Medicine and Health Sciences Commons^™

Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (Dipnech) To Carcinoid: Exploring The Link, Jacob D. Mcfadden Msii, Jeffrey P. Baliff Md

Department of Pathology Honors Program Student Research Symposium

Neuroendocrine cells (NECs) play important roles in normal lung development, autonomic regulation of lung function, and response to hypoxia or injury. They are located between the respiratory epithelium and the basement membrane of bronchi and bronchioles (below), often as single cells or small clusters.

NEC proliferation is a common pathologic occurrence, well established as a reactive response to chronic lung injury. Much less commonly, NEC proliferation is observed in the absence of apparent inciting factors. This neoplastic phenomenon is termed “diffuse idiopathic pulmonary neuroendocrine cell hyperplasia” (DIPNECH).

DIPNECH is recognized as a precursor lesion for carcinoid tumors. While the progression …

Ocular Manifestations Of Rosai-Dorfman Disease, Phoebe L. Mellen, B.S., Ralph C. Eagle Jr., M.D.

Department of Pathology Honors Program Student Research Symposium

History of Rosai-Dorfman Disease

In 1969, Dr. Juan Rosai and Dr. Ronald F. Dorfman reported four cases of an entity that previously had puzzled pathologists and clinicians. The four cases had failed to fit under any diagnosis, but shared a few common characteristics. Each patient presented with painless, massive lymphadenopathy, most commonly of the cervical lymph nodes¹. Other locations included the inguinal, intra-parotid, and axillary lymph nodes. The patients all presented with fever and leukocytosis¹. The differential diagnosis included malignant lymphoma, malignant histiocytosis, reticuloendotheliosis, and chronic inflammation. However, the histopathological characteristics of the cases did not …

Download Entire Issue- Jefferson Interprofessional Education And Care Newsletter, Spring, 2013, Volume 4, Issue 1

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Entire Spring 2013, Volume 4, No. 1 JCIPE newsletter

Upcoming Faculty And Staff Development Programs

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Interprofessional Geriatric Education and Practice Institute

Eastern Pennsylvania‐Delaware Geriatric Education Center : Interprofessional Geriatric Practice

Collaborating Across Borders (CAB IV) An American‐Canadian Dialogue on Interprofessional Health Education & Practice

From The Editors, Elizabeth Speakman, Edd, Rn, Anef, Christine A. Arenson, Md

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Welcome to the latest edition of the Jefferson Interprofessional Education and Care Newsletter. In our past newsletter we described a meeting that took place February 2011 that previewed the core competencies presented by IPEC. We are pleased to announce that TJU has adopted four IPE core competencies for Interprofessional Collaborative Practice, they are; Values/Ethics‐ Respect the unique cultures, values, roles/responsibilities and expertise of other health professionals; Roles/ Responsibilities‐ Explain the roles and responsibilities of other health/healthcare providers and how the team works together to provide care; Interprofessional Communication‐ Work to ensure common understanding of information, treatment, and health/healthcare decisions by …

Jeff-Chat Offers Students An Interprofessional Forum To Discuss Experiences, Danielle Elliot, Md, Scott Schmidt, Md, Claire Hoppenot, Md, Maria Hervada-Page, Mss

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Feelings of frustration, loss, and exhaustion are common among healthcare workers. Students placed among new experiences and in a dependent learning role are not shielded from these emotions but often experience them differently from other members of the healthcare team. In addition to the systematic and individual support available through TJUH, for the past year and a half Jeff‐ CHAT (Compassion, Humanism, Altruism, Trust) has provided a forum for students to discuss and reflect on difficult emotions and situations.

Functional And Quality-Of-Life Outcomes In Geriatric Patients With Type-Ii Dens Fracture., Alexander R Vaccaro, Christopher K Kepler, Branko Kopjar, Jens Chapman, Christopher Shaffrey, Paul Arnold, Ziya Gokaslan, Darrel Brodke, John France, Mark Dekutoski, Rick Sasso, S Tim Yoon, Christopher Bono, James Harrop, Michael G Fehlings

Rothman Institute Papers

BACKGROUND: Dens fractures are relatively common in the elderly. The treatment of Type-II dens fractures remains controversial. The aim of this multicenter prospective cohort study was to compare outcomes (assessed with use of validated clinical measures) and complications of nonsurgical and surgical treatment of Type-II dens fractures in patients sixty-five years of age or older.

METHODS: One hundred and fifty-nine patients with a Type-II dens fracture were enrolled in a multicenter prospective study. Subjects were treated either surgically (n = 101) or nonsurgically (n = 58) as determined by the treatment preferences of the treating physicians and the patients. The …

Treatment Of Intractable Neurogenic Cough With Cricopharyngeal Myotomy, Anne Lee Durstenfeld, Bs, Joseph Spiegel, Md, Mauritis Boon, Md

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

Objectives: Neuropathic cough that is incompletely responsive to medical therapy may be due to cricopharyngeal hypertonicity. The objective was to describe the utility of cricopharyngeal myotomy in alleviating symptoms of intractable neuropathic cough.

