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Ali HM, Keaton AB, Rourk K, Lohse C, Tasche KK, Price DL, Van Abel KM, Yin LX, Moore EJ. Partial superficial parotidectomy for pleomorphic adenoma of the parotid gland: Early post-operative outcomes. Am J Otolaryngol 2024; 45:104185. [PMID: 38104469 DOI: 10.1016/j.amjoto.2023.104185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION There has been historical controversy regarding the extent of resection in the management of pleomorphic adenomas. This study aims to evaluate the extent of surgery and short-term postoperative outcomes of partial superficial parotidectomy (PSP) for the management of pleomorphic adenomas at a tertiary, high-volume center. METHODS A retrospective chart review of patients who underwent PSP was performed. Variables included demographics, pre-operative facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence. RESULTS 151 adults who underwent PSP for pleomorphic adenoma from January 1st, 2000 to December 31st, 2022 were identified. Median age was 55 (IQR 40-66) years with females representing 74 % of the cohort. Median tumor size at presentation was 1.8 (IQR 1.3-2.3) cm. Baseline facial nerve function was excellent for most patients (House-Brackmann I, 99 %). Most patients underwent a superficial inferior parotidectomy (88 %). Modified Blair incision (70 %) was the most common incision. Intraoperatively, the facial nerve was identified in 149 (99 %) patients. The main trunk was identified in 126 (85 %) patients. No patient had tumor spillage. Only two patients required parotid bed reconstruction. The most common complication was ear numbness (60 %). Postoperatively, 114 patients were House-Brackmann grade I at both preoperative and postoperative assessment, 8 went from grade I to II, and 1 went from grade VI to II (Bell's palsy that resolved to grade II following surgery). Median follow-up was 1(IQR 1-5) month. CONCLUSION PSP is efficacious in the management of pleomorphic adenomas with preservation of facial nerve function, and minimal post-operative complications. Future study is needed to assess long term recurrence risk.
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Affiliation(s)
- Hawa M Ali
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Aniya B Keaton
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States; University of Tennessee, Knoxville, TN, United States
| | - Katelyn Rourk
- Mayo Clinic Alix School of Medicine, Rochester, MN, United States
| | - Christine Lohse
- Department of Quantitative Health Sciences, Rochester, MN, United States
| | - Kendall K Tasche
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Daniel L Price
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Kathryn M Van Abel
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Linda X Yin
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States
| | - Eric J Moore
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, United States.
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McMillan KB, McMillan DC, Shariq O, Lohse C, Dy B, Lyden M, Arce K. Association of hyperparathyroidism and benign fibro-osseous jaw tumors: a 25-year retrospective study at Mayo Clinic. Oral Maxillofac Surg 2023:10.1007/s10006-023-01195-x. [PMID: 37989891 DOI: 10.1007/s10006-023-01195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE The purpose of this study is to evaluate the association between hyperparathyroidism (PHPT), parathyroid hormone levels, and calcium levels in patients diagnosed with benign fibro-osseous lesions such as fibrous dysplasia (FD), ossifying fibroma (OF), central giant cell granulomas (GCG). METHODS This is a retrospective, single-center study from a sample of patients who underwent surgical treatment of FD, OF, and GCG at Mayo Clinic between 1996 and 2021. Patient demographics, history of PHPT, histopathological diagnosis, and relevant laboratory values such as parathyroid hormone (PTH), serum calcium, vitamin D, and alkaline phosphatase were collected. RESULTS Of the patients diagnosed with FD (n = 64), OF (n = 24), and GCG (n = 5), a diagnosis of PHPT was found in 2 patients (3.1%), 1 patient (4.2%), and 0 patients (0%), respectively. Elevated PTH levels (>65 pg/mL) were observed in 3 patients (4.7%) with FD, 1 patient (4.2%) with OF, and 1 patient (20%) with GCG. Mean (standard deviation) calcium levels were 9.3 (0.6) mg/dL in the FD group, 9.4 (0.5) mg/dL in the OF group, and 9.3 (0.6) mg/dL in the GCG group. Patients with fibro-osseous jaw tumors including FD, OF, and GCG may have increased risk of PHPT compared to the general population. CONCLUSION Patients with benign jaw tumors including FD, OF, and GCG may have increased risk of PHPT compared to the general population. Surgeons treating these benign tumors need to be cognizant of these findings, obtain appropriate laboratory studies, and incorporate multidisciplinary care including endocrinologists, endocrine surgeons, and maxillofacial surgeons.
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Affiliation(s)
- Kale B McMillan
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN, USA.
| | - Dane C McMillan
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN, USA
| | - Omair Shariq
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Christine Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Benzon Dy
- Division of Endocrine and Metabolic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Melanie Lyden
- Division of Endocrine and Metabolic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Kevin Arce
- Division of Oral and Maxillofacial Surgery, Section of Head & Neck Oncologic Surgery and Reconstruction, Department of Surgery, Mayo Clinic and Mayo College of Medicine, Rochester, MN, USA
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Shah M, Staab J, Anderson A, Eggers SD, Lohse C, McCaslin DL. Outcomes and Patient Experience in Individuals With Longstanding Dizziness. Am J Audiol 2023; 32:721-729. [PMID: 37079889 DOI: 10.1044/2023_aja-22-00152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
PURPOSE This study aimed to describe the relationship between changes in pre and post self-perceived dizziness handicap, scores on the patient health questionnaire, and perceptions of patient's value of being evaluated and managed by a multidisciplinary team. METHOD Seventy-eight patients completed the Dizziness Handicap Inventory (DHI) and Patient Health Questionnaire-Fourth Edition (PHQ-4) questionnaires post multidisciplinary clinical consultations and testing for the chief complaints of dizziness, unsteadiness, vertigo, or balance problems. The diagnoses of each patient were recorded from the clinical reports of each specialty consultation and were classified as structural, functional, or psychiatric. They were contacted by phone at least 6 months after their visit to obtain feedback regarding their symptoms and overall patient experience. RESULTS The change in DHI total score did not differ significantly by diagnosis (p = .56), indicating that patients experienced an improvement in DHI total score regardless of diagnosis. PHQ-4 anxiety scores worsened by a mean of 0.7 points for those with structural diagnoses (p = .04), improved by a mean of 0.7 points for psychiatric diagnoses (p = .16), and improved by a mean of 0.3 points for functional diagnoses (p = .39). Only seven patients would not recommend the team to a family or friend; these patients tended to report worsening DHI total scores (p = .27) compared to the significant improvement in DHI total scores for patients who would make such a recommendation (p < .001). Similarly, only 13 patients did not feel the information they received had a positive impact; these patients tended to report worsening DHI total scores (p = .18) compared to the significant improvement in DHI total scores for patients who did feel the information had a positive impact (p < .001). DISCUSSION The assessment and management of patients with chronic dizziness is challenging due to symptoms arising from multiple etiologies. Our finding of a vast difference between high satisfaction and relatively unchanged dizziness handicap suggests that there is value in seeing a multidisciplinary team where consultations are unhurried, care is coordinated, and expectations regarding treatment can be managed.
