Medicine and Health Sciences Commons^™

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Director of Undergraduate medical education for the Department of Orthopedic Surgery at the Sidney Kimmel Medical College, I am happy to once again oversee the third annual issue of the Bone Bulletin. Through the activities of the DePalma Orthopaedic Society, medical students at SKMC have an excellent venue to learn about orthopaedic surgery, and through articles in this publication our surgeons at Rothman Orthopaedics have enthusiastically mentored younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard on many initiatives in recent years: providing forums for orthopaedic faculty to speak about their …

Editors' Note, Liam Gibbons, Amit Syal

Bone Bulletin

We are thrilled to introduce the third edition of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal aims to offer an additional avenue for medical students to engage with orthopaedics in medical school. Through the 1-on-1 mentorship with physicians from the Rothman Orthopaedic Institute, students gain hands-on experience writing about and directly engaging with current orthopaedic research and developments.

After each edition, it’s been exciting to see the journal continue to grow, with increasing numbers of students eager to get involved. This year, we are proud to announce …

Sfdda Newsletter Spring 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Winter 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Fall 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Summer 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Spring 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Walking Pneumonia - Not Always So Timid A Case Of Severe Ards Due To Fulminant Mycoplasma Pneumonia, Tharun Shyam, Momna Noor, Yan Naing Tun, Saumya Nanda, Omair Khan, Ravikaran Patti

Journal of Community Hospital Internal Medicine Perspectives

Mycoplasma pneumoniae pneumonia (MPP) most commonly presents as bronchitis or as a self-limited ‘walking’ community acquired pneumonia. A fulminant form of MPP may occur in 0.5% to 2% of patients and is characterized by rapidly progressive respiratory failure and Acute respiratory distress syndrome (ARDS). Our case highlights the importance of considering fulminant MPP as a cause of ARDS, especially in the young adult and middle-aged population. We review the current literature and management principles of this rare disease with an emphasis on antibiotic stewardship and corticosteroid therapy. Further research is needed to better understand patterns of antibiotic resistance and to …

A Rare Case Of Familial Hypocalciuric Hypercalcemia In Patient With Pancreatitis, Muhammad Ijaz Khan, Tanvi Jain, Muhammad Mohsin Abid, Samra Israr, Muhammad Haris Khan

Journal of Community Hospital Internal Medicine Perspectives

Familial hypocalciuric hypercalcemia (FHH) is a rare autosomal dominant condition caused by mutations in the calcium-sensing receptor gene (CASR), leading to asymptomatic hypercalcemia. Here, we report a case of hypercalcemia in a patient with acute pancreatitis, subsequently diagnosed with FHH. A 41-year-old male presented with abdominal pain and elevated pancreatic enzymes. Imaging revealed changes consistent with acute pancreatitis. Surprisingly, serum calcium was elevated, which is uncommon in acute pancreatitis. Further work-up demonstrated normal parathyroid hormone (PTH), PTH-related peptide (PTHrp), and vitamin D levels. A 24- hour urinary calcium excretion of 24 mg/24 hr and a calcium-to-creatinine clearance ratio (CCCR) of …

An Unusual Presentation Of Iga Vasculitis And Iga Nephropathy: A Case Report, Mark A. Colantonio, Nicholas Condiles, Alan P. Lim, Khaled Shawwa

Journal of Community Hospital Internal Medicine Perspectives

Immunoglobulin A (IgA) nephropathy is the most common glomerulonephritis worldwide. While IgA nephropathy mainly presents with renal manifestations, systemic symptoms associated with vasculitis are uncommon. Oftentimes, creatinine is used as a serum marker for renal dysfunction; however, it may not always be sensitive, especially in patients with low muscle mass. In such cases, cystatin C may prove to be a better indicator of renal function. Here, we present a case of IgA nephropathy with a normal serum creatinine and elevated cystatin C, highlighting the utility of cystatin C in the setting of a normal creatinine and high suspicion for renal …

The Diagnostic Maze: Challenges In Autoimmune Hepatitis Lab Interpretation, Tina C. L. Phan, Esther Blondeau-Lecomte, Christopher D. Jackson

Journal of Community Hospital Internal Medicine Perspectives

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by the presence of circulating autoantibodies. The spectrum of disease manifestations extends from asymptomatic cases to mild symptoms and, in rare instances, acute liver failure. AIH is a diagnosis of exclusion, supported by the detection of autoantibodies such as anti-smooth-muscle antibody (ASMA). This case describes a 43-year-old female with myasthenia gravis, receiving monthly intravenous immunoglobulin (IVIG) infusions, who presented with persistently elevated liver enzymes and mildly elevated ASMA titers across multiple clinical encounters. A liver biopsy revealed severe acute hepatitis. While drug-induced liver injury (DILI) secondary to IVIG was initially …

When Patients Ask Chatgpt About Statins: Clinical Implications In The Community Setting, Jayashree Ravikumar

Journal of Community Hospital Internal Medicine Perspectives

No abstract for this article type.

