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Articles 4411 - 4440 of 8417

Full-Text Articles in Medical Specialties

Implications Of C1q/Tnf-Related Protein Superfamily In Patients With Coronary Artery Disease., Yanwei Zhang, Caihong Liu, Jing Liu, Rui Guo, Zheyi Yan, Wenxia Liu, Wayne Bond Lau, Xiangying Jiao, Jimin Cao, Kun Xu, Yongping Jia, Xin-Liang Ma, Yajing Wang Jan 2020

Implications Of C1q/Tnf-Related Protein Superfamily In Patients With Coronary Artery Disease., Yanwei Zhang, Caihong Liu, Jing Liu, Rui Guo, Zheyi Yan, Wenxia Liu, Wayne Bond Lau, Xiangying Jiao, Jimin Cao, Kun Xu, Yongping Jia, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

The C1q complement/TNF-related protein superfamily (CTRPs) displays differential effects on the regulation of metabolic homeostasis, governing cardiovascular function. However, whether and how they may serve as predictor/pro-diagnosis factors for assessing the risks of coronary artery disease (CAD) remains controversial. Therefore, we performed a clinical study to elaborate on the implication of CTRPs (CTRP1, CTRP5, CTRP7, and CTRP15) in CAD. CTRP1 were significantly increased, whereas CTRP7 and CTRP15 levels were decreased in CAD patients compared to the non-CAD group. Significant differences in CTRP1 levels were discovered between the single- and triple-vascular-vessel lesion groups. ROC analysis revealed that CTRP7 and CTRP15 may …


National Trends In Total Hip Arthroplasty For Traumatic Hip Fractures: An Analysis Of A Nationwide All-Payer Database., Anthony J Boniello, Alexander M Lieber, Kevin Denehy, Priscilla Cavanaugh, Yehuda E Kerbel, Andrew Star Jan 2020

National Trends In Total Hip Arthroplasty For Traumatic Hip Fractures: An Analysis Of A Nationwide All-Payer Database., Anthony J Boniello, Alexander M Lieber, Kevin Denehy, Priscilla Cavanaugh, Yehuda E Kerbel, Andrew Star

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Hemiarthroplasty (HA) has traditionally been the treatment of choice for elderly patients with displaced femoral neck fractures. Ideal treatment for younger, ambulatory patients is not as clear. Total hip arthroplasty (THA) has been increasingly utilized in this population however the factors associated with undergoing HA or THA have not been fully elucidated.

AIM: To examine what patient characteristics are associated with undergoing THA or HA. To determine if outcomes differ between the groups.

METHODS: We queried the Nationwide Inpatient Sample (NIS) for patients that underwent HA or THA for a femoral neck fracture between 2005 and 2014. The NIS …


Mitochondrial Quality Control In Age-Related Pulmonary Fibrosis., Willy Roque, Karina Cuevas-Mora, Freddy Romero Jan 2020

Mitochondrial Quality Control In Age-Related Pulmonary Fibrosis., Willy Roque, Karina Cuevas-Mora, Freddy Romero

Center for Translational Medicine Faculty Papers

Idiopathic pulmonary fibrosis (IPF) is age-related interstitial lung disease of unknown etiology. About 100,000 people in the U.S have IPF, with a 3-year median life expectancy post-diagnosis. The development of an effective treatment for pulmonary fibrosis will require an improved understanding of its molecular pathogenesis and the "normal" and "pathological' hallmarks of the aging lung. An important characteristic of the aging organism is its lowered capacity to adapt quickly to, and counteract, disturbances. While it is likely that DNA damage, chronic endoplasmic reticulum (ER) stress, and accumulation of heat shock proteins are capable of initiating tissue repair, recent studies point …


Assessment Of Activity Of Daily Life In Mucopolysaccharidosis Type Ii Patients With Hematopoietic Stem Cell Transplantation., Yasuyuki Suzuki, Madeleine Taylor, Kenji Orii, Toshiyuki Fukao, Tadao Orii, Shunji Tomatsu Jan 2020

