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Full-Text Articles in Medicine and Health Sciences

Biting The Hands That Feed “The Alligators”: A Case Study In Morbid Obesity Extremes, End-Of-Life Care, And Prohibitions On Harming And Accelerating The End Of Life, Michael J. Malinowski Jan 2018

Biting The Hands That Feed “The Alligators”: A Case Study In Morbid Obesity Extremes, End-Of-Life Care, And Prohibitions On Harming And Accelerating The End Of Life, Michael J. Malinowski

Journal Articles

Obesity, recognized as a disease in the U.S. and at times as a terminal illness due to associated medical complications, is an American epidemic according to the Centers for Disease Control and Prevention (“CDC”), American Heart Association (“AHA”), and other authorities. More than one third of Americans (39.8% of adults and 18.5% of children) are medically obese. This article focuses on cases of “extreme morbid obesity” (“EMO”)—situations in which death is imminent without aggressive medical interventions, and bariatric surgery is the only treatment option with a realistic possibility of success. Bariatric surgeries themselves are very high ...


Analysis Of Menstrual Effluent: Diagnostic Potential For Endometriosis, L. A. Warren, A. Shih, S. M. Renteira, T. Seckin, B. Blau, K. Simpfendorfer, C. N. Metz, P. K. Gregersen Jan 2018

Analysis Of Menstrual Effluent: Diagnostic Potential For Endometriosis, L. A. Warren, A. Shih, S. M. Renteira, T. Seckin, B. Blau, K. Simpfendorfer, C. N. Metz, P. K. Gregersen

Journal Articles

No abstract provided.


Changes In Balance And Joint Position Sense During A 12-Day High Altitude Trek: The British Services Dhaulagiri Medical Research Expedition, Sarah B. Clarke, Kevin Deighton, Caroline Newman, Gareth Nicholson, Liam Gallagher, Christopher J. Boos, Adrian Mellor, David R. Woods, John P. O'Hara Jan 2018

Changes In Balance And Joint Position Sense During A 12-Day High Altitude Trek: The British Services Dhaulagiri Medical Research Expedition, Sarah B. Clarke, Kevin Deighton, Caroline Newman, Gareth Nicholson, Liam Gallagher, Christopher J. Boos, Adrian Mellor, David R. Woods, John P. O'Hara

Journal Articles

Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in ...


Implementation And Utilization Of Hypofractionation For Breast Cancer, P. Gilbo, L. Potters, L. Lee Jan 2018

Implementation And Utilization Of Hypofractionation For Breast Cancer, P. Gilbo, L. Potters, L. Lee

Journal Articles

© 2018 The Authors Purpose: Hypofractionation (HF) of whole breast irradiation has become a standard treatment regimen because randomized trials continue to demonstrate equivalence in survival and local control compared with conventional fractionation. In 2011, the American Society for Radiation Oncology (ASTRO) adopted clinical guidelines on the proper selection of HF. Nevertheless, utilization remains lower than predicted. We evaluate the effects of clinical directives that serve as default treatment decisions and prospective contouring rounds on the implementation of HF in a large, multicenter radiation oncology department. Methods and materials: In 2010, we implemented consensus-driven and evidence-based clinical directives to guide treatment ...


Association Of Coronary Vessel Characteristics With Outcome In Patients With Percutaneous Coronary Interventions With Incomplete Revascularization, E. L. Hannan, Y. Zhong, P. B. Berger, A. K. Jacobs, G. Walford, F. S. K. Ling, F. J. Venditti, S. B. King Jan 2018

Association Of Coronary Vessel Characteristics With Outcome In Patients With Percutaneous Coronary Interventions With Incomplete Revascularization, E. L. Hannan, Y. Zhong, P. B. Berger, A. K. Jacobs, G. Walford, F. S. K. Ling, F. J. Venditti, S. B. King

Journal Articles

© 2017 American Medical Association. All rights reserved. IMPORTANCE Many studies have compared outcomes for incomplete revascularization (IR) among patients undergoing percutaneous coronary interventions (PCI), but little is known about whether outcomes are related to the nature of the IR. OBJECTIVE To determine whether some coronary vessel characteristics are associated with worse outcomes in patients with PCI with IR. DESIGN, SETTING, AND PARTICIPANTS New York's PCI registrywas used to examine mortality (median follow-up, 3.4 years) as a function of the number of vessels that were incompletely revascularized, the stenosis in those vessels, and whether the proximal left anterior descending ...