Incidence, Associated Abnormalities, And Outcomes Of Dextrocardia: A Registry-Based Study In Saudi Arabia, Naif Saad Alghasab, Bandar Alshehri, Sulaman Almesned, Hassan Harbi, Reem Alameer, Fahad Alshehri, Ahmad Alzeid, Meshari Alzhrani, Ghazi T. Almutiri, Sara Abou Al-Saud, Fahad Alobaid, Khalid S. Alnajashi, Federica Fogacci, Arrigo F.G. Cicero, Suleiman M. Kharabsheh

Journal of the Saudi Heart Association

Objective: The right-sided positioning of heart during embryonic development is termed dextrocardia, and it may be isolated or associated with visceral dextroposition or malformation. However, there are few studies on the condition. This study aimed to determine the incidence of cardiac and non-cardiac malformations, long-term follow-up, and survival analysis of patients with dextrocardia. Methods: This was a retrospective chart review of dextrocardia cases at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia from April 22, 1975, to December 31, 2016. A total of 259,246 transthoracic echocardiograms from that period were reviewed, and 357 patients were included in …

Artificial Intelligence Policies In Bioethics And Health Humanities: A Comparative Analysis Of Publishers And Journals, Christopher Bobier, Daniel Rodger, Daniel Hurst

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Rapid advancements in artificial intelligence (AI) pose novel ethical and practical challenges for scholarly publishing. Although AI-related policies are emerging in many disciplines, little is known about the extent and clarity of AI guidance in bioethics and health humanities journals.

METHODS: A search of publicly available journal lists from the American Society for Bioethics and Humanities, Health Humanities Consortium, and Association for Medical Humanities was supplemented with Google Scholar's top 20 bioethics journals ranked by h5-index. This yielded 54 unique journals, of which 50 remained after excluding those without a functional website or recent publications. AI policies were reviewed …

Overcoming Barriers To Literacy For Individuals Who Need Or Use Aac: Lived Experiences, Key Research Findings, And Future Directions, Janice Light, Christine Holyfield, David Mcnaughton, Dana Nieder, Jamie Preece

Communication Disorders and Occupational Therapy Faculty Publications and Presentations

Literacy supports participation in education, employment, healthcare, and community living, and enhances communication for individuals who need or use augmentative and alternative communication (AAC). Research has demonstrated that individuals with developmental disabilities who need or use AAC can successfully acquire a wide range of literacy skills when provided with effective tools and evidence-based, adapted instruction delivered by trained professionals. Unfortunately, individuals who need or use AAC typically face significant barriers to literacy learning: (1) They may be excluded from literacy instruction or only have access to instruction that requires spoken responses severely limiting their participation; (2) Their service providers may …

External Challenges For Individuals Who Need Or Use Aac Who Are Learning Language: Lived Experiences, Key Research Findings, And Future Directions, Christine Holyfield, Janice Light, Dana Nieder, Jamie Preece

Communication Disorders and Occupational Therapy Faculty Publications and Presentations

Language skills are essential to effective communication, but learning language is by no means a simple process for individuals with developmental disabilities who cannot rely on speech alone to be heard and understood. Research demonstrates that augmentative and alternative communication (AAC) interventions positively impact development across language domains (e.g., pragmatics, semantics, morphosyntax) and may also benefit speech production. However, these gains can only be realized if people have timely access to effective AAC and have meaningful opportunities to interact with others. This paper integrates the lived experiences of individuals who need or use AAC and their families with key research …

Pacific Rxtracts - July 2025, Pacific Rxtracts

Pacific RxTracts

Articles:

