Medicine and Health Sciences Commons^™

Residency Recruitment: Changes And Challenges, Karen A. Chojnacki, Md, Facs

Department of Surgery Presentations and Grand Rounds

No abstract provided.

Epidemiology Of Covid-19 And Predictors Of Outcome In Nigeria: A Single-Center Study., Olayinka Rasheed Ibrahim, Bello Muhammed Suleiman, Suleiman Bello Abdullahi, Taofeek Oloyede, Abdallah Sanda, Maruf Sanusi Gbadamosi, Bashir Olajide Yusuf, Rabilu Yandoma Iliyasu, Lawal Magaji Ibrahim, Adamu Danladi Dawud, Sulaiman Saidu Bashir, Nwawueze Efam Okonta, Wasinda Francis Umar, Abiodun Gbenga Tekobo, Muhammadu Sani Abubakar, Bashir Taiye Aminu, Shuaibu Onoruoyiza Ibrahim, Rasaq Olaosebikan, Olugbenga Ayodeji Mokuolu

Department of Pharmacology and Experimental Therapeutics Faculty Papers

There is a paucity of information regarding the epidemiology and outcome of COVID-19 from low/middle-income countries, including from Nigeria. This single-center study described the clinical features, laboratory findings, and predictors of in-hospital mortality of COVID-19 patients. Patients admitted between April 10, 2020 and June 10, 2020 were included. Forty-five patients with a mean age of 43 (16) years, predominantly male (87%), presented with fever (38%), cough (29%), or dyspnea (24%). In-hospital mortality was 16%. The independent predictors of mortality were hypoxemia (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.3-5.1) and creatinine > 1.5 mg/dL (aOR: 4.3; 95% CI: 1.9-9.8).

Inflammatory Myopathies: Update On Diagnosis, Pathogenesis And Therapies, And Covid-19-Related Implications., Marinos C. Dalakas

Department of Neurology Faculty Papers

The inflammatory myopathies constitute a heterogeneous group of acquired myopathies that have in common the presence of endomysial inflammation. Based on steadily evolved clinical, histological and immunopathological features and some autoantibody associations, these disorders can now be classified in five characteristic subsets: Dermatomyositis (DM) Polymyositis (PM), Necrotizing Autoimmune Myositis (NAM), Anti-synthetase syndrome-overlap myositis (Anti-SS-OM), and Inclusion-Body-Myositis (IBM). Each inflammatory myopathy subset has distinct immunopathogenesis, prognosis and response to immunotherapies, necessitating the need to correctly identify each subtype from the outset to avoid disease mimics and proceed to early therapy initiation. The review presents the main clinicopathologic characteristics of each subset …

Conduct Of Clinical Trials In The Era Of Covid-19: Jacc Scientific Expert Panel., Mitchell A. Psotka, William T. Abraham, Mona Fiuzat, Gerasimos Filippatos, Joann Lindenfeld, Tariq Ahmad, Ankeet S. Bhatt, Peter E. Carson, John G.F. Cleland, G. Michael Felker, James L. Januzzi, Dalane W. Kitzman, Eric S. Leifer, Eldrin F. Lewis, John J.V. Mcmurray, Robert J. Mentz, Scott D. Solomon, Norman Stockbridge, John R. Teerlink, Muthiah Vaduganathan, Orly Vardeny, David J. Whellan, Janet Wittes, Stefan D. Anker, Christopher M. O'Connor

Department of Medicine Faculty Papers

The coronavirus disease-2019 (COVID-19) pandemic has profoundly changed clinical care and research, including the conduct of clinical trials, and the clinical research ecosystem will need to adapt to this transformed environment. The Heart Failure Academic Research Consortium is a partnership between the Heart Failure Collaboratory and the Academic Research Consortium, composed of academic investigators from the United States and Europe, patients, the U.S. Food and Drug Administration, the National Institutes of Health, and industry members. A series of meetings were convened to address the challenges caused by the COVID-19 pandemic, review options for maintaining or altering best practices, and establish …

Mental Health And Wellbeing Of First Year Jefferson University Students During The Covid-19 Pandemic: A Photo-Elicitation Study, Olusegun Bakare, Lyena Birkenstock, Morgan Bush, Lizzie Critchlow, Marisa Felsher, Cari Picciano, Alex Reibstein, Olivia Siciliano

Qualitative Research Methods - Presentations

Research Question

How do first year Thomas Jefferson University students perceive their mental health and wellbeing in the context of the COVID-19 pandemic?

