Medicine and Health Sciences Commons^™

Sickle Cell Pain: A Critical Reappraisal., Samir K. Ballas, Kalpna Gupta, Patricia Adams-Graves

Department of Medicine Faculty Papers

Sickle cell pain includes 3 types: acute recurrent painful crises, chronic pain syndromes, and neuropathic pain. The acute painful crisis is the hallmark of the disease and the most common cause of hospitalization and treatment in the emergency department. It evolves through 4 phases: prodromal, initial, established, and resolving. Each acute painful episode is associated with inflammation that worsens with recurrent episodes, often culminating in serious complications and organ damage, such as acute chest syndrome, multiorgan failure, and sudden death. Three pathophysiologic events operate in unison during the prodromal phase of the crisis: vaso-occlusion, inflammation, and nociception. Aborting the acute …

16-Year Trends In The Infection Burden For Pacemakers And Implantable Cardioverter-Defibrillators In The United States 1993 To 2008., Arnold J Greenspon, Jasmine D Patel, Edmund Lau, Jorge A Ochoa, Daniel R Frisch, Reginald T Ho, Behzad B Pavri, Steven M Kurtz

Department of Medicine Faculty Papers

OBJECTIVES: We analyzed the infection burden associated with the implantation of cardiac implantable electrophysiological devices (CIEDs) in the United States for the years 1993 to 2008.

BACKGROUND: Recent data suggest that the rate of infection following CIED implantation may be increasing.

METHODS: The Nationwide Inpatient Sample (NIS) discharge records were queried between 1993 and 2008 using the 9th Revision of the International Classification of Diseases (ICD-9-CM). CIED infection was defined as either: 1) ICD-9 code for device-related infection (996.61) and any CIED procedure or removal code; or 2) CIED procedure code along with systemic infection. Patient health profile was evaluated …

Capacity Building For Participatory Health Services Research In Housing First, Lara Carson Weinstein, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Background:

Pathways to Housing ends chronic homelessness for individuals with serious mental illness (SMI) by providing housing first, and then combining that housing with supportive treatment services in the area of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This "scattered site" model fosters a sense of home and self-determination, and it helps speed client's reintegration into the community. The Pathways model has been remarkable successful in addressing chronic homelessness.

Research Question

What are the chronic physical disease self management support needs of Pathways to Housing clients?

Primary Provider Beliefs And Practice Patterns Contribute To The Lack Of Hiv/Hcv Coinfected Patients Undergoing Liver Transplantation In The United States, Jonathan M. Fenkel, Md, Victor J. Navarro, Md

Division of Gastroenterology and Hepatology Faculty Papers

Conclusions:

1. The majority of primary providers were ambivalent toward or against LT for HIV/HCV coninfected patients.

2. Half of all respondents were unlikely to refer cirrhotic coinfected patients for LT evaluation.

3. HIV specialists were significantly more likely to believe transplant should be offered, but reported no difference in likelihood of LT referral.

4. These findings suggest that primary provider beliefs and self-reported practice patterns may partially explain the paucity of coinfected US liver transplant recipients.

Aisr Connections, Fall 2011 (2011-2012 Orientation Issue), Aisr

The AC's Research Support Newsletter (Formerly AISR Connections)

Yearly publication of AISR Connections for 2011-2012.

Issue includes:

• FACT Program Incorporates iPads
• Classroom Technologies & Videoconferencing
• Jefferson Digital Commons Posts Half Million Downloads

The mission of Academic & Instructional Support & Resources (AISR) is to strengthen the educational, research and clinical activities of the Jefferson community by providing knowledge-based information, developing and managing instructional technologies and content, supporting and managing campus classroom technologies, and providing leadership in scholarly communication and publishing.

Religious Experiences Shrink Part Of The Brain, Andrew Newberg, M.D.

Marcus Institute of Integrative Health Faculty Papers

A study links life-changing religious experiences, like being born again, with atrophy in the hippocampus.

The article, “Religious factors and hippocampal atrophy in late life,” by Amy Owen and colleagues at Duke University represents an important advance in our growing understanding of the relationship between the brain and religion. The study showed greater atrophy in the hippocampus in individuals who identify with specific religious groups as well as those with no religious affiliation. It is a surprising result, given that many prior studies have shown religion to have potentially beneficial effects on brain function, anxiety, and depression.