High-Frequency Percussive Ventilation Facilitates Weaning From Extracorporeal Membrane Oxygenation In Adults, I. Gulkarov, J. Schiffenhaus, I. Wong, A. Afzal, F. Khusid, B. Worku Jan 2018

High-Frequency Percussive Ventilation Facilitates Weaning From Extracorporeal Membrane Oxygenation In Adults, I. Gulkarov, J. Schiffenhaus, I. Wong, A. Afzal, F. Khusid, B. Worku

Journal Articles

© 2018 American Society of Extra-Corporeal Technology. All Rights Reserved. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an invaluable rescue therapy for patients suffering from cardiopulmonary arrest, but it is not without its drawbacks. There are cases where patients recover their cardiac function, yet they fail to wean to mechanical conventional ventilation (MCV). The use of high-frequency percussive ventilation (HFPV) has been described in patients with acute respiratory failure (RF) who fail MCV. We describe our experience with five patients who underwent VA-ECMO for cardiopulmonary arrest who were successfully weaned from VA-ECMO with HFPV after failure to wean with MCV. Weaning trials ...


Determinants And Outcomes Of Vasoplegia Following Left Ventricular Assist Device Implantation, K. M. Tecson, B. Lima, A. Y. Lee, F. S. Raza, G. Ching, C. Lee, J. Felius, R. D. Baxter, S. Still, S. M. Joseph, +2 Additional Authors Jan 2018

Determinants And Outcomes Of Vasoplegia Following Left Ventricular Assist Device Implantation, K. M. Tecson, B. Lima, A. Y. Lee, F. S. Raza, G. Ching, C. Lee, J. Felius, R. D. Baxter, S. Still, S. M. Joseph, +2 Additional Authors

Journal Articles

No abstract provided.


Sternotomy Closure Using Rigid Plate Fixation: A Paradigm Shift From Wire Cerclage, K. B. Allen, K. J. Icke, V. H. Thourani, Y. Naka, K. J. Grubb, J. Grehan, N. Patel, T. S. Guy, K. Landolfo, M. Bonnell, +1 Additional Author Jan 2018

Sternotomy Closure Using Rigid Plate Fixation: A Paradigm Shift From Wire Cerclage, K. B. Allen, K. J. Icke, V. H. Thourani, Y. Naka, K. J. Grubb, J. Grehan, N. Patel, T. S. Guy, K. Landolfo, M. Bonnell, +1 Additional Author

Journal Articles

No abstract provided.


The U.S. Science And Technology “Triple Threat”: A Regulatory Treatment Plan For The Nation’S Addiction To Prescription Opioids, Michael J. Malinowski Jan 2018

The U.S. Science And Technology “Triple Threat”: A Regulatory Treatment Plan For The Nation’S Addiction To Prescription Opioids, Michael J. Malinowski

Journal Articles

No abstract provided.


Plasma Cell Differentiation Pathways In Systemic Lupus Erythematosus, S. Malkiel, A. N. Barlev, Y. Atisha-Fregoso, J. Suurmond, B. Diamond Jan 2018

Plasma Cell Differentiation Pathways In Systemic Lupus Erythematosus, S. Malkiel, A. N. Barlev, Y. Atisha-Fregoso, J. Suurmond, B. Diamond

Journal Articles

No abstract provided.


