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Articles 1381 - 1410 of 14899

Full-Text Articles in Medicine and Health Sciences

The Risk Of Interstitial Lung Disease In Psoriatic Arthritis Versus Psoriasis: A Retrospective Nationwide Database Analysis (2014-24), Andrew Engel, Christopher Xie, Ross Summer, Giorgos Loizidis May 2025

The Risk Of Interstitial Lung Disease In Psoriatic Arthritis Versus Psoriasis: A Retrospective Nationwide Database Analysis (2014-24), Andrew Engel, Christopher Xie, Ross Summer, Giorgos Loizidis

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

OBJECTIVES: Psoriasis (PsO) is a systemic autoimmune disease primarily characterized by erythematous plaques on the skin. While extra-dermal manifestations like psoriatic arthritis (PsA) are well recognized, data linking PsO to interstitial lung disease (ILD) remain limited. This study aimed to evaluate whether patients with PsA have a higher risk of developing ILD compared with patients with PsO.

METHODS: A retrospective analysis of the TriNetX US database (2014-24) was performed. Adult patients with PsO or PsA treated with systemic immunosuppressive medications were included, excluding those with other autoimmune diseases. ILD risk in PsO and PsA cohorts was compared with a reference …


Revisiting Traumatic Intracerebral Hemorrhage In The Context Of Enrich: Illustrative Cases, Erik Werheim, Brendan Mcshane, Zachary Sokol, Theodore Hannah, Robert Ziechmann, Phillip Villaneuva May 2025

Revisiting Traumatic Intracerebral Hemorrhage In The Context Of Enrich: Illustrative Cases, Erik Werheim, Brendan Mcshane, Zachary Sokol, Theodore Hannah, Robert Ziechmann, Phillip Villaneuva

Department of Surgery Faculty Papers

BACKGROUND: Traumatic intracerebral hemorrhage (tICH) is a common form of intracranial hemorrhage after traumatic brain injury (TBI). The role of surgical intervention in tICH remains a subject of discussion. Recent trials, such as Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH), have shown the efficacy of minimally invasive clot evacuation for non-tICH for hemorrhages with volumes of 30-80 mL. The generalizability of ENRICH to tICH remains unclear; however, it demonstrates the need for rigorous studies evaluating the efficacy of surgical intervention in tICH versus medical management.

OBSERVATIONS: Here the authors present 2 cases of tICH, both in the dominant temporal …


Cone Beam Ct Dose Optimisation: A Review And Expert Consensus By The 2022 Estro Physics Workshop Igrt Working Group, Lydia J. Wilson, Andria Hadjipanteli, Daniella E. Østergaard, Evelien Bogaert, Kirstie F. Brown, Rianne Dejong, James Earley, Magali Edouard, Marina Khan, Josh Lindsay, Jessica Van Der Himst, George X. Ding, Tim Wood, Marianne C. Aznar, Nuria Jornet, Georgios Ntentas May 2025

Cone Beam Ct Dose Optimisation: A Review And Expert Consensus By The 2022 Estro Physics Workshop Igrt Working Group, Lydia J. Wilson, Andria Hadjipanteli, Daniella E. Østergaard, Evelien Bogaert, Kirstie F. Brown, Rianne Dejong, James Earley, Magali Edouard, Marina Khan, Josh Lindsay, Jessica Van Der Himst, George X. Ding, Tim Wood, Marianne C. Aznar, Nuria Jornet, Georgios Ntentas

Department of Radiation Oncology Faculty Papers

Image guided radiotherapy (IGRT) using kilovoltage cone-beam CT (CBCT) has become an indispensable tool to ensure the geometric accuracy of radiotherapy treatment delivery. Although significant technical advances have been made in reducing imaging dose, the repeated imaging procedures can still accumulate significant dose to healthy tissues. Despite the widespread use, we still lack clear guidance for optimisation and widely accepted frameworks for evaluating the quality and suitability of CBCT imaging protocols. To address this gap, the 2022 European Society for Radiotherapy and Oncology (ESTRO) Physics Workshop focused on image-quality and imaging-dose optimisation for IGRT using CBCT. This publication represents a …


A Smart Pill Bottle And Text Messaging Intervention For Promoting Medication Adherence In Patients With Chronic Myeloid Leukemia: A Pilot Study Of Txt4 Tki, Kuang-Yi Wen, Neil Palmisiano, Rita Smith, Rachel Slamon, Gina Keiffer, Christian Fidler, Margaret Kasner, Lindsay Wilde, Md May 2025

