Extramedullary Disease in Adult Acute Myeloid Leukemia Is Common but Lacks Independent Significance: Analysis of Patients in ECOG-ACRIN Cancer Research Group Trials, 1980-2008.

Purpose Extramedullary disease (EMD) at diagnosis in patients with acute myeloid leukemia (AML) has been recognized for decades. Reported herein are results from a large study of patients with AML who were treated in consecutive ECOG-ACRIN Cancer Research Group frontline clinical trials in an attempt to define the incidence and clinical implications of EMD. Methods Patients with newly diagnosed AML, age 15 years and older, who were treated in 11 clinical trials, were studied to identify EMD, as defined by physical examination, laboratory findings, and imaging results.

A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on Hospital Teaching Status.

Background And Purpose: With the "weekend effect" being well described, the Brain Attack Coalition released a set of "best practice" guidelines in 2005, with the goal to uniformly provide standard of care to patients with stroke. We attempted to define a "weekend effect" in outcomes among patients with intracranial hemorrhage (ICH) over the last decade, utilizing the Nationwide Inpatient Sample (NIS) data. We also attempted to analyze the trend of such an effect.

A National Perspective of Do-Not-Resuscitate Order Utilization Predictors in Intracerebral Hemorrhage.

Nontraumatic intracerebral hemorrhage (ICH) is associated with substantial morbidity and mortality. Do-not-resuscitate (DNR) orders are linked to poorer outcomes in patients with ICH, possibly due to less active management. Demographic, regional, and social factors, not related to ICH severity, have not been adequately looked at as significant predictors of DNR utilization.

"I Felt Like It Was God's Hands Putting the Needles In": A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population.

Objectives: To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain.

Design: Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial.

Settings/location: Four community health centers in the Bronx, New York.

Incidence of cardiovascular events and gastrointestinal bleeding in patients receiving clopidogrel with and without proton pump inhibitors: an updated meta-analysis.

Background: Dual antiplatelet therapy is the standard of care after coronary stent placement but increases the bleeding risk. The effects of proton pump inhibitors (PPIs) on clopidogrel metabolism have been described, but the clinical significance is not yet definitive. We aimed to do an updated meta-analysis comparing outcomes in patients receiving clopidogrel with and without PPIs.

Integrative analysis of DNA methylation and gene expression data identifies EPAS1 as a key regulator of COPD.

Chronic Obstructive Pulmonary Disease (COPD) is a complex disease. Genetic, epigenetic, and environmental factors are known to contribute to COPD risk and disease progression. Therefore we developed a systematic approach to identify key regulators of COPD that integrates genome-wide DNA methylation, gene expression, and phenotype data in lung tissue from COPD and control samples.

Palatal myoclonus: algorithm for management with botulinum toxin based on clinical disease characteristics.

Objectives/hypothesis: To review the clinical characteristics and management of patients with palatal myoclonus and devise an algorithm for treatment with botulinum toxin based on presenting symptoms, clinical examination findings, and involved muscle groups.

Study Design: Retrospective chart review at two clinical research centers.

Methods: Between 1985 and 2011, 15 patients with a diagnosis of essential palatal myoclonus were assessed.

Randomized Evaluation of Carotid Occlusion and Neurocognition (RECON) trial: main results.

Objective: To determine whether extracranial-intracranial (EC-IC) bypass can improve cognition over 2 years compared to best medical therapy alone in patients with symptomatic internal carotid artery (ICA) occlusion and increased oxygen extraction fraction (OEF) on PET.

Methods: Patients underwent (15)O PET and were randomized if OEF ratio was >1.13 on the occluded side.

Regulatory T cells and the risk of CMV end-organ disease in patients with AIDS.

Objectives: Cytomegalovirus (CMV)-specific T-cell effectors (CMV-Teff) protect against CMV end-organ disease (EOD). In HIV-infected individuals, their numbers and function vary with CD4 cell numbers and HIV load. The role of regulatory T cells (Treg) in CMV-EOD has not been extensively studied.

Oromandibular dystonia: long-term management with botulinum toxin.

Objectives/hypothesis: To review the long-term management of patients with oromandibular dystonia (OMD) treated using botulinum toxin.

Study Design: Retrospective chart review at a clinical research center.

Methods: Between 1995 and 2011, 59 patients with a diagnosis of OMD were treated with botulinum toxin.

Bilateral breast reconstruction from a single hemiabdomen using angiosome-based flap design.

Unlabelled: Performing bilateral autologous breast reconstruction using the abdominal donor site usually entails harvesting one flap from each hemiabdomen. However, the overlapping vascular territories of the superior epigastric, deep inferior epigastric, superficial inferior epigastric, and superficial circumflex iliac vessels make it theoretically possible to harvest two flaps based on vessels from one hemiabdomen. This may be useful in the obese patient, where one hemiabdomen may provide adequate tissue to reconstruct two breasts.

