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1. Predictive Value of Noncontrast Head CT with Negative Findings in the Emergency Department Setting.

Author

Callen, AL, Chow, DS, Chen, YA, Richelle, HR, Pao, J, Bardis, M, Weinberg, BD, Hess, CP, and Sugrue, LP

Subjects
Head, Humans, Tomography, X-Ray Computed, Retrospective Studies, Predictive Value of Tests, Adult, Aged, Middle Aged, Emergency Service, Hospital, Female, Male, Clinical Research, Biomedical Imaging, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Clinical Sciences, Neurosciences, Nuclear Medicine & Medical Imaging
Abstract

Background and purposeNoncontrast head CTs are routinely acquired for patients with neurologic symptoms in the emergency department setting. Anecdotally, noncontrast head CTs performed in patients with prior negative findings with the same clinical indication are of low diagnostic yield. We hypothesized that the rate of acute findings in noncontrast head CTs performed in patients with a preceding study with negative findings would be lower compared with patients being imaged for the first time.Materials and methodsWe retrospectively evaluated patients in the emergency department setting who underwent noncontrast head CTs at our institution during a 4-year period, recording whether the patient had undergone a prior noncontrast head CT, the clinical indication for the examination, and the examination outcome. Positive findings on examinations were defined as those that showed any intracranial abnormality that would necessitate a change in acute management, such as acute hemorrhage, hydrocephalus, herniation, or interval worsening of a prior finding.ResultsDuring the study period, 8160 patients in the emergency department setting underwent a total of 9593 noncontrast head CTs; 88.2% (7198/8160) had a single examination, and 11.8% (962/8160) had at least 1 repeat examination. The baseline positive rate of the "nonrepeat" group was 4.3% (308/7198). The 911 patients in the "repeat" group with negative findings on a baseline/first CT had a total of 1359 repeat noncontrast head CTs during the study period. The rate of positive findings for these repeat examinations was 1.8% (25/1359), significantly lower than the 4.3% baseline rate (P

Published
2020

3. 03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population

Author

Johnson, G., Vergis, A., Unger, B., Park, J., Gillman, L., Hickey, K., Pace, D., Azin, A., Guidolin, K., Lam-Tin-Cheung, K., Chadi, S., Quereshy, F., Catton, J., Rubin, B., Bell, J., Marangos, J., Heesters, A., Stuart-McEwan, T., Shariff, F., Wright, F., Ahmed, N., Nadler, A., Hallet, J., Gentles, J., Chen, L., Hwang, H., Parapini, M., Hirpara, D., Sidhu, R., Scott, T., Karimuddin, A., Guo, R., Nguyen, A., Osborn, J., Wiseman, S., Nabata, K., Ertel, E., Lenet, T., Baker, L., Park, L., Vered, M., Zahrai, A., Shorr, R., Davis, A., McIsaac, D., Tinmouth, A., Fergusson, D., Martel, G., Rummel, S., Stefic-Cubic, M., Stewart, M., Melck, A., McKechnie, T., Anpalagan, T., Ichhpuniani, S., Lee, Y., Ramji, K., Eskicioglu, C., Zhu, A., Deng, S., Greene, B., Tsang, M., Palter, V., Jayaraman, S., Mann, A., Tittley, J., Cadeddu, M., Nguyen, M., Madani, A., Pasternak, J., Hong, D., Qu, L., Istl, A., Tang, E., Gray, D., Zuckerman, J., Coburn, N., Callum, J., McLeod, R., Pearsall, E., Lin, Y., Turgeon, A., Mahar, A., Kammili, A., Kriviraltcheva-Kaneva, P., Lee, L., Cools-Lartigue, J., Ferri, L., Mueller, C., Haas, B., Tillman, B., Guttman, M., Chesney, T., Zuk, V., Hsu, A., Chan, W., Vasdev, R., D’Souza, K., Huynh, C., Ling, L. Cadili J., Warburton, R., Hameed, M., Glass, L., Williamson, H., Murphy, P., Leslie, K., Hawel, J., Kerr, L., Zablotny, S., Roldan, H., He, W., Jiang, X., Zheng, B., Fiore, J., Feldman, L., Fried, G., Valanci, S., Balvardi, S., Cipolla, J., Kaneva, P., Demyttenaere, S., Boutros, M., Alhashemi, M., Miles, A., Purich, K., Verhoeff, K., Shapiro, J., Bigam, D., Kung, J., Fecso, A., Mosko, J., Skubleny, D., Hamilton, P., Ghosh, S., Widder, S., Schiller, D., Do, U., El Kefraoui, C., Pook, M., Barone, N., Montgomery, H., Nguyen-Powanda, P., Rajabiyazdi, F., Elhaj, H., Lapointe-Gagner, M., Olleik, G., Antoun, A., Safa, N., Di Lena, E., Meterissian, S., Meguerditchian, A., Lee, F., Baldini, G., Serrano Aybar, P.E., Parpia, S., Ruo, L., Tywonek, K., Lee, S., O’Neill, C., Faisal, N., Alfayyadh, A., Gundayao, M., Meyers, B.M., Habashi, R., Kruse, C., Levin, M., Aldrich, K., Grantcharov, T., Langerman, A., Forbes, H., Anantha, R., Fawcett, V., Hetherington, A., Pravong, V., Gervais, M., Rakovich, G., Selvam, R., Hu, R., Musselman, R., Raiche, I., Moloo, H., Liu, R., Elnahas, A., Alkhamesi, N., Alnumay, A., Schlachta, C., Walser, E., Zhang, C., Cristancho, S., Ott, M., Lee, A., Niu, B., Balaa, F., Gawad, N., Ren, K., Qiu, Y., Hamann, K., How, N., Leveille, C., Davidson, A., Eqbal, A., Sardiwalla, Y., Korostensky, M., Lee, E., Yang, I., Muaddi, H., Stukel, T., de Mestral, C., Nathens, A., Karanicolas, P., Frigault, J., Lemieux, S., Breton, D., Bouchard, P., Bouchard, A., Grégoire, R., Letarte, F., Bouchard, G., Drolet, S., Avoine, S., Gagné, J., Thibault, C., Jutras Bouthillette, N., Gosselin, M., Rosenzveig, A., Stuleanu, T., Jarrar, A., Kolozsvari, N., Skelhorne-Gross, G., Nenshi, R., Jerath, A., Gomez, D., Singh, K., Amir, T., Liu, E., Farquharson, S., Mao, R., Lan, L., Yan, J., Allard-Coutu, A., Mierzwa, A., Tin, R., Brisebois, R., Bradley, N., Wigen, R., Hartford, L., Van Koughnett, J., Vogt, K., Hilsden, R., Parry, N., Allen, L., Raskin, R., Jones, J., Neumann, K., Dwyer, C., Strickland, M., O’Dochartaigh, D., Lobay, K., Kabaroff, A., Chang, E., Sun, W., Beck, J., Davidson, J., Jones, S., Van Hooren, T., Schmitz, E., El Hafid, M., Dang, J., Mocanu, V., Lutzak, G., Sultanian, R., Wong, C., Karmali, S., Petrera, M., Pickell, M., Auer, R., Patro, N., Li, B., Wilson, H., Jogiat, U., Switzer, N., Li, C., Al Hinai, A., Cieply, A., Hawes, H., Joos, E., Saleh, A., Engels, P., Drung, J., Pang, G., Kwong, M., Ellsmere, J., Chang, D., Hutter, M., Spence, R., Abou Khalil, M., Vasilevsky, C., Morin, N., Longtin, Y., Liberman, S., Montpetit, P., Poirier, M., Mukherjee, K., Sebajang, H., Younan, R., Schwenter, F., De Broux, E., Larsen, K., Beckett, A., Nantais, J., Kay, J., Lohre, R., Ayeni, O., Goel, D., de