A Smart Pill Bottle And Text Messaging Intervention For Promoting Medication Adherence In Patients With Chronic Myeloid Leukemia: A Pilot Study Of Txt4 Tki, Kuang-Yi Wen, Neil Palmisiano, Rita Smith, Rachel Slamon, Gina Keiffer, Christian Fidler, Margaret Kasner, Lindsay Wilde, Md

Department of Medical Oncology Faculty Papers

BACKGROUND: Patients undergoing tyrosine kinase inhibitor (TKI) therapy for chronic myeloid leukemia (CML) often face challenges with adherence, despite the efficacy of the treatment. Theory-guided and evidence-informed interventions addressing psychosocial and adherence barriers are critical for promoting adherence. Using a mixed-method approach, the pilot study developed and evaluated the feasibility and potential impact of an intervention "txt4TKI," to support medication and symptom management among CML patients undergoing TKI therapy.

METHODS: Guided by the Necessity and Concerns framework, the study comprised two phases: Phase 1 involved qualitative patient needs assessment interviews informing intervention design. Phase 2 was a single-arm pilot study …


Cenobamate Use In Pregnancy: A Case Report, Tiara Paul, Maromi Nei May 2025

Cenobamate Use In Pregnancy: A Case Report, Tiara Paul, Maromi Nei

Department of Neurology Faculty Papers

No abstract provided.


A Semiclassical Model Of The Immediate Temperature Distribution Surrounding The Track Of Heavy Ions With Therapeutic Energies, Martin Rädler, Niayesh Afshordi, Reza Taleei, Katia Parodi, Ramin Abolfath, Julie Lascaud May 2025

A Semiclassical Model Of The Immediate Temperature Distribution Surrounding The Track Of Heavy Ions With Therapeutic Energies, Martin Rädler, Niayesh Afshordi, Reza Taleei, Katia Parodi, Ramin Abolfath, Julie Lascaud

Department of Radiation Oncology Faculty Papers

Objective. Spikes of high temperature and pressure are created in the vicinity of heavy ions, especially at the Bragg peak. The expected subsequent thermoacoustic effects are however not well understood. In particular, the distribution of the densely packed primary interactions has not been considered in molecular dynamics (MDs) simulations or shock wave solutions. In this work, we derive a dedicated model to describe the primary interactions and their radial distribution, applicable to the modeling of acoustic and thermodynamic effects at the nanoscale. Approach. Starting from first principles, we assemble a semiclassical model of the energy loss of the primary heavy …


The Effect Of Celecoxib And Mumab911 On Strain Adaptive Bone Remodeling And Fracture Repair In Female Mice: Implications For Rapidly Progressive Osteoarthritis, Nicholas Ruggiero, Alexandra Ciuciu, Ashkan Sedigh, Ibtesam Rajpar, David Shelton, Patrice Belanger, Kathryn Gropp, John A. Collins, Theresa A. Freeman, Ryan E. Tomlinson May 2025

The Effect Of Celecoxib And Mumab911 On Strain Adaptive Bone Remodeling And Fracture Repair In Female Mice: Implications For Rapidly Progressive Osteoarthritis, Nicholas Ruggiero, Alexandra Ciuciu, Ashkan Sedigh, Ibtesam Rajpar, David Shelton, Patrice Belanger, Kathryn Gropp, John A. Collins, Theresa A. Freeman, Ryan E. Tomlinson

Department of Orthopaedic Surgery Faculty Papers

Debilitating pain is the primary clinical feature of osteoarthritis (OA) that drives the enormous healthcare costs. Osteoarthritis-related pain is often treated with non-steroidal anti-inflammatory drugs (NSAIDs), which effectively relieve pain and inflammation by inhibition of prostaglandin synthesis. Antibodies directed against nerve growth factor (NGF) were tested some time ago as an alternative potential analgesic for musculoskeletal pain, including osteoarthritis-related pain. Unfortunately, clinical development of these drugs was put on hold due to adverse outcomes - primarily rapidly progressive osteoarthritis. Both prostaglandin synthesis and NGF have been implicated as critical mediators of strain adaptive bone remodeling, which may play a role …


M6a Modification Is Incorporated Into Bacterial Mrna Without Specific Functional Benefit, Klara Szydlo, Leonardo Santos, Thomas W. Christian, Sunita Maharjan, Amir Dorsey, Isao Masuda, Jingxuan Jia, Yuan Wu, Weixin Tang, Ya-Ming Hou, Zoya Ignatova May 2025

M6a Modification Is Incorporated Into Bacterial Mrna Without Specific Functional Benefit, Klara Szydlo, Leonardo Santos, Thomas W. Christian, Sunita Maharjan, Amir Dorsey, Isao Masuda, Jingxuan Jia, Yuan Wu, Weixin Tang, Ya-Ming Hou, Zoya Ignatova

