Translational Medical Research Commons^™

Electrophysiological Properties Of The Mitochondrial Permeability Transition Pores: Channel Diversity And Disease Implication., M. A. Neginskaya, E. V. Pavlov, S.-S. Sheu

Center for Translational Medicine Faculty Papers

The mitochondrial permeability transition pore (mPTP) is a channel that, when open, is responsible for a dramatic increase in the permeability of the mitochondrial inner membrane, a process known as the mitochondrial permeability transition (mPT). mPTP activation during Ca2+ dyshomeostasis and oxidative stress disrupts normal mitochondrial function and induces cell death. mPTP opening has been implicated as a critical event in many diseases, including hypoxic injuries, neurodegeneration, and diabetes. Discoveries of recent years indicate that mPTP demonstrates very complicated behavior and regulation, and depending on specific induction or stress conditions, it can function as a high-conductance pore, a small channel, …

The Er Stress/Upr Axis In Chronic Obstructive Pulmonary Disease And Idiopathic Pulmonary Fibrosis., Mahmoud Aghaei, Sanaz Dastghaib, Sajjad Aftabi, Mohamad-Reza Aghanoori, Javad Alizadeh, Pooneh Mokarram, Parvaneh Mehrbod, Milad Ashrafizadeh, Ali Zarrabi, Kielan Darcy Mcalinden, Mathew Suji Eapen, Sukhwinder Singh Sohal, Pawan Sharma, Amir A Zeki, Saeid Ghavami

Center for Translational Medicine Faculty Papers

Cellular protein homeostasis in the lungs is constantly disrupted by recurrent exposure to various external and internal stressors, which may cause considerable protein secretion pressure on the endoplasmic reticulum (ER), resulting in the survival and differentiation of these cell types to meet the increased functional demands. Cells are able to induce a highly conserved adaptive mechanism, known as the unfolded protein response (UPR), to manage such stresses. UPR dysregulation and ER stress are involved in numerous human illnesses, such as metabolic syndrome, fibrotic diseases, and neurodegeneration, and cancer. Therefore, effective and specific compounds targeting the UPR pathway are being considered …

Modelling Cross-Disciplinary Integration In Fda Multidisciplinary And Interdisciplinary Reviews For New Drug Products: A Phenomenological Descriptive Comparative Case Study, Kevin Bugin

Doctor of Philosophy in Translational Health Sciences Dissertations

Cross-disciplinary integration is a key feature of interdisciplinary research and the collaborative form is often one of the desired outcomes of Team Science endeavors. In 2019 the FDA began rolling out a new interdisciplinary approach to their cross-disciplinary assessment of marketing applications, with the key feature being integrated, collaborative review documents (Woodcock et al., 2020). FDA’s assessment of new drug products to allow them to enter the marketplace is a critical translational activity to protect the US public’s health that requires team-based integration and transparency (Woodcock, 2018). And, while increased cross-disciplinary integration through enhanced collaboration and communication is sought through …

Translating Evidence-Based Guidelines Into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit Of Nutrition Care In Patients With Foregut Tumors (Inform), Merran Findlay, Judith D. Bauer, Rupinder Dhaliwal, Marian De Van Der Schueren, Alessandro Laviano, Adrianne Widaman, Lisa Martin, Andrew G. Day, Leah M. Gramlich

Faculty Research, Scholarly, and Creative Activity

Malnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presents considerable challenges and consequently lags. This study aimed to describe and evaluate current international nutrition care practices compared with the best-available evidence for patients with foregut tumors who are at high risk of malnutrition. A multi-centre prospective cohort study enrolled 170 patients commencing treatment of curative intent for HNC (n = 119) or EC (n = 51) in 11 cancer …

A Narrative Review On The Basic And Clinical Aspects Of The Novel Sars-Cov-2, The Etiologic Agent Of Covid-19., Joseph Hokello, Adhikarimayum Lakhikumar Sharma, Girish C. Shukla, Mudit Tyagi

Center for Translational Medicine Faculty Papers

The novel SARS-CoV-2 is responsible for causing the ongoing outbreak of coronavirus disease 19 (COVID-19), a systemic infection in humans. Ever since it was first detected in December 2019, the number of confirmed cases has continued to increase. Within a short period, this disease has become a global issue, and therefore it is characterized as a pandemic. The current understanding and explanations are based on epidemiological, clinical and physiological observations. Besides, it remains a great challenge, as much remains to be understood about this new disease-causing virus. Therefore, we seek to provide an overview of SARS-CoV-2, including its classification, origin, …

