Medical Specialties Commons^™

Low Anterior Rectal Resection; The Impact Of Anastomotic Fistula On Incidence And Severity Of Low Anterior Resection Syndrome, Georgiana Cotofana-Graure, Cecil Mirea, Silviu Daniel Preda, Stefan Patrascu, Tiberiu Stefanita Tenea-Cojan, Adina Turcu-Stiolica, Alexandru Munteanu, Vlad Padureanu, Dragos Margaritescu, Sandu Ramboiu, Dan Cartu, Valeriu Surlin, Petru Radu

Journal of Mind and Medical Sciences

Objectives. Low anterior resection is a common surgical procedure for rectal cancer, but it is associated with a distressing complication known as Low Anterior Resection Syndrome (LARS). The incidence of LARS varies, with severe symptoms persisting in some patients even years after surgery. This study aimed to investigate the association between anastomotic leak and LARS severity in rectal cancer patients. Methods. A retrospective analysis was conducted on 100 rectal cancer patients who underwent LAR between 2017 and 2021. Patients were categorized based on LARS questionnaire responses into groups with anastomotic leakage and LARS, LARS alone, or no LARS. Various factors, …

Assessing Mid To Long Term Amputation-Free Survival Rates In Chronic Limb-Threatening Ischemia; A Study Of Hybrid Vascular Techniques, Cristian Traian Paius, Vlad Denis Constantin, Alexandru Carap, Andrei Tarus, Grigore Tinica

Journal of Mind and Medical Sciences

Introduction. Chronic limb-threatening ischemia (CLTI) is a debilitating condition characterized by inadequate blood supply to the lower extremities, often leading to tissue damage, ulcers, and limb loss. Amputation-free survival (AFS) serves as a crucial measure in evaluating interventions and managing CLTI, emphasizing limb preservation, functional restoration, and prevention of recurrent ischemic events. Objectives. This study aimed to assess mid to long term AFS in CLTI patients treated with hybrid vascular techniques. Materials and Methods. Conducted over 24 months at the Emergency Hospital of Saint Pantelimon in Bucharest, Romania, the study enrolled 62 adult CLTI patients, tracking them postoperatively. Kaplan Meyer …

Management Of Macrovascular Diabetic Complications: A Single-Center Case Series Analysis Of Consecutively Attending Patients In Primary Care, Sanda Maria Crețoiu, Mihaela Adela Iancu, Laura Maria Condur, Teodor Salmen, Andreea Steriu, Ana Maria Alexandra Stănescu, Irina Anca Eremia, Cristina Mihaela Olariu, Eliza Elena Cinteză, Camelia Cristina Diaconu

Journal of Mind and Medical Sciences

Introduction. The prevalence of diabetes mellitus is increasing, with type 2 diabetes (T2DM) being a major health priority for any public health system. Increased arterial stiffness in patients with diabetes will lead to the appearance of vascular complications. Increased arterial stiffness in patients with diabetes usually leads to vascular complications. Any earlier diagnosis of impaired macrovascular evidence may lead to improved outcomes in patient care. The objective of our study was to assess and evaluate the finger-toe pulse wave velocity (ftPWV), as a measure of arterial stiffness, in order to assist with early detection of macrovascular diabetic complications. Materials and …

Ovarian Cancer Prevention And Screening – Where Do We Stand Today?, Cristina Bucur, Irina Balescu, Sorin Petrea, Bogdan Gaspar, Lucian Pop, Valentin Varlas, Adrian Hasegan, Marilena Stoian, Gabriel Petre Gorecki, Nicolae Bacalbasa

Journal of Mind and Medical Sciences

Widely recognized as the most deathful gynecologic malignancy affecting women worldwide, ovarian cancer has reported a significant decline in terms of prevalence and incidence in the last decades. This fact has been especially explained by to the use of menopausal hormonal therapy and of oral contraceptives in association with genetic, oncologic and gynecologic counseling. The aim of the current review is to discuss about actual ovarian cancer prevention and screening tools. For this reason, we reviewed several data related to ovarian cancer, such as: incidence and risk factors, histopathological types (epithelial with high- and low-grade serous carcinomas, clear cell carcinoma, …

Genetic And Serological Markers In Colorectal Cancer Surgery, Adrian Silaghi, Vlad Denis Constantin, Dragos Serban, Dragos Epistatu, Ioana Paunica, Daniela Gabriela Bălan, Laura Florentina Rebegea

