Medicine and Health Sciences Commons^™

Incidence And Management Of Rhinosinusitis After Complex Orbitofacial Reconstruction, Wiliam Parkes, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Objective:

To discuss the incidence and management of rhinosinusitis after complex orbitofacial reconstruction.

Consistent Surgeon Evaluations Of Three-Dimensional Rendering Of Pet/Ct Scans Of The Abdomen Of A Patient With A Ductal Pancreatic Mass., Matthew E Wampole, John C Kairys, Edith P Mitchell, Martha L Ankeny, Mathew L Thakur, Eric Wickstrom

Department of Biochemistry and Molecular Biology Faculty Papers

Two-dimensional (2D) positron emission tomography (PET) and computed tomography (CT) are used for diagnosis and evaluation of cancer patients, requiring surgeons to look through multiple planar images to comprehend the tumor and surrounding tissues. We hypothesized that experienced surgeons would consistently evaluate three-dimensional (3D) presentation of CT images overlaid with PET images when preparing for a procedure. We recruited six Jefferson surgeons to evaluate the accuracy, usefulness, and applicability of 3D renderings of the organs surrounding a malignant pancreas prior to surgery. PET/CT and contrast-enhanced CT abdominal scans of a patient with a ductal pancreatic mass were segmented into 3D …

Perspectives Of Older Adults On Co-Management Of Low Back Pain By Doctors Of Chiropractic And Family Medicine Physicians: A Focus Group Study., Kevin J Lyons, Stacie A Salsbury, Maria A Hondras, Mark E Jones, Andrew A Andresen, Christine M Goertz

Department of Medical Genetics Faculty Papers

BACKGROUND: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs and to identify their concerns for receiving care under such a treatment model.

METHODS: We conducted 10 focus groups with 48 older adults who received LBP care in the past year. Interviews explored participants' care seeking experiences, co-management preferences, and perceived challenges to successful implementation of a MD-DC co-management model. We analyzed …

Inhibition Of Fas-Associated Death Domain-Containing Protein (Fadd) Protects Against Myocardial Ischemia/Reperfusion Injury In A Heart Failure Mouse Model., Qian Fan, Zheng M Huang, Matthieu Boucher, Xiying Shang, Lin Zuo, Henriette Brinks, Wayne Bond Lau, Jianke Zhang, J Kurt Chuprun, Erhe Gao

Department of Emergency Medicine Faculty Papers

AIM: As technological interventions treating acute myocardial infarction (MI) improve, post-ischemic heart failure increasingly threatens patient health. The aim of the current study was to test whether FADD could be a potential target of gene therapy in the treatment of heart failure.

METHODS: Cardiomyocyte-specific FADD knockout mice along with non-transgenic littermates (NLC) were subjected to 30 minutes myocardial ischemia followed by 7 days of reperfusion or 6 weeks of permanent myocardial ischemia via the ligation of left main descending coronary artery. Cardiac function were evaluated by echocardiography and left ventricular (LV) catheterization and cardiomyocyte death was measured by Evans blue-TTC …

Pneumonia Pathway Effects On Hospital Readmission Rates, Maribeth Kelly, Msn, Rn, Pccn, Raymond Malloy, Mha, Rrt, Brian Glynn, Bs, Rrt

Department of Nursing papers and presentations

Purpose

There are inconsistencies in treating inpatients with community acquired pneumonia (CAP) and providing adequate post

discharge follow-up contributing to significant hospital readmission rates and increased health care costs. Our null hypothesis for this study was that the use of a pneumonia care pathway will have a significant effect on hospital readmission rates.

Create Day Presentations Now In Jefferson Digital Commons, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Collaborative Research and Evidence Among Therapists and Educators (CREATE) Day is a clinical education program presented by occupational therapy graduate students in partial fulfillment of the Master of Science degree in Occupational Therapy at Thomas Jefferson University.