Department of Biochemistry and Molecular Biology Faculty Papers

N 6-Methyladenosine (m6A), the most abundant modification in eukaryotic messenger RNAs (mRNAs), has also been found at a low level in bacterial mRNAs. However, enzyme(s) that introduce m6A modification on mRNAs in bacteria remain elusive. In this work, we combine deep-sequencing approaches that identify m6A sites with in vitro biochemical studies to identify putative m6A methyltransferases that would modify Escherichia coli mRNAs. We tested four uncharacterized candidates predicted to encode proteins with putative methyltransferase domains, whose deletion decreased the m6A level. However, in vitro analysis with the purified putative methyltransferases revealed that none of them installs m6A on mRNA. Exposure …


Decoding Resistance To Immune Checkpoint Inhibitors In Non-Small Cell Lung Cancer: A Comprehensive Analysis Of Plasma Proteomics And Therapeutic Implications, Michal Harel, Nili Dahan, Coren Lahav, Eyal Jacob, Yehonatan Elon, Igor Puzanov, Ronan J. Kelly, Yuval Shaked, Raya Leibowitz, David P. Carbone, David R. Gandara, Adam P. Dicker May 2025

Decoding Resistance To Immune Checkpoint Inhibitors In Non-Small Cell Lung Cancer: A Comprehensive Analysis Of Plasma Proteomics And Therapeutic Implications, Michal Harel, Nili Dahan, Coren Lahav, Eyal Jacob, Yehonatan Elon, Igor Puzanov, Ronan J. Kelly, Yuval Shaked, Raya Leibowitz, David P. Carbone, David R. Gandara, Adam P. Dicker

Department of Radiation Oncology Faculty Papers

BACKGROUND: Immune checkpoint inhibitors (ICIs) have shown substantial benefit for patients with advanced non-small cell lung cancer (NSCLC). However, resistance to ICIs remains a major clinical challenge. Here, we perform a comprehensive bioinformatic analysis of plasma proteomic profiles to explore the underlying biology of treatment resistance in NSCLC.

METHODS: The analysis was performed on 388 "resistance-associated proteins" (RAPs) that were previously described as pretreatment plasma proteomic predictors within the PROphet computational model designed to predict ICI clinical benefit in NSCLC. Putative tissue origins of the RAPs were explored using publicly available datasets. Enrichment analyses were performed to investigate RAP-related biological …


The Effect Of Nonsteroidal Anti-Inflammatory Drugs On Union Rates Following Operative Repair Of Distal Radius Fractures, Michael Chang, Alexis Kasper, Juliet Chung, Justin Wright, Margaret Pennington, Asif M. Ilyas May 2025

The Effect Of Nonsteroidal Anti-Inflammatory Drugs On Union Rates Following Operative Repair Of Distal Radius Fractures, Michael Chang, Alexis Kasper, Juliet Chung, Justin Wright, Margaret Pennington, Asif M. Ilyas

Student Papers, Posters & Projects

Purpose

Multimodal pain regimens for controlling postoperative pain after surgery for fractures often include nonsteroidal anti-inflammatory drugs (NSAIDs). However, some surgeons remain reluctant toward prescribing NSAIDs because of concerns of compromised bone healing. The study hypothesis was that a short-term prescription of NSAIDs for postoperative pain after distal radius fracture repair would not result in a significant difference in union rates.

Methods

Consecutive patients who underwent surgical repair of a distal radius fracture with a volar locking plate from a single academic institution with five hand surgery fellowship-trained orthopedic surgeons were retrospectively reviewed. The cohort was divided into those prescribed …


Imaging Hallmarks Of Idiopathic Intracranial Hypertension And Insights Into Pathogenesis, Albalooshy Basimah, Scott Faro, Hsiangkuo Yuan, Kiran Talekar, Prabath Mondel, Enchao Qiu, Joga Chaganti May 2025

Imaging Hallmarks Of Idiopathic Intracranial Hypertension And Insights Into Pathogenesis, Albalooshy Basimah, Scott Faro, Hsiangkuo Yuan, Kiran Talekar, Prabath Mondel, Enchao Qiu, Joga Chaganti

Department of Radiology Faculty Papers

Idiopathic Intracranial hypertension (IIH), also referred to as pseudotumor cerebri, is a term used to describe increased intracranial pressure in the absence of a known identifiable secondary cause. Despite advancements of neuroimaging techniques, imaging of the pathological underpinnings in the diagnosis of IIH has been limited. Although the causation of IIH has been ascribed to increased Cerebrospinal Fluid production and disordered drainage through the dural sinuses, new evidence shows that the glymphatic system which is an alternate pathway of drainage is likely to play a pivotal role. In this review, we address the pathophysiological underpinnings in the causation of IIH …