The Odorant Receptor Or2w3 On Airway Smooth Muscle Evokes Bronchodilation Via A Cooperative Chemosensory Tradeoff Between Tmem16a And Cftr., Jessie Huang, Hong Lam, Cynthia Koziol-White, Nathachit Limjunyawong, Donghwa Kim, Nicholas Kim, Nikhil Karmacharya, Premraj Rajkumar, Danielle Firer, Nicholas M Dalesio, Joseph Jude, Richard C Kurten, Jennifer L Pluznick, Deepak A. Deshpande, Raymond B Penn, Stephen B Liggett, Reynold A Panettieri, Xinzhong Dong, Steven S An

Center for Translational Medicine Faculty Papers

The recent discovery of sensory (tastant and odorant) G protein-coupled receptors on the smooth muscle of human bronchi suggests unappreciated therapeutic targets in the management of obstructive lung diseases. Here we have characterized the effects of a wide range of volatile odorants on the contractile state of airway smooth muscle (ASM) and uncovered a complex mechanism of odorant-evoked signaling properties that regulate excitation-contraction (E-C) coupling in human ASM cells. Initial studies established multiple odorous molecules capable of increasing intracellular calcium ([Ca2+]i) in ASM cells, some of which were (paradoxically) associated with ASM relaxation. Subsequent studies showed a terpenoid molecule (nerol)-stimulated …

Simvastatin Induces Unfolded Protein Response And Enhances Temozolomide-Induced Cell Death In Glioblastoma Cells., Sanaz Dastghaib, Shahla Shojaei, Zohreh Mostafavi-Pour, Pawan Sharma, John B Patterson, Afshin Samali, Pooneh Mokarram, Saeid Ghavami

Center for Translational Medicine Faculty Papers

Glioblastoma (GBM) is the most prevalent malignant primary brain tumor with a very poor survival rate. Temozolomide (TMZ) is the common chemotherapeutic agent used for GBM treatment. We recently demonstrated that simvastatin (Simva) increases TMZ-induced apoptosis via the inhibition of autophagic flux in GBM cells. Considering the role of the unfolded protein response (UPR) pathway in the regulation of autophagy, we investigated the involvement of UPR in Simva-TMZ-induced cell death by utilizing highly selective IRE1 RNase activity inhibitor MKC8866, PERK inhibitor GSK-2606414 (PERKi), and eIF2α inhibitor salubrinal. Simva-TMZ treatment decreased the viability of GBM cells and significantly increased apoptotic cell …

Interleukin 35 Delays Hindlimb Ischemia-Induced Angiogenesis Through Regulating Ros-Extracellular Matrix But Spares Later Regenerative Angiogenesis., Hangfei Fu, Yu Sun, Ying Shao, Jason Saredy, Ramon Cueto, Lu Liu, Charles Drummer, Candice Johnson, Keman Xu, Yifan Lu, Xinyuan Li, Shu Meng, Eric R Xue, Judy Tan, Nirag C Jhala, Daohai Yu, Yan Zhou, Kayla J Bayless, Jun Yu, Thomas J Rogers, Wenhui Hu, Nathaniel W Snyder, Jianxin Sun, Xuebin Qin, Xiaohua Jiang, Hong Wang, Xiaofeng Yang

Center for Translational Medicine Faculty Papers

Interleukin (IL) 35 is a novel immunosuppressive heterodimeric cytokine in IL-12 family. Whether and how IL-35 regulates ischemia-induced angiogenesis in peripheral artery diseases are unrevealed. To fill this important knowledge gap, we used loss-of-function, gain-of-function, omics data analysis, RNA-Seq, in vivo and in vitro experiments, and we have made the following significant findings: i) IL-35 and its receptor subunit IL-12RB2, but not IL-6ST, are induced in the muscle after hindlimb ischemia (HLI); ii) HLI-induced angiogenesis is improved in Il12rb2-/- mice, in ApoE-/-/Il12rb2-/- mice compared to WT and ApoE-/- controls, respectively, where hyperlipidemia inhibits angiogenesis in vivo and in …

