The Karabots Junior Fellows Test a Game About How HIV Spreads

A student in the Karabots Junior Fellows Program plays CD4 Hunter, a mobile game about how HIV infects a healthy cell, on an iPad

Regular readers will know we frequently utilize games and game-based learning to create unique and memorable learning experiences for our students. Last year, our fourth cohort of the Karabots Junior Fellows Program playtested The Pox Hunter, a game about convincing Philadelphians in the early 18th century the importance of vaccines. They also designed their own forensic science themed board and card games, learned about the spread of disease by playing Pandemic 2, honed their powers of observation by taking part in a room escape, and tested their mental might with a series of thematic review games. Our fifth and most recent cohort has continued the legacy set forth by their predecessors, recently assisting Drexel University researchers playtest a game about how HIV infects health cells.

CD4 Hunter is a microbiology-themed mobile game currently under development by the Center for Business and Program Development of Drexel University’s Institute for Molecular Medicine and Infectious Diseases and the Department of Microbiology and Immunology. It cast the player in the role of an HIV virus. The player’s goal is to infect healthy cells in order to spread create more virus cells while resisting antibiotics. IMMID developed the game to instruct the public by means of game-based learning on how HIV spreads in the body.

Under the guidance of Mary Ann Comunale, EDD, MS, who helps oversee the project, students started with a brief questionnaire to gauge their knowledge of HIV transmission and serve as a means of measuring what they learned by playing the game. Then they paired up with iPads or on their phones and played CD4 Hunter. As they played, they wrote down their thoughts on every aspect of the game, including visuals, sound, controls, how effected it conveyed its message, and (of course) fun. Students competed for high scores, with the top scorers earning a Dunkin Donuts gift card for their efforts. Dr. Comunale followed their play session with another questionnaire to gauge how much they learned about the subject while playing the game. Everyone gave useful feedback and many of them downloaded the game on their phones to play later. Afterwards, the Fellows met with a panel of three graduate students specializing in epidemiology, virology, and vaccines, who shared insights into their research and life in graduate school.

Two students in the Karabots Junior Fellows Program play CD4 Hunter, a mobile game about how HIV infects a healthy cell, on an iPad

If you’d like to try CD4 Hunter for yourself, it is currently available for free on Apple iTunes and Google Play.


CPP Curiosities: Pick Your Poison: Historic Syphilis Treatments

Logo for CPP Curiosities

Greetings, fellow historico-medico aficionados and welcome to the triumphant return of CPP Curiosities, our semi-regular segment devoted to the medically weird. Kevin here to give you another tale of mildly-interesting medical miscellany. Past installments examined such topics as the iron lung, the preserved corpse of Vladimir Lenin, and that time President Grover Cleveland had a tumor removed during a secret surgery performed on a yacht.

Today’s installment is inspired by a presentation I recently delivered to visitors to the Mütter Museum on the subject of syphilis. Visitors that day got to see books related to the disease from our Historical Medical Library, including Corky the Killer, and handle reproductions of objects in our robust collection while learning about the history of the disease.

Youth Program Coordinator Kevin Impellizeri stands behind a table of specimens and books related to syphilis for a lesson at the Mütter Museum

Syphilis has been around for a long time. Today, it is treated through antibiotics; however, before the popularization of antibiotics in the 1940s, physicians attempted a wide variety of treatments, many of which were just as bad, if not worse, than the disease itself.

Let’s start by with a brief introduction to syphilis. Syphilis aka “the French Disease” aka “the Polish Disease” aka “the German Disease” aka “the Spanish Disease” aka “the Christian Disease”  is caused by the treponema pallidum bacteria and is spread through skin-to-skin contact with syphilitic lesions, usually during sexual contact. There are a few conflicting theories of where its specific origins lie, although there appears to be some consensus that it evolved as a strain of one of several other bone/skin conditions such as yaws or pinta. The earliest outbreak that is attributed to syphilis in Europe took place in Naples in 1494/1495, and there are some who argue the first strains of the disease came to the Continent aboard Christopher Columbus’ return trip from the New World in 1493.

