Medical Specialties Commons^™

Association Of Interleukin 10 Rs1800896 Polymorphism With Susceptibility To Breast Cancer: A Meta-Analysis., Ziyin Zhu, Ji-Bin Liu, Xi Liu, Linxue Qian

Department of Radiology Faculty Papers

Objective: To evaluate the correlation between interleukin 10 (IL-10) -1082A/G polymorphism (rs1800896) and breast cancers by performing a meta-analysis.

Methods: The Embase and Medline databases were searched through 1 September 2018 to identify qualified articles. Odds ratios (OR) and corresponding 95% confidence intervals (CIs) were applied to evaluate associations.

Results: In total, 14 case-control studies, including 5320 cases and 5727 controls, were analyzed. We detected significant associations between the IL10 -1082 G/G genotype and risk of breast cancer (AA + AG vs. GG: OR = 0.88, 95% CI = 0.80-0.97). Subgroup analyses confirmed a significant association in Caucasian populations (OR …

Ultra-Low-Dose Estrogen Therapy For Female Hypogonadism., Yukihiro Hasegawa, Tomoyo Itonaga, Kento Ikegawa, Satsuki Nishigaki, Masanobu Kawai, Eri Koga, Hideya Sakakibara, Judith L Ross

Department of Pediatrics Faculty Papers

In females, endogenous estrogen secretion increases gradually before pubertal development. The benefits of low-dose estrogen therapy in patients with Turner syndrome were originally discussed by Ross et al. and Quigley et al. These seminal studies used ethinyl estradiol (EE2), starting at a dose of 25 ng/kg/d. We hypothesized that the initial dosage of estrogen could be titrated to more closely mimic physiological increments of endogenous estrogen. Therefore, our recent study initiated EE2 treatment at a dosage of 1-2 ng/kg/d, an ultra-low-dose estrogen therapy in pediatric patients with Turner syndrome. The ultra-low-dose estrogen therapy in this syndrome produced a good …

Health Screenings Administered During The Domestic Medical Examination Of Refugees And Other Eligible Immigrants In Nine Us States, 2014-2016: A Cross-Sectional Analysis., Clelia Pezzi, Deborah Lee, Gayathri S. Kumar, Breanna Kawasaki, Lori Kennedy, Jenny Aguirre, Melissa Titus, Rebecca Ford, Blain Mamo, Kailey Urban, Stephen Hughes, Colleen Payton, Kevin Scott, Jessica Montour, Emily S. Jentes

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Refugees and other select visa holders are recommended to receive a domestic medical examination within 90 days after arrival to the United States. Limited data have been published on the coverage of screenings offered during this examination across multiple resettlement states, preventing evaluation of this voluntary program's potential impact on postarrival refugee health. This analysis sought to calculate and compare screening proportions among refugees and other eligible populations to assess the domestic medical examination's impact on screening coverage resulting from this examination.

METHODS AND FINDINGS: We conducted a cross-sectional analysis to summarize and compare domestic medical examination data from …

Primary & Secondary Prevention Of Cardiovascular Disease In Primary Care, Marshall Miller, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Review historical perspective and complexity of primary CVD prevention

Discuss primary & secondary prevention of CAD and the 2019 ACC/AHA guidelines

-- Review of the evidence & primary literature

• Focus on CV risk assessment, DM, ASA/DAPT
• Practical guidance and management considerations

-- CASES- let’s practice and discuss

Utilizing Digital Health To Collect Electronic Patient-Reported Outcomes In Prostate Cancer: Single-Arm Pilot Trial, Christine Tran, Ms, Adam Dicker, Md, Phd, Benjamin Leiby, Phd, Eric Gressen, Md, Noelle Williams, Md, Heather Jim, Phd

Kimmel Cancer Center Faculty Papers

Background: Measuring patient-reported outcomes (PROs) requires an individual’s perspective on their symptoms, functional status, and quality of life. Digital health enables remote electronic PRO (ePRO) assessments as a clinical decision support tool to facilitate meaningful provider interactions and personalized treatment.

Objective: This study explored the feasibility and acceptability of collecting ePROs using validated health-related quality of life (HRQoL) questionnaires for prostate cancer.

Methods: Using Apple ResearchKit software, the Strength Through Insight app was created with content from validated HRQoL tools 26-item Expanded Prostate Cancer Index Composite (EPIC) or EPIC for Clinical Practice and 8-item Functional Assessment of Cancer Therapy Advanced …

Associations Between Aquaglyceroporin Gene Polymorphisms And Risk Of Stroke Among Patients With Hypertension, Qingyun Tu, Li Yan, Chun Wang, Aohan Han, Yu Qin, Lan Cui, Quanyong Xiang

Department of Medical Oncology Faculty Papers

Background: Dysregulations ofAQP7andAQP9were found to be related to lipid metabolism abnormality, which had been provento be one of the mechanisms of stroke. However, limited epidemiological studies explore the associations betweenAQP7andAQP9and the risk of stroke among patients with hypertension in China.

