Medical Specialties Commons^™

Level 4 Visit, George Valco, Md

Department of Family & Community Medicine Presentations and Grand Rounds

• Medicare guidelines specifically with regard to PATH rules ( Physicians At Teaching Hospitals).
• Specific Documentation is a requirement for reimbursement under Medicare, Medicaid, and any 3rd party payers who refer to Medicare guidelines.
• Resident participation & documentation is incorporated by the Teaching Physicians (TP).

Brief Psychotherapy In Primary Care, Geoffrey Mills, Md, Phd

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Overview Case

Thread Goals

• Acknowledgement
• Rationale
• Background ‘theory’
• Framework(s) Practical applications

Mental Health Care Transitions From Incarceration, Graham Stratton, Md

Department of Family & Community Medicine Presentations and Grand Rounds

The scope of the problem of mental health and incarceration

• Case & Consideration 1: Severe Mental Illness ○ Brief history of de institutionalization and re institutionalization ○ Philadelphia’s jails at a glance
• Case & Consideration 2: Violence and trauma
• Consideration & Consideration 3: Addiction and substance use
• Models of transitions of care for reentry
• Community teams and resources
• Next steps for a Family Medicine physician

Osseous Changes Following Reverse Total Shoulder Arthroplasty Combined With Latissimus Dorsi Transfer: A Case Series, Jason S Klein, Peter S Johnston, Benjamin W Sears, Manan S Patel, Armodios M Hatzidakis, Mark D. Lazarus

Department of Orthopaedic Surgery Faculty Papers

Background: This is the first report on the incidence of proximal humerus osseous changes and associated clinical consequences in reverse total shoulder arthroplasty combined with a latissimus dorsi tendon transfer (RTSA+LDT).

Methods: A multicenter, retrospective review identified all patients who had undergone a primary RTSA+LDT and had at least 3-month radiographic follow-up between 2012 and 2017. Data collection included demographics, oral steroid use, repair technique for LDT fixation, radiographic humeral osseous changes, complications, and need for revision surgery.

Results: Twenty-four patients were included with an average age of 70.7 ± 7.9 years and follow-up of 16.3 (3-50) months. Ten patients …

Comparison Of Outcomes Of Hct In Blast Phase Of Bcr-Abl1- Mpn With De Novo Aml And With Aml Following Mds, Vikas Gupta, Soyoung Kim, Zhen-Huan Hu, Ying Liu, Mahmoud Aljurf, Ulrike Bacher, Amer Beitinjaneh, Jean-Yves Cahn, Jan Cerny, Edward Copelan, Shahinaz M Gadalla, Robert Peter Gale, Siddhartha Ganguly, Biju George, Aaron T Gerds, Usama Gergis, Betty K Hamilton, Shahrukh Hashmi, Gerhard C Hildebrandt, Rammurti T Kamble, Tamila Kindwall-Keller, Hillard M Lazarus, Jane L Liesveld, Mark Litzow, Richard T Maziarz, Taiga Nishihori, Richard F Olsson, David Rizzieri, Bipin N Savani, Sachiko Seo, Melhem Solh, Jeff Szer, Leo F Verdonck, Baldeep Wirk, Ann Woolfrey, Jean A Yared, Edwin P Alyea, Uday R Popat, Ronald M Sobecks, Bart L Scott, Ryotaro Nakamura, Wael Saber

Department of Medical Oncology Faculty Papers

Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL1- myeloproliferative neoplasms (MPNs) in blast phase (MPN-BP) vs de novo acute myeloid leukemia (AML), and AML with prior myelodysplastic syndromes (MDSs; post-MDS AML), are unknown. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we compared HCT outcomes in 177 MPN-BP patients with 4749 patients with de novo AML, and 1104 patients with post-MDS AML, using multivariate regression analysis in 2 separate comparisons. In a multivariate Cox model, no difference in overall survival (OS) or relapse was observed in patients with MPN-BP vs de novo AML with …

