Medical Specialties Commons^™

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 …

Reviving Focused Scrutiny In The Constitutional Review Of Public Health Measures, Robert Gatter

All Faculty Scholarship

This article re-examines the "focused scrutiny" standard proposed by Prof. Scott Burris in 1989 and argues for its application particularly during an infectious disease emergency such as the COVID-19 pandemic. Focused scrutiny seeks to tie judicial review of the constitutionality of public health measures closely to the facts of the particular disease and to evidence of the efficacy of each governmental action to prevent the spread of that disease, even when courts adopt rational basis testing.

Employee Testing, Tracing, And Disclosure As A Response To The Coronavirus Pandemic, Matthew T. Bodie, Michael Mcmahon

All Faculty Scholarship

As the COVID-19 pandemic continues to devastate the United States, the federal government has largely failed to implement a national program to prevent and contain the virus. As a result, many employers have undertaken their own workplace coronavirus mitigation efforts. This essay examines, in three parts, the legal framework surrounding employer systems of workplace testing, tracing, and disclosure. It first examines the legal issues surrounding employer-mandated COVID-19 testing and temperature checks, especially issues arising under the Americans with Disabilities Act (ADA) and Health Information Portability and Accountability Act (HIPAA). Regarding employer contact tracing efforts, the essay next reviews the multitude …

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 …

The Case For Face Shields: Improving The Covid-19 Public Health Policy Toolkit, Timothy L. Wiemken, Ana Santos Rutschman, Robert Gatter

All Faculty Scholarship

As the United States battles the later stages of the first wave of COVID-19 and faces the prospect of future waves, it is time to consider the practical utility of face shields as an alternative or complement to face masks in the policy guidance. Without face shields specifically noted in national guidance, many areas may be reluctant to allow their use as an alternative to cloth face masks, even with sufficient modification.

In this piece, we discuss the benefits of face shields as a substitute to face masks in the context of public health policy. We further discuss the implications …

Examining The Role Of Metabolic Pathways As Therapeutic Modalities For Triple Negative Breast Cancer, Jeremy Andrew Johnson

Theses and Dissertations--Toxicology and Cancer Biology

Triple negative breast cancer (TNBC) comprises 15-20% of breast cancers, affects a younger patient population than other subtypes, and is very aggressive. TNBC is comprised of a diverse group of tumors that have proven refractory to targeted therapy and can be difficult to treat. Patients generally receive neoadjuvant chemotherapy (NAC), surgery, and radiotherapy. The standard of care for NAC includes a taxane, an anthracycline, and/or cyclophosphamide, and administration of NAC has resulted in pathological complete response (pCR) in 30-40% of patients. However, a majority of TNBC patients will not reach pCR and instead have residual disease (RD), which is associated …

Be Covid Safe, Opeyemi Akinrinsola, Abigail Corkum, Karyn Furcolo, Christina Gareis, Dorothy Tang

Foundations of Public Health - Infographics

No abstract provided.

Guide To Mask Wearing 101, Laiquannah Hason, Jeremiah Kinsey, Kevin O'Connor

Foundations of Public Health - Infographics

No abstract provided.

"I Don't Like Wearing A Mask", Priyanka Bhatt, Devesh Dajee, Neha Jha, Ruhi Shah

Foundations of Public Health - Infographics

No abstract provided.

The 3 W'S To Staying Safe On & Off Campus During Covid-19, Amanda Guth, Matthew Kermitz, Kate Minke, Raya Patel

Foundations of Public Health - Infographics

No abstract provided.

Controlling The Waves Of Covid-19, Joseph M. Callaghan, Emily Mcdermott, Sofia Mitro, Christopher Stuever

Foundations of Public Health - Infographics

No abstract provided.

Spread Holiday Cheer, Not Covid-19, Sameh Gomaa, Sana Khalid, Michelle St. Omer Roy

Foundations of Public Health - Infographics

No abstract provided.

It's Your Responsibility, Simon Chen, Devanshi Dash, Jaime Nassur

Foundations of Public Health - Infographics

No abstract provided.

Digest Of The Philadelphia College Of Osteopathic Medicine, Philadelphia College Of Osteopathic Medicine

PCOM Digest 2020s

The (2020 No. 2) issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Updates

• Institutional Heritage: Celebrating a Golden Jubilee, Marking a Retirement

• Feature: PCOM Heroes of the Front Lines

• Feature: Exams May Be Cancelled, But Humanity Is Not: A Medical Student Perspective on the COVID-19 Pandemic

• Class Notes

• Obituaries: Lost on the Front Lines

Digest Of The Philadelphia College Of Osteopathic Medicine, Philadelphia College Of Osteopathic Medicine

PCOM Digest 2020s

The (2020 No. 1) issue of the digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• Updates

• Institutional Heritage: Founders’ Day 2020

• Marking a New Era of Healthcare Education in South Georgia

• Southwest Georgia: A Sense of Place

• Health Care in Rural Georgia

• Class Notes

Host Transcriptional Response To Persistent Infection With A Live-Attenuated Porcine Reproductive And Respiratory Syndrome Virus Strain, Jayeshbhai Chaudhari, Chia-Sin Liew, Aspen M. Workman, Jean-Jack Riethoven, David J. Steffen, Sarah Vitosh-Sillman, Hiep Vu

