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Is Current Evidence That Avoidance Of Inhalation Agents And Opioids May Decrease Metastasis Strong Enough For Crnas To Show A Willingness To Change Practice?, Michael Wesley Tillman 2016 University of Southern Mississippi

Is Current Evidence That Avoidance Of Inhalation Agents And Opioids May Decrease Metastasis Strong Enough For Crnas To Show A Willingness To Change Practice?, Michael Wesley Tillman

Doctoral Nursing Capstone Projects

Metastasis following the surgical resection of primary site breast cancer is a medical issue, which plagues mastectomy patients. The intention of this project was to synthesize current literature in order to make a presentation and disseminate it to Certified Registered Nurse Anesthetists (CRNAs) in southern Mississippi and assess the providers' willingness to change practice. CRNAs took part in a Qualtrics survey after viewing a PowerPoint presentation of evidence regarding anesthesia and metastasis. The presentation illustrated the anesthetic techniques and pharmacological agents utilized, which either mitigate or potentiate a patient's risk for metastasis. The survey assessed for a willingness to ...


Photothermal Therapy Improves The Efficacy Of A Mek Inhibitor In Neurofibromatosis Type 1-Associated Malignant Peripheral Nerve Sheath Tumors., Elizabeth E. Sweeney, Rachel A. Burga, Chaoyang Li, Yuan Zhu, Rohan Fernandes 2016 George Washington University

Photothermal Therapy Improves The Efficacy Of A Mek Inhibitor In Neurofibromatosis Type 1-Associated Malignant Peripheral Nerve Sheath Tumors., Elizabeth E. Sweeney, Rachel A. Burga, Chaoyang Li, Yuan Zhu, Rohan Fernandes

Pediatrics Faculty Publications

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive tumors with low survival rates and the leading cause of death in neurofibromatosis type 1 (NF1) patients under 40 years old. Surgical resection is the standard of care for MPNSTs, but is often incomplete and can generate loss of function, necessitating the development of novel treatment methods for this patient population. Here, we describe a novel combination therapy comprising MEK inhibition and nanoparticle-based photothermal therapy (PTT) for MPNSTs. MEK inhibitors block activity driven by Ras, an oncogene constitutively activated in NF1-associated MPNSTs, while PTT serves as a minimally invasive method to ablate ...


Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi 2016 Aurora Nursing Administration

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with ...


The Effects Of Apigenin On Cell Proliferation And Apoptosis In Glioblastoma Multiforme, Trevor Stump, Brittany Santee, Lauren Williams, Chelsae Heinze, Rachel Kunze, Samson Amos, Denise S. Simpson 2016 Cedarville University

The Effects Of Apigenin On Cell Proliferation And Apoptosis In Glioblastoma Multiforme, Trevor Stump, Brittany Santee, Lauren Williams, Chelsae Heinze, Rachel Kunze, Samson Amos, Denise S. Simpson

Samson Amos, R.Ph., Ph.D.

Glioblastoma multiforme (GBM) is a WHO grade IV brain tumor. These tumors are highly proliferative, infiltrative, necrotic, angiogenic, and resistant to apoptosis. One major characteristic of GBM is the overexpression of epidermal growth factor receptor (EGFR), which leads to cell growth and proliferation when activated. GBM is very difficult to treat due to its location, heterogeneity, and invasiveness; an effective treatment is therefore needed. The use of flavonoids, which are natural compounds found in many fruits and vegetables, has been studied in the treatment of many different tumor types. Apigenin is a specific flavonoid that has previously been shown to ...


A Proteogenomic Approach To Understanding Myc Function In Metastatic Medulloblastoma Tumors., Jerome A Staal, Yanxin Pei, Brian R. Rood 2016 George Washington University

A Proteogenomic Approach To Understanding Myc Function In Metastatic Medulloblastoma Tumors., Jerome A Staal, Yanxin Pei, Brian R. Rood

Pediatrics Faculty Publications

Brain tumors are the leading cause of cancer-related deaths in children, and medulloblastoma is the most prevalent malignant childhood/pediatric brain tumor. Providing effective treatment for these cancers, with minimal damage to the still-developing brain, remains one of the greatest challenges faced by clinicians. Understanding the diverse events driving tumor formation, maintenance, progression, and recurrence is necessary for identifying novel targeted therapeutics and improving survival of patients with this disease. Genomic copy number alteration data, together with clinical studies, identifies c-MYC amplification as an important risk factor associated with the most aggressive forms of medulloblastoma with marked metastatic potential. Yet ...


