Medicine and Health Sciences Commons^™

Revisiting Our Roots: Innovative Community-Based Psychosocial Fieldwork Programs: Classroom To Clinic, Susan Santalucia, Ms, Otr/L, Kimberly S. Mollo, Ms, Otr/L, Tina Angelis, Edd, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives:

1. Understand the core components of a community-based level 1 psychosocial experience that bridge and enhance student classroom learning.

2. Examine strategies to identify, create, and maintain partnerships with community based sites.

3. Explore 2-3 learning activities and/or strategies that facilitate student learning during the Level 1 experience in a community based psychosocial setting.

Bcl2 Expression And Bcl2/Myc Dual Expression Predicts Inferior Survival In Primary Central Nervous System Lymphoma, Guldeep Uppal, Md, Zi-Xuan (Zoe) Wang, Phd, Renu Bajaj, Phd, Mark T. Curtis, Md, Phd, Charalambos C. Solomides, Md, Jon Glass, Md, Peter M. Banks, Stephen C. Peiper, Md, Jerald Z. Gong, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Background

Primary CNS lymphoma (PCNSL) is a rare type of diffuse large B-cell lymphoma (DLBCL) arising from and usually confined to CNS. Understating of the pathogenesis and prognostic markers is a challenge due to rarity of this neoplasm and paucity of the material available to study. Recent studies have shown that dual expression of MYC and BCL2 in DLBCL contributes to inferior overall survival. The prognostic value of MYC and BCL2 in PCNSL is not well studied.

Avoid, Accommodate, Confront Or Collaborate: Using Simulation To Teach Conflict Resolution Skills, E. Adel Herge, Otd, Otr/L, Deborah A. Hopkins, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Objective:

• Interprofessional education competencies include understanding roles & responsibilities of team members, and demonstrating effective communication and team building skills (Pardue, 2013).
• Team conflict impacts patient safety and outcomes (Knickle & McNaughton, 2009; Wagner, Liston & Miller, 2011) so effective team communication and conflict resolution in an important skill for students to develop (Greer et al., 2012; Levi, 2014).
• Simulation is effective in teaching interprofessional communication skills to health profession students (Velde, 2009).

Implementation Of A Four Year Rehabilitation Curriculum For Medical Students, Nethra S. Ankam, Md

Department of Rehabilitation Medicine Faculty Papers

In 2009 the Vice-Dean of Undergraduate Medical Education modified the 4th year curriculum by eliminating the required clerkship in Rehabilitation Medicine, and the Department was tasked with the creation of a four year curricular thread. While disappointing, this was a blessing in disguise. For years, we attempted to fit a great deal of content into an ever decreasing timespan, to increasingly disinterested students. Our teachers were also burned out with the sheer volume of students.

Through collaboration with other course directors, we inserted content where it fit the developmental needs of the students. We were also able to introduce students …

Bridging The Evidence Gap: The Role Of Fieldwork Students, Tracey Vause-Earland, Ms, Otr/L, E. Adel Herge, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Introduction

Understanding and using evidence in practice improves health care delivery (Lugtenberg, Burgers, & Westert, 2009), reduces errors, and increases professional identity. Despite the call for increased use of evidence in occupational therapy decision making and positive attitudes of therapists toward use of evidence in practice), evidence based practice (EBP) is perceived by clinicians as time consuming and difficult due to lack of knowledge and/or resources (Humphries, et al, 2000; Bennett et al, 2003).

Evaluating The Effects Of Grasp Patterns And Grip Strength On Handwriting Skills, Jennifer Bebey, Ots, Kelsey Engelstad, Ots, Audrey Zapletal, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background Information

• Handwriting is a critical and complex skill that school aged children acquire over time.
• When a child demonstrates handwriting difficulties, he or she may have challenges with:

Completing written school assignments in a timely fashion,

Taking notes,

Finishing homework,

Completing exams, especially short answer.

• 80% to 85% of occupational therapy referrals in schools are due to atypical grasp pattern, fine motor and handwriting concerns that affect a child’s educational performance.

