Medicine and Health Sciences Commons^™

Comparison Of Home Therapy Vs Formal Outpatient Physical Therapy In Post-Operative Management Of Two-Incision Distal Bicep Tendon Repair, Joseph Botros, John Horneff Iii, Md, Thomas Harper, Brent Page

Phase 1

Background: Distal bicep tendon tears are a relatively uncommon injury, affecting 1.2/ 100,000 persons per year; they can also cause substantial loss in supination and flexion strength. The most common treatment is a double incision distal bicep tendon repair, which involves surgical reinsertion of the bicep tendon onto the radial tuberosity. Following surgery, physicians have traditionally recommended the patient undergo 5-12 weeks of formal outpatient physical therapy. This can be a significant cost and time burden to the patient. Therefore, some physicians have instead opted for home physical therapy, in which the patient is given instructions on exercises to complete …

Training The Next Generation Of Family Medicine Providers Through Group Buprenorphine-Naloxone Visits, Krystina Callahan, Lara Weinstein, Md, Erica Li, Md, Sunny Lai, Md, Alexis Silverio

Phase 1

Introduction: The rise in opioid use disorders (OUD) and fatal overdoses highlight the need to expand access to and capacity for treating OUD. Medication Assisted Treatment (MAT), a medication/group visit model, done in the office setting, is an effective remedy for treating OUD. Understanding residents’ perspectives on their clinical training in MAT can inform the design of a more effective and responsive curriculum.

Methods: A qualitative study using group semi-structured interviews with residents in an urban family medicine residency rotating through a federally qualified health center. Interviews centered on strengths and weaknesses of the MAT program, resident likeliness to …

Blood Transfusion Requirements For Patients On Extracorporeal Membrane Oxygenation, Min Choi, Hitoshi Hirose, Md, Phd

Phase 1

No abstract provided.

Diagnostic Accuracy Of Procalcitonin In Differentiating Sepsis From Noninfectious Sirs In Adult Patients With Subarachnoid Hemorrhage, Keshav Choudhuri, Umer Mukhtar, Md, M. Kamran Athar, Md, David Boorman, Ms, Fred Rincon, Md, Matthew Vibbert, Md, Syed O. Shah, Md, Jacqueline S. Urtecho, Md, Jack Jallo, Md

Phase 1

Background: Subarachnoid hemorrhage (SAH) is a frequent diagnosis in the neuro-intensive care unit (NICU) that can result in the development of systemic inflammatory response syndrome (SIRS) and fever. The differentiation between central fever and infectious fever is paramount in order to prevent superfluous diagnostic testing and overuse of empiric antibiotics.

Methods: A prospective chart review study conducted in the NICU between December 2012 and September 2015. Patients with SAH, fever (≥101.0°F) and/or who were SIRS positive and had PCT levels measured were included. The primary outcome was clinical infection defined as any positive culture or infiltrate on chest X-ray within …

The Impact Of Native Language Status On The Frequency Of Heart Failure Readmissions, Cooper Blazek, Dave Katzianer, Md

Phase 1

Introduction. Heart failure readmissions are costly and lead to poor health outcomes. The efficacy of discharge instructions or other outpatient interventions may be affected by patient’s primary language status. The aim of this study is to look at the impact of primary language status on the frequency of heart failure admissions.

Methods. This study was a retrospective chart review of EMRs, on Epic software, at Jefferson academic medical center and community affiliate in Philadelphia, PA between March 2017 and October 2018. Patients were included if they had a principal diagnosis of HF or a diagnosis associated with “acute” heart failure …

Oncology Hospital At Home: A Retrospective Chart Review Examining Whether Oncology Patients Placed Under Observation Status By The Ed Could Be Managed In The Home Setting, Mary Blumenfeld, Adam Binder, Md, Nathan Handley, Md

Phase 1

Introduction: Hospital at Home (HaH) programs deliver hospital-level care in the home setting rather than in the traditional inpatient unit. In the US, this model of care has focused on the general medicine population, but no such models for adult oncologic care have been described in the literature to date. The current study seeks to identify whether certain diagnoses of patients with cancer admitted to observation status are predictive for early discharge and potentially model diagnoses on which to build a HaH program.

