Medicine and Health Sciences Commons^™

Management Considerations Of Massive Hemoptysis While On Extracorporeal Membrane Oxygenation., Harrsion T. Pitcher, Meredith A. Harrison, Colette Shaw, Scott W. Cowan, Hitoshi Hirose, Nicholas C. Cavarocchi

Department of Surgery Faculty Papers

BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a life-saving procedure in patients with both respiratory and cardiac failure. Bleeding complications are common since patients must be maintained on anticoagulation. Massive hemoptysis is a rare complication of ECMO; however, it may result in death if not managed thoughtfully and expeditiously.

METHODS: A retrospective chart review was performed of consecutive ECMO patients from 7/2010-8/2014 to identify episodes of massive hemoptysis. The management of and the outcomes in these patients were studied. Massive hemoptysis was defined as an inability to control bleeding (>300 mL/day) from the endotracheal tube with conventional maneuvers, …

Teaching Communication Skills To Medical And Pharmacy Students Through A Blended Learning Course, Rick Hess, Nicholas E. Hagemeier, Reid Blackwelder, Daniel Rose, Nasar Ansari, Tandy Branham

ETSU Faculty Works

Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts.

Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions.

Results. Performance in all communication skill domains increased significantly for all students. …

Range Of Motion And Plantar Foot Pressures In Those With And Without A Lateral Hip Shift During An Overhead Squat, Erin M. Lally

Theses and Dissertations

Context: Asymmetrical loading between lower limbs can theoretically be explained as an inequality of strength, neuromuscular control, or subconscious reliance on one leg more than the other. Asymmetries are often identified utilizing costly equipment such as force plates and 3D motion analysis cameras. It is important to establish less costly ways of identifying movement and loading asymmetries for clinicians to utilize. One qualitative assessment that may identify asymmetries is a ‘lateral hip shift’ during an overhead squat. Objective: To identify differences in lower extremity range of motion (ROM) and plantar foot pressures in individuals with and without a lateral hip …

Optogenetic Interrogation Of Functional Synapse Formation By Corticospinal Tract Axons In The Injured Spinal Cord, Naveen Jayaprakash, Zimei Wang, Brian Hoeynck, Nicholas Krueger, Audra A. Kramer, Eric Balle, Daniel S. Wheeler, Robert A. Wheeler, Murray G. Blackmore

Biomedical Sciences Faculty Research and Publications

To restore function after injury to the CNS, axons must be stimulated to extend into denervated territory and, critically, must form functional synapses with appropriate targets. We showed previously that forced overexpression of the transcription factor Sox11 increases axon growth by corticospinal tract (CST) neurons after spinal injury. However, behavioral outcomes were not improved, raising the question of whether the newly sprouted axons are able to form functional synapses. Here we developed an optogenetic strategy, paired with single-unit extracellular recordings, to assess the ability of Sox11-stimulated CST axons to functionally integrate in the circuitry of the cervical spinal cord. Initial …

Upbeat Huntington’S Disease Film, Featuring Undaunted Family, Aims For 10 Million Views, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

The Rises And Falls Of Serving The Plhiv Population Of South Bangalore, Jessica Christian

The International Undergraduate Journal For Service-Learning, Leadership, and Social Change

No abstract provided.

Where To Draw The Line: The Balance Between Research And Medicine, Brandon Lucke-Wold

The International Undergraduate Journal For Service-Learning, Leadership, and Social Change

No abstract provided.

Myocardial Infarction In Neonatal Mice, A Model Of Cardiac Regeneration, Jessica N. Blom, Xiangru Lu, Paul Arnold, Qingping Feng

Paediatrics Publications

Myocardial infarction induced by coronary artery ligation has been used in many animal models as a tool to study the mechanisms of cardiac repair and regeneration, and to define new targets for therapeutics. For decades, models of complete heart regeneration existed in amphibians and fish, but a mammalian counterpart was not available. The recent discovery of a postnatal window during which mice possess regenerative capabilities has led to the establishment of a mammalian model of cardiac regeneration. A surgical model of mammalian cardiac regeneration in the neonatal mouse is presented herein. Briefly, postnatal day 1 (P1) mice are anesthetized by …

Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria For The Allocation Of Dual Kidneys In Adults, Jill N. D'Souza, Md, Katherine Mckee-Cole, Md, Abigail Strang, Md, Patrick Barth, Md, Aaron Chidekel, Md, Udayan Shah, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract:

Objective The recognition of wound-related complications following pediatric tracheotomy is on the rise. These complications can have a significant impact on clinical course as well as on hospital healthcare costs to the tracheotomy dependent child and family

Methods A tracheotomy database was created in 2000 and reviewed for incidence of major and minor complications.