Aims: We aimed to investigate the associations between genetic variants in AQP7andAQP9and the risk of stroke among patients with hypertension, as well as to explore gene-gene andgene-environment interactions.

Methods: Baseline blood samples were drawn from 211 cases with stroke and 633 matched controls. Genomic DNA was extracted by a commercially available kit. Genotyping of 5 single nucleotide polymorphisms (SNPs) in …

Molecular Genetics Of Keratinization Disorders - What's New About Ichthyosis, Jouni Uitto, Leila Youssefian, Amir Hossein Saeidian, Hassan Vahidnezhad

Department of Dermatology and Cutaneous Biology Faculty Papers

The heritable forms of keratinization disorders, including various forms of ichthyosis and keratodermas, comprise a phenotypically heterogeneous group of diseases which can be divided into syndromic and non-syndromic forms. In the non-syndromic forms, the clinical manifestations are limited to the cutaneous structures while the syndromic ones are associated with a spectrum of extracutaneous manifestations. The inheritance in different families can be autosomal dominant, autosomal recessive or either X-linked dominant or recessive. Currently at least 67 distinct genes have been associated with different forms of ichthyosis. These genes can be grouped on the basis of their physiological involvement, including genes encoding …

Dietary Alterations Modulate The Microrna 29/30 And Igf-1/Akt Signaling Axis In Breast Cancer Liver Metastasis., Anuradha A. Shastri, Anthony Saleh, Jason E. Savage, Tiziana Deangelis, Kevin Camphausen, Nicole L. Simone

Department of Radiation Oncology Faculty Papers

Background: Metastatic cancer is incurable and understanding the molecular underpinnings is crucial to improving survival for our patients. The IGF-1/Akt signaling pathway is often impaired in cancer leading to its progression and metastases. Diet modification is known to alter the IGF-1/Akt pathway and affect the expression of microRNA involved in tumor initiation, growth and metastases. Liver metastases are one of the most common type of metastases in breast and colon cancer. In the present study, we looked at the effect of diet modification on the expression of microRNA in normal liver and liver with breast cancer metastases using in vivo …

Design And Analysis Of A Novel Long-Distance Double Tendon-Sheath Transmission Device For Breast Intervention Robots Under Mri Field, Xiaohong Jia, Yongde Zhang, Jingang Jiang, Haiyan Du, Yan Yu

Department of Radiation Oncology Faculty Papers

Cancer represents a major threat to human health. Magnetic resonance imaging (MRI) provides superior performance to other imaging-based examination methods in the detection of tumors and offers distinct advantages in biopsy and seed implantation. However, because of the MRI environment, the material requirements for actuating devices for the medical robots used in MRI are incredibly demanding. This paper describes a novel double tendon-sheath transmission device for use in MRI applications. LeBus grooves are used in the original transmission wheels, thus enabling the system to realize long-distance and large-stroke transmission with improved accuracy. The friction model of the transmission system and …

Osteoblastoma In The Occipital Bone: A Case Report Of A Rare Tumor In The Calvarium, Lukas M. Trunz, Scott H. Faro, Richard J. Gorniak

Department of Radiology Faculty Papers

Osteoblastomas infrequently occur in the calvarium, displaying a preference for temporal and frontal bones when it does. We present an unusual case of a large, expansile osteoblastoma in the occipital bone of a 23-year-old man who presented with a nontender lump at the back of his head. Initial computed tomography scan showed a large occipital bone mass, and after additional imaging, a gross total resection was performed. Histopathological examination revealed an osteoblastoma. Although these tumors are benign, overlapping imaging characteristics of lesions affecting the calvarium often present a diagnostic dilemma. This case emphasizes the importance of imaging in the management …

Pediatric Resident Knowledge, Experience, Comfort, And Perceived Competency In Providing Sibling Psychosocial Support., David Buchbinder, Sonam Sidhu, Melissa A. Alderfer, Anne Lown, Russ C. Kolarik, Tommy Wang

Department of Pediatrics Faculty Papers

This article is the author’s final published version in International Journal of Medical Education, Volume 11, March 2020, Pages 73-75.

The published version is available at https://doi.org/10.5116/ijme.5e63.6a46. Copyright © Buchbinder et al.

