Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Clinical And Radiological Identification And Management Of Sapho Syndrome, Obyda Al-Housni, Jessica M. Alonso, Matthew Thornburg, Enny Cancio

HCA Healthcare Journal of Medicine

Introduction

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an autoinflammatory disease whose acronymic name stands for the symptoms commonly seen in the disease. These symptoms typically occur simultaneously, in different combinations, in patients during exacerbations of the disease. SAPHO syndrome is a rare disease, most frequently seen in patients aged 30 to 50. It is estimated to be found in 1 in 10 000 persons in White populations, with an even lower incidence seen in non-White populations.

Case Presentation

A post-menopausal woman with a medical history of SAPHO presented to the emergency department with left foot pain and …

Exploring Perinatal Ketamine For Postpartum Depression Following Cesarean Section: A Systematic Review, Jaylyn Thompson, David F Lo, Alexis Foschini, Suvan Sundaresh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The aim of this study was to explore the use of perinatal ketamine to see if it can be used for the reduction of postpartum depression (PPD) following cesarean section (C-section). PubMed, Cochrane, and Web of Science were the primary databases used for this review. Search terms used on January 5, 2024 incorporated "ketamine," "C-section," "postpartum depression," and related synonyms. The criteria for inclusion centered on studies published between January 1, 2008 and January 5, 2024. The final selection of articles was screened based on extraction criteria leaving eight randomized control trials in the final review. The selected data from …

Endoscopic Transventricular "Inside-Out" Corpus Callosotomy: Illustrative Case, Michael Baumgartner, Elias Atallah, Kathleen Galligan, Pamela Mcdonnell, Benjamin Kennedy

Department of Neurosurgery Faculty Papers

BACKGROUND: Tonic and atonic "drop attack" seizures are a classic and morbid semiology in Lennox-Gastaut syndrome, resulting in frequent injuries and emergency room visits, in addition to neurocognitive sequelae. Recent years have seen a growing interest in less invasive techniques for performing the classic surgical treatment for drop attacks in Lennox-Gastaut syndrome, that is, corpus callosotomy.

OBSERVATIONS: A 5-year-old boy with Lennox-Gastaut syndrome presented for surgical evaluation. He experienced up to 20 daily tonic seizures despite multiple antiseizure medications. Preoperative imaging revealed highly abnormal anatomy with severe ventriculomegaly and thinning of the cortex and corpus callosum. Open microsurgery or an …

Prevalence And Associated Risk Factors Of Current Hepatitis C Infection Among U.S. General Population And Injection Drug Users Aged 20-59 Years: Nhanes 2009-2018, Harun Mazumder, Md Faruk Hossain, Pratibha Shrestha, Sultan Mahmud, Maidul Husain, Rebeka Ahmed

School of Public Health Faculty Publications

INTRODUCTION: The people who inject drugs (PWID) are attributed to high-risk groups for transmission of the Hepatitis C virus (HCV). This study assessed the prevalence and associated factors of current HCV infection (CHI) among U.S. general population and PWID of ages between 20 and 59 years old. METHODS: This study utilized cross-sectional data from the 2009-2018 National Health and Nutrition Examination Survey, conducting separate analyses for the U.S. general population, including PWID and non-PWID, as well as specific analyses focusing solely on PWID. The analytical methods included the estimation of CHI prevalence, Rao-Scott chi-square test to compare CHI-positive and CHI-negative …

Utilization Of A Novel Scoring System In Predicting 30-Day Mortality In Acute Pulmonary Embolism, The Clot-5 Pilot Study, Alexandru Marginean, Punit Arora, Kevin Walsh, Elizabeth Bruno, Cathryn Sawalski, Riya Gupta, Frances Greathouse, Jacob Clarke, Quinn Mallery, Myoung Hyun Choi, Waddah Malas, Parth Shah, David Sutherland, Amudha Kumar, Igor Wroblewski, Ahmed Elkaryoni, Parth Desai, Yevgeniy Brailovsky, Amir Darki

Division of Cardiology Faculty Papers

OBJECTIVES: To construct a new scoring system utilizing biomarkers, vitals, and imaging data to predict 30-day mortality in acute pulmonary embolism (PE).