Reducing Disparities By Way Of A Cancer Disparities Research Training Program, Lee S. Caplan, Tabia H. Akintobi, Tandeca K. Gordon, Tiffany Zellner, Selina A. Smith, Daniel S. Blumenthal 2016 Morehouse School of Medicine and Walden University

Reducing Disparities By Way Of A Cancer Disparities Research Training Program, Lee S. Caplan, Tabia H. Akintobi, Tandeca K. Gordon, Tiffany Zellner, Selina A. Smith, Daniel S. Blumenthal

Journal of Health Disparities Research and Practice

Background: For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master’s degree students for careers dedicated to cancer disparities research.

Method: A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum ...


Sulfatase 2 Facilitates Lymphangiogenesis In Breast Cancer By Regulating Vegf-D., Chenfang Zhu, Xiaoliang Qi, Xin Zhou, Xin Nie, Yan Gu 2016 George Washington University

Sulfatase 2 Facilitates Lymphangiogenesis In Breast Cancer By Regulating Vegf-D., Chenfang Zhu, Xiaoliang Qi, Xin Zhou, Xin Nie, Yan Gu

Surgery Faculty Publications

In our previous studies, sulfatase 2 (Sulf2) was found to upregulate vascular endothelial growth factor-D (VEGF-D) expression in breast cancer. As VEGF-D plays an important role in lymphangiogenesis, we hypothesized that Sulf2 facilitates lymphangiogenesis in breast cancer by regulating VEGF-D. To evaluate the functions of Sulf2 on lymphangiogenesis in breast cancer, proliferation, apoptosis, cell cycle, cell mobility and tube-formation of lymphatic endothelial cells (LECs) were measured in vitro. Lymphangiogenesis in nude mouse ears and breast cancer xenografts were examined in vivo. Furthermore, the expression levels of related signaling pathway genes were screened and verified in LECs. We found that Sulf2 ...


Gastrointestinal Stromal Tumor (Gist) Of The Treitz’S Angle– A Very Rare Cause Of High Bowel Obstruction, Mădălina Elena Tobă, Dan Florin Ungureanu, Lota Corina Georgescu, Traian Pătraşcu 2016 Titu Maiorescu University of Bucharest, Faculty of Medicine

Gastrointestinal Stromal Tumor (Gist) Of The Treitz’S Angle– A Very Rare Cause Of High Bowel Obstruction, Mădălina Elena Tobă, Dan Florin Ungureanu, Lota Corina Georgescu, Traian Pătraşcu

Journal of Mind and Medical Sciences

Gastrointestinal stromal tumors (GIST) are somewhat rare gastrointestinal tumors - approximately 1% to 3% incidence, but they are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs are usually found in the stomach or small intestine but can occur anywhere within the gastrointestinal tract, even in extremely uncommon locations like duodeno-jejunal flexure. Only 3% – 5% of GISTs are located in the duodenum and tumors occurring in the angle of Treitz are even rarer, most published studies being case reports. These tumors have a size ranging from small lesions to large masses and can cause digestive bleeding or high bowel obstruction ...


Presence Of A Prophage Determines Temperature-Dependent Capsule Production In Streptococcus Pyogenes., Leslie Brown, Jeong-Ho Kim, Kyu Hong Cho 2016 George Washington University

Presence Of A Prophage Determines Temperature-Dependent Capsule Production In Streptococcus Pyogenes., Leslie Brown, Jeong-Ho Kim, Kyu Hong Cho

Biochemistry and Molecular Medicine Faculty Publications

A hyaluronic acid capsule is a major virulence factor in the pathogenesis of Streptococcus pyogenes. It acts as an anti-phagocytic agent and adhesin to keratinocytes. The expression of the capsule is primarily regulated at the transcriptional level by the two-component regulatory system CovRS, in which CovR acts as a transcriptional repressor. The covRS genes are frequently mutated in many invasive strains, and a subset of the invasive CovRS mutants does not produce a detectable level of the capsule at 37 °C, but produces a significant amount of the capsule at sub-body temperatures. Here, we report that a prophage has a ...