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Affiliation(s)
- Manami Shah
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Jeffrey Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Ann Anderson
- Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | | | - Christine Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Devin L McCaslin
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
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Lu L, Charney S, Pittelko R, Ochoa P, Bayan SL, Lohse C, Orbelo DM. Singing Voice Concern in Tertiary Laryngology Practice. J Voice 2023:S0892-1997(22)00413-1. [PMID: 36681566 DOI: 10.1016/j.jvoice.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To determine the prevalence and characteristics of patients who identify singing voice as a primary concern when presenting with general voice complaints to a voice clinic. METHODS Data were collected from medical records on demographics, medical history, laryngoscopy exam, diagnosis, and subsequent treatments; and from self-report questionnaires including the Voice Handicap Index-10 (VHI-10) and clinical voice questionnaire. RESULTS A total of 17% of patients presenting to a voice clinic with general voice problems who completed a VHI-10 identified singing voice as a primary concern. Compared to the reference cohort, patients concerned about singing voice report greater handicap on several questions of the VHI-10, particularly in personal and social life impact, loss of income, unpredictability of vocal clarity, subjective upset, and subjective handicap. Those concerned with singing voice were also more concerned about their vocal problem, and both more likely to be recommended voice therapy and participate in voice therapy despite no statistical differences in categorical diagnoses. CONCLUSIONS When considering both professional and recreational singers, voice concerns occurred in 17% of the cohort under study. Patients with singing voice concerns are accounted for largely by recreational singers, who remain poorly characterized in the literature. We underscore the importance of sensitivity and responsivity to the needs of this group of patients.
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Affiliation(s)
- Lauren Lu
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Sara Charney
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona
| | - Rebecca Pittelko
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Pablo Ochoa
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | - Semirra L Bayan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Christine Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Diana M Orbelo
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota.
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5
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Bowen AJ, San‐Marina S, Hunter D, Voss S, Bartemes K, Macura S, Meloche R, Spragg AM, Lohse C, Oldenburg MS, Ekbom DC. MRI
imaging versus histologic volumetric estimation of residual injection laryngoplasty material. Laryngoscope Investig Otolaryngol 2022; 7:454-459. [PMID: 35434315 PMCID: PMC9008163 DOI: 10.1002/lio2.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/11/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives To examine the degree of agreement between MRI and histologically generated volumetric measurements of residual injection laryngoplasty material. Methods Following left recurrent laryngeal nerve transection, rabbit vocal cords were injected with jellyfish collagen, Cymetra®, or Restylane®. Laryngeal tissue was harvested 4 or 12 weeks post injection followed by MRI imaging and histologic cross‐sectioning. Two raters estimated the volume of remaining injection material in specimens within MRI and histologic axial cross sections. Wilcoxon signed rank tests were employed to detect gross differences between inter‐rater measurements and between imaging modalities across time. Agreement between rater measurements and imaging (histology and MRI) was assessed using intra‐class correlation coefficients. Results Data was available from 16 rabbits sacrificed at 4 weeks (n = 8) and 12 weeks (n = 8). Inter‐rater testing of MRI imaging revealed no significant differences (p > .05) between rater measurements across time points, and excellent agreement (0.93; 95% confidence interval 0.80–0.98) while histologically estimated volumes demonstrated a significant difference at 4 weeks (p < .05) and overall good agreement (0.89; 95% confidence interval 0.59–0.97). Comparison of MRI and histologically estimated volume measurements revealed significant differences at the 4‐week time point (p < .05) but not at 12 weeks (p > .05). Overall, there is only moderate agreement between MRI and histology estimates (0.72; 95% confidence interval 0.22–0.90). Conclusions MRI imaging demonstrates good reliability and similar estimates of volume to histologically estimated measurements of residual injection laryngoplasty material at time points clinically relevant for future injection laryngoplasty experiments. Level of Evidence NA.
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Affiliation(s)
- Andrew Jay Bowen
- Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA
| | - Serban San‐Marina
- Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA
| | - Danielle Hunter
- Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA
| | - Stephen Voss
- Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA
| | - Kathleen Bartemes
- Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA
| | - Slobodan Macura
- Department of Biochemistry and Molecular Biology & Metabolomics Core Mayo Clinic Rochester Minnesota USA
| | - Ryan Meloche
- Department of Biochemistry and Molecular Biology & Metabolomics Core Mayo Clinic Rochester Minnesota USA
| | | | - Christine Lohse
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
| | | | - Dale C. Ekbom
- Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA
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Kiessling P, Bayan S, Lohse C, Orbelo D. Predicting Gag, Discomfort, and Laryngeal Visualization in Patients Undergoing Flexible Laryngoscopy with Stroboscopy. Ann Otol Rhinol Laryngol 2021:34894211011453. [PMID: 33890497 DOI: 10.1177/00034894211011453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate potential associations between the Predictive Gagging Survey (PGS) with patient experience of gag and discomfort as well as provider perception of patient gag and level of laryngeal visualization during flexible laryngoscopy with stroboscopy (FL-S). METHODS A total of 53 adult patients undergoing FL-S were recruited for this prospective non-controlled study. PGS was completed before FL-S. Patients rated perceived level of gag and discomfort on a 10-point severity scale after FL-S. Additionally, providers completed a Gagging Severity Index (GSI) reflecting their impression of patient gag and level of laryngeal visualization following FL-S. Spearman rank correlation coefficients were used to assess associations. RESULTS There was a positive association with PGS score and patient perception of gagging (0.34; P = .013) and patient perception of discomfort (0.38; P = .005). No significant association was found between PGS score and provider GSI (-0.12; P = .39) or level of laryngeal visualization (0.15; P = .29). A negative association was found between level of laryngeal visualization and patient perception of gagging (-0.34; P = .012) and discomfort (-0.44; P = .001). No significant differences were found between current and former smokers compared to never smokers for GSI or patient-perceived gag or discomfort. CONCLUSIONS While not predictive of GSI or level of laryngeal visualization, the PGS was found to be a useful tool in predicting patient experience of gagging and discomfort during FL-S, further reinforcing the subjective experience of this procedure. Use of the PGS may be helpful in identifying specific candidates who may struggle with subjective discomfort or gagging during FL-S for future studies considering interventions to manage and meaningfully decrease discomfort. Having such an instrument is important given the low number of individuals who struggle with discomfort during the exam.
