Rotationally Intensified Proton Lattice: A Novel Lattice Technique Using Spot-Scanning Proton Arc Therapy.

Purpose: The aim of this study was to explore the feasibility and dosimetric advantage of using spot-scanning proton arc (SPArc) for lattice radiation therapy in comparison with volumetric-modulated arc therapy (VMAT) and intensity modulated proton therapy (IMPT) lattice techniques.

Methods: Lattice plans were retrospectively generated for 14 large tumors across the abdomen, pelvis, lung, and head-and-neck sites using VMAT, IMPT, and SPArc techniques. Lattice geometries comprised vertices 1.

Prognostic value of central gland volume on MRI for biochemical recurrence after prostate radiotherapy.

Purpose: This study evaluates pretreatment prostate magnetic resonance imaging (MRI) metrics and clinical characteristics in predicting biochemical recurrence (BCR) after prostate radiotherapy (RT).

Methods: In this retrospective single institution study, we identified men in our prostate cancer database who underwent MRI within 6 months prior to completing definitive RT from May 2011 to February 2023. Central gland volume and peripheral zone volume were measured by a radiologist using manual segmentation, along with Prostate Imaging-Reporting and Data System (PI-RADS) score.

Evaluating the impact of a decision-making game on empathy development in pharmacy students from the dual perspectives of the patient and pharmacist.

Introduction: Doctor of Pharmacy programs are charged with developing students' empathy by the 2016 Accreditation Council for Pharmacy Education (ACPE) Standard 3 and the 2022 Curriculum Outcomes and Entrustable Professional Activities (COEPA). Although empathy is essential to optimal patient care, its subjective nature makes it challenging to teach and therefore literature is lacking on best teaching practices. The authors of this paper describe a novel simulated approach to elicit and assess empathy in a pharmacy classroom.

Spontaneous spinal epidural hematoma following IV heparin and catheter-directed thrombolysis for deep vein thrombosis.

Spontaneous spinal epidural hematoma () is a rare condition, and it usually presents with acute onset neck or back pain, progressive weakness, and other symptoms of spinal cord compression. Catheter-directed thrombolysis is one option for limbs threatened by iliofemoral venous thrombosis; other options, such as venous thrombectomy (either open or percutaneous), are also available. There are few reported cases of SSEH owing to catheter-directed thrombolysis for deep venous thrombosis ().

The Risk of Infection-Caused Mortality in Gastric Adenocarcinoma: A Population-Based Study.

Background: Gastric adenocarcinoma (GAC) is a deadly tumor. Postoperative complications, including infections, worsen its prognosis and may affect overall survival. Little is known about perioperative complications as well as modifiable and non-modifiable risk factors.

A narrative review of risk mitigation strategies in the management of opioids for chronic pain and palliative care in older adults: interprofessional collaboration with the pharmacist.

Background And Objective: The prevalence of chronic non-cancer pain (CNCP) in older adults is high. Opioids carry significant risk for harm in older adults. Yet, many older adults are established on long-term opioid therapy for the treatment of CNCP despite limited documented efficacy.

Elevated lipoprotein(a) levels: A crucial determinant of cardiovascular disease risk and target for emerging therapies.

Cardiovascular disease (CVD) remains a significant global health challenge despite advancements in prevention and treatment. Elevated Lipoprotein(a) [Lp(a)] levels have emerged as a crucial risk factor for CVD and aortic stenosis, affecting approximately 20 of the global population. Research over the last decade has established Lp(a) as an independent genetic contributor to CVD and aortic stenosis, beginning with Kare Berg's discovery in 1963.

Long-term survival in patients with brain-only metastatic non-small cell lung cancer undergoing upfront intracranial stereotactic radiosurgery and definitive treatment to the thoracic primary site.

Background And Purpose: To evaluate modern clinical outcomes for patients with brain-only metastatic non-small cell lung cancer (NSCLC) treated with intracranial stereotactic radiosurgery (SRS) with or without definitive treatment of the primary site.

