Publications by authors named "Rose Peter"

With advancing age, achievement of dietary adequacy for all nutrients is increasingly difficult and this is particularly so for minerals. Various factors impede mineral acquisition and absorption including reduced appetite, depressed gastric acid production and dysregulation across a range of signalling pathways in the intestinal mucosa. Minerals are required in sufficient levels since they are critical for the proper functioning of metabolic processes in cells and tissues, including energy metabolism, DNA and protein synthesis, immune function, mobility, and skeletal integrity.

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Objective: To examine the long-term perioperative changes in lumbar bone density, muscle size and fatty atrophy, and facet degeneration after transfemoral amputation (TFA).

Design: All patients who underwent TFA at an academic center between 2002-2022 were retrospectively identified. Patients were required to have preoperative and postoperative CT (>1 year) and regularly utilize a prosthesis.

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Background: Flat bone chondrosarcomas have worse outcomes than extremity tumors, but there is no data directly comparing the different flat bones. The aim of this study was to examine differences in recurrence and survival between pelvic and scapular chondrosarcoma.

Methods: One hundred and sixty-nine (42 scapula, 127 pelvic) patients with chondrosarcoma who underwent surgical resection were reviewed.

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Objective: To explore different anesthesia techniques for medialization thyroplasty and determine how these anesthesia techniques may influence patient safety, patient experience, and surgical outcomes during medialization thyroplasty in adult patients.

Data Sources: A comprehensive librarian-designed strategy was used to search EMBASE, MEDLINE, and Web of Science for English language studies from database inception to July 2023. The study was registered on Open Science Framework (10.

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Purpose: We assessed the efficacy of cediranib, olaparib, and cediranib/olaparib compared with standard-of-care chemotherapy (SOC) in platinum-resistant or platinum-refractory epithelial ovarian cancer (PROC).

Patients And Methods: NRG-GY005 is an open-label, four-arm, phase II/III superiority trial enrolling patients with high-grade serous/endometrioid PROC and one to three previous therapies. Key exclusion criteria included previous receipt of poly(ADP-ribose) polymerase inhibitor or receipt of antiangiogenic therapy in the recurrent setting.

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Article Synopsis
  • Synovial sarcoma is a rare type of tumor that can grow slowly and is often confused with non-cancerous lumps, leading to patients getting surgery they didn't really need.
  • In a study of 246 patients, about 35% had the tumors removed without proper planning, and most had more treatments afterward.
  • The results showed that these unplanned surgeries didn't hurt the chances of survival as much as some thought, but larger tumors and their location were linked to a higher risk of the disease coming back.
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  • Managing pelvic osteomyelitis (POM) related to stage IV pressure injuries needs input from various healthcare professionals and active involvement from patients and caregivers.
  • The review discusses a collaborative approach to evaluate and manage both pressure injuries and POM, emphasizing the importance of teamwork in healthcare.
  • It also points out the need for more research to improve patient outcomes, lower healthcare costs, and enhance quality of life for individuals affected by POM.
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Managing pelvic osteomyelitis (POM) in the setting of stage IV pressure injuries requires multidisciplinary evaluation as well as patient and caregiver engagement and is complicated by the lack of high-evidence data to guide best practices. In this review, we describe our approach to pressure injury and POM evaluation and management through multidisciplinary collaboration and highlight areas of future research that are necessary to enhance patient outcomes, reduce healthcare costs, and improve the quality of life of those affected by POM.

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Motivation: Large language models (LLMs) are being adopted at an unprecedented rate, yet still face challenges in knowledge-intensive domains such as biomedicine. Solutions such as pretraining and domain-specific fine-tuning add substantial computational overhead, requiring further domain-expertise. Here, we introduce a token-optimized and robust Knowledge Graph-based Retrieval Augmented Generation (KG-RAG) framework by leveraging a massive biomedical KG (SPOKE) with LLMs such as Llama-2-13b, GPT-3.

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SMYD3 (SET and MYND domain-containing 3) is a histone lysine methyltransferase highly expressed in different types of cancer(s) and is a promising epigenetic target for developing novel antitumor therapeutics. No selective inhibitors for this protein have been developed for cancer treatment. Therefore, the current study describes developing and characterizing a novel small molecule ZYZ384 screened and synthesized based on SMYD3 structure.

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Study Design: Survey study.

Objectives: The purpose of this study was to characterize the utility of 3D printed patient specific anatomic models for the planning of complex primary spine tumor surgeries.

Methods: A survey of individual members of an international study group of spinal oncology surgeons was performed.

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Soft tissue aneurysmal bone cysts (STABCs) are rare neoplasms histopathologically identical to aneurysmal bone cysts. These benign lesions are characterized by thin, peripheral ossification and no skeletal continuity. STABC may be difficult to distinguish from myositis ossificans (MO) and malignant entities from imaging and fine needle aspiration, due to rarity and overlapping features.

