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Article ; Online: Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer.

Nightingale, Ginah / Hajjar, Emily / Swartz, Kristine / Andrel-Sendecki, Jocelyn / Chapman, Andrew

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2015 Volume 33, Issue 13, Page(s) 1453–1459

Abstract: Purpose: The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record ... ...

Abstract	Purpose: The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment. Patients and methods: We retrospectively examined medication use in ambulatory senior adults with cancer to determine the prevalence of polypharmacy (PP) and potentially inappropriate medication (PIM) use and associated factors. PP was defined as concurrent use of five or more and less than 10 medications, and excessive polypharmacy (EPP) was defined as 10 or more medications. PIMs were categorized by 2012 Beers Criteria, Screening Tool of Older Person's Prescriptions (STOPP), and the Healthcare Effectiveness Data and Information Set (HEDIS). Results: A total of 248 patients received a geriatric oncology assessment between January 2011 and June 2013 (mean age was 79.9 years, 64% were women, 74% were white, and 87% had solid tumors). Only 234 patients (evaluated by pharmacists) were included in the final analysis. Mean number of medications used was 9.23. The prevalence of PP, EPP, and PIM use was 41% (n = 96), 43% (n = 101), and 51% (n = 119), respectively. 2012 Beers, STOPP, and HEDIS criteria classified 173 occurrences of PIMs, which were present in 40%, 38%, and 21% of patients, respectively. Associations with PIM use were PP (P < .001) and increased comorbidities (P = .005). Conclusion: A pharmacist-led comprehensive medication assessment demonstrated a high prevalence of PP, EPP, and PIM use. Medication assessments that integrate both 2012 Beers and STOPP criteria and consider cancer diagnosis, prognosis, and cancer-related therapy are needed to optimize medication use in this population.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Comorbidity ; Drug Prescriptions ; Female ; Humans ; Inappropriate Prescribing/prevention & control ; Male ; Medication Reconciliation ; Middle Aged ; Neoplasms/diagnosis ; Neoplasms/drug therapy ; Pharmacists ; Philadelphia ; Polypharmacy ; Program Evaluation ; Retrospective Studies ; Risk Factors
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2015-05-01
Publishing country	United States
Document type	Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.2014.58.7550
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Article ; Online: Meta-analysis: A brief introduction.

Andrel, Jocelyn A / Keith, Scott W / Leiby, Benjamin E

Clinical and translational science

2010 Volume 2, Issue 5, Page(s) 374–378

Abstract: Meta-analysis is the process of combining data from multiple sources and analyzing it together to increase power and provide a clearer picture of the effect of intervention or exposure on an outcome. The process is not complicated, but requires a great ... ...

Abstract	Meta-analysis is the process of combining data from multiple sources and analyzing it together to increase power and provide a clearer picture of the effect of intervention or exposure on an outcome. The process is not complicated, but requires a great deal of attention to detail. A specific set of inclusion criteria for studies must be defined. Published or available study results may be affected by publication bias of several different types, so the researcher should be sure to conduct a thorough search of available databases in order to include unpublished findings. Following selection, the group of studies should be examined using funnel plots or statistical tests. Meta-analysis models themselves must be selected to properly reflect the combined studies. Both fixed- and random-effects modeling are discussed. Two case studies are presented, illustrating a well-conducted meta-analysis and a meta-analysis that was more controversial.
MeSH term(s)	Adolescent ; Adult ; Clinical Trials as Topic ; Global Health ; Humans ; Meta-Analysis as Topic ; Middle Aged ; Models, Statistical ; Public Health ; Publication Bias ; Publications ; Research Design ; Treatment Outcome
Language	English
Publishing date	2010-04-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2433157-0
ISSN	1752-8062 ; 1752-8054
ISSN (online)	1752-8062
ISSN	1752-8054
DOI	10.1111/j.1752-8062.2009.00152.x
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Article ; Online: Evaluation of additive effect of quantitative fetal fibronectin to cervical length for prediction of spontaneous preterm birth among asymptomatic low-risk women.

Jwala, Sushma / Tran, Tino L / Terenna, Courtney / McGregor, Ali / Andrel, Jocelyn / Leiby, Benjamin E / Baxter, Jason K / Berghella, Vincenzo

Acta obstetricia et gynecologica Scandinavica

2016 Volume 95, Issue 8, Page(s) 948–955

Abstract: Introduction: Our objective was to evaluate the possible additive effect of quantitative fetal fibronectin to transvaginal ultrasound cervical length measurement between 18(0/7) and 23(6/7) weeks for prediction of spontaneous preterm birth at <37(0/7) ...