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Affiliation(s)
| | - Semirra Bayan
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Christine Lohse
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Diana Orbelo
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
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7
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Farrell KJ, Walker LE, Battaglioli N, Heaton HA, Lohse C, Sadosty AT. Six years of gender equity in emergency medicine chief resident selection. AEM Educ Train 2021; 5:e10595. [PMID: 33869983 PMCID: PMC8035632 DOI: 10.1002/aet2.10595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Affiliation(s)
| | - Laura E. Walker
- Department of Emergency MedicineMayo ClinicRochesterMinnesotaUSA
| | | | | | - Christine Lohse
- Department of Biomedical Statistics and InformaticsMayo ClinicRochesterMinnesotaUSA
| | - Annie T. Sadosty
- Department of Emergency MedicineMayo ClinicRochesterMinnesotaUSA
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8
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Derscheid DJ, Lohse C, Arnetz JE. Risk Factors for Assault and Physical Aggression Among Medically Hospitalized Adult Patients Who Had a Behavioral Emergency Call: A Descriptive Study. J Am Psychiatr Nurses Assoc 2021; 27:99-110. [PMID: 33393418 DOI: 10.1177/1078390320983441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Health care settings are a primary location for workplace violence that involves clients, but risk factors for behavioral emergencies in medical settings are largely unknown. AIM This study proposed to identify risk factors for assault and physical aggression among medically hospitalized patients who needed a behavior emergency response team. METHOD This descriptive study, conducted at a large Midwestern academic medical center, used univariable and multivariable logistic regression to assess relationships between demographic, medical, mental health, and contextual variables with assault and physical aggression. Predictive ability was summarized using area under the receiver operating characteristic curve. RESULTS Among patients who received a behavior emergency response (N = 820), 86 (10%) were assaultive. Physical aggression was the most significant predictor of assault. Physical aggression was predicted by older age, male gender, and verbal threats to others. Conversely, internalizing mental health conditions of anxiety, depression, and suicidal ideation were significant for decreased risk of assault and/or physical aggression. Contextual factors, identified as wanting to smoke or leave the hospital, were significantly associated with decreased risk of both assault and physical aggression. CONCLUSION Health care providers are encouraged to (1) consider the demonstration of physical aggression as a sign to urgently implement precautionary measures for safety, (2) avoid predicting violent situations based on particular medical or mental health conditions alone, and (3) understand that not all disruptive behavior leads to violent situations.
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Affiliation(s)
| | | | - Judith E Arnetz
- Judith E. Arnetz, PhD, MPH, PT, Research Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA
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9
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Yin LX, Puccinelli CL, Price DL, Karp EE, Price KA, Ma DJ, Lohse C, Moore EJ, Abel KMV. The prognostic role of medical comorbidities in surgically treated human papillomavirus-associated oropharyngeal squamous cell carcinoma. Oral Oncol 2020; 108:104822. [PMID: 32504888 DOI: 10.1016/j.oraloncology.2020.104822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Prognostic factors specific to surgically managed human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC) are not fully understood. Medical co-morbidities may have an impact on survival after surgical treatment. We aimed to identify co-morbidities associated with distant metastases-free survival (DMFS) and cancer-specific survival (CSS) in HPV(+)OPSCCs. METHODS This is a retrospective case series of HPV(+)OPSCC patients at a tertiary referral center from 2007 to 2016. All patients in the study underwent primary intent-to-cure transoral resection with concomitant neck dissection ± adjuvant radiation ± chemotherapy. Exclusion criteria included a history of previous head and neck cancer or distant metastases at diagnosis. Associations with DMFS and CSS were evaluated using univariable and multivariable Cox regression and summarized with hazard ratios (HRs). RESULTS 406 patients were included in the cohort (100% HPV(+), 90% Male). All had tumors of the tonsil (62%) or base of tongue (38%). Median follow-up for the cohort was 4.0 years (IQR: 2.6-6.2). Higher tumor stage and a higher Adult Comorbidity Evaluation-27 score were significantly associated with worse DMFS and CSS (p < 0.02 for all). A history of diabetes mellitus (N = 36, 9%) was significantly associated with DMFS (HR 3.05 [95%CI 1.26-7.37], p = 0.014) and CSS (HR 4.82 [95%CI 1.84-12.61], p = 0.001). On multivariable analysis, after adjusting for tumor stage, diabetes remained significantly associated with worse DMFS (HR 2.58 [95%CI 1.06-6.26], p = 0.037). CONCLUSION Diabetes mellitus may be associated with worse DMFS and CSS in surgically managed HPV(+)OPSCC.
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Affiliation(s)
- Linda X Yin
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Cassandra L Puccinelli
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Daniel L Price
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Emily E Karp
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Dan J Ma
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Christine Lohse
- Department of Heath Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Eric J Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Kathryn M Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA.
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10
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Youssef S, Bayan S, Ekbom D, Lohse C, Zimmermann T, Pittelko R, Orbelo DM. Breathiness and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) in Patients Undergoing Medialization Laryngoplasty With or Without Arytenoid Adduction. J Voice 2019; 35:312-316. [PMID: 31606224 DOI: 10.1016/j.jvoice.2019.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We hypothesized that, in patients with unilateral vocal fold paralysis (UVFP), the auditory-perception of breathiness measured with Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) would be higher preoperatively in patients who undergo medialization laryngoplasty (ML) with arytenoid adduction (AA) compared to ML alone. We further hypothesized that increased breathiness would correlate with increased glottal area at maximum glottal closure. STUDY DESIGN Retrospective chart review. METHODS CAPE-V recordings were rated by expert judges in 105 subjects with UVFP (47 ML+AA and 58 ML). Component scores of the CAPE-V prior to laryngeal framework surgery and those at 3 and/or 12 months postoperatively were compared. Assessment of glottal area width during maximum glottal closure was attempted. RESULTS Breathiness scores prior to laryngeal framework surgery were significantly greater in UVFP patients having ML+AA compared to ML only (P < 0.001). Roughness was greater for ML only (P = 0.003). At 3 months, adjusted for age and previous injection laryngoplasty, the ML+AA group showed greater improvement for breathiness (P <0.001), loudness (P < 0.001), strain (P = 0.037), and pitch (P = 0.039), while the ML only group showed greater improvement in roughness (P = 0.009). Results were similar at 12 months. Only 26% of glottal area widths were ratable using methods previously described; therefore, no further analysis was attempted. CONCLUSIONS In patients with UVFP baseline perception of breathiness is greater in those clinically selected for ML+AA compared to ML only. Glottal area measurements were not representative of the UVFP cohort and more stringent criteria are needed for valid and reliable glottal area assessment when using clinical flexible stroboscopic exams. Findings support the idea that surgeons may be making decisions about AA based, to at least some degree, on auditory perceptual evaluation of voice.