Identification Of Surrogate Biomarkers For Mucopolysaccharidosis Type Iva, Yasuhiko Ago, Shaukat Khan, Kimberly Klipner, Allison Bradford, Shunji Tomatsu May 2025

Identification Of Surrogate Biomarkers For Mucopolysaccharidosis Type Iva, Yasuhiko Ago, Shaukat Khan, Kimberly Klipner, Allison Bradford, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis type IVA (MPS IVA, Morquio A syndrome) is a rare inherited disorder characterized by skeletal dysplasia due to deficient N-acetylgalactosamine-6-sulfate sulfatase activity, resulting in glycosaminoglycan (GAG) accumulation. Identifying accurate biomarkers reflecting clinical severity and therapeutic response remains challenging. This study evaluated potential surrogate biomarkers, including N-terminal pro-C-type natriuretic peptide (NT-proCNP), collagen types I and II, mono-sulfated keratan sulfate (KS), di-sulfated KS, and chondroitin-6-sulfate (C6S), in blood and urine samples from 60 patients ranging from 1 to 62 years of age. NT-proCNP levels were significantly elevated in patients of all ages and negatively correlated with growth impairment, especially after 8 …


Methylprednisolone After Shoulder Arthroplasty Leads To Decreased Opioid Prescriptions Without An Increased Risk Of Infection: A Matched Cohort Analysis, Tej Joshi, Tuckerman Jones, Akhil Katakam, Daniella Ogilvie, Amanda Azer, Sefy Paulose, Balazs Galdi May 2025

Methylprednisolone After Shoulder Arthroplasty Leads To Decreased Opioid Prescriptions Without An Increased Risk Of Infection: A Matched Cohort Analysis, Tej Joshi, Tuckerman Jones, Akhil Katakam, Daniella Ogilvie, Amanda Azer, Sefy Paulose, Balazs Galdi

Jefferson Hospital Staff Papers and Presentations

Background

Due to the increasing demand for total shoulder arthroplasty, safe opioid stewardship paired with appropriate pain management is imperative for long-term patient care. A recent study has shown the potential for methylprednisolone use in the peri-operative period in order to decrease opioid consumption postoperatively.

Methods

The large TriNetX database was queried to identify all patients who were methylprednisolone naïve that underwent total shoulder arthroplasty with a minimum follow-up of 3 months. These patients were then further separated into two cohorts – those who received post-operative methylprednisolone within 7 days of the arthroplasty procedure and those who did not. After …


Towards Universal Chemosensory Testing: Needs, Barriers, And Opportunities, Steven D. Munger, Kai Zhao, Linda A. Barlow, Duncan Boak, Katie Boateng, Susan E. Coldwell, Pamela Dalton, Richard L. Doty, Jennifer E. Douglas, Valerie Duffy, Frank A. Franklin, John E. Hayes, Howard J. Hoffman, Patrice Hubert, Paule V. Joseph, Jeb M. Justice, Joshua M. Levy, Julie A. Mennella, Marianna Obrist, M. Yanina Pepino, Jayant M. Pinto, Edmund A. Pribitkin, Christopher T. Simons, Mark W. Albers, Valentina Parma May 2025

Towards Universal Chemosensory Testing: Needs, Barriers, And Opportunities, Steven D. Munger, Kai Zhao, Linda A. Barlow, Duncan Boak, Katie Boateng, Susan E. Coldwell, Pamela Dalton, Richard L. Doty, Jennifer E. Douglas, Valerie Duffy, Frank A. Franklin, John E. Hayes, Howard J. Hoffman, Patrice Hubert, Paule V. Joseph, Jeb M. Justice, Joshua M. Levy, Julie A. Mennella, Marianna Obrist, M. Yanina Pepino, Jayant M. Pinto, Edmund A. Pribitkin, Christopher T. Simons, Mark W. Albers, Valentina Parma

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Millions of people in the United States experience a reduced or distorted ability to smell or taste. Chemosensory disorders such as anosmia (the inability to smell), parosmia (distorted smell), or dysgeusia (altered taste) have major impacts on health and quality of life including difficulty sensing dangers such as fire or spoilage, a diminished palatability of food and drink that can negatively influence diet and nutrition, feelings of social isolation, and an increased incidence of frailty, anxiety, and depression. Smell or taste dysfunction can also be symptoms of other health issues, including sinonasal disease, cancer, or neurodegenerative disease. Aging adults are …


Surrogate Trust In The Intensive Care Unit: What Can We Do Better?, Abdul W. Kazi, Phoebe Chun, David Oxman, Erika J. Yoo May 2025

Surrogate Trust In The Intensive Care Unit: What Can We Do Better?, Abdul W. Kazi, Phoebe Chun, David Oxman, Erika J. Yoo

Department of Medicine Faculty Papers

BACKGROUND/OBJECTIVES: Previous investigation into patients' trust in medical providers is largely limited to the outpatient setting, where increased trust is associated with improved adherence, satisfaction, and self-reported quality of life. Contrastingly, in the intensive care unit (ICU), patients are frequently incapacitated, and it is surrogates that engage with clinicians for decision making. This pilot study aims to measure and compare surrogate trust in the healthcare system and ICU physicians.