Assessment Of Activity Of Daily Life In Mucopolysaccharidosis Type Ii Patients With Hematopoietic Stem Cell Transplantation., Yasuyuki Suzuki, Madeleine Taylor, Kenji Orii, Toshiyuki Fukao, Tadao Orii, Shunji Tomatsu

Department of Pediatrics Faculty Papers

The effectiveness of hematopoietic stem cell transplantation (HSCT) for mucopolysaccharidosis type II (MPS II, Hunter disease) remains controversial although recent studies have shown HSCT provides more clinical impact. This study aims to evaluate the long-term effectiveness of HSCT using the activity of daily living (ADL) scores in patients with MPS II. Sixty-nine severely affected MPS II patients (19 patients who received HSCT and 50 untreated patients) and 40 attenuated affected patients (five with HSCT and 35 untreated) were investigated by a simplified ADL questionnaire. The frequency of clinical findings and the scores of ADL (verbal, gross motor, and the level …


Foxd3 Regulates Vista Expression In Melanoma., Sheera R. Rosenbaum, Meghan Knecht, Mehri Mollaee, Zhijiu Zhong, Dan A. Erkes, Peter A. Mccue, Chervoneva, Adam C. Berger, Jennifer A. Lo, David E. Fisher, Jeffrey E. Gershenwald, Michael A. Davies, Timothy J. Purwin, Andrew E. Aplin Jan 2020

Foxd3 Regulates Vista Expression In Melanoma., Sheera R. Rosenbaum, Meghan Knecht, Mehri Mollaee, Zhijiu Zhong, Dan A. Erkes, Peter A. Mccue, Chervoneva, Adam C. Berger, Jennifer A. Lo, David E. Fisher, Jeffrey E. Gershenwald, Michael A. Davies, Timothy J. Purwin, Andrew E. Aplin

Department of Cancer Biology Faculty Papers

Immune checkpoint inhibitors have improved patient survival in melanoma, but the innate resistance of many patients necessitates the investigation of alternative immune targets. Many immune checkpoint proteins lack proper characterization, including V-domain Ig suppressor of T cell activation (VISTA). VISTA expression on immune cells can suppress T cell activity; however, few studies have investigated its expression and regulation in cancer cells. In this study, we observe that VISTA is expressed in melanoma patient samples and cell lines. Tumor cell-specific expression of VISTA promotes tumor onset in vivo, associated with increased intratumoral T regulatory cells, and enhanced PDL-1 expression on tumor-infiltrating …


Computer-Assisted Planning For Minimally Invasive Anterior Two-Thirds Laser Corpus Callosotomy: A Feasibility Study With Probabilistic Tractography Validation., Vejay N. Vakharia, Rachel E. Sparks, Sjoerd B. Vos, Yarema Bezchlibnyk, Ashesh D. Mehta, Jon T. Willie, Chengyuan Wu, Ashwini Sharan, Sebastien Ourselin, John S Duncan Jan 2020

Computer-Assisted Planning For Minimally Invasive Anterior Two-Thirds Laser Corpus Callosotomy: A Feasibility Study With Probabilistic Tractography Validation., Vejay N. Vakharia, Rachel E. Sparks, Sjoerd B. Vos, Yarema Bezchlibnyk, Ashesh D. Mehta, Jon T. Willie, Chengyuan Wu, Ashwini Sharan, Sebastien Ourselin, John S Duncan

Department of Neurosurgery Faculty Papers

BACKGROUND: Anterior two-thirds corpus callosotomy is an effective palliative neurosurgical procedure for drug-refractory epilepsy that is most commonly used to treat drop-attacks. Laser interstitial thermal therapy is a novel stereotactic ablative technique that has been utilised as a minimally invasive alternative to resective and disconnective open neurosurgery. Case series have reported success in performing laser anterior two-thirds corpus callosotomy. Computer-assisted planning algorithms may help to automate and optimise multi-trajectory planning for this procedure.

OBJECTIVE: To undertake a simulation-based feasibility study of computer-assisted corpus callostomy planning in comparison with expert manual plans in the same patients.