Pdz-Rhogef Is A Signaling Effector For Troy-Induced Glioblastoma Cell Invasion And Survival, Z. Ding, H. Dhruv, A. Kwiatkowska-Piwowarczyk, R. Ruggieri, J. Kloss, M. Symons, P. Pirrotte, J. M. Eschbacher, N. L. Tran, J. C. Loftus Jan 2018

Pdz-Rhogef Is A Signaling Effector For Troy-Induced Glioblastoma Cell Invasion And Survival, Z. Ding, H. Dhruv, A. Kwiatkowska-Piwowarczyk, R. Ruggieri, J. Kloss, M. Symons, P. Pirrotte, J. M. Eschbacher, N. L. Tran, J. C. Loftus

Journal Articles

© 2018 The Authors Glioblastoma multiforme (GBM) is the most common type of malignant brain tumors in adults and has a dismal prognosis. The highly aggressive invasion of malignant cells into the normal brain parenchyma renders complete surgical resection of GBM tumors impossible, increases resistance to therapeutic treatment, and leads to near-universal tumor recurrence. We have previously demonstrated that TROY (TNFRSF19) plays an important role in glioblastoma cell invasion and therapeutic resistance. However, the potential downstream effectors of TROY signaling have not been fully characterized. Here, we identified PDZ-RhoGEF as a binding partner for TROY that potentiated TROY-induced nuclear factor kappa ...


Reducing Seed Waste And Increasing Value Of Dynamic Intraoperative Implantation Of Pd-103 Seeds In Prostate Brachytherapy, P. K. Taylor, A, C. Riegel Jan 2018

Reducing Seed Waste And Increasing Value Of Dynamic Intraoperative Implantation Of Pd-103 Seeds In Prostate Brachytherapy, P. K. Taylor, A, C. Riegel

Journal Articles

© 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine. Several nomograms exist for ordering palladium-103 seeds for permanent prostate seed implants (PSI). Excess seeds from PSIs pose additional radiation safety risks and increase the cost of care. This study compared five nomograms to clinical data from dynamic modified-peripheral intraoperative PSI to determine (a) the cause of excess seeds and (b) the optimal nomogram for our institution. Pre- and intraoperative patient data were collected for monotherapy PSIs and compiled into a clinical database. All patients were prescribed ...


Sts/Sca/Amsect Clinical Practice Guidelines: Anticoagulation During Cardiopulmonary Bypass, L. Shore-Lesserson, R. A. Baker, V. Ferraris, P. E. Greilich, D. Fitzgerald, P. Roman, J. Hammon Jan 2018

Sts/Sca/Amsect Clinical Practice Guidelines: Anticoagulation During Cardiopulmonary Bypass, L. Shore-Lesserson, R. A. Baker, V. Ferraris, P. E. Greilich, D. Fitzgerald, P. Roman, J. Hammon

Journal Articles

© 2018 American Society of Extra-Corporeal Technology. All Rights Reserved. Despite more than a half century of "safe" cardio-pulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, the Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), and the American Society of Extracorporeal Technology (AmSECT) developed an Evidence Based Workgroup. This ...


Extremely Preterm (23 Weeks) Vaginal Cephalic Delivery En Caul And Subsequent Postpartum Intraventricular Hemorrhage And Respiratory Distress: A Teaching Case., R. Malik, A. Sarfraz, R. Faroqui, W. Onyebeke, J. Wanerman Jan 2018

Extremely Preterm (23 Weeks) Vaginal Cephalic Delivery En Caul And Subsequent Postpartum Intraventricular Hemorrhage And Respiratory Distress: A Teaching Case., R. Malik, A. Sarfraz, R. Faroqui, W. Onyebeke, J. Wanerman

Journal Articles

En caul deliveries are defined as a fetus that is delivered completely contained within an amniotic sac and are considered to be less common than 1 in 80,000 live births. Vaginal en caul births compared to abdominal or cesarean are the rarest subtype. Most en caul births are associated with prematurity and low gravida. The combination of prematurity, high gravida, vaginal en caul birth, and severe postpartum complications has not previously been described. We report a woman with gravida of 12 delivering vaginally a neonate female en caul at the extremely preterm gestational age of 23 weeks. The neonate ...