Feasibility Of Removable Balloon Implant For Simultaneous Magnetic Nanoparticle Heating And Hdr Brachytherapy Of Brain Tumor Resection Cavities., Paul R. Stauffer, Dario B. Rodrigues, Robert Goldstein, Thinh Nguyen, Yan Yu, Shuying Wan, Richard Woodward, Michael Gibbs, Ilya L. Vasilchenko, Alexey M. Osintsev, Voichita Bar-Ad, Dennis B. Leeper, Wenyin Shi, Kevin D. Judy, Mark D. Hurwitz

Department of Radiation Oncology Faculty Papers

AIM: Hyperthermia (HT) has been shown to improve clinical response to radiation therapy (RT) for cancer. Synergism is dramatically enhanced if HT and RT are combined simultaneously, but appropriate technology to apply treatments together does not exist. This study investigates the feasibility of delivering HT with RT to a 5-10mm annular rim of at-risk tissue around a tumor resection cavity using a temporary thermobrachytherapy (TBT) balloon implant.

METHODS: A balloon catheter was designed to deliver radiation from High Dose Rate (HDR) brachytherapy concurrent with HT delivered by filling the balloon with magnetic nanoparticles (MNP) and immersing it in a radiofrequency …

A Roller Coaster Ride Of Idiopathic Fibrosing Mediastinitis, Qian Zhang, Khine Shan

Abington Jefferson Health Papers

No abstract provided.

A Community Assessment Of Rapid Response Team Events Preceding Cardiopulmonary Arrest: Does It Improve Outcomes?, Vincent Chan, Ahmad Raza, Qian Zhang, Artem Minalyan, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

Rare Cause Of Fatal Liver Disease: A Case Of Acute Liver Failure In A Patient With Recently Diagnosed Metastatic Ovarian Carcinoma, Artem Minalyan, Qian Zhang, Vincent Chan

Abington Jefferson Health Papers

No abstract provided.

An Unlikely Combination Of Neutrophilic Predominant Pleural Effusion With Acid-Fast Bacilli Positivity, Vincent Chan, Qian Zhang, Ahmad Raza, Artem Minalyan, William Ward

Abington Jefferson Health Papers

No abstract provided.

"Brain Dead" Donor: A Case Of Brain Death Mimic Due To Pentobarbital Overdose, Artem Minalyan, Vincent Chan, Qian Zhang

Abington Jefferson Health Papers

No abstract provided.

Survival Analysis Based On The Duration Of Cpr After In-Hospital Cardiac Arrest, Ahmad Raza, Nayab Nadeem, Ahmad Arslan, Zain Ali, Qian Zhang, Usama Sadiq, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

Identifying Treatments For Taste And Smell Disorders: Gaps And Opportunities., Joel D. Mainland, Linda A. Barlow, Steven D. Munger, Sarah E. Millar, M. Natalia Vergara, Peihua Jiang, James E. Schwob, Bradley J. Goldstein, Shannon E. Boye, Jeffrey R. Martens, Donald A. Leopold, Linda M. Bartoshuk, Richard L. Doty, Thomas Hummel, Jayant M. Pinto, Casey Trimmer, Christine Kelly, Edmund A. Pribitkin, Danielle R. Reed

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The chemical senses of taste and smell play a vital role in conveying information about ourselves and our environment. Tastes and smells can warn against danger and also contribute to the daily enjoyment of food, friends and family, and our surroundings. Over 12% of the US population is estimated to experience taste and smell (chemosensory) dysfunction. Yet, despite this high prevalence, long-term, effective treatments for these disorders have been largely elusive. Clinical successes in other sensory systems, including hearing and vision, have led to new hope for developments in the treatment of chemosensory disorders. To accelerate cures, we convened the …

Lgi1 Encephalitis With Squamous Lung-Cell Carcinoma: Resolution After Tumor Resection., Akash Virupakshaiah, Marinos Dalakas, Neeja Desai, Scott Mintzer, Jeffrey Ratliff

Department of Neurology Faculty Papers

Encephalitis with leucine-rich glioma-inactivated-1 (LGI1) immunoglobulin G (IgG) anti-bodies classically presents with cognitive impairment and characteristic faciobrachial dystonicseizures.1In a murine model, human LGI1 IgG caused reduction of Kv1.1 channels andα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor receptors resulting in neuro-nal hyperexcitability indicating probable pathogenicity of LGI1 antibodies.2LGI1 autoimmu-nity is associated with malignancy in less than 10% of cases, including small cell lung cancer,prostate and colon cancer, squamous cell skin carcinoma, and neuroendocrine pancreaticcancer.3,4We present a case of LGI1 encephalitis only partially responsive to immunotherapywith eventual complete resolution after resection of a squamous cell lung carcinoma.

