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The American Medical Association's new Physician Practice Benchmark Survey shows a surge in telehealth adoption between 2018 and 2020, driven by the shift from in-person to virtual care during the pandemic. By Eric Wicklund Originally Posted on mHealth Intelligence Telehealth use by physicians jumped from 25 percent in 2018 to almost 80 percent in 2020, while almost 85 percent of psychiatrists connected with the patients via video visit or telephone during the height of the pandemic, according to the American Medical Association. The data contained in the AMA’s latest Physician Practice Benchmark Survey falls in line with dozens of similar studies and surveys, all showing that the use of connected health platforms soared last year as providers looked to shift as much care as possible from in-person to virtual care. Drawing from the responses of thousands of post-residency physicians across the country, the survey found that video-based visits jumped from 14.3 percent in 2018 to 70.3 percent in 2020 while 67 percent connected with patients last year via phone. Almost 60 percent used telehealth in 2020 for chronic care management, up from about 20 percent in 2018, and the amount of physicians who used telehealth to diagnose or treat patients increased from 15.6 percent to 58 percent. Remote patient monitoring jumped as well, with 20 percent of physicians say they used RPM in 2020, almost twice as many as in 2018. Broken down further, one-third of specialists used RPM, led by cardiologists (63.3 percent) and endocrinologists and diabetes care physicians (41.6 percent). The use of asynchronous, or store-and-forward, telehealth didn’t change much over the past few years, suggesting that much of the growth in telehealth was tied to reducing in-person care. Physicians also turned to telemedicine to consult with colleagues, though not as much as they use the technology to connect with patients. Some 26.2 percent worked in a practice that used videoconferencing to consult with colleagues in 2020, up from 11.6 percent in 2018, with 17.2 percent using the platform to consult with other healthcare professionals (11.6 percent in 2018) and 12 percent using the platform for second opinions (6.9 percent in 2018). Broken down into physician types, psychiatrists were most likely to adopt telehealth, while the three categories of primary care specialties – pediatricians, family/general practice physicians and general internists – all scored above 76 percent. Pediatricians were less likely than the other two to use the phone, manage patients with chronic care needs or offer preventive medicine. Dermatologists topped the list of those using video visits, at 87.3 percent, following by urologists at 87.2 percent. Among other specialists, endocrinologists and diabetes care physicians reported the highest use of telehealth to diagnose or treat patients (almost 72 percent), provide care management (92.1 percent) and provide preventive care (52.6 percent). And while 88.5 percent of hematologists and oncologists used video visits, only 68 percent used the phone. Finally, more than half of the gastroenterologists, nephrologists and neurologists in the survey said they used telehealth to provide acute care. “Research conducted over the past year illustrated telehealth’s role in allowing patients to retain access to care during the COVID-19 pandemic,” the report noted. “In turn, the use of telehealth and the expanded rules around coverage and payment for it allowed physician practices to keep their revenue streams positive rather than at or near zero and to remain open to serve their patients.” While these percentages are all high, they reflect telehealth use at the height of the pandemic. More recent studies have placed telehealth use at around 20 percent as patients shift back to in-person care and providers look to create a hybrid strategy that balances in-person and virtual care. It also speaks to the many federal and state emergency actions enacted during the pandemic to expand telehealth access and coverage, giving providers more incentive to use connected health. Most of those measures have ended or will end with the public health emergency, putting pressure on both states and Congress to establish a long-term telehealth policy that will keep the momentum going.