Materials And Methods: Patients with synchronously diagnosed NSCLC and brain-only metastatic disease treated with intracranial SRS at a single institution were retrospectively identified. Patients were stratified based on whether they did (A) or did not (B) receive definitive primary site treatment.

21 Gy single fraction prostate HDR brachytherapy: 5-year results of a single institution prospective pilot study.

Purpose: To present the outcome and toxicity results of a prospective trial of 21 Gy single fraction high-dose-rate (HDR) brachytherapy for men with low- or intermediate-risk prostate cancer.

Methods And Materials: Patients were treated according to an IRB-approved prospective study of single fraction HDR brachytherapy. Eligible patients had low- or intermediate-risk prostate cancer with tumor stage ≤ T2b, PSA ≤ 15, and Gleason score ≤ 7.

From Collapse to Recovery: Thiamine Intervention in Cardiac Beriberi.

This case report details the challenging presentation of a 68-year-old patient of cardio-circulatory collapse with pericardial effusion and recurrent pleural effusions. Hypotension did not respond to conventional intensive care measures. Despite comprehensive investigations, the underlying cause remained unidentified until intravenous thiamine replacement therapy was administered, restoring normotension and preventing pericardial or pleural effusion recurrence.

Subacute Combined Degeneration of the Spinal Cord Induced by Nitrous Oxide Abuse: A Rare Patient Presentation to a Spine Surgery Clinic: Illustrative Case.

Subacute combined degeneration (SCD) of the spinal cord is a disease involving the lateral and posterior columns of the spinal cord that can manifest in patients with vitamin B12 deficiency. Nitrous oxide (N2O)-induced SCD of the spinal cord is a result of N2O interfering with the metabolism of vitamin B12 and results in nervous system demyelination. This is an infrequent complication of N2O anesthesia; however, cases are rising with recreational N2O use.

Impact of Ambulatory Care Pharmacist-Led Management on Hemoglobin A1c Values among Patients with Uncontrolled Diabetes in a Primary Care Clinic vs Usual Care over Two Years.

Literature has shown the positive impact of ambulatory care pharmacists on diabetes management, yet additional research on clinical outcomes compared to traditional care models is warranted. The objective of this study is to evaluate the impact of an ambulatory care pharmacist on glycemic control over two years compared to patients who received usual care. This retrospective cohort study matched patients with a baseline hemoglobin A1c (HgbA1c) ≥8% managed by the ambulatory care pharmacist to patients who received usual care.

Evaluation of Interprofessional Quality Improvement Interventions Led by an Ambulatory Care Pharmacist on Adherence to a Controlled Substance Agreement Policy.

A controlled substance agreement (CSA) is a risk mitigation strategy for patients managed on controlled substance medications such as opioids and benzodiazepines. Limited literature exists to describe the role of the clinic pharmacy team to promote adherence to CSA monitoring parameters. The objective of this study is to evaluate the impact of interprofessional educational and clinical interventions led by an ambulatory care pharmacist on adherence to monitoring parameters within a CSA policy.

The Use of Lavender Aromatherapy for Pain After Total Hip and Total Knee Arthroplasty: A Randomized Trial.

A randomized clinical trial was conducted over a threemonth period with 102 participants undergoing a total hip arthroplasty (THA) or total knee arthroplasty (TKA). The study purpose was to assess whether there was a reduction in the use of opioids in the postoperative period for THA or TKA participants that utilized lavender aromatherapy as an adjunct to pain medication. The participants in the control and intervention group were administered nonopioid pain medication around the clock and opioids as needed after surgery.

Near-Surface Dose Correlates With Moist Desquamation and Unplanned Reconstructive Surgery in Patients With Implant-Based Reconstruction Receiving Postmastectomy Radiation Therapy.

Purpose: Postmastectomy radiation therapy (PMRT) reduces disease recurrence in appropriately selected patients but may compromise implant-based reconstruction. We investigated whether near-surface dose correlates with radiation-related toxic effects in these patients.

Methods And Materials: Patients receiving PMRT at a single institution from 2016 to 2019 were retrospectively reviewed.