METHODS: Ten patients were selected …


Why Do Women Deliver Where They Had Not Planned To Go? A Qualitative Study From Peri-Urban Nairobi Kenya., V. Naanyu, V. Mujumdar, C. Ahearn, M. Mcconnell, J. Cohen Jan 2020

Why Do Women Deliver Where They Had Not Planned To Go? A Qualitative Study From Peri-Urban Nairobi Kenya., V. Naanyu, V. Mujumdar, C. Ahearn, M. Mcconnell, J. Cohen

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: In urban Kenya, couples face a wide variety of choices for delivery options; however, many women end up delivering in different facilities from those they had intended while pregnant. One potential consequence of this is delivering in facilities that do not meet minimum quality standards and lack the capacity to provide treatment for obstetric and neonatal complications.

METHODS: This study investigated why women in peri-urban Nairobi, Kenya deliver in facilities they had not intended to use. We used 60 in-depth audio-recorded interviews in which mothers shared their experiences 2-6 months after delivery. Descriptive statistics were used to summarize socio-demographic …


Sevoflurane Pre-Conditioning Ameliorates Diabetic Myocardial Ischemia/Reperfusion Injury Via Differential Regulation Of P38 And Erk., Dina Xie, Jianli Zhao, Rui Guo, Liyuan Jiao, Yanqing Zhang, Wayne Bond Lau, Bernard Lopez, Theodore Christopher, Erhe Gao, Jimin Cao, Xin-Liang Ma, Yajing Wang Jan 2020

Sevoflurane Pre-Conditioning Ameliorates Diabetic Myocardial Ischemia/Reperfusion Injury Via Differential Regulation Of P38 And Erk., Dina Xie, Jianli Zhao, Rui Guo, Liyuan Jiao, Yanqing Zhang, Wayne Bond Lau, Bernard Lopez, Theodore Christopher, Erhe Gao, Jimin Cao, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

Diabetes mellitus (DM) significantly increases myocardial ischemia/reperfusion (MI/R) injury. During DM, cardioprotection induced by conventional pre-conditioning (PreCon) is decreased due to impaired AMP-activated protein kinase (AMPK) signaling. The current study investigated whether PreCon with inhaled anesthetic sevoflurane (SF-PreCon) remains cardioprotective during DM, and identified the involved mechanisms. Normal diet (ND) and high-fat diet (HFD)-induced DM mice were randomized into control and SF-PreCon (3 cycles of 15-minute period exposures to 2% sevoflurane) groups before MI/R. SF-PreCon markedly reduced MI/R injury in DM mice, as evidenced by improved cardiac function (increased LVEF and ±Dp/dt), decreased infarct size, and decreased apoptosis. To determine …


A New Regulatory Mechanism Of Protein Phosphatase 2a Activity Via Set In Acute Myeloid Leukemia., Elena Arriazu, Carmen Vicente, Raffaella Pippa, Irene Peris, Elena Martínez-Balsalobre, Patricia García-Ramírez, Nerea Marcotegui, Ana Igea, Diego Alignani, José Rifón, María C. Mateos, María L. Cayuela, Angel R. Nebreda, María D. Odero Jan 2020

A New Regulatory Mechanism Of Protein Phosphatase 2a Activity Via Set In Acute Myeloid Leukemia., Elena Arriazu, Carmen Vicente, Raffaella Pippa, Irene Peris, Elena Martínez-Balsalobre, Patricia García-Ramírez, Nerea Marcotegui, Ana Igea, Diego Alignani, José Rifón, María C. Mateos, María L. Cayuela, Angel R. Nebreda, María D. Odero

Department of Medical Oncology Faculty Papers

Acute myeloid leukemia (AML) is an aggressive hematologic malignancy. Although novel emerging drugs are available, the overall prognosis remains poor and new therapeutic approaches are required. PP2A phosphatase is a key regulator of cell homeostasis and is recurrently inactivated in AML. The anticancer activity of several PP2A-activating drugs (e.g., FTY720) depends on their interaction with the SET oncoprotein, an endogenous PP2A inhibitor that is overexpressed in 30% of AML cases. Elucidation of SET regulatory mechanisms may therefore provide novel targeted therapies for SET-overexpressing AMLs. Here, we show that upregulation of protein kinase p38β is a common event in AML. We …