Treatment Of Cancer Pain, Mark Dershwitz, Richard S. Pieters 2016 University of Massachusetts Medical School

Treatment Of Cancer Pain, Mark Dershwitz, Richard S. Pieters

Cancer Concepts: A Guidebook for the Non-Oncologist

Pain is one of the first concerns most cancer patients express when newly diagnosed or meeting a new physician. They are concerned about how much pain they presently have, how much pain they are likely to experience, and their physicians’ commitment to treating cancer pain. The reality is that many cancer patients will never experience pain during their course and for those that do, the great majority can be well-managed with the tools described in this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist. It is incumbent on every physician to understand the mechanisms of cancer pain and the ...


Expression Of Kallikrein-Related Peptidases (Klks) In Adenoid Cystic Carcinoma, Zachary R. Kerr 2016 The University of Western Ontario

Expression Of Kallikrein-Related Peptidases (Klks) In Adenoid Cystic Carcinoma, Zachary R. Kerr

Electronic Thesis and Dissertation Repository

Adenoid cystic carcinoma (ACC) of salivary glands is a malignancy known for its slow growth pattern, but poor long-term survival despite aggressive treatment. This highlights the need for an improved approach to its management.

It has been suggested that kallikrein-related peptidases (KLKs), a group of 15 serine proteases, may serve as biomarkers for salivary gland tumors. KLKs are involved in numerous biological processes and have been linked to several cancers.

This study evaluated KLK gene expression in ACC and normal salivary gland tissue (NSGT). Total RNA was isolated from 40 formalin-fixed, paraffin-embedded samples, which included 25 ACCs and 15 NSGTs ...


A Pilot Study Of Circulating Tumor Cells In Stage Iv Non-Small Cell Lung Carcinoma, Max Haid, Edward Chesna, Mary Theodoroff, Debra K. Spaeth, Cheruppolil R. Santhosh-Kumar, Zahid N. Dar 2016 Sheboygan Acupuncture

A Pilot Study Of Circulating Tumor Cells In Stage Iv Non-Small Cell Lung Carcinoma, Max Haid, Edward Chesna, Mary Theodoroff, Debra K. Spaeth, Cheruppolil R. Santhosh-Kumar, Zahid N. Dar

Journal of Patient-Centered Research and Reviews

Purpose

Measurement of the number of circulating tumor cells (CTCs) in the bloodstream has been shown to have prognostic significance in treating breast carcinoma. This pilot study was formulated to determine if stage IV non-small cell lung carcinomas similarly shed malignant cells into the circulation and if their presence has prognostic significance.

Methods

Patients with stage IV non-small cell lung carcinomas were tested once for CTCs in 7.5 ml of their blood prior to receiving any treatments. A proprietary blood collection kit produced by Veridex LLC (Raritan, NJ), which manufactures the instrument that performs the immunomagnetic CELLSEARCH® CTC assay ...


Exploiting Dna Repair And Er Stress Response Pathways To Induce Apoptosis In Glioblastoma Multiforme: A Dissertation, Jessica L. Weatherbee 2016 University of Massachusetts Medical School

Exploiting Dna Repair And Er Stress Response Pathways To Induce Apoptosis In Glioblastoma Multiforme: A Dissertation, Jessica L. Weatherbee

GSBS Dissertations and Theses

Glioblastoma multiforme (GBM) is a deadly grade IV brain tumor characterized by a heterogeneous population of cells that are drug resistant, aggressive, and infiltrative. The current standard of care, which has not changed in over a decade, only provides GBM patients with 12-14 months survival post diagnosis. We asked if the addition of a novel endoplasmic reticulum (ER) stress inducing agent, JLK1486, to the standard chemotherapy, temozolomide (TMZ), which induces DNA double strand breaks (DSBs), would enhance TMZ’s efficacy. Because GBMs rely on the ER to mitigate their hypoxic environment and DNA repair to fix TMZ induced DSBs, we ...


Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane 2016 University of Massachusetts Medical School

Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Background: The prevalence of untreated pain in nursing home residents with cancer is unacceptably high. Hospice may increase the likelihood of receiving pain management at the end of life.