SA, D., He, R., Hylton, D., Bedard, E., Johnson, S., Laing, B., Valji, A., Hanna, W., Turner, S., Akhtar-Danesh, G., Akhtar-Danesh, N., Shargall, Y., Gupta, V., Kidane, B., Limbachia, J., Sullivan, K., Farrokhyar, F., Leontiadis, G., Patel, Y., Churchill, I., Xie, F., Seely, A., Spicer, J., Yasufuku, K., Beauchamp, M., Wald, J., Mbuagbaw, L., Agzarian, J., Finley, C., Fahim, C., Abbas, M., Olaiya, O., Begum, H., Ednie, A., Palma, D., Warner, A., Malthaner, R., Fortin, D., Qiabi, M., Nayak, R., Nguyen, T., Louie, A., Rodrigues, G., Yaremko, B., Laba, J., Inculet, R., Alaichi, J., Mador, B., Lai, H., White, J., Kim, M., Darling, G., Rousseau, M., Samarasinghe, Y., Lee, M., Thiru, L., Levine, O., Juergens, R., Brogly, S., Li, W., Lougheed, D., Petsikas, D., Mistry, N., Gatti, A., Abdul, S., Anestee, C., Gilbert, S., Sundaresan, S., Villeneuve, P., Maziak, D., Razzak, R., Ashrafi, A., Tregobov, N., Hassanzadeh, N., Stone, S., Panjwani, A., Bong, T., Bond, R., Hafizi, A., De Meo, M., Rayes, R., Milette, S., Vagai, M., Usatii, M., Chandrasekaran, A., Giannias, B., Bourdeau, F., Sangwan, V., Bertos, N., Moraes, C., Huang, S., Quail, D., Walsh, L., Camilleri-Broet, S., Fiset, P., Bilgic, E., Quaiattini, A., Maurice-Ventouris, M., Najmeh, S., Esther, L., Lu, J., Malhan, R., Brophy, S., Brennan, K., French, D., Resende, V., Momtazi, M., Solaja, O., Sisson, D., Donahoe, L., Bedard, P., Hansen, A., De Perrot, M., Alghamedi, A., Simone, A., Huang, J., Murthy, S., Lin, J., Li, H., Crowther, M., Linkins, L., Lau, E., Schneider, L., Douketis, J., Greenberg, B., Allen-Avodabo, C., Davis, L., Zhao, H., Sirois, C., Mulder, D., Al Rawahi, A., Aftab Abdul, S., Nguyen, D., Anstee, C., Delic, E., Sasewich, H., Islam, T., Low, D., Humer, M., Le Nguyen, D., Kay, M., Shayegan, B., Adili, A., Kaafarani, M., Chouiali, F., Muthukrishnan, N., Maleki, F., Ovens, K., Gold, M., Sorin, M., Falutz, R., Forghani, R., Hunka, N., Kennedy, R., Bigsby, R., Bharadwaj, S., Gowing, S., Pearce, K., Jones, D., Kumar, S., Gingrich, M., Ahmadzai, Z., Thavorn, K., Namavarian, A., Mohammed, A., Uddin, S., Behzadi, A., Brar, A., Peters, E., Buduhan, G., Tan, L., Srinathan, S., Levy, J., Ringash, J., Sutradhar, R., Robinson, M., Bednarek, L., Wang, H., MacDonald, D., Graham, K., Enns, S., Tan, A., Bruinooge, A., Poole, E., Pascoe, C., Karakach, T., Halayko, A., Fang, B., Birch, D., Singh, H., Hershorn, O., Hochman, D., Helewa, R., Robertson, R., Cahill, C., Lipson, M., Afzal, A., Maclean, A., Roen, S., Buie, W., Chu, M., Amin, N., Jaffer, H., Rebello, R., Doumouras, A., Hajjar, R., Oliero, M., Cuisiniere, T., Fragoso, G., Calvé, A., Djediai, S., Annabi, B., Richard, C., Santos, M., Zhou, Y., Dodd), S., Ring, B., Yuan, Y., Garfinkle, R., Dell’Aniello, S., Bhatnagar, S., Ghitulescu, G., Faria, J., Brassard, P., Salama, E., Amar-Zifkin, A., Talwar, G., Daniel, R., AlSulaim, H., Alqahtani, M., Al-Masrouri, S., Chen, A., Patel, A., Brissette, V., Al Busaidi, N., Moon, J., Demian, M., MacRae, H., Alam, F., Holland, J., Cwintal, M., Rigas, G., Pang, A., Marinescu, D., Brown, C., Raval, M., Phang, P., Ghuman, A., Li, M., Muncner, S., Mihajlovic, I., Dykstra, M., Snelgrove, R., Monton, O., Smith, A., AlAamer, O., AlSelaim, N., AlMalki, M., Al-osail, A., Ruxton, R., Manuel, P., Mohamed, F., Motamedi, M.K., Serahati, S., Rajendran, L., Phang, T., Caminsky, N., Alavi, K., Paquette, I., MacLean, T., Wexner, S., Steele, S., Patel, S., Bordeianou, L., Sylla, P., Bayat, Z., Kennedy, E., Victor, C., Govindarajan, A., Liang, J., Roy, H., Baig, Z., Karimmudin, A., Gill, D., Ginther, N., Alrashid, F., Wiseman, V., Zhang, L., MacDonald, P., Merchant, S.M., Wattie Barnett, K., Caycedo-Marulanda, A., Patel, S.V., Harra, Z., Hegagi, M., Alghaithi, N., Papillon, E., Kasteel, N., Kaur, G., Bindra, S., Malhotra, A., Graham, C., MacLean, A., Beck, P., Jijon, H., Ferraz, J., Szwimer, R., Merchant, S., Kong, W., Gyawali, B., Hanna, T., Chung, W., Nanji, S., Booth, C., Li, V., Awan, A., Serrano, P., Jacobson, M., Chanco, M., Wen, V., Singh, N., Peiris, L., Pasieka, J., Ghatage, P., Buie, D., Bouchard-Fortier, A., Mack, L., Marini, W., Zheng, W., Swallow, C., Reedijk, M., DiPasquale, A., Prus-Czrnecka, Z., Delmar, L., Gagnon, N., Villiard, R., Martel, É., Cadrin-Chênevert, A., Ledoux, É., Racicot, C., Mysuria), S., Bazzarelli, A., Pao, J., Zhang, M., McKevitt, E., Kuusk, U., Van Laeken, N., Bovill, E., Isaac, K., Dingee, C., Hunter-Smith, A., Cuthbert, C., Fergus, K., Barbera, L., Efegoma, Y., Howell, D., Isherwood, S., Levasseur, N., Scheer, A., Simmons, C., Srikantham, A., Temple-Orberle, C., Xu, Y., Metcalfe, K., Quan, M., Alqaydi, A., la, J., Digby, G., Brind’Amour, A., Sidéris, L., Dubé, P., De Guerke, L., Fortin, S., Auclair, M., Trilling, B., Tremblay, J., Di Lena, É., Hopkins), B., Wong, S., Hopkins, B., Dumitra, S., Mysuria, S., Kapur, H., Bazarelli, A., Cadili, L., DeGirolamo, K., Ng, D., Ali, A., Eymae, D., Lee, K., Brar, S., Conner, J., Magalhaes, M., Allen, K., Baliski, C., Cyr, D., Sari, A., Messenger, D., Driman, D., Assarzadegan, N., Juda, A., Brar, M., Kirsch, R., Lamontagne, A., Gamache, Y., Mardinger, C., Lee, C., Duckworth, R., Brindle, M., Fraulin, F., Austen, L., Kortbeek, J., Hyndman, M., Jamjoum, G., Langer, S., Yuan Xu, Y., Kong, S., Lim, D., Retrouvey, H., Kerrebijn, I., Butler, K., O’Neill, A., Cil, T., Zhong, T., Hofer, S., McCready, D., Look Hong, N., Skipworth, J., Mah, A., Desai, S., Chung, S., Scudamore, C., Segedi, M., Vasilyeva, E., Li, J., Kim, P., Deprato, A., Dajani, K., Gilbert, R., Smoot, R., Tzeng, C., Rocha, F., Yohanathan, L., Cleary, S., Bertens, K., Reyna-Sepulveda, F., Badrudin, D., Gala-Lopez, B., Hanna, N., Wei, X., Kaliwal, Y., Wei, A., Henault, D., Barrette, B., Pelletier, S., Thebault, P., Beaudry-Simoneau, E., Rong, Z., Plasse, M., Dagenais, A. Roy M., Létourneau, R., Lapointe, R., Vandenbroucke-Menu, F., Nguyen, B., Soucy, G., Turcotte, S., Lemke, M., Waugh, E., Quan, D., Skaro, A., Lund, M., Glinka, J., Jada, G., Daza, J., Msallak, H., Zhang, B., Workneh, A., Faisal, S., Faisal, R., Fabbro, M., Gu, C., Claassen, M., Sapisochin, G., Breadner, D., Welch, S., Webb, A., Lester, E., Shapiro, A., Eurich, D., Essaji, Y., Shrader, H., Nayyar, A., Suraju, M., Williams-Perez, S., Ear, P., Chan, C., Smith, V., Rivers-Bowerman, M., Costa, A., Stueck, A., Campbell, N., Allen, S., Mir, Z., Golding, H., McKeown, S., Flemming, J., Groome, P., Djerboua, M., Elbekri, S., Girard, E., Morency-Potvin, P., Dagenais, M., Roy, A., Letourneau, R., Simoneau, E., Zuker, N., Oakley, M., Chartrand, G., Misheva, B., Bendavid, Y., Melland-Smith, M., Smith, L., Tan, J., Kahn, U., McLean, C., Fortin, M., Paré, X., Doyon, A., Keshavjee, S., Schwenger, K., Yadav, J., Fischer, S., Jackson, T., Allard, J., Okrainec, A., Anvari, S., Lovrics, O., Aditya, I., Khondker, A., Walsh, M., Hardy, K., Romanescu, R., Deaninck, F., Linton, J., Fowler-Woods, M., Fowler-Woods, A., Shingoose, G., Zmudzinski, M., Cloutier, Z., Archer, V., Shiroky, J., Abu Halimah, J., Boudreau, V., Marcil, G., Hardy-Henry, A., Lin, W., Hagen, J., and Connell, M.