The disease generally follows a four-stage pattern. The first, aptly named primary syphilis, is characterized by the appearance of a large sore known as a chancre at the site of infection. Aside from being unsightly, patients with primary syphilis don’t feel any discomfort and the chancre will go away on its own after about three to six weeks. During the second stage, again aptly named secondary syphilis, the infected patient will generally have a rash or skin lesions and can also exhibit symptoms similar to the flu such as fever, sore throat, swollen lymph nodes, muscle aches, and fatigue. Secondary syphilis has also been known to cause hair loss. As with its chancrous predecessor, these symptoms will go away on their own after a few weeks after which the disease enters its latent phase (which, you guessed it, is called latent syphilis) where a patient exhibits no outward symptoms. Syphilis can lie dormant in a person’s system for up to thirty years!

When syphilis reawakens after its latent stage is when the real health problems begin. During the syphilis’ final form, known as tertiary syphilis, the disease beings to attack the body, particularly the skin and skeleton. Syphilis causes bone and skin to deteriorate, leaving disfiguring lesions on the patient’s face. Tertiary syphilis can also spread to other organ systems, such as the eyes (ocular syphilis) or brain (neurosyphilis).

Wax model of a syphilitic face

Wax model of a syphilitic face

Historic treatments were often just as bad, if not worse, for a syphilitic patient than the disease itself. Mercury was the most popular treatment for syphilis before the twentieth century; mercury treatments gave birth to a common phrase associated with the disease: “A night with Venus, a lifetime with Mercury.” According to the World Health Organization, prolonged exposure to mercury can lead to respiratory, gastrointestinal, and neurological damage. In 1909, chemist Paul Ehlich developed an alternative to mercury therapy: Compound 606 aka Salvarsan. Named because it was the 606th trial chemical, Salvarsan is generally acknowledged as the first modern chemotherapy treatment, and Elrich went on to become the co-winner of the 1908 Nobel Prize in Physiology or Medicine. While considered effective in mitigating the early symptoms of syphilis, Salvarsan introduced another potentially deadly treatment: it was chock full of arsenic. According to the WHO, short term exposure to arsenic can cause vomiting, abdominal pain, diarrhea, numbness, and (depending on the level of exposure) death. Long-term exposure has been linked to skin, lung, and bladder cancers (long-time readers will recall arsenic was a suspected killer of President Zachary Taylor, although this was later disproven following an autopsy). Elrich eventually developed a replacement for Salvarsan, the creatively-named Neosalvarsan aka Compound 914, which contained slightly less arsenic; Neosalvarsan was the predominant treatment until the 1940s.

Skull with Syphilitic Necrotic

Skull with Syphilitic Necrosis, Mütter Museum, 1161.07

During the 1920s, Austrian psychiatrist Julius Wagner-Juaregg developed a novel approach to treating syphilis: infecting people with malaria. Malariotherapy is a branch of treatments that involves battling infection by inducing a high body temperature, a treatment generally known as pyrotherapy or fever therapy. Malaria is a potentially-useful pyrotherapy tool as it causes a high fever (in addition to chills, sweating, and body aches) and is curable with quinine. Wagner-Juaregg injected late-stage syphilitic patients with malaria and observed the parasite-induced fever’s efficacy in treating neurosyphilis. For his efforts, Wagner-Juaregg earned the 1927 Nobel Prize for Physiology and Medicine. Despite sounding like something a mad scientist might suggest, malariotherapy became a fairly common treatment for syphilis well through the 1950s. However, modern scientists have been divided as to its efficacy, citing in part Wagner-Juaregg’s ethically-questionable use of institutionalized patients. Incidentally, in more recent years, malariotherapy has been proposed as a treatment for HIV (see here and here) and (in at least one ill-advised instance of self-administered malariotherapy) Lyme Disease.

Fortunately, syphilis is easily treatable today with penicillin, which, although penicillin allergies are not uncommon, does not cause the severe long-term health repercussions of its heavy-metal predecessors. Also, using protection, such as condoms, during sexual intercourse can also prevent the spread of syphilis.