Study Design: Retrospective review.

Methods: A retrospective chart review was performed for three patients who underwent cricopharyngeal myotomy for intractable cough. Trigger phenomena, previous evaluation and treatment, and outcomes after surgery, namely patient perception of improvement and medication use after surgery, were assessed and documented.

Results: After cricopharyngeal myotomy, all three patients noted symptomatic improvement and were weaned off medication. Continued improvement was noted at follow …

Bortezomib (Ps-341) Treatment Decreases Inflammation And Partially Rescues The Expression Of The Dystrophin-Glycoprotein Complex In Grmd Dogs., Karla P C Araujo, Gloria Bonuccelli, Caio N Duarte, Thais P Gaiad, Dayson F Moreira, David Feder, José E Belizario, Maria A Miglino, Michael P Lisanti, Carlos E Ambrosio

Department of Stem Cell Biology and Regenerative Medicine Faculty Papers & Presentations

Golden retriever muscular dystrophy (GRMD) is a genetic myopathy corresponding to Duchenne muscular dystrophy (DMD) in humans. Muscle atrophy is known to be associated with degradation of the dystrophin-glycoprotein complex (DGC) via the ubiquitin-proteasome pathway. In the present study, we investigated the effect of bortezomib treatment on the muscle fibers of GRMD dogs. Five GRMD dogs were examined; two were treated (TD- Treated dogs) with the proteasome inhibitor bortezomib, and three were control dogs (CD). Dogs were treated with bortezomib using the same treatment regimen used for multiple myeloma. Pharmacodynamics were evaluated by measuring the inhibition of 20S proteasome activity …

Glucose Stimulation Induces Dynamic Change Of Mitochondrial Morphology To Promote Insulin Secretion In The Insulinoma Cell Line Ins-1e., Bong Sook Jhun, Hakjoo Lee, Zheng-Gen Jin, Yisang Yoon

Center for Translational Medicine Faculty Papers

Fission and fusion of mitochondrial tubules are the major processes regulating mitochondrial morphology. However, the physiological significance of mitochondrial shape change is poorly understood. Glucose-stimulated insulin secretion (GSIS) in pancreatic β-cells requires mitochondrial ATP production which evokes Ca(2+) influx through plasma membrane depolarization, triggering insulin vesicle exocytosis. Therefore, GSIS reflects mitochondrial function and can be used for evaluating functional changes associated with morphological alterations of mitochondria. Using the insulin-secreting cell line INS-1E, we found that glucose stimulation induced rapid mitochondrial shortening and recovery. Inhibition of mitochondrial fission through expression of the dominant-negative mutant DLP1-K38A eliminated this dynamic mitochondrial shape change …

Converging Evidence For The Processing Costs Associated With Ambiguous Quantifier Comprehension., Corey T Mcmillan, Danielle Coleman, Robin Clark, Tsao-Wei Liang, Rachel G Gross, Murray Grossman

Department of Neurology Faculty Papers

Traditional neuroanatomic models of language comprehension have emphasized a core language network situated in peri-Sylvian cortex. More recent evidence appears to extend the neuroanatomic network beyond peri-Sylvian cortex to encompass other aspects of sentence processing. In this study, we evaluate the neuroanatomic basis for processing the ambiguity in doubly-quantified sentences. For example, a sentence like "All the dogs jumped in a lake" can be interpreted with a collective interpretation (e.g., several dogs jumping into a single lake) or a distributive interpretation (e.g., several dogs each jumping into a different lake). In Experiment 1, we used BOLD fMRI to investigate neuroanatomic …

Promoting Health Literacy Through Leading Edge Occupational Therapy Education, Susan Toth-Cohen, Phd, Otr/L, Annalisa Synnestvedt, Ba, Ots, Alyssa Frey Peachey, Ots

Department of Occupational Therapy Posters and Presentations

Synopsis:

Health literacy has become a vital focus of U.S. healthcare. By incorporating health literacy knowledge, attitudes, and skills into entry-­‐level education, occupational therapy professionals can enact a leading role in health and human services teams to address our national healthcare goals.

Poster presentation at the American Occupational Therapy Association Annual Conference, San Diego, CA, April 2013.

Jefferson Digital Commons Quarterly Report: January-March 2013, Daniel G. Kipnis, Msi

Jefferson Digital Commons Reports

Jefferson Digital Commons quarterly report includes statistics, new libguide for the Jefferson Digital Commons, new assets added to the collection.

