Medical Specialties Commons^™

Astrocytes Infected With Chlamydia Pneumoniae Demonstrate Altered Expression And Activity Of Secretases Involved In The Generation Of Β-Amyloid Found In Alzheimer Disease, Zein Al-Atrache, Danielle B Lopez, Susan Hingley, Denah Appelt

PCOM Scholarly Works

BACKGROUND: Epidemiologic studies strongly suggest that the pathophysiology of late-onset Alzheimer disease (AD) versus early-onset AD has environmental rather than genetic causes, thus revealing potentially novel therapeutic targets to limit disease progression. Several studies supporting the "pathogen hypothesis" of AD demonstrate a strong association between pathogens and the production of β-amyloid, the pathologic hallmark of AD. Although the mechanism of pathogen-induced neurodegeneration of AD remains unclear, astrocytes, a key player of the CNS innate immune response and producer/metabolizer of β-amyloid, have been implicated. We hypothesized that Chlamydia pneumoniae infection of human astrocytes alters the expression of the amyloid precursor protein …

Speech And Language Outcomes In Patients With Ankyloglossia Undergoing Frenulectomy: A Retrospective Pilot Study, Srihari Daggumati, Jason E. Cohn, Matthew J. Brennan, Marissa Evarts, Brian J. Mckinnon, Alyssa R. Terk

Otolaryngology (ENT) Resident Research

Ankyloglossia is a controversial topic with no standardized treatment guidelines. A retrospective chart review was conducted to identify children who underwent lingual frenulectomy for speech and language impairment. Impairment severity was recorded pre- and postoperatively as mild, mild to moderate, moderate, moderate to severe, or severe. Variables were tested with chi-square analysis for their statistical relationship to improvements in speech and language. Children with preoperative moderate and moderate-to-severe speech and language impairment attained better speech and language outcomes after frenulectomy as compared with children with mild and mild-to-moderate impairment (100% vs 82%, P = .015). Sutured closure after frenulectomy was …

Guggulsterone Activates Adipocyte Beiging Through Direct Effects On 3t3-L1 Adipocytes And Indirect Effects Mediated Through Raw264.7 Macrophages., Colette N Miller, Janaiya S Samuels, Yusra Azhar, Ashish Parmar, Rangaiah Shashidharamurthy, Srujana Rayalam

PCOM Scholarly Works

Background: Plant-derived phytochemicals have been of emerging interest as anti-obesity compounds due to their apparent effects on promoting reduced lipid accumulation in adipocytes. Despite such promising evidence, little is known about the potential mechanisms behind their anti-obesity effects. The aim of this study is to establish potential anti-obesity effects of the phytochemical guggulsterone (GS). Methods: Mature 3T3-L1 adipocytes were treated with GS, derived from the guggul plant native in northern India, to investigate its effects on mitochondrial biogenesis and adipocyte "beiging." Further, to explore the relationship between macrophages and adipocytes, 3T3-L1s were treated with conditioned media from GS-treated RAW264.7 macrophages. …

The Use Of Dietary Interventions In Pediatric Patients, Shirin Madzhidova, Lusine Sedrakyan

PCOM Scholarly Works

Complementary and alternative treatment approaches are becoming more common among children with chronic conditions. The prevalence of CAM use among US adults was estimated to be around 42% in 2015 and around 44% to 50% among adults with neurologic disorders. Studies demonstrate that children with certain chronic illnesses such as asthma, cancer, genetic disorders, attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental disorders are treated with complementary and alternative treatments at higher rates. Dietary therapies are gaining increasing popularity in the mainstream population. Although the majority of "fad" diets do not have enough supporting evidence, some dietary therapies have been utilized for …

Marjolin's Tumor Complicating Chronic Periprosthetic Infection Of A Total Knee Arthroplasty, Timothy Horan, Matthew T. Wallace, Albert J. Aboulafia, Janet D. Conway

Orthopedic Surgery Resident Research

Marjolin's tumor is a term used to describe a malignancy developing in the setting of a chronic wound, infection, or other tissue subject to chronic inflammatory changes. These malignancies usually present after many years of chronicity, and can range from lower grade basal cell carcinomas to high-grade sarcomas. We present the case of a squamous cell carcinoma that developed within a chronic periprosthetic infection of a total knee arthroplasty of 7 years duration. The intra-articular location, association with an orthopaedic implant, and brief latency period are all unique features of this case.