Severe Maternal Morbidity Associated With Systemic Lupus Erythematosus Flare In The Second Trimester Of Pregnancy., M. J. Blitz, A. Fleischer Jan 2018

Severe Maternal Morbidity Associated With Systemic Lupus Erythematosus Flare In The Second Trimester Of Pregnancy., M. J. Blitz, A. Fleischer

Journal Articles

Pregnancy in women with systemic lupus erythematosus (SLE) is associated with an increased risk of adverse maternal and fetal outcomes. Here, we present a case of severe maternal morbidity in a 23-year-old primigravida with SLE and secondary Sjögren's syndrome who experienced a life-threatening multisystem flare at 17 weeks of gestational age. She presented to the emergency department complaining of cough with hemoptysis and shortness of breath. She developed hypoxic respiratory failure and was admitted to the intensive care unit. Bronchoscopy confirmed diffuse alveolar hemorrhage. Physical exam and laboratory evaluation were consistent with an active SLE flare, pancytopenia, and new-onset ...


Compassionate Coverage: A Patient Access Linen System, J. M. Rabin, K. C. Farner, A. H. Brody, A. Peyser, M. Kline Jan 2018

Compassionate Coverage: A Patient Access Linen System, J. M. Rabin, K. C. Farner, A. H. Brody, A. Peyser, M. Kline

Journal Articles

No abstract provided.


Effects Of Endovascular Cooling On Infarct Size In St-Segment Elevation Myocardial Infarction: A Patient-Level Pooled Analysis From Randomized Trials., M. Dae, W. O'Neill, C. L. Grines, S. Dixon, D. Erlinge, M. Noc, M. Holzer, A. Dee Jan 2018

Effects Of Endovascular Cooling On Infarct Size In St-Segment Elevation Myocardial Infarction: A Patient-Level Pooled Analysis From Randomized Trials., M. Dae, W. O'Neill, C. L. Grines, S. Dixon, D. Erlinge, M. Noc, M. Holzer, A. Dee

Journal Articles

OBJECTIVES: This study sought to examine the relationship between temperature at reperfusion and infarct size.

BACKGROUND: Hypothermia consistently reduces infarct size when administered prior to reperfusion in animal studies, however, clinical results have been inconsistent.

METHODS: We performed a patient-level pooled analysis from six randomized control trials of endovascular cooling during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) in 629 patients in which infarct size was assessed within 1 month after randomization by either single-photon emission computed tomography (SPECT) or cardiac magnetic resonance imaging (cMR).

RESULTS: In anterior infarct patients, after controlling for variability between studies ...


Patient-Reported Outcome Measures For Pediatric Psoriasis: A Systematic Review And Critical Appraisal From International Dermatology Outcome Measures (Ideom), N. Salame, J. Torres, J. Sandhu, K. C. Duffin, A. Garg, A. B. Gottlieb, J. Latella, J. F. Merola, A. W. Armstrong Jan 2018

Patient-Reported Outcome Measures For Pediatric Psoriasis: A Systematic Review And Critical Appraisal From International Dermatology Outcome Measures (Ideom), N. Salame, J. Torres, J. Sandhu, K. C. Duffin, A. Garg, A. B. Gottlieb, J. Latella, J. F. Merola, A. W. Armstrong

Journal Articles

No abstract provided.


Hereditary Diffuse Gastric Cancer: One Family's Story, H. M. Zylberberg, K. Sultan, S. Rubin Jan 2018

Hereditary Diffuse Gastric Cancer: One Family's Story, H. M. Zylberberg, K. Sultan, S. Rubin

Journal Articles

No abstract provided.


Retinal Vasproliferative Tumor In A Case Of X-Linked Retinoschisis Detachment, N. A. Patel, D. Laura, K. D. Tran, S. Chang, G. Barile, A. M. Berrocal Jan 2018

Retinal Vasproliferative Tumor In A Case Of X-Linked Retinoschisis Detachment, N. A. Patel, D. Laura, K. D. Tran, S. Chang, G. Barile, A. M. Berrocal

Journal Articles

© 2018 Purpose: To describe the first published case of X-linked retinoschisis (XLRS) detachment with retinal vasoproliferative tumor (RVPT) and provide a literature review of the subject. Observations: The authors describe a case of a 17 year old male with X-linked retinoschisis who presented with a retinal detachment and a retinal vasoproliferative tumor. The patient was treated with pars plana vitrectomy, endolaser, subtenon's kenalog and anti-VEGF (vascular endothelial growth factor) intravitreal injections. He regained 20/60 vision with a flat macula and had significant resolution of the associated vasoproliferative leakage seen on fluorescein angiography. Conclusions and importance: This case adds ...