Methods: Electronic medical records were reviewed for 130 adult cancer patients presenting to the Thomas Jefferson …

Neurostimulants To Improve Consciousness In Acute Comatose Patients, Lyena Birkenstock, Mohammed Kananeh

Phase 1

Patients in the neurology intensive care unit (NICU) suffering from coma have variable outcomes, even once the underlying condition has been treated. Coma is a detrimental condition with a high risk for mortality and disability. Currently, there is not a specific treatment regimen to treat, or even improve, comatose patients. In this study, we set out to compare the efficacy and side effect profile of different neurostimulants, including modafinil, adderall, and zolpidem. The target population includes adult patients in the Jefferson NICU with a diagnosis of persistent encephalopathy, despite the resolution of their admitting diagnoses. Patients are administered medication as …

Evaluation Of Rotator Cuff Repair With Concomitant Biceps Tenodesis, Matthew Beucherie, Daniel Nemirov, Sommer Hammoud, Md, Meghan Bishop, Md, Brandon Erickson, Md

Phase 1

Introduction: Surgical rotator cuff repair (RCR) has proven to be an effective treatment for rotator cuff tears. Commonly, rotator cuff tears are associated with concomitant biceps pathology, which are often treated by biceps tenodesis (BT). We hypothesize that patient outcomes will be similar in those that have undergone RCR with concomitant BT and isolated RCR.

Methods: This is a retrospective cohort study comparing patients who underwent arthroscopic RCR with arthroscopic or open BT to patients who underwent isolated RCR at a multisurgeon orthopaedic practice during the time period of November 2016 to December 2016. The outcome for comparison is …

Mci: Cpap Treatment Of Osa, Kaitlin Berry, Cindy Cheng, Md, Phd, Karl Doghramji, Md

Phase 1

Introduction: An estimated 30 percent of adults (20% of men and 10% of women) in the US have sleep apnea. Approximately 60% of patients with Mild Cognitive Impairment (MCI) are also diagnosed with Obstructive Sleep Apnea (OSA). The suggested mechanism of this is damage to the brain due to hypoxia during sleep. Few studies have investigated the effect of Continuous Positive Airway Pressure (CPAP) treatment for OSA, on mild cognitive impairment.

Methods: Patients are screened for eligibility based on specific inclusion and exclusion criteria. Potentially eligible patients who screen positive for MCI using the Telephone Interview for Cognitive Status …

Effect Of Contrast-Enhanced Echocardiograms On The Prognosis Of Infective Endocarditis, D. Arias, E. Halpern, F. Forsberg, J. R. Eisenbrey

Phase 1

Objective - Infective endocarditis (IE) is an infectious disease of the cardiac valves where bacteria colonize the valves; typically, via the formation of vegetations. Recent research has shown that the microbubbles in a contrast-enhanced ultrasound (CEUS) examination can move and dislodge bacterial vegetations in vitro. This study investigated whether CEUS resulted in faster resolution of IE in vivo by dislodging the vegetations.

Methods - This IRB approved retrospective study reviewed 36 patients who were diagnosed with IE via echocardiography. Data was sourced from patients within the Jefferson University Hospital’s Cardiology EMR system by searching for contrast and vegetation from …

Phosphorylation Of A K Channel By Pkc Regulates The Excitability Of Primary Sensory Neurons And Pain Signaling, Tyler D. Alexander, Lianteng Zhi, Phd, Tanziyah Muqeem, Manuel Covarrubias, Md, Phd

Phase 1

Introduction: Voltage-gated potassium channels (Kvs) play an important role in the termination of neuronal action potentials. Kv3.4 is one of many types of Kv channels, found throughout the human body – including in the axon terminals of dorsal root ganglia neurons. Kv3.4 channels are categorized as A-type currents and have prominent fast-inactivation that has been shown to be phosphorylation dependent. It is hypothesized that following spinal cord injury (SCI), Kv3.4 channels become hyperphosphorylated and their expression reduced – leading to an increase in nociceptive signaling.

