Emerging reports are painting a far more complex picture of clinical presentations for COVID-19 than previously thought, stemming to exceptionally high viral loads in nasal cavities. How will this affect the risk profile for otolaryngologists performing essential ENT procedures?
Published March 27, 2020
Twelve years after performing the first transcatheter aortic valve replacement, Penn Medicine continues to gain momentum in the transformation of cardiovascular transcatheter therapies. Dr. Howard Herrmann recounts the evolution in alternative technologies to improve patient safety and outcomes and the role these advancements have in shaping how we approach treatment.
Improving his patients’ post-surgical experience was Dr. Suhail Kanchwala's goal when he sought to develop a new method for autologous breast reconstruction. The result of his search has brought a new technique to the field, along with an array of benefits for patients, including reduction of post-surgical pain and opioid use.
To explore the origin of our country’s opioid epidemic, Mark Masselli and Margaret Flinter speak with Pulitzer Prize-winning Barry Meier, author of Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic which dives into the pivotal role Purdue Pharma, makers of the narcotic OxyContin, played in the greatest public health crisis of the 21st century.
Dr. Brian McDonough is joined by Dr. Mark Zucker, Director of the Cardiothoracic Transplantation Program at RWJBH/Newark Beth Israel Medical Center, and his HCM patient and founder of the Hypertrophic Cardiomyopathy Association, Lisa Salberg, to discuss her inspiring story and the importance of early diagnosis.
Quite suddenly, Bob Mitchell became very sick. He would endure three near-fatal episodes of ventricular tachycardia due to a heart muscle comprised of 54% scar tissue, as well as heart surgeries, two harrowing months of waiting on the transplant list for a new heart on life-supporting IV drips (during which time a malignant tumor was detected in his kidney), partial nephrectomy surgery to remove the cancer, another month of waiting, a 12-hour heart and kidney transplant surgery, and 100 days on life support in four different hospitals.
Host Dr. Maurice Pickard talks with novelist Bob Mitchell, author of Time for a Heart-to-Heart: Reflections on Life in the Face of Death about his inspiring story of the triumph of hope in the face of the direst of circumstances.
Spinal deformity places strain on the vertebrae and supporting muscles, tendons, ligaments, and tissues supporting the spinal column. The treatment and management of this condition becomes centrally important to maintain patient quality of life through functional mobility and activity levels.
Host, Dr. Barry Mennen and Dr. Comron Saifi discuss the leading assessment and treatment options for spinal deformity. Dr. Saifi is an Assistant Professor of Orthopaedic Surgery in the Division of Spine Surgery at the Perelman School of Medicine at the University of Pennsylvania.
A Gastrointestinal Stromal Tumor (GIST) is a rare sarcoma that begins in the digestive tract or stomach, with an incident rate in the United States of approximately 4,000 to 6,000 cases per year. Since these tumors behave differently from other gastrointestinal cancers, they require a specialized treatment plan.
Host Dr. Shira Johnson chats with Ronald DeMatteo, MD, FACS, Chair of the Department of Surgery and a surgical oncologist at Penn Medicine. They discuss the diagnosis, treatment and current clinical research of GIST. Dr. DeMatteo is a world-renowned surgical expert and researcher for the rare GIST. His research breakthroughs helped develop the new standard of care for GIST.
Physicians spend their entire careers striving to heal sick patients. But when these care providers become patients themselves, the abrupt reversal of roles can make for difficult adjustments.
Host Dr. Shira Johnson sits down with Dr. John Mulligan, VP for Emergency Room Physicians Medical Group and a practicing emergency physician, to share his experience, takeaways, and advice for transitioning from doctor to patient.
Anti-TNFα Treatment After Surgical Resection for Crohn's Disease Is Effective Despite Previous Pharmacodynamic Failure
Assa A1, Bronsky J, Kolho KL, Zarubova K, de Meij T, Ledder O, Sladek M, van Biervliet S, Strisciuglio C, Shamir R.
The outcome of patients with Crohn's disease who failed anti-tumor necrosis factor alpha (anti-TNFα) therapy despite adequate serum drug levels (pharmacodynamic failure) is unclear. We aimed to assess such pediatric patients who underwent intestinal resection and were re-treated with the same anti-TNFα agent postoperatively.
Pediatric patients with Crohn's disease who underwent intestinal resection and were treated with anti-TNFα agents postoperatively were assessed retrospectively. Patients were stratified to those with preoperative anti-TNFα pharmacodynamic failure and those with no preoperative anti-TNFα treatment.
A total of 53 children were included, 18 with pharmacodynamic failure and 35 controls. Median age at intestinal resection was 14.8 years with 23 (43%) girls. The median time from intestinal resection to anti-TNFα initiation was 8 months (interquartile range 4-14 months). At the time of postoperative anti-TNFα initiation, there were no differences in clinical, laboratory, and anthropometric measures between groups. Similar proportions of patients from both groups were in clinical remission on anti-TNFα treatment after 12 months and at the …
The surgical field is always being improved by cutting edge technology, but the processes used to connect surgical centers to hospitals lack innovation. Dr. Matt Birnholz sits down with Harold Mondschein, CEO and Co-Founder of Medtel Inc. to discuss methods of improving surgical outcomes by capturing structured data. Through better analytics, healthcare providers can better coordinate surgical care while reducing costs and inefficiencies.