Early Intervention Provider Use Of Child Caregiver-Teaching Strategies, Philippa Campbell, Phd, Catherine Ehret-Coletti, Ms

Department of Occupational Therapy Faculty Papers

Most current early intervention approaches emphasize the importance of a provider role as teacher or coach, a role in which providers give parents or other caregivers information about how to optimize children’s growth and development (Stremel & Campbell, 2007). However, few studies have examined the information that should be provided for caregivers or how this information is best delivered to caregivers although a number of rating scales are able to distinguish between roles of direct service provider for the child (e.g., traditional) and triadic interaction among provider, caregiver, and child (Campbell & Sawyer, 2007; Salisbury & Cushing, 2013). Related factors …

Cyclin D1 Determines Estrogen Signaling In The Mammary Gland In Vivo., Mathew C Casimiro, Chenguang Wang, Z Li, Gabriele Disante, Nicole E Willmart, Sankar Addya, Lei Chen, Yang Liu, Michael P. Lisanti, Richard Pestell

Department of Cancer Biology Faculty Papers

The CCND1 gene, which is frequently overexpressed in cancers, encodes the regulatory subunit of a holoenzyme that phosphorylates the retinoblastoma protein. Although it is known that cyclin D1 regulates estrogen receptor (ER)α transactivation using heterologous reporter systems, the in vivo biological significance of cyclin D1 to estrogen-dependent signaling, and the molecular mechanisms by which cyclin D1 is involved, are yet to be elucidated. Herein, genome-wide expression profiling conducted of 17β-estradiol-treated castrated virgin mice deleted of the Ccnd1 gene demonstrated that cyclin D1 determines estrogen-dependent gene expression for 88% of estrogen-responsive genes in vivo. In addition, expression profiling of 17β-estradiol-stimulated cyclin …

Antithrombin Iii Deficiency In A Patient Requiring Extracorporeal Membrane Oxygenation., Jonathan R. Sarik, Md, Shinya Unai, Md, Harrsion Pitcher, Md, Qiong Yang, Md, Hitoshi Hirose, Md, Phd, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Introduction:

Antithrombin or antithrombin III (ATIII) is a vitamin K-independent, natural anticoagulant that is the major inhibitor of thrombin. With the binding of heparin, a conformational change in antithrombin occurs that increases the inactivation of thrombin by antithrombin by 4000-fold. Antithrombin deficiency can be hereditary or acquired; the acquired form is frequently encountered in patients requiring mechanical circulatory support.

Formulation of clots within the circuit of extracorporeal membrane oxygenation (ECMO) is a life-threatening emergency and requires emergent intervention. Decreased ATIII is associated with a hypercoagulable state, which can lead to dangerous complications for patients requiring mechanical circulatory support.

We Came, We Saw, We Cannulated?, Hitoshi Hirose, Md, Phd, Kumar Gaurav, Md, Nicholas C. Cavarocchi, Md, Vanjul Agarwal, Md, Roselle Almeida, Md, Andrew Toscano, Md, Urvashi Vaid, Md, Ms, Bharat K. Awsare, M.D., Fccp, Michael Baram, Md

Department of Surgery Faculty Papers

Introduction: Despite advances in management of patients with severe acute respiratory distress syndrome (ARDS), mortality due to ARDS still remains high. In patients with refractory gas-exchange abnormalities, extracorporeal membrane oxygenation (ECMO) is considered as salvage therapy that aims to decrease ventilator induced lung injury and provide lung rest. injury and provide lung rest.

Methods: We conducted a retrospective study of patients diagnosed with ARDS from October 2010 to September 2012. The aim of the study was to describe the population of patients placed on ECMO for ARDS in our institution. All patients placed on ARDSnet protocol were identified in the …

You've Got A Friend In Me: Effectiveness Of Social Skills Interventions For Children With Adhd, Michelle Carlton, Kelly Davis, Jacquelyn Matlack, Marietta Van Ness

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Children diagnosed with ADHD present with the core symptoms of inattention and hyperactivity/impulsivity, which lead to challenges with school based activities, including peer interactions, academics, and extracurricular activities (McClelland, Morrison, & Holmes, 2000; Hoza, 2007). Current research identifies social skills interventions as a potential strategy for occupational therapists (OTs) to address these participation challenges of children with ADHD, however there is a multitude of interventions that fall under this umbrella. The variety of social skills interventions allows for flexibility and diversity in implementation, but poses the challenge of choosing the most effective intervention. This choice should be informed by evidence-based …

Rehabilitative Interventions To Improve Biomechanical Or Functional Outcomes For Children With Obstetric Brachial Plexus Palsy, Loren Massimino, Erin Mulrain, Katherine Scheponik, Rachel Wiley, Houman Ziai

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Background: Obstetric brachial plexus palsy (OBPP) affects children worldwide, with incidence rates ranging from 0.5 to 3 per 1000 live births (Foad, Mehlman & Ying, 2008). Injury characteristics vary greatly and therefore, discrepancies exist regarding the most effective rehabilitation interventions. These children receive conservative management (through occupational and physical therapy), Botulinum toxin, surgery, or a combination of treatments (Benjamin, 2005).