Journal of Mind and Medical Sciences

Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically and immune-stressed organisms), so that an early diagnosis (endoscopy, tumor markers, etc.) remains not only desirable but even a priority, especially in predisposed patients (genetic factors, lifestyle, etc.). As a consequence, the involvement of tumor markers in colon neoplasms has become more and more investigated in recent times. This review investigates the roles of serological and genetic …

Effect Of Continuous Renal Replacement Therapy On Serum Levels Of Inflammatory Cytokines/Interleukin-17 In Severe Acute Pancreatitis, Diana Iosif, Adrian Paul Suceveanu, Marius Prazaru, Iulia Cindea, Viorel Gherghina, Anca Mihaela Pantea Stoian, Laura Mazilu, Dragos Serban, Alina Nicoara, Andra Iulia Suceveanu

Journal of Mind and Medical Sciences

Despite continuous investigations in the diagnosis and treatment of severe acute pancreatitis (SAP), this disease still remains a critical condition with a mortality rate of up to 35%. The pathophysiology of SAP involves an important inflammatory reaction of the pancreas (mediated by inflammatory cytokines and immune system activation), causing severe local tissue damage as well as important systemic imbalances. IL-17 is an inflammatory mediator that have a pivotal role in SAP evolution, generating multiple interactions between inflammatory cytokines and significantly influencing the immune system response. Consequently, continuous renal replacement therapy/CRRT was added to the conventional therapy, leading to improved treatment …

Updating Data On Cognitive Impairment In Stroke Patients, Denisa Floriana Vasilica Pîrșcoveanu, Carmen Valeria Albu, Elena-Anca Târtea, Iulia Cristina Mărginean, George Alexandru Iacob, Elena Pinoșanu, Anca Maria Țucă, Cristina Maria Mărginean, Raluca Elena Sandu, Mircea Pîrșcoveanu

Journal of Mind and Medical Sciences

Vascular cognitive impairments are the expression of complex interactions between vascular etiology, risk factors (brain diseases, white matter lesions, etc.) and cellular changes at the brain level. Consequently, vascular cognitive impairment is highly dependent on the location, extent (volume of brain tissue affected) and number of lesions. Memory impairment is not necessarily characteristic of vascular cognitive decline, usually having an evolution with episodic exacerbations and multiple cerebrovascular attacks (cumulative effect), thus producing a gradual deterioration. In recent years, the concept of mild cognitive impairment has emerged as a potential form of predementia, but which can progress to different types of …

Venous Thrombosis Associated With Pancreatic Cancer, Vlad Buică, Camelia Diaconu, Octavian Andronic

Journal of Mind and Medical Sciences

Introduction. Cancer-associated thrombosis is a significant prognostic marker in pancreatic neoplasia, with a venous thromboembolism incidence of 17-34%. This study focuses on cancer-associated thrombosis risk factors, screening scores, and treatment options. Materials and Methods. Comprehensive database searches were conducted across Web of Science, PubMed, Reaxys, ScienceDirect, and Scopus. Results. Of the 37 articles reviewed, findings include splanchnic vein thrombosis correlating with pancreatic complications and survival rates. Gender differences in cancer-associated thrombosis risk were inconclusive, while African Americans showed a higher incidence of pulmonary embolism. Various cancer-associated thrombosis staging scores were evaluated, with ONKOTEV score outperforming Khorana. Direct oral anticoagulants were …

Diabetic Patients And Postoperative Complications In Colorectal Surgery, Ioana Paunica, Adrian Silaghi, Daniela Gabriela Bălan, Bogdan Socea, Cristian Balalau, Florin Silviu Groseanu, George Alexandru Popescu, Dragos Epistatu, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Diabetes mellitus is one of the most common comorbidities of patients undergoing surgery. Colorectal surgery is frequently associated with postoperative complications, and diabetic patients represent a population that presents a high risk of developing such complications. Understanding the interrelationships between neoplastic disease and diabetes, as well as the pathophysiological mechanisms underlying postoperative complications, are essential for effective therapeutic management. Genetic predispositions, alterations in the gut microbiota, inflammatory response, ischemic, thrombotic and infectious processes contribute significantly to the development of severe surgical complications, such as anastomotic fistulas. Postoperative ileus, characterized by gastrointestinal dysmotility, is common in diabetic patients due to neuropathic …

The Role Of Inflammation In Diabetic Retinopathy In Patients With Type Ii Diabetes; Potential Therapeutic Perspectives, Adriana Georgescu, Ana Dascalu, Daniela Stana, Cristina Alexandrescu, Anca Bobirca, Bogdan Mihai Cristea, Geta Vancea, Crenguta Sorina Serboiu, Dragos Serban, Corneliu Tudor, Andreea Letitia Arsene, Laura Carina Tribus