Pregnant Smokers Receiving Opioid Agonist Therapy Have An Elevated Nicotine Metabolite Ratio: A Replication Study., Henry R Kranzler, Yukiko Washio, Leah R Zindel, Kevin G Lynch, Dennis J. Hand, Rachel F Tyndale, Cheryl Oncken, Robert Schnoll

Department of Obstetrics and Gynecology Faculty Papers

INTRODUCTION: Pregnant women exposed chronically to opioids smoked more cigarettes per day (CPD) and had a higher nicotine metabolite ratio (NMR), 3-hydroxycotinine/cotinine, a biomarker of nicotine metabolism and clearance, than those not receiving opioids. We examined CPD and NMR in a group of pregnant smokers, a quarter of whom were receiving opioid agonist therapy (OAT).

AIMS AND METHODS: Pregnant smokers recruited to participate in a placebo-controlled trial of bupropion for smoking cessation provided a blood sample for measurement of NMR.

RESULTS: Half (52.4%) of the 124 women with NMR data were African American. OAT-treated women (n = 34, 27.4%; 27 …

Early General Hypothermia Improves Motor Function After Spinal Cord Injury In Rats; A Systematic Review And Meta-Analysis., Mahmoud Yousefifard, Mohammad Hossein Vazirizadeh-Mahabadi, Leila Haghani, Farhad Shokraneh, Alex R. Vaccaro, Vafa Rahimi-Movaghar, Mostafa Hosseini

Rothman Institute Papers

Introduction: There is still controversy about the effect of early hypothermia on the outcome of spinal cord injury (SCI). The aim of this review article is to investigate the effect of local or general hypothermia on improving the locomotion after traumatic SCI.

Methods: Electronic databases (Medline and Embase) were searched from inception until May 7, 2018. Two independent reviewers screened and summarized the relevant experimental studies on hypothermia efficacy in traumatic SCI. The data were analyzed and the findings were presented as pooled standardized mean difference (SMD) and 95% confidence interval (95% CI).

Results: 20 papers contain-ing 30 separate experiments …

Absence-To-Bilateral-Tonic-Clonic Seizure: A Generalized Seizure Type., Sándor Beniczky, Guido Rubboli, Athanasios Covanis, Michael R Sperling

Department of Neurology Faculty Papers

OBJECTIVE: To test the hypothesis that absence seizures can evolve to generalized tonic-clonic seizures, we documented electroclinical features of this novel seizure type.

METHODS: In 4 large video-EEG databases, we identified recordings of seizures starting with impaired awareness that, without returning to baseline interictal state, evolved to generalized tonic-clonic seizures. We extracted the detailed semiologic and electrographic characteristics of these seizures, and we documented the clinical background, diagnoses, and therapeutic responses in these patients.

RESULTS: We identified 12 seizures from 12 patients. All seizures started with a period of impaired awareness and bursts of generalized spike or polyspike and slow-wave …

Eptinezumab For The Prevention Of Chronic Migraine: Efficacy And Safety Through 24 Weeks Of Treatment In The Phase 3 Promise-2 (Prevention Of Migraine Via Intravenous Ald403 Safety And Efficacy-2) Study., Stephen Silberstein, Merle Diamond, Nada A. Hindiyeh, David M. Biondi, Roger Cady, Joe Hirman, Brent Allan, Susan Pederson, Barbara Schaeffler, Jeff Smith

Department of Neurology Faculty Papers

BACKGROUND: PROMISE-2 was a phase 3, randomized, double-blind, placebo-controlled study that evaluated the efficacy and safety of repeat intravenous (IV) doses of the calcitonin gene-related peptide-targeted monoclonal antibody eptinezumab (ALD403) for migraine prevention in adults with chronic migraine. This report describes the results of PROMISE-2 through 24 weeks of treatment.