Preparing for work or a night out with friends or a partner might have previously meant putting on some makeup, spending a little extra time on your hair and generally a lot of time primping in front of the bathroom mirror. But in the midst of a pandemic, this getting ready routine has gotten a lot easier; for most of us, it means picking out a face mask and heading out the door. But with a mask that covers the majority of your face, you might be starting to focus on some of the little things that you’ve been ignoring or overlooking—namely, your eyes. Several cosmetic surgeons and dermatologists are reporting increased patient interest in cosmetic procedures like Botox and eyelid lifts. During COVID-19, your eyes have truly become a window to the world—and you want to make sure they look good! According to Catherine Weng, MD, who is board-certified in both facial plastic and reconstructive surgery and otolaryngology, there are many options for anyone who is interested in making their eyes stand out from above a mask. “There are many surgical and non-surgical options for people who are looking to improve their appearance,” says Dr. Weng, who sees patients at Main Line Health King of Prussia. “Depending on your health, your skin type and what you’re looking for there are many options available that can reduce fine lines and wrinkles and improve the appearance of your eyes and the surrounding area.” At her office in King of Prussia, Dr. Weng offers browlifts, facelifts, eyelid surgeries as well as injectables and fillers. And while procedures like these may be trendy right now, they’re nothing new. “We see patients of all ages and they’re coming to us for various reasons,” says Dr. Weng. “For some people, these can help correct facial injuries or traumas but for others, these surgeries are primarily cosmetic. Whatever the reason, these offer our patients the benefit of confidence and improved self-esteem.” You may not be ready to commit to surgery just yet, but there are some steps you can take to make your eyes pop while the majority of your face is masked. Dr. Weng offers her advice for maintaining healthy, vibrant skin around the eyes: Sun protection: You know how important sun protection is for keeping your skin healthy, yet many people still do not use a broad spectrum sunscreen on a daily basis. Even during winter, your eyes are exposed to the sun. Make sure they’re protected by wearing sunscreen on your face or a moisturizer that contains SPF. Be gentle: The skin around your eyes is six to 10 times thinner than the skin in other areas of your face. Avoid scratching, rubbing or pulling on the area to prevent wrinkles. Instead, if you’re applying a product, use your pinky finger to gently dab and rub it into the area. Let makeup soak off: Instead of using wipes to remove your eye makeup—which often require you to pull or tug at your lashes or the skin surrounding your eyes—try letting it soak off. Use a cotton round soaked in makeup remover and press it gently to your eye for 20-30 seconds. It stubborn eye makeup sticks around, use cotton swabs to target these areas. Sleep well, eat well and exercise: An overall healthy lifestyle is good for your skin. Make time for sleep and regular exercise, and limit your intake of salty foods and alcohol, two groups that can cause dehydration and puffiness. Quit smoking: The toxins in cigarette smoking can speed up skin aging and make it more prone to wrinkles. If you’re a smoker quit. If you’re not, avoid secondhand smoke. Are you an international patient? Philadelphia International Medicine serves international patients. To schedule an appointment with a specialist at Main Line Health visit us at philadelphiamedicine.com

If you or a loved one has been diagnosed with cancer, you know how it can adversely affect energy levels. Cancer-related fatigue is a common and debilitating symptom experienced by cancer survivors during and after treatment. It is characterized by an overwhelming, total-body exhaustion that interferes with daily life and can’t be treated with rest alone. This level of chronic fatigue can last months after cancer treatment is complete and can have a negative impact on your social, occupational and general functioning, which may lead to a considerably reduced quality of life. “Cancer-related fatigue is not just a side effect of chemotherapy or radiation,” explains Julie Caldwell, PT, MPT, CLT, a Main Line Health physical therapist and certified lymphedema therapist who works with cancer patients. “It stems from a combination of factors, including emotional distress, financial or family strain, and even secondary complications such as thyroid problems, anemia, pain or hormonal imbalance.” Understanding cancer-related fatigue and treatment Caldwell sees patients at Bryn Mawr Rehab, part of Main Line Health, where therapists work closely with other providers (including referring physicians) to develop an individualized treatment plan, which also includes a customized plan for exercise⏤all designed to help patients with cancer-related fatigue achieve the highest level of independence possible. When you’re treated for cancer-related fatigue at Bryn Mawr Rehab, your team of providers may include: Physical therapists Dietitians Social workers Oncology nurse navigators Radiation and/or chemotherapy oncology nurses For treatment of a variety of cancer-related fatigue conditions, including: Decreased endurance Reduced energy Whole-body tiredness Shortness of breath after light activity Pain Decreased concentration Fatigue after prolonged bed rest Cancer-related fatigue treatments and therapies Therapy for cancer-related fatigue is designed for your unique needs and goals, which may include boosting physical strength and endurance, learning strategies to decrease energy expenditure, and fueling up with adequate nutrition. Therefore, a treatment