• First Blood Test Approved For the Diagnosis of Alzheimer’s Disease
• Rare Withdrawal Reaction Prompts Label Update for Common Antihistamines
• FDA Approves SUSVIMO: Shifting Diabetic Retinopathy Treatment from Monthly Injections to Continuous Therapy
• Battle Against Resistant Hypertension
• Two Is Better than One: Obicetrapib and Ezetimibe, a Novel Combination Pill for High Cholesterol
• Histo-blood Group ABO System Transferase and Venous Thromboembolism Risk
• GLP-1 Agonists and Thiazolidinedione Combination Therapy in Type 2 Diabetes
• Dual Pathway Targeting in Type 2 Diabetes: Exploring the Synergy of GLP1- RAs and SGLT2-inhibitors
• Two Vaccines, One Shot: Combined Immunizations Against COVID-19 and Influenza
• Mirikizumab: A New Frontier …

Single-Level Anterior Cervical Discectomy And Fusion Is Associated With Higher Nonroutine Discharge Rates Compared To Cervical Disc Arthroplasty In Obese Patients, Paul G. Mastrokostas, Luke B. Schwartz, Eli Berglas, Aaron B. Lavi, Leonidas E. Mastrokostas, Jonathan Dalton, Christopher K. Kepler, Arya Varthi, Jad Bou Monsef, Afshin E. Razi, Mitchell K. Ng

Rothman Institute Papers

CONTEXT: Obesity is a recognized risk factor for adverse outcomes in cervical spine surgery. While cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF), comparative outcomes among obese patients remain underexplored.

AIMS: The aim of this study is to compare nonroutine discharge rates and other postoperative outcomes between obese patients undergoing single-level ACDF and CDA.

SETTINGS AND DESIGN: Retrospective cohort study using a national database.

SUBJECTS AND METHODS: The National Inpatient Sample was queried to identify obese patients who underwent single-level ACDF or CDA between 2016 and 2020. Inclusion and exclusion criteria were …

Commentary On Quality Improvement Case Series: Leukemic Arthritis Mimicking Septic Arthritis In A Pediatric Patient, Alexandre Arkader, Mihir M Thacker, Karim Masrouha

Department of Medicine Faculty Papers

No abstract provided.

Factors Related To Hypertension In Pediatric Patients Who Do Not Have Obstructive Sleep Apnea: A Retrospective Chart Study, Alyssa Exarchakis, Alexandra Cohen, Penghao Wang, Seema Rani, Diana Martinez

Department of Medicine Faculty Papers

Background/Objectives: The relationship between OSA and adult hypertension has been extensively studied; however, it remains understudied in pediatric patients without OSA. The aim of this study is to identify factors associated with pediatric hypertension without OSA, through an IRB-approved retrospective chart review of patients who underwent polysomnography at Nemours Children's Hospital, DE/NJ between January 2020 and July 2023. Methods: Eligibility criteria included children 8-17 years, completed PSG, and clinic visit blood pressure (BP). Anthropometrics, demographics, social determinants, and medical history were obtained from electronic medical records. Hypertension was defined as the average systolic and/or diastolic BP that is …

Brivaracetam Effectiveness And Patient-Reported Outcomes In Clinical Practice: Data From A 12-Month Prospective, Observational Study In The United States., Hina Dave, Michael R. Sperling, Hamada Hamid Altalib, Heidi Henninger, Roger J. Porter, Michael Gelfand, Prashant Dongre, Sami Elmoufti, Melinda S. Martin, Anne-Liv Schulz, Jacqueline A. French

Department of Neurology Faculty Papers

OBJECTIVE: Evaluate real-world effectiveness, patient-reported outcomes (PROs), and safety/tolerability of brivaracetam in patients (≥16 years) with focal-onset seizures currently receiving ≥ 1 antiseizure medication (ASM), and with historical or current use of levetiracetam, lamotrigine, oxcarbazepine, and/or carbamazepine.

METHODS: EP0088 was a 12-month, prospective, observational study of brivaracetam in a clinical practice setting in the US. Primary study outcome was brivaracetam retention at 12 months after brivaracetam initiation. Effect of brivaracetam on patients' perceptions of their health was assessed using Patient-Reported Outcomes Measurement Information System (PROMIS) short forms and Seizure-Related Disability Assessment Scale (SERDAS). Safety outcomes included incidence of treatment-emergent adverse …