Journal of Mind and Medical Sciences

Diabetic retinopathy is one of the major causes of visual impairment and blindness in adult population. The pathology is complex, the metabolic changes induced by the hyperglycemic environment leading to neurodegeneration, microvascular damage, with secondary ischemic and inflammatory changes in the retina. This review aims to update the literature data related to the role of inflammation in the onset and progression of diabetic retinopathy. Thus, the molecular and biochemical mechanisms triggered by excess glucose increase the expression of genes involved in inflammatory processes, which leads to the synthesis of inflammatory cytokines such as Il1, Il6, TNF alpha as well as …

Open Versus Laparoscopic Appendectomy: A Literature Review, Nicole Kiril Nikolov, Hannah Theresa Reimer, Alvin Sun, Benjamin David Bunnell, Zachary Isaac Merhavy

Journal of Mind and Medical Sciences

Appendectomy is the most common emergency abdominal surgery in the United States. Open appendectomy has been the standard procedure for decades, whereas laparoscopic appendectomy is a newer, less-invasive method of removing the appendix. This review intends to elucidate the similarities and differences between these two procedures as well as explore the advantages and disadvantages of each approach. Socioeconomic factors, associated costs, preoperative imaging, operative time and methods, length of hospital stay, recovery time, and complications associated with open and laparoscopic appendectomy are discussed. Overall, laparoscopic appendectomy has shorter hospital stays and recovery times, requires less analgesics, and results in better …

Selective Serotonin Reuptake Inhibitors And Pharmacological Resetting Of The Mind, Ion G. Motofei, David L. Rowland

Journal of Mind and Medical Sciences

Mental activity is capable of processing analytical data (mathematics, physics, socio-political science, philosophy, etc.) similar to computer software. At the same time, mental activity largely depends on the brain, which works like a hard component of a computer. While the computer stores data on a physical medium, mental activity and data are supported by physiological mechanisms that are constantly operating (both in wakefulness and sleep). For this reason, the lack of brain oxygenation even for short periods of time (5-10 minutes) causes the loss of all data, including the disappearance of the individual's existence as a mental entity. This means …

Observational Analysis For Predicting Initial Spikes In Testing Volume Of Cohorts Inside And Outside Of A Regional Covid-19 Screening Program, Adam M. Franks, Seth Bergeron, Tammy Bannister, Justin Spradling, Tamara Lowe, Paris Johnson, Rajan Lamichhane, Stephen M. Petrany

Marshall Journal of Medicine

BACKGROUND Containing the highly contagious SARs-CoV-2 pathogen requires a safe and effective screening program. The aim of this observational cohort study is to analyze a regional testing center and identify factors predicting testing rates that direct supply and staffing needs.

METHODS A drive-through SAR-CoV-2 regional testing facility was created. Number of tests and positive results were collected for eighteen months. Data for testing demand was compared to positive results, percent positive rates (PPR), known external factors, and county PPR. Dissimilarities were contrasted with dynamic time warp and a detailed agreement analysis. The Grainger’s test was utilized to assess the degree …

The Case For Using Composition Tomography To Evaluate Perirectal Necrotizing Fasciitis: Is It Really Necessary?, Tyler Bayliss, David Denning

Marshall Journal of Medicine

Clinical reviews of Fournier’s Gangrene state that diagnostic protocol includes interpreting CT, MRI, or Ultrasound imaging along with clinical symptoms and lab findings. We think that the use of imaging techniques as a diagnostic tool is no longer needed as Fournier’s Gangrene is specific enough of a disease that clinicians can diagnose using labs and physical examination alone.

Cases of perirectal necrotizing soft tissue infection recorded at St. Marys Medical Center were reviewed. Results of physical exams and imaging were compared along with measurements of severity upon admittance and length of stay. Due to the COVID-19 pandemic, we investigated if …

Suspected Thiamine Deficiency Secondary To Chronic Gastrointestinal Illness: A Case Report, Abigail L. Meckley, Natalie Lagattuta, Elise Gonzalez, Chamonix Kinimaka, Jessica El-Bahri

HCA Healthcare Journal of Medicine

Introduction

Thiamine deficiency, also known as beriberi, is a nutritional disorder caused by a lack of thiamine (vitamin B₁) in the diet. It can occur in 2 forms: dry beriberi, which affects the nervous system, and wet beriberi, which affects the cardiovascular system. Gastrointestinal beriberi is a subtype that affects the digestive system and can lead to multisystem involvement. In the United States (US), thiamine deficiency often arises from chronic malnutrition secondary to alcoholism, known as Wernicke-Korsakoff Syndrome.