Setting Tertiary Care Pediatric Referral Center

Results We identified a post-tracheotomy complication rate of 19.9%, of which the most common complication was wound breakdown (65% of complications).

Conclusion Rate of post-tracheotomy wound-care complications is 12.9%. Wound description is subjective and prone to inter-observer variability. A …

Factors Influencing Resection In Locoregional Pancreatic Cancer Patients, Amy Cunningham, Mph, Phd(C), Brian P.H. Chen, Scm, Pharmd, David Delgado, Phd

College of Population Health Posters

Objective:

Identify factors associated with resection in a national sample of locoregional pancreatic cancer patients.

Poster presented at ISPOR conference in Washington DC.

A Simplified Technique For Implant-Abutment Level Impression After Soft Tissue Adaptation Around Provisional Restoration, Ahmad Kutkut, Osama Abu-Hammad, Robert Q. Frazer

Oral Health Practice Faculty Publications

Impression techniques for implant restorations can be implant level or abutment level impressions with open tray or closed tray techniques. Conventional implant-abutment level impression techniques are predictable for maximizing esthetic outcomes. Restoration of the implant traditionally requires the use of the metal or plastic impression copings, analogs, and laboratory components. Simplifying the dental implant restoration by reducing armamentarium through incorporating conventional techniques used daily for crowns and bridges will allow more general dentists to restore implants in their practices. The demonstrated technique is useful when modifications to implant abutments are required to correct the angulation of malpositioned implants. This technique …

Did A Physician-Targeted Intervention That Reduced Potentially Inappropriate Prescribing To Elderly Patients Also Reduce Related Hospitalizations?, Jacquelyn Mcrae, Pharmd, Sarah E. Hegarty, Pharmd, M. Alcusky, A. Vegesna, S. Varga, S. W. Keith, S. Del Canale, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

To determine whether a general practitioner focused intervention aimed at decreasing PIM prescribing in the elderly can decrease the risk of PIM-related hospitalizations.

Poster presented at 2016 ISPOR conference in Washington DC.

Literature Review On Hospital Costs For Patients Undergoing Hysterectomy, Brian P.H. Chen, Scm, Pharmd, Hang Cheng, Martha Romney, Rn, Ms, Jd, Mph, Carine Chia-Wen Hsiao

College of Population Health Posters

Objective:

This study aims to identify the range of direct hospital costs associated with a minimally invasive or abdonimal hysterectomy procedure across different countries.

Poster presented at 2016 ISPOR conference in Washington DC.

Expression And Function Of Pannexins In The Inner Ear And Hearing, Hong-Bo Zhao

Otolaryngology--Head & Neck Surgery Faculty Publications

Pannexin (Panx) is a gene family encoding gap junction proteins in vertebrates. So far, three isoforms (Panx1, 2 and 3) have been identified. All of three Panx isoforms express in the cochlea with distinct expression patterns. Panx1 expresses in the cochlea extensively, including the spiral limbus, the organ of Corti, and the cochlear lateral wall, whereas Panx2 and Panx3 restrict to the basal cells of the stria vascularis in the lateral wall and the cochlear bony structure, respectively. However, there is no pannexin expression in auditory sensory hair cells. Recent studies demonstrated that like connexin gap junction gene, Panx1 deficiency …

Cancer Stem Cell Metabolism., Maria Peiris-Pagès, Ubaldo E. Martinez-Outshoorn, Richard G. Pestell, Federica Sotgia, Michael P Lisanti

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

Cancer is now viewed as a stem cell disease. There is still no consensus on the metabolic characteristics of cancer stem cells, with several studies indicating that they are mainly glycolytic and others pointing instead to mitochondrial metabolism as their principal source of energy. Cancer stem cells also seem to adapt their metabolism to microenvironmental changes by conveniently shifting energy production from one pathway to another, or by acquiring intermediate metabolic phenotypes. Determining the role of cancer stem cell metabolism in carcinogenesis has become a major focus in cancer research, and substantial efforts are conducted towards discovering clinical targets.