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Affiliation(s)
| | - Semirra Bayan
- Mayo Clinic Department of Otolaryngology, Rochester, Minnesota
| | - Dale Ekbom
- Mayo Clinic Department of Otolaryngology, Rochester, Minnesota
| | - Christine Lohse
- Mayo Clinic Division of Biomedical Statistics and Informatics, Rochester, Minnesota
| | | | | | - Diana M Orbelo
- Mayo Clinic Department of Otolaryngology, Rochester, Minnesota.
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11
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Hernandez MC, Khasawneh M, Contreras-Peraza N, Lohse C, Stephens D, Kim BD, Zielinski MD. Vaccination and splenectomy in Olmsted County. Surgery 2019; 166:556-563. [PMID: 31378483 DOI: 10.1016/j.surg.2019.04.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/08/2019] [Accepted: 04/13/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To determine the long-term impact of vaccination on any postoperative infection in adults who underwent splenectomy. METHODS All adults (≥18 years) who underwent splenectomy from 1965 to 2011 in Olmsted County, MN were identified using the Rochester Epidemiology Project. Descriptive statistics, Kaplan-Meier estimates, and Cox proportional hazard ratios were performed. RESULTS There were 724 patients who underwent splenectomy; 47% were female with a median age of 55 (35-69) years. Overall vaccination rate (pneumococcal, H influenza, meningococcal) was 62% (n = 449). There were 268 (36%) patients who developed a post-splenectomy infection; most presented with sepsis 148 (55%). The 3 most common infections included pneumonia (124, 17%), bloodstream (67, 9%), and urinary tract infection (49, 7%). Median time to infection was quicker in non-vaccinated compared with vaccinated patients (1.5 [0.1-4.3] vs 3.3 [1.9-9.8] years, P = .01). CONCLUSION In this population-based study, the highest risk of infection after splenectomy was in patients who did not receive complete vaccination. Lack of complete vaccination was associated with a reduced time to infection and increased rates of bloodstream infections at 5 years. Infectious complication risk reduced as vaccination protocols improved for all indications except for malignancy. Adults who underwent a splenectomy should continue to receive booster vaccines.
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Affiliation(s)
- Matthew C Hernandez
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN
| | - Mohammad Khasawneh
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN
| | | | - Christine Lohse
- Department of Health Science Research, Mayo Clinic, Rochester, MN
| | - Daniel Stephens
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN
| | - Brian D Kim
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN
| | - Martin D Zielinski
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN.
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12
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Khasawneh MA, Contreras-Peraza N, Hernandez MC, Lohse C, Jenkins DH, Zielinski MD. Outcomes after splenectomy in children: a 48-year population-based study. Pediatr Surg Int 2019; 35:575-582. [PMID: 30712082 DOI: 10.1007/s00383-019-04439-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE In children who have undergone splenectomy, there may be impaired immunologic function and an increased risk of infection. We aimed to define the long-term rate of and risk factors for post-splenectomy infection using a population-based cohort study. METHODS All children (< 18 years) who underwent splenectomy from 1966 to 2011 in Olmsted County, MN were identified using the Rochester Epidemiology Project (REP). Descriptive statistics, Kaplan-Meier estimates, and Cox Proportional hazard ratios were performed to evaluate for risk factors associated with developing infection. RESULTS Ninety patients underwent splenectomy and 46% were female. Indications included trauma (42%), benign hematologic disease (33%), malignancy (13%), and other (11%). Most were performed open. Vaccination was completed in (72%) for pneumococcal, H. influenza, and meningococcal vectors. Nineteen patients developed infection, and associated factors included non-traumatic, non-malignant disease [HR 4.83 (1.18-19.85)], and performance of multiple surgical procedures [HR 2.80 (1.09-7.21)]. Estimated survival free of infection rates at 15 and 20 years following surgery was both 97%. CONCLUSIONS After splenectomy in children, most patients do not develop infection. Nearly three-quarters of patients were vaccinated with the lowest rates in patients that underwent a splenectomy for trauma. In patients who received multiple procedures during a splenectomy, the infection risk was higher.
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Affiliation(s)
- Mohammad A Khasawneh
- Division of Trauma, Critical Care and General Surgery, Department of Surgery, St. Mary's Hospital, Mayo Clinic, Mary Brigh 2-810, 1216 Second Street SW, Rochester, MN, 55902, USA
| | - Nicolas Contreras-Peraza
- Division of Trauma, Critical Care and General Surgery, Department of Surgery, St. Mary's Hospital, Mayo Clinic, Mary Brigh 2-810, 1216 Second Street SW, Rochester, MN, 55902, USA
| | - Matthew C Hernandez
- Division of Trauma, Critical Care and General Surgery, Department of Surgery, St. Mary's Hospital, Mayo Clinic, Mary Brigh 2-810, 1216 Second Street SW, Rochester, MN, 55902, USA
| | - Christine Lohse
- Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
| | - Donald H Jenkins
- Division of Trauma, Critical Care and General Surgery, Department of Surgery, St. Mary's Hospital, Mayo Clinic, Mary Brigh 2-810, 1216 Second Street SW, Rochester, MN, 55902, USA
| | - Martin D Zielinski
- Division of Trauma, Critical Care and General Surgery, Department of Surgery, St. Mary's Hospital, Mayo Clinic, Mary Brigh 2-810, 1216 Second Street SW, Rochester, MN, 55902, USA.
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Shenoy N, Bhagat TD, Cheville J, Lohse C, Bhattacharyya S, Tischer A, Machha V, Gordon-Mitchell S, Choudhary G, Wong LF, Gross L, Ressigue E, Leibovich B, Boorjian SA, Steidl U, Wu X, Pradhan K, Gartrell B, Agarwal B, Pagliaro L, Suzuki M, Greally JM, Rakheja D, Thompson RH, Susztak K, Witzig T, Zou Y, Verma A. Ascorbic acid-induced TET activation mitigates adverse hydroxymethylcytosine loss in renal cell carcinoma. J Clin Invest 2019; 129:1612-1625. [PMID: 30702441 DOI: 10.1172/jci98747] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/24/2019] [Indexed: 12/31/2022] Open
Abstract
Although clear cell renal cell carcinoma (ccRCC) has been shown to result in widespread aberrant cytosine methylation and loss of 5-hydroxymethylcytosine (5hmC), the prognostic impact and therapeutic targeting of this epigenetic aberrancy has not been fully explored. Analysis of 576 primary ccRCC samples demonstrated that loss of 5hmC was strongly associated with aggressive clinicopathologic features and was an independent adverse prognostic factor. Loss of 5hmC also predicted reduced progression-free survival after resection of nonmetastatic disease. The loss of 5hmC in ccRCC was not due to mutational or transcriptional inactivation of ten eleven translocation (TET) enzymes, but to their functional inactivation by l-2-hydroxyglutarate (L2HG), which was overexpressed due to the deletion and underexpression of L2HG dehydrogenase (L2HGDH). Ascorbic acid (AA) reduced methylation and restored genome-wide 5hmC levels via TET activation. Fluorescence quenching of the recombinant TET-2 protein was unaffected by L2HG in the presence of AA. Pharmacologic AA treatment led to reduced growth of ccRCC in vitro and reduced tumor growth in vivo, with increased intratumoral 5hmC. These data demonstrate that reduced 5hmC is associated with reduced survival in ccRCC and provide a preclinical rationale for exploring the therapeutic potential of high-dose AA in ccRCC.