Subjects
Abstracts, Canadian Association of General Surgeons, Canadian Hernia Society, Canada, Canadian Association of Thoracic Surgeons, Canadian Hepato-Pancreato-Biliary Association, Humans, Canadian Society of Surgical Oncology, Canadian Association of Bariatric Physicians and Surgeons, Canadian Society of Colon and Rectal Surgeons
Published
2022

5. 2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. 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Author

Johnson, G., primary, Hickey, K., primary, Azin, A., primary, Guidolin, K., primary, Shariff, F., primary, Gentles, J., primary, Parapini, M., primary, Guo, R., primary, Ertel, E., primary, Lenet, T., primary, Nabata, K., primary, McKechnie, T., primary, Zhu, A., primary, Nguyen, M., primary, Qu, L., primary, Zuckerman, J., primary, Kammili, A., primary, D’Souza, K., primary, Glass, L., primary, Kerr, L., primary, He, W., primary, Lee, L., primary, Balvardi, S., primary, Miles, A., primary, Fecso, A., primary, Skubleny, D., primary, Do, U., primary, Serrano Aybar, P.E., primary, Kruse, C., primary, Forbes, H., primary, Pravong, V., primary, Selvam, R., primary, Liu, R., primary, Walser, E., primary, Lee, A., primary, Ren, K., primary, Muaddi, H., primary, Frigault, J., primary, Rosenzveig, A., primary, Skelhorne-Gross, G., primary, Singh, K., primary, Mierzwa, A., primary, Wigen, R., primary, Raskin, R., primary, Dwyer, C., primary, Sun, W., primary, Schmitz, E., primary, Patro, N., primary, Wilson, H., primary, Li, C., primary, Drung, J., primary, Pang, G., primary, Abou Khalil, M., primary, Larsen, K., primary, Lan, L., primary, He, R., primary, Akhtar-Danesh, G., primary, Hirpara, D., primary, Sullivan, K., primary, Jogiat, U., primary, Patel, Y., primary, Abbas, M., primary, Ednie, A., primary, Alaichi, J., primary, Turner, S., primary, Lee, Y., primary, Nayak, R., primary, Mistry, N., primary, Abdul, S., primary, Razzak, R., primary, De Meo, M., primary, Esther, L., primary, Brophy, S., primary, Resende, V., primary, Sisson, D., primary, Alghamedi, A., primary, Shargall, Y., primary, Greenberg, B., primary, Huynh, C., primary, Al Rawahi, A., primary, Humer, M., primary, Le Nguyen, D., primary, Kaafarani, M., primary, Hunka, N., primary, Churchill, I., primary, Finley, C., primary, Jones, D., primary, Gupta, V., primary, Peters, E., primary, Robinson, M., primary, Wang, H., primary, Graham, K., primary, Bruinooge, A., primary, Verhoeff, K., primary, Cahill, C., primary, Hajjar, R., primary, Purich, K., primary, Garfinkle, R., primary, Talwar, G., primary, AlSulaim, H., primary, Brissette, V., primary, Holland, J., primary, Brown, C., primary, Li, M., primary, Monton, O., primary, AlAamer, O., primary, Ruxton, R., primary, Motamedi, M.K., primary, Caminsky, N., primary, Bayat, Z., primary, Liang, J., primary, Roy, H., primary, Moon, J., primary, Salama, E., primary, Wiseman, V., primary, Harra, Z., primary, Hegagi, M., primary, Alghaithi, N., primary, Papillon, E., primary, Kasteel, N., primary, Szwimer, R., primary, Merchant, S., primary, Li, V., primary, Jacobson, M., primary, Marini, W., primary, DiPasquale, A., primary, Gagnon, N., primary, Mysuria), S., primary, Hunter-Smith, A., primary, Alqaydi, A., primary, Di Lena, É., primary, Mysuria, S., primary, Kapur, H., primary, Cadili, L., primary, Ng, D., primary, Allen, K., primary, Cyr, D., primary, Allard-Coutu, A., primary, Mardinger, C., primary, Nguyen, D., primary, Langer, S., primary, Lim, D., primary, Reyna-Sepulveda, F., primary, Hanna, N., primary, Henault, D., primary, Lemke, M., primary, Lund, M., primary, Park, L., primary, Glinka, J., primary, Waugh, E., primary, Webb, A., primary, Essaji, Y., primary, Shrader, H., primary, Smith, V., primary, Gilbert, R., primary, Mir, Z., primary, Elbekri, S., primary, Zuker, N., primary, Chartrand, G., primary, Melland-Smith, M., primary, McLean, C., primary, Fortin, M., primary, Keshavjee, S., primary, Deaninck, F., primary, Cloutier, Z., primary, Shiroky, J., primary, Jarrar, A., primary, Lin, W., primary, Connell, M., primary, Vergis, A., additional, Unger, B., additional, Park, J., additional, Gillman, L., additional, Pace, D., additional, Lam-Tin-Cheung, K., additional, Chadi, S., additional, Quereshy, F., additional, Catton, J., additional, Rubin, B., additional, Bell, J., additional, Marangos, J., additional, Heesters, A., additional, Stuart-McEwan, T., additional, Wright, F., additional, Ahmed, N., additional, Nadler, A., additional, Hallet, J., additional, Chen, L., additional, Hwang, H., additional, Hirpara, D., additional, Sidhu, R., additional, Scott, T., additional, Karimuddin, A., additional, Nguyen, A., additional, Osborn, J., additional, Wiseman, S., additional, Nabata, K., additional, Baker, L., additional, Park, L., additional, Vered, M., additional, Zahrai, A., additional, Shorr, R., additional, Davis, A., additional, McIsaac, D., additional, Tinmouth, A., additional, Fergusson, D., additional, Martel, G., additional, Rummel, S., additional, Stefic-Cubic, M., additional, Stewart, M., additional, Melck, A., additional, Anpalagan, T., additional, Ichhpuniani, S., additional, Lee, Y., additional, Ramji, K., additional, Eskicioglu, C., additional, Deng, S., additional, Greene, B., additional, Tsang, M., additional, Palter, V., additional, Jayaraman, S., additional, Mann, A., additional, Tittley, J., additional, Cadeddu, M., additional, Madani, A., additional, Pasternak, J., additional, Hong, D., additional, Istl, A., additional, Tang, E., additional, Gray, D., additional, Coburn, N., additional, Callum, J., additional, McLeod, R., additional, Pearsall, E., additional, Lin, Y., additional, Turgeon, A., additional, Mahar, A., additional, Kriviraltcheva-Kaneva, P., additional, Lee, L., additional, Cools-Lartigue, J., additional, Ferri, L., additional, Mueller, C., additional, Haas, B., additional, Tillman, B., additional, Guttman, M., additional, Chesney, T., additional, Zuk, V., additional, Hsu, A., additional, Chan, W., additional, Vasdev, R., additional, Huynh, C., additional, Ling, L. Cadili J., additional, Warburton, R., additional, Hameed, M., additional, Williamson, H., additional, Murphy, P., additional, Leslie, K., additional, Hawel, J., additional, Zablotny, S., additional, Roldan, H., additional, Jiang, X., additional, Zheng, B., additional, Fiore, J., additional, Feldman, L., additional, Fried, G., additional, Valanci, S., additional, Cipolla, J., additional, Kaneva, P., additional, Demyttenaere, S., additional, Boutros, M., additional, Alhashemi, M., additional, Purich, K., additional, Verhoeff, K., additional, Shapiro, J., additional, Bigam, D., additional, Kung, J., additional, Mosko, J., additional, Hamilton, P., additional, Ghosh, S., additional, Widder, S., additional, Schiller, D., additional, El Kefraoui, C., additional, Pook, M., additional, Barone, N., additional, Balvardi, S., additional, Montgomery, H., additional, Nguyen-Powanda, P., additional, Rajabiyazdi, F., additional, Elhaj, H., additional, Lapointe-Gagner, M., additional, Olleik, G., additional, Antoun, A., additional, Safa, N., additional, Di Lena, E., additional, Meterissian, S., additional, Meguerditchian, A., additional, Lee, F., additional, Baldini, G., additional, Parpia, S., additional, Ruo, L., additional, Tywonek, K., additional, Lee, S., additional, O’Neill, C., additional, Faisal, N., additional, Alfayyadh, A., additional, Gundayao, M., additional, Meyers, B.M., additional, Habashi, R., additional, McKechnie, T., additional, Levin, M., additional, Aldrich, K., additional, Grantcharov, T., additional, Langerman, A., additional, Anantha, R., additional, Fawcett, V., additional, Hetherington, A., additional, Gervais, M., additional, Rakovich, G., additional, Hu, R., additional, Musselman, R., additional, Raiche, I., additional, Moloo, H., additional, Elnahas, A., additional, Alkhamesi, N., additional, Alnumay, A., additional, Schlachta, C., additional, Zhang, C., additional, Cristancho, S., additional, Ott, M., additional, Niu, B., additional, Balaa, F., additional, Gawad, N., additional, Qiu, Y., additional, Hamann, K., additional, How, N., additional, Leveille, C., additional, Davidson, A., additional, Eqbal, A., additional, Sardiwalla, Y., additional, Korostensky, M., additional, Lee, E., additional, Yang, I., additional, Ren, K., additional, Stukel, T., additional, de Mestral, C., additional, Nathens, A., additional, Karanicolas, P., additional, Lemieux, S., additional, Breton, D., additional, Bouchard, P., additional, Bouchard, A., additional, Grégoire, R., additional, Letarte, F., additional, Bouchard, G., additional, Drolet, S., additional, Avoine, S., additional, Gagné, J., additional, Thibault, C., additional, Jutras Bouthillette, N., additional, Gosselin, M., additional, Stuleanu, T., additional, Jarrar, A., additional, Kolozsvari, N., additional, Nenshi, R., additional, Jerath, A., additional, Gomez, D., additional, Amir, T., additional, Liu, E., additional, Farquharson, S., additional, Mao, R., additional, Lan, L., additional, Yan, J., additional, Allard-Coutu, A., additional, Tin, R., additional, Brisebois, R., additional, Bradley, N., additional, Walser, E., additional, Hartford, L., additional, Van Koughnett, J., additional, Vogt, K., additional, Hilsden, R., additional, Parry, N., additional, Allen, L., additional, Jones, J., additional, Neumann, K., additional, Strickland, M., additional, O’Dochartaigh, D., additional, Lobay, K., additional, Kabaroff, A., additional, Chang, E., additional, Beck, J., additional, Davidson, J., additional, Jones, S., additional, Van Hooren, T., additional, El Hafid, M., additional, Dang, J., additional, Mocanu, V., additional, Lutzak, G., additional, Sultanian, R., additional, Wong, C., additional, Karmali, S., additional, Petrera, M., additional, Pickell, M., additional, Auer, R., additional, Li, B., additional, Sun, W., additional, Jogiat, U., additional, Switzer, N., additional, Al Hinai, A., additional, Cieply, A., additional, Hawes, H., additional, Joos, E., additional, Saleh, A., additional, Engels, P., additional, Kwong, M., additional, Ellsmere, J., additional, Chang, D., additional, Hutter, M., additional, Spence, R., additional, Vasilevsky, C., additional, Morin, N., additional, Longtin, Y., additional, Liberman, S., additional, Montpetit, P., additional, Poirier, M., additional, Mukherjee, K., additional, Sebajang, H., additional, Younan, R., additional, Schwenter, F., additional, De Broux, E., additional, Skelhorne-Gross, G., additional, Beckett, A., additional, Nantais, J., additional, Kay, J., additional, Lohre, R., additional, Ayeni, O., additional, Goel, D., additional, de SA, D., additional, Hylton, D., additional, Bedard, E., additional, Johnson, S., additional, Laing, B., additional, Valji, A., additional, Hanna, W., additional, Turner, S., additional, Akhtar-Danesh, N., additional, Shargall, Y., additional, Gupta, V., additional, Kidane, B., additional, Limbachia, J., additional, Farrokhyar, F., additional, Leontiadis, G., additional, Patel, Y., additional, Churchill, I., additional, Xie, F., additional, Seely, A., additional, Spicer, J., additional, Yasufuku, K., additional, Sullivan, K., additional, Beauchamp, M., additional, Wald, J., additional, Mbuagbaw, L., additional, Agzarian, J., additional, Finley, C., additional, Fahim, C., additional, Olaiya, O., additional, Begum, H., additional, Palma, D., additional, Warner, A., additional, Malthaner, R., additional, Fortin, D., additional, Qiabi, M., additional, Nayak, R., additional, Nguyen, T., additional, Louie, A., additional, Rodrigues, G., additional, Yaremko, B., additional, Laba, J., additional, Inculet, R., additional, Mador, B., additional, Lai, H., additional, White, J., additional, Kim, M., additional, Darling, G., additional, Rousseau, M., additional, Samarasinghe, Y., additional, Lee, M., additional, Thiru, L., additional, Levine, O., additional, Juergens, R., additional, Brogly, S., additional, Li, W., additional, Lougheed, D., additional, Petsikas, D., additional, Gatti, A., additional, Anestee, C., additional, Gilbert, S., additional, Sundaresan, S., additional, Villeneuve, P., additional, Maziak, D., additional, Ashrafi, A., additional, Tregobov, N., additional, Hassanzadeh, N., additional, Stone, S., additional, Panjwani, A., additional, Bong, T., additional, Bond, R., additional, Hafizi, A., additional, Rayes, R., additional, Milette, S., additional, Vagai, M., additional, Usatii, M., additional, Chandrasekaran, A., additional, Giannias, B., additional, Bourdeau, F., additional, Sangwan, V., additional, Bertos, N., additional, Moraes, C., additional, Huang, S., additional, Quail, D., additional, Walsh, L., additional, Camilleri-Broet, S., additional, Fiset, P., additional, Bilgic, E., additional, Quaiattini, A., additional, Maurice-Ventouris, M., additional, Najmeh, S., additional, Lu, J., additional, Malhan, R., additional, Brennan, K., additional, French, D., additional, Momtazi, M., additional, Solaja, O., additional, Donahoe, L., additional, Bedard, P., additional, Hansen, A., additional, De Perrot, M., additional, Simone, A., additional, Huang, J., additional, Murthy, S., additional, Lin, J., additional, Li, H., additional, Crowther, M., additional, Linkins, L., additional, Lau, E., additional, Schneider, L., additional, Douketis, J., additional, Allen-Avodabo, C., additional, Davis, L., additional, Zhao, H., additional, Sirois, C., additional, Mulder, D., additional, Aftab Abdul, S., additional, Nguyen, D., additional, Anstee, C., additional, Delic, E., additional, Sasewich, H., additional, Islam, T., additional, Low, D., additional, Al Rawahi, A., additional, Kay, M., additional, Shayegan, B., additional, Adili, A., additional, Chouiali, F., additional, Muthukrishnan, N., additional, Maleki, F., additional, Ovens, K., additional, Gold, M., additional, Sorin, M., additional, Falutz, R., additional, Forghani, R., additional, Kennedy, R., additional, Bigsby, R., additional, Bharadwaj, S., additional, Gowing, S., additional, Pearce, K., additional, Kumar, S., additional, Gingrich, M., additional, Ahmadzai, Z., additional, Thavorn, K., additional, Namavarian, A., additional, Mohammed, A., additional, Uddin, S., additional, Jones, D., additional, Behzadi, A., additional, Brar, A., additional, Buduhan, G., additional, Tan, L., additional, Liu, R., additional, Srinathan, S., additional, Levy, J., additional, Ringash, J., additional, Sutradhar, R., additional, Bednarek, L., additional, MacDonald, D., additional, Enns, S., additional, Tan, A., additional, Poole, E., additional, Pascoe, C., additional, Karakach, T., additional, Halayko, A., additional, Fang, B., additional, Birch, D., additional, Singh, H., additional, Hershorn, O., additional, Hochman, D., additional, Helewa, R., additional, Robertson, R., additional, Lipson, M., additional, Afzal, A., additional, Maclean, A., additional, Roen, S., additional, Buie, W., additional, Chu, M., additional, Amin, N., additional, Kruse, C., additional, Jaffer, H., additional, Rebello, R., additional, Doumouras, A., additional, Oliero, M., additional, Cuisiniere, T., additional, Fragoso, G., additional, Calvé, A., additional, Djediai, S., additional, Annabi, B., additional, Richard, C., additional, Santos, M., additional, Zhou, Y., additional, Dodd), S., additional, Ring, B., additional, Yuan, Y., additional, Dell’Aniello, S., additional, Bhatnagar, S., additional, Ghitulescu, G., additional, Faria, J., additional, Brassard, P., additional, Salama, E., additional, Amar-Zifkin, A., additional, Daniel, R., additional, Alqahtani, M., additional, Garfinkle, R., additional, Al-Masrouri, S., additional, Chen, A., additional, Patel, A., additional, Al Busaidi, N., additional, Moon, J., additional, Demian, M., additional, MacRae, H., additional, Alam, F., additional, Cwintal, M., additional, Rigas, G., additional, Pang, A., additional, Marinescu, D., additional, Raval, M., additional, Phang, P., additional, 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Published
2021
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6. Effectiveness of Structured Teaching Program on Knowledge, Attitude and Practice Regarding Breast Self-Examination among Women who are Admitted and their Attendants in Christian Institute of Health Sciences and Research, Dimapur, Nagaland