Recurrent De Novo Variants In The Spliceosomal Factor Crnkl1 Are Associated With Severe Microcephaly And Pontocerebellar Hypoplasia With Seizures, Sankalita Ray Das, Rosie Sullivan, Mischa S G Ruegg, Julia Horsfield, Jordan Doran, Gemma Poke, Nathalie De Vries, Sarah Duerinckx, Damien Lederer, Muzhirah Haniffa, Wee-Teik Keng, Gaik-Siew Ch'ng, David A Parry, Andrew P Jackson, Masamune Sakamoto, Naomichi Matsumoto, Noriko Miyake, Shin Nabatame, Hidetoshi Taniguchi, Emma Wakeling, Katrin Õunap, Pilvi Ilves, Ghayda Mirzaa, Andrew Timms, Emily Pao, Kimberly A Aldinger, William Dobyns, Axel Bohring, Beate Behre, Daniel G Calame, James R Lupski, Juan M Pascual, Marc Abramowicz, Gregory Gimenez, Louise S Bicknell

Faculty, Staff and Students Publications

Splicing is a complex process that is required to create the transcriptomic diversity needed for specialized functions in higher eukaryotes. The spliceosome contains more than 100 proteins and RNA molecules, which coordinate this dynamic process. Despite the ubiquity of splicing, pathogenic variants in spliceosomal components often cause a tissue-specific phenotype, hinting at further complexities that are not yet fully understood. We have identified a cohort of ten families with de novo missense variants in a spliceosomal component, CRNKL1, where nine individuals harbor one of two missense variants that both affect the same amino acid, Arg267. All affected individuals share a …

Amino Acid Transporter Lat1 (Slc7a5) Promotes Metabolic Rewiring In Tnbc Progression Through The L-Trp/Qprt/Nad+ Pathway, Margot Y. Fedoroff, Lei Zhao, Shaomin Wang, Alok Bhushan, Haifeng Yang, Karen M. Bussard, Stephen C. Peiper, Jun He

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Cancer cells uptake excessive nutrients by expressing higher levels of glucose and/or amino acid transporters to meet their increased energy demands. L-type amino acid transporter 1 (LAT1), is regarded as a cancer-specific transporter for the uptake of large neutral amino acids such as L-tryptophan. However, the mechanism by which LAT1 rewires cellular metabolism to promote cancer progression and chemoresistance have not yet been investigated.

METHODS: The protein levels of LAT1, p-PKM2, and p-LDHA were determined in breast cancer tissue arrays by immunohistochemistry staining followed by survival analysis. The orthotopic breast cancer models in mice, syngeneic breast cancer models, and …

The Impact Of Operative Level On Patient-Reported Outcome Measures Following Single-Level Posterior Lumbar Decompression For Disc Herniation, Jonathan Dalton, Robert Oris, Omar Tarawneh, Gregory Toci, Rajkishen Narayanan, Dominic Finan, Hannah Bash, Marco Goldberg, John Mangan, Barrett Woods, Mark Kurd, Ian Kaye, Jose Canseco, Alan Hilibrand, Alex Vaccaro, Gregory Schroeder, Christopher Kepler

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: To compare the impact of upper versus lower lumbar decompression on patient-reported outcome measures (PROMs).

MATERIALS AND METHODS: Patients undergoing L1-L2, L2-L3, L4-L5, or L5-S1 single-level elective decompression with 1-year PROMs were identified. Included PROMs were the Oswestry Disability Index (ODI), visual analog scale (VAS) back and leg, and Short Form-12 physical (PCS) and mental (MCS) component scores. Minimal clinically important differences (MCID) were calculated. Multivariable regressions assessed the independent predictive ability of operative level controlling for demographic confounders.

RESULTS: Three hundred and forty-six patients were included (94 upper lumbar decompressions). Upper lumbar decompression patients were older (64.0 vs. …

A Comparison Of Different Posterior Arthrodesis Techniques Versus Anterior Dens Screw For Odontoid Fractures: A Systematic Review And Meta-Analysis, Pavlos Texakalidis, Stavros Matsoukas, Michael Cloney, Mykhaylo Krushelnytskyy, Kevin Swong, Najib El Tecle, Tyler Koski, Nader Dahdaleh

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: Odontoid fractures are often managed surgically. The most common approaches are anterior dens screw (ADS) and posterior arthrodesis (PA), with the latter being associated with significantly higher fusion rates. PA techniques can include wiring, C1-C2 transarticular (TA) screws, and C1 lateral mass (LM)-C2 pars/pedicle screws. Most comparative studies group multiple PA techniques together when comparing PA versus ADS. Our objective was to systematically review the literature and identify studies that separately provide fusion rates of each different posterior C1-C2 arthrodesis (PA) technique utilized compared to ADS.