Multimethod Teaching Strategies To Integrate Selected Qsen Competencies In A Doctor Of Nursing Practice Distance Education Program, Mary Lou Manning, Phd, Crnp, Anthony J. Frisby, Phd

College of Nursing Faculty Papers & Presentations

The Quality and Safety Education for Nurses (QSEN) initiative identified 6 competencies for the education of nurses (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) and the related knowledge, skills, and attitudes (KSAs) for each competency. The initial QSEN focus was on competency development during prelicensure nursing education, with subsequent attention on adapting the KSAs for graduate programs that prepare advanced practice nurses for clinical roles. Description of successful QSEN competency integration in Doctor of Nursing Practice (DNP) programs is limited. Although the ultimate goal is executing DNP programs where quality and safety is thoroughly integrated …

From Bench To Bedside And Beyond: Potential Uses Of Vivo In An Academic Medical Center, John C. Kairys, Md, Facs, Jack London, Phd, Karl Steiner, Phd

Department of Surgery Faculty Papers

PowerPoint presentation: From Bench to Bedside and Beyond:Potential Uses of VIVO in an Academic Medical Center.

International Evidence On Medical Spending, Robert D. Lieberthal

College of Population Health Faculty Papers

Abstract
U.S. medical spending is high by measures including the level of spending, level of spending per capita, and level of spending as a share of GDP. U.S. medical spending growth is average by measures including the annual growth rate, annual growth rate per capita, and annual growth in spending as a percent of GDP. The volatility of U.S. medical spending growth is low by measures including the standard deviation, skew, and excess kurtosis.

Foreign healthcare systems, with a much larger government involvement, have not been able to control medical spending growth better than the U.S. with its mixed system. …

Bionic Technologies Transforming The Science Of Healthcare Delivery, Scott A. Waldman , M.D., Ph.D, Andre Terzic , M.D., Ph.D

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Individualization of patient care is creating an envisioned future in which practitioners wield a new doctor’s bag deploying individual molecular, genetic, cellular, and systems profiles. These emerging tools are refining traditional paradigms of disease palliation into nuanced patient management algorithms employing prognostic risk stratification, therapeutic response prediction, and adverse event avoidance. Advancing technologies are enabling a shift to more proximal nodes along the continuum of pathobiology. Innovations in biomarker platforms, genomic profiling, and molecular imaging reveal the earliest stages of pathophysiology, limiting systems disruption to cells and tissues while preserving integrated organ function, enabling risk mitigation and disease prevention. At …

Implementing An Msn Nursing Program At A Distance Through An Urban-Rural Partnership, Ksenia Zukowsky, Phd, Aprn, Nnp-Bc, Beth Ann Swan, Phd, Crnp, Faan, Mary Powell, Phd, Crnp, Anthony J. Frisby, Phd, Lori Lauver, Phd, Rn, Margaret Mary West, Phd, Cne, Rn, Alexis Marsella, Ba

College of Nursing Faculty Papers & Presentations

Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural …

Oncologic Efficacy Is Not Compromised, And May Be Improved With Minimally Invasive Esophagectomy., Adam C Berger, Aaron Bloomenthal, Benny Weksler, Nathaniel Evans, Karen A Chojnacki, Charles J Yeo, Ernest L Rosato

Department of Surgery Faculty Papers

BACKGROUND: Major morbidity and mortality rates continue to be high in large series of transthoracic esophagectomies. Minimally invasive approaches are being increasingly used. We compare our growing series of minimally invasive (combined thoracoscopic and laparoscopic) esophagectomies (MIEs) with a series of open transthoracic esophagectomies.

STUDY DESIGN: We identified 65 patients who underwent an MIE with thoracoscopy/laparotomy (n = 11), Ivor Lewis (n = 2), or 3-hole approach (n = 52). These patients were compared with 53 patients who underwent open Ivor-Lewis esophagectomy (n = 15) or 3-hole esophagectomy (n = 38) over the past 10 years.

RESULTS: The MIE and …

Maternal Health Workforce Shortages In Southeast Pennsylvania, Jacqueline E. Kohl

Master of Public Health Capstone Presentations

Since 1997, 19 maternity wards have closed in Southeastern Pennsylvania, leaving only 23 to serve the women and families in the area. Additionally, there have been reports of maternal health workforce shortages, causing many women difficulty in accessing the care they need. This aims of this qualitative study were to define the problem of maternal health workforce shortages in the region and to identify potential solutions. Ten key stakeholders were identified for participation. A single researcher conducted interviews using a structured interview guide. Results were analyzed for content and major themes by two researchers. The eight sections include: 1. preconception …

Ercc1 And Rrm1 As Predictors Of Survival And Response In Pancreatic Ductal Adenocarcinoma Treated With Gemcitabine-Based Chemotherapy, Thomas Holdbrook, Kathleen D. Danenberg, Suneeta Satti, Jessica Kline, Charles J. Yeo, Jonathan R. Brody, Peter Mccue, Agnieszka K. Witkiewicz