Case Presentation

A 45-year-old female with no known past medical history or alcohol use disorder came to the emergency department …

Actinic Granuloma Complicated By Secondary Syphilis: A Case Report, Kevin H. Nguyen, Christopher M. Wong, Ethan Q. Nguyen

HCA Healthcare Journal of Medicine

Introduction

Actinic granuloma (AG) is a rare skin eruption thought to result from a sun-induced inflammatory response attracting giant cells, which are large, multinucleated, and inflammatory, to form granulomas and degrade surrounding elastic material. Clinically, lesions begin on sun-exposed skin as pink papules and nodules that coalesce into demarcated annular plaques with a hypopigmented center. Histologically, actinic elastosis surrounds the outer annulus ring, with histiocytes and giant cells within the raised border, and the innermost central zone is filled with minimal to absent elastic fibers.

Case Presentation

We present a middle-aged female with a pruritic eruption of diffuse erythematous macules …

A Case Series Of Unusual Iga Vasculitis, Jared Bradley, Ian Whitaker, Brittany Lyons, Amy Mangla

HCA Healthcare Journal of Medicine

Introduction

Immunoglobulin A vasculitis (IgA)is a rare condition characterized by palpable purpura, often involving the skin, gastrointestinal tract, joints, and kidneys. Presentation is usually acute and is more common in children and adolescents of Southeast Asian and European descent. In the adult population, it is less common and therapies are not as well-established.

Case Presentation

Disease prevalence of IgA vasculitis outside Southeast Asian and European populations is not well-documented. In this case series, we present 2 cases of IgA vasculitis in 2 older adult males, one of Native American descent and one of African American descent.

Conclusion

IgA vasculitis must …

Acute Bilateral Pyelonephritis In The Setting Of Newly Diagnosed Diabetes Mellitus: A Case Report, Jessenia Ariana Contreras, Satwinder Singh, Ramesh Alwarappan

HCA Healthcare Journal of Medicine

Introduction

Acute pyelonephritis is a bacterial infection that starts in the bladder and ascends to the kidneys, causing inflammation of the renal parenchyma. Women are more likely to get infected compared to men, with diabetics being at higher risk. The pathophysiology of how diabetics are more prone to getting urinary tract infections/pyelonephritis has been studied, particularly the difference between bilateral pyelonephritis and unilateral pyelonephritis.

Case Presentation

This case presentation follows a 51-year-old Spanish-speaking woman with a past medical history of prediabetes, bilateral tubal ligation, and perimenopause. She presented to the hospital for abdominal and back pain, fevers, and weakness that …

Covid-19 In The Setting Of Hiv And Severe Hemophilia A: A Case Report, Ryan Wilson, Chae Ko, Rahul Kashyap

HCA Healthcare Journal of Medicine

Introduction

A hyperactive immune response is the driving force behind severe Coronavirus disease 2019 (COVID-19). Complications of severe COVID-19 include acute respiratory distress syndrome, acute respiratory failure, and increased risk of venous thromboembolism (VTE). The management of patients with COVID-19 includes respiratory support, decreasing immune response to the virus to prevent the progression of disease, and anticoagulation to prevent VTE.

Case Presentation

We present the case of a patient with a history of human immunodeficiency virus (HIV) and hemophilia A admitted with COVID-19. This case demonstrates the difficulties present when managing COVID-19 in patients with specific comorbidities. Anticoagulation is a …

Management Of Keloid-Associated Pruritus With Topical Crisaborole 2% Ointment: A Case Report, Daniel A. Nguyen, Elizabeth Thai Ms, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

The pathophysiology of keloid formation is poorly understood, and current treatments, including intralesional corticosteroids, cryotherapy, and surgery, are often associated with high resistance to treatment and recurrence. The multifactorial pathogenesis of keloid formation suggests that aberrant inflammatory cytokine signaling associated with keratinocyte dysregulation may contribute to keloid-associated pruritus.