plan may include components such as: Supervised exercise with vital signs monitored during and after therapy session Education on energy conservation techniques Physical modalities such as heat/cold, soft tissue mobilization and joint mobilization Postural education Core body strengthening Along with management of the complex stressors of cancer, this comprehensive approach allows patients to participate in activities that improve overall quality of life. “Patients need time to heal. It’s a long process,” says Caldwell. “Our program addresses the whole person so you feel empowered during this time. We are with you each step of the way.” Through the program at Bryn Mawr Rehab, you may also receive alternative therapies, such as acupuncture or massage. The therapy team can further connect you to additional community support. Philadelphia International Medicine serves international patients. To find out more about our cancer-related fatigue, rehab programs in support of cancer patients or cancer care, call us at 215.563.4733

Pushing the Limits of Minimally Invasive Rectal Cancer Surgery A colorectal surgery team at Lankenau Medical Center, part of Main Line Health, has reported encouraging results with a first-of-its-kind minimally invasive transanal approach to definitive surgical treatment of rectal cancer. First reported rectal cancer surgeries using a state-of-the-art robotic platform The surgical team, led by John Marks, MD, published its experience with the first two of a series of rectal cancer cases in a prospective study of a novel single-port robotic surgical platform the team is investigating for minimally invasive and transanal surgery across a range of colorectal disease (ClinicalTrials.gov Identifier: NCT03700593). Dr. Marks is the first colorectal surgeon in the world to report clinical experience with this new robotic surgical platform for transanal dissection of rectal cancer. Both rectal cancer cases involved a preoperative stage T3N1 lesion in the lower third of the rectum, a notoriously difficult location in which to perform a precise, oncologically sound resection that is also sphincter­sparing. In both cases, following protocol-directed neoadjuvant chemoradiotherapy, a total mesorectal excision (TME) was completed transanally using the new single-port robotic technology, without conversion or operative complications. The two patients underwent surgery in December 2018 and January 2019, respectively, and received a 6-month course of adjuvant chemotherapy, after which their temporary ileostomies were reversed. At an average of 22.5 months of follow-up, neither patient had experienced local recurrence or distant spread of their disease, morbidity or death. For Dr. Marks, the early positive results are an encouraging sign of what is possible for patients with difficult-to-access rectal cancer. While the new single-port robotic technology is not yet approved by the U.S. Food and Drug Administration for colorectal applications, his published experience documents the feasibility and safety of single-port robotic transanal TME in experienced hands. The challenge of performing a high-quality rectal cancer resection Surgery plays a critical role in the care of patients with rectal cancer but is challenging to perform and poses a risk to sphincter function. A precise and complete TME is critical to achieve oncologic control and to reduce the rate of cancer recurrence. Dr. Marks describes the new single-port robotic surgery platform as a “game-changer” for performing rectal cancer resections and says he believes it can bring quality rectal cancer resection within reach for more surgeons and more patients with rectal cancer. “With its superior dexterity for precise work in the tight bony confines of the pelvis, it brings robotic surgery capabilities to anatomic areas you cannot get to any other way,” he explains. “Also, its excellent optics give us the ability to see and cut and sew better, and we've found that better for the surgeon is better for the patient. “Finally,” he adds, “on top of this we can do these complex operations safely and effectively through a single 1-inch incision or no incision at all.” Dr. Marks sees the emergence of new technology that has allowed him to transanally perform high-quality TME dissections as the culmination of a career of innovation. As he explains, a major focus of his professional career has been the marriage of optimal rectal cancer management with the highest possible quality of life--and the use of new technology to accomplish both. A giant in the fields of minimally invasive colorectal surgery and rectal cancer management, Dr. Marks is committed to sharing knowledge gained through clinical investigations such as the study he and his Lankenau colleagues are conducting on colorectal applications of single-port robotic and transanal robotic surgery. In addition to the initial rectal cancer cases reported this month, the team previously reported its initial clinical experience with single-port robotic left colectomy, single-port robotic right colectomy, and transanal minimally invasive surgery for benign rectal neoplasms. "We're focused on sharing what we've learned with others, so we all learn from each other and get better quickly for our patients,” says Dr. Marks. JOHN MARKS, MD is Chief of Colorectal Surgery at Main Line Health and Director of the Rectal Cancer Program at Lankenau Medical Center, part of Main Line Health. Dr. Marks leads Main Line Health’s multidisciplinary rectal cancer team at Lankenau Medical Center, which is among an elite group of international rectal cancer specialists currently working to define new pathways for improved outcomes in rectal cancer care. Main Line Health’s rectal cancer team has treated more than 1400 patients and frequently publishes findings from systematic follow-up in this patient population.