Author

Rabha N., P. F. Chisa, A. Pazhiini, Rungsung R., S. H. Pao J., and Simpson C.

Subjects
medicine.medical_specialty, medicine.diagnostic_test, Teaching program, medicine.disease, Breast cancer, Family medicine, Global health, medicine, Sampling (medicine), Positive attitude, Psychology, Pre-assessment, Breast self-examination, Biomedical sciences
Abstract

Introduction: Breast cancer is a global health issue and a leading cause of death among women internationally.Breast self-examination (BSE) is an important screening measure for detecting breast cancer. Knowing the fact motivated to assess the effectiveness of structured teaching program on knowledge, attitude and practice of women regarding breast self-examination. Materials and Methods: The study design was one group pre-testpost-test.It was done among the women admitted in Christian Institute of Health Sciences and Research, Dimapur and it was approved by Research Committee. The sample size was 57 and the samples were selected by convenience sampling. Data was collected using self-administered questionnaire. Structured teaching with demonstration of BSE was done immediately after pre assessment and the post-test was done after 48 hours. Data was analyzed using descriptive and inferential statistics. Result: The result of the study showed that in pre-test, 58 (98%) had inadequate knowledge, 48 (84%) had positive attitude and 55 (96%) had inadequate practice towards breast self-examination and the post-test revealed 37 (65%) had adequate knowledge, 57 (100%) had positive attitude and 53 (93%) had adequate practice towards BSE. Conclusion: The study showed that the knowledge and practice on breast self-examination were inadequate. It has been found that majority of the women do have good attitude towards BSE but still some women believe that BSE is something considered to be embarrassing. This study revealed that STP was effective to improve the knowledge, attitudeand practice on BSE among women.

Published
2020
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9. Nodal staging affects adjuvant treatment choices in elderly patients with clinically node-negative, estrogen receptor-positive breast cancer.

Author

Laws, A., Cheifetz, R., Warburton, R., McGahan, C. E., Pao, J. S., Kuusk, U., Dingee, C., Quan, M. L., and McKevitt, E.

Subjects
HORMONE receptor positive breast cancer, OLDER patients, BREAST cancer, SENTINEL lymph node biopsy, BREAST cancer surgery, ESTROGEN
Abstract

Background In response to Choosing Wisely recommendations that sentinel lymph node biopsy (slnb) should not be routinely performed in elderly patients with node-negative (cN0), estrogen receptor-positive (er+) breast cancer, we sought to evaluate how nodal staging affects adjuvant treatment in this population. Methods From a prospective database, we identified patients 70 or more years of age with cN0 breast cancer treated with surgery for er+ her2-negative invasive disease during 2012-2016. We determined rates of, and factors associated with, nodal positivity (pN+), and compared the use of adjuvant radiation (rt) and systemic therapy by nodal status. Results Of 364 patients who met the inclusion criteria, 331 (91%) underwent slnb, with 75 (23%) being pN+. Axillary node dissection was performed in 11 patients (3%). On multivariate analysis, tumour size was the only factor associated with pN+ (p = 0.007). Nodal positivity rates were 0%, 13%, 23%, 33%, and 27% for lesions preoperatively sized at 0-0.5 cm, 0.5-1 cm, 1.1-2.0 cm, 2.1-5.0 cm, and more than 5.0 cm. Compared with patients assessed as node-negative, those who were pN+ were more likely to receive axillary rt (lumpectomy: 53% vs. 1%, p < 0.001; mastectomy: 43% vs. 2%, p < 0.001), and adjuvant systemic therapy (endocrine: 82% vs. 69%; chemotherapy plus endocrine: 7% vs. 2%, p = 0.002). Conclusions Of elderly patients with cN0 er+ breast cancer, 23% were pN+ on slnb. Size was the primary predictor of nodal status, and yet significant rates of nodal positivity were observed even in tumours preoperatively sized at 1 cm or less. The use of rt and systemic adjuvant therapies differed by nodal status, although the long-term oncologic implications require further investigation. Multidisciplinary input on a case-by-case basis should be considered before omission of slnb. [ABSTRACT FROM AUTHOR]

Published
2020
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15. The Cochlea in Branchio-Oto-Renal Syndrome: An Objective Method for the Diagnosis of Offset Cochlear Turns.