Jefferson Digital Commons Quarterly Report: Jan-Mar 2014, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi

Jefferson Digital Commons Reports

The Jefferson Digital Commons has 184 new deposits this quarter. Ending this quarter brings the total number of assets to 8,811 and a total of 1,765,509 downloads.

The most downloaded asset this quarter was: Multi-nutrient supplement improves hormone ratio associated with cancer risk. with 86 downloads registered from Jan 6, 2014 to April 1st.

In this Issue:

• Reminders
• Assorted Highlights
• New Methods for providing feedback
• Exploring the JDC Visually
• New from the Archives
• What People are Saying
• Announcements

Entire inventory of newly added assets spreadsheet located at bottom of page.

The Effect Of Breathable Under Pads To Decrease Hospital Acquired Pressure Ulcers: A Nurse Resident Project, Sara Meshino, Bsn, Rn, Bridget Trefz, Bsn, Rn

Department of Nursing papers and presentations

PURPOSE

To reduce the rate of hospital acquired pressure ulcers (HAPU), in June 2013, a large urban academic medical center switched from non-breathable to breathable under pads for incontinent patients lying on either a standard bed (low risk patients) or low-air-loss mattress (high risk patients). Standard pressure ulcer prevention measures were maintained. Staff on two oncology units sought to determine the effectiveness of breathable vs. non-breathable under pads in reducing the rate of HAPU and UAPU.

Interleukin-7-Dependent B Lymphocytes Are Required For The Anti-Pneumococcal Polysaccharide Response And Protective Immunity To Streptococcus Pneumoniae, Gregory S. Dickinson, Phd, Raja Vuyyuru, Timothy L. Manser, Phd, John F. Kerney, Kishore Alugupalli, Phd

Department of Microbiology and Immunology Faculty Papers

Unlike human adults or adult mice, young children or young mice respond poorly to pneumococcal polysaccharides (PPS). In mice, B1b lymphocytes are the major responders to a variety of bacterial polysaccharides including PPS. Despite having B1b cells, young mice are severely impaired in responding to PPS, suggesting that B cells in the young are distinct from those in adults. Since B lymphopoeisis early in life is largely Interleukin-7 (IL-7)-independent, while in adults it is IL-7-dependent, we hypothesize that B cells developed in the presence of IL-7 are required for generating anti-PPS antibody responses. In support of this, we found that …

Metformin Inhibits Androgen-Induced Igf-Ir Up-Regulation In Prostate Cancer Cells By Disrupting Membrane-Initiated Androgen Signaling., Roberta Malaguarnera, Antonella Sacco, Alaide Morcavallo, Sebastiano Squatrito, Antimo Migliaccio, Andrea Morrione, Marcello Maggiolini, Antonino Belfiore

Department of Urology Faculty Papers

We have previously demonstrated that, in prostate cancer cells, androgens up-regulate IGF-I receptor (IGF-IR) by inducing cAMP-response element-binding protein (CREB) activation and CREB-dependent IGF-IR gene transcription through androgen receptor (AR)-dependent membrane-initiated effects. This IGF-IR up-regulation is not blocked by classical antiandrogens and sensitizes cells to IGF-I-induced biological effects. Metformin exerts complex antitumoral functions in various models and may inhibit CREB activation in hepatocytes. We, therefore, evaluated whether metformin may affect androgen-dependent IGF-IR up-regulation. In the AR(+) LNCaP prostate cancer cells, we found that metformin inhibits androgen-induced CRE activity and IGF-IR gene transcription. CRE activity requires the formation of a CREB-CREB …

Implementation Of A Residency Twitter Account To Provide Curricular Enrichment, Bryan Lebude, Md, Subhashini Appulingam Sellers, Md, Gretchen Diemer, Md, Facp