Department of Surgery Faculty Papers

Conclusion:

In this study, we used RT-PCR and IHC to analyze RRM1 and ERCC1 mRNA and protein expression in PDA specimens. PDA patients with low expression of RRM1 by IHC derived benefit from gemcitabine-based chemotherapy. Assessment of RRM1 mRNA expression was limited by the small sample size. Low ERCC1 expression by RT-PCR was associated with a 2.5 times higher risk of mortality than high expression (p=0.031). There was no association between ERCC1 expression by IHC and survival; however, agreement between mRNA and protein expression was poor for ERCC1. This study demonstrates the ERCC1 and RRM1 expression have an impact on …

Epidermal Growth Factor Receptor Overexpression In Resected Pancreatic Cancer, Amit Mahipal, Mary J. Mcdonald, Agnieszka Witkiewicz, Brian I. Carr

Department of Medical Oncology Faculty Papers

Conclusions:

Membrane EGFR overexpression is associated with poorer clinical outcomes in patients with pancreatic cancer receiving adjuvant therapy post resection.

Cytoplasmic EGFR overexpression is not associated with clinical outcomes.

A Trial Of Simulated Breech Delivery Skills Retention For Ob/Gyn And Ed Residents, Cj Sultana, R. Hall

Department of Obstetrics and Gynecology Faculty Papers

Conclusion:

A pilot study showed that simulation using video and high fidelity simulators can substitute for clinical experience for teaching breech delivery with retention of skills at one and three month intervals.

Expression Of Aldehyde Dehydrogenase In Dysplastic Lesions Arising From Inflammatory Bowel Disease, Adam D. Toll, Bruce M. Boman, Juan P. Palazzo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Conclusion: Our study demonstrates ALDH1 is significantly expressed in dysplatic lesions arising from IBD. ALDH1-expression in cancer stem cells suggest an important causative role in the progression to cancer in IBD. Although we found high sensitivity for dysplasia, the specificity was poor. In addition to neoplasia, ALDH1-expressing stem cells proliferate in response to chronic inflammation, accounting for the cases of inflammatory atypia with positive ALDHI1 expression.

Improving Function In Age-Related Macular Degeneration: Design And Methods Of A Randomized Clinical Trial., Barry W Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions …

Implementing Integrated Primary And Behavioral Healthcare Within A Housing First Program, Lara C. Weinstein, Md, Benjamin Henwood, Lcsw

Department of Family & Community Medicine Presentations and Grand Rounds

At Pathways to Housing-Philadelphia, mental health services to support consumers' independent living are delivered through Assertive Community Treatment (ACT) teams. ACT is an evidence-based mental health intervention known to reduce psychiatric hospitalization and increase housing stability. ACT team members include social workers, substance abuse, counselors, nurses, and psychiatrists, with ideal staff to client ratios of 1 to 10. Through a novel collaboration between the program and the Deparment of Family and Community Medicine at Thomas Jefferson University, a primary-care physician was embedded into the ACT services to form an integrated health-care team.

The Pulmonologist's Role In Caring For Pregnant Women With Regard To The Reproductive Risks Of Diagnostic Radiological Studies Or Radiation Therapy., Robert Brent

Department of Pediatrics Faculty Papers

Radiography of the chest, head, neck, teeth, or extremity exposes the embryo or ovary to insignificant exposures of radiation except when radionuclides are utilized. In some instances, there is no exposure at all. Pulmonologists are fortunate with regard to the specific studies they request to provide clinical care because most of the diagnostic tests do not directly expose the uterus (embryo) or ovary. This article discusses radiation risks and their evaluation and pregnancy-related issues in diagnostic radiological studies.

Septic Shock: Current Management And New Therapeutic Frontiers, R. Phillip Dellinger, Md

Division of Pulmonary and Critical Care Medicine Presentations and Grand Rounds

No audio is available for this presentation.

Dr. R. Phillip Dellinger is a Professor of Medicine who holds a faculty appointment in the Division of Pulmonary and Critical Care Medicine at the Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey. He is also the Vice-Chair, Department of Medicine and the Director, Medical/Surgical/Cardiovascular Surgical Intensive Care Unit at the Cooper Medical Center in Camden New Jersey. In 2006-2007, he was selected as South Jersey Top Docs by South Jersey Magazine. Dr. Dellinger's interests are in the treatment and outcomes of septic shock.

Last Names Begin With Y-Z.

Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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Last Names Begin With K-L.

Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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Jefferson Medical College 19th century matriculates

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