Objectives: To estimate whether receipt of hospice in nursing homes increases the receipt of pain management for nursing home residents with cancer at the end of life.

Methods: We conducted a cross-sectional study on a national sample of Medicare decedents who had cancer and were nursing home residents during the last 90 days of life in 2011–2012. We used the last Minimum Data Set (MDS) 3.0 assessment before death ...


Alcoholic Hepatitis Accelerates Early Hepatobiliary Cancer By Increasing Stemness And Mir-122-Mediated Hif-1alpha Activation, Aditya Ambade, Abhishek Satishchandran, Gyongyi Szabo 2016 University of Massachusetts Medical School

Alcoholic Hepatitis Accelerates Early Hepatobiliary Cancer By Increasing Stemness And Mir-122-Mediated Hif-1alpha Activation, Aditya Ambade, Abhishek Satishchandran, Gyongyi Szabo

Gyongyi Szabo

Alcohol-related hepatocellular carcinoma (HCC) develops with advanced alcoholic liver disease and liver fibrosis. Using adult mice, we evaluate the effect of alcoholic steatohepatitis on early hepatobiliary carcinoma after initiation by diethyl-nitrosamine (DEN). Here we show that alcohol-fed DEN-injected mice have higher ALT and liver-to-body weight ratio compared to pair-fed DEN-injected mice. Alcohol feeding results in steatohepatitis indicated by increased pro-inflammatory cytokines and fibrotic genes. MRI and liver histology of alcohol+DEN mice shows hepatobiliary cysts, early hepatic neoplasia and increase in serum alpha-fetoprotein. Proliferation makers (BrdU, cyclin D1, p53) and cancer stem cell markers (CD133 and nanog) are significantly up-regulated ...


Health Literacy-Listening Skill And Patient Questions Following Cancer Prevention And Screening Discussions, Kathleen M. Mazor, Donald L. Rubin, Douglas W. Roblin, Andrew E. Williams, Paul K. J. Han, Bridget Gaglio, Sarah L. Cutrona, Mary E. Costanza, Joann L. Wagner 2016 University of Massachusetts Medical School

Health Literacy-Listening Skill And Patient Questions Following Cancer Prevention And Screening Discussions, Kathleen M. Mazor, Donald L. Rubin, Douglas W. Roblin, Andrew E. Williams, Paul K. J. Han, Bridget Gaglio, Sarah L. Cutrona, Mary E. Costanza, Joann L. Wagner

University of Massachusetts Medical School Faculty Publications

OBJECTIVE: Patient question-asking is essential to shared decision making. We sought to describe patients' questions when faced with cancer prevention and screening decisions, and to explore differences in question-asking as a function of health literacy with respect to spoken information (health literacy-listening).

METHODS: Four-hundred and thirty-three (433) adults listened to simulated physician-patient interactions discussing (i) prophylactic tamoxifen for breast cancer prevention, (ii) PSA testing for prostate cancer and (iii) colorectal cancer screening, and identified questions they would have. Health literacy-listening was assessed using the Cancer Message Literacy Test-Listening (CMLT-Listening). Two authors developed a coding scheme, which was applied to all ...


Beta1 Integrin- And Jnk-Dependent Tumor Growth Upon Hypofractionated Radiation, Aejaz Sayeed, Huimin Lu, Qin Liu, David Deming Ii, Alexander Duffy, Peter McCue, Adam P. Dicker, Roger J. Davis, Dmitry Gabrilovich, Ulrich Rodeck, Dario C. Altieri, Lucia R. Languino 2016 Thomas Jefferson University

Beta1 Integrin- And Jnk-Dependent Tumor Growth Upon Hypofractionated Radiation, Aejaz Sayeed, Huimin Lu, Qin Liu, David Deming Ii, Alexander Duffy, Peter Mccue, Adam P. Dicker, Roger J. Davis, Dmitry Gabrilovich, Ulrich Rodeck, Dario C. Altieri, Lucia R. Languino

Open Access Articles

Radiation therapy is an effective cancer treatment modality although tumors invariably become resistant. Using the transgenic adenocarcinoma of mouse prostate (TRAMP) model system, we report that a hypofractionated radiation schedule (10 Gy/day for 5 consecutive days) effectively blocks prostate tumor growth in wild type (beta1wt /TRAMP) mice as well as in mice carrying a conditional ablation of beta1 integrins in the prostatic epithelium (beta1pc-/- /TRAMP). Since JNK is known to be suppressed by beta1 integrins and mediates radiation-induced apoptosis, we tested the effect of SP600125, an inhibitor of c-Jun amino-terminal kinase (JNK) in the TRAMP model system. Our results ...