Objective: To present the results of a systematic review of the literature to identify rehabilitative interventions that demonstrate statistically significant functional/biomechanical outcomes in children with OBPP.

Methods: A systematic search of the databases PubMed, CINAHL, and MEDLINE …

Doing It Well: Education To Promote Satisfaction With Sexual Intimacy For People With Spinal Cord Injury, Allison Duggan, Erin Maniscalco, Dannielle Miccinello, Lauren Pasciuto, Catherine Scaccia

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Physical and psychosocial effects of a spinal cord injury may lead to concerns and difficulty with sexual satisfaction, exploration, and arousal as well as diminished confidence with participation in intimate relationships (Craig Hospital, 2012). Current research indicates a decreased level of satisfaction with participation in sexual intimacy for adults with spinal cord injury (Fisher et al., 2002). Occupational therapists have a key role in the rehabilitation of individuals with spinal cord injury, and sexuality is an area of occupation which falls within our scope of practice (AOTA, 2008). Therefore it is necessary that occupational therapists are assertive in addressing the …

Technology In Practice: Promoting Participation In Patients With High Level Of Spinal Cord Injury, Morgan Gill, Kate Nuschke, Kaitlin O'Sullivan, Casey Puvogel, Alex Sagnor

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Motor impairment often occurs following a spinal cord injury, limiting participation in functional tasks. Although the primary rehabilitative focus is to cure paralysis, not all patients experience full recovery. For those who may not regain complete motor function, rehabilitative interventions are needed to bridge the gap between disability and optimal participation. During rehabilitation, patients prioritize increasing independence and participation in meaningful activities (Rigby, Ryan, & Campbell, 2010). More specifically, regaining arm and hand function was reported as a top priority during treatment for individuals with complete spinal cord injury (Peckham, et al., 2001). Technology has been utilized to improve participation …

Dementia And Technology: Evidence Supporting Assistive Technology For Individuals With Alzheimer’S Disease And Related Dementias, Diana Skoutelas, Christine Tanner, Gabriella Vulpis, Gittel Zelczer

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

The prevalence of Alzheimer’s disease in the Unites States is estimated to be 5.2 million (Alzheimer’s Association, 2013). Alzheimer’s disease and related dementias (ADRD) can impact an individual’s ability to independently participate in daily occupations within their environment due to executive dysfunction, memory loss, poor judgment, and decreased problem solving (Desai, Grossberg, & Sheth, 2004; Alzheimer’s Association, 2013). Due to the rising prevalence of dementia, Labelle and Mihailidis (2006) note the importance of occupational therapists finding innovative and evidence-based strategies to enable participation in daily occupations. The purpose of this presentation is to present the results of a literature review …

Thinking Through The Chemo-Fog: Occupational Therapy’S Role In Promoting Participation In Adults With Breast Cancer, Amanda Ally, Lisa Ferguson, Emily Grabow, Katrina Long, Alisha Sharp

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Breast cancer is currently the most common type of cancer in women (American Cancer Society, 2012). In 2012, 2,971,610 women in the United States were breast cancer survivors (American Cancer Society, 2012). Chemotherapy is often used to effectively treat breast cancer but can cause chemobrain, or chemotherapy-related cognitive impairments (CRCI), including decreased attention, concentration, memory, and difficulty learning new skills and completing routine tasks (American Cancer Society, 2013). CRCI can persist for years and may impact an individual’s occupational performance in daily activities and occupations. Occupational therapy practitioners currently work with this population in other areas including cancer-related fatigue management, …

Beyond Piecework: Employment For Persons With Intellectual And Developmental Disabilities, Kelly Brandwene, Ilese Coleman, Adva Epstein, Alyssa Peachey, Lauren Rosenthal

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

All people deserve competitive, fulfilling employment (Lysaght, Cobigo, Hamilton, 2011). Many people with intellectual or developmental disabilities (I/DD) have difficulty obtaining competitive employment despite desiring to work (Lysaght, Ouellett-Kuntz, & Lin, 2010). In past years, people with I/DD have been employed in sheltered workshops; however, they are often paid below minimum wage, do not receive benefits, and are viewed as subordinates. Workers report the desire to work outside of sheltered employment. Competitive employment (integrated/supported employment), can lead to social justice, social inclusion, personal growth, and improved financial situations (Migliore, Mank, Grossi, & Rogan, 2007). Occupational therapists are suited to assist …