New Normal For Medical Practice Post Covid-19?, David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Population Health And The Pandemic: Emerging Stronger Next Time., David B. Nash

College of Population Health Faculty Papers

No abstract provided.

Jefferson Digital Commons Quarterly Report: July-September 2020, Kelsey Duinkerken, Msi, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

Included in this Report

• Abington Health Articles
• Articles
• Collaborative Healthcare: Interprofessional Practice, Education, and Evaluation (JCIPE)
• Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)
• Covid 19-: Spread the Science, Not the Virus
• Department of Family and Community Medicine Presentations and Grand Rounds
• Master of Population Health Program Thesis and Capstone Presentations
• Master of Public Health Thesis and Capstone Presentations
• Jefferson Surgical Solutions
• The Medicine Forum
• Sex and Gender Health Education Summit 2020
• Student Papers and Posters
• Misc. Uploads
• What people are saying about the Jefferson Digital Repository

Case Report: Tocilizumab For The Treatment Of Sars-Cov-2 Infection In A Patient With Aplastic Anemia, Gina Keiffer, Zach French, Lindsay Wilde, Joanne Filicko-O'Hara, Usama Gergis, Adam Binder

Department of Medicine Faculty Papers

While cytokine storm develops in a minority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, novel treatment approaches are desperately needed for those in whom it does. Tocilizumab, an interleukin-6 receptor antibody, has been utilized for the treatment of cytokine storm in a number of severe inflammatory conditions, including in patients with severe coronavirus disease 2019 (COVID-19). Here, we present the first published case utilizing this therapy in a patient with underlying immunodeficiency. Our patient with aplastic anemia developed cytokine storm due to COVID-19 manifested by fever, severe hypoxia, pulmonary infiltrates, and elevated inflammatory markers. Following treatment …

A Sonographer’S Step-By-Step Approach For Preventing Transmission Of Covid-19, Corinne Wessner, Joann Nelson, Sarah Mott, Maria Francesco, Laurence Needleman

Department of Radiology Faculty Papers

The 2019 novel coronavirus, known as COVID-19, has greatly affected the way sonographers care for their patients. Sonography can be a useful imaging tool for surveillance and diagnosis of various conditions associated with COVID-19 patients or patients under investigation (PUIs). Currently, there are limited resources and protocols for preventing the transmission of COVID-19 from ultrasound equipment. Our institution has created a detailed protocol for scanning COVID-19 patients or PUIs to address this important issue.

Letter: Thrombotic Neurovascular Disease In Covid-19 Patients., Ahmad Sweid, Batoul Hammoud, Joshua H. Weinberg, Mazen Oneissi, Eytan Raz, Maksim Shapiro, Maureen Deprince, Stavropoula Tjoumakaris, Michael R. Gooch, Nabeel A. Herial, Hekmat Zarzour, Victor Romo, Robert Rosenwasswer, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Although the respiratory system is the primary target of the coronavirus, studies have demonstrated a strong tropism to the central nervous system (CNS).^1,2 The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. This receptor is also found in the CNS and plays a crucial role in autoregulating cerebral perfusion pressure.^3,4 Additionally, epidemiological data demonstrated increased mortality due to cardiovascular and cerebrovascular diseases during flu pandemics due to a hypercoagulable state.^5,6 The triad of neuroinvasion of SARS-CoV-2, induction of hypercoagulable state,^{5-9 …}