METHODS: Patients received up to two 30-min IV administrations of eptinezumab 100 mg, 300 mg, or placebo separated by 12 weeks. Patients recorded migraine and headache endpoints in a daily eDiary. Additional assessments, including patient-reported outcomes, were performed at regularly scheduled clinic visits throughout the 32-week study period (screening, day …

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

College of Population Health Faculty Papers

No abstract provided.

Variation In Early Number Skills And Mathematics Achievement: Implications From Cognitive Profiles Of Children With Or Without Turner Syndrome, Sarah L Lukowski, Emily R Padrutt, Kyriakie Sarafoglou, Judith L. Ross, Jennifer R Law, Rachel E Olson, Michèle M M Mazzocco

Department of Pediatrics Faculty Papers

Individuals with Mathematics Learning Disabilities have persistent mathematics underperformance but vary with respect to their cognitive profiles. The present study examined mathematics ability and achievement, and associated mathematics-specific numerical skills and domain-general cognitive abilities, in young children with Turner syndrome compared to their matched peers. We utilized two independent peer groups so that group comparisons would account for verbal skills, a hypothesized strength of girls with Turner syndrome, and nonsymbolic magnitude comparison skills, a hypothesized difference of girls with Turner syndrome. This individual matching approach afforded characterization of mathematics profiles of girls with Turner syndrome and girls without Turner syndrome …

Early Evidence Of Dose-Dependent Pharmacodynamic Activity Following Treatment With Sy-5609, A Highly Selective And Potent Oral Cdk7 Inhibitor, In Patients With Advanced Solid Tumors, Kyriakos P. Papadopoulos, Manish R. Sharma, Erika Hamilton, Debra Richardson, Babar Bashir, Dejan Juric, Geoffrey Shapiro, Graeme Hodgson, Nan Ke, Anthony D'Ippolito, Liv Johannessen, Qing Kang-Fortner, Li Zhou, Maria Rosario, William Zamboni, Hina A. Jolin, Catherine Madigan, Michael J. Kelly, David A. Roth

Department of Medical Oncology Posters

No abstract provided.

Modulation Of Sleep-Courtship Balance By Nutritional Status In Drosophila, José M Duhart, Victoria Baccini, Yanan Zhang, Daniel R Machado, Kyunghee Koh

Farber Institute for Neuroscience Faculty Papers

Sleep is essential but incompatible with other behaviors, and thus sleep drive competes with other motivations. We previously showed Drosophila males balance sleep and courtship via octopaminergic neurons that act upstream of courtship-regulating P1 neurons (Machado et al., 2017). Here, we show nutrition modulates the sleep-courtship balance and identify sleep-regulatory neurons downstream of P1 neurons. Yeast-deprived males exhibited attenuated female-induced nighttime sleep loss yet normal daytime courtship, which suggests male flies consider nutritional status in deciding whether the potential benefit of pursuing female partners outweighs the cost of losing sleep. Trans-synaptic tracing and calcium imaging identified dopaminergic neurons projecting to …

Nipple Sparing Mastectomy: A Review Of Outcomes At A 1 Single Institution, Steven Woodward, Md, Alliric Willis, Melissa Lazar, Adam C. Berger, Theodore Tsangaris

Department of Surgery Faculty Papers

Introduction

Nipple sparing mastectomy (NSM) offers patients who are not candidates for breast conserving treatment an aesthetically pleasing alternative to traditional mastectomy. Some studies have demonstrated its oncologic safety while others have demonstrated residual occult tumor cells at the nipple areolar complex (NAC). These data prompt further review of oncologic outcomes after NSM.

Methods

A single institution retrospective chart review of all NSMs performed by 4 breast surgeons at Thomas Jefferson University Hospital over a span of 2012-2019. In this cohort we review the reconstruction performed, axillary lymph node status, surgical margins, final pathology, loss of the NAC, recurrence rates, …

A Systematic Approach To Big Data Analysis In Cataract Patients In Telangana State, India, Amna Alalawi

Full-Text Theses & Dissertations

Big data is the new gold, especially in healthcare. Advances in collecting and processing Electronic Medical Records (EMRs), coupled with increasing computer capabilities have resulted in an increased interest in the use of big data in healthcare. Big data require collection and analysis of data at an unprecedented scale and represents a paradigm shift in healthcare, offering on one hand the capacity to generate new knowledge more quickly than traditional scientific approaches, and, on the other hand, a holistic understanding of specific illnesses when socio-demographics are incorporated in the analysis. Big data promises more personalized and precision medicine for patients …

Virtual Connectivity During Quarantine: The Role Of Social Media For Radiation Oncology During Covid-19, Miriam A Knoll, Mudit Chowdhary, Adam Dicker, Thomas Eichler

Kimmel Cancer Center Faculty Papers

No abstract provided.

