Publications by authors named "Westbrook K"

Background: Aromatase inhibitors (AIs) are a cornerstone of adjuvant systemic therapy for postmenopausal patients with hormone-receptor positive (HR+) breast cancer. Although AIs decrease cancer recurrence rates and improve survival rates, approximately 50 % of patients experience arthralgia-persistent pain related to worse patient outcomes and poor AI adherence. Current medical interventions for AI-associated arthralgia have limited efficacy and side effects that restrict their use among older patients.

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  • Sexual concerns are prevalent among breast cancer survivors, impacting their sexual adjustment significantly, which suggests that involving partners in the therapeutic process could be beneficial.
  • The study tested the Intimacy Enhancement (IE) intervention, a telephone-based program for couples, to tackle these sexual issues, comparing its effectiveness to a control group intervention.
  • Results indicated that the IE intervention led to notable short-term improvements in the sexual function and satisfaction of survivors, although sustaining these benefits over time may require additional strategies.
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Prostate cancer is one of the most common globally diagnosed cancers in men. It most frequently metastasizes to bones, lymph nodes, lungs, or the liver. There are limited data investigating the impact of prostate cancer on patients who have undergone ileal pouch-anal anastomosis.

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Introduction: Breast cancer treatment patterns and quality of care among patients experiencing incarceration are underexplored. This study examined associations between incarceration and breast cancer disease and treatment characteristics.

Methods: This retrospective analysis was conducted at a tertiary center in the Southeastern United States that serves as the state's safety-net hospital and primary referral site for the state's prisons.

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Purpose: This study aimed to assess safety and efficacy of a modified KEYNOTE 522 protocol, which incorporated pembrolizumab every 6 weeks, allowing for concomitant dose-dense (14 day) doxorubicin and cyclophosphamide (ddAC). By optimizing this dosing, the intention of this modified protocol was to improve pathologic complete response (pCR) rates in a population associated with a poorer prognosis.

Methods: This was a retrospective, single-center, cohort study.

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  • The study investigated the genomic diversity and antibiotic susceptibilities of Enterococcus faecalis from patients with infective endocarditis (IE).
  • The researchers collected 60 E. faecalis isolates and used whole-genome sequencing and pharmacokinetic models to analyze their antibiotic resistance, notably to ampicillin and ceftriaxone.
  • Results indicated that a significant portion of isolates (35%) belonged to two specific lineages (ST6 and ST179) associated with increased resistance, especially in ST6, highlighting the need for alternative antibiotic combinations for effective treatment.
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Survival with operable breast cancer has improved markedly in recent decades, however, treatment-related cardiovascular toxicities threaten to offset these gains. Ovarian function suppression paired with aromatase inhibition, for premenopausal women with hormone receptor (HR)-positive breast cancer, is a newer widely adopted therapy with the potential for significant long-term cardiovascular toxicity. Abrupt estrogen deprivation for non-cancer reasons is associated with accelerated coronary artery disease.

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Introduction: This study compared the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation techniques for osteotomy and root-end resection (RER).

Methods: Fifty roots from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (all, n = 25). Cone-beam computed tomography scans were taken pre and postoperatively.

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Trastuzumab deruxtecan (T-DXd) is an antibody drug conjugate with a topoisomerase I payload that targets the human epidermal growth factor receptor 2 (HER2). T-DXd is approved for patients with previously treated HER2-positive or HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+/ISH-) metastatic/unresectable breast cancer (BC). In a second-line HER2-positive metastatic BC (mBC) population (DESTINY-Breast03 [ClinicalTrials.

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Background: Patients with an ileal pouch-anal anastomosis (IPAA) can experience pouch inflammation postoperatively. The use of antitumor necrosis factor (anti-TNF) biologics may be associated with pouch inflammation, but limited data exist on the impact of multiple advanced therapies on development of subsequent pouch inflammation. The aim of this study was to assess for an association between preoperative use of multiple advanced therapies and risk of endoscopically detected inflammatory pouch diseases (EIPDs).

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Introduction: This study compared the accuracy and efficiency of a novel static computer-aided surgical technique using a 3-dimensional (3D)-printed surgical guide (3D-SG) with a fully guided drill protocol (3D-SG FG) to the freehand (FH) osteotomy and root-end resection (RER).

Methods: Forty-six roots from 2 cadaver heads were divided into 2 groups: 3D-SG FG (n = 23) and FH (n = 23). Cone-beam computed tomographic scans were taken preoperatively and postoperatively.

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Background: Initial trials evaluating Oncotype DX, reported as a recurrence score (RS) from 0 to 100, were not powered to evaluate overall survival, and premenopausal women were underrepresented. The purpose of this study was to explore the benefit of chemotherapy according to RS among younger women eligible for oncotype testing.