Author

Juliano AF, D'Arco F, Pao J, Picariello S, Clement E, Moonis G, and Robson CD

Subjects
Humans, Retrospective Studies, Protein Tyrosine Phosphatases genetics, Intracellular Signaling Peptides and Proteins, Nuclear Proteins genetics, Cochlea diagnostic imaging, Mutation, Homeodomain Proteins genetics, Branchio-Oto-Renal Syndrome diagnostic imaging, Branchio-Oto-Renal Syndrome genetics
Abstract

Background and Purpose: An "unwound" or "offset" cochlea has been described as a characteristic imaging feature in patients with branchio-oto-renal syndrome, and recently recognized to be associated in particular to those with EYA1 gene mutations. Determination of this feature has traditionally relied on subjective visual assessment. Our aim was to establish an objective assessment method for cochlear offset (the cochlear turn alignment ratio) and determine an optimal cutoff turn alignment ratio value that separates individuals with EYA1 -branchio-oto-renal syndrome from those with SIX1 -branchio-oto-renal syndrome and healthy controls., Materials and Methods: Temporal bone CT or MR imaging from 40 individuals with branchio-oto-renal syndrome and 40 controls was retrospectively reviewed. Cochlear offset was determined visually by 2 independent blinded readers and then quantitatively via a standardized technique yielding the cochlear turn alignment ratio. The turn alignment ratio values were compared between cochleae qualitatively assessed as "not offset" and "offset." Receiver operating characteristic analysis was used to determine the ability of the turn alignment ratio to differentiate between these populations and an optimal cutoff turn alignment ratio value. Cochlear offset and turn alignment ratio values were analyzed for each branchio-oto-renal syndrome genotype subpopulation and for controls., Results: The turn alignment ratio can accurately differentiate between cochleae with and without an offset ( P  < .001). The optimal cutoff value separating these populations was 0.476 (sensitivity = 1, specificity = 0.986, J = 0.986). All except 1 cochlea among the EYA1 -branchio-oto-renal syndrome subset and all with unknown genotype branchio-oto-renal syndrome had a cochlear offset and a turn alignment ratio of <0.476. All except 1 cochlea among the SIX1 -branchio-oto-renal syndrome subset and all controls had no offset and a turn alignment ratio of >0.476., Conclusions: There is a statistically significant difference in turn alignment ratios between offset and nonoffset cochleae, with an optimal cutoff of 0.476. This cutoff value allows excellent separation of EYA1 -branchio-oto-renal syndrome from SIX1 -branchio-oto-renal syndrome and from individuals without branchio-oto-renal syndrome or sensorineural hearing loss. The turn alignment ratio is a reliable and objective metric that can aid in the imaging evaluation of branchio-oto-renal syndrome., (© 2022 by American Journal of Neuroradiology.)

Published
2022
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16. Re-Examining the Cochlea in Branchio-Oto-Renal Syndrome: Genotype-Phenotype Correlation.

Author

Pao J, D'Arco F, Clement E, Picariello S, Moonis G, Robson CD, and Juliano AF

Subjects
Cochlea diagnostic imaging, Genetic Association Studies, Homeodomain Proteins genetics, Humans, Intracellular Signaling Peptides and Proteins genetics, Nuclear Proteins genetics, Protein Tyrosine Phosphatases genetics, Retrospective Studies, Branchio-Oto-Renal Syndrome diagnostic imaging, Branchio-Oto-Renal Syndrome genetics
Abstract

Background and Purpose: Temporal bone imaging plays an important role in the work-up of branchio-oto-renal syndrome. Previous reports have suggested that the unwound or offset cochlea is a highly characteristic marker for branchio-oto-renal syndrome. Our goals were to examine the prevalence of this finding in a branchio-oto-renal syndrome cohort and analyze genetic-phenotypic associations not previously established., Materials and Methods: This multicenter retrospective study included 38 ears in 19 unrelated individuals with clinically diagnosed branchio-oto-renal syndrome and confirmed mutations in the EYA1 or SIX1 genes. Two blinded neuroradiologists independently reviewed and documented temporal bone imaging findings in 13 categories for each ear. Imaging phenotypes were correlated with genotypes., Results: There was excellent interrater agreement for all 13 phenotypic categories (κ ≥ 0.80). Of these, 9 categories showed statistically significant differences between patients with EYA1 -branchio-oto-renal syndrome and SIX1 -branchio-oto-renal syndrome. Cochlear offset was present in 100% of patients with EYA1 -branchio-oto-renal syndrome, but in only 1 ear (12.5%) among patients with SIX1 -branchio-oto-renal syndrome. A short thorny appearance of the cochlear apical turn was observed in most patients with SIX1 -branchio-oto-renal syndrome., Conclusions: An offset cochlea is associated with the EYA1 -branchio-oto-renal syndrome genotype. The SIX1 -branchio-oto-renal syndrome genotype is associated with a different cochlear phenotype that almost always is without offset and has a short thorny tip as the apical turn. Therefore, cochlear offset is not a characteristic marker for all patients with branchio-oto-renal syndrome. The lack of a cochlear offset in a patient with clinically suspected branchio-oto-renal syndrome does not exclude the diagnosis and, in fact, may be predictive of the SIX1 genotype., (© 2022 by American Journal of Neuroradiology.)

Published
2022
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17. 2021 Canadian Surgery Forum: Virtual, online Sept. 21-24, 2021.