Progress In The Therapy Of Myasthenia Gravis: Getting Closer To Effective Targeted Immunotherapies, Marinos Dalakas

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: To provide an update on immunomodulating and immunosuppressive therapies in myasthenia gravis and highlight newly approved, or pending approval, therapies with new biologics.

RECENT FINDINGS: Preoperative IVIg is not needed to prevent myasthenic crisis in stable myasthenia gravis patients scheduled for surgery under general anesthesia, based on controlled data. Rituximab, if initiated early in new-onset myasthenia gravis, can lead to faster and more sustained remission even without immunotherapies in 35% of patients at 2 years. Biomarkers determining the timing for follow-up infusions in Rituximab-responding AChR-positive patients are discussed. Most patients with MuSK-positive myasthenia gravis treated with Rituximab …

Unexpected Brain Imaging Findings In Patients With Seizures, Boulenouar Mesraoua, Matthias Koepp, Bernhard Schuknecht, Dirk Deleu, Hassan J Al Hail, Gayane Melikyan, Lubna Elsheikh, A A Asadi-Pooya

Department of Neurology Faculty Papers

New imaging technologies have advanced our ability to localize the epileptogenic zone in patients with epilepsy. As a result of the constant improvement of the image quality, magnetic resonance imaging (MRI) has become the most important ancillary tool in the management of patients with epilepsy. Magnetic resonance imaging for the evaluation of patients with epilepsy should be done using a special temporal lobe protocol and read by physicians experienced with the findings in patients with epilepsy. On the other hand, in the healthy populations, incidental structural brain abnormalities have been reported in 18% of people. Incidental, subtle, or unexpected structural …

Photodynamic Therapy In Ocular Oncology., Mehdi Mazloumi, Lauren A Dalvin, Seyed-Hossein Abtahi, Negin Yavari, Antonio Yaghy, Arman Mashayekhi, Jerry A Shields, Carol L Shields

Wills Eye Hospital Papers

Over the past two decades, we have witnessed the increasing use of photodynamic therapy (PDT) in the field of ocular oncology. Based on a review of the literature and our own experience, we herein review the role of PDT for the management of intraocular tumors. The discussion includes two main topics. First, we discuss the application of PDT for benign tumors, including circumscribed choroidal hemangioma, choroidal osteoma, retinal astrocytoma, retinal capillary hemangioma (retinal hemangioblastoma), and retinal vasoproliferative tumor. Second, we assess the role of PDT for malignant tumors, including choroidal melanoma and choroidal metastasis.

Barriers To Psychosocial Support And Quality Of Life For Patients With Inflammatory Bowel Disease: A Survey Study, Rebecca Lawrence, Md, Cuckoo Choudhary, Md

Department of Medicine Faculty Papers

Background: Psychological comorbidities are common among people with inflammatory bowel disease (IBD) and are associated with worse disease outcomes. Evidence-based psychotherapy is an effective means to increase psychosocial support. This study aimed to identify the barriers to attending psychotherapy.

Methods: This electronic survey study included a demographic, quality of life, and barriers to psychotherapy questionnaire. Quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Barriers were assessed using the Perceived Barriers to Psychological Treatments scale (PBPT). Linear regression was used to identify participant characteristics associated with higher PBPT scores.

Results: One hundred eighty-seven …

Announcing The Isev2020 Special Achievement Award Recipients: Andrew Hill And Edit Buzás; And The Recipient Of The Isev2020 Special Education Award: Carolina Soekmadji., Kenneth W Witwer, Lucia R Languino, Alissa M Weaver, Marca H Wauben

Kimmel Cancer Center Faculty Papers

No abstract provided.