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Affiliation(s)
- Niraj Shenoy
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Tushar D Bhagat
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | | | | | | | | | | | - Gaurav Choudhary
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Li-Fan Wong
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | - Emily Ressigue
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | | | - Ulrich Steidl
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | - Kith Pradhan
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Benjamin Gartrell
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | | | | | - Masako Suzuki
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - John M Greally
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Dinesh Rakheja
- University of Texas Southwestern Medical School, Dallas, Texas, USA
| | | | - Katalin Susztak
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Yiyu Zou
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
| | - Amit Verma
- Albert Einstein College of Medicine, Montefiore Medical Center, New York, New York, USA
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14
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Carr BM, O'Neil A, Lohse C, Heller S, Colletti JE. Bridging the gap to effective feedback in residency training: perceptions of trainees and teachers. BMC Med Educ 2018; 18:225. [PMID: 30285708 PMCID: PMC6169074 DOI: 10.1186/s12909-018-1333-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 09/25/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Clinical feedback is an important part of residency training, yet literature suggests this complex interaction is not completely understood. In particular, little is known about what resident versus attending physicians expect as feedback. This study investigates this gap in knowledge by examining differences in interactions that residents and attendings view as feedback. METHODS Surveys containing sample clinical feedback scenarios were distributed to residents and attending physicians in emergency medicine and general surgery at a large academic medical center. Respondents were asked to decide whether useful feedback was provided in each scenario, and responses were compared between the two groups. Continuous features were summarized with medians, interquartile ranges (IQRs), and ranges; categorical features were summarized with frequency counts and percentages. Comparisons of features between residents and attendings were evaluated using Wilcoxon rank sum, chi-square, and Fisher exact tests. Statistical analyses were performed using version 9.4 of the SAS software package (SAS Institute, Inc.; Cary, NC). All tests were two-sided and p-values < 0.05 were considered statistically significant. RESULTS Seventy-two individuals responded to the survey out of approximately 110 invitations sent (65%), including 35 (49%) residents and 37 (51%) attendings. Of 35 residents, 31 indicated their level of training, which included 13 (42%) PGY-1, 9 (29%) PGY-2, 6 (19%) PGY-3, and 3 (10%) PGY-4, respectively. Of 37 attendings, 34 indicated the number of years since completion of residency or last fellowship, at a median of 9 years (IQR 4-14; range 1-31). No significant difference was found in residents' and attendings' perceptions of what constituted feedback in the sample scenarios. CONCLUSIONS While this study did not find a statistical difference in perception of feedback between residents and attendings, additional factors should be considered when investigating perceived feedback deficiencies. Further research is needed to better understand and improve the clinical feedback process.
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Affiliation(s)
- Brendan M Carr
- Department of Emergency Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, 55904, USA.
| | - Amy O'Neil
- Department of Emergency Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Christine Lohse
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Stephanie Heller
- Division of Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - James E Colletti
- Department of Emergency Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, 55904, USA
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15
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Abstract
Obese children are at higher risk of developing psoriasis, and obesity severity is correlated with psoriasis severity. The relationship between obesity and pediatric psoriasis was explored in a well-defined population. Obesity and psoriasis coexist at diagnosis, but it is likely that obesity commonly precedes psoriasis in children.
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Affiliation(s)
- Manrup K Hunjan
- Department of General Internal Medicine, Sandwell and West Birmingham Hospital Trust, Birmingham, UK
| | | | - Christine Lohse
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Megha Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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16
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Mason RJ, Atwell T, Lohse C, Bhindi B, Schmit G, Schmitz J, Leibovich BC, Boorjian SA, Thompson RH. Synchronous nephron-sparing approaches for bilateral renal masses: peri-operative and renal functional outcomes. BJU Int 2018; 122:243-248. [DOI: 10.1111/bju.14221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Ross J. Mason
- Department of Urology; Mayo Clinic; Rochester MN USA
| | - Thomas Atwell
- Department of Diagnostic Radiology; Mayo Clinic; Rochester MN USA
| | - Christine Lohse
- Department of Health Sciences Research; Mayo Clinic; Rochester MN USA
| | - Bimal Bhindi
- Department of Urology; Mayo Clinic; Rochester MN USA
| | - Grant Schmit
- Department of Diagnostic Radiology; Mayo Clinic; Rochester MN USA
| | - John Schmitz
- Department of Diagnostic Radiology; Mayo Clinic; Rochester MN USA
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Bhindi B, Lohse C, Cheville J, Mason R, Tollefson M, Harrington S, Dong H, Parker A, Boorjian S, Thompson RH, Leibovich B. PD57-02 CREATION OF A TISSUE EXPRESSION BIOMARKER-AUGMENTED PROGNOSTIC MODEL FOR PATIENTS WITH METASTATIC RENAL CELL CARCINOMA. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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18
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Gershman B, Thompson RH, Boorjian S, Lohse C, Costello B, Cheville J, Leibovich B. MP48-14 RADICAL VERSUS PARTIAL NEPHRECTOMY FOR CT1 RENAL CELL CARCINOMA: A PROPENSITY-SCORE BASED ANALYSIS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Shah P, Lyon T, Lohse C, Cheville J, Leibovich B, Boorjian S, Thompson RH. PD16-12 PROGNOSTIC EVALUATION OF PERINEPHRIC FAT, RENAL SINUS FAT, AND RENAL VEIN INVASION FOR PATIENTS WITH PATHOLOGIC STAGE T3A RENAL CELL CARCINOMA. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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20
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Bhindi B, Cheville J, Lohse C, Mason R, Harrington S, Dong H, Boorjian S, Thompson RH, Leibovich B. MP66-12 BIM EXPRESSION IN PERITUMORAL LYMPHOCYTES IS AN INDEPENDENT PREDICTOR OF SURVIVAL IN PATIENTS WITH METASTATIC CLEAR CELL RENAL CELL CARCINOMA. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Marinelli J, Janus J, van Gompel J, Link M, Lohse C, Foote R, Price K, Chintakuntlawar A. Metastatic Esthesioneuroblastoma: A Systematic Review and Meta-analysis. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- John Marinelli
- School of Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Jeffrey Janus
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Jamie van Gompel
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael Link
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Christine Lohse
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Robert Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States
| | - Katharine Price
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, United States
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22