Author

Johnson G, Vergis A, Unger B, Park J, Gillman L, Hickey K, Pace D, Azin A, Guidolin K, Lam-Tin-Cheung K, Chadi S, Quereshy F, Guidolin K, Catton J, Rubin B, Bell J, Marangos J, Heesters A, Stuart-McEwan T, Quereshy F, Shariff F, Wright F, Ahmed N, Nadler A, Hallet J, Gentles J, Chen L, Hwang H, Parapini M, Hirpara D, Sidhu R, Scott T, Karimuddin A, Guo R, Nguyen A, Osborn J, Wiseman S, Nabata K, Ertel E, Hwang H, Lenet T, Baker L, Park L, Vered M, Zahrai A, Shorr R, Davis A, McIsaac D, Tinmouth A, Fergusson D, Martel G, Nabata K, Rummel S, Stefic-Cubic M, Karimuddin A, Stewart M, Melck A, McKechnie T, Anpalagan T, Ichhpuniani S, Lee Y, Ramji K, Eskicioglu C, Zhu A, Deng S, Greene B, Tsang M, Palter V, Jayaraman S, McKechnie T, Mann A, Tittley J, Cadeddu M, Nguyen M, Madani A, Pasternak J, McKechnie T, Ramji K, Hong D, Qu L, Istl A, Tang E, Gray D, Zuckerman J, Coburn N, Callum J, McLeod R, Pearsall E, Lin Y, Turgeon A, Martel G, Hallet J, Mahar A, Kammili A, Kriviraltcheva-Kaneva P, Lee L, Cools-Lartigue J, Ferri L, Mueller C, Zuckerman J, Haas B, Tillman B, Guttman M, Chesney T, Zuk V, Mahar A, Hsu A, Chan W, Vasdev R, Coburn N, Hallet J, D'Souza K, Huynh C, Ling LCJ, Warburton R, Hwang H, Hameed M, Glass L, Williamson H, Murphy P, Tang E, Leslie K, Hawel J, Kerr L, Zablotny S, Roldan H, He W, Jiang X, Zheng B, Lee L, Fiore J Jr, Feldman L, Fried G, Mueller C, Valanci S, Balvardi S, Cipolla J, Kaneva P, Demyttenaere S, Boutros M, Lee L, Feldman L, Fiore J, Balvardi S, Alhashemi M, Cipolla J, Lee L, Fiore J Jr, Feldman L, Miles A, Purich K, Verhoeff K, Shapiro J, Bigam D, Kung J, Fecso A, Chesney T, Mosko J, Skubleny D, Hamilton P, Ghosh S, Widder S, Schiller D, Do U, El Kefraoui C, Pook M, Barone N, Balvardi S, Montgomery H, Nguyen-Powanda P, Rajabiyazdi F, Elhaj H, Lapointe-Gagner M, Olleik G, Kaneva P, Antoun A, Safa N, Di Lena E, Meterissian S, Meguerditchian A, Fried G, Alhashemi M, Lee F, Baldini G, Feldman L, Fiore J Jr, Serrano Aybar PE, Parpia S, Ruo L, Tywonek K, Lee S, O'Neill C, Faisal N, Alfayyadh A, Gundayao M, Meyers BM, Habashi R, Kruse C, McKechnie T, Levin M, Aldrich K, Grantcharov T, Langerman A, Forbes H, Anantha R, Fawcett V, Hetherington A, Pravong V, Gervais M, Rakovich G, Selvam R, Hu R, Musselman R, Raiche I, Moloo H, Liu R, Elnahas A, Alkhamesi N, Hawel J, Tang E, Alnumay A, Schlachta C, Walser E, Zhang C, Cristancho S, Ott M, Lee A, Niu B, Balaa F, Gawad N, Ren K, Qiu Y, Hamann K, How N, Leveille C, Davidson A, Eqbal A, Sardiwalla Y, Korostensky M, McKechnie T, Lee E, Yang I, Ren K, Muaddi H, Stukel T, de Mestral C, Nathens A, Karanicolas P, Frigault J, Lemieux S, Breton D, Bouchard P, Bouchard A, Grégoire R, Letarte F, Bouchard G, Drolet S, Frigault J, Avoine S, Drolet S, Letarte F, Bouchard A, Gagné J, Thibault C, Grégoire R, Jutras Bouthillette N, Gosselin M, Bouchard P, Rosenzveig A, Stuleanu T, Jarrar A, Kolozsvari N, Skelhorne-Gross G, Nenshi R, Jerath A, Gomez D, Singh K, Amir T, Liu E, Farquharson S, Mao R, Lan L, Yan J, Allard-Coutu A, Mierzwa A, Tin R, Brisebois R, Bradley N, Wigen R, Walser E, Hartford L, Van Koughnett J, Vogt K, Hilsden R, Parry N, Allen L, Leslie K, Raskin R, Jones J, Neumann K, Dwyer C, Strickland M, Bradley N, O'Dochartaigh D, Lobay K, Kabaroff A, Chang E, Widder S, Anantha R, Sun W, Beck J, Anantha R, Liu R, Davidson J, Jones S, Van Hooren T, Van Koughnett J, Ott M, Schmitz E, Raiche I, Sun W, El Hafid M, Dang J, Mocanu V, Lutzak G, Sultanian R, Wong C, Karmali S, Schmitz E, Petrera M, Pickell M, Auer R, Patro N, Li B, Lee Y, Wilson H, Mocanu V, Sun W, Dang J, Jogiat U, Kung J, Switzer N, Karmali S, Wong C, Li C, Al Hinai A, Cieply A, Hawes H, Joos E, Saleh A, Li C, Saleh A, Engels P, Drung J, Allen L, Leslie K, Pang G, Kwong M, Schlachta C, Alkhamesi N, Hawel J, Elnahas A, Guidolin K, Ellsmere J, Chadi S, Quereshy F, Chang D, Hutter M, Spence R, Abou Khalil M, Boutros M, Vasilevsky C, Morin N, Longtin Y, Liberman S, Demyttenaere S, Montpetit P, Poirier M, 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Ovens K, Gold M, Sorin M, Falutz R, Rayes R, Forghani R, Spicer J, Hunka N, Kennedy R, Bigsby R, Bharadwaj S, Gowing S, Churchill I, Gatti A, Hylton D, Sullivan K, Patel Y, Farrokhyar F, Leontiadis G, Hanna W, Finley C, Begum H, Pearce K, Agzarian J, Hanna W, Shargall Y, Akhtar-Danesh N, Jones D, Anstee C, Kumar S, Gingrich M, Simone A, Ahmadzai Z, Thavorn K, Seely A, Gupta V, Namavarian A, Mohammed A, Uddin S, Jones D, Behzadi A, Brar A, Qu L, Qiabi M, Nayak R, Malthaner R, Peters E, Buduhan G, Tan L, Liu R, Srinathan S, Kidane B, Gupta V, Levy J, Kidane B, Mahar A, Ringash J, Sutradhar R, Darling G, Coburn N, Robinson M, Bednarek L, Buduhan G, Liu R, Tan L, Srinathan S, Kidane B, Wang H, French D, MacDonald D, Graham K, Enns S, Buduhan G, Srinathan S, Liu R, Tan A, Kidane B, Bruinooge A, Poole E, Pascoe C, Karakach T, Buduhan G, Tan L, Srinathan S, Halayko A, Kidane B, Verhoeff K, Mocanu V, Fang B, Dang J, Kung J, Switzer N, Birch D, Karmali S, Johnson G, Singh H, Vergis A, Park J, Hershorn O, Hochman D, Helewa R, Johnson G, Robertson R, Vergis A, Johnson G, Vergis A, Singh H, Park J, Helewa R, Azin A, Cahill C, Lipson M, Afzal A, Maclean A, Wong C, Roen S, Buie W, McKechnie T, Anpalagan T, Chu M, Lee Y, Amin N, Hong D, Eskicioglu C, McKechnie T, Ramji K, Kruse C, Jaffer H, Rebello R, Amin N, Doumouras A, Hong D, Eskicioglu C, Hajjar R, Oliero M, Cuisiniere T, Fragoso G, Calvé A, Djediai S, Annabi B, Richard C, Santos M, Purich K, Zhou Y, Dodd S, Ring B, Yuan Y, White J, Garfinkle R, Dell'Aniello S, Bhatnagar S, Morin N, Ghitulescu G, Faria J, Vasilevsky C, Brassard P, Boutros M, Garfinkle R, Salama E, Amar-Zifkin A, Morin N, Ghitulescu G, Faria J, Vasilevsky C, Boutros M, Talwar G, Daniel R, McKechnie T, Levine O, Eskicioglu C, AlSulaim H, Alqahtani M, Garfinkle R, Al-Masrouri S, Vasilevsky C, Morin N, Boutros M, McKechnie T, Chen A, Patel A, Lee Y, Doumouras A, Hong D, Eskicioglu C, Brissette V, Al Busaidi N, Rajabiyazdi F, Moon J, Demian M, Vasilevsky C, Morin N, Boutros M, Selvam R, Moloo H, MacRae H, Alam F, Raiche I, Holland J, Cwintal M, Rigas G, Vasilevsky C, Morin N, Ghitulescu G, Faria J, Pang A, Boutros M, Holland J, Moon J, Marinescu D, Morin N, Ghitulescu G, Pang A, Vasilevsky C, Boutros M, Brown C, Karimuddin A, Raval M, Phang P, Ghuman A, Li M, Muncner S, Mihajlovic I, Dykstra M, Snelgrove R, Wang H, Monton O, Smith A, Moon J, Demian M, Garfinkle R, Vasilevsky C, Rajabiyazdi F, Boutros M, AlAamer O, AlSelaim N, AlMalki M, Al-Osail A, Ruxton R, Manuel P, Mohamed F, Motamedi MK, Serahati S, Rajendran L, Brown C, Raval M, Karimuddin A, Ghuman A, Phang T, Caminsky N, Moon J, Rajabiyazdi F, Chadi S, Alavi K, Paquette I, MacLean T, Wexner S, Liberman S, Steele S, Park J, Patel S, Bordeianou L, Auer R, Sylla P, Morin N, Ghuman A, Boutros M, Bayat Z, Kennedy E, Victor C, Govindarajan A, Liang J, Vasilevsky C, Pang A, Ghitulescu G, Faria J, Morin N, Boutros M, Marinescu D, Roy H, Baig Z, Karimmudin A, Raval M, Brown C, Phang T, Gill D, Ginther N, Moon J, Marinescu D, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Moon J, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Salama E, Alrashid F, Vasilevsky C, Ghitulescu G, Faria J, Morin N, Boutros M, Wiseman V, Zhang L, MacDonald P, Merchant SM, Wattie Barnett K, Caycedo-Marulanda A, Patel SV, Harra Z, Vasilevsky C, Ghitulescu G, Morin N, Boutros M, Pang A, Hegagi M, Alqahtani M, Morin N, Ghitulescu G, Vasilevsky C, Boutros M, Alghaithi N, Marinescu D, Al-Masrouri S, Pang A, Vasilevsky C, Boutros M, Papillon E, Kasteel N, Kaur G, Bindra S, Malhotra A, Graham C, MacLean A, Beck P, Jijon H, Ferraz J, Buie W, Szwimer R, Moon J, Demian M, Pang A, Morin N, Vasilevsky C, Rajabiyazdi F, Boutros M, Azin A, Merchant S, Kong W, Gyawali B, Hanna T, Chung W, Nanji S, Patel S, Booth C, Li V, Awan A, Serrano P, Jacobson M, Chanco M, Wen V, Singh N, Peiris L, Pasieka J, Ghatage P, Buie D, MacLean T, Bouchard-Fortier A, Mack L, Marini W, Zheng W, Swallow C, Reedijk M, DiPasquale A, Peiris L, Prus-Czrnecka Z, Delmar L, Gagnon N, Villiard R, Martel É, Cadrin-Chênevert A, Ledoux É, Racicot C, Mysuria S, Bazzarelli A, Pao J, Chen L, Zhang M, McKevitt E, Warburton R, Kuusk U, Van Laeken N, Bovill E, Isaac K, Dingee C, Hunter-Smith A, Cuthbert C, Fergus K, Barbera L, Efegoma Y, Howell D, Isherwood S, Levasseur N, Scheer A, Simmons C, Srikantham A, Temple-Orberle C, Xu Y, Metcalfe K, Quan M, Alqaydi A, la J, Merchant S, Digby G, Pravong V, Brind'Amour A, Sidéris L, Dubé P, De Guerke L, Fortin S, Auclair M, Trilling B, Tremblay J, Di Lena É, Hopkins B, Wong S, Meterissian S, Di Lena É, Barone N, Hopkins B, Dumitra S, Kaneva P, Fiore J, Meterissian S, Mysuria S, McKevitt E, Warburton R, Chen L, Bazzarelli A, Pao J, Bovill E, Zhang M, Kuusk U, Isaac K, Van Laeken N, Dingee C, Kapur H, McKevitt E, Warburton R, Pao J, Dingee C, Bazarelli A, Kuusk U, Chen L, Cadili L, DeGirolamo K, McKevitt E, Pao J, Dingee C, Bazzarelli A, Warburton R, Ng D, Ali A, Eymae D, Lee K, Brar S, Conner J, Magalhaes M, Swallow C, Allen K, Baliski C, Cyr D, Sari A, Messenger D, Driman D, Assarzadegan N, Juda A, Swallow C, Kennedy E, Brar M, Conner J, Kirsch R, Allard-Coutu A, Singh K, Lamontagne A, Gamache Y, Allard-Coutu A, Mardinger C, Lee C, Duckworth R, Brindle M, Fraulin F, Austen L, Kortbeek J, Hyndman M, Nguyen D, Jamjoum G, Meguerditchian A, Langer S, Yuan Xu Y, Kong S, Quan M, Lim D, Retrouvey H, Kerrebijn I, Butler K, O'Neill A, Cil T, Zhong T, Hofer S, McCready D, Metcalfe K, Lim D, Greene B, Look Hong N, Parapini M, Skipworth J, Mah A, Desai S, Chung S, Scudamore C, Segedi M, Vasilyeva E, Li J, Kim P, Verhoeff K, Deprato A, Purich K, Kung J, Bigam D, Dajani K, Lenet T, Gilbert R, Smoot R, Martel G, Tzeng C, Rocha F, Yohanathan L, Cleary S, Bertens K, Reyna-Sepulveda F, Badrudin D, Gala-Lopez B, Hanna N, Brogly S, Wei X, Booth C, Nanji S, Zuckerman J, Coburn N, Mahar A, Callum J, Kaliwal Y, Jayaraman S, Wei A, Martel G, Hallet J, Zuckerman J, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Henault D, Barrette B, Pelletier S, Thebault P, Beaudry-Simoneau E, Rong Z, Plasse M, Dagenais ARM, Létourneau R, Lapointe R, Vandenbroucke-Menu F, Nguyen B, Soucy G, Turcotte S, Lemke M, Waugh E, Leslie K, Quan D, Skaro A, Tang E, Lund M, Allen L, Glinka J, Jada G, Quan D, Skaro A, Tang E, Park L, Daza J, Li V, Msallak H, Zhang B, Workneh A, Faisal S, Faisal R, Fabbro M, Gu C, Claassen M, Zuk V, Hallet J, Martel G, Sapisochin G, Serrano P, Glinka J, Skaro A, Leslie K, Jada G, Quan D, Tang E, Waugh E, Lemke M, Glinka J, Skaro A, Leslie K, Tang E, Waugh E, Breadner D, Liu R, Tang E, Allen L, Welch S, Skaro A, Leslie K, Glinka J, Waugh E, Tang E, Jada G, Quan D, Skaro A, Webb A, Lester E, Shapiro A, Eurich D, Bigam D, Essaji Y, Shrader H, Nayyar A, Suraju M, Williams-Perez S, Ear P, Chan C, Smith V, Rivers-Bowerman M, Costa A, Stueck A, Campbell N, Allen S, Gala-Lopez B, Gilbert R, Lenet T, Cleary S, Smoot R, Tzeng C, Rocha F, Martel G, Bertens K, Mir Z, Golding H, McKeown S, Nanji S, Flemming J, Groome P, Mir Z, Djerboua M, Nanji S, Flemming J, Groome P, Elbekri S, Turcotte S, Girard E, Morency-Potvin P, Lapointe R, Vandenbroucke-Menu F, Dagenais M, Roy A, Letourneau R, Plasse M, Simoneau E, Rong Z, Zuker N, Oakley M, Chartrand G, Misheva B, Bendavid Y, Frigault J, Lemieux S, Breton D, Bouchard G, Drolet S, Melland-Smith M, Smith L, Tan J, Kahn U, McLean C, Mocanu V, Birch D, Karmali S, Switzer N, Fortin M, Paré X, Doyon A, Keshavjee S, Schwenger K, Yadav J, Fischer S, Jackson T, Allard J, Okrainec A, Lee Y, Anvari S, Chu M, Lovrics O, Aditya I, Malhan R, Khondker A, Walsh M, Doumouras A, Hong D, He W, Vergis A, Hardy K, Romanescu R, Deaninck F, Linton J, Fowler-Woods M, Fowler-Woods A, Shingoose G, Vergis A, Hardy K, Zmudzinski M, Cloutier Z, McKechnie T, Lee Y, Archer V, Doumouras A, Shiroky J, Abu Halimah J, Ramji K, Boudreau V, Mierzwa A, Mocanu V, Marcil G, Dang J, Switzer N, Birch D, Karmali S, Mierzwa A, Jarrar A, Hardy-Henry A, Kolozsvari N, Lin W, Hagen J, Connell M, Sun W, Dang J, Mocanu V, Kung J, Switzer N, Birch D, and Karmali S