Department of Medicine Faculty Papers

Background

_{The Problem}

_{With the goals of improving patient safety and resident well-being, the ACGME’s 2011 revision of duty-hour requirements included a 16-hour limit on continuous duty hours for postgraduate year 1 (PGY-1) trainees, increased supervision for junior trainees, as well as mandated rest periods between duty hours.1 These rules place limitations on the ability of trainees to attend scheduled educational activities during standard work hours; a recent study showed a decrease in resident availability for teaching conferences compared with the 2003 duty hour regulations.2 Residency training programs must develop alternative avenues for education and encouraging inquiry outside of traditional …}

Jeffhope News-Summer 2014

JeffHOPE News

Issue includes:

• Question of the Day
• Creating an Education Program at Mercy
• The Impact of a Simple Intervention
• Reevaluating Our Population's Needs
• JeffHOPE Goes Electronic EMR at Clinic

Hematopoietic Cell Transplant Co-Morbidity Index (Hct-Ci): Ability To Predict Outcomes In Haploidentical (Hi) Hematopoietic Stem Cell Transplantation (Hsct), Neil D. Palmisiano, Md, Sameh Gaballa, Md, Onder Alpdogan, Matthew Carabasi, Md, Joanne Filicko-O'Hara, Md, Margaret Kasner, Md, Ubaldo E. Martinez-Outshoorn, Md, John L. Wagner, Md, Mark Weiss, Md, Neal Flomenberg, Md, Dolores Grosso, Dnp

Department of Medical Oncology Faculty Papers

Introduction

We developed a 2 step approach to HI HSCT in which a fixed dose of allogeneic T cells are infused after reduced intensity (RIC) or myeloablative conditioning (HSCT step 1). After 2-3 days, cyclophosphamide (CY) 60 mg/kg/d x 2 is given to establish bidirectional tolerance. One day after the CY, a CD 34 selected stem cell product is infused (HSCT step 2).

This approach has been associated with a low incidence of non-relapse mortality (NRM) resulting in a significant improvement in overall survival (OS) in patients (pts) undergoing HI HSCT at our institution. This abstract examined the predictability of …

Outcomes Of Older Patients Undergoing 2-Step Approach To Haploidentical And Matched Related Peripheral Blood Hematopoietic Stem Cell Transplantation (Hsct): A Single Institutional Experience, Sameh Gaballa, Md, Seyfettin Onder Alpdogan, Md, Matthew Carabasi, Md, Joanne Filicko-O'Hara, Md, Margaret Kasner, Md, Benjamin E Leiby, Phd, Ubaldo E. Martinez-Outshoorn, Md, Edward C Pequignot, Md, Sarah Rosado, Shannon Rudolph, Ms, John L Wagner, Md, Mark Weiss, Md, Neal Flomenberg, Md, Dolores Grosso, Dnp

Department of Medical Oncology Faculty Papers

Introduction:

HSCT is a curative option for many patients (pts) with hematological malignancies.

Significant advances in supportive care and conditioning regimens over the past decade have allowed the extension of this therapy to older individuals.

Information regarding the outcomes of this older subset of pts undergoing HSCT is limited, especially those undergoing haploidential (HI) HSCT.

Objectives:

To describe the outcomes of patients 60 years of age or older undergoing haploidential and matched related (MR) HSCT using the 2-step approach.

Yoga Therapy For Irritable Bowl Syndrome: Integrative Medicine Grand Rounds, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Please join us for Integrative Medicine Grand Rounds on Tuesday, April 1, 2014 in 925 Chestnut Street, 2nd floor conference room from 8:00-9:00 am. Please note the venue for this exciting program. Senthamil R. Selvan, Ph.D.. is presenting and the title of his presentation is: “Yoga Therapy for Irritable Bowl Syndrome: Interim Results of a Randomized Control Study.”

Cell-Mediated Immunity And Vaccines, Jaya Kumari, Senthamil R. Selvan, Stéphane Bécart, Subhasis Chattopadhyay, Roy Ambli Dalmo

Department of Medical Oncology Faculty Papers

No abstract provided.

