Publications by authors named "Alice Chung"
Introduction: Effective communication and understanding are imperative for heart transplant (HT) recipients who require lifelong adherence to treatment plans and medications. Whether non-native English speaking (NNES) recipients have inferior outcomes compared to native English-speaking recipients (NES) has not been studied post-HT.
Methods: We reviewed adult HT recipients at Columbia University Irving Medical Center from January 2005-December 2022; primary language was determined by chart review.
Background: Nipple delay (ND) is a staged procedure that improves nipple-areolar complex (NAC) viability in nipple-sparing mastectomy (NSM) patients who are high-risk for NAC or skin-flap necrosis. This study compared postoperative outcomes and risk factors between patients treated with ND-NSM and NSM alone.
Methods: Patient demographics, risk factors for NAC or skin-flap necrosis, tumor characteristics, and operative outcomes were compared between ND-NSM and NSM groups from 2009 to 2023.
Article Synopsis
- Sarcopenia, or muscle loss, is often overlooked in patients with advanced heart failure, especially those undergoing heart transplants, but it significantly impacts postoperative outcomes.
- This study found that patients with preoperative sarcopenia had fewer days alive and out of the hospital in the year following heart transplant, with a median difference of 17 days compared to those without sarcopenia.
- The research highlights that diagnosing sarcopenia using pectoralis muscle-area index from CT scans could provide valuable insights for transplant evaluations and predict poorer outcomes.
Article Synopsis
- Nipple sparing mastectomy (NSM) is a common procedure for breast cancer patients, but the best way to monitor patients afterward remains unclear.
- A study involving 399 patients from 2007 to 2021 compared those followed by clinical breast exams (CBE) alone to those who also had MRI surveillance, analyzing recurrence rates and survival outcomes.
- Results indicated that while MRI follow-up led to more biopsies, there was no significant difference in overall survival rates between the two groups, suggesting that CBE may be sufficient for postoperative monitoring.
Article Synopsis
- National guidelines suggest that older patients (≥65 years) with favorable invasive breast cancer can skip sentinel node biopsy (SNB) during treatment, but there's a lack of prospective studies on this.
- A study involved 125 ER+ breast cancer patients aged 65 and older who underwent breast-conserving surgery (BCS) without SNB, focusing on recurrence rates and survival outcomes.
- Results showed only 1.6% of patients experienced axillary recurrence, with high 3-year survival rates, supporting the idea that SNB may not be necessary for this demographic.
Article Synopsis
- * Researchers used advanced techniques to analyze biopsies from patients at different treatment stages with pembrolizumab, revealing distinct immune responses in both non-responders and responders.
- * Non-responders showed little immune activity, while responsive tumors fell into two groups: one with pre-existing anti-tumor immunity and the other that only activated a strong immune response after combining pembrolizumab with radiotherapy.
Article Synopsis
- * Various factors contribute to the underrepresentation of women in HT, including barriers to access, implicit bias, and increased waitlist mortality, especially at higher priority levels.
- * The study calls for further research on sex-specific issues related to noninvasive monitoring, kidney outcomes post-transplant, and patient experiences, emphasizing the need for equal referral patterns to improve outcomes for women in heart transplantation.
Article Synopsis
- The study focused on older women (70+) with early-stage estrogen receptor-positive invasive breast cancer and the potential for overtreatment, assessing the omission of sentinel lymph node biopsy and radiotherapy post-breast-conserving surgery.
- Analysis of 881 patients revealed that the use of radiotherapy significantly decreased for low-risk patients from 58% in 2012 to 36% in 2022, while high-risk patients maintained stable treatment rates.
- Results indicated appropriate de-escalation of treatment for low-risk invasive breast cancer cases, showing that factors like age and tumor characteristics impacted treatment decisions.
Article Synopsis
- * A total of 170 BRCA patients who underwent prophylactic mastectomies were analyzed from 2006 to 2022, revealing a significant discrepancy between preoperative imaging and final pathology results, with only a small percentage showing abnormal findings.
- * The findings suggest minimal benefit from routine SLNB in these cases, as most procedures indicated no metastatic disease and highlighted the need to reconsider imaging protocols before surgery.
Article Synopsis
- Significant weight loss (≥10%) before a heart transplant is linked to lower 1-year survival rates post-surgery, with a study showing survival rates at 86.9% for those who lost weight compared to 91.0% for those who didn't.
- The study analyzed data from nearly 6,000 adult heart transplant recipients, confirming that preoperative weight loss serves as an independent mortality predictor even when accounting for other health factors like hospitalization status and obesity.
- The findings suggest that implementing nutritional interventions prior to transplant could help improve survival outcomes for patients experiencing significant weight loss.
Article Synopsis
- Invasive lobular carcinoma (ILC) often leads to high re-excision rates after breast-conserving surgery, and the relationship between lesion size on various imaging techniques and actual tumor size is unclear.
- A study reviewed data from patients with stage I-III breast cancer who underwent surgery, using Pearson correlation analysis to compare tumor sizes from imaging (mammography, ultrasound, and MRI) to final pathology results.
- Results indicated that MRI correlated most closely with actual tumor size, but overall imaging sizes underestimated tumors frequently, and using MRI did not significantly reduce the need for re-excision.
Article Synopsis
- * A study analyzed 1,046 women in New York undergoing their first frozen embryo transfer, dividing them by income levels and insurance coverage.
- * The findings indicated that neither income nor insurance coverage had a significant effect on live birth rates, suggesting that while financial barriers exist in accessing treatment, they do not impact outcomes once IVF has started.