METHODS: We measured surrogate trust in both the healthcare system and providers by administering two domain-specific trust-measuring surveys (the Healthcare System Distrust Scale and a modified Trust in Physicians Scale) to …


Evaluation Of Knowledge, Attitudes And Vaccine Hesitancy Towards Mmr Vaccine Among Parents In The United Arab Emirates, Kamel A. Samara, Hiba Jawdat Barqawi, Deema M. Alhayali, Samah Mohamed Kannas, Rim M. Elmorsy, Eman Abu-Gharbieh May 2025

Evaluation Of Knowledge, Attitudes And Vaccine Hesitancy Towards Mmr Vaccine Among Parents In The United Arab Emirates, Kamel A. Samara, Hiba Jawdat Barqawi, Deema M. Alhayali, Samah Mohamed Kannas, Rim M. Elmorsy, Eman Abu-Gharbieh

Abington Jefferson Health Papers

BACKGROUND: The Measles, Mumps, and Rubella (MMR) vaccine is highly effective, but vaccine hesitancy (VH) is a key barrier to achieving herd immunity. This study aims to assess the general attitudes and knowledge of UAE parents regarding measles and the MMR vaccine while identifying determinants of VH.

METHODOLOGY: A cross-sectional study was done from 15th April 2024 and 5th June 2024. This study recruited 462 parents residing in the UAE using convenience sampling. Recruitment occurred through various social media platforms including WhatsApp, X, and Instagram, as well as in public by approaching parents in parks and malls. Information collected included …


Sociodemographic And Psychosocial Characteristics Of E-Cigarette Ever-Use: U.S. Hints 6 Survey, Lilianna Phan, Kuang-Yi Wen, Hee Jun Kim, Julie A. Barta, Hee-Soon Juon May 2025

Sociodemographic And Psychosocial Characteristics Of E-Cigarette Ever-Use: U.S. Hints 6 Survey, Lilianna Phan, Kuang-Yi Wen, Hee Jun Kim, Julie A. Barta, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

Objective

With high U.S. e-cigarette use prevalence and e-cigarette health risks, we examined associated factors for ongoing public health efforts.

Methods

We used national data from the 2022 Health Information National Trends Survey to estimate the overall U.S. prevalence of e-cigarette ever- and current-use and to examine associations by sociodemographics (i.e., age, race/ethnicity, gender, marital status, employment status, education level) and depressive symptoms (i.e., PHQ-4; no, mild, moderate or severe symptoms) using weighted multivariable logistic regressions adjusted for cigarette smoking status (n = 5924).

Results

In 2022, 17.1 % of U.S. adults ever-used e-cigarettes; of which, 4.3 % currently-used …


Tacrolimus Dosing In Liver Transplant Recipients Using Phenotypic Personalized Medicine: A Phase 2 Randomized Clinical Trial, Jeffrey Khong, Megan Lee, Curtis Warren, Un Kim, Sergio Duarte, Kenneth Andreoni, Sunaina Shrestha, Mark Johnson, Narendra Battula, Danielle Mckimmy, Thiago Beduschi, Ji-Hyun Lee, Derek Li, Chih-Ming Ho, Ali Zarrinpar May 2025

Tacrolimus Dosing In Liver Transplant Recipients Using Phenotypic Personalized Medicine: A Phase 2 Randomized Clinical Trial, Jeffrey Khong, Megan Lee, Curtis Warren, Un Kim, Sergio Duarte, Kenneth Andreoni, Sunaina Shrestha, Mark Johnson, Narendra Battula, Danielle Mckimmy, Thiago Beduschi, Ji-Hyun Lee, Derek Li, Chih-Ming Ho, Ali Zarrinpar

Department of Surgery Faculty Papers

Tacrolimus is the most commonly used immunosuppression drug after solid organ transplantation; however, its dosing is challenging due to substantial inter-individual variability, often resulting in blood levels that deviate from the target therapeutic range. We explored whether a dynamically customized, phenotypic-outcome-guided drug dosing method could improve maintenance of drug trough levels within pre-determined target ranges, focusing on tacrolimus immediately after liver transplantation. This single-center, partially blinded, completed clinical trial involved 62 adults undergoing liver transplantation, block randomized into parallel groups: standard-of-care (SOC) clinician-determined or Phenotypic Personalized Medicine (PPM)-guided tacrolimus dosing. The primary outcome was percentage of post-transplant days with large …