Methods: We used embryonic DRG neurons, transfected with one of four types of viral …

Assessing The Elevation Of Cardiac Biomarkers And The Severity Of Covid-19 Infection: A Meta-Analysis, Cucnhat Walker, Subrata Deb, Hua Ling, Zhe Wang

PCOM Scholarly Works

- Purpose: Since December 2019, coronavirus disease 2019 infection has become a global pandemic. The cases of Coronavirus Disease 2019 (COVID-19)-related acute cardiac injury with unknown pathophysiologic mechanism has become increasingly prevalent. However, it is not yet understood how the extent of cardiac injury differs with the intensity of viral infection. In the current study, we aimed to assess the association between elevated cardiac biomarkers and the severity of COVID-19 infection.

METHODS: A systematic literature search was performed across PubMed and Embase databases from December 1, 2019 to July 10, 2020, to identify studies that reported cardiac biomarkers of troponin …

Presumed Consent And Priority Allocation Systems For Organ Donation Legislation In The United States: Making The Moral Case, Ann K. Shapiro, Peter A. Depergola Ii

Philosophy, Theology and Religious Studies Faculty Publications

In recent decades, developed nations, such as the United States, have seen the gap between the demand and the supply of transplantable organs widen, despite national campaigns intended to promote donor registration. This organ shortage crisis has deprived thousands of a basic quality of life and has caused a substantial increase in the cost of alternative medical care such as dialysis. In an attempt to address the shortage, some countries have instituted explicit “opt-out” and “priority allocation” policies that operate under the principle of presumed consent and offer higher priority on transplantation lists to registered donors. This paper seeks to …

The Intellectual Property Of Vaccines: Takeaways From Recent Infectious Disease Outbreaks, Ana Santos Rutschman

All Faculty Scholarship

This Essay examines the ways in which intellectual property regimes influence incentives for the development of new vaccines for infectious diseases. Charting the tension between market forces and public health imperatives, the Essay considers an emerging solution to the long-standing problem of insufficient incentives for vaccine research and development: the rise of public-private partnerships in the health space. The Essay provides a short case study on CEPI, a large-scale public-private partnership dedicated exclusively to funding research on vaccines for infectious diseases. In exploring how the interaction between intellectual property rules and practices affect vaccine innovation, the Essay offers illustrations from …

An Epic Fail, Marsha Griggs

All Faculty Scholarship

All at once, the U.S. found itself embattled with the threat of COVID-19, the new normal of social distancing, and the perennial scourge of racial injustice. While simultaneously battling those ills, the class of 2020 law graduates found themselves also contending with inflexible bar licensing policies that placed at risk their health, safety, and careers. During a global health pandemic, bar licensing authorities made the bar exam a moving target riddled with uncertainty and last-minute cancellations. This costly and unsettling uncertainty surrounding the bar exam administration was unnecessary because multiple alternatives were available to safely license new attorneys. A ball …

Vaccines And Ip Preparedness In The Coronavirus Outbreak, Ana Santos Rutschman

All Faculty Scholarship

The COVID-19 pandemic has shed renewed light on the importance of research and development (R&D) on biopharmaceutical products needed to prevent or lessen the burden posed by outbreaks of infectious diseases. Among these, the need for new vaccines has become of paramount importance. While a race to develop different types of vaccines unfolds at unusual speed, there are still significant shortcomings in the ecosystem that leads to the production and dissemination of vaccines targeting infectious diseases like COVID-19.