Anti-Integrin Therapy For Inflammatory Bowel Disease, S. C. Park, Y. T. Jeen Jan 2018

Anti-Integrin Therapy For Inflammatory Bowel Disease, S. C. Park, Y. T. Jeen

Journal Articles

© The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. In inflammatory bowel disease (IBD), tumor necrosis factor plays an important role in mediating inflammation, but several other pathways are also involved in eliciting an inflammatory response. One such pathway is the invasion of the intestinal mucosa by leukocytes. Leukocytes within the systemic circulation move to sites of inflammation, and blocking this pathway could be an important treatment strategy for IBD. Antiintegrin therapy blocks the action of integrin on the surface of circulating immune cells and endothelial cell adhesion molecules, thereby inhibiting the interactions between leukocytes and ...


A Small, Well-Differentiated Rectal Neuroendocrine Tumor With Multiple Lymph Node Metastases: A Case Report, S. J. Nam, G. B. Chae, S. Lee, S. C. Park, C. D. Kang, S. J. Lee Jan 2018

A Small, Well-Differentiated Rectal Neuroendocrine Tumor With Multiple Lymph Node Metastases: A Case Report, S. J. Nam, G. B. Chae, S. Lee, S. C. Park, C. D. Kang, S. J. Lee

Journal Articles

© 2018, Spandidos Publications. All rights reserved. The incidence of rectal neuroendocrine tumor (NET), which is often diagnosed during routine surveillance endoscopy, is increasing. The majority of these tumors are small and asymptomatic, possessing benign features with favorable prognoses. At present, small rectal NETs without high-risk factors are typically treated by local resection, including endoscopic mucosal resection, endoscopic submucosal dissection, or transanal endoscopic microsurgery, with or without additional imaging follow-up by abdominal computed tomography or magnetic resonance imaging. The present study, however, describes a case of a small rectal NET without any known risk factors, which was accompanied by substantial locoregional ...


Spontaneous Coronary Artery Dissection: Current State Of The Science: A Scientific Statement From The American Heart Association, S. N. Hayes, C. E. S. H. Kim, J. Saw, D. Adlam, C. Arslanian-Engoren, K. E. Economy, S. K. Ganesh, R. Gulati, J. H. Mieres, M. J. Wood, +5 Additional Authors Jan 2018

Spontaneous Coronary Artery Dissection: Current State Of The Science: A Scientific Statement From The American Heart Association, S. N. Hayes, C. E. S. H. Kim, J. Saw, D. Adlam, C. Arslanian-Engoren, K. E. Economy, S. K. Ganesh, R. Gulati, J. H. Mieres, M. J. Wood, +5 Additional Authors

Journal Articles

© 2018 American Heart Association, Inc. Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female ...


Real-World Clinical Utility And Impact On Clinical Decision-Making Of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve: Lessons From The Advance Registry., T. A. Fairbairn, K. Nieman, T. Akasaka, B. L. Nørgaard, D. S. Berman, G. Raff, L. M. Hurwitz-Koweek, G. Pontone, M. Poon, M. R. Patel, +13 Additional Authors Jan 2018

Real-World Clinical Utility And Impact On Clinical Decision-Making Of Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve: Lessons From The Advance Registry., T. A. Fairbairn, K. Nieman, T. Akasaka, B. L. Nørgaard, D. S. Berman, G. Raff, L. M. Hurwitz-Koweek, G. Pontone, M. Poon, M. R. Patel, +13 Additional Authors