BACKGROUND: Acute PE, a well-known manifestation of venous thromboembolic disease, is responsible for over 100,000 deaths worldwide yearly. Contemporary management algorithms rely on a multidisciplinary approach to care via PE response teams (PERT) in the identification of low, intermediate, and high-risk patients. The PESI and sPESI scores have been used as cornerstones of the triage process in assigning risk of 30-day mortality for patients presenting with acute PE; however, the specificity of these scoring systems has often come …

Inflammation, Physical Activity, And Disease-Free Survival In Stage Iii Colon Cancer: Calgb/Swog 80702 (Alliance), Justin C. Brown, Chao Ma, Qian Shi, Felix Couture, Philip Kuebler, Pankaj Kumar, Benjamin Tan, Smitha Krishnamurthi, Victor Chang, Richard M. Goldberg, Eileen M. O'Reilly, Anthony F. Shields, Jeffrey A. Meyerhardt

School of Medicine Faculty Publications

Background: Both inflammation and insufficient physical inactivity contribute to individual-level risk of disease recurrence and death in stage III colon cancer. The extent to which increased inflammatory risk can be offset by sufficient physical activity remains unknown. Methods: This cohort study was nested within the CALGB/SWOG 80702 (Alliance) randomized trial. Inflammatory burden was quantified by high-sensitivity C-reactive protein, interleukin-6, and soluble tumor necrosis factor-α receptor 2 after recovery from tumor resection. Physical activity was measured during and after postoperative chemotherapy. The primary endpoint was disease-free survival. Results: The 3-year disease-free survival rate was 88.4% among patients with low inflammation and …

Minocycline-Induced Retinal Pigment Epithelium Hyperpigmentation Masquerading As Age-Related Macular Degeneration: Case Presentation And Proposed Mechanism, Michael D. Yu, Nikhil Bommakanti, Yoshihiro Yonekawa, Jose S. Pulido

Wills Eye Hospital Papers

PURPOSE: We describe the case of an 80-year-old man with bilateral minocycline-induced retinal pigment epithelium (RPE) hyperpigmentation, which initially masqueraded as AMD. Secondarily, using multimodal imaging features, we propose a mechanism for the development of minocycline-induced RPE hyperpigmentation.

OBSERVATIONS: The patient was referred with concern for AMD given the presence of macular drusenoid deposits on optical coherence tomography. However, funduscopic evaluation showed dense granular parafoveal hyperpigmentation, with a diffuse slate-colored hyperpigmentation throughout the peripheral fundus. Short-wavelength fundus autofluorescence of the macula disclosed no irregularities (as would be expected with drusen) while on near-infrared reflectance (NIR) imaging, numerous hyperreflective foci were …

Quantifying Radiographs In Endodontics: A Survey, Pavneet K. Bains, Albert F. Mcmullen Iii, Haley D. Kessler, Andrew G. Chapple

School of Dentistry Faculty Publications

Purpose: The aim of this study was to investigate the average quantity of radiographs obtained during non-surgical endodontic treatment and trends in endodontic radiography among U.S. members of the AAE. Materials & Methods: A survey was sent via e-mail to 4,269 active U.S. members of the AAE. Data were collected over a period of approximately 4 months. The number of radiographs reported for non-surgical endodontic treatment was compared across fourteen variables using Kruskal Wallace tests. Chi Square tests of Independence were also used to evaluate trends in endodontic radiography based on three primary categorical variables of interest: years of experience, …

Appropriateness Of Imaging For Low-Risk Prostate Cancer-Real World Data From The Pennsylvania Urologic Regional Collaboration (Purc), Raidizon Mercedes, Dennis Head, Elizabeth Zook, Eric Eidelman, Jeffrey Tomaszewski, Serge Ginzburg, Robert Uzzo, Marc Smaldone, John Danella, Thomas Guzzo, Daniel Lee, Laurence Belkoff, Jeffrey Walker, Adam Reese, Mihir Shah, Bruce Jacobs, Jay Raman

Einstein Health Papers

Imaging for prostate cancer defines the extent of disease. Guidelines recommend against imaging low-risk prostate cancer patients with a computed tomography (CT) scan or bone scan due to the low probability of metastasis. We reviewed imaging performed for men diagnosed with low-risk prostate cancer across the Pennsylvania Urologic Regional Collaborative (PURC), a physician-led data sharing and quality improvement collaborative. The data of 10 practices were queried regarding the imaging performed in men diagnosed with prostate cancer from 2015 to 2022. The cohort included 13,122 patients with 3502 (27%) low-risk, 2364 (18%) favorable intermediate-risk, 3585 (27%) unfavorable intermediate-risk, and 3671 (28%) …

Microvascular Autologous Breast Reconstruction With The Lateral Thigh Perforator Flap, Stefania M.H. Tuinder, Joep A.F. Van Rooij, Robert J. Allen

School of Medicine Faculty Publications

The lateral thigh perforator flap is an excellent alternative to the deep inferior epigastric artery perforator (DIEP) flap for patients with absolute or relative contraindications for a DIEP flap and adequate volume at the lateral thigh. Preoperative physical examination, preoperative markings, and radiological perforator mapping are essential for adequate surgical preparation. The flap is based on septocutaneous perforators of the lateral circumflex femoral artery, located in the posterior septum between the tensor fascia latae and the gluteus medius muscle. Being relatively stiff, septocutaneous perforators are sensitive to kinking and compression, which is important to keep in mind during flap inset. …

