Outcomes and complications of postoperative seroma cavities following soft-tissue sarcoma resection.

Introduction: Seroma development is a known complication following extremity and trunk soft-tissue sarcoma (STS) resection. The purpose of this study is to evaluate and characterize seroma outcomes and the development of associated complications.

Methods: A retrospective review of 123 patients who developed postoperative seromas following STS resection at a single institution was performed.

Natural history of intraosseous low-grade chondroid lesions of the proximal humerus.

Introduction: Enchondromas and grade 1 chondrosarcomas are commonly encountered low-grade chondroid tumors in the proximal humerus. While there is a concern for malignant transformation, few studies have evaluated the natural history of these lesions. The purpose of this study is to evaluate the natural history of proximal humerus low-grade chondroid lesions managed both conservatively and surgically, and to define management criteria using clinical and radiographic findings for these low-grade chondroid lesions.

Stereotactic body radiotherapy for metastatic sarcoma to the lung: adding to the arsenal of local therapy.

Introduction: Conventional treatment of pulmonary metastatic sarcoma primarily involves surgery, with systemic therapy added in select patients. However, broader applications of radiation therapy techniques have prompted investigation into the use of stereotactic body radiotherapy (SBRT) for treatment of metastatic sarcoma, an attractive non-invasive intervention with potential for lower rates of adverse events than surgery. Current data are limited to retrospective analyses.

Outcome comparison between muscle and fasciocutaneous flaps after secondary orthopedic procedures.

Lower extremity wounds associated with fractures and bony defects often require secondary orthopedic procedures after flap coverage has been performed. In this study, we compare complications between muscle and fasciocutaneous flaps after secondary orthopedic procedures. A retrospective chart review study of all lower extremity soft tissue reconstructions by a single surgeon over seven years yielded a subgroup of patients who underwent secondary orthopedic procedures, including hardware removal, hardware revision, and bone grafting after flap reconstruction.

Preoperative Radiation Performed at a Nonsarcoma Center May Lead to Increased Wound Complications Following Resection in Patients With Soft Tissue Sarcomas.

Objectives: Preoperative radiation therapy (RT) followed by wide-local excision with or without chemotherapy is widely accepted as management for soft tissue sarcomas (STS). Although studies have demonstrated excellent local control with this technique, there can be significant morbidity with the development of wound complications. It has been shown that sarcoma resections performed at a high-volume center lead to improved survival and functional outcomes.

Complex Femoral Reconstruction Following Pathologic Subtrochanteric Femur Fracture Secondary to Paget's Disease of the Bone: A Case Report with Long-Term Follow-up.

Introduction: Paget's disease (PD) is the most common metabolic bone disorder after osteoporosis. Clinically, it can result in pain, bony deformity, pathologic fractures, and, in the late stage, progression to malignancy. At a pathophysiological level, PD manifests as an imbalance between the homeostasis of bone destruction and formation.

High consequence infectious diseases training using interprofessional simulation and TeamSTEPPS.

Background: The comfort level of health care workers to respond to an infectious disease outbreak or epidemic is likely directly related to the amount of education, training, and experience they have in responding to these events.

Methods: A quasi-experimental study evaluated health care workers' state anxiety, self-efficacy, and interprofessional teamwork when working with patients simulated to have a potentially high consequence infectious disease.

Results: Pretest-posttest 1 scores revealed a significant decrease in state anxiety (P < .

A demonstration project on the impact of safety culture on infection control practices in hemodialysis.

Background: Infections among hemodialysis patients continues to be major causes of morbidity and mortality despite advances in the science of infection prevention. Many infections are potentially preventable, yet research suggests that evidence-based interventions are not uniformly practiced in dialysis settings. The purpose of the project was to reduce the risk of infection among hemodialysis patients in an outpatient dialysis clinic in upstate New York through the development of an enhanced patient safety culture.

Does Vacuum-assisted Closure Reduce the Risk of Wound Complications in Patients With Lower Extremity Sarcomas Treated With Preoperative Radiation?

Background: Although preoperative radiation followed by wide local excision yields excellent local control in soft tissue sarcomas, the risk of wound complications is reported to be higher compared with the incidence in patients who were administered postoperative radiation therapy. Vacuum (vac)-assisted closure may improve wound healing, but it is unknown whether vac-assisted closure during soft tissue sarcoma resection may reduce the risk of wound complications or impair local disease control.

Questions/purposes: (1) Does the use of a wound vac application at the time of soft tissue sarcoma resection reduce the risk of developing wound complications after lower extremity sarcoma resection? (2) Is vac-assisted closure associated with an increased risk of local relapse?

Methods: From 2000 to 2016, 312 patients with stage I to III soft tissue sarcomas were treated.

Creation of a competency-based professional development program for infection preventionists guided by the APIC Competency Model: steps in the process.

Background: Infection Preventionists have varying levels of educational preparation. Many have no prior experience in IP. The diversity makes design of professional development programs challenging.

Postoperative Day 1 Glucose May Be Associated With Wound Complications in Sarcomas Treated With Preoperative Radiation.