Article Synopsis
- The study investigates how Paravertebral blocks (PVB) and liposomal bupivacaine (LB) affect pain control, length of stay (LOS), and hospitalization costs for patients undergoing mastectomy with implant-based reconstruction (IBR).
- Results show that patients receiving PVB had a significantly shorter LOS and lower pain scores in the post-anesthesia care unit (PACU) compared to those without any pain blocks, although their total costs were higher.
- Both PVB and LB led to similar benefits in pain relief and LOS compared to no block, highlighting the effectiveness of these pain management techniques in surgical recovery.
Comparison of fresh and frozen ejaculated spermatozoa in sibling oocyte recipient cycles.
Reprod Biomed Online
February 2022
Article Synopsis
- A study investigated the pregnancy outcomes in couples with non-male factor infertility using either fresh or frozen sperm combined with donor eggs.
- The study analyzed data from 408 patients, comparing fertilization, pregnancy, delivery, and implantation rates between fresh and frozen sperm, finding that fresh sperm led to significantly better results.
- The conclusion highlights that using frozen sperm was associated with lower delivery rates and higher pregnancy loss compared to fresh sperm, despite controlling for oocyte quality.
Article Synopsis
- Phyllodes tumors (PT) are rare tumors classified as benign, borderline, or malignant, with the study involving 76 patients diagnosed between 2009 and 2019.
- Among the patients, 61.8% had benign PT, 11.8% had borderline, and 26.3% had malignant, with a mean age of 52 at diagnosis.
- Surgical treatments varied: benign PT often received excisional biopsy, while malignant PT frequently underwent lumpectomy or mastectomy; recurrence rates were low, but positive margins were linked to higher recurrence.
Article Synopsis
- The study evaluates national compliance with the Cancer Program Practice Profile Reports (CP3R) metrics, focusing on the use of combination chemotherapy or chemo-immunotherapy for certain breast cancer patients within 120 days of diagnosis.
- An analysis of data from the National Cancer Database shows an increase in treatment concordance from 75.7% in 2004 to 89.5% in 2014, with better overall survival for patients receiving recommended treatments.
- Patients treated at academic hospitals and those with private insurance experienced greater survival benefits, highlighting the importance of accessibility to high-quality care.
Article Synopsis
- Fibroepithelial lesions of the breast (FEL) include a range of tumors such as fibroadenomas and phyllodes tumors, which can be challenging to distinguish in core needle biopsies.
- A study of 305 patients from 2009 to 2019 found that 25.8% of cases upgraded to phyllodes tumors after excision, with factors like age over 50, larger size, and specific histological features increasing upgrade risk.
- The results suggest excising FEL is generally recommended, but monitoring smaller tumors may be a safe option for some patients.
Article Synopsis
- - Marjolin's ulcers (MUs) are a serious degenerative condition that can lead to cancer, often linked to past burns but also associated with any chronic, non-healing wound.
- - The primary type of cancer resulting from MUs is cutaneous squamous cell carcinoma (SCC), which tends to be more aggressive and deadly compared to typical SCC.
- - The report discusses a specific case of managing an open wound on the breast, shedding light on a new cause of Marjolin's ulcer in that area.
Article Synopsis
- - A 65-year-old woman with a right lung transplant developed severe difficulty breathing and was found to have disseminated Mycobacterium tuberculosis (MTB) presenting as an empyema necessitans (EN), leading to hospitalization.
- - During her stay, she experienced daily fevers and was diagnosed with a right-sided chest wall abscess and pleural effusion, where cultures confirmed MTB growth within a week.
- - After starting treatment with multiple antituberculosis medications, she suffered severe side effects, including hemorrhagic pancreatitis and distributive shock, highlighting the challenges of managing MTB infections in organ transplant patients.
Article Synopsis
- The study aimed to examine the impact of higher body mass index (BMI) on endometrial receptivity in donor egg recipients (DERs).
- It included 142 patients categorized into two groups based on BMI: normal weight (group A) and overweight/obese (group B), analyzing outcomes like implantation rates, positive pregnancy rates, and live birth rates.
- Results showed no significant differences between the two groups for implantation (54.5% vs. 56.3%), positive pregnancy (77.5% vs. 80.3%), or live birth rates (54.9% vs. 60.6%), indicating that higher BMI does not negatively affect uterine receptivity.
Article Synopsis
- The Commission on Cancer (CoC) creates Cancer Program Practice Profile Reports (CP3R) that establish quality care standards, focusing on three breast cancer metrics: radiation treatment after surgeries and hormonal therapy for certain breast cancer stages.
- A study analyzing the National Cancer Database from 2004 to 2014 showed that a significant percentage of patients met these metrics, with 91.1% for BCSRT, 88.4% for MASTRT, and 90.7% for HT in 2014; however, compliance rates were lower in community hospitals compared to Integrated Network Cancer Programs (INCPs).
- Despite increased compliance rates aligning with CoC standards, particularly in comprehensive cancer programs, MASTRT
Article Synopsis
- The study aimed to investigate the impact of paternal age on pregnancy outcomes in donor egg recipients using oocytes from the same donor in the same stimulation cycle.
- Conducted as a retrospective cohort study, it compared outcomes between two groups of sperm donors: those under 45 years old and those 45 years or older.
- Results indicated that younger paternal age correlated with higher pregnancy and live birth rates, while older paternal age was linked to lower pregnancy rates, although the differences were not statistically significant.