When should surgery be considered as a treatment option for patients with Crohn’s or colitis? Host Rebecca Kaplan of the Crohn’s and Colitis Foundation is joined by Dr. Michael Kwiatt, Assistant Professor of Surgery at Cooper University Hospital in New Jersey, to discuss when to consider surgery. Additionally, he will touch on the common surgical complications and differences in surgical approach for patients with respective diseases.
Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease in Patients Naïve to or Who Have Failed Tumor Necrosis Factor Antagonist Therapy.
Sands BE1, Sandborn WJ, Van Assche G, Lukas M, Xu J, James A, Abhyankar B, Lasch K.
Vedolizumab is a gut-selective α4β7 integrin antagonist for the treatment of moderately to severely active Crohn's disease (CD). Aims of this study were to characterize the efficacy and safety of vedolizumab induction and maintenance therapy in patients who were naïve to tumor necrosis factor-alpha (TNF-α) antagonist therapy (TNF-naïve) or who had discontinued TNF-α antagonist therapy because of inadequate response (i.e., primary nonresponse), loss of response, or intolerance (collectively classified as the TNF-failure population).
Post hoc analyses of the efficacy data for 516 TNF-naïve and 960 TNF-failure patients from the GEMINI 2 and GEMINI 3 trials were evaluated at weeks 6, 10, and 52 and included clinical remission (CD Activity Index [CDAI] score ≤150), enhanced clinical response (≥100-point decrease from baseline in CDAI score), durable clinical remission (remission at ≥80% of visits), and corticosteroid-free remission. Adverse events were summarized for the TNF-naïve and TNF-failure subgroups by treatment received.
Among patients who responded to vedolizumab induction at week 6, 48.9% …
Recorded on location at the Crohn’s & Colitis Foundation’s Annual Meeting in Orlando, host Dr. Lea Ann Chen, Assistant Professor of Medicine at New York University, discusses surgical indications for the IBD patient with Dr. Miguel Regueiro, Professor of Medicine at the University of Pittsburgh.
Dr. Andrew Wilner chats with Dr. Steven Neal, board certified ENT surgeon and Fellow of the American Academy of Facial Plastic and Reconstructive Surgery. Dr. Neal is a Clinical Instructor at the Oregon Health Science Center in Portland, OR, who also serves on the faculty of the Art of Rhinoplasty Course in San Francisco, CA. He teaches a seminar called "Aesthetics Boot Camp for Surgeons." and has taught hundreds of surgeons over the past 25 years to apply the "art" that must be combined with medical science to achieve optimal results with plastic surgery.
Severe ulcerative colitis continues to cause frequent medical emergencies requiring hospitalization for optimal management. Host Dr. Caren Heller, Chief Scientific Officer at the Crohn's & Colitis Foundation, discusses several medical rescue therapies for severe ulcerative colitis in the hospital setting with Dr. Adam Cheifetz, Associate Professor of Medicine at Beth Israel Deaconess Medical Center.
Back and neck pain is extremely common, with 80-90% of people experiencing some pain within their lifetime. About 90% of cases resolve within six weeks, but for those patients whose pain persists, questions arise as to who should be referred next for further consultation. While patients often see a spine specialist at first, the care journey sometimes leads to a neurosurgeon or orthopaedic spine surgeon. Can this pathway from primary care to neurosurgery or orthopaedic surgery ever be expedited?
Dr. Patrick Connolly, neurosurgeon at Penn Medicine joins host Dr. Matt Birnholz to discuss when primary care physicians should consider referring patients to neurosurgeons for neck and back pain. Dr. Connolly will also discuss the different types of surgical options for patients seeking prolonged back and neck pain relief.
Hosts Dr. John Russell and Dr. Amy Mackey sit down to reflect on their individual and shared experiences participating in medical missions from their respective vantage points of family medicine and obstetrics & gynecology.
Dr. Taine Pechet, chief of surgery at Penn Presbyterian Medical Center and associate professor of clinical surgery at Penn Medicine joins host Dr. Matt Birnholz to discuss his thoughts on who should be regularly screen for lung cancer and the various diagnostic techniques from his perspective as a thoracic surgeon. Dr. Pechet also discusses the surgical outcomes for these patient and his thoughts on what is on the horizon for the lung cancer field.
Host Dr. Matt Birnholz welcomes Dr. Paris D. Butler, who will be discussing breast reduction surgery for women who suffer from chronic back pain and breast cancer patients undergoing reconstructive surgery following a diagnosis. Dr. Butler will go into detail about the pros and cons of taking an immediate versus a delayed reconstruction approach and the various techniques associated.
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