The surgeon recommended a colonoscopy. But instead of a skin tag, the procedure showed that Diane had a large polyp in her colon. She would need surgery to remove the polyp and part of her colon. Diane would also need to spend a week in the hospital and two months recovering. She was stunned. “I’m 64, and this was the first time I really had any health issue,” Diane says. “I left there in tears, thinking ‘I cannot believe this is happening to me.’ I didn’t want a part of my colon removed. Research indicated a colon resection could create problems for years to come.” Studying up Diane immediately started contacting friends and acquaintances in health care for advice. During those conversations, one name kept coming up: John Marks, MD. Through online research, Diane learned how Dr. Marks, chief of colorectal surgery at Main Line Health, is known internationally for pioneering minimally invasive surgical techniques. She made an appointment for a consultation with him, and in October 2020, after a thorough examination, Diane got what she was hoping for—a better option. Dr. Marks told her she was a candidate for a state-of-the-art procedure he performs at Lankenau Medical Center that enables him to remove select polyps and rectal cancers while preserving the colon. Called single port robotic transanal minimally invasive surgery (SP rTAMIS), it involves removing the polyp entirely through the anus without any abdominal incision. Patients have less postoperative pain, fewer complications and a much faster recovery than with open surgery. “This is really a tremendous story of technology and innovation being brought to the clinical forefront to help our patients have optimal outcomes for colorectal diseases,” Dr. Marks says. Head-of-the-class care Dr. Marks is one of an elite group of surgeons using the latest generation of robotic technology to improve patient care. In fact, Dr. Marks helped develop the procedure Diane would have, and he has the most experience performing the procedure worldwide. The da Vinci® SP surgical system is designed for deep and narrow access through tissue in the body, making it easier for surgeons to maneuver their specialized instruments in a small, confined space. During robotic TAMIS with the da Vinci SP system, these instruments are passed through a single cannula, or thin tube, to the rectum to remove the polyp. The hole in the rectum is then closed with sutures, from the inside out. The ability to enter the body through a single 1-inch incision or no incision at all allows surgeons to perform complex procedures in the most minimally invasive way. Excellence recognized In 2019 Lankenau Medical Center became the first and only hospital on the East Coast to be awarded three-year accreditation by the National Accreditation Program for Rectal Cancer (NAPRC) for its rectal cancer program. “We’re proud that we’re one of the first dozen centers in America to earn this distinction,” Dr. Marks says. “It’s recognition that our multidisciplinary approach to rectal cancer management at Lankenau, involving radiation oncology, medical oncology, radiology, pathology and of course colorectal surgery, leads to far better outcomes for patients.” Back to school Dr. Marks further explains, “By better outcomes we mean longer survival, less frequent local recurrence, higher rates of sphincter preservation and higher rates of cure with the highest quality of life, meaning avoiding colostomy.” Dr. Marks performed Diane’s robotic TAMIS in December 2020 at Lankenau. Fortunately, the pathology showed the polyp was benign. After the procedure, Diane’s pain was so minimal it was easily managed with only Tylenol. “Shortly after the surgery—I’d say 20 minutes after coming out of general anesthesia—I walked to the restroom, which was probably 50 yards away,” she says. “And I felt pretty good. I left the hospital on a Friday, after spending just one night. And after resting Saturday and Sunday, Monday I was back to teaching my seventh graders. “Since this has happened to me, I’ve told so many people: ‘Do your research,’” she says. “Dr. Marks is a miracle worker. The care he and his team gives is outstanding.” Main Line Health offers advanced treatment for cancer along with coordinated, compassionate care every step of the way

Infectious diseases physician and Chair of the Jefferson COVID-19 Task Force Dr. John Zurlo discusses everything from masking up (even when you’re fully vaccinated) to the potential of booster shots. By Jessica Lopez August 11, 2021 Infectious diseases physician Dr. John Zurlo has been a point person for COVID-19 since the early stages of the pandemic. He has served as the Chair of the Jefferson COVID-19 Task Force. He too felt the relief that so many others did when cases dipped early this summer, wondering if we had seen the worst of COVID. However, as cases again begin to spike across the country and in the Philadelphia region, as well as the introduction of the Delta variant, Dr. Zurlo is referring to this new chapter of the pandemic as “Chapter XXX,” because we still do not know how many other chapters lie ahead. If you’re struggling to keep up with information these days, you’re not alone. Recommendations on masking have changed yet again but the push for vaccination remains. “It is the single most important thing you can do to keep yourself and your community safe,” says Dr. Zurlo. For those who are fully vaccinated, worries are emerging as some have had breakthrough infections. Here, we turn to Dr. Zurlo for what he knows about the Delta variant, if and how much we should be adjusting our lifestyles to stay safe, and if boosters will be recommended in the near future. You have been fully vaccinated since January 2021. Do you still wear a mask in public? I don’t know whether people are vaccinated or not in these environments and we are all safer if everyone wears them. So yes, if I’m going to any indoor spaces like the grocery stores, I’m wearing a mask. From a public health perspective, there are people in our community who are immunocompromised and may not respond to the vaccine. In older populations, vaccines also may not work as well. It is for these people that I wear a mask while in public settings and believe that everyone should. Remember that facemasks work best at preventing you from infecting someone else. We do not know how effective vaccination is in completely preventing infection. There is a chance that a vaccinated person can develop a mild infection and spread it. Do you agree then with the CDC’s recommendation to mask up in indoor public settings? I agree with the recommendation. It’s a reasonable precaution. I do want to point out, however, that this is not as easy in a restaurant, where, of course, you are unmasked to eat. That’s a challenge. We have not seen a major surge in cases in our region but the numbers are climbing. In parts of the city with low vaccination rates, we would expect to see an increasing number of cases. And so this masking recommendation makes sense. I have taken a mask in my pocket with me wherever I go since the start of the pandemic. This is almost the best time if you think about it for Philadelphia to mask up because we’re not seeing a massive increase in cases. With masking, we can hopefully prevent a major