Institution
Lankenau Medical Center
Healthcare•Philadelphia, Pennsylvania, United States•
About: Lankenau Medical Center is a healthcare organization based out in Philadelphia, Pennsylvania, United States. It is known for research contribution in the topics: Atrial fibrillation & Medicine. The organization has 436 authors who have published 414 publications receiving 7095 citations. The organization is also known as: Lankenau Hospital.
Topics: Atrial fibrillation, Medicine, Cancer, Warfarin, Stroke
Papers
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TL;DR: It is found that patients who underwent NET for N+ disease had a higher axillary pCR than previously reported (10%) in smaller studies, and may be a suitable option for axillary downstaging, which is currently underutilized.
Abstract: Several studies have proven that neoadjuvant endocrine therapy (NET) has a similar beneficial therapeutic effect in estrogen-positive (ER+) breast cancer (BC) with improved breast conservation rate in patients undergoing NET versus neoadjuvant chemotherapy (NAC). The impact of axillary complete pathologic response (pCR) is less clear. We evaluate the impact of NET on axillary downstaging and surgical management. Using the National Cancer Database (NCDB), we identified all patients with node positive (N+), ER+, HER2− BC undergoing NET and performed a systemic review of literature using PRISMA guidelines. The literature review identified 1479 clinically N+ patients in four studies, 148 of whom had axillary pCR (10.0%). In the two studies of patients with invasive lobular carcinoma (ILC), 7.8% (69/883) of clinically N+ patients had axillary pCR. The NCDB query identified 4580 female patients with clinically N+ ER+ HER2− BC who underwent NET from 2010 to 2016 with mean age of 61.4 years. Patients who achieved a pCR were more likely to have N1 disease (p 0.008), moderately differentiated tumors (p 0.003), and ductal histology (p 0.04). There was no statistically significant difference in race, comorbidity score, education, income, hospital setting, or clinical tumor stage. Of the 4580 total patients, 663 (14.48%) had an axillary pCR (pN0) after NET, and 3917 (85.52%) remained pN+. We found that patients who underwent NET for N+ disease had a higher axillary pCR than previously reported (10%) in smaller studies. Although NET is not a common treatment option for women with N+ ER+ HER2− BC, it may be a suitable option for axillary downstaging, which is currently underutilized.
20 citations
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TL;DR: A narrative review of the emerging roles of CEUS in interventional oncology finds that the dynamic and real-time information afforded by CEUS can improve biopsy guidance, ablation therapy, and provide early evidence of tumor viability after locoregional therapy.
Abstract: Contrast-enhanced ultrasound (CEUS) has evolved from the use of agitated saline to second generation bioengineered microbubbles designed to withstand insonation with limited destruction. While only one of these newer agents is approved by the Food and Drug Administration for use outside echocardiography, interventional radiologists are increasingly finding off-label uses for ultrasound contrast agents. Notably, these agents have an extremely benign safety profile with no hepatic or renal toxicities and no radiation exposure. Alongside diagnostic applications, CEUS has begun to develop its own niche within the realm of interventional oncology. Certainly, the characterization of focal solid organ lesions (such as hepatic and renal lesions) by CEUS has been an important development. However, interventional oncologists are finding that the dynamic and real-time information afforded by CEUS can improve biopsy guidance, ablation therapy, and provide early evidence of tumor viability after locoregional therapy. Even more novel uses of CEUS include lymph node mapping and sentinel lymph node localization. Critical areas of research still exist. The purpose of this article is to provide a narrative review of the emerging roles of CEUS in interventional oncology.
20 citations
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TL;DR: Propensity analysis suggests that RBCT may be associated with poor outcome rather than being a marker of disease severity, however, when DCI is present, RBCt may help improve outcome.
20 citations
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TL;DR: This study demonstrates SP has less blood loss, smaller incisions, is quicker in left colectomy, and tends to be quicker across all procedures, without compromise in quality of surgical technique.
Abstract: Single-port (SP) surgery has been characterized as having limited applicability regarding procedure, disease, and patient characteristics. There is a question if SP procedures offer disadvantages or advantages to multiport (MP) colorectal surgery. We hypothesize that SP is equivalent to MP and is a safe alternative in the full spectrum of colorectal disease and procedures. A case-matched analysis of a prospectively maintained database to compare perioperative outcomes in SP versus MP was performed. Criteria included age, gender, BMI, previous abdominal surgery, previous XRT, disease process, and procedure. 95 exact matches for all 7 criteria were found between 159 SP and 1,617 MP cases. Perioperative outcomes, surgical technique, morbidity, mortality, local recurrence, and 5-year survival were analyzed. There was lower mean EBL in SP but no difference in transfusion requirement. OR time for SP left colectomy was shorter, with a trend to shorter OR times found in all procedures. 99 % SP and 98 % MP had no intra-operative complications. Conversion to open was equivalent (0/1). Mean largest incision was smaller for SP. There were no differences in return of bowel function or length of hospital stay. There were no mortalities. There were no differences in perioperative morbidity, local recurrence, distant metastasis, or overall 5-year survival. SP is a safe alternative to MP colorectal surgery across the full array of procedures in equivalent patients. This study demonstrates SP has less blood loss, smaller incisions, is quicker in left colectomy, and tends to be quicker across all procedures. Conversion and morbidity rates are equivalent to MP, without compromise in quality of surgical technique. While proper training is essential, concerns regarding the inability to use SP laparoscopic colorectal surgery safely are unfounded in nearly exactly matched patients. These issues will require further study as SP laparoscopic colorectal surgery is practiced more widely.
20 citations
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Sheba Medical Center1, University of Amsterdam2, University of Bordeaux3, Catholic University of Korea4, Tokyo Medical and Dental University5, National Taiwan University6, Beth Israel Deaconess Medical Center7, Tel Aviv Sourasky Medical Center8, Children's Medical Center of Dallas9, University of Turin10, Cardiovascular Institute of the South11, Xiamen University12, University of Padua13, Kansai Medical University14, St George’s University Hospitals NHS Foundation Trust15, University of Girona16, Université libre de Bruxelles17, University of Barcelona18, Copenhagen University Hospital19, Hannover Medical School20, Lankenau Medical Center21, University of Ulsan22, Tel Aviv University23
TL;DR: Asian patients with Brugada syndrome present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG, however, they have less FHSCD and markedly lower SCN5A mutation rates.
19 citations
Authors
Showing all 440 results
Name | H-index | Papers | Citations |
---|---|---|---|
Abass Alavi | 113 | 1298 | 56672 |
Robert T. Sataloff | 51 | 680 | 10252 |
Flemming Forsberg | 49 | 333 | 9769 |
Michael D. Ezekowitz | 43 | 164 | 16799 |
Gan-Xin Yan | 42 | 105 | 10110 |
William A. Gray | 41 | 135 | 6830 |
Peter D. Le Roux | 36 | 81 | 4522 |
James M. Mullin | 35 | 98 | 4095 |
Georgia Panagopoulos | 32 | 102 | 3250 |
Karen Chiswell | 30 | 132 | 3477 |
Peter R. Kowey | 29 | 113 | 3083 |
Tracey L. Evans | 29 | 97 | 4465 |
Pietro Delise | 27 | 103 | 5080 |
Caleb B. Kallen | 24 | 44 | 3517 |
Louis E. Samuels | 23 | 95 | 2380 |