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Marinelli J, Janus J, Van Gompel J, Link M, Moore E, Van Abel K, Peck B, Lohse C, Price D. Dural Invasion Predicts Neck Metastases in Esthesioneuroblastoma. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- John Marinelli
- Mayo Clinic School of Medicine, Jacksonville, Florida, United States
| | - Jeffrey Janus
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Jamie Van Gompel
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael Link
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Eric Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Kathryn Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Brandon Peck
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Christine Lohse
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Daniel Price
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
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23
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Mohr D, Petterson T, Lohse C, O’Fallon WM, Melton LJ, Heit J, Silverstein M. The Epidemiology of Venous Thromboembolism in the Community. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1616243] [Citation(s) in RCA: 221] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe incidence of venous thromboembolism exceeds 1 per 1000; over 200,000 new cases occur in the United States annually. Of these, 30% die within 30 days; one-fifth suffer sudden death due to pulmonary embolism. Despite improved prophylaxis, the incidence of venous thromboembolism has been constant since 1980. Independent risk factors for venous thromboembolism include increasing age, male gender, surgery, trauma, hospital or nursing home confinement, malignancy, neurologic disease with extremity paresis, central venous catheter/ transvenous pacemaker, prior superficial vein thrombosis, and varicose veins; among women, risk factors include pregnancy, oral contraceptives, and hormone replacement therapy. About 30% of surviving cases develop recurrent venous thromboembolism within ten years. Independent predictors for recurrence include increasing age, obesity, malignant neoplasm, and extremity paresis. About 28% of cases develop venous stasis syndrome within 20 years. To reduce venous thromboembolism incidence, improve survival, and prevent recurrence and complications, patients with these characteristics should receive appropriate prophylaxis.
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24
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Funk E, Kummer T, Friedrich C, Lohse C, Heaton H. 389 My Visit Board: Improving Patient Understanding of Emergency Department Care. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Carr A, Revuru V, Lohse C. Association of Systemic Conditions with Dental Implant Failures in 6,384 Patients During a 31-Year Follow-up Period. Int J Oral Maxillofac Implants 2017; 32:1153-1161. [DOI: 10.11607/jomi.5888] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Mason RJ, Atwell TD, Lohse C, Bhindi B, Weisbrod A, Boorjian SA, Leibovich BC, Schmit GD, Thompson RH. Renal functional outcomes in patients undergoing percutaneous cryoablation or partial nephrectomy for a solitary renal mass. BJU Int 2017; 120:544-549. [PMID: 28548236 DOI: 10.1111/bju.13917] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To compare renal functional changes after percutaneous cryoablation (PCA) or partial nephrectomy (PN). PATIENTS AND METHODS Patients who underwent PCA or PN for a solitary renal mass at a single institution were identified (2003-2013). Estimated glomerular filtration rates (eGFRs) were calculated at baseline, discharge, and at the 3-month follow-up using the Chronic Kidney Disease Epidemiology Collaboration equation. Changes in renal function were compared between groups using 1:1 propensity score (PS) matching, adjustment for PS quintile, and inverse probability weighting (IPW). RESULTS There were 2 040 procedures available for the PS analyses, including 448 PCA and 1 592 PN. After PS adjustments, there were no significant differences in baseline clinical features between PCA and PN patients. In the PS-matched analysis, the change in eGFR from baseline to discharge for PCA and PN patients was -3.1 and -1.1 mL/min/1.73 m2 , respectively (P = 0.038), with percentage changes of -4.5% and 0% respectively (P = 0.006). From baseline to the 3-month follow-up, the absolute change in eGFR for PCA and PN patients was -4.3 and -2.1 mL/min/1.73 m2 , respectively (P = 0.008), and the percentage change was -6.1% and -2.4% respectively (P = 0.005). Similar results were obtained after adjusting for PS quintiles and in the IPW analysis. Importantly, the rate of chronic kidney disease stage progression at the 3-month follow-up was similar between the groups (21% vs 18%). CONCLUSIONS Our results confirm that both PCA and PN have a minor impact on renal function. While we observed a statistically greater decline in eGFR after PCA compared with PN, both approaches result in excellent preservation of renal function.
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Affiliation(s)
- Ross J Mason
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | | | - Christine Lohse
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Bimal Bhindi
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Adam Weisbrod
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Grant D Schmit
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Parker W, Lohse C, Cheville J, Zaid H, Boorjian S, Frank I, Thompson RH, Leibovich B. MP72-01 PREDICTING RENAL CELL CARCINOMA PROGRESSION AFTER SURGERY. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gershman B, Thompson RH, Boorjian S, Larcher A, Capitanio U, Montorsi F, Carenzi C, Bertini R, Briganti A, Lohse C, Cheville J, Leibovich B. MP55-16 RADICAL NEPHRECTOMY WITH OR WITHOUT LYMPH NODE DISSECTION FOR NON-METASTATIC RENAL CELL CARCINOMA: A MULTI-INSTITUTIONAL ANALYSIS. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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29
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Parker W, Merrill S, Schulte P, Mason R, Thompson RH, Lohse C, Frank I. MP72-12 SURVEILLANCE AFTER SURGERY FOR RENAL CELL CARCINOMA: A RISK-ADAPTED APPROACH. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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30
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Abdou Y, Lohse C, Comfere NI. Use of the term "rule out" in requisition forms may cause diagnostic delays in dermatopathology practice. Int J Dermatol 2016; 56:86-91. [PMID: 27778322 DOI: 10.1111/ijd.13403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 03/03/2016] [Accepted: 05/18/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Timely pathologic diagnosis relies on the communication of specific clinical information in the requisition form (RF). Clinical information may use nonspecific terms such as "rule out", the use of which may result in diagnostic delays and the unnecessary application of pathology stains and sections. OBJECTIVE This study was designed to evaluate the relationship between use of the term "rule out" and time to diagnosis, and the use of additional pathology stains and sections in integrated and non-integrated dermatopathology practices. METHODS A retrospective double-cohort study of 475 RFs from the integrated practice (of which 182 used the term "rule out" [RO] and 293 did not [NRO]) and 412 RFs from the non-integrated practice (RO, n = 126; NRO, n = 286) was performed. RESULTS No significant differences emerged between groups of patients with, respectively, RO and NRO RFs in the integrated practice with respect to time to diagnosis, and numbers of additional tissue sections or stains applied. By contrast, the use of RFs containing the term "rule out" was associated with significantly longer times to diagnosis and higher rates of use of pathology stains and sections in comparison with NRO RFs in the non-integrated practice. However, the study is limited by its status as a retrospective review of data sourced from a single institution. CONCLUSIONS Use of the term "rule out" in RFs may not significantly impact key care delivery outcomes in an integrated practice. However, it may cause diagnostic delays and the use of unnecessary pathology services in a non-integrated practice.