Mta3-Sox2 Module Regulates Cancer Stemness And Contributes To Clinical Outcomes Of Tongue Carcinoma., Zhimeng Yao, Liang Du, Min Xu, Kai Li, Haipeng Guo, Guodong Ye, Dianzheng Zhang, Robert P Coppes, Hao Zhang

PCOM Scholarly Works

Cancer cell plasticity plays critical roles in both tumorigenesis and tumor progression. Metastasis-associated protein 3 (MTA3), a component of the nucleosome remodeling and histone deacetylase (NuRD) complex and multi-effect coregulator, can serve as a tumor suppressor in many cancer types. However, the role of MTA3 in tongue squamous cell cancer (TSCC) remains unclear although it is the most prevalent head and neck cancer and often with poor prognosis. By analyzing both published datasets and clinical specimens, we found that the level of MTA3 was lower in TSCC compared to normal tongue tissues. Data from gene set enrichment analysis (GSEA) also …

The Feasibility Of A Behavioral Group Intervention After Weight-Loss Surgery: A Randomized Pilot Trial, Michelle R. Lent, Laura K Campbell, Mackenzie C Kelly, Jessica L Lawson, Jessica M Murakami, Sasha Gorrell, G Craig Wood, Marianne M Yohn, Stephanie Ranck, Anthony T Petrick, Krystal Cunningham, Megan E Lamotte, Christopher D Still

PCOM Scholarly Works

BACKGROUND: Formal psychosocial support programs after weight-loss surgery are limited in scope and availability.

OBJECTIVE: This randomized pilot study evaluated the feasibility of a postoperative behavioral intervention program.

MATERIALS AND METHODS: Postoperative weight-loss surgery patients (N = 50) were recruited from February 2017-July 2017 and randomized to a four-month behavioral program or usual care wait-list. Outcomes evaluated in addition to feasibility included health-related quality of life (Short Form -36), psychosocial functioning and adherence. Secondary outcomes included within-group changes for each outcome.

RESULTS: Out of eight possible sessions, intervention participants attended a mean of 4.2 sessions. Intervention group participants experienced greater …

Does Preprandial Oral Lactase Supplement Reduce Abdominal Pain In Lactose-Intolerant Adult Patients After A Lactose-Containing Meal?, Margaryta Tolchynska

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not preprandial oral lactase supplement reduces abdominal pain in lactose-intolerant adult patients after a lactose-containing meal.

STUDY DESIGN: A systematic review of three randomized, blinded, controlled primary research studies published between the years of 2010 and 2018.

DATA SOURCES: One randomized controlled trial (RCT), one randomized comparative study, and one randomized crossover study evaluating the efficacy of 9,000 units of preprandial oral lactase supplement in reducing abdominal pain due to lactose intolerance (LI). All studies were published in peer-reviewed journals and found via the use of PubMed, …

Is Botulinum Toxin Injection Effective In Reducing Pain In Patients Diagnosed With Plantar Fasciitis?, David A. Fry

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not botulinum toxin injection is effective in reducing pain in patients diagnosed with plantar fasciitis.

STUDY DESIGN: Review of three randomized controlled trials (RCTs) comparing the efficacy of botulinum toxin injections versus corticosteroid injections for improving pain and dysfunction in those diagnosed with plantar fasciitis.

DATA SOURCES: All articles were presented in English and were taken from peer reviewed sources using PubMed. All articles were published from 2012-2017.