Case Presentation

In this paper, we report 2 cases of keloid-associated pruritus that were successfully treated with topical crisaborole 2% ointment, a phosphodiesterase 4 (PDE4) inhibitor. Both patients had previously undergone multiple unsuccessful treatments before being treated with crisaborole 2% ointment. In both cases, the patients experienced complete relief of pruritus …

Colon Cancer Metastasis To Spermatic Cord Presenting As An Inguinal Hernia, Jessica G. Laenger, Eamon Ff Rooney, Patrick F. Dial, Candie T. Le, Sanda A. Tan

HCA Healthcare Journal of Medicine

Introduction

Inguinal hernias are very common. Their pathology and treatment are typically strait forward. Metastatic cancer can sometimes present as an inguinal hernia, but this presentation is often local metastasis.

Case Presentation

Herein we describe the case of a 68-year-old man who presented with a 2-month history of an inguinal hernia. Intraoperatively, the hernia sac was found to contain a mass attached to the spermatic cord, which was later determined to be a metastatic lesion from a locally advanced proximal transverse colon adenocarcinoma.

Conclusion

A spermatic cord mass can be a rare presentation of colon cancer metastasis. Colon cancer should …

Mpox-Induced Proctitis, Saif Ghias, Niyati Joshi, Dzenana Cabaravdic, Ramesh Nathan, Jasprit Takher

HCA Healthcare Journal of Medicine

Introduction

Mpox, formerly known as monkeypox, is a zoonotic virus in the genus Orthopoxvirus, which has a variable incubation period and an extensive array of symptoms. While those infected with Mpox have displayed generalized viral prodromal symptoms, atypical symptoms such as proctitis have also been seen. Proctitis associated with Mpox is a relatively infrequent initial presenting symptom with a reported incidence of 14-32.9% that has seen an uptick in prevalence since the 2022 global endemic.

Case Presentation

We present a confirmed case of Mpox in a 27-year-old male who presented with 3 days of intermittent anorectal bleeding and various forms …

Ischemic Colitis In A Middle-Aged Man With Covid-19: Case Report And Review Of Literature, Lara Appiah, Subhasis Misra, Stephen Jones

HCA Healthcare Journal of Medicine

Introduction

Coronavirus disease 2019 (COVID-19) was a pandemic that began in 2019 and continues to have morbid and deadly consequences throughout the world. During the beginning of the pandemic, many considered older adults and immunocompromised younger adults to be the only populations at risk for the severe consequences of COVID-19. Throughout the pandemic, this was proven wrong with several case reports and studies showing that relatively younger adults can also suffer serious consequences from this perplexing virus.

Case Presentation

We report a rare case of ischemic colitis in a 42-year-old obese man who presented to the emergency department with quintessential …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Porokeratosis, Henry Lim, Christopher M. Wong, Christian J. Scheufele, Daniel A. Nguyen, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Porokeratosis was first described in 1893. It is a relatively rare disorder with over 9 subtypes. Lesions are clinically characterized as well-demarcated, erythematous papules (raised, <1 cm) or plaques (raised, >1 cm), with an atrophic center, and raised scaly border. Porokeratosis is an important diagnosis to identify because it may undergo malignant transformation and mimics many commonly encountered diagnoses. These commonly mimicked diagnoses include squamous cell carcinoma, tinea corporis, nummular dermatitis, and psoriasis vulgaris, to name a few. The clinical images in this review focus on identifying porokeratosis along the full spectrum of skin tones.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Chronic Atopic Dermatitis, Cecilia Nguyen, Jordan Thompson, Daniel A. Nguyen, Christopher M. Wong, Christian J. Scheufele, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Atopic dermatitis is a chronic inflammatory skin disorder classically affecting flexural areas of the body. It is present in children and adults, including those with darker skin pigmentation. Chronic lesions are hyperpigmented plaques that are dry, cracked, and/or scaly often with lichenification. Differential diagnoses include psoriasis, seborrheic dermatitis, ichthyosis, and pityriasis rosea. This article will showcase clinical images with varying presentations of chronic atopic dermatitis in a range of age groups and skin colors according to the Fitzpatrick scale.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Seborrheic Dermatitis, Christian J. Scheufele, Christopher M. Wong, Daniel A. Nguyen Do, Pharmd, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Seborrheic dermatitis is a common dermatologic disease affecting patients of all ages, ethnicities, and skin pigmentations. The rash often affects the scalp, ears, and central face. The underlying skin pigmentation of the individual may affect how this disease presents. We present several cases of seborrheic dermatitis in individuals of varying ages, genders, and skin pigmentations.