Surgical management of airway dysfunction in Parkinson's disease compared with Parkinson-plus syndromes.

Objectives: We sought to compare the laryngeal symptoms of Parkinson's disease (PD) with those of multiple system atrophy (MSA), a Parkinson-plus syndrome; to review the differences in surgical management of upper airway dysfunction between patients with PD and those with MSA; and to present a treatment algorithm for management of upper airway disorders in patients with PD and MSA.

Methods: We analyzed the airway manifestations of each disease, including clinical and physiological test results and management outcomes, in a case series of 30 patients (24 with PD and 6 with MSA).

Results: Vocal fold atrophy causing bowing with a midfold glottic gap was common in patients with PD.

Protein transfection of mouse lung.

Increasing protein expression enables researchers to better understand the functional role of that protein in regulating key biological processes(1). In the lung, this has been achieved typically through genetic approaches that utilize transgenic mice(2,3) or viral or non-viral vectors that elevate protein levels via increased gene expression(4). Transgenic mice are costly and time-consuming to generate and the random insertion of a transgene or chronic gene expression can alter normal lung development and thus limit the utility of the model(5).

A new paradigm for the management of essential vocal tremor with botulinum toxin.

Objectives/hypothesis: 1) To clarify essential voice tremor (EVT) phenomenology; 2) To report a management paradigm for essential voice tremor using botulinum toxin.

Study Design: Retrospective analysis of prospectively collected data.

Methods: Phenomenology from patients diagnosed with EVT between April 1996 and March 2012 was recorded, charted, and analyzed.

Infections and radiation injuries involving the chest wall.

Soft tissue necrosis secondary to infection and radiation injury account for the majority of chest wall resections performed today that are unrelated to malignancy. Principles of treatment for chest wall infection and necrosis rely partially on the underlying cause and overall health of the patient but, in general, are based on wide resection of devitalized tissue and subsequent reconstruction with soft tissue coverage. Unlike resection for malignancy, fibrosis of underlying tissues often precludes skeletal reconstruction without concurrent loss of chest wall integrity or pulmonary function.

The safety and efficacy of laparoscopic surgical staging and debulking of apparent advanced stage ovarian, fallopian tube, and primary peritoneal cancers.

Objectives: To describe our experience with laparoscopic primary or interval tumor debulking in patients with presumed advanced ovarian, fallopian tube, or peritoneal cancers.

Methods: This is a retrospective analysis of a prospective case series. Women with presumed advanced (FIGO stage IIC or greater) ovarian, fallopian tube, or primary peritoneal cancers deemed appropriate candidates for laparoscopic debulking by the primary surgeon(s) were recruited.

Sublobar resection: a movement from the Lung Cancer Study Group.

The 1995 Lung Cancer Study Group consensus recommending lobectomy for stage I non-small cell lung cancer (NSCLC) has directed lung cancer resections since its publication. However, enhancements in imaging technology over the last decade have produced larger cohorts of patients presenting with localized, early-stage disease. Today, multislice computer tomography is widely available, capable of detecting NSCLC at smaller sizes, with improved spatial resolution, and is used in screening programs for high-risk individuals.

New technologies for reproductive medicine: laparoscopy, endoscopy, robotic surgery and gynecology. A review of the literature.

Computer-enhanced telesurgery, called robotic-assisted surgery, is the latest innovation in the minimal invasive surgery field. In gynecology, this machine has been applied in several applications, in the fields of benign gynecology, reproductive medicine, urogynecology, and oncology. The purpose of this paper was to review the published scientific literature regarding robotics and its application to gynecology thus far and summarize findings of this computer enhanced laparoscopic technique.

Laryngeal neuropathy of Charcot-Marie-Tooth disease: further observations and novel mutations associated with vocal fold paresis.

Objectives/hypothesis: To describe and define laryngeal neuropathy in Charcot-Marie-Tooth (CMT) disease.

Study Design/methods: Retrospective record review from a university laryngology practice.

Results: Four adult CMT patients presented with laryngeal symptoms.

Transnasal Transsphenoidal Endoscopic Repair of CSF Leakage Using Multilayer Acellular Dermis.

Unlabelled: Cerebrospinal fluid (CSF) leaks result from a communication between the subarachnoid space and the upper aerodigestive tract. Because of the risk of complications such as meningitis, brain abscess, and pneumocephalus, all persistent CSF leaks should be repaired. Surgical repair may be achieved transcranially or extracranially using a wide variety of autogenous, allogenic, and synthetic patching materials.