OUTCOMES: Outcomes of investigation measured are pain score measured using the VASvisual analog scale and Foot Health Status Questionnaire. …

Is There A Greater Statistically Significant Difference In The Clearance Or Partial Clearance Of Anogenital/Genital Warts When It Comes To Combination Therapies That Include Cryotherapy Versus Cryotherapy Alone?, Erika Burbano

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine if there is a statistically significant difference in using combination therapies that include cryotherapy vs. cryotherapy alone in the clearance of genital/anogenital warts.

STUDY DESIGN: Systematic review of three peer reviewed primary studies that were published between 2009-2014.

DATA SOURCES: Review of a double-blind placebo-controlled study, a single-blinded randomized controlled study, and a randomized clinical comparative study from 2011. All sources were selected from PubMed based on the applicability to the clinical question and how accurately they answered the question regarding the patient population

OUTCOMES: The outcomes of investigation …

Do Adults Undergoing Minimally Invasive Quadriceps-Sparing Total Knee Arthroplasty Have Less Of A Risk Of Developing A Postoperative Deep Venous Thrombosis As Compared To Patients Undergoing A Standard Medial Parapatellar Total Knee Arthroplasty?, Jessica Cataldo-Ramirez

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Do adults undergoing minimally invasive quadriceps-sparing total knee arthroplasty have less of a risk of developing a postoperative deep venous thrombosis as compared to patients undergoing a standard medial parapatellar total knee arthroplasty?”

STUDY DESIGN: A review of one case series published in 2007 and two randomized controlled trials published in 2014.

DATA SOURCES: Primary literature found in PubMed that compared the surgical outcomes of minimally invasive quadriceps-sparing total knee arthroplasty to standard medial parapatellar total knee arthroplasty.

OUTCOME MEASURED: Postoperative deep venous thrombosis development.

RESULTS: …

Is Lifitegrast 5.0% Ophthalmic Solution Effective In Improving Eye Dryness And Safe, In Terms Of Ocular Adverse Effects, In Adults 18 Years Or Older With Dry Eye Disease?, Aubrey E. Cole

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not lifitegrast 5.0% ophthalmic solution is effective in improving eye dryness and safe, in terms of ocular adverse effects, in adults 18 years or older with dry eye disease (DED).

Study Design: Systematic review of three primary double-blinded, randomized placebocontrolled trials that were published in peer-reviewed journals between 2014-2017.

Data Sources: Studies were obtained through the PubMed database based on relevance to the clinical question and evaluation of patient-oriented outcomes.

Outcomes Measured: Efficacy of lifitegrast treatment was measured based on the eye dryness …

Does Botulinum Toxin A Injections Into The Pelvic Floor Muscles Of Women With Chronic Genitopelvic Pain And Vaginal Spasm Improve Pain And Sexual Functioning?, Emily R. Broadbent

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidenced based medicine review is to determine whether or not botulinum toxin A injections into the pelvic floor muscles of women with chronic genitopelvic pain and vaginal spasm improve pain and sexual functioning.

STUDY DESIGN: Review of two double blind randomized controlled trials and one case series from peer reviewed journals published between 2006-2011.

DATA SOURCES: Two randomized controlled trials and one case series were found using PubMed, Google Scholar, and Cochrane Library.

OUTCOMES MEASURED: All three studies measured pain and sexual functioning using selfreported surveys including the visual analog scale for pain, Female Sexual …

Synapsis: Philadelphia Campus (2019), Philadelphia College Of Osteopathic Medicine

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The 2019 Philadelphia Campus Synapsis includes Orientation, White Coat, Gala, Life at PCOM, Anatomy Groups, Radiology, Family Medicine, Match.