Prophylactic Mesh Reinforcement For Non-Midline Incisions: A Systematic Review, Rainna Coelho, Oluwatunmininu Anwoju, Ali Siddiqui, Andrew Youssef, Oscar A. Olavarria, Nalia H. Dhanani, Karla Bernardi, Zuhair Ali, Mike Liang

HCA Healthcare Journal of Medicine

Background

Many abdominal-pelvic surgeries utilize incisions not along the linea alba, such as transverse, laparoscopic, ostomy reversal, or ostomy formation incisions. The prevalence of ventral incisional hernias (VIH) at these sites and the efficacy of prophylactic mesh in preventing VIH remains unclear.

Methods

PubMed, Embase, Scopus, and Cochrane databases were systematically reviewed from inception to September 2022. We included published randomized controlled trials (RCTs) that compared prophylactic mesh reinforcement versus no mesh. The primary outcome was the incidence of VIH at postoperative follow-up equal to or greater than 24 months. Secondary outcomes included surgical site infection (SSI) and surgical site …

Outcomes Of Drug-Eluting Stents In Comparison To Bare Metal Stents In Cancer Patients With Percutaneous Coronary Intervention: A Systematic Review And Meta-Analysis, Muhammad Siddiqui, Eric Warner, Joey Junarta, Parker O’Neill, David Signarovitz, Eyad Kanawati, Mohammed Murtaza, David Fischman

Division of Cardiology Faculty Papers

Background: Studies have demonstrated poor prognosis in cancer patients who undergo percutaneous coronary intervention (PCI) for coronary artery disease (CAD). Cancer patients receiving PCI are at increased risk of in-stent thrombosis, bleeding, hospital readmissions, and cardiovascular and noncardiovascular mortality when compared to patients without cancer. It is unclear if the poor outcomes in cancer patients are related to the stent type utilized for PCI. This meta-analysis attempts to identify differences in efficacy and safety outcomes when comparing drug-eluting stents (DESs) with bare metal stents (BMSs) in cancer patients.

Methods: This meta-analysis is reported according to the Preferred Reporting Items for …

Phase I Trial Of Single-Photon Emission Computed Tomography-Guided Liver-Directed Radiotherapy For Patients With Low Functional Liver Volume, Enoch Chang, Franklin C L Wong, Beth A Chasen, William D Erwin, Prajnan Das, Emma B Holliday, Albert C Koong, Ethan B Ludmir, Bruce D Minsky, Sonal S Noticewala, Grace L Smith, Cullen M Taniguchi, Maria J Rodriguez, Sam Beddar, Rachael M Martin-Paulpeter, Joshua S Niedzielski, Gabriel O Sawakuchi, Emil Schueler, Luis A Perles, Lianchun Xiao, Janio Szklaruk, Peter C Park, Arvind N Dasari, Ahmed O Kaseb, Bryan K Kee, Sunyoung S Lee, Michael J Overman, Jason A Willis, Robert A Wolff, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Eugene J Koay

Faculty, Staff and Student Publications

BACKGROUND: Traditional constraints specify that 700 cc of liver should be spared a hepatotoxic dose when delivering liver-directed radiotherapy to reduce the risk of inducing liver failure. We investigated the role of single-photon emission computed tomography (SPECT) to identify and preferentially avoid functional liver during liver-directed radiation treatment planning in patients with preserved liver function but limited functional liver volume after receiving prior hepatotoxic chemotherapy or surgical resection.

METHODS: This phase I trial with a 3 + 3 design evaluated the safety of liver-directed radiotherapy using escalating functional liver radiation dose constraints in patients with liver metastases. Dose-limiting toxicities were …

Pathological Response In Resectable Non-Small Cell Lung Cancer: A Systematic Literature Review And Meta-Analysis, Nathalie A Waser, Melanie Quintana, Bernd Schweikert, Jamie E Chaft, Lindsay Berry, Ahmed Adam, Lien Vo, John R Penrod, Joseph Fiore, Donald A Berry, Sarah Goring

Faculty, Staff and Student Publications

BACKGROUND: Surrogate endpoints for overall survival in patients with resectable non-small cell lung cancer receiving neoadjuvant therapy are needed to provide earlier treatment outcome indicators and accelerate drug approval. This study's main objectives were to investigate the association among pathological complete response, major pathological response, event-free survival and overall survival and to determine whether treatment effects on pathological complete response and event-free survival correlate with treatment effects on overall survival.

METHODS: A comprehensive systematic literature review was conducted to identify neoadjuvant studies in resectable non-small cell lung cancer. Analysis at the patient level using frequentist and Bayesian random effects (hazard …