Poison Control Experts Challenge the Karabots Junior Fellows

Students in the Krabots Junior Fellows Program speak with Robb Bassett, Interim Director of the Poison Control Center at Children's Hospital of Philadelphia

Challenge videos are all the rage on YouTube, from the “Cinnamon Challenge” (where one tries to eat a tablespoon of cinnamon without any liquid) to the “Chubby Bunny Challenge” (where a person tries to stuff as many marshmallows into their mouth and say, “Chubby Bunny”) to the “Ghost Pepper Challenge” (where a person eats a ghost pepper, one of the spiciest peppers on Earth). Searches on YouTube will find a plethora of videos of these and similar challenges, with different YouTubers competing to create the most audacious or entertaining video.

Recently students in the Karabots Junior Fellows learned about the potential health risks of these challenges from a pair of experts. Robb Bassett, DO, FAAEM, FCPP and Steven Walsh, MD, who, in addition to serving as Fellows of the College of Physicians of Philadelphia, are both experts when it comes to medical emergencies. Dr. Bassett is the interim Medical Director of the Poison Control Center at the Children’s Hospital of Philadelphia while Dr. Walsh is the attending physician in the Department of Emergency Medicine at Einstein Medical Center. The pair took the students through several popular YouTube challenges, explaining their possible health risks. For example, the Cinnamon Challenge, according to a 2013 report in the medical journal Pediatrics, can cause aspiration, pulmonary inflammation or even permanent respiratory damage; the effects can be exacerbated in people with asthma.

Robb Bassett, Interim Director of the Poison Control Center at Children's Hospital of Philadelphia, shows a PowerPoint slide on counterfeit drugs to students in the Karabots Junior Fellows Program

They used this as a way to segue into a talk about the risks of counterfeit recreational or prescription drugs. Did you know that, when formed into a pill, rat poison can be made to resemble prescription painkillers like Oxycontin? Bassett and Walsh explained the hazards of counterfeit drugs, while the students asked them a variety of questions related to their fields, YouTube challenges, and the ethics of treating different kinds of patients in emergency situations. Overall it was an engaging talk where many of the students shared their opinions and gained new knowledge.

The Karabots Junior Fellows Take a Closer Look at Eyes

Image of a Papier Mache Eye model on display at the Mütter Museum

Did you know that many eye disorders show no early warning signs? This is the reason it is important to receive regular eye examinations. This was just one of many important facts students in the fifth cohort of the Karabots Junior Fellows Program learned during a full day of activities devoted to the eye.

Dr. Michael DellaVecchia delivers a presentation on ophthalmology to students in the Karabots Junior Fellows Program

For a professional perspective on the eye, they met with Michael DellaVecchia, MD, PhD, FACS, Clinical Assistant Professor of Ophthalmology at Jefferson University Hospitals and a Fellow of the College of Physicians of Philadelphia. Dr. DellaVecchia shared his years of experience as an ophthalmologist and screened shockingly informative videos of him performing several different eye procedures, including conducting cataract surgery (a procedure where a patient’s lens is replaced by an artificial one) and removing a parasitic worm a patient had the misfortune of bringing home from a humanitarian trip to Africa. He also demonstrated several different types of eye trauma he has encountered from patients over a long career.

Students in the Karabots Junior Fellows Program perform simple examinations on each other while wearing goggles that simulate the effects of glaucoma

After meeting with Dr. DellaVecchia, the students got the opportunity to assume the roles of ophthalmologists and eye patients. Trying on a variety of specialized goggles used to simulate the effects of three different conditions–cataracts, glaucoma, and macular degeneration–the students performed simple eye examinations on each other. While one wore a specific pair of goggles, another student tested their distant, focused, and peripheral vision, recording their findings in order to draw conclusions on how these different conditions affect a person’s vision.