Proteinuria, Goni Katz-Greenberg, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Objectives

• Definition
• Screening/Measurement
• Etiology
• Treatment

Male Luts – Introduction And Overview, Thenappan Chandrasekar, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline & Goals

• Background – What are “LUTS”?

• Anatomy

• Pathophysiology

• Storage – bladder filling symptoms
• Voiding – urine flow symptoms
• Post-micturition

• Major etiologies and management

• BPH / BOO
• OAB
• Nocturia

• Related to Prostate Cancer?

Modified Glucose-Insulin-Potassium Regimen Provides Cardioprotection With Improved Tissue Perfusion In Patients Undergoing Cardiopulmonary Bypass Surgery, Kun Zhao, Yue Zhang, Jia Li, Qin Cui, Rong Zhao, Wensheng Chen, Jincheng Liu, Bijun Zhao, Yi Wan, Xin-Liang Ma, Shiqiang Yu, Dinghua Yi, Feng Gao

Department of Emergency Medicine Faculty Papers

Background Laboratory studies demonstrate glucose-insulin-potassium (GIK) as a potent cardioprotective intervention, but clinical trials have yielded mixed results, likely because of varying formulas and timing of GIK treatment and different clinical settings. This study sought to evaluate the effects of modified GIK regimen given perioperatively with an insulin-glucose ratio of 1:3 in patients undergoing cardiopulmonary bypass surgery. Methods and Results In this prospective, randomized, double-blinded trial with 930 patients referred for cardiac surgery with cardiopulmonary bypass, GIK (200 g/L glucose, 66.7 U/L insulin, and 80 mmol/L KCl) or placebo treatment was administered intravenously at 1 mL/kg per hour 10 minutes …

Meaning-Centered Supervision: A Structured Self-Reflection Model To Reconnect With Personal And Professional Meaning In Palliative Care Work, Rebecca Cammy, Msw, Lcsw

Department of Medical Oncology Posters

Meaning-centered supervision explores participant’s sense of meaning of past, present, and future personal and professional experiences. The series aims to reintegrate selfreflection into clinical practice through experiential exercises, homework journaling, and group discussion. Social workers develop a narrative around themes of professional attitude, living and creating work life, and connections with the social work profession. The goal is to help palliative care social workers create a sense meaning and purpose in their work as they develop their personal and professional identities. Additionally, the hope is to support supervisees through any concerns of burnout and compassion fatigue.

Public Social Media Consultations For Dermatologic Conditions: An Online Survey, Elizabeth Schoenberg, Doaa Shalabi, Jordan Wang, Nazanin Saedi, Matthew Keller

Department of Dermatology and Cutaneous Biology Faculty Papers

The use of social media in medicine has been increasingly studied in recent years, especially concerning its role in patient outreach, education, diagnosis, and management. Dermatology is a unique field in that patients can post photographs of their skin ailments when seeking online medical advice and information. This study examines the role of public social media consultations for dermatologic conditions. A large portion of patients utilize social media for dermatologic consultations and many do not seek care from a dermatologist afterward. Future studies should trend this phenomenon, especially as the use of social media continues to expand.

Flavonoids And Other Polyphenols Act As Epigenetic Modifiers In Breast Cancer., Priyanga Selvakumar, Aja Badgeley, Paige Murphy, Hina Anwar, Urvashi Sharma, Katharine Lawrence, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Breast cancer is a common cancer that occurs due to different epigenetic alterations and genetic mutations. Various epidemiological studies have demonstrated an inverse correlation between breast cancer incidence and flavonoid intake. The anti-cancer action of flavonoids, a class of polyphenolic compounds that are present in plants, as secondary metabolites has been a major topic of research for many years. Our review analysis demonstrates that flavonoids exhibit anti-cancer activity against breast cancer occurring in different ethnic populations. Breast cancer subtype and menopausal status are the key factors in inducing the flavonoid's anti-cancer action in breast cancer. The dose is another key …

Transcutaneous Electrical Nerve Stimulation (Tens) For Pain Management In Sickle Cell Disease., Sudipta Pal, Ruchita Dixit, Soe Moe, Myron Anthony Godinho, Adinegara Bl Abas, Samir K. Ballas, Shanker Ram, Uduman Ali M. Yousuf

Cardeza Foundation for Hematologic Research

BACKGROUND: Sickle cell disease (SCD), one of the most common inherited disorders, is associated with vaso-occlusive pain episodes and haemolysis leading to recurrent morbidity, hospital admissions and work or school absenteeism. The crises are conventionally treated with opioids, non-opioids and other adjuvants with the risk of developing complications, addictions and drug-seeking behaviour. Different non-pharmacological treatments, such as transcutaneous electrical nerve stimulation (TENS) have been used for managing pain in other painful conditions. Hence, the efficacy of TENS for managing pain in SCD needs to be reviewed.