surge in cases. Has there been a significant uptick in cases since the Delta variant presented in our region? The Delta variant is clearly more transmissible and contagious. We have been mapping the number of cases all the way back to the beginning of the pandemic. We are now seeing case numbers rise since mid-July in both New Jersey and Pennsylvania. We are still seeing relatively small numbers of new hospital admissions on a daily basis but the numbers are slowly rising. We don’t want to go back to where we were in December and January when we were admitting nearly 100 patients per day. How effective are the COVID-19 vaccines against Delta? Data shows a very distinct correlation between low vaccination rates and high hospitalization rates. The vast majority of hospitalizations we are seeing across the country during this Delta surge are among unvaccinated individuals. This is however a developing story. There’s a much-referenced Israeli study that looked at the Pfizer vaccine and they noted declining effectiveness of the vaccine against Delta. They found it 39% effective in preventing symptomatic infection. But what they did note was that the vaccination was 88% effective in preventing hospitalization and 91% effective in preventing severe disease. This study was criticized because it only sampled some hundreds of patients. There’s a more recent study from the United Kingdom that was published in the New England Journal of Medicine, looking at 19,000 patients with symptomatic infection. They compared infections caused by the Alpha variant, also known as the UK variant, which we saw in our surge in the spring both in Philadelphia and across the country, to the Delta variant, which took hold in the UK several weeks earlier than the U.S. The researchers looked at vaccinations that included the Pfizer vaccine and the AstraZeneca vaccine, which is not available here in the United States. The Pfizer vaccine showed 94% effectiveness for the Alpha variant and 88% for the Delta variant and slightly lower numbers for the AstraZeneca vaccine. So this study suggested a high rate of protection from this Delta strain. All studies of vaccination and the Delta variant have shown that they are very effective in preventing severe COVID infection. I will also add we have reason to believe that Moderna is also effective, according to a briefing by Dr. Jay Butler from the Infectious Diseases Society of America in mid-July. They reported that 97% of newly reported cases with serious infection are among unvaccinated individuals. Should you get a booster shot if you are already fully vaccinated? Booster shots may be a reality for immunocompromised individuals and older populations in the near future. The challenge is that there are many kinds of immunocompromised patients, including bone marrow transplant patients, cancer patients and patients receiving immunosuppressive medications to treat autoimmune diseases like lupus. We do know that the vaccines are not as effective in many of these patient populations and in some elderly patients, who we know don’t respond as well as younger populations to many kinds of vaccines. There may be a rationale for distributing boosters to individuals to prevent infection from variants like the Delta variant. As for the general population, it is quite conceivable that we’ll find that over time, the effectiveness of vaccine wanes in all of us and we may need vaccine boosters, perhaps once more in a year or two, perhaps every few years. That is yet to be determined. There may be a rationale for distributing boosters to individuals to prevent infection from variants like the Delta variant. At this point in time, there is no clear guidance on the need for boosters, but this is once again, as everything with COVID, a developing story. Should travel plans be postponed right now? Personally, I probably wouldn’t make any plans to travel right now to areas of high COVID transmission, especially with what we’re seeing in many southern states. Places like Jacksonville, Florida are seeing higher hospitalization rates than what they were seeing in December/January. If you have to travel, be super careful and wear a mask. Otherwise, don’t put yourself at risk—even though we believe that the risk of getting very sick with COVID-19 is very small when you’re fully vaccinated. Should you get tested if you are vaccinated and start to have respiratory symptoms? I think you should get tested. If you are a part of a high-risk group, you could qualify for monoclonal antibody infusion, which we believe reduces the severity of infection. And even if you’re not in that high-risk group, it’s important to get tested for the people around you. In my line of work as a healthcare worker, I certainly do, as we are required to do so to protect our patients and ensure that infection is not spread any farther. We are all-around lots of different people and we do not know if they’ve been vaccinated, so if you’re in doubt, get tested. Originally Published on The Health Nexus

To address the complex needs of patients experiencing health issues at least 30 days following a positive COVID test result, Bryn Mawr Rehab, part of Main Line Health, is now offering personalized, multidisciplinary care for patients’ physical rehabilitation through its Post-COVID Recovery Program. The effects of COVID can last for weeks or months and some may have lifelong health issues due to COVID in what’s become known as ‘long hauler’ syndrome. Physical complications, post COVID, may include impairments in muscle strength, memory difficulties or brain fog, heart and lung capacity, pain, balance, endurance, and walking ability leading to a loss of function and independence. "We are pleased to be able to offer the Post-COVID Recovery Program to our patients as they recover from the effects of the virus and help them return to their lives. Bryn Mawr Rehab is staffed with expert physicians and therapists who can personalize an individual’s treatment plan that best addresses their health needs while providing our highest level of care,” says Donna Phillips, president of Bryn Mawr Rehab. The program’s multidisciplinary, outpatient therapeutic approach offers patients access to specialty physicians, psychologists, nutritionists and dieticians, and occupational, physical and speech therapists, highlighting Main Line Health’s continuing commitment to health care leadership within our communities. Designed to extend beyond therapy, the recovery program’s team of specialists offer services and resources to treat the patient’s customized needs. A patient may be referred to the program directly by their primary care physician or specialist provider or they may require an evaluation by a physiatrist (doctor of physical medicine and rehabilitation) to assess their overall needs that’s followed by an individualized therapy plan. Mithra Maneyapanda, MD, a physician at Bryn Mawr Rehab involved with the development of the program, says the resources and therapies offered to patients allow them to focus on areas where more recovery may be needed. “Our care team provides specialized support and therapies that are individualized to meet the needs of our patients who are recovering from COVID with dedicated, compassioned care,” notes Dr. Maneypanda.