Cardio-Oncology For The 21st Century: Introduction., Marc L Schwartz, Md

Division of Cardiology Faculty Papers

Based on the latest statistics the prognosis for patients with malignancy has dramatically improved. The overall 5 year survival rate for those who were diagnosed with a cancer between 2002 and 2008 was approximately 65%¹, and as of 2008, 12 million Americans were cancer survivors.² However, this extended longevity now exposes these patients to the risk of other health issues related to their primary cancer or to the treatment that ensured their survival. Specifically, patients who have not succumbed prematurely to their oncologic disease may develop cardiovascular disease that is either a result of the long-term effects …

Type Ii Diabetes And Dietary Preferences In A Rapidly Urbanizing Region Of West Africa, Megan Doherty

Master of Public Health Capstone Presentations

This study aims to identify themes in food preferences, knowledge, attitudes and behaviors (KAB) among a mix of rural and urban Ghanaians in the greater Kumasi region; to inform health interventions targeting better patient management of type II diabetes in a rapidly urbanizing region of Ghana; and to inform social marketing strategies by providing insight into consumption patterns. Urban centers in Sub-Saharan Africa have been especially impacted by the persistence of infectious disease and accompanying rise in non-communicable disease prevalence, including type II diabetes. In fact, type II diabetes recently registered as tenth among top causes of death in Kumasi, …

The Effects Of A Standardized Patient Education Program On Self-Management Outcomes In Patients With Hiv, Jason J. Schafer

Master of Public Health Capstone Presentations

The purpose of this pilot study was to determine the potential impact of a standardized HIV education program delivered during a provider visit on patient self-management of HIV as measured by adherence to care. Following a baseline assessment of HIV knowledge and adherence using validated tools, eligible patients were randomized to receive the standard of care normally provided in clinic, or the standard of care and a10-minute scripted educational presentation delivered during the clinic visit. Following the presentation, patients in the intervention group received the same knowledge assessment tool they received at baseline to identify knowledge changes. Patient adherence to …

Scoring Rubrics: Educators Tools To Facilitate Student Learning,, Mary Hanson-Zalot, Kathleen Day

Tech Talks

This session will focus on the creation and implementation of scoring rubrics. Basic rubric construction will be presented along with discussion of rubric functions for varying levels of students. Some information on the use of rubrics in the new Blackboard system will follow.

13 PowerPoint slides

Assessment Of Early Tumor Response To Cytotoxic Chemotherapy With Dynamic Contrast-Enhanced Ultrasound In Human Breast Cancer Xenografts., Jian-Wei Wang, Wei Zheng, Ji-Bin Liu, Yao Chen, Long-Hui Cao, Rong-Zhen Luo, An-Hua Li, Jian-Hua Zhou

Department of Radiology Faculty Papers

There is a strong need to assess early tumor response to chemotherapy in order to avoid adverse effects from unnecessary chemotherapy and allow early transition to second-line therapy. This study was to quantify tumor perfusion changes with dynamic contrast-enhanced ultrasound (CEUS) in the evaluation of early tumor response to cytotoxic chemotherapy. Sixty nude mice bearing with MCF-7 breast cancer were administrated with either adriamycin or sterile saline. CEUS was performed on days 0, 2, 4 and 6 of the treatment, in which time-signal intensity (SI) curves were obtained from the intratumoral and depth-matched liver parenchyma. Four perfusion parameters including peak …

Roles And Mechanism Of Mir-199a And Mir-125b In Tumor Angiogenesis., Jun He, Yi Jing, Wei Li, Xu Qian, Qing Xu, Feng-Shan Li, Ling-Zhi Liu, Bing-Hua Jiang, Yue Jiang

Computational Medicine Center Faculty Papers

MicroRNAs (miRNAs) have been shown to be involved in different aspects of cancer biology including tumor angiogenesis. In this study, we identified that two miRNAs, miR-199a and miR-125b were downregulated in ovarian cancer tissues and cell lines. Overexpression of miR-199a and miR-125b inhibited tumor-induced angiogenesis associated with the decrease of HIF-1α and VEGF expression in ovarian cancer cells. Moreover, the levels of miR-199a and miR-125b were negatively correlated with VEGF mRNA levels in ovarian tissues. We further showed that direct targets of miR-199a and miR-125b HER2 and HER3 were functionally relevant. Forced expression of HER2 and HER3 rescued miR-199a- and …

Assessing The Health Needs Of The Burmese And Bhutanese Refugees In South Philadelphia, Patricia Tolu-Ajayi

CwiC-PH

While refugees initially receive government aid (eg, Refugee Medical Assistance) upon arrival to the US, they often have unresolved medical concerns that persist beyond their initial period of government assistance (8 Months). To address these unmet health needs, Refugee Health Partners at Thomas Jefferson University started a free clinic targeting refugees from Bhutan and Burma living in South Philadelphia. An important finding from this clinic was that many refugees do not utilize the health care system, regardless of insurance status. Consequently, it is not known what health and social issues are most prevalent.