Three students in the Karabots Junior Fellows Program dissect cow eyes

The students competed their closer “look” at the eye with a cow eye dissection. Guided by Museum Educator Marcy Engleman, they dissected a cow’s eye to gain a greater understanding of its structure and anatomy. After a long session, they left with a fresh perspective on how our eyes work and the importance of taking care of your eyes.

If you’re an educator or are just looking to learn more about the anatomy and pathology of the eye, the College of Physicians of Philadelphia has two lessons available to you via our online exhibit: Memento Mütter.



The Karabots Junior Fellows Study Teen Health

Official logo for Teen Health Week 2018

Longtime readers will recall that students in the Karabots Junior Fellows Program, as well as the Teva Internship and Out4STEM Programs, have been involved in Teen Health Week since its inception (see here and here). Created in 2016 as a joint program of the Center for Education (formerly the Center for Education and Public Initiatives), Real Talk with Dr. Offutt, and the Pennsylvania Department of Health, Teen Health Week is an annual event that seeks to raise awareness of the unique health issues facing teens. What began in 2016 as Pennsylvania Teen Health Week has rapidly expanded into a global health initiative.

Students in the Karabots Junior Fellows Program observe a slide presented by Dr. Laura Offutt as part of a lesson on teen health

Recently, the newest cohort of the Karabots Junior Fellows Program met with Dr. Laura Offutt to talk about issues related to teen health and introduce them to the tenets of Teen Health Week. Dr. Offutt has a background in internal medicine, is a Fellow of the College of Physicians of Philadelphia, and was the chief driving force behind the creation of Teen Health Week. She is  also the founder of Real Talk with Dr. Offutt, an accurate, judgment-free health resource for teens. Subjects she addressed with the class included myths surrounding hookah smoking, the dangers of texting and driving, and the risk of sexual assault on college campuses. Later in the semester, the students will help develop an informational toolkit for Teen Health Week 2018 related to mental health.

Teen Health Week 2018 will take place March 18-24, 2018. For more information about THW and how you can get involved, check out our official Teen Health Week website or follow #teenhealth2018 on Twitter or Instagram.

The Teva Interns Learn to Become Mighty Writers

A whiteboard with advice on finding one's authorial voice during a session on personal essay writing for the Teva Pharmaceuticals Internship Program

We in the Center for Education are committed to helping students in our various youth programs prepare for their future academic and professional careers beyond high school. To that end, our students engage in a variety of activities related to career and college preparation.

A challenging aspect of any college application is trying to make yourself stand out in the eyes of college admissions boards. One notable tactic for making your application stand out among the thousands of applicants colleges and universities evaluate every year is an effective college essay. Writing a strong college essay is no easy task, so it is essential to give students the resources necessary to succeed.

Recently, students in the Teva Pharmaceuticals Internship Program met with Carrie Hagan of Mighty Writers, an organization dedicated to helping Philadelphia school students strengthen and refine their writing and communication skills. Carrie taught them helpful techniques for taking a personal experience and gradually transforming that experience into an effective and memorable essay. These included starting with a single sentence and branching out from there, writing for ten minutes straight, and even acting out a personal experience with other students.

Students in the Teva Pharmaceuticals Internship Program act out a scene.

These and other college prep activities are giving our students the opportunity to stand out among their peers.

Out4STEM at OutFest Philly 2017

Side-by-Side logos for Out4STEM (left) and OutFest Philly 2017 (right)

October 11 marks National Coming Out Day, a day for celebrating pride in people who identify as LGBTQIA and their allies and honoring the freedom for people to be their true selves.

This past Sunday, October 8, marked the 26th annual celebration of OutFest Philly. Coinciding with National Coming Out Day, OutFest Philly is a day-long celebration of LGBTQ+ pride and seeks to raise awareness of issues directly affecting the community. Among the numerous participating organizations, students in the Out4STEM Internship Program were on hand in the Gayborhood to take part in the festivities and raise awareness of the Program and health-related topics.

The Out4STEM Program aims to provide Philadelphia’s LGBTQ+ youth with healthcare and STEM-oriented instruction, mentorship, academic support, and college/career preparation in an inclusive, safe space.