The Operative Management In Bariatric Acute Abdomen (Oba) Survey: Long-Term Complications Of Bariatric Surgery And The Emergency Surgeon's Point Of View., Belinda De Simone, Luca Ansaloni, Massimo Sartelli, Yoram Kluger, Fikri M. Abu-Zidan, Walter L. Biffl, Arianna Heyer, Federico Coccolini, Gian Luca Baiocchi, Oba Trial Supporters Jan 2020

The Operative Management In Bariatric Acute Abdomen (Oba) Survey: Long-Term Complications Of Bariatric Surgery And The Emergency Surgeon's Point Of View., Belinda De Simone, Luca Ansaloni, Massimo Sartelli, Yoram Kluger, Fikri M. Abu-Zidan, Walter L. Biffl, Arianna Heyer, Federico Coccolini, Gian Luca Baiocchi, Oba Trial Supporters

Student Papers, Posters & Projects

Background: The number of bariatric procedures is increasing worldwide. No consensus or guidelines about the emergency management of long-term complications following bariatric surgery are currently available. The aim of this study is to investigate by a web survey how an emergency surgeon approaches this unique group of patients in an emergency medical scenario and to report their personal experience.

Method: An international web survey was sent to 197 emergency surgeons with the aim to collect data about emergency surgeons' experience in the management of patients admitted in the emergency department for acute abdominal pain after bariatric surgery. The survey was …


Grk6 Regulates The Hemostatic Response To Injury Through Its Rate-Limiting Effects On Gpcr Signaling In Platelets., Xi Chen, Shuchi Gupta, Matthew Cooper, Daniel Dehelian, Xuefei Zhao, Meghna U. Naik, Jeremy G.T. Wurtzel, Timothy J. Stalker, Lawrence E. Goldfinger, Jeffrey Benovic, Lawrence F. Brass, Steven E. Mckenzie, Ulhas P. Naik, Peisong Ma Jan 2020

Grk6 Regulates The Hemostatic Response To Injury Through Its Rate-Limiting Effects On Gpcr Signaling In Platelets., Xi Chen, Shuchi Gupta, Matthew Cooper, Daniel Dehelian, Xuefei Zhao, Meghna U. Naik, Jeremy G.T. Wurtzel, Timothy J. Stalker, Lawrence E. Goldfinger, Jeffrey Benovic, Lawrence F. Brass, Steven E. Mckenzie, Ulhas P. Naik, Peisong Ma

Cardeza Foundation for Hematologic Research

G protein-coupled receptors (GPCRs) mediate the majority of platelet activation in response to agonists. However, questions remain regarding the mechanisms that provide negative feedback toward activated GPCRs to limit platelet activation and thrombus formation. Here we provide the first evidence that GPCR kinase 6 (GRK6) serves this role in platelets, using GRK6-/- mice generated by CRISPR-Cas9 genome editing to examine the consequences of GRK6 knockout on GPCR-dependent signaling. Hemostatic thrombi formed in GRK6-/- mice are larger than in wild-type (WT) controls during the early stages of thrombus formation, with a rapid increase in platelet accumulation at the site of injury. …


Endoscopic Rhizotomy For Chronic Lumbar Zygapophysial Joint Pain., Yuntao Xue, Tao Ding, Dajie Wang, Jianli Zhao, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Wanyi Wang, Miao Lu, Chao Wu Jan 2020

Endoscopic Rhizotomy For Chronic Lumbar Zygapophysial Joint Pain., Yuntao Xue, Tao Ding, Dajie Wang, Jianli Zhao, Huilin Yang, Xiaofeng Gu, Dehong Feng, Yafeng Zhang, Hao Liu, Fenglin Tang, Wanyi Wang, Miao Lu, Chao Wu

Department of Anesthesiology Faculty Papers

BACKGROUND: Chronic lumbar zygapophysial joint pain is a common cause of chronic low back pain. Percutaneous radiofrequency ablation (RFA) is one of the effective management options; however, the results from the traditional RFA need to be improved in certain cases. The aim of this study is to investigate the effect of percutaneous radiofrequency ablation under endoscopic guidance (ERFA) for chronic low back pain secondary to facet joint arthritis.