Cbf-1 Promotes The Establishment And Maintenance Of Hiv Latency By Recruiting Polycomb Repressive Complexes, Prc1 And Prc2, At Hiv Ltr., Adhikarimayum Lakhikumar Sharma, Joseph Hokello, Shilpa Sonti, Sonia Zicari, Lin Sun, Aseel Alqatawni, Michael Bukrinsky, Gary Simon, Ashok Chauhan, René Daniel, Mudit Tyagi

Center for Translational Medicine Faculty Papers

The C-promoter binding factor-1 (CBF-1) is a potent and specific inhibitor of the human immunodeficiency virus (HIV)-1 LTR promoter. Here, we demonstrate that the knockdown of endogenous CBF-1 in latently infected primary CD4+ T cells, using specific small hairpin RNAs (shRNA), resulted in the reactivation of latent HIV proviruses. Chromatin immunoprecipitation (ChIP) assays using latently infected primary T cells and Jurkat T-cell lines demonstrated that CBF-1 induces the establishment and maintenance of HIV latency by recruiting polycomb group (PcG/PRC) corepressor complexes or polycomb repressive complexes 1 and 2 (PRC1 and PRC2). Knockdown of CBF-1 resulted in the dissociation of PRCs …

The Generation Of An Engineered Interleukin-10 Protein With Improved Stability And Biological Function, Faisal Minshawi, Sebastian Lanvermann, Edward Mckenzie, Rebecca Jeffery, Kevin Couper, Stamatia Papoutsopoulou, Axel Roers, Werner Muller

Center for Translational Medicine Faculty Papers

Interleukin-10 (IL-10) is an immunoregulatory cytokine that plays a pivotal role in modulating inflammation. IL-10 has inhibitory effects on proinflammatory cytokine production and function in vitro and in vivo; as such, IL-10 is viewed as a potential treatment for various inflammatory diseases. However, a significant drawback of using IL-10 in clinical application is the fact that the biologically active form of IL-10 is an unstable homodimer, which has a short half-life and is easily degraded in vivo. Consequently, IL-10 therapy using recombinant native IL-10 has had only limited success in the treatment of human disease. To improve the therapeutic potential …

Efficient Non-Epigenetic Activation Of Hiv Latency Through The T-Cell Receptor Signalosome., Joseph Hokello, Adhikarimayum Lakhikumar Sharma, Mudit Tyagi

Center for Translational Medicine Faculty Papers

Human immunodeficiency virus type-1 (HIV-1) can either undergo a lytic pathway to cause productive systemic infections or enter a latent state in which the integrated provirus remains transcriptionally silent for decades. The ability to latently infect T-cells enables HIV-1 to establish persistent infections in resting memory CD4+ T-lymphocytes which become reactivated following the disruption or cessation of intensive drug therapy. The maintenance of viral latency occurs through epigenetic and non-epigenetic mechanisms. Epigenetic mechanisms of HIV latency regulation involve the deacetylation and methylation of histone proteins within nucleosome 1 (nuc-1) at the viral long terminal repeats (LTR) such that the inhibition …

Sexual Dysfunction After Rectal Cancer Treatment, Sarah M. Popek

Clinical and Translational Science Center Scholarly Output

Introduction: Treatment for rectal cancer results in sexual dysfunction. Sexual function is a component of the HR-QOL (health related quality of life) measures. The incidence of sexual dysfunction following treatment for rectal cancer and its impact on the HR-QOL is not well delineated, particularly on women.

Objectives: To prospectively assess the degree of sexual dysfunction that occurs after treatment for Stage I-III rectal cancer and the corresponding short term (<3 months) and long term (<2 years) effect on the Quality of Life measure for oncology (QOL-30).

