Multilevel Mentorship Prepares Youth for the Oncology Workforce in Appalachian Kentucky.

Kentucky faces the highest age-adjusted overall cancer incidence rates and the second highest overall cancer mortality rates in the United States, with the eastern Appalachian Region of the state contributing significantly to this burden. As one of 57 National Cancer Institute (NCI)-designated comprehensive cancer centers in the country, the University of Kentucky Markey Cancer Center is Kentucky's only NCI-designated comprehensive cancer center. This designation is important for receiving the support necessary to fund programs that can further the cancer research, education, and community outreach opportunities for Kentuckians.

Case report: Migratory biliary stent resulting in sigmoid colon perforation.

Biliary stent insertion during endoscopic retrograde cholangiopancreatography is a therapeutic intervention to relieve obstruction and facilitate flow through the biliary tree. In rare circumstances, these stents can migrate and result in distal gastrointestinal perforation, which may necessitate endoscopic or surgical intervention. We report a case involving a 79-year-old female who presented with peritonitis due to sigmoid colon perforation following biliary stent migration.

Becoming Endemic: Anaplasmosis Imported Across State Borders.

is the causative agent of human granulocytic anaplasmosis (HGA), a tick-borne illness with increasing incidence since being described in the 1990s. Importantly, the presentation can be vague, yet prompt treatment is paramount. An 81-year-old Caucasian female was hospitalized in Cincinnati, Ohio, for fever and confusion following prolonged outdoor exposure in Emlenton, Pennsylvania.

Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation: a multi-institutional, retrospective study.

Background: Cerebral cavernous malformations (CCMs) frequently manifest with haemorrhages. Stereotactic radiosurgery (SRS) has been employed for CCM not suitable for resection. Its effect on reducing haemorrhage risk is still controversial.

Reconceptualizing the Juvenile Bunion.

Background: The operative management of the juvenile bunion has not enjoyed the same level of success as its adult counterpart leading to the concern that we do not fully understand what differentiates these 2 deformities. This study aims to (1) characterize the radiographic and pedobarographic features commonly encountered in the juvenile bunion and (2) determine which of these radiographic or pedobarographic parameters correlate with patient-reported outcome (PRO) scores at the time of presentation.

Methods: An IRB-approved retrospective analysis of prospectively enrolled patients between 10 and 18 years of age with bunion deformities was performed at a single pediatric institution over a 4-year period.

Impella Versus Extracorporeal Membranous Oxygenation (ECMO) for Cardiogenic Shock: A Systematic Review and Meta-analysis.

The use of mechanical circulatory support (MCS) in cardiogenic shock (CS) is increasing. We conducted a systematic review and meta-analysis to compare the outcomes of Impella use with extracorporeal membranous oxygenation (ECMO) support in patients with CS. We searched the Medline, EMBASE, Cochrane, and Clinicaltrials.

Failure mode and effects analysis (FMEA) to enhance the safety and efficiency of Gamma Knife radiosurgery.

This risk analysis describes our Failure Mode and Effects Analysis (FMEA) for Gamma Knife stereotactic radiosurgery at our community hospital. During bi-monthly meetings over 5 months, our FMEA team mapped a detailed Gamma Knife process tree and identified potential failure modes, each were scored a Risk Priority Number (RPN) for severity, occurrence, detectability. In our process tree of 14 subprocesses and 177 steps, we identified 31 potential failure modes: 7 high scoring (RPN o150) and 3 modes (<150) selected by clinicians for mitigation strategies.

Outcomes of screening for gammopathies in children and adults with Gaucher disease type 1 in a cohort from Brazil and the United States.

Multiple myeloma is the most common hematological malignancy in Gaucher disease type 1 (GD1). There is a lack of outcome data and consensus regarding screening of gammopathies. This study explores utility of screening in Porto Alegre, Brazil, and Cincinnati, Ohio.