Abstract	Introduction: Our objective was to evaluate the possible additive effect of quantitative fetal fibronectin to transvaginal ultrasound cervical length measurement between 18(0/7) and 23(6/7) weeks for prediction of spontaneous preterm birth at <37(0/7) weeks among asymptomatic low-risk women. Material and methods: A prospective observational study was performed of asymptomatic women with singleton gestations between 18(0/7) and 23(6/7) weeks and no prior spontaneous preterm birth. Women with multiple gestations, rupture of membranes, vaginal bleeding, intercourse or vaginal exam within 48 h of enrollment were excluded. Physicians were blinded to the quantitative fetal fibronectin levels, but the cervical length measurements were made available. The primary outcome was spontaneous preterm birth at <37(0/7) weeks. Results: Of the 528 asymptomatic low-risk women who were prospectively enrolled, 36 (6.82%) had spontaneous preterm birth at <37(0/7) weeks. Using the receiver-operating characteristic curve, fetal fibronectin value of ≥5 ng/mL was identified as the optimal cut-off for predicting spontaneous preterm birth at <37(0/7) weeks. As compared with cervical length ≥20 mm alone, with the use of cervical length ≤20 mm or quantitative fetal fibronectin ≥5 ng/mL as screening criteria for prediction of spontaneous preterm birth at <37(0/7) weeks; sensitivity improved from 11.11 to 61.11%, specificity decreased from 99.59 to 55.08%, positive predictive value decreased from 66.67 to 9.05%, negative predictive value marginally improved from 93.87 to 95.09% and predictive accuracy decreased from 93.56 to 55.49%. Conclusions: Although the sensitivity improved, other predictive statistics and predictive accuracy did not improve by the addition of mid-trimester quantitative fetal fibronectin to cervical length measurement. Therefore, addition of mid-trimester quantitative fetal fibronectin to cervical length measurement cannot be recommended at this time for prediction of spontaneous preterm birth at <37(0/7) weeks in asymptomatic low-risk women.
MeSH term(s)	Adult ; Asymptomatic Diseases ; Biomarkers/metabolism ; Cervical Length Measurement ; Female ; Fibronectins/metabolism ; Follow-Up Studies ; Humans ; Predictive Value of Tests ; Pregnancy ; Premature Birth/diagnosis ; Premature Birth/metabolism ; Prognosis ; Prospective Studies ; ROC Curve ; Risk ; Sensitivity and Specificity ; Single-Blind Method
Chemical Substances	Biomarkers ; FFN protein, human ; Fibronectins
Language	English
Publishing date	2016-08
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	80019-3
ISSN	1600-0412 ; 0001-6349
ISSN (online)	1600-0412
ISSN	0001-6349
DOI	10.1111/aogs.12907
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Article ; Online: Risk stratification for the development of post-ERCP pancreatitis by sphincter of Oddi dysfunction classification.

Beltz, Sara / Sarkar, Avik / Loren, David E / Andrel, Jocelyn / Kowalski, Thomas / Siddiqui, Ali A

Southern medical journal

2013 Volume 106, Issue 5, Page(s) 298–302

Abstract: Objectives: To explore whether there is a difference in the frequency of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in patients with manometrically confirmed sphincter of Oddi dysfunction (SOD) types I, II, and III.: ... ...

