adolescent With An Acetabular Hip Fracture: A Case Report, Emily Lodge, Kirsten Buchanan

Case Report Posters

Pediatric hip fractures are uncommon. 85 to 90 percent of pediatric hip fracture are a result of high-energy trauma. There is a paucity of literature describing best rehabilitation practices. Agility outcome measures, as well as observational and video gait analysis have not been fully investigated in the rehabilitation of pediatric hip fractures. The purpose of this case report was to investigate the use of agility outcome measures, as well as observational and video gait analysis in the rehabilitation of a fourteen year-old male motocross athlete with a hip fracture.

Treatment Of A Patient With Thoracolumbar Scoliosis Utilizing A Regional Interdependence Approach Including Components Of The Schroth Method: A Case Report, Samantha Fisk

Case Report Posters

Spinal deformity is a challenging spinal disorder in adults. A scoliotic curve of >10 degrees exists in up to 12% of the population. There is little evidence regarding indications for physical therapy treatment in elderly individuals with adult scoliosis. Current study results favor surgical intervention, but not all elderly individuals are surgical candidates. While surgery is the definitive measure, there is limited evidence to guide non-surgical treatment. This case investigated components of the Schroth method, as an adjunct to traditional physical therapy (PT) treatment. A Regional Interdependence approach (RIA) was utilized for a patient with scoliosis referred to PT for …

Management Of A Patient Lumbar Spinal Stenosis And Carotid Aneurysm Using Therapeutic Exercise, Education, And Manual Therapy: A Case Report, Nicholas Adriance

Case Report Posters

Lumbar Spinal Stenosis (LSS) is a clinical syndrome of buttock or lower extremity pain, which may occur with or without back pain, associated with diminished space available for the neural and vascular elements in the lumbar spine. Comorbidities frequently complicate the exercise selection of patients in physical therapy. One such comorbidity is a carotid artery aneurysm. A carotid Aneurysm is a bulging or ballooning in the wall of the internal or external carotid artery. Patients who undergo surgical management for carotid artery aneurysm are placed on exercise restrictions based on the size and location of the aneurysm. The purpose of …

Medical School Watercooler Newsletter - November 8, 2015, Lindsey Lyle

Watercooler Newsletter

This is the November 8, 2015 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

USA Stanton Road Clinic Featured in Local News

USA Physicians Group Participates in Benefits Fair

USA Welcomes Amanda Kelly, CRNP

Dr. James W. Fleshman Jr. Presents Frazer/Leigh Memorial Lecture

The Use Of Postural Reeducation And Strengthening Exercises In The Reversal Of Functional Scoliosis: A Case Report, Cory Marcoux

Case Report Posters

Non-structural scoliosis: abnormal spinal curvatures that have sufficient mobility, and can therefore resolve with postural change. There is a multitude of research regarding structural and idiopathic scoliosis, but very minimal literature about non-structural (functional) scoliosis and more importantly, how to treat it. The purpose of this case report was to examine the use of stretching, strengthening, and postural reeducation for a patient who presented with a non-structural scoliosis.

Investigating The Influences Of Language Delay And/Or Familial Risk For Dyslexia On Brain Structure In 5-Year-Olds, Nora Maria Raschle, Bryce Larkin Chessell Becker, Sara Smith, Lynn Valérie Fehlbaum, Yingying Wang, Nadine Gaab

Center for Brain, Biology, and Behavior: Faculty Publications

Early language delay has often been associated with atypical language/literacy development. Neuroimaging studies further indicate functional disruptions during language and print processing in school-age children with a retrospective report of early language delay. Behavioral data of 114 5-year-olds with a retrospective report of early language delay in infancy (N = 34) and those without (N = 80) and with a familial risk for dyslexia and those without are presented. Behaviorally, children with a retrospective report of early language delay exhibited reduced performance in language/reading-related measures. A voxel-based morphometry analysis in a subset (N = 46) demonstrated an association between reduced …

Communication & Interventions For People With Alzheimer’S Dementia, Ann Eckhardt, Amy Yeates, Wendy Kooken, Noël Kerr

Pursuing the Ephemeral, Painting the Enduring: Alzheimer’s and the Artwork of William Utermohlen

A powerpoint for a presentation given at the Illinois Wesleyan University Wakeley Gallery, November 18, 2015 as part of Pursuing the Ephemeral, Painting the Enduring: Alzheimer's and the Artwork of William Utermohlen, Exhibition and Scholarly Reflections.