PHILADELPHIA (July 13, 2021)– Salarius Pharmaceuticals, Inc. (Nasdaq: SLRX), a clinical-stage biopharmaceutical company developing potential new medicines for patients with pediatric cancers, solid tumors, and other cancers, announced today that Fox Chase Cancer Center in Philadelphia, PA, has been added as an active trial site for the dose-expansion stage of the ongoing clinical trial evaluating the company’s lead drug candidate, seclidemstat, in patients with relapsed or refractory Ewing sarcoma and advanced FET-rearranged sarcomas. The addition of Fox Chase expands to nine the number of active sites participating in the open label trial intended to assess seclidemstat at the recommended Phase 2 dose (RP2D). Patient recruitment is now underway at all sites, and the first patients in the dose-expansion stage of the clinical trial have been dosed. Seclidemstat is a novel, oral, reversible inhibitor of lysine-specific histone demethylase 1 (LSD1), an enzyme that has been shown to play a key role in the development and progression of several cancers. Per the amended protocol, the trial’s dose-expansion stage now includes three patient arms. The first arm will enroll up to 30 patients with Ewing sarcoma, a rare and deadly pediatric bone cancer, and will investigate seclidemstat in combination with topotecan and cyclophosphamide, a commonly used second- and third- line chemotherapy regimen. Salarius believes data released during ASCO 2021 demonstrated synergy in an Ewing sarcoma cell line when seclidemstat was used in combination with topotecan and cyclophosphamide. Salarius believes this treatment combination and its use as a second- and third-line therapy could greatly expand the addressable patient population for seclidemstat and improve outcomes by allowing physicians to use seclidemstat earlier in the Ewing sarcoma continuum of care. The trial’s second patient arm will investigate seclidemstat as a single agent in up to 15 patients with myxoid liposarcoma. The third patient arm will investigate seclidemstat as a single agent in up to 15 patients with select sarcomas that share a biology similar to Ewing sarcoma, also referred to as FET-rearranged or Ewing-related sarcomas. In data released at ASCO 2021, a subset of patients with advanced FET-rearranged sarcomas treated with single-agent seclidemstat resulted in stable disease (SD) and prolonged time to progression (TTP) which Salarius believes suggests disease control, a clinically relevant endpoint for soft tissue sarcomas. All patient arms are designed to evaluate safety and efficacy endpoints in patients with advanced disease. Salarius expects to report data in 2022 and provide earlier updates if possible. “We are excited to be working with Salarius and look forward to exploring the potential of seclidemstat and its ability to inhibit the LSD1 enzyme,” stated Johnathan Whetstine, Ph.D., Director, Cancer Epigenetics Institute (CEI), Fox Chase Cancer Center. “Based on our extensive research into the epigenetic causes of cancer, we believe LSD1 inhibition holds great promise in the treatment of many cancers. We believe data from preclinical studies using Ewing sarcoma cell lines has demonstrated the molecule’s ability to hit two aspects of the enzyme simultaneously. This, added to clinical data showing drug activity across Ewing and other sarcomas, support the further exploration of seclidemstat in these high unmet need patient populations.” Dr. Whetstine is a consultant to Salarius and has also served in an advisory capacity. The recently founded CEI at Fox Chase is a national hub for epigenetics study and collaboration focused on mechanisms promoting cancer and therapeutic resistance. Its mission is to facilitate academic-to-industry and academic-to-academic partnerships with the goal of promoting discovery in cancer epigenetics. David Arthur, CEO of Salarius Pharmaceuticals, stated, “Our goal is to make a difference in the lives of patients fighting cancer, and we believe the data we have released to date has been compelling. To now be working with a cancer research center of the caliber of Fox Chase Cancer Center further affirms the potential of seclidemstat to have a meaningful impact on the treatment of Ewing sarcoma and other cancers. We look forward to providing additional updates throughout 2021.” Trial enrollment at Fox Chase will be led by Margaret von Mehren, M.D., Chief of Sarcoma Oncology. In addition to Fox Chase, active clinical trial site locations include, Johns Hopkins All Children’s Hospital in St. Petersburg, FL; Children’s Hospital of Los Angeles in Los Angeles, CA; Moffitt Cancer Center in Tampa, FL; Dana-Farber Cancer Institute in Boston, MA; MD Anderson Cancer Center in Houston, TX; Nationwide Children’s Hospital in Columbus, OH; Memorial Sloan Kettering Cancer Center in New York City; and the Sarcoma Oncology Center in Santa Monica, CA.