Ultrasound-Guided Intralesional Bleomycin Injection (Ibi) For Treatment Of Cutaneous Hemangiomas And Vascular Malformations, Yousuf Memon, Nuzhat I. Malik, Naveed Anjum, S. Kamran Ahmed, Sadaf Saeed 2016 The Indus Hospital

Ultrasound-Guided Intralesional Bleomycin Injection (Ibi) For Treatment Of Cutaneous Hemangiomas And Vascular Malformations, Yousuf Memon, Nuzhat I. Malik, Naveed Anjum, S. Kamran Ahmed, Sadaf Saeed

The Journal of Global Radiology

Purpose: To report the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin in the treatment of cutaneous hemangiomas and vascular malformations.

Material & Methods: The medical records of patients with cutaneous hemangiomas and vascular malformations treated with the intralesional injection of bleomycin under ultrasound guidance between August 2009 and June 2013 at the Indus Hospital, Karachi were reviewed retrospectively using a computerized medical record information management system. Data were extracted using a pre-coded performa that included patient demographics, type and location of lesion, number of treatments, presenting/pre- and post-treatment clinical symptoms (pain, swelling, heaviness, size, discoloration), ultrasound appearance and vascularity, and post-treatment side effects. The dose range of bleomycin was 0.5-1.0 mg/kg, but not exceeding 15 mg in a single session. A maximum of four treatments were given in any given patient except for one, who presented with recurrence after a year of complete resolution. Therapeutic outcome was determined using review of ultrasound images and recorded clinical assessment. Treatment response was categorized as: (i) complete resolution [more than 90% reduction]; (ii) substantial reduction [more than 50% reduction]; (iii) mild reduction [25% reduction]; or, (iv) no improvement [ < 10% reduction].

Results: A total of 30 patients (16 female, 14 male), ranging in age from 8 months to 48 years (mean age 10.2 years), were treated from 2009 to 2013. There were 23 hemangiomas. Seven were vascular malformations, of which five were lymphatic malformations and two were venous malformations. Twenty-eight lesions were located in the head and neck region, and two were ...


Principles Of Surgical Oncology, Giles F. Whalen 2016 University of Massachusetts Medical School

Principles Of Surgical Oncology, Giles F. Whalen

Cancer Concepts: A Guidebook for the Non-Oncologist

Surgery is a branch of medicine that developed primarily around the management of wounds, infections, and bladder stones. Along the way, it also became the primary treatment modality for malignant solid tumors. For many cancers, surgical resection remains the foundation of curative treatment. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist aims to introduce the history of cancer surgery, to answer the question of “What is a surgical oncologist?”, and to discuss the different categories of cancer surgery.


The Smurf2-Yy1-C-Myc Axis In The Germinal Center Reaction And Diffuse Large B Cell Lymphoma: A Dissertation, Sally E. Trabucco 2016 University of Massachusetts Medical School

The Smurf2-Yy1-C-Myc Axis In The Germinal Center Reaction And Diffuse Large B Cell Lymphoma: A Dissertation, Sally E. Trabucco

GSBS Dissertations and Theses

Diffuse large B cell lymphoma (DLBCL) is the most common non-Hodgkin’s lymphoma. Patients who fail conventional therapy (~50%) have a poor prognosis and few treatment options. It is essential to understand the underlying biological processes, the progression of the disease, and utilize this information to develop new therapeutics.

DLBCL patients with high C-MYC expression have a poor prognosis and new therapeutics for these patients are needed. This thesis describes work testing the hypothesis that JQ1, which can indirectly inhibit C-MYC in some tumors, can be used as an effective treatment for DLBCL. Some tumors have an unknown mechanism causing ...


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