Osteoporosis In Men, Seunggee Hong

Senior Honors Theses

Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density. Osteoporosis can occur in both genders. Women are more likely to be diagnosed with osteoporosis. Since men have larger bones than women, it is difficult to diagnose osteoporosis. However, presently, the occurrence rate of osteoporosis in men is increasing. It is very important to be aware of an increase of the true frequency of osteoporosis in men which is essential for prevention and long-term health. The purpose of this thesis is to examine pathogenesis of osteoporosis, hormone-related factors, lifestyle, diet, and exercise habits …

Care With Dignity: A Patient-Centered Focus For Treatment Of Vulnerable Populations, Marlee Madora, Molly Klores

CwiC Posters

Summary:

Philadelphia FIGHT is a comprehensive HIV/AIDS service organization providing primary care, consumer education, advocacy, and research on potential treatments and vaccines. FIGHT was formed as a partnership of individuals living with HIV/ AIDS and clinicians, who joined together to improve the lives of people living with the disease. Today, FIGHT serves an even broader patient population and recently received designation as a Federally Qualified Health Center. FIGHT strives to address not only HIV-infected patients, but all at-risk populations through education, outreach, and preventative medicine.

The annual Bridging the Gaps interns are responsible for several projects, including a client satisfaction …

A Review Of The Evidence: Prewarming Adults Prior To General Anesthesia In The Prevention Of Unplanned Perioperative Hypothermia, Paige F. Wrigley

Senior Honors Theses

Unplanned perioperative hypothermia (UPH), a common event in the surgical setting, is associated with many adverse patient outcomes. In current perioperative practice, patient core temperature is monitored and active warming interventions are implemented during the intraoperative and postoperative phases in response to UPH. The literature suggests preoperative warming of patients as a proactive measure may be more effective in the prevention of UPH. In the form of an integrative review, this thesis seeks to address the research question: For adult patients undergoing general anesthesia, how does preoperative warming compared to no preoperative warming affect UPH incidence? A database search yields …

Targeting Autopalmitoylation To Modulate Protein S-Palmitoylation, Laura Dawn Hamel

USF Tampa Graduate Theses and Dissertations

Palmitoylation refers to the covalent attachment of fatty acids, such as palmitate, onto the cysteine residues of proteins. This process may subsequently alter their localization and function. Nearly all of the enzymes that catalyze palmitoylation, zDHHC protein acyl transferases (PATs), are implicated in neurological disorders, infectious diseases, and cancer in humans. Of particular interest to those who study palmitoylation are Ras family GTPas and zDHHC9-GCP16, the zDHHC PAT that palmitoylates Ras proteins. Erf2-Erf4 is the zDHHC PAT that palmitoylates Ras proteins in Saccharomyces cerevisiae. Currently, there are no methods to therapeutically target palmitoylation for the treatment of disease. One …

Open Access Challenge, Amy Dailey, Janelle Wertzberger

Open Access Week at Gettysburg College

This class activity is designed to help health sciences students understand challenges to accessing public health information in a variety of settings. The exercise was created for students in Prof. Dailey’s Global Health class (HS 322) at Gettysburg College in Fall 2015.

The activity, as well as notes for instructors considering using this exercise, are both shared here.