Investigating How Social Support Impacts The Use Of Primary Healthcare Services For Women Undergoing Treatment For Opioid Use Disorder, Sydney Macon, Vanessa Short, Phd, Mph May 2025

Investigating How Social Support Impacts The Use Of Primary Healthcare Services For Women Undergoing Treatment For Opioid Use Disorder, Sydney Macon, Vanessa Short, Phd, Mph

Health Equity and Quality Improvement (HEQI) Summit

Background

Individuals with substance use disorders often face challenges in accessing and utilizing primary care, exacerbated by a lack of social support. Understanding the intricate dynamics between social support and primary care utilization is crucial for enhancing healthcare delivery, especially among vulnerable populations such as women undergoing substance use disorder treatment. There is a lack of research regarding this connection and our research aims to change that. We want to explore how social support influences the use of regular healthcare, particularly for women facing substance use challenges. By doing this research, we hope it will lead to future discoveries of …


Improving Guideline-Based Prep Management In A Philadelphia-Based Academic Family Medicine Office, Brittany Macdonald, Md, Marshall Miller, Md, Nwando Ekezie, Md, Maia Mandel, Md, Christina Boras, Md, Eunice Choe, Md, Meghan Swyryn, Md, Meg Broderick, Md, Pascaline Karanja, Md, Julia Beatini, Md, Julie Jones May 2025

Improving Guideline-Based Prep Management In A Philadelphia-Based Academic Family Medicine Office, Brittany Macdonald, Md, Marshall Miller, Md, Nwando Ekezie, Md, Maia Mandel, Md, Christina Boras, Md, Eunice Choe, Md, Meghan Swyryn, Md, Meg Broderick, Md, Pascaline Karanja, Md, Julia Beatini, Md, Julie Jones

Health Equity and Quality Improvement (HEQI) Summit

Background

Pre-Exposure Prophylaxis (PrEP) significantly reduces the risk of contracting HIV:

  • Reduces risk from sexual contact by 99%
  • Reduces risk from injection drug use by at least 74%

Despite its effectiveness, PrEP is underutilized in the USA.

  • In 2019, an estimated 224,000 Americans received a prescription for PrEP despite 1.1 million people having indications for PrEP.
  • Lack of provider knowledge surrounding PrEP clinical guidelines is a common reason for underutilization.


Screening And Diagnosis Of Gestational Diabetes, And Perinatal Outcomes In Patients With Bariatric Surgery History, Silpa Annavarapu, Bs, Charlette Williams, Md, Rodney Mclaren, Jr., Md, Sarah Boudova, Md, Phd May 2025

Screening And Diagnosis Of Gestational Diabetes, And Perinatal Outcomes In Patients With Bariatric Surgery History, Silpa Annavarapu, Bs, Charlette Williams, Md, Rodney Mclaren, Jr., Md, Sarah Boudova, Md, Phd

Health Equity and Quality Improvement (HEQI) Summit

Background

- ~1 in 5 women of reproductive age are obese, with bariatric surgery increasing in popularity as an intervention

- Gestational diabetes mellitus (GDM) is associated with shoulder dystocia, polyhydramnios, weight >4500g, hypoglycemia, hyperbilirubinemia, NICU admission, respiratory distress, cesarean delivery, gestational hypertension (HTN), and Preeclampsia

- Adverse outcomes of GDM can be mitigated with early diagnosis and blood glucose management

- The glucose tolerance test (GTT) is the current gold standard for diagnosing gestational diabetes (GDM)

  • Individuals with a history of bariatric surgery may not tolerate the sugar load or volume of the GTT
  • The GTT may not accurately …


From Oversight To Insight: Enhancing Vte Prophylaxis Through System-Level Improvements, Nehar Damle, Jessica Cobb, Jordan Feingold, Yunisse Gonzalez, Lamya Jaigirdar, Sheraz Qamar, Claire Ketchem May 2025

From Oversight To Insight: Enhancing Vte Prophylaxis Through System-Level Improvements, Nehar Damle, Jessica Cobb, Jordan Feingold, Yunisse Gonzalez, Lamya Jaigirdar, Sheraz Qamar, Claire Ketchem

Health Equity and Quality Improvement (HEQI) Summit

Background

- Hospitalized patients – particularly those with prior venous thromboembolism (VTE), reduced mobility, severe sepsis, and operative procedures - are at significantly elevated risk for recurrent VTE events1-4

