115,254 research outputs found
On the Job: Tina Nichols
As Office Supervisor in the Division of Transplant Surgery, Tina Nichols spends her days tackling a variety of time-sensitive tasks â from setting up meetings and working on provider credentialing to sorting out billing issues and scheduling patients for surgery. She supports five surgeons, a physician assistant and a nurse practitioner across their academic and clinical responsibilities, including both transplant and general surgery cases.
Nichols joined the Division of Transplant Surgery in 2015 after spending more than four years with Jeffersonâs Department of Radiation Oncology. Prior to that, she worked for a private OB-GYN practice for seven years. She credits that initial job experience for familiarizing her with nearly every aspect of medical office management, including handling medical records, supervising filing staff and overseeing appointment scheduling. Most of all, she says, it taught her how to tackle challenges on the fly â and work well under pressure.
To be sure, the stakes are high for many patients served by the Division of Transplant Surgery. For Nichols, helping those patients is one of the best parts of her job.
âTransplant patients could be on the list for several years,â she says. âItâs so rewarding to support a team that works tirelessly to help people get a second chance at a normal life.â
While Nichols doesnât provide clinical care, she always strives to deliver a positive patient experience: âI like patients to know they can call me and I will help them get what they need. They shouldnât face any additional stress or hardship when theyâre already going through what is often a very difficult time.â
A South Jersey native, Nichols will graduate from Thomas Jefferson University with a Bachelor of Science in Health Services Management this December. When not working or studying, she spends time with her fiancé, Pat, and enjoys her longstanding passion for the performing arts, especially singing
Cardiac transplantation : an evolving practice
When Barnard performed the first orthotopic transplant he became an instant celebrity. By todayâs standards the method of retrieval was daring and fraught with risk. In this article the author starts by explaining the first attempted heart transplant being performed in 1968. Heart transplantation still provides the best outcome and 5 year survival in established centres now approximates 65%. The immediate success of surgery is directly related to the correct choice of the ideal donors and recipients.peer-reviewe
Transplant Surgery Pipeline: A Report from the American Society of Transplant Surgeons Pipeline Taskforce
BACKGROUND: Transplant surgery fellowship has evolved over the years and today there are 66 accredited training programs in the US and Canada. There is growing concern, however, about the number of US-trained general surgery residents pursuing transplant surgery. In this study, we examined the transplant surgery pipeline, comparing it with other surgical subspecialty fellowships, and characterized the resident transplantation experience.
METHODS: Datasets were compiled and analyzed from surgical fellowship match data obtained from the National Resident Matching Program and ACGME reports and relative fellowship competitiveness was assessed. The surgical resident training experience in transplantation was evaluated.
RESULTS: From 2006 to 2018, a total of 1,094 applicants have applied for 946 transplant surgery fellowship positions; 299 (27.3%) were US graduates. During this period, there was a 0.8% decrease per year in US-trained surgical residents matching into transplant surgery (p = 0.042). In addition, transplant surgery was one of the least competitive fellowships compared with other National Resident Matching Program surgical subspeciality fellowships, as measured by the number of US applicants per available fellowship position, average number of fellowship programs listed on each applicant\u27s rank list, and proportion of unfilled fellowship positions (each, p \u3c 0.05). Finally, from 2015 to 2017, there were 57 general surgery residency programs that produced 77 transplant surgery fellows, but nearly one-half of the fellows (n = 36 [46.8%]) came from 16 (28.1%) programs.
CONCLUSIONS: Transplant surgery is one of the least competitive and sought after surgical fellowships for US-trained residents. These findings highlight the need for dedicated efforts to increase exposure, mentorship, and interest in transplantation to recruit strong US graduates
Effects of Perceived Treatment on Quality of Life and Medical Outcomesin a Double-blind Placebo Surgery Trial
Context This study was part of a large double-blind sham surgeryâcontrolled trial designed to determine the effectiveness of transplantation of human embryonic dopamine neurons into the brains of persons with advanced Parkinson\u27s disease. This portion of the study investigated the quality of life (QOL) of participants during the 1 year of double-blind follow-up.
Objectives To determine whether QOL improved more in the transplant group than in the sham surgery group and to investigate outcomes at 1 year based on perceived treatment (the type of surgery patients thought they received).
Design Participants were randomly assigned to receive either the transplant or sham surgery. Reported results are from the 1-year double-blind period.
Setting Participants were recruited from across the United States and Canada. Assessment and surgery were conducted at 2 separate university medical centers.
Participants A volunteer sample of 40 persons with idiopathic Parkinson\u27s disease participated in the transplant ( parent ) study, and 30 agreed to participate in the related QOL study: 12 received the transplant and 18 received sham surgery.
Interventions Interventions in the parent study were transplantation and sham brain surgery. Assessments of QOL were made at baseline and 4, 8, and 12 months after surgery.
Main Outcome Measures Comparison of the actual transplant and sham surgery groups and the perceived treatment groups on QOL and medical outcomes. We also investigated change over time.
Results There were 2 differences or changes over time in the transplant and sham surgery groups. Based on perceived treatment, or treatment patients thought they received, there were numerous differences and changes over time. In all cases, those who thought they received the transplant reported better scores. Blind ratings by medical staff showed similar results.