Analysis Of Gene Transcription Changes Following Chlamydia Pneumoniae Infection Of Thpl Monocytes May Have Relevance To Alzheimer's Disease, Desiré Guthier

PCOM Biomedical Studies Student Scholarship

There is increasing evidence that neuroinflammation caused by infectious agents is an important etiologic factor in neurodegenerative diseases including Alzheimer's disease (AD). One infectious agent that has been associated with AD is Chlamydia pneumoniae (Cpn). Cpn DNA can be detected within peripherally circulating mononuclear cells and there is evidence that infected mononuclear cells could be involved in chronic infection and contribute to inflammation at numerous anatomical sites, including the brain. Understanding Cpn genetic changes progressing from an acute to a chronic infection within monocytes may help to further elucidate. the role of Cpn infected monocytes with regard to …

Delta-Aminolevulinic Acid-Mediated Photodiagnoses In Surgical Oncology: A Historical Review Of Clinical Trials., Joseph F Georges, Amber Valeri, Huan Wang, Aaron Brooking, Michael Kakareka, Steve S Cho, Zein Al-Atrache, Michael Bamimore, Hany Osman, Joseph Ifrach, Si Yu, Carrie Li, Denah Appelt, John Y K Lee, Peter Nakaji, Kristin Brill, Steven S. Yocom

PCOM Scholarly Works

Fluorescence imaging is an emerging clinical technique for real-time intraoperative visualization of tumors and their boundaries. Though multiple fluorescent contrast agents are available in the basic sciences, few fluorescence agents are available for clinical use. Of the clinical fluorophores, delta aminolevulinic acid (5ALA) is unique for generating visible wavelength tumor-specific fluorescence. In 2017, 5ALA was FDA-approved for glioma surgery in the United States. Additionally, clinical studies suggest this agent may have utility in surgical subspecialties outside of neurosurgery. Data from dermatology, OB/GYN, urology, cardiothoracic surgery, and gastrointestinal surgery show 5ALA is helpful for intraoperative visualization of malignant tissues in multiple …

Long-Term Use Of Beta-Blocker Medication In Pediatric Long Qt Syndrome Patients: Neuropsychological Profiles, Kara J. Rudisill

PCOM Psychology Dissertations

Long QT syndrome (LQTS) is a heart rhythm disorder characterized by a disruption of the heart’s electrical activity that may cause accelerated and uncontrolled heartbeats referred to as ventricular fibrillation. LQTS is primarily treated with beta-blocker medications, which reduce the risk of experiencing an arrhythmia through regulating the heart rate. However, the potential neuropsychological side-effects associated with the use of beta-blocker medication may impact the executive functioning skills, mental health, and behavior of the affected pediatric population at home. As a result, a child’s academic performance and emotional regulation etiology may be misunderstood by his or her parents, caregivers, and …

Does Stem Cell Injection Improve Quality Of Life In Patients With Cardiopathy Patients?, Shoua Shue Casillas

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not stem cell injections improve the quality of life in patients with cardiopathy.

STUDY DESIGN: Review of three randomized controlled trial (RCT) articles. All articles were published between 2012 – 2017 and were all printed in the English language.

DATA SOURCES: All three RCT articles were found through PubMed.

OUTCOMES MEASURED: One of the outcomes measured in each of the articles were improvement in quality of life in patients with cardiopathy. Among the three review articles, quality of life was measured using either the Kansas City Cardiomyopathy …

Is Apremilast 30mg Effective In Lowering Dlgi Scores In Patients With Plaque Psoriasis In 16 Weeks Of Therapy?, Hunter N. Dennard

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is Apremilast 30 mg effective in lowering DLQI scores in patients with plaque psoriasis in 16 weeks of therapy?”

Study Design: Review of three randomized, blind, placebo-controlled clinical trials published between the years 2013 and 2016.

Data Sources: All studies were published in peer-reviewed journals that were located using PubMed database searches.