- Although clinical evidence supports use of pharmacologic VTE prophylaxis in highrisk patients, gaps in delivery remain common (highlighted below):

  • Miscommunication between managing teams
  • Unclear documentation
  • Lack of standardized peri-procedural protocols
  • Challenges in care coordination

- Missed or delayed VTE prophylaxis represents a frequent and preventable threat to inpatient safety

- We present a near miss event involving a hospitalized patient with severe sepsis and history of pulmonary embolism within …


Utility Of Community Partnership And Sustainable Street Outreach, Daniel Lee, Hannah Klinghoffer, Mallika Kodavatiganti, Luke Benedict, Kelsey Van Housen, Ashley Wetzel, Lele Yang, Alisha Agarwal, Shane Nieves, Charlotte Harris, Jessica Lely, Vinh Dang, Ivel Morales, Md May 2025

Utility Of Community Partnership And Sustainable Street Outreach, Daniel Lee, Hannah Klinghoffer, Mallika Kodavatiganti, Luke Benedict, Kelsey Van Housen, Ashley Wetzel, Lele Yang, Alisha Agarwal, Shane Nieves, Charlotte Harris, Jessica Lely, Vinh Dang, Ivel Morales, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

  • 14,088 individuals experience homelessness (IEH) across the state of Pennsylvania, with over 50% concentrated in Pittsburgh and Philadelphia1
  • In late 2021, only 4 medical school programs existed that conducted street outreach to support individuals experiencing homelessness in Pennsylvania before the pandemic.2 None existed at the undergraduate level.
  • Street outreach has been linked to increased motivation of IEH to seek services by removing stigma via positive, nonjudgmental relationships.3,4


Enhancing Patient Education Of Antimicrobial Side Effects At Discharge, Isaac Daudelin, Md, Phd, Bojan Lazarevic, Jordan Feingold-Link, Md, Nehar Damle, Md, Pharmd, Caroline Brugger, Crnp, Rachel Carr, Pa-C, Devin Weber, Md, Daniel Taupin, Md, Mhqs May 2025

Enhancing Patient Education Of Antimicrobial Side Effects At Discharge, Isaac Daudelin, Md, Phd, Bojan Lazarevic, Jordan Feingold-Link, Md, Nehar Damle, Md, Pharmd, Caroline Brugger, Crnp, Rachel Carr, Pa-C, Devin Weber, Md, Daniel Taupin, Md, Mhqs

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem: Patients discharged from the hospital on antimicrobial agents often receive insufficient education about potential side effects that warrant medical attention(1). We identified a critical gap in patient communication and safety that occurred during discharge at a large urban academic center.

Stakeholders

  • Patients
  • Physicians
  • Nurses
  • Pharmacists
  • Outpatient providers
  • Nurse practitioners
  • Physician assistants

Objective: This project aimed to utilize a multidisciplinary team to:

  1. Quantify a gap in patient education
  2. Create an interactive navigator- which would not rely on provider memory and automatically include relevant information in patient discharge paperwork
  3. Implement within 3 months into the EPIC system
  4. Measure the effect …


Identifying Unnecessary And Excessive Use Of Intravenous Heparin For The Treatment Of Intermediate-Risk Pulmonary Embolism, Youssef Elfatatry, Ryan Gardner, Chukwuemezie Kamanu, Ruben Rhoades May 2025

Identifying Unnecessary And Excessive Use Of Intravenous Heparin For The Treatment Of Intermediate-Risk Pulmonary Embolism, Youssef Elfatatry, Ryan Gardner, Chukwuemezie Kamanu, Ruben Rhoades

Health Equity and Quality Improvement (HEQI) Summit

Problem Statement

- Intermediate-risk pulmonary embolism (PE) is a diagnosis with heterogenous presentations and mortality rates ranging from 2% to 15%.

- European Society of Cardiology (ESC) guidelines recommend low-molecular weight heparin (LMWH) as first line therapy in most patients. Despite this, the use of IV heparin in intermediate-risk PE remains widespread, due to uncertainty regarding patients receiving further procedures and mitigation of bleeding risk.