Methods: Validated questionnaires will be administered to assess sexual function and quality of life. The International Index of Erectile Dysfunction will be administered to male patients and …

Metformin Enhances Autophagy And Normalizes Mitochondrial Function To Alleviate Aging-Associated Inflammation, Leena P. Bharath, Madhur Agrawal, Grace Mccambridge, Dequina A. Nicholas, Hatice Hasturk, Jing Liu, Lao Jiang, Rui Liu, Zhenheng Guo, Jude T. Deeney, Caroline M. Apovian, Jennifer Snyder-Cappione, Gregory S. Hawk, Rebecca M. Fleeman, Riley M. F. Pihl, Katherine Thompson, Anna C. Belkina, Licong Cui, Elizabeth A. Proctor, Philip A. Kern, Barbara S. Nikolajczyk

Clinical and Translational Science Faculty Publications

Age is a non-modifiable risk factor for the inflammation that underlies age-associated diseases; thus, anti-inflammaging drugs hold promise for increasing health span. Cytokine profiling and bioinformatic analyses showed that Th17 cytokine production differentiates CD4+ T cells from lean, normoglycemic older and younger subjects, and mimics a diabetes-associated Th17 profile. T cells from older compared to younger subjects also had defects in autophagy and mitochondrial bioenergetics that associate with redox imbalance. Metformin ameliorated the Th17 inflammaging profile by increasing autophagy and improving mitochondrial bioenergetics. By contrast, autophagy-targeting siRNA disrupted redox balance in T cells from young subjects and activated the Th17 …

Foundational Research And Nih Funding Enabling Emergency Use Authorization Of Remdesivir For Covid-19, Ekaterina Galkina Cleary, Matthew J. Jackson, Zoë Folchman-Wagner, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Emergency Use Authorization for remdesivir months after discovery of COVID-19 is unprecedented. Typically, decades of research and public-sector funding are required to establish the mature body of foundational research requisite for efficient, targeted drug discovery and development. This work quantifies the body of research related to remdesivir’s biological target, RNA-dependent RNA polymerase (RdRp), or parent chemical structure, nucleoside analogs (NcAn), through 2019, as well as NIH funding for this research 2000–2019. There were 6,567 RdRp-related publications in PubMed, including 1,263 with NIH support, and 11,073 NcAn-related publications, including 2,319 with NIH support. NIH support for RdRp research comprised 2,203 Project …

Nih Funding For Research Underlying New Cancer Therapies, Ekaterina Galkina Cleary, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Contemporary discovery and development of cancer drugs are based on the model that investments in basic biomedical science will provide insights that can be translated into new cures. In the USA, basic research is primarily funded by the National Institutes of Health (NIH),1 which allocates half of its research budget to basic science,2 with smaller amounts contributed by philanthropy, academics, or industry.1 Basic science is formally defined as the “systematic study directed toward fuller knowledge or understanding of the fundamental aspects of phenomena and observable facts without specific application towards processes or products in mind”.3 However, science is often useinspired,4 …

Shedding Light On The Role Of Extracellular Vesicles In Hiv Infection And Wound Healing., Aseel Alqatawni, Adhikarimayum Lakhikumar Sharma, Beatrice Attilus, Mudit Tyagi, Rene Daniel

Center for Translational Medicine Faculty Papers

Extracellular vesicles (EVs) play an important role in intercellular communication. They are naturally released from cells into the extracellular environment. Based on their biogenesis, release pathways, size, content, and function, EVs are classified into exosomes, microvesicles (MVs), and apoptotic bodies (ApoBDs). Previous research has documented that EVs, specifically exosomes and MVs, play an important role in HIV infection, either by promoting HIV infection and pathogenesis or by inhibiting HIV-1 to a certain extent. We have also previously reported that EVs (particularly exosomes) from vaginal fluids inhibit HIV at the post-entry step (i.e., reverse transcription, integration). Besides the role that EVs …

The Short Variant Of Optic Atrophy 1 (Opa1) Improves Cell Survival Under Oxidative Stress., Hakjoo Lee, Sylvia B Smith, Shey-Shing Sheu, Yisang Yoon

Center for Translational Medicine Faculty Papers

Optic atrophy 1 (OPA1) is a dynamin protein that mediates mitochondrial fusion at the inner membrane. OPA1 is also necessary for maintaining the cristae and thus essential for supporting cellular energetics. OPA1 exists as membrane-anchored long form (L-OPA1) and short form (S-OPA1) that lacks the transmembrane region and is generated by cleavage of L-OPA1. Mitochondrial dysfunction and cellular stresses activate the inner membrane-associated zinc metallopeptidase OMA1 that cleaves L-OPA1, causing S-OPA1 accumulation. The prevailing notion has been that L-OPA1 is the functional form, whereas S-OPA1 is an inactive cleavage product in mammals, and that stress-induced OPA1 cleavage causes mitochondrial fragmentation …