Neuromuscular Electrical Stimulation And Quadriceps Strength Following Patellar Fracture And Open Reduction Internal Fixation Surgery: A Case Report, Chelsea Hussey

Case Report Posters

Patellar fractures account for approximately 1% of all fractures and are most common in people who are 20 to 50 years old. Comminuted patellar fractures occur when the bone shatters into three or more pieces and is usually caused by a direct blow to the knee. Open reduction internal fixation (ORIF) surgery is typically needed if the bone is broken into three or more pieces near the center of the patella. Quadriceps weakness is common following this type of injury and surgery, and the literature reflects varying opinions as to what is the best method for regaining strength. The purpose …

Balance And Gait Training To Reduce Fall Risk In A Patient With Bilateral Foot And Hand Deformities Secondary To Rheumatoid Arthritis: A Case Report, Kirsten Bombardier

Case Report Posters

Each year, one out of three adults over the age of 65 sustains a fall. Although the risk of suffering a fall increases with age, falls are not an unavoidable aspect of the aging process. Fall risk can be heightened in patients with medical comorbidities that impact the physiological senses which help maintain balance. Rheumatoid arthritis (RA) is a chronic inflammatory disorder that affects the lining of the joints and causes painful swelling that can eventually result in bone erosion and joint deformity. The fall incidence rate in individuals with RA is 0.62 falls per person per year as compared …

A Three-Week Intensive Pediatric Physical Therapy Plan Of Care For A Child With Spastic Quadriplegia Cerebral Palsy: A Case Report, Brandie Schmierer, Kirsten Buchanan

Case Report Posters

The benefits of physical therapy (PT) on gross motor function and general strength in children with spastic quadriplegia cerebral palsy (CP) are well documented. There have been no firm conclusions that have determined the optimal duration and intensity of PT interventions for patients with spastic quadriplegia CP. CP occurs as a result of a brain injury associated with birth. Worldwide the prevalence of CP was 1.5 to 3.0 per 1,000 live births in 2009. Previous research demonstrated that PT intervention in children with CP improved gross motor function and strength, decreased the assistance required for mobility, and decreased step length …

Use Of A Task-Oriented Approach In The Physical Therapy Management Of A Patient Following A Posterior Inferior Cerebellar Artery Stroke: A Case Report, Erika Derks

Case Report Posters

3.4% of the 600,000 strokes that occur annually in the United States are cerebellar strokes. Despite the rarity of cerebellar strokes, their impact can cause severe acute neurological morbidity. The posterior inferior cerebellar artery (PICA) supplies the inferior portion of the cerebellum. PICA infarct can lead to deficits in gait and postural stability, coordination, and Cognition and attention. The task-oriented approach has been demonstrated as an effective intervention for patients with cerebrovascular accidents, but limited research has been done on its use in patients with cerebellar stroke. The purpose of this case report was to provide an overview of the …

Functional Mobility Management Of A Patient With Adult-Onset Hereditary Proximal Motor Neuropathy Following A Tibial Fracture: A Case Report, Timothy Lira, Amy J. Litterini

Case Report Posters

This patient was clinically appealing and complex because of the combination of an acute fracture due to an injurious fall and significant past medical history (PMH) of both the rare condition of adult-onset hereditary proximal motor neuropathy (AHPMN) and congestive heart failure (CHF). The chronic co-morbidities created the need for an innovative approach to treatment sequencing to potentially mitigate the risk for excessive fatigue, such as positional grouping of interventions and prescribed rest periods. This unique opportunity to document the physical therapy (PT) management of a patient with the combination of both rare and chronic conditions makes this case a …

Trunk Control And Standing Tolerance Of A Patient With Paraparesis As A Result Of Transverse Myelitis And Mycotic Aneurysm Rupture: A Case Report, Ashley Tomaswick

Case Report Posters

Transverse myelitis is a condition where a segment of the spinal cord becomes inflamed. This results in impairments below the level of the inflammation, including paraparesis or paraplegia, autonomic dysfunction, and/or pain. Cerebral mycotic aneurysms are a form of brain injury where an artery bursts and diminishes blood supply to the brain. The resulting impairments vary depending on the area of the brain affected. The purpose of this case report was to describe the interventions provided to a patient with paraparesis as a result of transverse myelitis and multiple cerebral mycotic aneurysm ruptures to progress toward achieving his goals of …