Conclusions The placebo effect was very strong in this study, demonstrating the value of placebo-controlled surgical trials
Those who Give: Art and Gail Pasquarella Support Jefferson Transplant Institute
Art Pasquarella is a donor in every sense of the word. He gave a kidney as a living donor to one of his brothers. He gives his time as a volunteer for the National Kidney Foundation. And he and his wife, Gail, have made a very generous gift to support the vision for the Jefferson Transplant Institute.
As Art explains, the Pasquarellas had more than one reason to support transplant services at Jefferson. The first reason was a kidney transplant for Artâs late father, Valentino H. Pasquarella, Sr., in the mid-1990s. âJefferson did a fabulous job for my father,â Art recalls, âThat started our familyâs affinity toward Jefferson.â
Some 15 years later, Artâs oldest brother, Valentino H. Pasquarella, Jr., was suffering from another type of kidney disease, which had developed from an illness during infancy. Art and his other brother, Joe, underwent the battery of tests to determine compatibility. After discovering that he was a 100 percent match, Art signed on to be a living donor. In November 2010, Adam Frank, MD, FACS, and Carlo Gerardo Ramirez, MD, FACS, operated on Art and Val, respectively. The operations were both successful, and today the Pasquarella family continues to enjoy spending time together. Art is thankful that his big brother still joins him at the table: âVal has one heck of a sense of humor,â Art laughs. âHeâs the âentertainerâ at our family dinners, and my daughters and nephews are quick to indicate their disappointment if their Uncle Val is going to miss a family dinner.â
When he isnât enjoying time with his family, Art works as executive vice president and chief operating officer of Equus Capital Partners, Ltd., in Center City. Since 2006, he has also been active with the National Kidney Foundation. For two years, he served as chair of the Delaware Valley Board of the National Kidney Foundation. In 2011, he joined the National Board of the National Kidney Foundation and will soon become chair of the National Boardâs Development Committee.
âItâs one thing to support a charity by writing checks and soliciting for donations,â he says. âBeing a living donor has brought it all really close to home. You realize you have the opportunity to actually change someoneâs life.â
With their generous donation, the Pasquarellas hope to change more lives by supporting Cataldo Doria, MD, PhD, FACS, the Nicoletti Family Professor of Transplant Surgery and Director, Division of Transplant Surgery, in developing and implementing the Transplant Institute. As Dr. Doria explains, the Transplant Institute represents a multi-institutional alignment of the transplant programs within the Jefferson Health System: âOur goal is for participating hospitals to collaborate on strategic, clinical, quality and financial initiatives â thereby strengthening our collective performance,â he says. âThe Institute will work to promote standardized clinical pathways and protocols and to deliver a streamlined experience for the patient.â For information about planned giving, or to make a contribution to the Department of Surgery, please contact Lara Goldstein in the Jefferson Foundation at 215-955-8797 or Email Lara Goldstei
Francis Daniels Moore: one of the brightest minds in the surgical field.
Francis Daniels Moore was a pioneer ahead of his time who made numerous landmark contributions to the field of surgery, including the understanding of metabolic physiology during surgery, liver and kidney transplant, and the famous Study on Surgical Services of the United States (SOSSUS) report of 1975 that served for decades as a guideline for development of surgical residencies. He was the epitome of what a physician should be, a compassionate and dedicated surgeon, innovative scientist, and a medical professional dedicated to quality medical education across all specialties
Organ transplantation from deceased donors with cancer: is it safe?
Michael A Nalesnik1, Michael G Ison21Division of Transplantation and Hepatic Pathology, Department of Pathology, University of Pittsburgh Medical Center, Pittsburg, PA, USA; 2Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USAAbstract: The availability of donor organs continues to be insufficient to meet the needs of patients actively waiting for transplant. Consequently, there is continuing pressure to increase the donor organ pool while simultaneously assuring safety for the recipient population. The complication of donor malignancy transmission has been documented almost from the beginning of transplantation, and continues to be a concern today. The anecdotal nature of case reports and compiled series ensures that clinical decisions related to organ use from donors with malignancy will of necessity continue to be made on the basis of low-level evidence. Despite this limitation, the literature indicates that not all donor neoplasms have the same risk for transmission to the recipient, and it is necessary to consider the specific malignancy affecting the donor, as well as the condition of the recipient, before a decision is made to transplant or discard a given organ. Published cases suggest that certain forms of neoplasia, such as melanoma, choriocarcinoma, sarcoma, small cell carcinoma, or metastatic carcinomas serve as strong contraindications to organ donation. In contrast, considerable experience exists to suggest that certain tumors of the central nervous system, small subclinical prostate carcinomas, or small renal cell carcinomas resected prior to transplant, among other tumors, should not in themselves disqualify an individual from donating organs in the appropriate circumstance. This review presents the case for considering organ transplantation in the setting of certain donor malignancies and discusses factors to be weighed in such decisions. Additionally, donors with a history of cancer are considered, and features that may aid in reaching a conclusion for or against transplantation of organs from these patients are presented.Keywords: organ transplantation, donor organs, malignancy, complication
Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2
Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2
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