OBJECTIVES: To assess the benefits and harms of TENS for managing pain in people …

Cardiac Interventions In Patients With Achondroplasia: A Systematic Review., Amrita Sukhavasi, Thomas J O'Malley, Elizabeth J Maynes, Jae Hwan Choi, Jonathan S Gordon, Kevin Phan, Vakhtang Tchantchaleishvili

Jefferson Hospital Staff Papers and Presentations

Patients with achondroplasia and other causes of dwarfism suffer from increased rates of cardiovascular disease relative to the remainder of the population. Few studies have examined these patients when undergoing cardiac surgery or percutaneous intervention. This systematic review examines the literature to determine outcomes following cardiac intervention in this unique population. An electronic search was performed in the English literature to identify all reports of achondroplasia, dwarfism, and cardiac intervention. Of the 5,274 articles identified, 14 articles with 14 cases met inclusion criteria. Patient-level data was extracted and analyzed. Median patient age was 55.5 [interquartile ranges (IQR), 43.8, 59.8] years, …

Proximal Tibial Replacement In Revision Knee Arthroplasty For Non-Oncologic Indications., Brianna Fram, Eric B. Smith, Gregory K. Deirmengian, John A. Abraham, John Strony, Michael B. Cross, Danielle Y. Ponzio

Rothman Institute Papers

Proximal tibial metaphyseal bone loss compromises the alignment and fixation of components during revision total knee arthroplasty. In massive, segmental defects with loss of collateral ligamentous support and lack of bone to support the use of prosthetic augments or metaphyseal cones or sleeves, a hinged proximal tibial replacement or a so-called "megaprosthesis" should be available. While proximal tibial replacement is the reconstructive method of choice in the setting of bone tumor resection, applications in non-oncologic joint arthroplasty are rare and may offer an opportunity for limb salvage in dire clinical scenarios with massive proximal tibial bone loss. This report reviews …

Our Wicked Problem, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

The Coronavirus is more than a health problem. It is a “wicked” problem disrupting work, education, travel, politics, financial indicators, and more. This label came about in 1973 to help describe a special class of situations that are volatile, uncertain and ambiguous, often difficult to recognize, and difficult or impossible to solve because of incomplete, contradictory, and changing requirements. There is no clear problem definition due to interdependencies so the problem cannot be fully understood until after the solution comes about.

Our Invisible Enemy, Larry M. Starr, Darshi Mody

School of Continuing and Professional Studies Coronavirus Papers

The novel coronavirus is invisible to the eye because it is microscopic measuring 80-160 nanometers in size; a nanometer is one billionth of a meter.

While we cannot see it in the air or on a surface, millions of us have seen the virus in full color when we discuss it on the local and national TV news, in articles and stories online, and in print media. This is because the virus is routinely pictured and used to attract us to the information being presented. The paradox is that millions of people can now recognize this invisible enemy.

Repeatedly presenting …

Disruptive Effects Of The Coronavirus – Errors Of Commission And Of Omission?, John Pourdehnad, Larry M. Starr, Venard Scott Koerwer, Harry Mccloskey

School of Continuing and Professional Studies Coronavirus Papers

It is increasingly evident that the coronavirus disease, COVID-19, is more than a health problem; it is and will continue to adversely affect work and workplaces, education, families and social engagements, political and environmental dimensions, and financial indicators. Apart from its health ramifications, the crisis is revealing serious challenges in the global supply chain. Those difficulties are, at least in part, consequences of unwise, short-sighted business decisions made over the course of decades to outsource and downsize.

Pandemic Lockdown Must Fail: Save Lives Without Crippling The Economy, Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

In the following working paper, I want to make a plea for what I am calling a “reverse quarantine”—quarantining people who are over 65 (who number 52 million), before they get sick. We need to complement this policy with federally funded and locally organized efforts to support seniors in place, drawing on the wellsprings of American pragmatism, the capacity to respond in emergencies, American volunteerism, and neighbor-to-neighbor assistance. We can’t turn quarantine into imprisonment. We must work as hard as we can to create a psychological sense of community at a moment when, paradoxically, social distancing is driving us apart. …

Youth Single-Sport Specialization In Professional Baseball Players., Patrick S Buckley, Michael C Ciccotti, Meghan Bishop, Patrick Kane, Stephen Selverian, Dominique Exume, John D'Angelo, William Emper, Kevin B Freedman, Sommer Hammoud, Steven B Cohen, Michael G Ciccotti

Rothman Institute Papers

Background: An increasing number of youth baseball athletes are specializing in playing baseball at younger ages.