Background: Uncontrolled blood glucose impacts key phases of the wound healing process. Various factors have been associated with postoperative wound complications in soft tissue sarcomas; however, the association of postoperative early morning blood glucose with wound complications, if any, remains to be determined. Because blood glucose levels may be modified, understanding whether glucose levels are associated with wound complications has potential therapeutic importance.

Emergency Nurse Implementation of the Brief Smoking-Cessation Intervention: Ask, Advise, and Refer.

Problem: Smoking is the single most avoidable risk factor for many health problems such as cardiovascular disease and pulmonary dysfunction. Emergency departments provide care for many patients who smoke. Patients who smoke and are discharged to home from emergency departments do not customarily receive smoking-cessation information.

Myoepithelioma of soft tissue: A cytological-pathological correlation with literature review.

Myoepitheliomas of soft tissue are rare tumors with variable morphologic, immunohistochemical and molecular profiles and therefore are diagnostically challenging for pathologists. We report a case in a 60-year-old male with a painless slowly growing 3cm mass on left medial forefoot. Core biopsy of the mass showed a neoplastic proliferation of plasmacytoid tumor cells, consistent with myoepithelioma of soft tissue.

Preoperative Radiation Therapy Followed by Reexcision May Improve Local Control and Progression-Free Survival in Unplanned Excisions of Soft Tissue Sarcomas of the Extremity and Chest-Wall.

. The management for unplanned excision (UE) of soft tissue sarcomas (STS) has not been established. In this study, we compare outcomes of UE versus planned excision (PE) and determine an optimal treatment for UE in STS.

Biopsies in the Community Lead to Postoperative Complications in Soft Tissue Sarcomas.

Percutaneous biopsies allow for precise diagnosis in soft tissue sarcomas and have a low rate of complications. However, it is unknown whether biopsies performed in a community setting lead to higher rates of wound complications at the time of resection. The goal of this study was to determine whether percutaneous biopsies performed at a sarcoma center have lower rates of wound complications compared with those performed in the community setting.

Pseudo-winging of the scapula caused by scapular osteochondroma: review of literature and case report.

A 20-year-old male was evaluated for winging of the scapula and an enlarging axillary mass of 4 months' duration. Imaging demonstrated a multiloculated cystic lesion that extended into the axilla and superiorly displaced the brachial plexus and axillary vessels surrounding an exostotic mass arising from the scapula. Surgery confirmed the mass to be a benign osteochondroma with a reactive bursa.

The effect of smoking and major vein resection on post-therapy lymphedema in soft tissue sarcomas treated with neoadjuvant radiation and limb-salvage surgery.

Background: Neoadjuvant therapy with radiation +/- chemotherapy is an accepted management for soft tissue sarcomas (STS). The incidence of post-therapy lymphedema is around 30%. The purpose of this study was to identify variables that predict for post-therapy lymphedema.

Prognostic variables in patients with primary soft tissue sarcoma of the extremity and trunk treated with neoadjuvant radiotherapy or neoadjuvant sequential chemoradiotherapy.

Background: Neoadjuvant radiotherapy (NRT) is an effective strategy to treat soft tissue sarcomas (STS). However, the role of neoadjuvant chemoradiotherapy (NCRT) remains to be determined.

Methods: From May 1999 to July 2010, 112 patients with localized STS of the extremity and trunk who were treated with NRT or NCRT followed by surgery were retrospectively reviewed.

Multimodality management of metastatic patients with soft tissue sarcomas may prolong survival.

Objectives: Patients who develop metastatic disease from soft tissue sarcoma have a poor prognosis. The purpose of this study was to identify metastatic survival rates and identify prognostic variables that predict for these outcomes.

Methods: Between 2000 and 2010, 182 patients with stage I to IV primary soft tissue sarcomas of the extremity and trunk were treated with multimodality treatment.

Preventing adolescent tobacco use and assisting young people to quit: population-, community-, and individually focused evidence-based interventions.

Tobacco use among adolescents is declining in the United States but remains a major public health problem in the United States and globally. The Healthy People 2020 model of determinants of health is useful in understanding the complex interaction of factors that help explain adolescent smoking-related behaviors. Nurses are well positioned to take leadership roles in health care settings, schools, and their own communities as well as at the state, national, and global levels in advocating for policies that prevent and treat adolescent tobacco use and the subsequent burden of disease in future populations.

Extremity soft tissue sarcoma resections: how wide do you need to be?

Background: Sarcomas require a wide margin of resection including a cuff of normal tissue to minimize the risk of local recurrence. The amount of tissue that constitutes a wide margin is unclear in the literature.

Questions/purposes: We therefore determined whether a close resection margin for soft tissue sarcoma resulted in an increased incidence of locally recurrent disease and whether additional factors, including radiation therapy, outside biopsies, and tumor biology, affected the risk of local recurrence.

A survey study of musculoskeletal disorders among eye care physicians compared with family medicine physicians.

Purpose: To evaluate the prevalence of musculoskeletal disorders among eye care physicians compared with family medicine physicians.

Design: Case control study.

Participants And Controls: Ophthalmologists and optometrists at the University of Iowa and Mayo Clinic (participants) and family medicine physicians at the University of Iowa and Mayo Clinic (controls).