Project AIM:

- We aim to (1) identify prescribing patterns and outcomes of anticoagulant therapy on admission, and (2) propose and implement a "PE Care Pathway" in EPIC to address uncertainty in risk-stratifying and treating …


Post-Operative Management Of Chronic Subdural Hematomas, Steven R. Glener, Md May 2025

Post-Operative Management Of Chronic Subdural Hematomas, Steven R. Glener, Md

Health Equity and Quality Improvement (HEQI) Summit

Primary Objective & Outcome Measures

Objective: Identify standard of care for post-operative subacute to chronic subdural hematomas (cSDH) that undergo burr hole evacuation

Primary outcomes:

  • Rate of SDH recurrence requiring re-evacuation or MMA embolization

Secondary outcomes:

  • LOS
  • Readmission for a medical problem related to chronic subdural evacuation


Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh May 2025

Future Of Transplant Centers: Leveraging Integration Of Transplant Institutes To Mitigate The Impact Of Transplant Professional Shortages And Enhance Patient Outcomes, Kiran Goli, Prashamsa Shenoy, Paula Martinez-Cantarin, Maitreyee Gupta, Rakesh Gulati, Pooja Singh

Health Equity and Quality Improvement (HEQI) Summit

Background

The Increasing Organ Transplant Access (IOTA) Model introduced by the Centers for Medicare & Medicaid Services (CMS) emphasizes increasing transplant volumes, reducing disparities, and enhancing care efficiency. Transplant centers face unique challenges, including workforce shortages, growing demand for organ transplants, care delivery inefficiencies, and the need to align with the achievement, efficiency, and quality domains of the IOTA model while fostering health equity. Integration, whether through mergers, acquisitions, or strategic alliances, offers transplant centers a competitive advantage in optimizing resources, expanding access, and meeting CMS metrics.


Bacterial Contamination Of Multiple Platelet Units At A University Hospital-Affiliated Blood Donation Center In Philadelphia, Pa: A Quality Improvement Project, Alissa F. Schurr, Do, Violet Quann, Do, Aaron S. Gomez, Md, Alberto Martinez Mencia, Juliana Guarente, Md, Allison F Goldberg, Md May 2025

Bacterial Contamination Of Multiple Platelet Units At A University Hospital-Affiliated Blood Donation Center In Philadelphia, Pa: A Quality Improvement Project, Alissa F. Schurr, Do, Violet Quann, Do, Aaron S. Gomez, Md, Alberto Martinez Mencia, Juliana Guarente, Md, Allison F Goldberg, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

  • Our facility collects 1-2 platelets per month from donors via apheresis.
  • Bacterial risk mitigation for our facility is performed by large-volume delayed sampling (LVDS).


Visiting Medical Student Stipends In The Us | An Analysis Of Equity Within Physiatry, Ashley Otto, Do, Mbs, Jeffrey Gray, Md, Summer Nestorowicz, Md, Adrian Oppong, Md, Ms, Oluseye Raymond, Md, Andrew Walrond, Md, Alexis Tingan, Md, Marisa Moreta, Do May 2025

Visiting Medical Student Stipends In The Us | An Analysis Of Equity Within Physiatry, Ashley Otto, Do, Mbs, Jeffrey Gray, Md, Summer Nestorowicz, Md, Adrian Oppong, Md, Ms, Oluseye Raymond, Md, Andrew Walrond, Md, Alexis Tingan, Md, Marisa Moreta, Do

Health Equity and Quality Improvement (HEQI) Summit

Introduction & Aims

Health inequities are ubiquitous throughout medicine especially pertaining to accessibility, affordability, and availability. These challenges disproportionately affect minorities- both patients and providers alike [3,4]. Patient outcomes have been shown to improve when treated by physicians of similar backgrounds [3,4,7]. The journey to improve outcomes begins with pre-residency rotations; medical students who can complete audition rotations have an increased opportunity to matriculate into said residency program. Physical Medicine & Rehabilitation (PM&R), like many specialties, is disproportionately represented by men and Caucasians [1,5, 8] with the greatest drop in URM representation occurring between applicants and residents [Escalon]. This project …


The Effect Of Targeted Outreach To Improve Cpap Adherence In Patients With Socioeconomic Disparities, Henry Ideker, Md, Ethan Zheng, Ba, Stephen White, Md, Ritu Grewal, Md May 2025

The Effect Of Targeted Outreach To Improve Cpap Adherence In Patients With Socioeconomic Disparities, Henry Ideker, Md, Ethan Zheng, Ba, Stephen White, Md, Ritu Grewal, Md

Health Equity and Quality Improvement (HEQI) Summit

Introduction

  • Continuous positive airway pressure (CPAP) is first line treatment for obstructive sleep apnea (OSA) in adults given its high efficacy; however, it is limited by poor patient compliance
  • Socioeconomic disparities are known to be associated with significantly worse health outcomes and adherence to therapy1
  • Area deprivation index (ADI) is a validated tool that highlights populations with high socioeconomic disparities on a neighborhood level.2 Prior research in our department in 2022 demonstrated significantly worse CPAP adherence in OSA patients with higher ADI scores.3
  • Initial CPAP use has been shown to predict long-term adherence, and strategies to maximize …