Outcome Measured: The DLQI is a 10-item questionnaire that assesses the impact of skin disease on health-related quality of life (HRQOL) over the previous week. Scores for each item range from 0 (not at …

Are Anti-Pd-1/Pd-L1 Monoclonal Antibodies Effective In Prolonging Overall Survival In Patients With Advanced Non-Small Cell Lung Cancer?, Sara Bintner

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not anti-PD-1/PD-L1 monoclonal antibodies are effective in prolonging overall survival in patients with advanced non-small cell lung cancer (NSCLC).

Study Design: A systematic review and data analysis of three randomized control trials (RCTs) published after 2010. The studies were located in English written peer reviewed journals.

Data sources: Three RCTs, which evaluated the efficacy of anti-PD-1/PD-L1 monoclonal antibodies, including nivolumab and pembrolizumab, as first and second or consecutive line therapy in patients with advanced NSCLC compared to cytotoxic agents. The studies utilized were found in EBSCO host …

Is Tribulus Terrestris Effective At Increasing Sexual Desire In Adult Women Suffering From Hypoactive Sexual Desire Disorder?, Trevene T. Bell

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective evidence-based medicine (EBM) review is to determine whether or not Tribulus terrestris is effective at increasing sexual desire in adult women suffering from hypoactive sexual desire disorder (HSDD).

Study Design: Review of three randomized controlled trials published in 2014, 2016, and 2017; selection was based on their relevance to the clinical question and on their patient-oriented outcomes.

Data Sources: Three peer-reviewed primary studies comparing the use of Tribulus terrestris to placebo in the treatment of HSDD were found on PubMed. Outcome(s) Measured: For each trial, patients were divided into either Tribulus terrestris treatment or …

Is Sinupret (Bno 1016- Herbal Combination) An Effective Treatment For The Symptoms Of Acute And Chronic Rhinosinusitis Compared To Non-Treatment In Male And Female Adults Ages 18-75?, Sarah K. Boyle

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Sinupret (BNO 1016- herbal combination) is an effective treatment for the symptoms of acute and chronic rhinosinusitis compared to non-treatment in male and female adults ages 18-75? Study Design: This is a systematic review of three randomized controlled trials (RCTs) regarding Sinupret treatment for sinonasal symptoms. All RCTs were published in the English language in peer-reviewed journals in 2011, 2015, and 2017. Data Sources: Three randomized controlled trials were found using PubMED and CINAHL databases. Outcomes Measured: Symptom relief of acute and chronic rhinosinusitis was measured …

Does Whole Body Vibration Therapy Improve Balance In Patients With Type 2 Diabetes Mellitus?, Samantha L. Aksu

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not whole body vibration (WBV) therapy improves balance in patients with type 2 diabetes mellitus (DM).

STUDY DESIGN: A review of three peer-reviewed studies published between 2013 and 2015.

DATA SOURCES: Two randomized controlled trials and one case series. Using PubMed and Google Scholar, studies were selected if they assessed the effects of whole body vibration therapy on improving balance in diabetic patients, and whether the outcomes were patient oriented.

UTCOMES MEASURED: The outcome measured in this study was balance, which was assessed using the Timed Up …

Is The Use Of A Fresh-Frozen Allograft More Effective Than A Hamstring Autograft In Preserving Functional Knee Ability Post-Surgery In Acl Reconstruction?, Carly E. Black

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of the selective EBM review is to determine whether or not, “Is the use of fresh-frozen allograft more effective than a hamstring autograft in preserving functional knee ability post-surgery in ACL reconstruction?”

STUDY DESIGN: Review of two randomized control trials (RCTs) and one prospective randomized study published between 2011 and 2016, all in English language. The articles compared allograft tendon versus autograft tendon when undergoing ACL reconstructive surgery.

DATA SOURCES: Two randomized control trials (RCTs) and one prospective randomized study were found using PubMed, NCBI, and Cochrane databases. All articles were published in reviewed journals and selected …

Is Low-Level Laser Therapy (Lllt) Effective In Reducing Pain And Ulcer Size In Diabetic Patients With Foot Ulcers?, Corey J. Elmer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Low-level laser therapy (LLLT) is an effective therapy in reducing pain and ulcer size in diabetic patients with foot ulcers.