Efficacy Of Hydroxychloroquine And Tocilizumab In Patients With Covid-19: Single-Center Retrospective Chart Review., Sohaib Roomi, Waqas Ullah, Faizan Ahmed, Soban Farooq, Usama Sadiq, Asad Chohan, Munnam Jafar, Maryum Saddique, Shristi Khanal, Robert Watson, Margot Boigon

Abington Jefferson Health Papers

BACKGROUND: During the initial phases of the COVID-19 pandemic, there was an unfounded fervor surrounding the use of hydroxychloroquine (HCQ) and tocilizumab (TCZ); however, evidence on their efficacy and safety have been controversial.

OBJECTIVE: The purpose of this study is to evaluate the overall clinical effectiveness of HCQ and TCZ in patients with COVID-19. We hypothesize that HCQ and TCZ use in these patients will be associated with a reduction in in-hospital mortality, upgrade to intensive medical care, invasive mechanical ventilation, or acute renal failure needing dialysis.

METHODS: A retrospective cohort study was performed to determine the impact of HCQ …

Safety And Efficacy Of Hydroxychloroquine In Covid-19: A Systematic Review And Meta-Analysis, Waqas Ullah, Hafez M. Abdullah, Sohaib Roomi, Yasar Sattar, Talal Almas, Smitha Narayana Gowda, Rehan Saeed, Maryam Mukhtar, Ammar Ahmad, Tony Oliver, M. Chadi Alraies, Donald C. Haas, David L. Fischman

Abington Jefferson Health Papers

Background: During the initial phases of the coronavirus disease 2019 (COVID-19) epidemic, there was an unfounded fervor surrounding the use of hydroxychloroquine (HCQ); however, recently, the Centers for Disease Control and Prevention (CDC) has recommended against routine use of HCQ outside of study protocols citing possible adverse outcomes.

Methods: Multiple databases were searched to identify articles on COVID-19. An unadjusted odds ratio (OR) was used to calculate the safety and efficacy of HCQ on a random effect model.

Results: Twelve studies comprising 3,912 patients (HCQ 2,512 and control 1400) were included. The odds of all-cause mortality (OR: 2.23, 95% confidence …

Calculating Life And Death In A Time Of Covid, Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

The current pandemic makes us feel helpless. We can respond to its predation pragmatically but its silent march through the population promotes dread. Our helplessness undermines our belief in our culture as the source of our self-esteem and felt significance. One response to our experience of helplessness is the omnipotent stance, the idea that we can master the virus, stop it in its tracks, command one another to comply with injunctions and wreak a path of destruction by devastating the economy. Omnipotence promotes magical thinking. In the service of defeating death, we ignore actual suffering; deaths of despair and deaths …

Jefferson Digital Commons Quarterly Report: April-June 2020, Kelsey Duinkerken, Msi, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• New Collection: COVID-19 Papers, Posters, and Presentations
• Articles
• Collaborative Research and Evidence Among Therapists and Educators (CREATE) Day Presentations
• COVID-19 Working Papers
• Dissertations
• Doctorate of Occupational Therapy (OTD) Capstones
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• House Staff Quality Improvement and Patient Safety Posters
• JeffMD Scholarly Inquiry Abstracts
• Journals and Newsletters
• Master of Public Health Capstone Presentations
• Posters
• Spread the Science, NOT the Virus Seminar Series
• What People are Saying About the Jefferson the Digital Commons

Journal Club, Zeynep Uzumcu, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline

• Review coronavirus life-cycle
• Review mechanism of action of remdesivir
• Review previous research on remdesivir
• Close reading of article - Methods - Results - Discussion
• Future research
• Implications for our practice

Zooming-Out Covid-19: Virtual Clinical Experiences In An Emergency Medicine Clerkship., Shruti Chandra, Chaiya Laoteppitaks, Nina Mingioni, Dimitrios Papanagnou

