The effect of Paget disease on axillary lymph node metastases and survival in invasive ductal carcinoma.

Background: The objective of this study was to examine the effect of Paget disease (PD) on axillary lymph node metastases and survival in patients who had concomitant invasive ductal carcinoma (PD-IDC).

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify women who were diagnosed with PD-IDC from 2000 to 2011, comparing baseline demographic and tumor characteristics with those who were diagnosed with IDC alone during the same period. Multivariable logistic regression was used to examine the association of PD-IDC with axillary lymph node metastasis, and breast cancer-specific survival and overall survival were compared between the PD-IDC and IDC groups using the Kaplan-Meier method and Cox proportional hazards regression.

Ustekinumab associated with flares of psoriatic arthritis.

Importance: Ustekinumab is a human monoclonal antibody that binds to the shared p40 subunit of interleukin (IL) 12 and IL-23. It is approved in the United States for adults (>18 years) with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy. In 1 phase 2 trial of ustekinumab for treatment of psoriatic arthritis, joint disease improved.

The abscopal effect associated with a systemic anti-melanoma immune response.

The clearance of nonirradiated tumors after localized radiation therapy is known as the abscopal effect. Activation of an antitumor immune response has been proposed as a mechanism for the abscopal effect. Here we report a patient with metastatic melanoma who received palliative radiation to his primary tumor with subsequent clearance of all his nonirradiated in-transit metastases.

Head and neck radiotherapy compliance in an underserved patient population.

Objectives/hypothesis: Compliance to intensive multiweek radiation therapy (RT) regimens in head and neck cancer (HNC) patients is challenging, particularly among medically underserved patients with fewer financial and social resources. Treatment prolongation reduces local control and overall survival rates, making adherence to treatment a key factor in optimal outcome. We evaluated factors affecting compliance in medically underserved patients who received RT for HNC in a large municipal hospital setting in New York City.

Management and outcomes for children with pyloric stenosis stratified by hospital type.

Background: Access to health care has been a source of controversy and public attention in health policy. The issues of access to and utilization of the healthcare system by infants and children is less well documented. Moreover, the impact on outcomes of race, ethnicity, and economic status in infants is vaguely addressed.

Lessons learned for pediatric disaster preparedness from September 11, 2001: New York City trauma centers.

The assault on the World Trade Center on September 11, 2001, has mandated that there be improved disaster preparedness for both children and adults in the immediate future. Fortunately, the events of September 11, 2001, spared 3,400 near miss children from substantial harm; however, NYC was not well prepared to handle significant numbers of pediatric patients had they been severely injured. Furthermore, there have been several medical sequelae of the attacks that have manifest long after the immediate postevent period.

Management and outcomes for children with acute appendicitis differ by hospital type: areas for improvement at public hospitals.

Background: Access to health care is a well-recognized issue in health policy, but use once patients have entered the health care system is uncommonly addressed.

Methods: We performed a retrospective review of children between 2 and 17 years of age with pathologically confirmed appendicitis at our public city hospital and private university hospital and compared management and outcomes.

Results: Among patients with acute appendicitis, the median length of stay was a day longer in the public hospital (2 days vs 1 day, P = <.