Anterior Talofibular Ligament Abnormality On Routine Magnetic Resonance Imaging Of The Ankle, Patrick Kane, Md, David Pedowitz, Md, Adam C C. Zoga, Md, Steven M. Raikin, Md

Rothman Institute Conference Posters

The anterior talo­fibular ligament (ATFL) extends from the anteroinferior border of the ­fibula to the talar neck. Primary restraint to ankle inversion in plantar‑exion. Injury (acute or chronic) can be diagnosed with physical exam, stress X-Rays, ultrasound or magnetic resonance imaging (MRI).

Purpose:

MRI abnormalities in asymptomatic individuals known in other areas of orthopaedics (shoulder and spine). Purpose of our study: determine the prevalence of ATFL abnormalities found on MRI in asymptomatic individuals. Asymptomatic individuals - those undergoing MRI for pathology unrelated to lateral ankle trauma, instability, or inversion injuries.

A Clinical Decision Support Tool To Predict The Risk Of Failure In Patients With Femoroacetabular Impingement Undergoing Hip Preservation Surgery, Claudio Diaz-Ledezma, Md, Mitchell Maltenfort, Phd, Lesley Walinchus, Bs, Benjamin Hendy, Bs, Thomas Novack, Bs, Javad Parvizi, Md, Frcs

Rothman Institute Conference Posters

In modern orthopaedics, risk prediction scores can help discriminate between ideal and poor candidates for a specifi­c therapeutic intervention. We consider these tools useful during the process of shared medical decision-making1. To our knowledge, such a strategy has never been explored in the ­field of hip preservation surgery.

The aim of our study is to generate a clinical decision support tool to predict risk of failure after hip preservation surgery among patients with femoroacetabular impingement (FAI).

High Variability In Outcomes Of Two-Stage Exchange To Treat Periprosthetic Joint Infection, Benjamin Zmistowski, Bs, Paul Lichstein, Md, Aaron H Carter, Md, Joshua J. Minori, Do, Javad Parvizi, Md

Rothman Institute Conference Posters

Introduction:

Periprosthetic joint infection (PJI) is a challenging condition to manage with sobering morbidity and mortality.1,2 Treatment options range from simple irrigation and debridement with prosthetic retention to explantation and placement of a temporary cement spacer. Indictations for each option are unclear and non-uniform despite signi­cant efforts to understand the management outcomes. Until recently, a uniform de­nition of success was unavailable, thus clouding the discussion of treatment options. Two-stage exchange is currently considered the “gold-standard” in North America, yet an appropriate understanding of the actual success and ancillary effects of treatment is needed. With the advantage of an expert opinion …

Is Further Treatment Necessary For Patellar Crepitus After Total Knee Arthroplasty?, Bo-Hyun Hwang, Md, Chang-Hyun Nam, Md, Kwang-Am Jung, Md, Alvin Ong, Md, Su-Chan Lee, Md

Rothman Institute Conference Posters

Introduction:

• Posterior-stabilized (PS) TKA that sacrifice the cruciate ligaments improves pain and function in patients with advanced osteoarthritis.
• Patellar crepitus appears to be due to a spectrum of peripatellar fibrosynovial formations and is usually encountered after PS-TKA, which uniquely has an intercondylar box to accept the tibial post.
• Symptoms of patellar crepitus occur most commonly during terminal knee extension and occur usually from 3 to 9 months after PS-TKA, and in some cases, this phenomenon is symptomatic enough to warrant an arthroscopic procedure or open arthrotomy.
• The development of patellar crepitus after PS-TKA appears related to many factors such as …

Threshold For Synovial Cell Count And Neutrophil Differential In Diagnosis Of Periprosthetic Knee Infection: A Multi-Institutional Study, Benjamin Zmistowski, Bs, Carlos Higuera, Md, Jane Liu, Ba, Wael Barsoum, Md, Joseph Mendelis, Ba, Craig Della Valle, Md, Javad Parvizi, Md

Rothman Institute Conference Posters

Introduction:

Synovial fl­uid analysis is an important tool in the work-up of suspected periprosthetic joint infection (PJI). Yet, there is confl­icting guidance for the analysis of synovial fl­uid aspiration, including a lack of uniform thresholds for white blood cell (WBC) count and neutrophil percentage (PMN%)1-3. Therefore, a multi-institutional study was undertaken to reassess these thresholds, compare preoperative versus intraoperative sample collection, and assess variation in results between institutions.