Journal Articles

Aims:Non-invasive assessment of stable chest pain patients is a critical determinant of resource utilization and clinical outcomes. Increasingly coronary computed tomography angiography (CCTA) with selective CCTA-derived fractional flow reserve (FFRCT) is being used. The ADVANCE Registry, is a large prospective examination of using a CCTA and FFRCT diagnostic pathway in real-world settings, with the aim of determining the impact of this pathway on decision-making, downstream invasive coronary angiography (ICA), revascularization, and major adverse cardiovascular events (MACE). Methods and results:A total of 5083 patients with symptoms concerning for coronary artery disease (CAD) and atherosclerosis on CCTA were enrolled at ...


Confronting System Barriers For St- Elevation Mi In Low And Middle Income Countries With A Focus On India, S. Mehta, C. Granger, C. L. Grines, A. Jacobs, T. D. Henry, I. Rokos, A. Lansky, A. Baumbach, R. Botelho, S. Hiremath, +8 Additional Authors Jan 2018

Confronting System Barriers For St- Elevation Mi In Low And Middle Income Countries With A Focus On India, S. Mehta, C. Granger, C. L. Grines, A. Jacobs, T. D. Henry, I. Rokos, A. Lansky, A. Baumbach, R. Botelho, S. Hiremath, +8 Additional Authors

Journal Articles

© 2017 Our previous research found seven specific factors that cause system delays in ST-elevation Myocardial infarction management in developing countries. These delays, in conjunction with a lack of organized STEMI systems of care, result in inefficient processes to treat AMI in developing countries. In our present opinion paper, we have specifically explored the three most pertinent causes that afflict the seven specific factors responsible for system delays. In doing so, we incorporated a unique strategy of global STEMI expertise. With this methodology, the recommendations were provided by expert Indian cardiologist and final guidelines were drafted after comprehensive discussions by the ...


Is Transcatheter Aortic Valve Replacement Better Than Surgical Aortic Valve Replacement In Patients With Chronic Obstructive Pulmonary Disease? A Nationwide Inpatient Sample Analysis, T. Ando, O. Adegbala, E. Akintoye, S. Ashraf, M. Pahuja, A. Briasoulis, H. Takagi, C. L. Grines, L. Afonso, T. Schreiber Jan 2018

Is Transcatheter Aortic Valve Replacement Better Than Surgical Aortic Valve Replacement In Patients With Chronic Obstructive Pulmonary Disease? A Nationwide Inpatient Sample Analysis, T. Ando, O. Adegbala, E. Akintoye, S. Ashraf, M. Pahuja, A. Briasoulis, H. Takagi, C. L. Grines, L. Afonso, T. Schreiber

Journal Articles

No abstract provided.


Insulin-Like Growth Factor 2: A Poor Prognostic Biomarker Linked To Racial Disparity In Women With Uterine Carcinosarcoma, A. R. Van Arsdale, R. C. Arend, M. J. Cossio, B. K. Erickson, Y. Wang, D. W. Doo, C. A. Leath, G. L. Goldberg, G. S. Huang Jan 2018

Insulin-Like Growth Factor 2: A Poor Prognostic Biomarker Linked To Racial Disparity In Women With Uterine Carcinosarcoma, A. R. Van Arsdale, R. C. Arend, M. J. Cossio, B. K. Erickson, Y. Wang, D. W. Doo, C. A. Leath, G. L. Goldberg, G. S. Huang