METHODS: This is a prospective study enrolled 60 patients. The cases were randomized into two groups: 30 patients in the control group underwent traditional percutaneous radiofrequency ablation, others underwent ERFA. The lumbar …


Improving The Inhaler, Kabir Malkani, Jesse Evensky, Bradley Freid, Alex Reibstein, Gregory C. Kane, Md Jan 2020

Improving The Inhaler, Kabir Malkani, Jesse Evensky, Bradley Freid, Alex Reibstein, Gregory C. Kane, Md

Phase 1

Background: It is estimated that about 1 in 10 Americans use inhalers to deliver inhaled drugs for respiratory disease such as COPD and asthma. Some studies have shown that up to 84% of people use their inhaler incorrectly, which can cause long term problems and acute flareups. Therefore, improving the inhaler design to allow for ease of use was the main focus of our project.

Methods: We had a discussion with a pulmonary critical care attending who provided information on proper patient inhaler use and common user errors. He also gave us a sample of different inhalers on the market …


Color-Changing Device To Improve Adherence To Foley Catheter Replacement Protocols And Reduce Urinary Tract Infection Frequency, Alexander Straus, Ms, Kurt Hill, Bryn Cross, Jason M. Fields, Md Jan 2020

Color-Changing Device To Improve Adherence To Foley Catheter Replacement Protocols And Reduce Urinary Tract Infection Frequency, Alexander Straus, Ms, Kurt Hill, Bryn Cross, Jason M. Fields, Md

Phase 1

Background: Catheter associated urinary tract infections (CAUTI) are a major source of patient morbidity and mortality in healthcare settings and have a significant financial impact on the healthcare system. Many hospitals have clinical protocols in place to continually reassess the necessity of indwelling foley catheters and remove them if their use is no longer warranted. However, it is still common for indwelling foley catheters to be overlooked and remain in place, even after meeting criteria for removal. A design project was conducted that sought to improve adherence to clinical protocols, and reduce frequency of CAUTIs, by creating a color-changing device …


Opioid Tolerance Influences Outcomes After Lumbar Fusion In Patients With Degenerative Pathology, Noah Levy, Max Detweiler, Dhruv K.C. Goyal, Ariana Reyes, Alexander R. Vaccaro Jan 2020

Opioid Tolerance Influences Outcomes After Lumbar Fusion In Patients With Degenerative Pathology, Noah Levy, Max Detweiler, Dhruv K.C. Goyal, Ariana Reyes, Alexander R. Vaccaro

Phase 1

Introduction: Extended opioid use prior to surgery has been implicated in poorer postoperative outcomes. However, it remains unclear if there is a significant difference in postoperative outcomes among preoperative opioid-naïve and opioid-tolerant patients who undergo lumbar spinal fusion. The purpose of this study was to determine the effect of preoperative opioid use on patient-reported outcome measures in patients undergoing lumbar spinal fusion.

Methods: This retrospective cohort analysis identified 260 patients who underwent lumbar spinal fusion at a high-volume, single institution. There were two cohorts: patients who were opioid-naïve (defined as total opioid consumption of ≤ 7 days in …


Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Austin Klein, Danielle Snyderman, Md Jan 2020

Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Austin Klein, Danielle Snyderman, Md

Phase 1

Background: Continuing Care Retirement Communities (CCRC’s) are long-term care facilities for senior adults where residents can live in different “levels of care” (LOC)––Independent, Assisted, Nursing––depending on their needs. It is beneficial for the CCRC administration to have residents in the appropriate LOC for their given needs. However, the current process for determining which LOC is appropriate for a given resident lacks structure and provides a challenge for administrators. This project seeks to provide CCRC administrators an efficient, structured way for determining which level of care is most appropriate based on the needs of the resident and the resources available from …


Prediction Of Neonatal Birthweight Associated With Maternal Obesity And Diabetes, Laura Gleason, Rebekah Mccurdy, Md, Mph Jan 2020

Prediction Of Neonatal Birthweight Associated With Maternal Obesity And Diabetes, Laura Gleason, Rebekah Mccurdy, Md, Mph

Phase 1

Introduction: To design a model that will predict neonatal birth weight within obese mothers by diabetic status.