Department of Emergency Medicine Faculty Papers

In the setting of the novel 2019 coronavirus (COVID‐19) pandemic, it has been challenging to provide medical students in the Emergency Medicine (EM) clerkship meaningful clinical experiences that would meet clinical course goals and objectives, as well as satisfy Liaison Committee for Medical Education (LCME) requirements. During the EM clerkship, students play an integral role in interviewing patients, formulating treatment plans, facilitating patient discharges, and counseling patients. Immediately available direct and indirect supervision are paramount to ensure student learning and safe patient care. The authors present a novel clinical educational experience for senior medical students in an EM clerkship that …

Telemedicine For The Spine Surgeon In The Age Of Covid-19: Multicenter Experiences Of Feasibility And Implementation Strategies., Daniel Franco, Thiago Montenegro, Glenn A Gonzalez, Kevin Hines, Aria Mahtabfar, Melvin D Helgeson, Rakesh Patel, James Harrop

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Multicenter study.

OBJECTIVES: The COVID-19 pandemic has obligated physicians to recur to additional resources and make drastic changes regarding the standard physician-patient encounter. In the last century, there has been a substantial improvement in technology, which over the years has opened the door to a new form of medical practicing known as telemedicine.

METHODS: Healthcare workers from three hospitals involved in the care for COVID-19 patients in the united states were invited to share their experience using telemedicine to deliver clinical care to their patients.

RESULTS: Since the appearance of this worldwide outbreak, social distancing has been a …

Artificial Intelligence-Powered Search Tools And Resources In The Fight Against Covid-19., Larry J Kricka, Sergei Polevikov, Jason Y Park, Paolo Fortina, Sergio Bernardini, Daniel Satchkov, Valentin Kolesov, Maxim Grishkov

Department of Cancer Biology Faculty Papers

Emerging technologies are set to play an important role in our response to the COVID-19 pandemic. This paper explores three prominent initiatives: COVID-19 focused datasets (e.g., CORD-19); Artificial intelligence-powered search tools (e.g., WellAI, SciSight); and contact tracing based on mobile communication technology. We believe that increasing awareness of these tools will be important in future research into the disease, COVID-19, and the virus, SARS-CoV-2.

The 2019-2020 Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Pandemic: A Joint American College Of Academic International Medicine-World Academic Council Of Emergency Medicine Multidisciplinary Covid-19 Working Group Consensus Paper., Stanislaw P. Stawicki, Rebecca Jeanmonod, Andrew C. Miller, Lorenzo Paladino, David F. Gaieski, Anna Q. Yaffee, Annelies De Wulf, Joydeep Grover, Thomas J. Papadimos, Christina Bloem, Sagar C. Galwankar, Vivek Chauhan, Michael S. Firstenberg, Salvatore Di Somma, Donald Jeanmonod, Sona M. Garg, Veronica Tucci, Harry L. Anderson, Lateef Fatimah, Tamara J. Worlton, Siddharth P Dubhashi, Krystal S. Glaze, Sagar Sinha, Ijeoma Nnodim Opara, Vikas Yellapu, Dhanashree Kelkar, Ayman El-Menyar, Vimal Krishnan, S. Venkataramanaiah, Yan Leyfman, Hassan Ali Saoud Al Thani, Prabath Wb Nanayakkara, Sudip Nanda, Eric Cioè-Peña, Indrani Sardesai, Shruti Chandra, Aruna Munasinghe, Vibha Dutta, Silvana Teixeira Dal Ponte, Ricardo Izurieta, Juan A. Asensio, Manish Garg

Department of Emergency Medicine Faculty Papers

What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this …

Chinese Expert Consensus On Critical Care Ultrasound Applications At Covid-19 Pandemic, Faqin Lv, Md, Jinrui Wang, Md, Xing Yu, Md, Aiping Yang, Md, Ji-Bin Liu, Md, Linxue Qian, Md, Huixiong Xu, Md, Ligang Cui, Md, Mingxing Xie, Md, Xi Liu, Md, Chengzhong Peng, Md, Yi Huang, Md, Haiyan Kou, Md, Shengzheng Wu, Md, Xi Yang, Md, Bin Tu, Md, Huaping Jia, Md, Qingyi Meng, Md, Je Liu, Md, Ruizhong Ye, Md