Single Nucleotide Polymorphism Of Srebf-1 Gene Associated With An Increased Risk Of Endometrial Cancer In Chinese Women., Chun-Ping Qiu, Qing-Tao Lv, Samina Dongol, Chenguang Wang, Jie Jiang

Department of Cancer Biology Faculty Papers

AIM: Elevated levels of sterol regulatory element-binding protein-1 (SREBP-1) have been found in endometrial cancer (EC), suggesting that it is essential to the development of EC. Obesity and diabetes have been established as known risk factors of EC, while SREBF-1 gene polymorphisms have also been found to be associated with obesity and type II diabetes. Therefore, we hypothesize that single nucleotide polymorphism (SNP) in SREBF-1 gene may be associated with increased risk of EC.

METHOD: We analyzed the sequence of SREBF-1 in tissue samples from 30 EC cases and 6 benign controls using high throughput method. Based on the primary …

Postoperative Urinary Retention (Pour): What Are The Risk Factors?, Eric H. Tischler, Ba, Camilo Restrepo, Md, Jennifer Oh, Ba, Mitchell Maltenfort, Phd, Javad Parvizi, Md, Frcs

Rothman Institute Conference Posters

Introduction

Total hip arthroplasty (THA) is a successful procedure alleviating pain in patients with debilitating arthritis. Postoperative urinary retention (POUR) is a common complication following surgery and is managed with intermittent or continued urinary catheterization. POUR has been estimated in retrospective literature to be on the order of 5% – 70% of surgical cases with early catheter removal or without a catheter. At our institution, and based on a Level 1 study here, urinary catheter is not used routinely in patients undergoing THA under regional anesthesia. The purpose of this study was to evaluate the incidence of POUR and risk …

Myd88-Dependent Immunity To A Natural Model Of Vaccinia Virus Infection Does Not Involve Toll-Like Receptor 2., Michael L Davies, Janet J Sei, Nicholas A Siciliano, Ren-Huan Xu, Felicia Roscoe, Luis J Sigal, Laurence C. Eisenlohr, Christopher C Norbury

Department of Microbiology and Immunology Faculty Papers

UNLABELLED: Although the pattern recognition receptor Toll-like receptor 2 (TLR2) is typically thought to recognize bacterial components, it has been described to alter the induction of both innate and adaptive immunity to a number of viruses, including vaccinia virus (VACV). However, many pathogens that reportedly encode TLR2 agonists may actually be artifactually contaminated during preparation, possibly with cellular debris or merely with molecules that sensitize cells to be activated by authentic TLR2 agonists. In both humans and mice, the most relevant natural route of infection with VACV is through intradermal infection of the skin. Therefore, we examined the requirement for …

Chronic Arsenic Exposure And Angiogenesis In Human Bronchial Epithelial Cells Via The Ros/Mir-199a-5p/Hif-1Α/Cox-2 Pathway., Jun He, Min Wang, Yue Jiang, Qiudan Chen, Shaohua Xu, Qing Xu, Bing-Hua Jiang, Ling-Zhi Liu

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: Environmental and occupational exposure to arsenic is a major public health concern. Although it has been identified as a human carcinogen, the molecular mechanism underlying the arsenic-induced carcinogenesis is not well understood.Objectives: We aimed to determine the role and mechanisms of miRNAs in arsenic-induced tumor angiogenesis and tumor growth.Methods: We utilized an in vitro model in which human lung epithelial BEAS-2B cells were transformed through long-term exposure to arsenic. A human xenograft tumor model was established to assess tumor angiogenesis and tumor growth in vivo. Tube formation assay and chorioallantoic membranes assay were used to assess tumor angiogenesis.Results: We …

The Hand In Art: Hand Of Hope, John S. Taras, Md

Department of Orthopaedic Surgery Faculty Papers

The “Hand of Hope” (Fig. 1) statue was commissioned for display in the street-level lobby of my practice, The Philadelphia Hand Center, by its founders, James M. Hunter, MD, and Lawrence H. Schneider, MD. The work became a hallmark of the practice’s former Walnut Street location as well as a recognizable feature of its neighborhood.