Abstract	Objectives: To explore whether there is a difference in the frequency of postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in patients with manometrically confirmed sphincter of Oddi dysfunction (SOD) types I, II, and III. Methods: A retrospective review of all of the patients who underwent an ERCP with SOD type I or patients with manometrically confirmed SOD type II or type III (mean basal sphincter pressure ≥ 40 mm Hg) from 2006 to 2010 was performed. The primary outcome measure was development of post-ERCP acute pancreatitis in each of the SOD groups. Factors associated with acute pancreatitis in each group were examined by univariate analysis. Results: We identified 147 patients with SOD. Biliary sphincterotomy was performed in all of the patients, and pancreatic sphincterotomy was performed in 68 of the 147 (46%). All of the patients underwent stenting of the pancreatic duct. Post-ERCP pancreatitis occurred in 23% of the study cohort. Patients with SOD type III had a higher frequency of post-ERCP pancreatitis compared with the SOD type I and type II groups (31% vs 20% vs 6%, respectively; P = 0.024). Those with SOD type III had a greater frequency of post-ERCP pancreatitis (odds ratio 6.7; P = 0.05) compared with those with SOD type I. Patients with SOD type III had a two times greater frequency of developing post-ECRP pancreatitis compared with those with SOD type II. Conclusions: SOD type III is strongly associated with the development of post-ERCP pancreatitis compared with SOD type I.
MeSH term(s)	Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct Diseases/classification ; Common Bile Duct Diseases/diagnosis ; Common Bile Duct Diseases/physiopathology ; Female ; Humans ; Male ; Manometry ; Pancreatitis/diagnosis ; Pancreatitis/physiopathology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sphincter of Oddi/physiopathology
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.1097/SMJ.0b013e318290c6be
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Article ; Online: High dose rate brachytherapy boost for prostate cancer: a systematic review.

Zaorsky, Nicholas G / Doyle, Laura A / Yamoah, Kosj / Andrel, Jocelyn A / Trabulsi, Edouard J / Hurwitz, Mark D / Dicker, Adam P / Den, Robert B

Cancer treatment reviews

2014 Volume 40, Issue 3, Page(s) 414–425

Abstract: Studies of dose-escalated external beam radiation therapy (EBRT) and low dose rate brachytherapy (LDR-BT) have shown excellent rates of tumor control and cancer specific survival. Moreover, LDR-BT combined with EBRT (i.e. "LDR-BT boost") is hypothesized ... ...

Abstract	Studies of dose-escalated external beam radiation therapy (EBRT) and low dose rate brachytherapy (LDR-BT) have shown excellent rates of tumor control and cancer specific survival. Moreover, LDR-BT combined with EBRT (i.e. "LDR-BT boost") is hypothesized to improve local control. While phase II trials with LDR-BT boost have produced mature data of outcomes and toxicities, high dose rate (HDR)-BT has been growing in popularity as an alternative boost therapy. Boost from HDR-BT has theoretical advantages over LDR-BT, including improved cancer cell death and better dose distribution from customization of catheter dwell times, locations, and inverse dose optimization. Freedom from biochemical failure rates at five years for low-, intermediate-, high-risk, and locally advanced patients have generally been 85-100%, 80-98%, 59-96%, and 34-85%, respectively. Late Radiation Therapy Oncology Group grade 3-4 toxicities have also been encouraging with <6% of patients experiencing any toxicity. Limitations of current HDR-BT boost studies include reports of only single-institution experiences, and unrefined reports of toxicity or patient quality of life. Comparative effectiveness research will help guide clinicians in selecting the most appropriate treatment option for individual patients based on risk-stratification, expected outcomes, toxicities, quality of life, and cost.
MeSH term(s)	Brachytherapy/adverse effects ; Disease Progression ; Humans ; Male ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy ; Radiotherapy Dosage ; Risk Factors
Language	English
Publishing date	2014-04
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	125102-8
ISSN	1532-1967 ; 0305-7372
ISSN (online)	1532-1967
ISSN	0305-7372
DOI	10.1016/j.ctrv.2013.10.006
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Article ; Online: Race and response to colon cancer screening interventions.

Siddiqui, Ali A / Sifri, Randa / Hyslop, Terry / Andrel, Jocelyn / Rosenthal, Michael / Vernon, Sally W / Cocroft, James / Myers, Ronald E

Preventive medicine

2011 Volume 52, Issue 3-4, Page(s) 262–264

Abstract: Objective: We report race-related differences in response to behavioral interventions in colorectal cancer (CRC) screening.: Methods: From 2002 through 2005, a total of 1430 primary care patients (578 whites and 852 African Americans) from Jefferson ... ...