Falling Into Home Mods: Occupational Therapy’S Role In Keeping Older Adults Safe At Home, Elizabeth Janeczko, Brendan Kiernan, Mary Susan Paige, Stephanie Reitemeier, Joshua Springer

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Falls are the leading cause of injury-related deaths and the most common cause of nonfatal injuries and hospital admissions for older adults aged 65 and older.¹ Other consequences of falls are increased fear of falling, and decreased independence and participation in performance of daily activities. In the past decade, evidence has identified the multifactorial approach, which includes home modification, as the most effective approach in preventing falls in older adults.² Occupational therapists have the education and unique skill set to perform client-centered home modifications. The purpose of this presentation is to describe the results of an evidenced-based literature …

Can't Hold Me Back! Constraint-Induced Movement Therapy For Children With Cp: Evidence Based Review, Rebecca Coale, Danni Eisner, Alissa Herman, Sarah Merhaut

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Children with cerebral palsy (CP) have various functional impairments impacting participation in meaningful occupations. While Constraint-Induced Movement Therapy (CIMT) is a widely used intervention for adult populations, a modified version of this technique is a relatively new practice in pediatrics (Charles et al., 2006). Occupational therapy intervention, such as CIMT, can support functional goal attainment to enhance participation and quality of life (Boyd et al., 2010). The purpose of this presentation is to synthesize results of a comprehensive evidence-based review and identify treatment characteristics that impact efficacious use of mCIMT on children with hemiplegic CP. Practitioners will learn about best …

Clinical Effectiveness Of Motor Imagery Post-Stroke: An Evidence Based Review, Azadeh Narimanian, Amanda Reese, Karina Ryabo, Rachel Shepp, Annalisa Synnestvedt

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Following a stroke, many individuals experience participation limitations secondary to upper extremity hemiparesis (Shenn & Leishear, 2011). Motor imagery, the mental representation of movement without any body movement, is an evidenced-based intervention to optimize upper extremity function for patients following stroke (Dickstein & Deutsch, 2007). Motor imagery is a readily applicable, safe, and cost-effective intervention that can help clients achieve a variety of occupational goals within diverse environments (Guttman, Burstin, Brown, Bril, & Dickstein, 2012). The purpose of this presentation is to present the results of an evidence-based review examining the use of motor imagery to increase functional outcomes for …

Paws With A Purpose: Evidence Supporting The Use Of Animal Assisted Therapy To Improve Quality Of Life In Adults With Psychiatric Diagnoses, Julia Andraka, Lacey Brinser, Kelly D'Ambrosio, Jordan Justice, Elizabeth Rugen

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Approximately 62.7 million Americans have a psychiatric diagnosis, including Alzheimer’s disease and mental disorders^1,6. Adults who are diagnosed with these conditions experience a variety of limitations, including decreased quality of life⁴. Occupational Therapy (OT) has been shown to be an effective treatment to increase quality of life in adults with psychiatric diagnoses³. Occupational therapists working within the mental health field often need to use creative and innovative approaches to motivate their clients, including Animal-assisted therapy (AAT). AAT is a unique intervention approach that has the potential to improve a person’s emotional, physical, cognitive and …

Transitions For Tomorrow: An Evidence-Based Review Of Post-Secondary Transition Planning For Individuals With Autism, Julie Bardenwerper, James Gillette, Elizabeth Luk, Hilary Moser, Alanna Raffel

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disability in the US other than ADHD (IACC, 2012). Currently, the prevalence of individuals with ASD is estimated to be 1 in 88 in the US (CDC, 2012). Therefore, increasing numbers of children with ASD will age out of high school and transition to postsecondary settings. Individuals with ASD have demonstrated less successful postsecondary outcomes than individuals with other disabilities (Shattuck et al., 2011). Currently, there is limited research supporting the methods of successful transition planning for students with ASD (IACC, 2012). The purpose of this presentation is to introduce the …

Regulation Of Cell Death By Transfer Rna., Ya-Ming Hou, Xiaolu Yang

Department of Biochemistry and Molecular Biology Faculty Papers

SIGNIFICANCE: Both transfer RNA (tRNA) and cytochrome c are essential molecules for the survival of cells. tRNA decodes mRNA codons into amino-acid-building blocks in protein in all organisms, whereas cytochrome c functions in the electron transport chain that powers ATP synthesis in mitochondrion-containing eukaryotes. Additionally, in vertebrates, cytochrome c that is released from mitochondria is a potent inducer of apoptosis, activating apoptotic proteins (caspases) in the cytoplasm to dismantle cells. A better understanding of both tRNA and cytochrome c is essential for an insight into the regulation of cell life and death.