Assessment of the Use of Pharmacologic Venous Thromboembolism Prophylaxis in Post-Traumatic Brain Injury Patients.

Background: Traumatic brain injury (TBI) is an independent risk factor for venous thromboembolism (VTE). Prophylaxis (PPX) beyond 48 hours increases VTE risk 3- to 4-fold. Pharmacologic VTE PPX initiation is controversial due to potential bleeding complications.

Evaluation of First-line Radiosurgery vs Whole-Brain Radiotherapy for Small Cell Lung Cancer Brain Metastases: The FIRE-SCLC Cohort Study.

Importance: Although stereotactic radiosurgery (SRS) is preferred for limited brain metastases from most histologies, whole-brain radiotherapy (WBRT) has remained the standard of care for patients with small cell lung cancer. Data on SRS are limited.

Objective: To characterize and compare first-line SRS outcomes (without prior WBRT or prophylactic cranial irradiation) with those of first-line WBRT.

Relationship between pin type and depth of skull penetration during frame placement for Gamma Knife radiosurgery.

Purpose: Our retrospective study addresses the largely unknown effect of fixation pin type on depth of skull penetration during Gamma Knife frame placement.

Methods: Absolute and relative depths were compared for 404 pins of aluminum and titanium in 101 patients who underwent Gamma Knife frame placement at 0.4 Nm (3.

Well-Differentiated Papillary Mesothelioma with Omental Calcifications: A Case Report and Review of the Literature.

BACKGROUND Omental calcifications of the peritoneum are typically small and asymptomatic. However, larger psammomatous bodies that cause symptoms such as abdominal pain and bloating are often associated with tumors such as primary serous papillary carcinoma, mesothelioma, or metastatic ovarian cancer. CASE REPORT We describe omental calcifications in a 68-year-old woman who had been asymptomatic for the last 10 years.

Staging Melanoma: What's Old and New.

The melanoma expert panel devised the evidence-based eighth edition American Joint Committee on Cancer staging system by conducting vigorous analyses of stage I, II, and III patients from the International Melanoma Database and Discovery Platform. Key changes in the eighth edition are regarding subcategorization of T1, M1, pathologic stage grouping of stage I and III, and refining the definitions and terminologies used in the staging system. As the knowledge of tumor biology improves, the staging of melanoma will continue to evolve to enable betterment of care.

Serratia Liver Abscess Infection and Cardiomyopathy in a Patient with Diabetes Mellitus: A Case Report and Review of the Literature.

BACKGROUND Liver abscesses remain difficult to diagnose and treat. Risk factors include diabetes mellitus, liver cirrhosis, and immunodeficiency. The majority are pyogenic, resulting from bacterial infection.

Anterior Cruciate Ligament Graft Conditioning Required to Prevent an Abnormal Lachman and Pivot Shift After ACL Reconstruction: A Robotic Study of 3 ACL Graft Constructs.

Background: Anterior cruciate ligament (ACL) graft conditioning protocols to decrease postoperative increases in anterior tibial translation and pivot-shift instability have not been established.

Purpose: To determine what ACL graft conditioning protocols should be performed at surgery to decrease postoperative graft elongation after ACL reconstruction.

Study Design: Controlled laboratory study.

Development of a Web-based Curriculum to Prepare Diagnostic Radiology Residents during Post-Graduate Year 1 by Promoting Learning via Spaced Repetition and Interim Testing: If You Build It, Will They Come?

Rationale And Objectives: The purpose of this pilot project was to determine the feasibility of creating a single web-based resource to allow independent study for pre-radiology interns during their first post-graduate year of training, and to measure intern use of and satisfaction with this resource.

Materials And Methods: A web-based curriculum, based on the principles of spaced learning and interim testing, was created and housed on an institutional learning management system. The curriculum consisted of narrated, interactive learning modules, electronic flashcards, and quizzes.

Brentuximab vedotin plus bendamustine: a highly active first salvage regimen for relapsed or refractory Hodgkin lymphoma.