Methods: A secondary data analysis of an RCT (NCT 02909582) was utilized to create a neonatal birth weight prediction model. Women (n=325) with a BMI > 35 kg/m2 from a tertiary academic institution, 2016 – 2019, were included to estimate the risk of large for gestational age (LGA) infants and neonatal birth weight based on maternal prepregnancy BMI and diabetic status. LGA was defined as an infant birth weight > 90th percentile. Analysis included Chi-square, t-test, multivariate logistic and linear regression.

Results: Mean birthweight did …


Associations Between Oncogenic Risk Markers And Clinical Outcomes Among Black And White Colorectal Cancer Patients, Victoria B. Starks, Edith P. Mitchell, Md, Facp Jan 2020

Associations Between Oncogenic Risk Markers And Clinical Outcomes Among Black And White Colorectal Cancer Patients, Victoria B. Starks, Edith P. Mitchell, Md, Facp

Phase 1

Introduction: Blacks have a 25% higher incidence of colorectal cancer compared to their white societal counterparts. Additionally, the overall mortality rate among black colorectal cancer patients is 50% higher than that of whites. However, little is known about the biomarkers prevalent among blacks and their possible correlation to treatment response and patient outcomes.

Objective: The objective of this study is to explore disease trends that may unveil a correlation between molecular markers and poor clinical outcomes among black colorectal cancer patients.

Methods: De-identified patient data was obtained from The Oncology Data Services Department (Cancer Registry) of TJUH. The population cohort …


The Role Of Rassf5 On Cell Growth And Hippo Signaling In Rhabdomyosarcoma, Megan Garver, Lee Helman, Md, Katrina Slemmons, Phd Jan 2020

The Role Of Rassf5 On Cell Growth And Hippo Signaling In Rhabdomyosarcoma, Megan Garver, Lee Helman, Md, Katrina Slemmons, Phd

Phase 1

Introduction: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood. Dysregulation of the Hippo pathway, a signaling cascade that regulates many biological processes, is associated with many human cancers. The goal of my project was to delete RASSF5, a regulator of the Hippo pathway, in RMS cells utilizing CRISPR/Cas9 and then to evaluate how the absence of RASSF5 affects RMS cell growth and Hippo signaling, with and without DNMTi Tx.

Methods: A lipofectamine transfection was performed in two different RMS cell lines, Rh30 & RD, in which two different CRIPSR/Cas9 vectors with RASSF5 guide RNA were introduced. …


Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Austin Klein, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Danielle Snyderman, Md Jan 2020

Helping Continuing Care Retirement Communities Determine The Best Level Of Care For Each Patient, Austin Klein, Nicholas Safian, Grant Schultheis, Sopuru Ezeonu, Danielle Snyderman, Md

Phase 1

Background: The vast majority of healthcare costs are spent on the last decade of life. Older patients often have complex medical histories complicated further by physical, mental and social limitations. High levels of hospital readmittance and nonadherence further complicate care for senior adult patients. Continuing Care Retirement Communities (CCRCs) are long term care facilities that attempt to support this diverse array of problematic patients. Residents can live in several different groupings called “Levels of Care” (LOC). To maximize safety, quality of care, and patient satisfaction, it is important to place residents in the right context. This project seeks to drive …


Treatment Of Persistent Air Leaks Using Endobronchial Valves, Michael Zimmerman, Cole Zingas, Achala Donuru, Scott W. Cowan, Nathaniel Evans Iii, Boyd Hehn Jan 2020

Treatment Of Persistent Air Leaks Using Endobronchial Valves, Michael Zimmerman, Cole Zingas, Achala Donuru, Scott W. Cowan, Nathaniel Evans Iii, Boyd Hehn

Phase 1

Introduction: Persistent air leaks (PAL) are from bronchopleural fistula resulting from communication between the bronchial tree and pleural space. Endobronchial valves (EBVs) are unidirectional valves placed bronchoscopically preventing airflow to the diseased lung lobe. For non-operable patients with PALs, EBVs offer a potential non-invasive treatment approach to stop air leak and allow lung healing. The purpose of this study is to retrospectively analyze EBV placement to treat non-operable adult patients with PALs.