Nebraska Center for Virology: Faculty Publications

Both virulent and live-attenuated porcine reproductive and respiratory syndrome virus (PRRSV) strains can establish persistent infection in lymphoid tissues of pigs. To investigate the mechanisms of PRRSV persistence, we performed a transcriptional analysis of inguinal lymphoid tissue collected from pigs experimentally infected with an attenuated PRRSV strain at 46 days post infection. A total of 6404 differentially expressed genes (DEGs) were detected of which 3960 DEGs were upregulated and 2444 DEGs were downregulated. Specifically, genes involved in innate immune responses and chemokines and receptors associated with T-cell homing to lymphoid tissues were down regulated. As a result, homing of virus-specific …

Individual And Joint Effects Of Metformin And Statins On Mortality Among Patients With High-Risk Prostate Cancer., Xiang-Lin Tan, Jian-Yu E, Yong Lin, Timothy R Rebbeck, Shou-En Lu, Mingyi Shang, William K Kelly, Anthony D'Amico, Mark N Stein, Lanjing Zhang, Thomas L Jang, Isaac Yi Kim, Kitaw Demissie, Anna Ferrari, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

BACKGROUND: Pre-clinical studies suggest that metformin and statins may delay prostate cancer (PCa) metastases; however, data in humans are limited. To the best of our knowledge, this is the first human study aimed to quantify the individual and joint effects of statin and metformin use among patients with high-risk PCa.

METHODS: This population-based retrospective cohort study identified patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Exposure to metformin and statins was ascertained from Medicare Prescription Drug Event files. The association with all-cause and PCa mortality were evaluated using Cox proportional hazard model with competing causes of death, …

Unusual Infectious Metastases Secondary To Acupuncture Induced Mssa Septicemia, Kayla Chory, Neil Bobenhouse, Maria Pena, Adwait Mehta

Faculty, Staff and Student Publications

We describe a rare case of methicillin-sensitive

Evaluating Historical Paradigms Of Sterility In Perinatal Microbiology And Ramifications For Pregnancy Outcomes, Jonathan Greenberg

Wayne State University Dissertations

Next-generation sequencing technologies, especially 16S rRNA gene and metagenomic sequencing have allowed investigations of low microbial biomass tissues of the human body. While these sequencing methodologies have provided large amounts of reliable data for higher microbial biomass sites, such as the mouth, intestine, and vagina, tissues of low microbial biomass sites are subject to specific caveats that were not appropriately considered in early investigations of these sites. Low microbial biomass sites of particular interest have included those of the reproductive and urinary systems. Utilization of DNA sequencing methodologies have allowed researchers to challenge existing paradigms of sterility around these sites …

Hormonal Regulation Of Glycine Decarboxylase And Its Metabolic Outcomes, Ruta Milind Jog

Wayne State University Dissertations

The amino acid glycine is involved in generation of multiple critical metabolites including glutathione, heme, and creatinine. Interestingly, in both humans and rodents, circulating glycine levels are significantly reduced in obesity, glucose intolerance, type II diabetes and non-alcoholic fatty liver disease. The glycine cleavage system is the predominant glycine degradation pathway in humans. The rate-limiting enzyme of glycine cleavage system is glycine decarboxylase (GLDC), and loss-of-function mutations of GLDC cause hyperglycinemia. Here, we show that GLDC gene expression is upregulated in livers of mouse models of diabetes and diet-induced obesity as well as in the fasted state in normal animals. …

Effect Of Hiv Prevalence And Gender On Cardiovascular Disease Deaths, Tanjeev Ahmad

Scholarship in Medicine - All Papers

Cardiovascular disease is a widely diagnosed condition that can have many etiologies and factors that changes its prognosis. This project was aimed at investigating two potential factors that changes its prognosis: HIV status and gender. Data on HIV status was collected from NCHHSTP AtlasPlus for all US states and territories and data on cardiovascular disease deaths and corresponding gender was collected from Interactive Atlas of Heart Disease and Stroke for all US states and territories. Using a linear regression test, a correlation was tested for between HIV status and cardiovascular disease deaths for every US state/territory followed by a test …

Quality Improvement: Patient Education For Management Of Hypertension In Pregnancy, Kriti Goel

Scholarship in Medicine - All Papers

Objective: We introduced maternal hypertension education tools that address illiteracy in underserved populations. Through these tools, we aim to improve patients’ knowledge of their conditions. We also aim to determine if healthcare providers perceive a benefit to the use of the tools. Ultimately, we hope these changes will lead to better short- and long-term health outcomes for mother and child.

Methods: Pregnant women with any form of hypertension at Five Rivers Center for Women’s Health (FRHC) were surveyed during OB visits. The Patient Questionnaire includes objective knowledge questions on their condition and self-reported comprehension questions. Forty-five women were surveyed during …