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Affiliation(s)
- Yara Abdou
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Christine Lohse
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Nneka I Comfere
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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31
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Hunjan M, Anderson K, Tollefson M, Marnach M, Lohse C. 141 Prenatal risk factors associated with increasing incidence of infantile hemangiomas. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Zaid H, Boorjian S, Parker W, Lohse C, Cheville J, Leibovich B, Thompson RH. MP64-19 FACTORS PREDICTING BLOOD LOSS AND POSITIVE MARGINS AT TIME OF PARTIAL NEPHRECTOMY: ANALYSIS OF A CONTEMPORARY COHORT. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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33
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Gershman B, Takahashi N, Moreira D, Thompson RH, Boorjian S, Lohse C, Costello B, Cheville J, Leibovich B. MP03-05 RADIOGRAPHIC SIZE OF RETROPERITONEAL LYMPH NODES PREDICTS PATHOLOGIC NODAL INVOLVEMENT FOR PATIENTS UNDERGOING RADICAL NEPHRECTOMY FOR RENAL CELL CARCINOMA: DEVELOPMENT OF A RISK PREDICTION MODEL. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Parker W, Frank I, Zaid H, Lohse C, Cheville J, Boorjian S, Leibovich B, Thompson RH. MP64-08 CONTEMPORARY UTILIZATION OF THE SSIGN SCORE. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Psutka S, Jewett M, Fadaak K, Finelli A, Thompson RH, Herrin J, Lohse C, Boorjian S, Stewart-Merrill S, Atwell T, Schmit G, Costello B, Legere L, Shah N, Leibovich B. MP73-11 A COMPREHENSIVE COMPETING RISK CALCULATOR FOR PATIENTS WITH CORTICAL RENAL MASSES < 10CM: A NOVEL CLINICAL DECISION AID FOR SHARED DECISION-MAKING REGARDING INDIVIDUALIZED TREATMENT SELECTION. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bailey G, Boorjian S, Ziegelmann M, Westerman M, Lohse C, Cheville J, Leibovich B, Thompson R. MP78-02 URINARY COLLECTING SYSTEM INVASION IS ASSOCIATED WITH POOR SURVIVAL IN CLEAR CELL RENAL CELL CARCINOMA PATIENTS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gershman B, Moreira D, Thompson RH, Boorjian S, Lohse C, Costello B, Cheville J, Leibovich B. MP03-11 RETROPERITONEAL LYMPH NODE DISSECTION IS NOT ASSOCIATED WITH IMPROVED SURVIVAL AMONG PATIENTS UNDERGOING CYTOREDUCTIVE NEPHRECTOMY FOR METASTATIC RENAL CELL CARCINOMA: A PROPENSITY-SCORE BASED ANALYSIS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gershman B, Moreira D, Thompson RH, Boorjian S, Lohse C, Costello B, Cheville J, Leibovich B. MP64-01 RETROPERITONEAL LYMPH NODE DISSECTION IS NOT ASSOCIATED WITH SURVIVAL OUTCOMES AMONG PATIENTS UNDERGOING RADICAL NEPHRECTOMY FOR NON-METASTATIC RENAL CELL CARCINOMA: A PROPENSITY-SCORE BASED ANALYSIS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Link M, Carlson M, Lund-Johansen M, Tveiten O, Driscoll C, Myrseth E, Lohse C. Quality of Life Analysis in Vestibular Schwannoma Patients: to Leave or Not to Leave… Gross Total Vs. Less than Gross Total Resection in an International Cohort of Patients. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Eckel-Passow JE, Serie DJ, Cheville JC, Ho TH, Harrington SM, Hilton T, Lohse C, Shreders A, Kapur P, Brugarolas J, Thompson RH, Leibovich BC, Kwon ED, Joseph RW, Parker AS. Abstract 10: Concordance of BAP1, PBRM1, Ki-67, and TOPOIIa protein expression in primary clear cell renal cell carcinoma tumors and patient-matched metastatic tumors. Clin Cancer Res 2016. [DOI: 10.1158/1557-3265.pmsclingen15-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Efforts to improve clear cell renal cell carcinoma (ccRCC) mortality have focused primarily on evaluating prognostic biomarkers in primary tumors in order to identify indicators of response to treatment and targets for novel therapies. To date little attention has been paid to the status of these biomarkers in the more therapeutically-relevant metastatic tumor. Thus, we evaluated concordance of expression of four key prognostic ccRCC biomarkers (BAP1, PBRM1, Ki-67 and TOPOIIa) in a large cohort of patient-matched primary ccRCC and metastatic tumors.
Methods: We identified 114 patients treated surgically for ccRCC between 1990 and 2005 who had synchronous (M1) or metachronous (M0) metastases, underwent metastasectomy for at least one metastatic lesion and had archived tissue available from the primary and at least one metastatic tumor. We performed IHC on all primary and metastatic tumors for BAP1, PBRM1, Ki-67, and TOPOIIa using previously-published protocols. BAP1 and PBRM1 expression was categorized as positive or negative and Ki-67 and TOPOIIa was quantified as the number of positive cells per mm2. For BAP1 and PBRM1, we calculated the concordance between patient-matched primary and metastatic tumors as the percentage of pairs where the primary and metastatic tumor had the same designation (i.e., positive or negative). For TOPOIIa and Ki-67, we assessed concordance using Spearman correlation coefficient. Analysis of variance was used to evaluate if concordance between primary-metastatic tumor pairs for TOPOIIa and Ki-67 was associated with metastatic site, metastatic timing (M0/M1), metastatic tumor grade, metastatic tumor necrosis, and metastatic tumor sarcomatoid differentiation.