Continued Clinic Staff Education, Joseph S. Hong

CwiC-PH

Improving patient care by providing teaching sessions to hospital and clinic staff. The staff include medical assistants, technicians, and front office staff. The desired result would be to create an environment of scientific curiosity and improved understanding, for what the patients are dealing with. Thereby improving empathetic care when interacting with the patient.

Helping Refugees Navigate The Health Care Maze, Jenna Fox, Andy Kay

CwiC-PH

Jenna’s main focus during her Bridging the Gaps assignment at NSC was an outcomes assessment for use in grant applications. Her side projects included client service and education development

Analysis Of Importance Of Implementing Spiritual Assessment And Care Of Patients In Clinical Settings, You Na Park

CwiC-PH

Health professionals need to take care of patients’ spirituality, evaluate various spiritual approaches from both professional and public voices, and address concerns and potential conflicts in meeting the patients’ spiritual needs. There is a number of strategies and solutions to addressing the concerns of spiritual assessments and management of the patients in clinical setting.

Where Are They Now? Understanding How Src Directorship Influences Medical Student Career Trajectories And Outcomes Post-Graduation, Anita Modi,, Ann Vale, James D. Plumb, Md, Mph

CwiC-PH

JeffHOPE, a student-run clinic (SRC) designed to empower and care for Philadelphia's underserved population, was established in 1991 by the students of Jefferson Medical College. Since its inception, the program has been led by over 100 student directors, who oversee each of the five JeffHOPE clinics staffed by fellow medical students every week. But where are the directors now, and how did their leadership experiences caring for the underserved influence their career trajectories? Through the administration of a 20-question survey, we aimed to explore the experiences and accomplishments of medical student directors throughout the 20-year history of JeffHOPE, as well …

Asthma Questionnaire For An Immigrant Chinese Population, Ho-Hin Choy, Whitney Shiau, Md, Audrey Lung Md, Faap

CwiC-PH

Asthma is a key public health problem for the pediatric population of the United States. 7 million children in the United States have been diagnosed with asthma at some point in their lives (1). Asthma remains a disease that occurs in higher rates among minority populations. Those living in inner-city environments are most at risk. A study performed in an inner-city area of Boston, MA showed that 16% of an Asian American school age population had previously diagnosed asthma with an additional 3% having possible undiagnosed asthma (2). Northeast Medical Services (NEMS), a federally qualified community health center (FQHC), serves …

Mural Painting In South Philadelphia: A Means Of Addressing Racism Directed Against Bhutanese And Burmese Refugees, And Improving Health Outcomes, Meera Bhardwaj

CwiC-PH

INTRODUCTION

• Acculturation is the process of adjusting personal behavior patterns in response to prolonged interaction with another culture [1, 2].
• Discrimination in the host country significantly affects the acculturation process. Refugees have an extremely high risk for discrimination [3]. Discrimination exacerbates existing mental health conditions and activates the HPA [4].
• In the South Philadelphia refugees from Bhutan and Myanmar have been resettled into the neighborhood of East Passyunk/Moymensing. This demographic change has unfortunately resulted in acts of discrimination by the local community against the refugees.
• Mural Arts is painting a mural in the heart of this neighborhood. This mural will …

The Contribution Of Schizophrenia To Homelessness: Analysis Of The Housing First Model And Possible Prevention Of Serious Mental Illness, Elijah Grillo

CwiC-PH

The Problem

• 2.6 million schizophrenics in the US accounting for more inpatient treatment days than any other medical illness (national cost: $62 billion/year).

• 6% (~160,000) are homeless or live in shelters

• Make up 36% of the 700,000 homeless individuals in the US.

Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox

CwiC-PH

• Assessed needs and looked for solutions that are
• Executed and maintained locally Income-generating
• Provided skills trainings to CHWs on these topics
• Help initiate projects using these skills
• These projects show some modest continuing success

Growing Green Communities Through Urban Gardening In Haddington, Allison Rague, Zach Goldstein

CwiC-PH

Allison, Krista, and Zach worked on a farm and surrounding community gardens with high school students from Philadelphia Youth Network (PYN). The 25 PYN youths were divided into groups and focused on different projects related to urban gardening. The groups included social media, marketing, garden/landscape design, environmental education, and construction/ farm maintenance. Each youth was given the opportunity to explore his or her own interests within the realm of farming.

The Current State Of Health Care In China, Jonathan Yadlosky

CwiC-PH

After decentralizing health management in the early 1980s, China’s health care system developed many of the problems that we in the United States are currently working to solve. Though China is literally on the other side of the world, I think we might learn a few very important lessons from a close look at their successes, failures, trends, and goals in health care administration and delivery.