METHODS: A systematic literature review was conducted according to the Preferred …

How Are We Defining Preoperative Anemia? A Comparison Of Various Anemia Thresholds Among Patients Undergoing Short-Construct Lumbar Spinal Fusion, Tariq Issa, Omar Tarawneh, Teeto Ezeonu, Mark Lambrechts, Mark Kurd, Ian Kaye, Jose Canseco, Alan Hilibrand, Alex Vaccaro, Christopher Kepler, Gregory Schroeder

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Anemia is a risk factor for increased transfusions. However, various definitions of anemia have been described in scientific literature and a consensus on how to appropriately diagnose anemia or who to preoperatively optimize is lacking. We aimed to compare multiple anemia definitions and evaluate if any threshold best predicts transfusion requirements and surgical outcomes following spinal fusion.

METHODS: We conducted a retrospective cohort study of 1-2 level posterior spinal fusions. Preoperative hemoglobin was defined based on preoperative laboratories within 28 days of surgery. Anemia was diagnosed using the World Health Organization (WHO), the American Society of Hematology (ASH), and …

A Systematic Review Of Flotation-Restricted Environmental Stimulation Therapy (Rest), Elnaz Lashgari, Emma Chen, Jackson Gregory, Uri Maoz

Psychology Faculty Articles and Research

Background

Restricted Environmental Stimulation Therapy (REST) is a therapeutic technique that involves immersing an individual in an environment with minimal sensory input or stimulation. The goal of REST is to induce a state of relaxation that is deeper than what can be achieved through other forms of relaxation techniques. Research suggests that REST can help reduce anxiety, alleviate chronic pain, improve sleep, and enhance creativity and cognitive function. Flotation-REST is a popular type of REST that utilizes an enclosed tank filled with buoyant saltwater to facilitate relaxation. This study aimed to synthesize the evidence on studies that investigate the effects …

Intersectionality Gaps Among Multiple Social Determinants In U.S. Infant And Maternal Mortality Rates, Mary D. Kirkley

Walden Dissertations and Doctoral Studies

The purpose of this quantitative, cross-sectional study was to examine whether social determinants interactively influence U.S. maternal and infant mortality rates. Grounded in the Social Ecological Model, this study analyzed secondary data from the Centers for Disease Control and Prevention’s National Vital Statistics System were analyzed using multivariable logistic regression. The final sample included 110,402 maternal deaths and 55,839 infant deaths, with inclusion criteria requiring complete data on race, education, age, marital status, gender (for infants), residency, and year of death. Exclusion criteria included non-U.S. resident deaths or missing demographic data. Results revealed statistically significant interaction effects: race/ethnicity with education …

Examining The Association Between The Timing Of The First Antenatal Check; Number Of Antenatal Care (Anc) Visits During Pregnancy With Maternal Mortality In Nigeria, Kanayo Omonoju

Walden Dissertations and Doctoral Studies

Maternal mortality is growing at an alarming rate in Nigeria, ranking the second highest Maternal Mortality Rate (MMR) globally. This cross-sectional study examined the association between the timing of the first antenatal check and the number of Antenatal Care (ANC) visits during pregnancy and its impact on maternal mortality using the Nigerian Demographic and Health Survey (NDHS) 2018 among a study population of women 15 - 49 years old. The theoretical framework for this study was grounded in the socioecological model. Multiple logistic regression was used to determine if there are relationships between timing of first antenatal check, the number …

Transcriptomic And Histological Characteristics Of Innate Immune Activation In Brain Parenchyma In A Rat Model Of Neonatal Intraventricular Hemorrhage, Miriam Zamorano, Sanjna Udtha, Aidan M Collier, Erica Underwood, Razan El Sayed, Ankit Agarwal, Devin S Hatchell, Chunfeng Tan, Paul J Nietert, Scott D Olson, Brandon A Miller

Faculty, Staff and Student Publications

Background: Intraventricular hemorrhage (IVH) remains a major complication in preterm infants with lifelong sequelae. There is no effective treatment for IVH other than supportive care and surgery for post-hemorrhagic hydrocephalus. We previously reported that the innate neuroimmune response in an animal model of IVH was dependent on developmental stage, only occurring in older animals.

Methods: This study utilized a lysed-blood injection model of IVH in rats. This model specifically captures the effects of blood products released by IVH on brain parenchyma. We performed RNAseq and differential gene expression analysis on CD11b/c-positive cells in the brain (microglia/macrophages) to define gene expression …