RECENT ADVANCES: A recent study showed that the …

Unraveling The Mechanism Of 2,4-Dinitrofluorobenzene-Associated Cell Death, Franklin Thelmo

Summer Training Program in Cancer Immunotherapy

The mechanism by which the hapten 2,4-dinitrophenyl (DNP) mediates cell death is unclear according to current literature. To determine how DNP mediates death in the B16F10 murine melanoma cell line in vitro, cells were modified with 2,4-dinitro-1-fluorobenzene (DNFB). Following modification, cell lysates were collected and analyzed via Western blottings with known apoptotic or necrotic markers. Our results indicated that DNFB treated cells do not express the apoptotic marker Cleaved Caspase-3 and have no change in levels of the necrotic marker Cyclophilin A. We conclude that DNFB is not inducing apoptosis in B16F10 cells. Future research will further examine the …

The Conception Of Gcc- Specific Chimeric Antigen Receptors, Raven Smith-Parris

Summer Training Program in Cancer Immunotherapy

Colorectal Cancer is an aggressive disease that claims the lives of both men and women every year. It is the second leading cause of cancer-related death in the U.S. The overwhelming mortality rate it amasses begs for the discovery of alternative forms of treatment. The nature of cancer requires immunotherapeutic approach that is tumor specific in nature. Adoptive T-cell therapy is an alternative that satisfies these conditions. Guanylyl Cyclase C is a receptor found on the luminal side of the gut that is tissue-specific for the intestinal epithelium. Further, its expression is maintained throughout colorectal tumorigenesis making in an excellent …

Adoptive T Cell Therapy For Metastatic Colorectal Cancer, Shauna Ebanks

Summer Training Program in Cancer Immunotherapy

Colorectal cancer is the second leading cause of cancer-related death in US (1). Most of the mortality reflects local, regional and distant metastatic tumors. Cancers that are confined within the wall of the colon are often curable with surgery while tumor cells that have spread into other organs like liver and lung has low curable possibility, even though the chemotherapies and monoclonal antibodies can extend the person's life and improve quality of life(2, 3). Surgery is the main treatment for primary colorectal tumors but recurrence can happen and develop into metastasis. In addition, colorectal cancer …

Scott Memorial Library Information Flyer Fall 2013-2014, Education Services

The AC's Research Support Newsletter (Formerly AISR Connections)

Scott Memorial Library information flyer for Fall 2013.

Aisr Connections (Fall 2013-2014), Education Services

The AC's Research Support Newsletter (Formerly AISR Connections)

AISR Connections highlighting new services and happenings at the Scott Memorial Library at Thomas Jefferson University.

Improving Function In Age-Related Macular Degeneration: A Randomized Clinical Trial., Barry W. Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E. Leiby, Allen C. Ho, William S. Tasman

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To compare the efficacy of problem-solving therapy (PST) with supportive therapy (ST) to improve targeted vision function (TVF) in age-related macular degeneration (AMD).

DESIGN: Single-masked, attention-controlled, randomized clinical trial with outcome assessments at 3 months (main trial endpoint) and 6 months (maintenance effects).

PARTICIPANTS: Patients with AMD (n = 241) attending retina practices.

INTERVENTIONS: Whereas PST uses a structured problem-solving approach to reduce vision-related task difficulty, ST is a standardized attention-control treatment.

MAIN OUTCOME MEASURES: We assessed TVF, the 25-item National Eye Institute Vision Function Questionnaire plus Supplement (NEI VFQ), the Activities Inventory (AI), and vision-related quality of life …

Cancer Metabolism: New Validated Targets For Drug Discovery., Federica Sotgia, Ubaldo E. Martinez-Outshoorn, Md, Michael P. Lisanti

Kimmel Cancer Center Faculty Papers

Recent studies in cancer metabolism directly implicate catabolic fibroblasts as a new rich source of i) energy and ii) biomass, for the growth and survival of anabolic cancer cells. Conversely, anabolic cancer cells upregulate oxidative mitochondrial metabolism, to take advantage of the abundant fibroblast fuel supply. This simple model of "metabolic-symbiosis" has now been independently validated in several different types of human cancers, including breast, ovarian, and prostate tumors. Biomarkers of metabolic-symbiosis are excellent predictors of tumor recurrence, metastasis, and drug resistance, as well as poor patient survival. New pre-clinical models of metabolic-symbiosis have been generated and they genetically validate …