The Antenatal Corticosteroids Trial (Act)'S Explanations For Neonatal Mortality - A Secondary Analysis., Fernando Althabe, Vanessa Thorsten, Karen Klein, Elizabeth M. Mcclure, Patricia L. Hibberd, Robert L. Goldenberg, Waldemar A. Carlo, Ana Garces, Archana Patel, Omrana Pasha, Elwyn Chomba, Nancy F. Krebs, Shivaprasad Goudar, Richard J. Derman, Fabian Esamai, Edward A. Liechty, Nellie I. Hansen, Sreelatha Meleth, Dennis D. Wallace, Marion Koso-Thomas, Alan H. Jobe, Pierre M. Buekens, José M. Belizán

Community Health Sciences

BACKGROUND:

The Antenatal Corticosteroid Trial assessed the feasibility, effectiveness, and safety of a multifaceted intervention to increase the use of antenatal corticosteroids (ACS) in mothers at risk of preterm birth at all levels of care in low and middle-income countries. The intervention effectively increased the use of ACS but was associated with an overall increase in neonatal deaths. We aimed to explore plausible pathways through which this intervention increased neonatal mortality.

METHODS:

We conducted a series of secondary analyses to assess whether ACS or other components of the multifaceted intervention that might have affected the quality of care contributed to …

Serratia Fonticola, Pathogen Or Bystander? A Case Series And Review Of The Literature, Roberto Viau, Robin L.P. Jump

Faculty Scholarship

Serratia fonticola is an unusual human pathogen, previously described primarily as causing skin and soft tissue infections following trauma. There is little information in the literature about its treatment or susceptibilities. We describe the case of a 67-year-old male with paraplegia who developed urosepsis due to S. fonticola. Blood and urine cultures obtained prior to the initiation of antimicrobials both grew S. fonticola. The patient completed a 15-day course of antimicrobials and had an uneventful recovery.We reviewed 17 other patients with clinical cultures positive for S. fonticola. Of these, 11 isolates were from the genitourinary system, most often as part …

Kcnq Channel Openers Reverse Depressive Symptoms Via An Active Resilience Mechanism, Allyson K. Friedman, Barbara Juarez, Stacy M. Ku, Hongxing Zhang, Rhodora C. Calizo, Jessica J. Walsh, Depish Chaudhury, Song Zhang, Angel Hawkins, David M. Dietz, James W. Murrogh, Maria Ribadeneira, Erik H. Wong, Rachael L. Neve, Ming-Hu Han

Publications and Research

Less than half of patients suffering from major depressive disorder, a leading cause of disability worldwide, achieve remission with current antidepressants, making it imperative to develop more effective treatment. A new therapeutic direction is emerging from the increased understanding of natural resilience as an active stress-coping process. It is known that potassium (Kþ) channels in the ventral tegmental area (VTA) are an active mediator of resilience. However, no druggable targets have been identified to potentiate active resilience mechanisms. In the chronic social defeat stress model of depression, we report that KCNQ-type Kþ channel openers, including FDA-approved drug retigabine (ezogabine), show …

Human Papillomavirus Infection In Rwanda At The Moment Of Implementation Of A National Hpv Vaccination Programme, Fidele Ngabo, Silvia Franceschi, Iacopo Baussano, M. Chantal Umulisa, Peter Snijders, Anne Uyterlinde, Fulvio Lazzarato, Vanessa Tenet, Maurice Gatera, Agnes Binagwaho, Gary Clifford

Dartmouth Scholarship

Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18–69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PC.

The Antenatal Corticosteroids Trial (Act): A Secondary Analysis To Explore Site Differences In A Multi-Country Trial., Karen Klein, Elizabeth M. Mcclure, Daniela Colaci, Vanessa Thorsten, Patricia L. Hibberd, Fabian Esamai, Ana Garces, Archana Patel, Sarah Saleem, Omrana Pasha, Elwyn Chomba, Waldemar A. Carlo, Nancy F. Krebs, Shivaprasad Goudar, Richard J. Derman, Edward A. Liechty, Marion Koso-Thomas, Pierre M. Buekens, José M. Belizán, Robert L. Goldenberg, Fernando Althabe

Community Health Sciences

BACKGROUND:

The Antenatal Corticosteroid Trial (ACT) assessed the feasibility, effectiveness, and safety of a multifaceted intervention to increase the use of antenatal corticosteroids (ACS) in mothers at risk of preterm birth at all levels of care in low and middle-income countries. The intervention effectively increased the use of ACS but had no overall impact on neonatal mortality in the targeted <5(th) percentile birth weight infants. Being in the intervention clusters was also associated with an overall increase in neonatal deaths. We sought to explore plausible pathways through which this intervention increased neonatal mortality.