My first exposure to ophthalmology as a medical student was in pediatric retina, and I never looked back. There are many challenges, yet even more rewards, in treating children with retinal conditions. The surgeries are technically challenging and require extreme precision. Pediatric retinal surgeries require creativity and thinking outside the box, and the usual tenets of adult surgery can take you down the wrong path. Not only are the eyes smaller, but the anatomic proportions are different, and you’re working with a whole different set of diseases. Also, not only are you treating the child in front of you, but the parents require healing as well. The rewards are many. Being able to diagnose and treat genetic conditions for an entire family can save the vision of generations to come, or telling a mother that her baby will be able to see - there’s nothing better than that. At Wills Eye Hospital and Mid Atlantic Retina, we take care of a tremendous volume of complex surgical patients, both adults and children. My partners and I work with a world class team dedicated to one singular mission: to save vision. From the Desk of Dr. Yoshihiro Yonekawa Dr. Yoshihiro Yonekawa is an adult and pediatric retina specialist. He received his MD with honors from Weill Cornell Medical College, where he was recognized with the Edward Norton Award in Ophthalmology and grants from Fight for Sight and the National Eye Institute. He completed his ophthalmology residency at Harvard Medical School, and received many awards for his clinical and research expertise, including those from the American Academy of Ophthalmology (AAO). Dr. Yonekawa subsequently underwent specialized fellowship training in adult and pediatric retina surgery at Associated Retinal Consultants, William Beaumont Hospital. He received prestigious national awards during fellowship from the Heed Ophthalmic Foundation, Ronald G. Michels Foundation, and the Retina Society. Dr. Yonekawa treats both adults and children with conditions of the retina. He is committed to restoring and maintaining vision to improve the quality of life for his patients. Read more about our Ophthalmology Network

Basel Ramlawi, MD, a clin ical professor with Main Line Health’s Lankenau Institute for Medical Research (LIMR) as well as chief of cardiothoracic surgery at Main Line Health and co-director of the Lankenau Heart Institute, was a contributing author of a study finding greater availability of personal protective equipment (PPE) and better conservation practices are key to alleviating cardiac surgeons’ anxiety amid the COVID-19 pandemic. Francis P. Sutter, DO, FACS, FACOS, chief of Cardiothoracic Surgery for Lankenau Medical Center, part of Main Line Health, was also among nearly 60 of the nation’s most distinguished cardiac surgeons listed as authors of the study, which surveyed physicians from 67 adult cardiac surgery institutions across North America. The study found that 90% of respondents indicated a greater availability of PPE would help reduce their anxiety around the pandemic. The authors also called for reviewing the evidence and developing standardized guidelines regarding safe reuse of PPE during the current and future pandemics. Recommendations from the Centers for Disease Control and Prevention (CDC) were in flux during the early stages of the pandemic. The CDC recommends that during crisis situations, N95 respiratory masks be used only during procedures generating aerosols (minute respiratory particles that are small and light enough to remain suspended in the air for long periods). But as shortages grew critical, the CDC recommended reuse of PPE that was intended for one-time use, and to resort to scarves or bandannas if necessary. Nearly half (49%) of users of N95 respirators recycled them using ultraviolet light, followed by 13% using heat, and 12% doing sterilization at home or using other methods. Twenty-two percent of institutions asked physicians to reuse them for one day, followed by 21% requesting reuse for a week, and 6% for a month. The survey had other important findings. Worries of cardiac surgeons were topped by exposing their family to COVID-19 (81%), followed by contracting the disease (68%), running out of PPE (28%) and concerns with hospital resources (28%). The survey also found that among those on cardiac teams, nurses were the ones most likely to be redeployed to care for COVID-19 patients (88%), followed by advanced care practitioners (69%), trainees (28%) and surgeons (25%). The study, "Cardiac surgeons' concerns, perceptions, and responses during the COVID-19 pandemic," was published earlier this month in the Journal of Cardiac Surgery. Physicians were surveyed over a 16-day period in spring 2020.