Abstract	Objective: We report race-related differences in response to behavioral interventions in colorectal cancer (CRC) screening. Methods: From 2002 through 2005, a total of 1430 primary care patients (578 whites and 852 African Americans) from Jefferson Family Medicine Associates, a large primary care practice affiliated with Thomas Jefferson University, completed a baseline survey and were randomized to 1 of 4 groups, as follows: control (usual care), standard intervention (SI), tailored intervention (TI), or tailored intervention plus phone (TIP). The SI group received a targeted print intervention by mail. The TI group received the targeted intervention and tailored message pages that addressed perceptions related to screening. The TIP group received the targeted intervention, tailored message pages, and a telephone reminder. Results: CRC screening rates for whites and African Americans were comparable in usual care (33% versus 32%, respectively). In response to intervention, however, whites exhibited significantly higher (p=0.005) screening rates than African Americans (53% versus 43%, respectively; adjusted OR=1.44; 95% CI=1.12-1.86). This effect is largely explained by differential response to mailed print interventions. Conclusions: Whites and African Americans may respond differently to mailed interventions intended to increase CRC screening. Research is needed on methods that can both increase screening and racial equity in screening.
MeSH term(s)	African Americans/psychology ; African Americans/statistics & numerical data ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/ethnology ; Colorectal Neoplasms/prevention & control ; European Continental Ancestry Group/psychology ; European Continental Ancestry Group/statistics & numerical data ; Female ; Health Promotion/methods ; Humans ; Male ; Mass Screening/psychology ; Mass Screening/statistics & numerical data ; Middle Aged ; Patient Acceptance of Health Care/ethnology ; Philadelphia ; Postal Service ; Reminder Systems ; Telephone
Language	English
Publishing date	2011-03
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2011.01.005
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Article ; Online: Clinical-pathological features and treatment modalities associated with recurrence in DCIS and micro-invasive carcinoma: Who to treat more and who to treat less.

Toss, Angela / Palazzo, Juan / Berger, Adam / Guiles, Frances / Sendecki, Jocelyn Andrel / Simone, Nicole / Anne, Rani / Avery, Tiffany / Jaslow, Rebecca / Lazar, Melissa / Tsangaris, Theodore / Cristofanilli, Massimo

Breast (Edinburgh, Scotland)

2016 Volume 29, Page(s) 223–230

Abstract: The primary aim in the management of DCIS is the prevention of recurrence and contralateral tumor. Risk factors for DCIS recurrence and appropriate treatments are still widely debated. Adjuvant therapies after surgical resection reduce recurrences and ... ...

Abstract	The primary aim in the management of DCIS is the prevention of recurrence and contralateral tumor. Risk factors for DCIS recurrence and appropriate treatments are still widely debated. Adjuvant therapies after surgical resection reduce recurrences and contralateral disease, but these treatments have significant financial costs, side effects and there is a group of low-risk patients who would not gain additional benefit. The aim of our analysis was to identify clinical-pathological features and treatment modalities associated with recurrence in DCIS and microinvasive carcinoma. In the Thomas Jefferson University Cancer Registry of Philadelphia, we identified 865 patients with DCIS or micro-invasive carcinoma treated between 2003 and 2013. Associations between recurrence and demographic factors (age at diagnosis, ethnicity), biological features (ER, PR and HER2) and treatment modalities (surgery, radiotherapy and endocrine treatment) were assessed. Our single institution register-based study showed that distribution of age at diagnosis and biological features did not significantly differ among ethnic groups. Younger women and micro-invasive carcinoma patients were more likely to undergo mastectomy, while African Americans were more likely to take endocrine therapy and undergo radiotherapy. In our sample only ER/PR negative DCIS were associated with significantly higher recurrence rate. Moreover, we reported a high rate of HER2 positive recurrences, suggesting that expression of this oncogene may represent a potential biomarker for DCIS at high risk of recurrence. To better define the molecular profile of the subgroup at worse prognosis might help to identify biomarkers predictive of recurrence or second tumors, identifying patients candidates for more appropriate treatments.
MeSH term(s)	Adult ; Age Factors ; Aged ; Antineoplastic Agents, Hormonal/therapeutic use ; Breast Neoplasms/chemistry ; Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Carcinoma, Intraductal, Noninfiltrating/chemistry ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Carcinoma, Intraductal, Noninfiltrating/therapy ; Female ; Humans ; Mastectomy/statistics & numerical data ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/prevention & control ; Receptor, ErbB-2/analysis ; Risk Factors
Chemical Substances	Antineoplastic Agents, Hormonal ; ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2016-10
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1143210-x
ISSN	1532-3080 ; 0960-9776
ISSN (online)	1532-3080
ISSN	0960-9776
DOI	10.1016/j.breast.2016.07.023
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Zs.A 3620: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Impact of obesity on perioperative morbidity and mortality after pancreaticoduodenectomy.