Department of Radiology Faculty Papers

The spread of new coronavirus (SARS-Cov-2) follows a different pattern than previous respiratory viruses, posing a serious public health risk worldwide. World Health Organization (WHO) named the disease as COVID-19 and declared it a pandemic. COVID-19 is characterized by highly contagious nature, rapid transmission, swift clinical course, profound worldwide impact, and high mortality among critically ill patients. Chest X-ray, computerized tomography (CT), and ultrasound are commonly used imaging modalities. Among them, ultrasound, due to its portability and non-invasiveness, can be easily moved to the bedside for examination at any time. In addition, with use of 4G or 5G networks, remote …

Critical Care Ultrasonography And Its Application For Covid-19, Xi Liu, Md, Yang Hai, Md, Bin Ma, Md, Weelic Chong, Md, Ji-Bin Liu, Md

Department of Radiology Faculty Papers

Ultrasound has developed as an invaluable tool in diagnosis and proper management in the intensive care unit (ICU). Application of critical care ultrasonography is quite distinct from the routine comprehensive diagnostic ultrasound exam, because the urgent setting mandates a goal-directed approach. Performing accurate and efficient critical care ultrasound requires ultrasound providers to first understand the pathophysiology of the disease and related imaging findings, and then follow the protocols to perform a focused ultrasound exam. In the ongoing coronavirus disease 2019 (COVID-19) pandemic, ultrasound plays an essential role in diagnosing and monitoring critically ill COVID-19 patients in the ICU. Our review …

A Crisis Is A Terrible Thing To Waste: Recovering A Sense Of Agency In Coronavirus Times, Steven F. Freeman

School of Continuing and Professional Studies Coronavirus Papers

No abstract provided.

Jefferson Digital Commons Quarterly Report: January-March 2020, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• New Look for the Jefferson Digital Commons
• Articles
• COVID-19 Working Papers
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• JeffMD Scholarly Inquiry Abstracts
• Journals and Newsletters
• Master of Public Health Capstones
• Oral Histories
• Posters and Conference Presentations
• What People are Saying About the Jefferson the Digital Commons

Our Multi-Pandemic, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

Application of systems thinking to identify and understand complex problems and to discover innovative ways to intervene has been advocated separately within public health, education, finance, and many other spheres of society. We need it now for the multi-pandemic.

Systems View Of Coronavirus, Sung Won Paek, Larry M. Starr

School of Continuing and Professional Studies Coronavirus Papers

No one envisioned the kinds of problems that emerged from the novel coronavirus nor had anyone considered its interactive scope. Now is the time to begin to redesign our processes and systems so that when confronted again we can cope and navigate better. Everyone needs to be a partner in these redesigns and each of the health, social, educational, and other systems must be integrated because it is their interconnections that coproduce and give meaning to our lives.

No Double Trouble: How To Reopen The Economy., Larry Hirschhorn, Phd

School of Continuing and Professional Studies Coronavirus Papers

This policy introduces a measure of choice, consonant with our culture. Those younger than 65 can make their own personal tradeoffs between heath and livelihood, while older people, knowing that the virus will be spreading more quickly through the population will be even more cautious, thus preventing their early deaths. We return decisions to people while ensuring that the sum total of decisions does not overwhelm our hospitals. One felicitous result of this policy is that the virus will spread more quickly through the healthier population. This means that when the elderly re-engage in social life they will encounter fewer …

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

School of Continuing and Professional Studies Coronavirus Papers

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

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

School of Continuing and Professional Studies Coronavirus Papers

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

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

School of Continuing and Professional Studies Coronavirus Papers

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