Ethanol Induced Neurotoxicity Through Dysregulation Of Ampk In A Fetal Alcohol Syndrome Model, Jessica Gebhardt

Theses and Dissertations--Medical Sciences

Ethanol consumption during pregnancy is rising in the U.S., including the rate of binge drinking. It is reported around 1 in 27 women engage in binge drinking activities while pregnant. The third trimester is a sensitive period of neuronal growth in which ethanol induced neurotoxicity can cause many harmful effects including Fetal Alcohol Spectrum Disorders. It has been shown that ethanol decreases the activity of AMPK through increasing lipid peroxidation, both of which are correlated to neurotoxicity. AICAR is a synthetic analog of AMP which significantly increases AMPK activity and may have beneficial effects in an organotypic hippocampal model of …

Experiences Of Adolescents In The General Education Setting Interacting With Peers With Intellectual Disability, Katie Goldey

Theses and Dissertations--Rehabilitation Sciences

Social interaction is critical to health, quality of life, and linguistic and cognitive development. However, young people with intellectual disabilities are unlikely to have equitable opportunities for social interaction. This may be particularly true of adolescents. This study used qualitative phenomenological methods to examine the lived experiences of students in the general education setting interacting with their peers with intellectual disability. Twenty participants engaged in one on one interviews with the author. Interviews were recorded, transcribed verbatim, and analyzed for overarching themes. Four main themes emerged from the data including: (1) Teens just don’t have many opportunities to interact with …

Examining Cultural Influences On Dietary Behaviors Among Mexican Americans With Low Acculturation, Austyn Erickson

Theses and Dissertations--Nutrition and Food Systems

Mexican Americans represent approximately 63 percent of the total Hispanic population in the US and are disproportionately affected by health disparities related to poor nutrition status. With this community among the fastest growing populations in the US, it is critical to address the health disparities and the relationship between culture and diet to provide evidence-based nutrition interventions that are culturally sensitive to specific communities. The purpose of this cross-sectional exploratory study is to examine the relationship between cultural values and dietary behaviors among a low-income, urban, clinical sample of Mexican Americans using the Mexican American Cultural Values Scale, dietary assessment, …

Value-Based Reimbursements In The Us Health Care Market : Direct And Spillover Effects Of Medicare Readmissions Program, Soumyadeb Chatterjee

Legacy Theses & Dissertations (2009 - 2024)

In this thesis, I take up the question of how the Medicare penalties introduced by the Hospital Readmissions Reduction program (HRRP) impacted the US health care system. The demand side of US health care system is highly fragmented where hospitals and other providers have to serve very different kinds of patients from different payers. Since the majority of a hospital's income is drawn from Medicare, a sharp reduction in its reimbursements is bound to have an effect on its health care delivery to all patients.

Alterations In Corticotropin-Releasing Factor Receptor Type 1 In The Hypothalamus And Preoptic Area During The Postpartum Period, Rose Ann M. De Guzman

Legacy Theses & Dissertations (2009 - 2024)

Despite the apparent sex difference in prevalence of anxiety in humans, pre-clinical studies that have led to anxiolytic drug discoveries between 1960 and 2012 used male animals and approximately 6% of 10,000 studies used female animals. The generalizability of the efficacy of these drugs to both sexes may be limited if data derived are predominantly based on the male brain. The purpose of this dissertation, therefore, was to investigate potential underlying neuronal mechanisms that could be contributing to the sex differences in stress-related mood disorder prevalence and to focus on shedding light on female brains.

Spina Bifida Mortality By Clinical And Demographic Characteristics Using The New York State Birth Defects Registry, 2008-2016, Anaclare Mackenzie Sullivan

Legacy Theses & Dissertations (2009 - 2024)

Background: Spina bifida is the most common neural tube defect. It has been associated with increased mortality, disability, and may require lifelong medical care. Few previous studies have assessed the impact that maternal race/ethnicity or variations in clinical features of the disease may have on mortality.