Subjects
Canada, Humans
Published
2021
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18. Genomic Profiling of Combined Hepatocellular Cholangiocarcinoma Reveals Genomics Similar to Either Hepatocellular Carcinoma or Cholangiocarcinoma.

Author

Murugesan K, Sharaf R, Montesion M, Moore JA, Pao J, Pavlick DC, Frampton GM, Upadhyay VA, Alexander BM, Miller VA, Javle MM, Bekaii Saab TS, Albacker LA, Ross JS, and Ali SM

Subjects
Adult, Aged, Aged, 80 and over, Bile Duct Neoplasms pathology, Carcinoma, Hepatocellular pathology, Cholangiocarcinoma pathology, Female, Genomics, Humans, Liver pathology, Liver Neoplasms pathology, Machine Learning, Male, Middle Aged, Young Adult, Bile Duct Neoplasms genetics, Carcinoma, Hepatocellular genetics, Cholangiocarcinoma genetics, Liver Neoplasms genetics
Abstract

Purpose: Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a rare, aggressive primary liver carcinoma, with morphologic features of both hepatocellular carcinomas (HCC) and liver cholangiocarcinomas (CCA)., Methods: The genomic profiles of 4,975 CCA, 1,470 HCC, and 73 cHCC-CCA cases arising from comprehensive genomic profiling in the course of clinical care were reviewed for genomic alterations (GA), tumor mutational burden, microsatellite instability status, genomic loss of heterozygosity, chromosomal aneuploidy, genomic ancestry, and hepatitis B virus status., Results: In cHCC-CCA, GA were most common in TP53 (65.8%), TERT (49.3%), and PTEN (9.6%), and 24.6% cHCC-CCA harbored potentially targetable GA. Other GA were predominantly associated with either HCC or CCA, including, but not limited to, TERT , FGFR2 , IDH1 , and presence of hepatitis B virus. On the basis of these features, a machine learning (ML) model was trained to classify a cHCC-CCA case as CCA-like or HCC-like. Of cHCC-CCA cases, 16% (12/73) were ML-classified as CCA-like and 58% (42/73) cHCC-CCA were ML-classified as HCC-like. The ML model classified more than 70% of cHCC-CCA as CCA-like or HCC-like on the basis of genomic profiles, without additional clinico-pathologic input., Conclusion: These findings demonstrate the use of ML for classification as based on a targeted exome panel used during routine clinical care. Classification of cHCC-CCA by genomic features alone creates insights into the biology of the disease and warrants further investigation for relevance to clinical care., Competing Interests: Karthikeyan Murugesan Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Pharma AG Patents, Royalties, Other Intellectual Property: Antibiotic resistance causation identification (US10629291B2) filed with Koninklijke Philips NV, Analytic prediction of antibiotic susceptibility (US20190279738A1) filed with Koninklijke Philips NV, Methods and devices for characterizing and treating combined hepatocellular cholangiocarcinoma, with Foundation Medicine Inc Travel, Accommodations, Expenses: Foundation Medicine Radwa Sharaf Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Meagan Montesion Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Jay A. Moore Employment: Foundation Medicine Stock and Other Ownership Interests: Roche James Pao Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Research Funding: Foundation Medicine Patents, Royalties, Other Intellectual Property: Provisional patent submitted for Foundation Medicine, dealing with machine learning for gene predictions Dean C. Pavlick Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Garrett M. Frampton Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Vivek A. Upadhyay Employment: EQRx Stock and Other Ownership Interests: EQRx Consulting or Advisory Role: Foundation Medicine Brian M. Alexander Employment: Foundation Medicine Leadership: Foundation Medicine Stock and Other Ownership Interests: Roche Research Funding: Lilly, Puma Biotechnology, Celgene Open Payments Link: https://openpaymentsdata.cms.gov/physician/854258/summary Vincent A. Miller Employment: Foundation Medicine, EQRx Leadership: Revolution Medicines Stock and Other Ownership Interests: Foundation Medicine, Mirati Therapeutics, Revolution Medicines, EQRx Patents, Royalties, Other Intellectual Property: Receives periodic royalties related to T790M patent awarded to Memorial Sloan Kettering Cancer Center Milind M. Javle Consulting or Advisory Role: QED Therapeutics, Oncosil, Incyte, Mundipharma EDO GmbH, AstraZeneca, Merck, EMD Serono Other Relationship: Rafael Pharmaceuticals, Incyte, Pieris Pharmaceuticals, Merck, Merck Serono, Novartis, Seattle Genetics, BeiGene, QED Therapeutics, Bayer Tanios S. Bekaii Saab Consulting or Advisory Role: Amgen, Ipsen, Lilly, Bayer, Roche/Genentech, AbbVie, Incyte, Immuneering, Seattle Genetics, Pfizer, Boehringer Ingelheim, Janssen, Eisai, Daiichi Sankyo/UCB Japan, AstraZeneca, Exact Sciences, Natera, Treos Bio, Celularity, SOBI, BeiGene, Foundation Medicine Patents, Royalties, Other Intellectual Property: Patent WO/2018/183488, Patent WO/2019/055687 Other Relationship: Exelixis, Merck, AstraZeneca, Lilly, Pancreatic Cancer Action Network Lee A. Albacker Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Jeffrey S. Ross Employment: Foundation Medicine Leadership: Foundation Medicine Stock and Other Ownership Interests: Foundation Medicine Consulting or Advisory Role: Celsius Therapeutics, Tango Therapeutics Research Funding: Foundation Medicine Siraj M. Ali Employment: EQRx Consulting or Advisory Role: Elevation Oncology, In8bio, Pillar Biosciences, Takeda, ArcherDx Stock and Other Ownership Interests: In8bio, Pillar Biosciences, EQRx Patents: Foundation Medicine No other potential conflicts of interest were reported. Karthikeyan Murugesan Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Pharma AG Patents, Royalties, Other Intellectual Property: Antibiotic resistance causation identification (US10629291B2) filed with Koninklijke Philips NV, Analytic prediction of antibiotic susceptibility (US20190279738A1) filed with Koninklijke Philips NV, Methods and devices for characterizing and treating combined hepatocellular cholangiocarcinoma, with Foundation Medicine Inc Travel, Accommodations, Expenses: Foundation Medicine Radwa Sharaf Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Meagan Montesion Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Jay A. Moore Employment: Foundation Medicine Stock and Other Ownership Interests: Roche James Pao Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Research Funding: Foundation Medicine Patents, Royalties, Other Intellectual Property: Provisional patent submitted for Foundation Medicine, dealing with machine learning for gene predictions Dean C. Pavlick Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Garrett M. Frampton Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Vivek A. Upadhyay Employment: EQRx Stock and Other Ownership Interests: EQRx Consulting or Advisory Role: Foundation Medicine Brian M. Alexander Employment: Foundation Medicine Leadership: Foundation Medicine Stock and Other Ownership Interests: Roche Research Funding: Lilly, Puma Biotechnology, Celgene Open Payments Link: https://openpaymentsdata.cms.gov/physician/854258/summary Vincent A. Miller Employment: Foundation Medicine, EQRx Leadership: Revolution Medicines Stock and Other Ownership Interests: Foundation Medicine, Mirati Therapeutics, Revolution Medicines, EQRx Patents, Royalties, Other Intellectual Property: Receives periodic royalties related to T790M patent awarded to Memorial Sloan Kettering Cancer Center Milind M. Javle Consulting or Advisory Role: QED Therapeutics, Oncosil, Incyte, Mundipharma EDO GmbH, AstraZeneca, Merck, EMD Serono Other Relationship: Rafael Pharmaceuticals, Incyte, Pieris Pharmaceuticals, Merck, Merck Serono, Novartis, Seattle Genetics, BeiGene, QED Therapeutics, Bayer Tanios S. Bekaii Saab Consulting or Advisory Role: Amgen, Ipsen, Lilly, Bayer, Roche/Genentech, AbbVie, Incyte, Immuneering, Seattle Genetics, Pfizer, Boehringer Ingelheim, Janssen, Eisai, Daiichi Sankyo/UCB Japan, AstraZeneca, Exact Sciences, Natera, Treos Bio, Celularity, SOBI, BeiGene, Foundation Medicine Patents, Royalties, Other Intellectual Property: Patent WO/2018/183488, Patent WO/2019/055687 Other Relationship: Exelixis, Merck, AstraZeneca, Lilly, Pancreatic Cancer Action Network Lee A. Albacker Employment: Foundation Medicine Stock and Other Ownership Interests: Roche Jeffrey S. Ross Employment: Foundation Medicine Leadership: Foundation Medicine Stock and Other Ownership Interests: Foundation Medicine Consulting or Advisory Role: Celsius Therapeutics, Tango Therapeutics Research Funding: Foundation Medicine Siraj M. Ali Employment: EQRx Consulting or Advisory Role: Elevation Oncology, In8bio, Pillar Biosciences, Takeda, ArcherDx Stock and Other Ownership Interests: In8bio, Pillar Biosciences, EQRx Patents: Foundation Medicine No other potential conflicts of interest were reported., (© 2021 by American Society of Clinical Oncology.)