Design, Synthesis, And Evaluation Of Oleyl-Wrh Peptides For Sirna Delivery, Mrigank Shekhar Rai, Muhammad Imran Sajid, Jonathan Moreno, Keykavous Parang, Rakesh Kumar Tiwari

Pharmacy Faculty Articles and Research

Delivering nucleic acid therapeutics across cell membranes is a significant challenge. Cell-penetrating peptides (CPPs) containing arginine (R), tryptophan (W), and histidine (H) show promise for siRNA delivery. To improve siRNA delivery and silence a model STAT3 gene, we hypothesized that oleyl acylation to CPPs, specifically (WRH)n, would enhance STAT3 silencing efficiency in breast and ovarian cancer cells. Using Fmoc/tBu solid-phase peptide chemistry, we synthesized, purified, and characterized the oleyl-conjugated (WRH)n (n = 1–4) peptides. The peptide/siRNA complexes were non-cytotoxic at N/P 40 (~20 μM) against MDA-MB-231, MCF-7, SK-OV-3, and HEK-293 cells after 72 h incubation. All peptide/siRNA complexes showed serum …

Standardizing Documentation Of Patients’ Measurable Decline To Increase Medicare Compliance In The Hospice Setting, Julia A. Gines

Master's Projects and Capstones

Problem: Staff nurses have difficulties standardizing documentation of patients’ measurable decline during the admission and recertification process to justify the need for hospice services. Context: According to Murrin (2016), the average Medicare compliance rate of hospice organizations is 86%. This quality improvement (QI) project aims to increase an outpatient hospice organization’s Medicare compliance rate of 66% to the average, nationwide level through standardization of documentation (Frontz, 2021). Interventions: The proposed intervention is to implement a QI project of the following assessment tools: Palliative Performance Scale (PPS), Functional Assessment Staging Tool (FAST) and Mid-Upper Arm Circumference (MUAC). Clinical nurses will attend …

In-House Polydimethylsiloxane Microfluidic Device On Single Cell Trapping And Culturing Of Leukemia Cell Line: Comparison Between Conventional And Conventional With Centrifugal Methods, Alongkorn Pimpin, Sudchaya Bhanpattanakul, Tepparit Wongpakham, Chomkwan Tawatcharaporn, Thanawit Siha-Umphai, Mookdapa Sinsiriphan, Atikan Chalermchuang, Tewan Tongmanee, Attawut Thanomsridetchai, Thammawit Suwannaphan, Witsaroot Sripumkhaie, Pattaraluck Pattamang, Mayuree Chanasakulniyom, Praprudee Piyaviriyakul, Wutthinun Jeamsaksiri, Achariya Sailasuta, Theerawat Tharasanit, Theerayuth Kaewamatawong

The Thai Journal of Veterinary Medicine

To develop a suitable model to study biological and characterization of Cancer stem cells (CSCs), single cell trapping and culturing using microfluidic techniques have become a high-through put system that can manage and control microenvironment and practical intracellular analysis. The aim of this study was to develop and validate a microfluidic device for single cell trapping and culturing using the leukemia cell line as a cell model. Comparison between conventional and conventional with centrifugal methods was also analyzed. To compare trapping efficacy between these 2 methods, leukemia cell concentration of 1.5×106 cells/ml was loaded with a flow rate of 0.25 …

Recurrent Inflammatory Myofibroblastic Tumor Of Larynx Harboring A Novel Thbs1::Alk Fusion, Namra Ajmal, Stacey Gargano, Ujwala Gosavi, Madalina Tuluc

Computational Medicine Center Faculty Papers

Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue tumor primarily occurring in the abdominopelvic region of young patients, and it is characterized by spindle-shaped myofibroblasts, or fibroblasts surrounded by inflammatory infiltrate. Herein, we report a case of a 24-year-old male with a firm submucosal mass in the anterior right vocal fold diagnosed as an IMT that recurred 14 months later. The tumor demonstrated a novel THBS1::ALK fusion containing Exons 1-7 of the thrombospondin 1 (THBS1) gene fused to Exon 19 of the anaplastic lymphoma kinase (ALK) gene via next-generation sequencing with the NextSeq sequencer. The fusion of THBS1 to …

Endodontic Microsurgery Using Dynamic Navigation And Trephine Burs, Trenton Smith, Sameer Jain, Jeffery Nick Sanders, Michael Block, Mark Odom, Albert F. Mcmullen