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Aims: Venous tumour thrombus (VTT) is a rare finding in osteosarcoma. Despite the high rate of VTT in osteosarcoma of the pelvis, there are very few descriptions of VTT associated with extrapelvic primary osteosarcoma. We therefore sought to describe the prevalence and presenting features of VTT in osteosarcoma of both the pelvis and the limbs.

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•Next generation sequencing identified a BRCA 2 mutation in a patient with stage IVB neuroendocrine cancer of the cervix.•Treatment with rucaparib resulted in disease stabilization for 74 months.•The patient remains fully active working full time as a nurse and pursing a nurse practitioner degree.

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Purpose: Niraparib is a poly(adenosine diphosphate [ADP]-ribose) polymerase inhibitor approved for the maintenance treatment of advanced ovarian cancer (OC). Niraparib was originally approved in recurrent OC at a fixed starting dose (FSD) of 300 mg once daily (QD). This analysis characterized the population pharmacokinetics (PK) of niraparib and evaluated the relationships between exposure, efficacy, and safety to support clinical use of an individualized dosing strategy, in which the starting dose of niraparib was adjusted based on patient characteristics to improve the benefit-risk profile.

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Background: Radiation-associated soft tissue sarcomas (RA-STS) are rare complications of patients receiving radiation therapy (RT) and are generally associated with a poor prognosis. Most of the literature surrounding RA-STS of the chest is centered on angiosarcoma. Therefore, we aim to document the management and outcome of patients with non-angiosarcoma RA-STS of the chest.

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Article Synopsis
  • Traumatic rib fractures significantly impact patient health, prompting the development of a comprehensive clinical practice guideline (CTCPG) at Vancouver General Hospital to improve patient management and outcomes.* -
  • A study comparing patients before and after the CTCPG implementation revealed increased use of multimodal pain therapy and a notable decrease in delirium, although other outcomes like hospital stay and mortality remained unchanged.* -
  • The findings suggest that the CTCPG enhances pain management and reduces delirium incidence, but further multicenter studies are needed to confirm these benefits in chest trauma care.*
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Background: Endoprostheses (EPC) are often utilized for reconstruction of the proximal humerus with either hemiarthroplasty (HA) or reverse arthroplasty (RA) constructs. RA constructs have improved outcomes in patients with primary lesions, but no studies have compared techniques in metastatic disease. The aim of this study is to compare functional outcomes and complications between HA and RA constructs in patients undergoing endoprosthetic reconstruction for proximal humerus metastases.

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Objective(s): To evaluate whether extended dosing of antibiotics (ABX) after cytoreductive surgery (CRS) with large bowel resection for advanced ovarian cancer is associated with reduced incidence of surgical site infection (SSI) compared to standard intra-operative dosing and evaluate predictors of SSI.

Methods: A retrospective single-institution cohort study was performed in patients with stage III/IV ovarian cancer who underwent CRS from 2009 to 2017. Patients were divided into two cohorts: 1) standard intra-operative dosing ABX and 2) extended post-operative ABX.

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Objective: Chordomas are rare tumors of the skull base and spine believed to arise from the vestiges of the embryonic notochord. These tumors are locally aggressive and frequently recur following resection and adjuvant radiotherapy. Proton therapy has been introduced as a tissue-sparing option because of the higher level of precision that proton-beam techniques offer compared with traditional photon radiotherapy.

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  • Metastasis-directed spine SBRT has been shown to improve local control and overall survival in selected patients, with a focus on clinical and dosimetric factors influencing local failure rates.
  • A study analyzed 522 treatments, highlighting that a minimum dose of 15.3 Gy in single-fraction deliveries significantly improves local control, with local failure rates being lower when this dose is achieved.
  • Epidural and soft tissue involvement are significant predictors of local failure, emphasizing the importance of targeting and dosing in SBRT for better treatment outcomes.
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Background: We sought to create a laparoscopic-based model to predict the ability to perform a minimally invasive (MIS) cytoreductive surgery in advanced epithelial ovarian cancer patients who have received neoadjuvant chemotherapy (NACT).

Methods: Fifty women were enrolled in a multi-institutional prospective pilot study (NCT03378128). Each patient underwent laparoscopic evaluation of 43 abdominopelvic sites followed by surgeon dictated surgical approach, either continue MIS or laparotomically.

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Objective: Incompletely resected epithelial ovarian cancer represents a poor prognostic subset of patients. Novel treatment strategies are needed to improve outcomes for this population. We evaluated a treatment strategy combining platinum-based chemotherapy with pembrolizumab followed by pembrolizumab maintenance therapy in the first-line treatment after incomplete resection of epithelial ovarian cancer patients.

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Iodine is a trace element required to produce the thyroid hormones, which are critical for development, growth and metabolism. To ensure appropriate population iodine nutrition, convenient and accurate methods of monitoring are necessary. Current methods for determining iodine status either involve a significant participant burden or are subject to considerable intra-individual variation.

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