Results: There were a total of 161 patient-matched metastatic tumors available for the 114 patients: 78 patients had only a single metastasis while 36 patients had two or more metastases. While sites of metastases varied, pulmonary metastases were the most common (44% of all metastases). Loss of BAP1 expression was observed in19% of the primary ccRCC and 98.6% of the tumor pairs had concordant BAP1 status between the paired primary and metastatic tumors. Loss of PBRM1 was observed in 56% of the primary ccRCC tumors and 89.3% of tumor pairs showed concordant PBRM1 status. By comparison, median expression of Ki-67 was 65.0mm2 in the primary ccRCC tumors and the Pearson correlation with the patient-matched metastatic tumors was 0.43. The difference in Ki-67 expression between primary-metastatic tumor pairs was associated with necrosis in the metastatic tumor (p=0.014). Median expression of TOPOIIa was 2.6mm2 in the primary ccRCC tumors and the Pearson correlation with the patient-matched metastatic tumors was 0.25. The difference in TOPOIIa expression between primary-metastatic tumor pairs was associated with metastatic site (p=0.0006) and metastases to the heart were significantly different than pulmonary metastases (p<0.0001). Additionally, synchronous metastases had larger differences from their patient-matched primary tumors in comparison to metachronous metastases (p=0.012), as did necrotic metastases (p=0.028).
Conclusion: We observed high concordance for loss of BAP1 and PBRM1 expression between primary ccRCC and metastatic tumors in the same patient. Conversely, we noted high discordance in protein expression of Ki-67 and TOPOIIa between patient-matched primary-metastatic tumor pairs. Moreover, this discordance varied by key pathological features. Our results suggest that using the status of a biomarker in primary ccRCC as a guide for the status in metastatic tumors is not always appropriate and needs to be evaluated on a marker-by-marker basis.
Citation Format: Jeanette E. Eckel-Passow, Daniel J. Serie, John C. Cheville, Thai H. Ho, Sue M. Harrington, Tracy Hilton, Christine Lohse, Amanda Shreders, Payal Kapur, James Brugarolas, R Houston Thompson, Bradley C. Leibovich, Eugene D. Kwon, Richard W. Joseph, Alexander S. Parker. Concordance of BAP1, PBRM1, Ki-67, and TOPOIIa protein expression in primary clear cell renal cell carcinoma tumors and patient-matched metastatic tumors. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Integrating Clinical Genomics and Cancer Therapy; Jun 13-16, 2015; Salt Lake City, UT. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(1_Suppl):Abstract nr 10.
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Uzodi A, Lohse C, Banerjee R. Population-Based Study of Incidence and Antimicrobial Resistance Patterns of Extraintestinal Escherichia Coli Infections in Children in Olmsted County, Minnesota, 2012. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Simmenroth-Nayda A, Görlich Y, Wagner M, Müther M, Lohse C, Utte L, Leiterholt S, Hoerauf H, Feltgen N. [Undergraduate teaching in ophthalmology. Do standardized practical examinations make sense?]. Ophthalmologe 2015; 111:235-40. [PMID: 23712519 DOI: 10.1007/s00347-013-2859-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND University teaching in ophthalmology has tended to focus on imparting knowledge rather than practical skills. The new skills laboratory at the University Medical Center in Göttingen enables practical skills to be taught. The focus is on basic skills that could help all physicians. The learning goals set are techniques considered basic in ophthalmology that can be mastered without requiring any physician to operate major equipment. METHODS The design and results from four semesters of an ophthalmological objective structured clinical examination (OSCE) following students engaged in peer-teaching, as well as feedback from a student questionnaire are described. RESULTS Practical skills can successfully be taught and mastered within 1 week and 68-100 % of all students achieved the maximum scores in the individual tests. The OSCE and peer- eaching were well received by the students. CONCLUSIONS Practical skills and peer teaching fulfill student educational goals in ophthalmology and are well accepted by undergraduates.
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Affiliation(s)
- A Simmenroth-Nayda
- Abteilung Allgemeinmedizin und STÄPS , Universitätsmedizin Göttingen, Georg August Universität, Humboldtallee 38, 37075, Göttingen, Deutschland,
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Gershman B, Moreira D, Boorjian S, Lohse C, Cheville J, Costello B, Leibovich B, Thompson RH. MP69-05 EVALUATION OF POST-OPERATIVE COMPLICATIONS AND PROLONGED LENGTH OF STAY FOLLOWING CYTOREDUCTIVE NEPHRECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Psutka S, Moynagh M, Schmit G, Thompson RH, Boorjian S, Stewart S, Lohse C, Cheville J, Leibovich B, Tollefson M. MP35-19 THE IMPACT OF EXCESS FAT MASS ON MORTALITY AFTER RADICAL NEPHRECTOMY FOR RENAL CELL CARCINOMA: BEYOND BODY MASS INDEX. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Viers B, Thompson RH, Boorjian S, Lohse C, Leibovich B, Tollefson M. MP35-02 PRETREATMENT NEUTROPHIL-TO-LYMPHOCYTE RATIO CAN PREDICT TUMOR AGGRESSIVENESS IN NEWLY DIAGNOSED RENAL LESIONS. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Viers B, Boorjian S, Lohse C, Psutka S, Morrisson G, Leibovich B, Thompson RH. MP50-10 INCIDENCE AND RISK FACTORS FOR PERIOPERATIVE THROMBOEMBOLIC EVENTS AMONG PATIENTS WITH RENAL CELL CARCINOMA AND INFERIOR VENA CAVA TUMOR THROMBUS. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Psutka S, Moynagh M, Schmit G, Thompson RH, Boorjian S, Stewart S, Lohse C, Cheville J, Leibovich B, Tollefson M. MP35-18 SARCOPENIA IS INDEPENDENTLY ASSOCIATED WITH INCREASED MORTALITY FOLLOWING RADICAL NEPHRECTOMY FOR LOCALIZED RENAL CELL CARCINOMA. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Psutka S, Thompson RH, Boorjian S, Cheville J, Stewart S, Lohse C, Costello B, Que F, Leibovich B. MP70-12 IS CONCOMITANT HEPATIC RESECTION FOR LOCALLY ADVANCED OR METASTATIC RENAL CELL CARCINOMA AT THE TIME OF NEPHRECTOMY SAFE? A MATCHED COHORT STUDY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Viers B, Thompson RH, Psutka S, Lohse C, Leibovich B, Tollefson M, Boorjian S. MP69-12 THE ASSOCIATION OF STATIN THERAPY WITH CLINICOPATHOLOGIC OUTCOMES AND SURVIVAL AMONG PATIENTS WITH LOCALIZED RENAL CELL CARCINOMA UNDERGOING NEPHRECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Moreira D, Gershman B, Lohse C, Boorjian S, Cheville J, Leibovich B, Thompson RH. MP44-14 PARANEOPLASTIC SYNDROMES ARE ASSOCIATED WITH ADVERSE PROGNOSIS AMONG PATIENTS WITH RENAL CELL CARCINOMA UNDERGOING NEPHRECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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