Published
2021
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19. Paired Testing of Sexually Transmitted Infections With Urine Pregnancy Tests in Incarcerated Women.

Author

Dang CM, Pao J, Taherzadeh D, and Nijhawan AE

Subjects
Chlamydia trachomatis, Female, Humans, Male, Neisseria gonorrhoeae, Pregnancy, Prevalence, Chlamydia Infections diagnosis, Chlamydia Infections epidemiology, Gonorrhea diagnosis, Gonorrhea epidemiology, Pregnancy Tests, Prisoners, Sexually Transmitted Diseases diagnosis, Sexually Transmitted Diseases epidemiology
Abstract

Background: In correctional facilities, sexually transmitted infections (STIs) are common, are often asymptomatic, and may lead to adverse outcomes such as infertility and increased HIV acquisition. In January 2020, testing for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) was paired with routine urine pregnancy tests among women entering a large county jail to increase testing and detection of STIs., Methods: The results of all GC/CT urine tests in the Dallas County Jail were collected from October 2019 to February 2020. Medical records were reviewed to collect demographic factors and to determine the positivity of GC/CT infections, time to results, and time to treatment., Results: With paired testing, monthly testing rates increased 4.7-fold among incarcerated females from 125 to 589 tests without substantial change for males (174 to 163). The number of infections detected in females increased from 25 (7%) of 359 to 62 (5.3%) of 1171 for GC and 42 (11.2%) of 374 to 129 (11%) of 1177 for CT without a significant difference in GC (P = 0.23) or CT positivity (P = 0.66). Younger women (≤25 years) had the highest rates of CT (18.8% [66/350]), whereas GC was highest among women aged 31 to 35 years (9.9% [32/321]). Average time to results and treatment were 5.8 and 1.8 days, respectively., Conclusions: Pairing GC/CT testing with routine urine pregnancy tests resulted in a large (4.7-fold) increase in the number of STI tests and a comparable increase (3.7- to 4.6-fold) in the number of infections detected. Future efforts should focus on incorporating STI testing into routine jail practices and expediting treatment to further improve outcomes in this vulnerable population., Competing Interests: Conflict of Interest and Sources of Funding: The authors have no conflicts of interest to share. A.E.N. receives the following grant funding relevant to this project: NIH R34 DA045592 and U01 DA 053039., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.)

Published
2021
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20. Prospective surveillance and targeted physiotherapy for arm morbidity after breast cancer surgery: a pilot randomized controlled trial.

Author

Rafn BS, Hung S, Hoens AM, McNeely ML, Singh CA, Kwan W, Dingee C, McKevitt EC, Kuusk U, Pao J, Van Laeken N, Goldsmith CH, and Campbell KL

Subjects
Female, Humans, Middle Aged, Muscle Strength physiology, Pilot Projects, Range of Motion, Articular physiology, Breast Neoplasms surgery, Continuity of Patient Care, Physical Therapy Modalities, Postoperative Complications, Upper Extremity physiopathology
Abstract

Objective: To evaluate prospective surveillance and targeted physiotherapy (PSTP) compared to education (EDU) on the prevalence of arm morbidity and describe the associated program cost., Design: Pilot randomized single-blinded controlled trial., Setting: Urban with assessments and treatment delivered in hospitals., Participants: Women scheduled for breast cancer surgery., Interventions: Participants were randomly assigned (1:1) to PSTP ( n = 21) or EDU ( n = 20) and assessed presurgery and 12 months postsurgery. All participants received usual care, namely, preoperative education and provision of an education booklet with postsurgical exercises. The PSTP group was monitored for arm morbidity every three months and referred for physiotherapy if arm morbidity was identified. The EDU group received three education sessions on nutrition, stress and fatigue management., Main Outcome Measures: Arm morbidity was based on changes in the surgical arm(s) from presurgery in four domains: (1) shoulder range of motion, (2) strength, (3) volume, and (4) upper body function. Complex arm morbidity indicated ≥2 domains impaired. Second, the cost of the PSTP program was described., Results: At 12 months, 18 (49%) participants (10 PSTP and 8 EDU) had arm morbidity, with EDU participants presenting more complex arm morbidity compared to PSTP participants. PSTP participants attended 4.4 of 5 assessments with 90% retention. The PSTP program cost was $150 covered by the Health Care Provider and the Patient Out-of-Pocket Travel cost was CAN$40., Conclusion: Our results suggest that PSTP is feasible among women with breast cancer for early identification of arm morbidity. A larger study is needed to determine the cost and effectiveness benefits.

Published
2018
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21. Routine shave margins are not necessary in early stage breast cancer treated with Breast Conserving Surgery.

Author

Pajak C, Pao J, Ghuman A, McKevitt EC, Kuusk U, Dingee CK, and Warburton R

Subjects
Adult, Aged, Aged, 80 and over, British Columbia, Female, Humans, Middle Aged, Neoplasm, Residual pathology, Reoperation statistics & numerical data, Retrospective Studies, Breast Neoplasms pathology, Breast Neoplasms surgery, Margins of Excision, Mastectomy, Segmental
Abstract

Introduction: Breast Conserving Surgery (BCS) is considered standard of care for women with early stage breast cancer. Between 20 and 50% of women treated with BCS will require re-operation for positive or close margins and it has been suggested that routine cavity shave margins may reduce the frequency of positive margins., Methods: Retrospective chart review of a prospectively maintained surgical database of patients undergoing BCS for early stage breast cancer, at a single institution, between January 2012 and December 2015. Cohort was followed until June 2016 to capture re-operations., Results: Among 2096 patients with stage 0-III breast cancers, 872 (42%) underwent primary mastectomies and 1224 (58%) underwent primary BCS. Margins were positive in 128 (11%) and close in 442 (36%). Re-operation rate for patients after BCS was 19%., Conclusion: A lower than predicted positive margin rate suggests that routine shave margins are not warranted at our institution., (Copyright © 2018. Published by Elsevier Inc.)

Published
2018
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22. IGF1R- and ROR1-Specific CAR T Cells as a Potential Therapy for High Risk Sarcomas.

Author

Huang X, Park H, Greene J, Pao J, Mulvey E, Zhou SX, Albert CM, Moy F, Sachdev D, Yee D, Rader C, Hamby CV, Loeb DM, Cairo MS, and Zhou X

Subjects
Adoptive Transfer methods, Animals, Bone Neoplasms metabolism, Bone Neoplasms therapy, Cell Line, Tumor, DNA Transposable Elements genetics, Humans, Interferon-alpha immunology, Interferon-alpha metabolism, Interferon-gamma immunology, Interferon-gamma metabolism, Interleukin-13 immunology, Interleukin-13 metabolism, K562 Cells, MCF-7 Cells, Mice, Mice, Inbred NOD, Mice, SCID, Receptor Tyrosine Kinase-like Orphan Receptors immunology, Receptor, IGF Type 1, Receptors, Antigen, T-Cell immunology, Sarcoma metabolism, Sarcoma therapy, T-Lymphocytes metabolism, Bone Neoplasms immunology, Receptor Tyrosine Kinase-like Orphan Receptors metabolism, Receptors, Antigen, T-Cell metabolism, Receptors, Somatomedin metabolism, Sarcoma immunology, T-Lymphocytes immunology
Abstract

Patients with metastatic or recurrent and refractory sarcomas have a dismal prognosis. Therefore, new targeted therapies are urgently needed. This study was designed to evaluate chimeric antigen receptor (CAR) T cells targeting the type I insulin-like growth factor receptor (IGF1R) or tyrosine kinase-like orphan receptor 1 (ROR1) molecules for their therapeutic potential against sarcomas. Here, we report that IGF1R (15/15) and ROR1 (11/15) were highly expressed in sarcoma cell lines including Ewing sarcoma, osteosarcoma, alveolar or embryonal rhabdomyosarcoma, and fibrosarcoma. IGF1R and ROR1 CAR T cells derived from eight healthy donors using the Sleeping Beauty (SB) transposon system were cytotoxic against sarcoma cells and produced high levels of IFN-γ, TNF-α and IL-13 in an antigen-specific manner. IGF1R and ROR1 CAR T cells generated from three sarcoma patients released significant amounts of IFN-γ in response to sarcoma stimulation. The adoptive transfer of IGF1R and ROR1 CAR T cells derived from a sarcoma patient significantly reduced tumor growth in pre-established, systemically disseminated and localized osteosarcoma xenograft models in NSG mice. Infusion of IGF1R and ROR1 CAR T cells also prolonged animal survival in a localized sarcoma model using NOD/scid mice. Our data indicate that both IGF1R and ROR1 can be effectively targeted by SB modified CAR T cells and that such CAR T cells may be useful in the treatment of high risk sarcoma patients.

Published
2015
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