Clinical Reasoning And Intervention Selection For A Patient With Lower Extremity Weakness Following Acute Alcoholic Polyneuropathy: A Case Report, Sarah Uzel

Case Report Posters

Alcoholic polyneuropathy is a sensorimotor peripheral polyneuropathy. APN usually affects individuals over 40 years old with a history of chronic alcoholism. Most cases occur chronically over several months. Acute cases of APN may develop over the course of weeks. Symptoms of APN include paresthesia and paralysis. There are a variety of suspected mechanisms for etiology for APN. Literature is sparse in relation to physical therapy management and interventions for a patient with acute alcoholic polyneuropathy. The purpose of this case report was to describe the clinical reasoning behind interventions selected for a patient with acute alcoholic polyneuropathy in the acute …

Acute Care Outcome Measures In A Patient Status-Post Right Total Knee Arthroplasty (Tka) Following A Left Tka Staged Five Weeks Apart: A Case Report, Stephanie Sanderson

Case Report Posters

Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures in the U.S. Osteoarthritis (OA) is the most common reason for a total knee arthroplasty. Cartilage and bone is removed from the distal end of the femur and proximal end of the tibia and is replaced with metal alloy components that recreate the joint surface. Some evidence suggests that staging bilateral TKA within three months of each other may increase the patient’s risk for mortality and complications. The purpose of this case report was to document acute care outcome measures in a patient who underwent bilateral TKA …

Use Of Therapeutic Exercise, Functional Endurance And Gait Re-Training In A Deconditioned Patient With Acute Respiratory Failure: A Case Report, Ellen Forslund

Case Report Posters

The human body requires oxygen-rich blood in order to work efficiently. During respiration, air passes from the nose and mouth and into the alveoli of the lungs. When air reaches the alveoli, oxygen passes into the capillaries as carbon dioxide moves out of the capillaries, otherwise known as gas exchange. Respiratory failure may occur when there is a lack of oxygen passing from the lungs into the blood (hypoxemic), or if the lungs cannot remove carbon dioxide from the blood (hypercapnic). Chronic respiratory failure is caused by conditions such as muscular dystrophy, amyotrophic lateral sclerosis (ALS), spinal cord injuries, or …

Vestibular Rehabilitation For A 17-Year Old Female With Post-Concussion Symptoms: A Case Report, Elizabeth Mosley

Case Report Posters

Post-concussion syndrome is defined as a group of symptoms occurring after a traumatic brain injury (TBI) that can last weeks, months, or years. The diagnosis of post-concussion syndrome is not well agreed upon, but does include at least three of the following symptoms: headache, dizziness, fatigue, irritability, insomnia, concentration or memory difficulty, and intolerance of stress or emotion. The Centers for Disease Control and Prevention estimates that 1.7 million Americans experience TBI annually. The purpose of this case report is to describe the physical therapy management using vestibular rehabilitation of an adolescent female with post-concussion symptoms two months post-injury.

Thomas Jefferson University's Reader Survey Captures Ir's Value, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Dan Kipnis, Education Services Librarian at Thomas Jefferson University, has come up with an ingenious way to capture hard-to-find reader feedback on publications in their IR, The Jefferson Digital Commons. Dan explains that the results “will be used in quarterly reports and for demonstrating value to administrators and the entire community at Thomas Jefferson University.”

A Disease-Based Approach To The Vertical And Horizontal Integration Of A Medical Curriculum, Charles A. Gullo Phd, Brian R. Dzwonek, Bobby L. Miller

Biochemistry and Microbiology

As medical disciplines have become increasingly interdisciplinary and evidenced-based medicine is widely practiced, there is a need for curricula that reflect these changes. The newly revised LCME standards 1.1 Strategic Planning and Continuous Quality Improvement and 8.3 Curricular Design, Review, Revision/Content Monitoring require ongoing curricular review to assure accreditation compliancy. We have completed a comprehensive review of our curriculum and have moved from a discipline-based curriculum to that of one that focuses on a systems/disease-based model. The approach allows for a more horizontally integrated curriculum in the preclinical years, while the use of 115 distinct disease and eight themes creates …