Primary Care Commons^™

Today's Cigarette And E-Cigarette Landscape, Richard C. Wender, Md

Department of Family & Community Medicine Presentations and Grand Rounds

E-cigarettes are one of the most difficult and complex public health issues most of us have confronted.

Most anti-tobacco experts and advocates line up on a spectrum from embracing e-cigarettes as a promising way to reduce the harm of tobacco products all the way to being the greatest threat to progress in our 60 year war on big tobacco.

Journal Club, Zeynep Uzumcu, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline

• Review coronavirus life-cycle
• Review mechanism of action of remdesivir
• Review previous research on remdesivir
• Close reading of article - Methods - Results - Discussion
• Future research
• Implications for our practice

Breast Cancer Treatment: Basics For The Primary Care Provider, Sarah Hirsh, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. To review the prevalence of breast cancer and the mortality rate of breast cancer in the United States.
2. To understand breast cancer staging and its role in prognostication.
3. To understand the therapies offered for the treatment of non-metastatic, invasive breast cancer and their side effects.
4. To review the role of the PCP in caring for patients undergoing treatment for breast cancer and those in remission.

Improving Osteoporosis Screening Rates In A Primary Care Practice Using An Emr-Based Intervention, Conor Murphy, Ashley Barnes, Rukaiya Bashir, Peter Block

House Staff Quality Improvement and Patient Safety Conference (2020-)

Objective

• Osteoporosis is defined as a T-score ≤ -2.5 on DEXA or history of fragility fracture
• Affects a significant proportion of our population over 65 with an estimated annual cost burden of $22 billion
• Only 46% of females over 65 years of age had been screened for osteoporosis at JHAP
• Our study aims to increase that percentage between July 2019 and July 2020 from 46% to 60%

Identifying Barriers To Statin Therapy In Diabetic Patients In A Large Ambulatory Practice, Jennifer Moyer, Md, Rachel Ehrman-Dupre, Md, Andrew Rabovsky, Md, Simon Newsom, Md, Pooja Padgaonkar, Md, Julita Mitchell, Md, Sarah Hirsh, Md, Madeline Taskier, Md, Robert Wiley, Md, Lilli Flink, Md, Greta Bires, Md, Geoffrey Mills, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aim 1: To understand the root cause(s) for gaps in statin therapy within a large ambulatory care practice.

Aim 2: To improve provider awareness of indications for statin therapy, as recommended by the ACC/AHA guidelines.

Aim 3: To increase the proportion of patients with diabetes at our practice that are on statin therapy.

Cirrhosis For The Pcp, Krys Foster, Md, Mph

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Understand the morbidity and mortality associated with Cirrhosis in the United States
• Recognize etiologies and clinical presentation of cirrhosis
• Identify decompensated cirrhosis and approaches to treatment and monitoring

Agenda

• Definition and Epidemiology
• Etiologies
• Clinical Presentation
• Diagnosis and Evaluation/Classification
• Management of Compensated Cirrhosis
• Decompensated Cirrhosis & Complications
• ○ Portal Hypertension ○ Varices ○ Ascites ○ SBP ○ Hepatorenal Syndrome ○ Hepatic Encephalopathy
• Secondary Prevention and Long Term Management
• Conclusions

Vaccines, Children, And The Public Health Trust, Christopher Chambers, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

1. Review the impact of immunizations on the public health over the past 50 years.
2. Childhood Vaccines Now
3. Describe the challenges associated with trying to eliminate “immunizable” diseases. Examples: Invasive Pneumoccal Disease, Neisseria meningitis
4. The Future

Accelerating Primary Care Transformation At Jefferson (Jeffapct): Reflections From A Five- Year Hrsa Grant, Christine A. Arenson, Md, Amy Cunningham, Phd, Mph, Samantha Kelly, Ma, Randa Sifri, Md

Department of Family & Community Medicine Presentations and Grand Rounds

JeffAPCT Overview

Five year HRSA-funded grant (7/1/15-6/30/20)

Leadership team from Family Medicine, Internal Medicine, Physician Assistant Program

• Objective 1: To improve/ expand primary care and population health curriculum across the continuum of primary care providers and trainees (students, residents, and practitioners)
• Objective 2: To create an enhanced, sustainable model of primary care physician faculty development for PCMH Transformation
• Objective 3: To create a new, sustainable model of faculty development for community-based primary care preceptors (MD/DO, PA, NP, others)

Goals Of Care 101, Alexandra Evans, Do, Adam Pennarola, Md, Elham Siddiqui, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Hospice and Palliative Medicine - Alexandra Evans, DO

Approaching Goals of Care in the Outpatient World - Elham Siddiqui, MD

Inpatient Goals of Care Discussion - Adam Pennarola, MD

Sti & Prep Updates, Marshal Miller, Md, Aahivs, Sunny Lai, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Apply key findings from the DISCOVER trial to PrEP clinical decision-making
• Understand the gaps in PrEP research for cisgender women and adolescents
• Understand the use of on-demand pre-exposure prophylaxis
• Review Current treatment recs and emerging data on Gonococcal and Chlamydial infection
• Discuss diagnostic and management options for non-gonococcal urethritis

Fatigue In Primary Care: Doctor, Why Am I So Tired?, Nina Mingioni, Md

Clinical Education Teaching Tools

Learning Objectives:

1. Identify top causes of fatigue in women
2. Develop an evidence-based approach to assessing a patient with fatigue
3. Reflect on the evidence for available screening tools for fatigue

Primary & Secondary Prevention Of Cardiovascular Disease In Primary Care, Marshall Miller, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Review historical perspective and complexity of primary CVD prevention

Discuss primary & secondary prevention of CAD and the 2019 ACC/AHA guidelines

-- Review of the evidence & primary literature

• Focus on CV risk assessment, DM, ASA/DAPT
• Practical guidance and management considerations

-- CASES- let’s practice and discuss

Male Luts – Introduction And Overview, Thenappan Chandrasekar, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline & Goals

• Background – What are “LUTS”?

• Anatomy

• Pathophysiology

• Storage – bladder filling symptoms
• Voiding – urine flow symptoms
• Post-micturition

• Major etiologies and management

• BPH / BOO
• OAB
• Nocturia

• Related to Prostate Cancer?

Proteinuria, Goni Katz-Greenberg, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline and Objectives

• Definition
• Screening/Measurement
• Etiology
• Treatment