Publications by authors named "Peter Vu"

Article Synopsis
  • - Spinal cord stimulation (SCS) is a minimally invasive method used to treat severe neuropathic pain, but it's important to be aware of possible biologic complications during implantation.
  • - Although biologic complications like infection and nerve injury happen less often than device-related issues, they can have more serious effects on patients.
  • - Understanding these potential complications is essential for doctors to ensure patient safety and improve outcomes when using SCS for pain management.
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Objectives: Cancer pain is among the most prevalent and challenging symptoms in cancer care, with up to 95% of patients with late-stage cancer experiencing moderate-to-severe pain. Conventional pharmacologic treatments, including opioids, carry risks, and patients' conditions may be refractory to medical management or have contraindications. Neurostimulation techniques, such as spinal cord stimulation (SCS), dorsal root ganglion stimulation (DRGS), and peripheral nerve stimulation (PNS), have shown promise in treating treatment-induced cancer pain.

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Among the 2 million amputees in the United States, 60% to 90% will experience phantom limb pain (PLP). Managing PLP presents challenges with current evidence-based pharmacological and interventional therapies yielding varied results. In recent years, advancements in neuromodulation, such as scrambler therapy (ST), have demonstrated effectiveness in addressing various chronic and neuropathic pain syndromes.

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Article Synopsis
  • Chemotherapy-induced peripheral neuropathy (CIPN) is a painful condition that increasingly affects cancer survivors but lacks effective treatments and understanding of its biological mechanisms.
  • Research has highlighted the dorsal root ganglia (DRG) as a key player in CIPN, showing how chemotherapy drugs negatively impact sensory neurons in this area, leading to nerve-related symptoms.
  • Although preclinical studies suggest potential pathways for treatment, there is a scarcity of clinical research on direct interventions related to the DRG, indicating a need for further studies to explore effective therapeutic options for CIPN management.
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  • Crohn's disease is a chronic inflammatory bowel condition that leads to significant abdominal pain and complications like abscesses and strictures; approximately 60% of patients experience this pain, regardless of the severity of their disease.
  • A 20-year-old female college student with Crohn's disease and juvenile idiopathic arthritis struggled with persistent pain despite various pain management medications, negatively impacting her quality of life.
  • After considering dorsal root ganglion (DRG) stimulation, the patient experienced a notable 25% decrease in pain and improved daily functioning, leading to satisfaction with the treatment and a decision for permanent implantation.
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Article Synopsis
  • * These guidelines are designed to support physicians in making informed decisions about CRC screening for patients who do not have specific genetic syndromes.
  • * Recent updates include insights on both primary and secondary CRC prevention, particularly addressing when to start screening for average-risk individuals and those with a relevant personal history of cancer.
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Objective: To identify and quantify ability bias in generative artificial intelligence large language model chatbots, specifically OpenAI's ChatGPT and Google's Gemini.

Design: Observational study of language usage in generative artificial intelligence models.

Setting: Investigation-only browser profile restricted to ChatGPT and Gemini.

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Article Synopsis
  • Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the lower back, and its management requires a tailored approach that emphasizes non-pharmacological treatments and can include corticosteroid injections for severe cases.
  • A review of literature across multiple databases identified 7 studies that explored the impact of sacroiliac joint (SIJ) corticosteroid injections on pain associated with axSpA and sacroiliitis.
  • The findings suggest that SIJ corticosteroid injections can effectively reduce pain in patients with refractory axSpA, and using imaging guidance during injections may enhance treatment outcomes compared to traditional methods.
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Metastasis to the clitoris is extremely rare. Here, we report a highly unusual case of high-grade squamous cell carcinoma of the cervix metastasizing to the clitoris a year following surgery and chemoradiotherapy. The patient presented with a painless clitoral mass identified through physical examination.

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Article Synopsis
  • Chemotherapy-induced peripheral neuropathy (CIPN) can occur after cancer treatment, and spinal cord stimulation (SCS) is being explored for treating severe cases.
  • A study examined the effectiveness of two types of SCS (tonic vs. burst) in improving pain and gait in patients with CIPN, alongside quantitative sensory testing (QST) outcomes.
  • Results showed improvements in gait scores and pain relief, although some sensory testing outcomes were inconsistent; the study highlights the potential of different SCS waveforms in managing CIPN and emphasizes the importance of psychophysical testing as a monitoring tool.
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Purpose Of Review: Spinal cord stimulation (SCS) is an increasingly utilized therapy for the treatment of neuropathic pain conditions. Though minimally invasive and reversable, there are several important device-related complications that physicians should be aware of before offering this therapy to patients. The aim of this review is to synthesize recent studies in device-related SCS complications pertaining to cylindrical lead implantation and to discuss etiologies, symptoms and presentations, diagnostic evaluation, clinical implications, and treatment options.