School of Dentistry Faculty Publications

Objectives: The use of the surgical operating microscope, CBCT imagining, biocompatible filling materials and ultrasonic instruments have improved the success and predictability of apical surgery. Despite these advances, more accurate and precise techniques for creating osteotomies and root-resections (apicoectomies) have not been widely adopted. This study highlights how dynamic navigation systems (DNS) can help avoid unnecessary dentin removal and “mitigate iatrogenic errors” such as root perforation. Methods: A total of 56 root-end resections were planned and completed on two sets of identical TrueJaw Endosurg models (DE Labs, Santa Barbra, CA, USA). One set of maxillary and mandibular jaws were used …

Influence Of Cbct Different Radiation Doses On Mandibular Soft Tissue Thickness Measurements, Marwa Ezz Elarab, Mahinaz Reda Abdelhamed

Dentistry

Purposes: Study the influence of changing CBCT radiation doses (using ultra low dose and high dose systems) on soft tissues thickness measurements and compare the results with the direct measurements method. Methods:9 fresh pig mandiblue were utilized for each of two CBCT scan systems (Planmeca Promax 3D MID). Nine disposable needles were inserted into the gingival tissue of each jaw until reaching resistance from the underlying bone. A mark on each needle at its entrance point into the soft tissue was created using a permanent marker. Jaws were scanned twice, using ultra low (Rad UL) and high (Rad H) exposure …

Enpp1 Enzyme Replacement Therapy Improves Ectopic Calcification But Does Not Rescue Skeletal Phenotype In A Mouse Model For Craniometaphyseal Dysplasia, Ernst Reichenberger, Kevin O'Brien, Ayano Hatori, Thomas Carpenter, Koen Van De Wetering, Lisa Flaman, Jennifer Howe, Daniel Ortiz, Yves Sabbagh, I-Ping Chen

Jefferson Institute of Molecular Medicine Papers and Presentations

Craniometaphyseal dysplasia (CMD) is a rare genetic bone disorder, characterized by progressive thickening of craniofacial bones and flared metaphyses of long bones. Craniofacial hyperostosis leads to the obstruction of neural foramina and neurological symptoms such as facial palsy, blindness, deafness, or severe headache. Mutations in ANKH (mouse ortholog ANK), a transporter of small molecules such as citrate and ATP, are responsible for autosomal dominant CMD. Knock-in (KI) mice carrying an ANK_F377del mutation (Ank^KI/KI) replicate many features of human CMD. Pyrophosphate (PPi) levels in plasma are significantly reduced in Ank^KI/KI mice. PPi is a potent inhibitor of …

Changing Landscape Of Liver Transplant In The United States—Time For A New Innovative Way To Define And Utilize The “Non-Standard Liver Allograft”—A Proposal, Rashmi Seth, Kenneth Andreoni

Department of Surgery Faculty Papers

Since the first liver transplant was performed over six decades ago, the landscape of liver transplantation in the US has seen dramatic evolution. Numerous advancements in perioperative and operative techniques have resulted in major improvements in graft and patient survival rates. Despite the increase in transplants performed over the years, the waitlist mortality rate continues to remain high. The obesity epidemic and the resultant metabolic sequelae continue to result in more marginal donors and challenging recipients. In this review, we aim to highlight the changing characteristics of liver transplant recipients and liver allograft donors. We focus on issues relevant in …

Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano

School of Medicine Faculty Publications

Introduction: Tertiary syphilis, a late form of the disease with neurologic, cutaneous, and cardiovascular manifestations, is rarely seen in the United States in modern times. Also called the “great imitator,” syphilis tends to mimic other disease processes, which can lead to a delay in proper diagnosis and treatment. Case: We present the case of a 59-year-old woman who presented for evaluation of possible squamous cell carcinoma of the vulva. After multiple inconclusive biopsies and extensive workup with multiple providers, she was instead found to have cutaneous and neurologic tertiary syphilis. A correct diagnosis was delayed in this patient due to …

Clinical Implementation Of Tissue-Sparing Posterior Cervical Fusion: Addressing Market Access Challenges, Morgan Lorio, Pierce Nunley, Joshua Heller, Bruce Mccormack, Kai-Uwe Lewandrowski, Jon Block

Department of Neurosurgery Faculty Papers

Background: The traditional open midline posterior cervical spine fusion procedure has several shortcomings. It can cause soft tissue damage, muscle atrophy, compromise of the lateral masses and painful prominent posterior cervical instrumentation or spinous process if there is dehiscence of the fascia. Additionally, patients frequently experience the rapid development of adjacent segment disease, which can result in the reemergence of debilitating pain and functional impairment. Clinical relevance: Tissue-sparing posterior cervical fusion is an alternative method for treating patients with symptomatic cervical degenerative disc disease. However, widespread clinical adoption has been challenged by ambiguity, misunderstandings and misinterpretations regarding appropriate procedural reimbursement …