Williams, Timothy K / Rosato, Ernest L / Kennedy, Eugene P / Chojnacki, Karen A / Andrel, Jocelyn / Hyslop, Terry / Doria, Cataldo / Sauter, Patricia K / Bloom, Jordan / Yeo, Charles J / Berger, Adam C

Journal of the American College of Surgeons

2009 Volume 208, Issue 2, Page(s) 210–217

Abstract: Background: Obesity has been implicated as a risk factor for perioperative and postoperative complications. The aim of this study was to determine the impact of obesity on morbidity and mortality in patients undergoing pancreaticoduodenectomy (PD).: ... ...

Abstract	Background: Obesity has been implicated as a risk factor for perioperative and postoperative complications. The aim of this study was to determine the impact of obesity on morbidity and mortality in patients undergoing pancreaticoduodenectomy (PD). Study design: Between January 2000 and July 2007, 262 patients underwent PD at Thomas Jefferson University Hospital, of whom 240 had complete data, including body mass index (BMI; calculated as kg/m(2)) for analysis. Data on BMI, preoperative parameters, operative details, and postoperative course were collected. Patients were categorized as obese (BMI >or= 30), overweight (BMI >or= 25 and < 30), or normal weight (BMI < 25). Complications were graded according to previously published scales. Other end points included length of postoperative hospital stay, blood loss, and operative duration. Analyses were performed using univariate and multivariable models. Results: There were 103 (42.9%) normal-weight, 71 (29.6%) overweight, and 66 (27.5%) obese patients. There were 5 perioperative deaths (2.1%), with no differences across BMI categories. A significant difference in median operative duration and blood loss between obese and normal-weight patients was identified (439 versus 362.5 minutes, p = 0.0004; 650 versus 500 mL, p = 0.0139). In addition, median length of stay was significantly longer for BMI (9.5 versus 8 days, p = 0.095). Although there were no significant differences in superficial wound infections, obese patients did have an increased rate of serious complications compared with normal-weight patients (24.2% versus 13.6%, respectively; p = 0.10). Conclusions: Obese patients undergoing PD have a substantially increased blood loss and longer operative time but do not have a substantially increased length of postoperative hospital stay or rate of serious complications. These findings should be considered when assessing patients for operation and when counseling patients about operative risk, but they do not preclude obese individuals from undergoing definitive pancreatic operations.
MeSH term(s)	Aged ; Blood Loss, Surgical ; Body Mass Index ; Female ; Humans ; Length of Stay ; Male ; Medical Records ; Middle Aged ; Obesity/complications ; Overweight/complications ; Pancreaticoduodenectomy/adverse effects ; Pancreaticoduodenectomy/methods ; Pancreaticoduodenectomy/mortality ; Pennsylvania/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Complications/mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2009-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1181115-8
ISSN	1879-1190 ; 1072-7515
ISSN (online)	1879-1190
ISSN	1072-7515
DOI	10.1016/j.jamcollsurg.2008.10.019
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Article ; Online: Differential expression of cytochrome P450 omega-hydroxylase isoforms and their association with clinicopathological features in pancreatic ductal adenocarcinoma.

Gandhi, Ankit V / Saxena, Shivam / Relles, Daniel / Sarosiek, Konrad / Kang, Christopher Y / Chipitsyna, Galina / Sendecki, Jocelyn Andrel / Yeo, Charles J / Arafat, Hwyda A

Annals of surgical oncology

2013 Volume 20 Suppl 3, Page(s) S636–43

Abstract: Background: The cytochrome P450 (CYP) superfamily consists of enzymes that catalyze the oxidation of lipids, steroids, and drugs. In particular, the CYP4 family plays an essential role in lipid metabolism by the ω-hydroxylation of terminal ends of fatty ...