Dr. Robert H. Rosenwasser will be awarded the Strittmatter Award by The Philadelphia County Medical Society on June 25th! Since 1923, the Strittmatter Award, the Philadelphia County Medical Society’s most prestigious scientific award honors a physician who has demonstrated to the Society the most valuable contributions to the healing art, surgical or medical. Dr. Rosenwasser is among the country’s first dually trained cerebrovascular neurosurgeons, meaning he is able to treat diseases of the brain’s circulatory system using both conventional surgical methods and minimally invasive interventional radiology techniques. As a cerebrovascular neurosurgeon, he treats patients who have had strokes, aneurysms, AVMs, and carotid artery stenosis. He also serves as president of the Vickie and Jack Farber Institute for Neuroscience and is responsible for strategic directions in neuroscience. He worked to establish the Jefferson Neuroscience Network (JNN)—a telemedicine system that affords Jefferson stroke physicians the ability to remotely assess and make treatment recommendations for people with suspected stroke throughout the region. In 2014, the American Association of Neurological Surgeons awarded Dr. Rosenwasser the Cushing Award for Technical Excellence and Innovation in Neurosurgery, which recognized his career-long effort to include interventional radiology techniques in neurosurgical training. Get to know Dr. Rosenwasser:

As a corporate partner, PIM is proud to support Citizen Diplomacy International, the Greater Philadelphia region's international affairs organization. A nonprofit organization founded by the City of Philadelphia in 1954, Citizen Diplomacy is the regional partner of the U.S. Department of State to engage Philadelphians in foreign affairs. Their programs include the prestigious International Visitor Leadership Program, the Sister Cities Program in 10 countries, and the Citizen Diplomat Academy Youth Exchange Program. Through international exchange, they promote the best of Philadelphia and connect Philadelphia's institutions and people to others around the globe in pursuit of a more peaceful and prosperous world. In response to the COVID-related shortage in international education for young people, Citizen Diplomacy recently launched the Citizen Diplomat Academy; a free, virtual, international exchange program for high school and university students in Philadelphia and abroad who are interested in addressing the world’s most pressing challenges. Philadelphia students have not traveled since February 2020 and schools are not planning to resume in-person programs until earliest Spring 2022, leaving a two-year--or even longer--gap in high school exchange programs. In this all virtual out-of-school time program, students make friends with peers abroad who share their interest in STEM innovation and social entrepreneurship. Social opportunities are combined with lessons in the core skills of diplomacy, cross-cultural dialogue, business, and civic engagement from a rotating group of instructors from the top universities, business start-ups, social innovation labs, and cultural institutions in Philadelphia and around the world. The program appeals to a generation of young people who see themselves as global citizens, entrepreneurial innovators, and cultural changemakers, and who possess the confidence and skill set to thrive in a global marketplace. Exchange programs are critical to initiating a life-long interest in global affairs and to building education equity. One such student is Joyce, is a 15-year-old , Asian American student from a low-income Philadelphia neighborhood, who applied to the program sharing, "Due to this pandemic my social interactions, hobbies, and genuine interests have been halted and I am worn out from being so deprived of the experiences of normal life. I imagined the first year of high school to be a chance to properly meet people and a new chapter of my life, and so far it has been very different. '' After her four-week exchange with Sister City Frankfurt and Philadelphia, Joyce said that, “I learned so many genuine and raw topics that are rarely discussed in school. Rather than merely eye-opening, it was endearing to hear others my age speak about such topics, issues, and learn together. And having people from other countries have discussions with me was genuinely enjoyable. The professionals really gave me such great insight on work opportunities and pathways, problems in different industries, and so much more.” CEO Siobhan Lyons, says of the organization's three-year commitment to serve 80% students of color and other minority groups, "BIPOC students who are participating in our free international exchange programs, “How to Succeed as a STEM Innovator” and “How to Succeed as a Social Innovator”, will not have access to face-to-face, live international education for 2 -3 years. All Philadelphia students to have equitable access to educational opportunities. These virtual international exchange opportunities keep learning and dialogue across cultures possible." Especially at PIM, we understand that one introduction to an international friend can influence the trajectory of someone's life in a positive, lasting way. For more information, including details on how to participate and opportunities to donate, visit: https://cdiphila.org/citizen_diplomat_academy.