Journal Articles

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. The objective of this study was to investigate the relationship of insulin-like growth factor 2 (IGF2) expression and survival in women with uterine carcinosarcoma (UCS). Insulin-like growth factor 2 protein expression was determined by immunohistochemical staining of tumor tissues from 103 patients with UCS. The H-score (product of staining intensity and percentage positive cells) was quantified for the epithelial cytoplasmic (EC), epithelial nuclear (EN), and malignant stromal compartments. Multivariable Cox proportional hazard regression models were used to examine the relationship of IGF2 levels with progression-free survival (PFS) and overall survival (OS). Adjusting for stage, race, and adjuvant therapy, PFS and OS were reduced in patients with high IGF2 (H-score ≥ median) in the EC and EN compartments. Black race was independently associated with reduced PFS and OS in patients with early-stage disease, and IGF2 levels in the EC were higher in black than in white patients (P = 0.02, Wilcoxon test). In a race-stratified multivariable analysis, high IGF2 in the epithelial compartments more than doubled the risk of death in black women; HR = 2.43 (95% CI: 1.18–5.01, P = 0.02) for high IGF2 in the EC; and HR = 2.34 (95% CI: 1.25–4.39, P = 0.008) for high IGF2 in the EN. In conclusion, high tumor IGF2 expression is an independent risk factor for reduced PFS and OS in UCS. Black women have elevated tumor IGF2 compared with white women, and decreased survival associated with high IGF2. These findings identify IGF2 as a candidate biomarker for survival linked to racial disparity in women with UCS.


Robotic-Assisted Sacrocolpopexy With Versus Without Concomitant Midurethral Sling: A 2-Year Follow-Up Of Urinary Symptoms And Quality Of Life, J. S. Schachar, K. S. Williams, H. A. Winkler Jan 2018

Robotic-Assisted Sacrocolpopexy With Versus Without Concomitant Midurethral Sling: A 2-Year Follow-Up Of Urinary Symptoms And Quality Of Life, J. S. Schachar, K. S. Williams, H. A. Winkler

Journal Articles

© 2018 Journal of Mid-life Health | Published by Wolters Kluwer - Medknow. Objective: The objective of this study was to assess long-term postoperative urinary incontinence (UI) symptoms and quality of life (QOL) in patients after robotic-assisted sacrocolpopexy (RASC) with or without concomitant midurethral sling (MUS). Materials and Methods: This is a cross-sectional survey of patients comparing long-term postoperative urinary symptoms and QOL measurements in women who underwent RASC with or without MUS. We included all patients from 2011 to 2014 who had RASC with or without MUS. All patients had preoperative urodynamic testing (UDS). Patients who demonstrated stress UI on UDS underwent ...


Twelve-Month Efficacy And Safety Data For The "Stress Incontinence Control, Efficacy And Safety Study": A Phase Iii, Multicenter, Prospective, Randomized, Controlled Study Treating Female Stress Urinary Incontinence Using The Vesair Intravesical Balloon, H. Winkler, K. Jacoby, S. Kalota, J. Snyder, K. Cline, K. Robertson, R. Kahan, L. Green, K. Mccammon, C. Rardin, +1 Author Jan 2018

Twelve-Month Efficacy And Safety Data For The "Stress Incontinence Control, Efficacy And Safety Study": A Phase Iii, Multicenter, Prospective, Randomized, Controlled Study Treating Female Stress Urinary Incontinence Using The Vesair Intravesical Balloon, H. Winkler, K. Jacoby, S. Kalota, J. Snyder, K. Cline, K. Robertson, R. Kahan, L. Green, K. Mccammon, C. Rardin, +1 Author

Journal Articles

© 2018 Wolters Kluwer Health, Inc. Objectives The "Stress Incontinence Control, Efficacy and Safety Study" (SUCCESS) is a phase III study of the Vesair Balloon in women with stress urinary incontinence who had failed conservative therapy, and either failed surgery, were not candidates for surgery, or chose not to have surgery. The safety and efficacy of the balloon at 12 months is reported for those participants in the treatment arm who elected to continue with the SUCCESS trial beyond the primary end point at 3 months. Methods The SUCCESS trial is a multicenter, prospective, single-blinded, randomized, sham-controlled study. Participants were randomized ...


Two Successful Pregnancies Following Fertility Preservation In A Patient With Anaplastic Astrocytoma: A Case Report, A. Peyser, S. L. Bristow, A. Hershlag Jan 2018

Two Successful Pregnancies Following Fertility Preservation In A Patient With Anaplastic Astrocytoma: A Case Report, A. Peyser, S. L. Bristow, A. Hershlag

Journal Articles

No abstract provided.