After a sojourn of several years residing next to Thomas Eakins’ portrait of the operative theatre in “The Gross Clinic,” at Thomas Jefferson University, the sculpture has returned to grace our office’s lobby in the historic Benjamin Franklin Hotel.

Adiponectin Inhibits Tumor Necrosis Factor-Α-Induced Vascular Inflammatory Response Via Caveolin-Mediated Ceramidase Recruitment And Activation., Yajing Wang, Xiaoliang Wang, Wayne Bond Lau, Yuexing Yuan, David Booth, Jing-Jing Li, Rosario Scalia, Kyle Preston, Erhe Gao, Walter Koch, Xin-Liang Ma

Department of Medicine Faculty Papers

RATIONALE: Anti-inflammatory and vascular protective actions of adiponectin are well recognized. However, many fundamental questions remain unanswered.

OBJECTIVE: The current study attempted to identify the adiponectin receptor subtype responsible for adiponectin's vascular protective action and investigate the role of ceramidase activation in adiponectin anti-inflammatory signaling.

METHODS AND RESULTS: Adiponectin significantly reduced tumor necrosis factor (TNF)α-induced intercellular adhesion molecule-1 expression and attenuated TNFα-induced oxidative/nitrative stress in human umbilical vein endothelial cells. These anti-inflammatory actions were virtually abolished by adiponectin receptor 1 (AdipoR1-), but not AdipoR2-, knockdown (KD). Treatment with adiponectin significantly increased neutral ceramidase (nCDase) activity (3.7-fold; P87% of adiponectin-induced nCDase …

Flow-Diversion Panacea Or Poison?, Mario Zanaty, Nohra Chalouhi, Md, Stavropoula I. Tjoumakaris, Robert H. Rosenwasswer Md, L. Fernando Gonzalez, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

Endovascular therapy is now the treatment of choice for intracranial aneurysms (IAs) for its efficacy and safety profile. The use of flow diversion (FD) has recently expanded to cover many types of IAs in various locations. Some institutions even attempt FD as first line treatment for unruptured IAs. The most widely used devices are the pipeline embolization device (PED), the SILK flow diverter (SFD), the flow redirection endoluminal device (FRED), and Surpass. Many questions were raised regarding the long-term complications, the optimal regimen of dual antiplatelet therapy, and the durability of treatment effect. We reviewed the literature to address these …

Basic Concepts In Stem Cells: Integrative Medicine Grand Rounds, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Please join us for Integrative Medicine Grand Rounds on Tuesday, March 4, 2014 in 925 Chestnut Street, 2nd floor conference room from 8:00-9:00 am. Please note the venue for this exciting program. Anthony J. Bazzan, MD, ABIHM. is presenting and the title of his presentation is: “Basic Concepts in Stem Cells”

Mouse Models For Pseudoxanthoma Elasticum: Genetic And Dietary Modulation Of The Ectopic Mineralization Phenotypes., Qiaoli Li, Haitao Guo, David W Chou, Annerose Berndt, John P Sundberg, Jouni Uitto

Department of Dermatology and Cutaneous Biology Faculty Papers

Pseudoxanthoma elasticum (PXE), a heritable ectopic mineralization disorder, is caused by mutations in the ABCC6 gene. Null mice (Abcc6(-/-) ) recapitulate the genetic, histopathologic and ultrastructural features of PXE, and they demonstrate early and progressive mineralization of vibrissae dermal sheath, which serves as a biomarker of the overall mineralization process. Recently, as part of a mouse aging study at The Jackson Laboratory, 31 inbred mouse strains were necropsied, and two of them, KK/HlJ and 129S1/SvImJ, were noted to have vibrissae dermal mineralization similar to Abcc6(-/-) mice. These two strains were shown to harbor a single nucleotide polymorphism (rs32756904) in the …