Purpose: The purpose of our study was to describe the age and prevalence of single-sport specialization in a cohort of current professional baseball athletes. In addition, we sought to understand the trends surrounding single-sport specialization in professional baseball players raised within and outside the United States (US).

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: A survey was distributed to male professional baseball athletes via individual team athletic trainers. Athletes were asked if and at what age they had chosen to specialize in …

Correlation Of Early Outcomes And Intradiscal Interleukin-6 Expression In Lumbar Fusion Patients., John D Koerner, Dessislava Z Markova, Greg D Schroeder, Christopher L Antonacci, Joseph Mendelis, Alexander R Vaccaro, D Greg Anderson, Chris K Kepler

Department of Orthopaedic Surgery Faculty Papers

OBJECTIVE: To determine if there is correlation between intradiscal levels of interleukin-6 (IL-6) and early outcome measures in patients undergoing lumbar fusion for painful disc degeneration.

METHODS: Intervertebral disc tissue was separated into annulus fibrosus/nucleus pulposus and cultured separately in vitro in serum-free medium (Opti-MEM). Conditioned media was collected after 48 hours. The concentration of IL-6 was quantified using enzyme-linked immunosorbent assay. Pearson correlation coefficients quantified relationships between IL-6 levels and pre- and postoperative visual analogue scale (VAS) back pain and Oswestry Disability Index (ODI), as well as change in VAS/ODI.

RESULTS: Sixteen discs were harvested from 9 patients undergoing …

Causes Of Congenital Corneal Opacities And Their Management In A Tertiary Care Center., Remzi Karadag, Christopher J Rapuano, Kristin M Hammersmith, Parveen K Nagra

Wills Eye Hospital Papers

PURPOSE: To evaluate causes and management of congenital corneal opacities (CCO) diagnosed in a tertiary care eye center and to compare the data with a previous study at the same institution.

METHODS: Computerized medical records in all patients with congenital corneal opacities diagnosed in the Cornea Service at Wills Eye Hospital (Philadelphia, PA) between January 1, 2007, and December 31, 2015, were retrospectively reviewed. Children aged 12 years and younger at the first visit were included in the study. Patients' demographics, ocular diagnosis, laterality, associated ocular abnormalities, other ocular surgery performed prior or subsequent to the first visit, and their …

Health Of Special Immigrant Visa Holders From Iraq And Afghanistan After Arrival Into The United States Using Domestic Medical Examination Data, 2014-2016: A Cross-Sectional Analysis., Gayathri S Kumar, Clelia Pezzi, Simone Wien, Blain Mamo, Kevin Scott, Colleen Payton, Kailey Urban, Stephen Hughes, Lori Kennedy, Nuny Cabanting, Jessica Montour, Melissa Titus, Jenny Aguirre, Breanna Kawasaki, Rebecca Ford, Emily S Jentes

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Since 2008, the United States has issued between 2,000 and 19,000 Special Immigrant Visas (SIV) annually, with the majority issued to applicants from Iraq and Afghanistan. SIV holders (SIVH) are applicants who were employed by, or on behalf of, the US government or the US military. There is limited information about health conditions in SIV populations to help guide US clinicians caring for SIVH. Thus, we sought to describe health characteristics of recently arrived SIVH from Iraq and Afghanistan who were seen for domestic medical examinations.

METHODS AND FINDINGS: This cross-sectional analysis included data from Iraqi and Afghan SIVH …

Reversing Heart Failure With A Ventricular Anchoring Device: Another Hope For Myopathic Mitral Regurgitation., J. Eduardo Rame

Center for Translational Medicine Faculty Papers

No abstract provided.

Cost-Effectiveness Analysis Of Ocriplasmin Versus Watchful Waiting For Treatment Of Symptomatic Vitreomacular Adhesion In The Us, Arshad M Khanani, Pravin U Dugel, Julia A Haller, Alan L Wagner, Benedicte Lescrauwaet, Ralph Schmidt, Craig Bennison

Wills Eye Hospital Papers

Aim: Evaluate the cost-effectiveness of ocriplasmin in symptomatic vitreomacular adhesion (VMA) with or without full-thickness macular hole ≤400 μm versus standard of care.

Methods: A state-transition model simulated a cohort through disease health states; assignment of utilities to health states reflected the distribution of visual acuity. Efficacy of ocriplasmin was derived from logistic regression models using Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole trial data. Model inputs were extracted from Phase III trials and published literature. The analysis was conducted from a US Medicare perspective.

Results: Lifetime incremental cost-effectiveness ratio was US$4887 per quality-adjusted life year gained …