METHODS:

We conducted secondary analyses to assess site differences in outcome and potential explanations for the differences in outcomes if found. By site, and in the intervention and control clusters, we evaluated characteristics of the mothers and care systems, the …

People In The News

Office of Diversity & Inclusion Initiatives Newsletter

• Edith Mitchell, MD
• Jerry McCauley, MD
• Elizabeth Sophy
• Salam Beah

Thomas Jefferson University Chief Diversity Officer Mr. Joseph Hill

Office of Diversity & Inclusion Initiatives Newsletter

In 2013, Dr. Steve Klasko became President and CEO of Thomas Jefferson University. Amongst the many ideas that he brought with him, he demanded that diversity and inclusion become a part of our daily lives. Diversity is part of the Blueprint for Strategic Action, Jefferson’s strategic plan. One month after his arrival at Jefferson, a communication went out to the Jefferson community that described the importance of an inclusive and diverse environments well as the importance of it being woven into our culture.

Skmc Council On Diversity And Inclusion

Office of Diversity & Inclusion Initiatives Newsletter

The SKMC Council for Diversity and Inclusion (D & I) is charged with enhancing the diversity and inclusiveness of the medical college community to allow us to best achieve our mission in patient care, education and research, and to the ability of our graduates to best serve the heath and health care needs of the public. The Council reviews and assesses the status and effectiveness of diversity and inclusion initiatives within the student, resident and faculty communities of SKMC and make recommendations regarding initiatives, policies, and resources needed to achieve desired outcomes. Headed by Mark L. Tykocinski, MD, the Anthony …

Student Group Activity

Office of Diversity & Inclusion Initiatives Newsletter

Descriptions of the following Student Groups:

• Student National Medical Association
• JeffLGBTQ
• Jewish Student Association
• Jefferson Muslim Society
• Latino Medical Students Association
• Medical Spanish Translator Program
• Diversity Council
• Asian Pacific American Medical Students Association
• Diversity and Inclusion Student Advisory Board

Recruitment

Office of Diversity & Inclusion Initiatives Newsletter

In 2015, SKMC took a team approach to recruitment. A team comprised of students, residents, and faculty, along with the diversity deans staffed recruiting tables at a variety of national venues. SKMC regularly recruits at the AAMC Minority Career Fair, the Student National Medical Association, and the Latino Medical Student Association. At the National Medical Association (the oldest and largest medical association for black physicians) in August 2015, the team included Mr. Joseph Hill, Chief Diversity Officer for Thomas Jefferson University.

Graduate Medical Education

Office of Diversity & Inclusion Initiatives Newsletter

To expand and enhance diversity and inclusion for our resident physicians, three initiatives targeting Graduate Medical Education are underway.

Faculty Initiatives

Office of Diversity & Inclusion Initiatives Newsletter

New URM faculty welcome meeting

Faculty Development-Unconscious Bias Workshop

Support for Minority and women faculty development

Formal Diversity Training

SKMC Search and Hiring Policy

Pipeline Programs

Office of Diversity & Inclusion Initiatives Newsletter

Asstated by the American Association of Medical Colleges, “a medical education program must develop programs or partnerships aimed at broadening diversity among qualified applicants for medical school admission”. Minority doctors comprise about 6 percent of the total U.S. physician population, a number that has not changed since the 1960s, says Traci R. Trice, MD, assistant dean for diversity and student diversity programs. “If you look more specifically at certain populations, particularly black males, the numbers have even gone down,” she notes. Yet African Americans comprise about 15 percent of the general U.S. population and Hispanics or Latinos make up about …

A Message From The Diversity Dean, Dr. Bernard Lopez, Bernard Lopez, Md

Office of Diversity & Inclusion Initiatives Newsletter

Welcome to the first newsletter from the Office of Diversity & Inclusion, intended to reach our students, residents, and faculty and spread awareness about diversity initiatives at the Sidney Kimmel Medical College at Thomas Jefferson University!

25th Annual Grandon Lecture Now In The Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

The Impact of HealthCare on the 2016 Election by Gail R. Wilensky, PhD, the 25th Annual Dr. Raymond C. Grandon Lecture, is now available in the Jefferson Digital Commons.