Methods: We retrospectively analyzed all adult patients that underwent EBV placement for PAL treatment at our institution from January 2016 to June 2019. All patients failed conservative …


Late Complications Of Free Flaps In Head And Neck Microvascular Reconstruction, Swapna Vasudevan, Cory Bovenzi, Md Jan 2020

Late Complications Of Free Flaps In Head And Neck Microvascular Reconstruction, Swapna Vasudevan, Cory Bovenzi, Md

Phase 1

Introduction: Late free flap complications (LFFC) in head and neck reconstructive surgery occur over 72 hours postoperatively and result in flap loss in 97% of cases. Due to the rarity of LFFC, there is minimal research regarding risk factors for their development. Identifying risk factors for LFFC will result in improved monitoring of patients to prevent flap loss. This study aims to identify risk factors for the development of LFFC.

Methods: The target population of this retrospective cohort study was 116 patients who had undergone an Orbital Exenteration at Thomas Jefferson University Hospital (TJUH) and had LFFC. Data was …


Effects Of Corneal Transplant On Rates Of Retinal Detachment, Daniel S. Mackinnon, Zeba A. Syed, Md, Durga Borkar, Hannah Levin Jan 2020

Effects Of Corneal Transplant On Rates Of Retinal Detachment, Daniel S. Mackinnon, Zeba A. Syed, Md, Durga Borkar, Hannah Levin

Phase 1

Introduction: Corneal transplant remains the gold standard treatment for irreversible corneal damage. The purpose of this study is to evaluate retinal detachment rates and clinical outcomes after penetrating keratoplasty (PK) and endothelial keratoplasty (EK). We hypothesized that corneal transplants would increase the rate of RD.

Methods: This retrospective cohort study utilized corneal transplant data from all surgical visits from PK or EK between April 1, 2012 and August 31, 2018. Individual charts were reviewed from patients who had a subsequent retinal detachment. Incidence of retinal detachment following PK or EK was the main outcome measured.

Results: A total of …


Simulation Of Status Epilepticus Is Effective Teaching For Junior Neurology Residents, Pankhuri Jha, Navya George, Jeffrey Ratliff Jan 2020

Simulation Of Status Epilepticus Is Effective Teaching For Junior Neurology Residents, Pankhuri Jha, Navya George, Jeffrey Ratliff

Phase 1

Purpose: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. At Jefferson, acute management of SE falls to the inpatient neurologist, requiring early competency.

Methods: During a 2 week educational “bootcamp”, 9 PGY2 residents participated in a 2 hour simulation of acute SE with two clinical scenarios. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Prior to and following the simulation, residents took a survey to gauge their knowledge and confidence in managing SE.

Results and Conclusions: There was an increase in the number of residents expressing confidence in their …


A Module Based Method Of Teaching A Novel Approach To Electrocardiogram Interpretation, Emily Fishbein, Alexandra Koutsoubis, Jennifer White, Md, Dimitrios Papanagnou, Md Jan 2020

A Module Based Method Of Teaching A Novel Approach To Electrocardiogram Interpretation, Emily Fishbein, Alexandra Koutsoubis, Jennifer White, Md, Dimitrios Papanagnou, Md

Phase 1

Purpose: The traditional approach to 12-lead electrocardiogram interpretation has limitations in the ED setting because it is tedious and does not emphasize pattern recognition for potentially fatal conditions that ED physicians must recognize. Additionally, while lecture-based learning is necessary, learning modules can help learners gain a better understanding of the material. The purpose of this study was to create and implement a self-paced learning module that teaches a novel way of ECG interpretation through the following steps: is it sinus? is it wide? is there ischemia? and does this herald sudden death?