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  • Facet joint septic arthritis (FJSA) is a rare cause of neck pain, often leading to severe complications, and requires careful diagnosis for effective treatment.
  • A unique case involving a 66-year-old man demonstrated FJSA in the cervical spine caused by Moraxella osloensis, showing symptoms like neck pain and numbness, identified through MRI and cultures.
  • The case highlights the typical role of Staphylococcus aureus in FJSA cases, emphasizes the importance of early diagnosis and treatment, and adds new insights into this uncommon condition.
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  • * Initial treatments often include medication and injections, but total knee arthroplasty (TKA) is considered for severe cases, usually improving pain and function within three months.
  • * Despite TKA's benefits, many patients still experience chronic postoperative pain; the case study highlights a patient with a previous TKA and a non-operable patella fracture who found significant relief using Peripheral Nerve Stimulation (PNS) after other treatments failed.
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Bertolotti's syndrome, also known as lumbosacral transitional vertebrae, is a relatively rare spinal condition characterized by an anatomical variation in the lower spine. Conservative approaches such as physical therapy, anti-inflammatory medications and lifestyle modifications may be recommended for mild cases. In more severe cases or when conservative measures fail to provide relief, injections such as may be considered to alleviate pain.

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Unlabelled: Total neoadjuvant therapy (TNT) is the recommended treatment for locally advanced rectal cancer. The optimal sequence of TNT is debated: induction (chemotherapy first) or consolidation (chemoradiation first)? We aim to evaluate the practice patterns and clinical outcomes of total neoadjuvant therapy with either induction or consolidation regiments in the United States for patients with locally advanced rectal cancer.

Methods: This is a retrospective analysis of the National Cancer Database for patients with clinical stage II or stage III rectal cancer, diagnosed between 2006 and 2017, who underwent total neoadjuvant therapy followed by surgery.

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Low back pain (LBP) is a challenging clinical condition for both patients and physicians. It requires a comprehensive initial diagnosis to avoid missing potential causes. One less common cause is superior cluneal neuralgia (SCN), which can present with limited lumbar motion, LBP, buttock pain, or an antalgic gait.

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Treatment of hematologic malignancies with patient-derived anti-CD19 chimeric antigen receptor (CAR) T-cells has demonstrated long-term remissions for patients with otherwise treatment-refractory advanced leukemia and lymphoma. Conversely, CAR T-cell treatment of solid tumors, including advanced gastric cancer (GC), has proven more challenging due to on-target off-tumor toxicities, poor tumor T-cell infiltration, inefficient CAR T-cell expansion, immunosuppressive tumor microenvironments, and demanding preconditioning regimens. We report the exceptional results of autologous Claudin18.

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Cervical radicular pain is commonly treated with cervical epidural steroid injections. The transforaminal approach allows for direct treatment of the steroid at a particular nerve root or level. Still, it carries a significant risk of morbidity and mortality with thromboembolism or injury to cervical vasculature.

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Purpose Of Review: The aim of this review is to educate healthcare professionals regarding buprenorphine for the use of opioid use disorder (OUD) as well as for chronic pain management. This review provides physicians and practitioners with updated information regarding the distinct characteristics and intricacies of prescribing buprenorphine.

Recent Findings: Buprenorphine is approved by the US Food and Drug Administration (FDA) for acute pain, chronic pain, opioid use disorder (OUD), and opioid dependence.

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Article Synopsis
  • Non-invasive scar management techniques include pressure therapy, silicone moisturizers, and UV protection to prevent moisture loss and reduce hypertrophic scars.
  • A study was conducted with 40 participants to test the effects of five different moisturizers and one silicone gel on hydration, blood flow, and water loss from the skin.
  • Results indicated that while silicone gel had minimal effect on skin hydration, Alhydran significantly reduced blood flow, and Lipikar increased it; however, the overall clinical impact of these products on scarring needs further investigation.
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