STUDY DESIGN: Systematic review of three randomized controlled trials (RCTs) from peer reviewed journals, published in 2015, 2016 and 2017.

DATA SOURCES: The studies compare the effectiveness of LLLT versus conventional wound treatment in reducing pain and ulcer size in diabetic patients with foot ulcers. All studies were found using PubMed and CINAHL Plus.

OUTCOMES MEASURED: Pain as perceived by the patient, measured by visual analog …

Is Aromatherapy Effective In Treating Emotional Instability In Women Undergoing Surgical Breast Procedures?, Stephanie Deem

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is aromatherapy effective in treating emotional instability in women undergoing surgical breast procedures?”

Study Design: Systematic review of one single-site, randomized study, one randomized control trial, and one randomized, placebo-controlled study, all English language, one published in 2016 and two published in 2017.

Data Sources: Studies were published in peer-reviewed journals and researched via the PubMed Database.

Outcomes Measured: All of the articles analyzed the effectiveness of aromatherapy in treating emotional instability in women undergoing surgical breast procedures. Improved emotional instability was …

Does Acupressure Help To Reduce Symptoms In Individuals Receiving Chemotherapy?, Gabriele Cuna

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective for this selective EBM review is to determine whether or not acupressure can help to reduce symptoms in individuals receiving chemotherapy.

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published between the years of 2007-2014.

DATA SOURCES: Three randomized control trials evaluating if acupressure can reduce nausea and vomiting symptoms in cancer patients undergoing chemotherapy. Sources were chosen from Google Scholar and PubMed based on their relevance to the clinical topic.

OUTCOMES MEASURED: The outcomes that are measured in the articles are chemotherapy-related nausea and vomiting. Two of the articles measured these patient oriented outcomes …

Is Honey, As Adjunctive Therapy, Effective In Alleviating Nasal Allergy Symptoms?, Arielle N. Ditzel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether honey used as adjunctive therapy is effective in alleviating nasal allergy symptoms.

STUDY DESIGN: This is a systematic review of three randomized controlled trials published between 2010-2013, all in the English language.

DATA SOURCES: Three randomized controlled trials, which studied the effects of honey used as adjunctive therapy for the relief of nasal allergy symptoms, these were obtained using PubMed.

OUTCOMES MEASURED: The outcome of each study was a patient reported decrease in the number of days and the severity of nasal allergy symptoms including: sneezing, itching, nasal …

Does Adjuvant Therapy With Omega-3 Fatty Acids (Fish Oil) Improve Joint Tenderness In Patients With Rheumatoid Arthritis?, Eileen Fauteux

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not adjuvant therapy with Omega-3 fatty acids (fish oil) improves joint tenderness in patients with Rheumatoid Arthritis.

STUDY DESIGN: Review of 3 double-blind, randomized controlled trials from 2010- 2017.

DATA SOURCES: Three peer-reviewed journal articles written in English were found using PubMed. Articles were selected based on their relevance to the question and whether the outcome measured was patient-oriented evidence that matters.

OUTCOME(S) MEASURED: All articles analyzed the effectiveness of adjunctive treatment with omega-3 fatty acids on the improvement of joint tenderness in patients with rheumatoid arthritis. …

Are Probiotics Effective In Reducing Symptoms Of Atopic Dermatitis?, Samuel H. Kim

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not probiotics are effective in reducing symptoms of atopic dermatitis.

STUDY DESIGN: Selective EBM review of three randomized, double-blind, placebo-controlled trials published after 2009, all English language.

DATA SOURCES: All three studies were published in peer-reviewed journals found on PubMed and selected based on relevance to the proposed clinical question.

OUTCOMES MEASURED: The main outcome measured was the percentage change in SCORAD index to determine severity of atopic dermatitis before and after trial through objective and subjective findings. Additional outcomes included DLQ index which was evaluated via …