Abstract	Background: The cytochrome P450 (CYP) superfamily consists of enzymes that catalyze the oxidation of lipids, steroids, and drugs. In particular, the CYP4 family plays an essential role in lipid metabolism by the ω-hydroxylation of terminal ends of fatty acids. Disturbance of this system has been associated with increased angiogenesis, proliferation, and metastasis of several cancers. This study aimed to detect the expression of CYP4 isoforms (CYP4A11, CYP4F2, CYP4F3) in pancreatic ductal adenocarcinoma (PDA) and their association with clinicopathological features. Methods: Pancreatic specimens were collected from 73 patients who underwent surgical resection at the Thomas Jefferson University Hospital. Quantitative polymerase chain reaction was used to examine the cytochrome P450 isoforms in PDA (n = 62), adjacent-normal (n = 30), and benign tissues (n = 11). Logistic regression models were used to analyze gene expression among tissue types. Spearman rank correlations were calculated for isoform expression and for age. Differences in expression by gender were assessed via t test. Other clinicopathological variables (diabetes, smoking, obesity, T stage, perineural invasion, nodal status) were analyzed by Wilcoxon rank sum. Results: CYP4 expression for isoforms was significantly higher in PDA tissues versus matched-adjacent tissues (p < 0.01). PDA tumors expressed significantly higher levels of CYP4F2 and CYP4F3 when compared to benign lesions (p < 0.01). Significant associations were found between low levels of CYP4F2 and CYP4F3 and increased age of PDA patients. Interestingly, all isoforms were expressed at higher levels in male patients. Conclusions: Transcriptional upregulation of cytochrome P450 ω-hydroxylase suggests that these enzymes have the potential to be used as distinguishing markers in pancreatic pathology.
MeSH term(s)	Aged ; Carcinoma, Pancreatic Ductal/genetics ; Carcinoma, Pancreatic Ductal/mortality ; Carcinoma, Pancreatic Ductal/pathology ; Cytochrome P-450 Enzyme System/genetics ; Female ; Follow-Up Studies ; Humans ; Isoenzymes ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreas/metabolism ; Pancreatic Neoplasms/genetics ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Prognosis ; RNA, Messenger/genetics ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Survival Rate
Chemical Substances	Isoenzymes ; RNA, Messenger ; Cytochrome P-450 Enzyme System (9035-51-2) ; cytochrome P-450 omega-hydroxylase (EC 1.14.99.-)
Language	English
Publishing date	2013-12
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-013-3128-x
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Article: Relationship of inferior vena cava filter usage in post-surgical patients by various surgical and medical subspecialists.

Marmor, David B / Merli, Geno J / Whellan, David J / Andrel, Jocelyn / Fisicaro, Tamara / Shamimi-Noori, Saum / Adams, Suzanne / Rubin, Alexander / Feldman, Arthur M

The American journal of cardiology

2008 Volume 102, Issue 2, Page(s) 226–230

Abstract: Venous thromboembolism is a common and often fatal problem in postsurgical patients. These patients are usually treated with either therapeutic anticoagulation or the placement of inferior vena cava (IVC) filters. Controversy surrounds the use of IVC ... ...

Abstract	Venous thromboembolism is a common and often fatal problem in postsurgical patients. These patients are usually treated with either therapeutic anticoagulation or the placement of inferior vena cava (IVC) filters. Controversy surrounds the use of IVC filters, because no data exist proving survival benefit. In this study, 264 inpatient medical records of patients who underwent major surgical procedures and had the diagnosis of deep venous thrombosis or pulmonary embolism were examined. Among these patients, those who received IVC filters were identified, and the documented indications for filter placement were reviewed. Rates of IVC filter placement per venous thromboembolism event and specific indications were examined across surgical subspecialties and by type of medical consultant. Sixty percent of patients received IVC filters. IVC filter placement rates varied significantly across surgical subspecialties (p <0.0001), with the highest rate in the orthopedic surgery subgroup (80%). Rates of IVC filter use also differed significantly (p <0.0007) between medical consultants who specialized in antithrombotic medicine (46.8%) and those who did not (68.3%). Significant differences also existed in specific indications for filter placement between medical and surgical subspecialties. In conclusion, most of this study's population received IVC filters. Rates of IVC filter placement varied by the specialties of surgeons and medical consultants. The heterogeneity of treatment strategies coupled with the lack of data for this patient population highlights the need for future prospective studies to guide evidence-based treatment.
MeSH term(s)	Female ; Humans ; Male ; Medicine/statistics & numerical data ; Postoperative Complications/prevention & control ; Postoperative Period ; Pulmonary Embolism/prevention & control ; Retrospective Studies ; Specialization ; Specialties, Surgical/statistics & numerical data ; Time Factors ; Treatment Outcome ; Vena Cava Filters/utilization ; Vena Cava, Inferior ; Venous Thrombosis/prevention & control
Language	English
Publishing date	2008-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2008.03.044
Database	MEDical Literature Analysis and Retrieval System OnLINE

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