Methods: The objective endpoint of this study was …


Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md Jan 2020

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …


Examining Israeli Emergency Medical Preparedness In The Context Of Jefferson And Affiliates Practices, Jamie D. Garden, Amit S. Padaki Jan 2020

Examining Israeli Emergency Medical Preparedness In The Context Of Jefferson And Affiliates Practices, Jamie D. Garden, Amit S. Padaki

Phase 1

Introduction: Recent domestic disasters have demonstrated the challenges and vulnerabilities in the US health care disaster preparedness framework, challenges that extend to Thomas Jefferson University Hospital System (TJUH), in Philadelphia, PA. As Israel serves as a global leader in civilian defense and disaster preparedness, this study examines best practices in response to a mass casualty event at Hadassah Hospital in Jerusalem, Israel, and compares them with existing protocol at TJUH. The list of best practices generated from this research allows for a greater understanding of standards that are feasibly employable at TJUH.

Methods: This study examined hospital staff response practices …


Protocol For Ground Glass Opacity, Elissa Goldman Jan 2020

Protocol For Ground Glass Opacity, Elissa Goldman

Phase 1

Rationale: Pure ground glass opacities (GGO), identified incidentally or on lung cancer screening, may indicate pre-invasive subtypes of lung adenocarcinoma. These neoplasms typically demonstrate indolent patterns of growth, and Fleischner Society guidelines recommend up to five years of serial imaging. Our aim was to determine the frequency of diagnosed lung adenocarcinoma arising from GGO detected beyond 5 years of CT surveillance.

Methods: We reviewed all pathologic diagnoses of lung adenocarcinoma (n=442) between 2016 and 2018 of a tertiary academic hospital and National Cancer Institute-designated cancer center to identify all cancers that arose from ground glass opacities detected on CT scan. …


Ain To Ulnar Motor Nerve Transfer Meta Analysis, Melanie Luikart, Asif M. Ilyas, Md Jan 2020

Ain To Ulnar Motor Nerve Transfer Meta Analysis, Melanie Luikart, Asif M. Ilyas, Md

Phase 1

Background: There are currently few comprehensive studies of end-to-end and “supercharged” reverse end-to-side (SETS) anterior interosseous nerve (AIN) to ulnar nerve transfers for treatment of ulnar neuropathy. The authors performed a literature review existing published literature to evaluate the indications for, and utility of, AIN-ulnar nerve transfer as a treatment method and to inform future treatment decisions.

Methods: A literature review was performed based on the following inclusion criteria: inclusion of anterior interosseous nerve or AIN, ulnar nerve or ulnar motor nerve, transfer or nerve transfer, and outcome, motor, clinical, ulnar neuropathies, ulnar nerve paralysis, treatment or function. Exclusion criteria …


Alkalinizing Agents: A Review Of Prescription, Over-The-Counter, And Medical Food Supplements., Karen L. Stern, Noah Canvasser, Michael Borofsky, Vanessa M. Gleason, Guido Kamphuis, Marawan M. El Tayeb, Ryan Hsi, Kymora B. Scotland Jan 2020

Alkalinizing Agents: A Review Of Prescription, Over-The-Counter, And Medical Food Supplements., Karen L. Stern, Noah Canvasser, Michael Borofsky, Vanessa M. Gleason, Guido Kamphuis, Marawan M. El Tayeb, Ryan Hsi, Kymora B. Scotland

Jefferson Hospital Staff Papers and Presentations

Introduction

Kidney stones affect 1 in every 11 people in the United States each year. There is a significant high recurrence rate without a stone prevention protocol. Alkali citrate is beneficial in decreasing stone recurrence, but due to the cost and gastrointestinal side effects there is a low adherence rate. This study aims to serve as a review of some of the most commonly used alkalizing over‐ the‐ counter supplements that are advertised to prevent and treat kidney stones.

Methods

Data was gathered by a comprehensive online literature search and company inquiries for kidney stone prevention supplements. An additional informal …