Autologous stem cell transplantation (ASCT) is standard of care for patients with Hodgkin lymphoma (HL) who have relapsed/refractory disease after frontline chemotherapy. Achievement of complete remission (CR) with pre-ASCT salvage chemotherapy predicts favorable outcomes post-ASCT. This phase 1/2 study evaluated the combination of brentuximab vedotin (BV) plus bendamustine as a first salvage regimen in relapsed/refractory HL.

Decreased opioid consumption and enhance recovery with the addition of IV Acetaminophen in colorectal patients: a prospective, multi-institutional, randomized, double-blinded, placebo-controlled study (DOCIVA study).

Background: We hypothesized that administration of IV acetaminophen alone would reduce the opioid consumption in post-operative colorectal surgery and reduce the side effects of narcotics.

Methods: Patients were randomized to receive either IV acetaminophen or placebo in addition to opioid PCA. Primary endpoints evaluated were opioid consumption and pain visual analogue scale score (PVASS) during first 48 h post-operatively.

Low-impact sports activities are feasible after meniscus transplantation: a systematic review.

Purpose: To determine sports activities achieved after meniscus transplantation and if associations exist between sports activity levels and transplant failure or progression of tibiofemoral osteoarthritis (OA).

Methods: A systematic search was performed using PubMed and Cochrane online databases. Inclusionary criteria were English language, clinical trials published from 1996 through May 2017, minimum 2 years of follow-up, and sports activity data reported.

Efficacy and safety of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, alirocumab and evolocumab, a post-commercialization study.

Background: Efficacy-safety of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, alirocumab (ALI) and evolocumab (EVO), have previously been evaluated through controlled clinical trials with selective patient groups. Post-commercially, in 69 patients with heterozygous familial hypercholesterolemia (HeFH) and/or cardiovascular disease (CVD) with suboptimal LDL cholesterol (LDLC) lowering on maximal tolerated LDLC therapy, we assessed efficacy and safety of ALI and EVO.

Methods: Post-commercially, we started 29 patients on ALI 75 mg, 18 on ALI 150 mg, and 22 on EVO 140 mg every 2 weeks added to a maximally tolerated LDLC-lowering regimen.

Meniscal Transplantation in Symptomatic Patients Under Fifty Years of Age: Survivorship Analysis.

Background: The purpose of this study was to prospectively evaluate the long-term results and survivorship of meniscal transplantation in a consecutive series of patients.

Methods: Forty cryopreserved menisci were implanted into thirty-eight patients. Survival end points were transplant removal, revision, or tibiofemoral compartment pain with daily activities.

Diagnostic ramifications of ocular vascular occlusion as a first thrombotic event associated with factor V Leiden and prothrombin gene heterozygosity.

Aim: This study aimed to assess the diagnostic ramifications of vascular occlusion of the ocular vein and artery as a first thrombotic event associated with factor V Leiden (FVL) and/or prothrombin gene (PTG) heterozygosity.

Methods: Patients with ocular vein (n=191) and artery (n=74) occlusion, free of cardioembolic etiologies, were sequentially referred from vitreoretinal specialists for measurement of thrombophilia-hypofibrinolysis and compared to 110 healthy normal controls.

Results: Of the 265 patients, 29 (11%; 17 women, 12 men) of all referred ocular vascular occlusion (OVO) cases were found to be heterozygous for FVL and/or PTG, including 16 with FVL, 12 with PTG, and 1 with both.

A systematic review of the incidence and clinical significance of postoperative meniscus transplant extrusion.

Purpose: To determine the incidence and clinical significance of postoperative meniscus transplant extrusion.

Methods: A systematic search was performed using PubMed and Cochrane online databases. Inclusionary criteria were English language, clinical trials of meniscus transplantation published from 1984 to 2014, and meniscus extrusion measured on magnetic resonance imaging (MRI).