A Call For Grounding Implicit Bias Training In Clinical And Translational Frameworks, Nao Hagiwara, Frederick W. Kron, Mark W. Scerbo, Ginger S. Watson

Psychology Faculty Publications

Since the publication of Unequal Treatment in 2003,¹ the number of studies investigating the implicit bias of health-care providers and its troubling consequences has increased exponentially. Bias can occur in all three psychological components: affects (ie, prejudice), cognition (ie, stereotypes), and behaviour (ie, discrimination). Implicit bias refers to prejudicial attitudes towards and stereotypical beliefs about a particular social group or members therein. These prejudicial attitudes and stereotypical beliefs are activated spontaneously and effortlessly, which often result in discriminatory behaviours.² This definition is consistent with how implicit bias is defined in psychology³ and in literature on health disparities. …

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.

Dna Dependent Protein Kinase (Dna-Pk) Enhances Hiv Transcription By Promoting Rna Polymerase Ii Activity And Recruitment Of Transcription Machinery At Hiv Ltr., Sonia Zicari, Adhikarimayum Lakhikumar Sharma, Geetaram Sahu, Larisa Dubrovsky, Lin Sun, Han Yue, Tejaswi Jada, Alex Ochem, Gary Simon, Michael Bukrinsky, Mudit Tyagi

Center for Translational Medicine Faculty Papers

Despite reductions in mortality from the use of highly active antiretroviral therapy (HAART), the presence of latent or transcriptionally silent proviruses prevents HIV cure/eradication. We have previously reported that DNA-dependent protein kinase (DNA-PK) facilitates HIV transcription by interacting with the RNA polymerase II (RNAP II) complex recruited at HIV LTR. In this study, using different cell lines and peripheral blood mononuclear cells (PBMCs) of HIV-infected patients, we found that DNA-PK stimulates HIV transcription at several stages, including initiation, pause-release and elongation. We are reporting for the first time that DNA-PK increases phosphorylation of RNAP II C-terminal domain (CTD) at serine …

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 …

Neurostimulants To Improve Consciousness In Acute Comatose Patients, Lyena Birkenstock, Mohammed Kananeh

Phase 1

Patients in the neurology intensive care unit (NICU) suffering from coma have variable outcomes, even once the underlying condition has been treated. Coma is a detrimental condition with a high risk for mortality and disability. Currently, there is not a specific treatment regimen to treat, or even improve, comatose patients. In this study, we set out to compare the efficacy and side effect profile of different neurostimulants, including modafinil, adderall, and zolpidem. The target population includes adult patients in the Jefferson NICU with a diagnosis of persistent encephalopathy, despite the resolution of their admitting diagnoses. Patients are administered medication as …

State-Level Cpr Education Legislation Associated With Higher Survival After Out-Of-Hospital Cardiac Arrest In Older Adults, Megan Barnes, David G. Buckler, Tyler D. Alexander, Marissa Lang, Alexis Zebrowski, Douglas J. Wiebe, Benjamin S. Abella, Brendan G. Carr

Phase 1

Introduction: State-level legislation requiring CPR education prior to high school graduation is associated with an increased likelihood of community-level CPR training. CPR Legislation has also been shown to be associated with increased bystander CPR. We hypothesized that states with CPR Legislation would be associated with higher survival following out-of-hospital cardiac arrest (OHCA).

Methods: Utilizing 2014 Medicare Claims data for emergency department visits and inpatient stays, we identified OHCA via ICD-9-CM code. CPR Legislation data was collected through online statute review. Exposure to CPR Legislation was assessed using the patient state of residence. All disposition categories were considered survival to discharge …

Mci: Cpap Treatment Of Osa, Kaitlin Berry, Cindy Cheng, Md, Phd, Karl Doghramji, Md

Phase 1

Introduction: An estimated 30 percent of adults (20% of men and 10% of women) in the US have sleep apnea. Approximately 60% of patients with Mild Cognitive Impairment (MCI) are also diagnosed with Obstructive Sleep Apnea (OSA). The suggested mechanism of this is damage to the brain due to hypoxia during sleep. Few studies have investigated the effect of Continuous Positive Airway Pressure (CPAP) treatment for OSA, on mild cognitive impairment.