The Impact Of The Residency Area On Risk Factors For Tuberculosis Among People Living In Three Different Regions Of Kazakhstan, Assel Bukharbayeva

Legacy Theses & Dissertations (2009 - 2024)

Background and introduction:

Targeting The Rage Signaling Pathway To Ameliorate The Complications Of Diabetes, Stephen James Dansereau

Legacy Theses & Dissertations (2009 - 2024)

Diabetes is a global health epidemic that can be devastating to those afflicted,

A Comparative Spatial And Climate Analysis Of Human Granulocytic Anaplasmosis And Human Babesiosis In New York State (2013-2018), Collin J. O'Connor

Legacy Theses & Dissertations (2009 - 2024)

Human granulocytic anaplasmosis (HGA) and human babesiosis are tick-borne diseases spread by Ixodes scapularis (the blacklegged or deer tick) and are the result of infection with Anaplasma phagocytophilum and Babesia microti, respectively. In New York State (NYS), incidence rates of these diseases increased concordantly until around 2013, when rates of HGA began to increase more rapidly than human babesiosis, and the spatial extent of the diseases diverged. Surveillance data of tick-borne pathogens (2007 to 2018) and reported human cases of HGA (n=4,297) and human babesiosis (n=2,986) (2013 to 2018) from the New York State Department of Health (NYSDOH) showed a …

Timing Of Antiretroviral Initiation And Virologic Outcomes Among Hiv-Positive Adults In Ukraine (2010--2015), Yaroslav Zelinskyi

Legacy Theses & Dissertations (2009 - 2024)

Background and introduction:

Knowledge, Attitudes, And Practices Of Healthcare Professionals Working In Schools Regarding Tickborne Disease Prevention And Lyme Disease In New York State And Maryland, Kristen Howard

Legacy Theses & Dissertations (2009 - 2024)

Background: Ticks, Lyme disease, and other tickborne diseases are a concern of public health entities in Maryland and New York State. Children are at an increased risk of contracting a tickborne disease. Healthcare professionals working in schools (HPWS) are often front-line providers and health educators for school-aged children. The knowledge, attitudes, and practices of HPWS regarding ticks and tickborne disease is currently unknown. While there are educational materials available, uptake and use of these programs is also unknown.

Traditional Latinx Gender Role Norms And Exposure To Sexual Health Programming For Latinx Men Who Have Sex With Men (Lmsm), Austin Connor Eklund

Legacy Theses & Dissertations (2009 - 2024)

Latinx men who have sex with men (LMSM) are at significantly greater risk for HIV infection than their non-Latinx peers. One important way of helping prevent the spread of HIV is exposing vulnerable populations to HIV prevention programming. Little is known about what factors predict exposure to HIV prevention programming for LMSM. Given extant links between traditional masculine gender role norms and health outcomes, this study sought to examine possible relations between constructs of machismo, caballerismo, and heterosexual self-presentation, along with demographic covariates, and exposure to HIV prevention programming among LMSM. Among the 530 LMSM in our sample, 89% reported …

Implementing A Police Assisted Addiction Recovery Initiative In Rural New York : How Police-Provided Transportation May Reduce Barriers To Treatment Uptake, Emily Mae Bruce

Legacy Theses & Dissertations (2009 - 2024)

Background:

Does Common-Sense Communication And The Interpersonal Relationship Predict Oral Health Self-Management?, Kieran J. Maestro

Legacy Theses & Dissertations (2009 - 2024)

This study sought to understand how patients’ perceptions of the nature and manner of communication with dental health professionals may impact their health self-management quality and habits in the context of preventable illness. Specifically, this study investigated the distinct and overlapping impacts of (a) communication based in the Common Sense Self-Regulation Model (CSM; Leventhal et al., 1980), and (b) the interpersonal relationship between the patient and the dental health professional provider on patients’ oral hygiene quality and habits. It was hypothesized that the interpersonal relationship would positively moderate a positive relation between CSM-based communication and patients' oral health self-management and …