Methods: Women aged 40-50, diagnosed with HR-positive, HER2-negative breast cancer between 2010 and 2017 were selected from the National Cancer Database (NCBD).

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Purpose: SOLAR-1 investigated alpelisib-fulvestrant (ALP + FLV) in patients with HR + /HER2-, PIK3CA-mutated advanced breast cancer and demonstrated a clinically significant increase in all-grade and grade (G) 3-4 hyperglycemia (HG) compared to placebo-fulvestrant. Given high rates of HG, a preventative protocol and identification of associated risk factors was implemented.

Methods: This single-center, retrospective study included patients receiving ALP + FLV.

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spp. are opportunistic pathogens that cause nosocomial infections. Bacteriophages could be used to treat antibiotic-resistant infections.

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  • Bacteriophage therapy shows promise as an alternative to antibiotics, but more characterized phages are needed.
  • Researchers collected 23 bacterial isolates related to cystic fibrosis and clinical infections and isolated over a dozen phages from hospital wastewater.
  • They characterized these phages using genomic techniques and tested their effectiveness against bacterial mutants and biofilms, highlighting the potential for tailored bacteriophage treatments.
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The NCCN Guidelines for Hematopoietic Growth Factors provide recommendations for the appropriate use of growth factors in the clinical management of febrile neutropenia (FN), chemotherapy-induced thrombocytopenia (CIT), and chemotherapy-induced anemia (CIA). Management and prevention of these sequelae are an integral part of supportive care for many patients undergoing cancer treatment. The purpose of these guidelines is to operationalize the evaluation, prevention, and treatment of FN, CIT, and CIA in adult patients with nonmyeloid malignancies and to enable the patient and clinician to assess management options for FN, CIT, and CIA in the context of an individual patient's condition.

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  • Many patients stop endocrine therapy for breast cancer due to side effects, making it tough to identify at-risk individuals.
  • Research established the minimal important difference (MID), which highlights clinically significant changes in patient-reported outcomes (PROs).
  • In a study of 321 women undergoing endocrine therapy, a correlation was found between worsening PRO scores and the likelihood of discontinuation, particularly linked to endocrine symptoms and sleep disturbances.*
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  • Cancer affects not only patients but also their partners, highlighting the need for effective communication in managing psychological and relationship adjustments during treatment.
  • Two conceptual models, the social-cognitive processing (SCP) model and the relationship intimacy (RI) model, will be tested to understand their impact on adjustments both day-to-day and over one year.
  • The study will use a comprehensive, multi-method approach, including self-reports, real-time assessments via smartphones, and laboratory conversations, involving cancer patients and their partners to evaluate communication dynamics and their effects.
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Zieve's syndrome (ZS) is a triad of hemolytic anemia, cholestatic jaundice and hyperlipidemia that presents in the setting of alcohol abuse and liver disease. ZS is not well known and remains underdiagnosed. We present a case of ZS in a 38-year-old female with a history of chronic alcohol abuse and pancreatitis to raise awareness of ZS.

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Context: Women with metastatic breast cancer (MBC) experience a significant symptom burden, including cancer pain. Yoga is a mind-body discipline that has shown promise for alleviating cancer pain, but few studies have included patients with metastatic disease or examined the acute effects of yoga practice.

Objectives: To determine whether daily pain changed significantly during a randomized controlled trial of the Mindful Yoga program among women with MBC and whether time spent in yoga practice was related to daily pain.

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Background: Sexual concerns are distressing for breast cancer survivors and interfere with their intimate relationships. This study evaluates the efficacy of a four-session couple-based intervention delivered via telephone, called Intimacy Enhancement (IE). The IE intervention is grounded in social cognitive theory and integrates evidence-based techniques from cognitive behavioral couple therapy and sex therapy to address survivors' sexual concerns and enhance their and their partners' sexual, relationship, and psychological outcomes.

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Management of febrile neutropenia (FN) is an integral part of supportive care for patients undergoing cancer treatment. The NCCN Guidelines for Hematopoietic Growth Factors provide suggestions for appropriate evaluation, risk determination, prophylaxis, and management of FN. These NCCN Guidelines are intended to guide clinicians in the appropriate use of growth factors for select patients undergoing treatment of nonmyeloid malignancies.

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Anticipating and making health care decisions about appropriate or preferred treatment around end-of-life care are intellectually challenging and emotionally distressing for metastatic breast cancer (MBC) patients, new interventions are needed. This study examined the effect of , an online and personalized coping and decision aid curriculum, on the completion of advance care directives and shared decision making among patients and their loved ones, clinicians, and spirit. Participants were randomized 1:1 to or wait-listed usual care conditions.

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