Methods: Patients are screened for eligibility based on specific inclusion and exclusion criteria. Potentially eligible patients who screen positive for MCI using the Telephone Interview for Cognitive Status …

Blood Transfusion Requirements For Patients On Extracorporeal Membrane Oxygenation, Min Choi, Hitoshi Hirose, Md, Phd

Phase 1

No abstract provided.

Evaluation Of Rotator Cuff Repair With Concomitant Biceps Tenodesis, Matthew Beucherie, Daniel Nemirov, Sommer Hammoud, Md, Meghan Bishop, Md, Brandon Erickson, Md

Phase 1

Introduction: Surgical rotator cuff repair (RCR) has proven to be an effective treatment for rotator cuff tears. Commonly, rotator cuff tears are associated with concomitant biceps pathology, which are often treated by biceps tenodesis (BT). We hypothesize that patient outcomes will be similar in those that have undergone RCR with concomitant BT and isolated RCR.

Methods: This is a retrospective cohort study comparing patients who underwent arthroscopic RCR with arthroscopic or open BT to patients who underwent isolated RCR at a multisurgeon orthopaedic practice during the time period of November 2016 to December 2016. The outcome for comparison is …

Falls And Traumatic Brain Injury In The Elderly On Aspirin Or Anticoagulant Therapy, Jonathan Bassig, David Nauheim, Stanton Miller, Patricia Williams, Tingting Zhan

Phase 1

Introduction: Traumatic brain injury (TBI) after a fall in individuals aged 65 and older is a leading cause of morbidity and mortality, but the effect of aspirin and anticoagulant therapy on TBI severity is not fully understood. This study evaluated whether the severity of TBI is associated with use of aspirin or anticoagulant therapy or in combination.

Methods: Using retrospective chart review, we identified patients age 65 or older who fell and sustained head trauma that were admitted to Thomas Jefferson University Hospital trauma service from 2017-2018. Based on final diagnosis, patients were classified into three groups of TBI …

Training The Next Generation Of Family Medicine Providers Through Group Buprenorphine-Naloxone Visits, Krystina Callahan, Lara Weinstein, Md, Erica Li, Md, Sunny Lai, Md, Alexis Silverio

Phase 1

Introduction: The rise in opioid use disorders (OUD) and fatal overdoses highlight the need to expand access to and capacity for treating OUD. Medication Assisted Treatment (MAT), a medication/group visit model, done in the office setting, is an effective remedy for treating OUD. Understanding residents’ perspectives on their clinical training in MAT can inform the design of a more effective and responsive curriculum.

Methods: A qualitative study using group semi-structured interviews with residents in an urban family medicine residency rotating through a federally qualified health center. Interviews centered on strengths and weaknesses of the MAT program, resident likeliness to …

Functional Outcomes After Lumbar Fusion In Opioid-Tolerant Patients, Max Detweiler, Noah Levy, Dhruv K.C. Goyal, Ariana Reyes, Alex R. Vaccaro, Md, Phd, Mba

Phase 1

Introduction: Prolonged opioid use after lumbar fusion surgery is implicated with increased hospital readmissions, higher postoperative pain scores, and longer return to work time. There are several non-modifiable risk factors for postoperative opioid use including socioeconomic status and gender. The purpose of this study was to determine the effects of opioid-tolerance on PROMs and to determine risk factors for prolonged opioid use after lumbar spine surgery.

Method: Using retrospective cohort analysis, patients who underwent lumbar spinal fusion at TJUH were identified and determined to be either opioid-naïve or opioid-tolerant using the Pennsylvania PDMP. Outcomes included number of opioid tablets consumed, …

Transdermal Lidocaine For Perioperative Pain: A Systematic Review Of The Literature, Alexa Cohen, Jordan Smoker, Mohammad R. Rasouli, Eric S. Schwenk

Phase 1

Introduction: Recent data have shown that the risk of taking chronic opioids after surgery increases after about 5 days of postoperative opioid therapy. Alternatives to opioids are desirable, and transdermal lidocaine is one such perioperative multimodal agent. This review provides a summary of the perioperative studies that have examined transdermal lidocaine as an analgesic in the perioperative period.

Methods: We conducted searches of PubMed and Scopus databases. Studies involving patients who were undergoing surgery and were given either transdermal lidocaine, placebo, or active comparator in the perioperative period with the primary endpoint of improvement in pain were included in …