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Article: Mammographically Occult Invasive Lobular Carcinoma With Intradermal Invasion.

Khanna, Shefali / Puckett, Yana

2022 Volume 14, Issue 7, Page(s) e27358

Abstract: While shortcomings in the detection of invasive lobular carcinoma (ILC) continue to be studied, research is ongoing to determine detection rates using current breast imaging modalities in combination with physical examination findings. In the following ... ...

Abstract	While shortcomings in the detection of invasive lobular carcinoma (ILC) continue to be studied, research is ongoing to determine detection rates using current breast imaging modalities in combination with physical examination findings. In the following case report, we describe the rare presentation of a patient diagnosed by punch biopsy with grade III, estrogen receptor (ER)-/progesterone receptor (PR)-positive invasive lobular carcinoma with intradermal invasion. This patient presented with findings similar to inflammatory breast cancer (IBC) including pain in the left nipple, skin warmth, and erythema circumferentially encompassing approximately two-thirds of the left breast. This case study is of significance as, to date, it is the first report of an invasive lobular carcinoma that presented clinically as inflammatory breast cancer and was occult on both diagnostic mammography and ultrasound. While imaging remains the primary method of breast cancer detection, it is important to note that clinical findings of dermal invasion of the breast may prompt further investigation with a biopsy and close follow-up, regardless of imaging results.
Language	English
Publishing date	2022-07-27
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.27358
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Surgical Management of Gallstone Ileus: A Clinical Case Report.

Drinnon, Kyle / Puckett, Yana

Cureus

2021 Volume 13, Issue 12, Page(s) e20141

Abstract: A 74-year-old female with a past medical history of hypertension, osteoarthritis, osteoporosis, bladder suspension, and right hip surgery presented with a one-day history of cramping abdominal pain, intermittent vomiting, and obstipation. Bowel ... ...

Abstract	A 74-year-old female with a past medical history of hypertension, osteoarthritis, osteoporosis, bladder suspension, and right hip surgery presented with a one-day history of cramping abdominal pain, intermittent vomiting, and obstipation. Bowel obstruction was confirmed with imaging, and the decision was made to proceed to the operating room for an exploratory laparotomy. During the procedure, a gallstone was found in the terminal ileum and was removed.
Language	English
Publishing date	2021-12-03
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.20141
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Article: Case Report of Surgical Management of Duodenal Perforation Secondary to Stent in a Patient With Gastric Outlet Obstruction Due to a Rare Neuroendocrine Adenocarcinoma of Duodenum.

Drinnon, Kyle / Puckett, Yana

Cureus

2021 Volume 13, Issue 11, Page(s) e19562

Abstract: Neuroendocrine adenocarcinomas of the duodenum comprise a rare subset of neuroendocrine tumors and commonly present with symptoms of gastric outlet obstruction (GOO). Most of the time, patients are recommended a GI bypass in the setting of metastatic ... ...

Abstract	Neuroendocrine adenocarcinomas of the duodenum comprise a rare subset of neuroendocrine tumors and commonly present with symptoms of gastric outlet obstruction (GOO). Most of the time, patients are recommended a GI bypass in the setting of metastatic disease. In a small subset of patients who prefer a non-operative approach or are poor surgical candidates, duodenal stenting can often accomplish similar results as surgery. However, duodenal stenting is associated with numerous complications, including duodenal stent migration and, less commonly, duodenal perforation. We present a case where duodenal stenting resulted in a perforation of the second portion of the duodenum that ultimately required a definitive pancreaticoduodenectomy.
Language	English
Publishing date	2021-11-14
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.19562
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Article: A Proposed Algorithm on the Modern Management of Rectus Sheath Hematoma: A Literature Review.

Liao, En-Dien / Puckett, Yana

Cureus

2021 Volume 13, Issue 11, Page(s) e20008

Abstract: Rectus sheath hematoma (RSH) is a common entity with no clearly established protocol for management. Existing literature on RSH is outdated and does not incorporate modern technological advances in medicine and imaging. A total of 21 studies were ... ...

Abstract	Rectus sheath hematoma (RSH) is a common entity with no clearly established protocol for management. Existing literature on RSH is outdated and does not incorporate modern technological advances in medicine and imaging. A total of 21 studies were included in this literature review based on PubMed and Google Scholar searches. Modern literature was selected from the last 10 years with the inclusion of three past pieces of literature. We performed a literature review to identify the latest research on RSH management and to consolidate an algorithm to help guide modern RSH treatment. Current RSH classification, scoring system, algorithm, and other predictors for treatment plan are discussed. The best RSH management requires early recognition of RSH followed by the appropriate implementation of conservative management and procedural intervention. The decision on picking the treatment of choice is assisted with the use of predictors, such as hematoma size, rate of hemoglobin drop, and the number of blood transfusions. Further studies are needed to clearly establish predictors among the different types of procedural intervention, and we hope the consolidated algorithm on current literature can help promote the standardization of protocol in the future.
Language	English
Publishing date	2021-11-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.20008
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Article: Above and Below the Diaphragm: A Previously Undescribed Case of Recurrent Boerhaave Syndrome Diagnosed With Computerized Tomography Esophagram.

Anand, Rohan / Puckett, Yana / Ronaghan, Catherine A

Cureus

2022 Volume 14, Issue 4, Page(s) e24015

Abstract: Boerhaave syndrome, defined as a spontaneous rupture of the esophagus, is an uncommon clinical entity. Recurrent spontaneous rupture of the esophagus is even rarer and has only been described in a handful of case reports. The rupture most often occurs in ...

Abstract	Boerhaave syndrome, defined as a spontaneous rupture of the esophagus, is an uncommon clinical entity. Recurrent spontaneous rupture of the esophagus is even rarer and has only been described in a handful of case reports. The rupture most often occurs in the thoracic esophagus. Spontaneous rupture of the intraabdominal esophagus is extremely rare. The extravasation of gastric contents, including bile, acid, and bacteria, into a body cavity precipitates severe sepsis. This results in a high mortality rate without emergent treatment. Such treatment often necessitates surgical repair with primary closure, tissue grafts, or esophagectomy in particularly severe cases. This is a case of a 64-year-old male who suffered Boerhaave syndrome twice separated by two years. The patient was transferred from an outside facility initially presenting with chest and abdominal pain, which developed after eating. CT esophagram with water soluble contrast demonstrated contrast extravasation into the right mediastinum/hemithorax, consistent with a diagnosis of Boerhaave syndrome. Repair was accomplished with an intercostal muscle pedicle patch, and the patient was subsequently discharged. This case report details, to our knowledge, the first case of a left intraabdominal and right thoracic esophageal rupture combination.
Language	English
Publishing date	2022-04-10
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.24015
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Article: Dyspnoea at rest predictor of increased in-hospital mortality in metastatic cancer patients undergoing emergent surgery in United States.

Majdinasab, Elleana J / Puckett, Yana

Ecancermedicalscience

2020 Volume 14, Page(s) 1112

Abstract: Background: Dyspnoea is an extremely common finding in patients presenting with metastatic cancer and can be caused by cancer progression, treatment toxicity or pathology secondary to deteriorating overall health. In this study, we decided to analyse ... ...

Abstract	Background: Dyspnoea is an extremely common finding in patients presenting with metastatic cancer and can be caused by cancer progression, treatment toxicity or pathology secondary to deteriorating overall health. In this study, we decided to analyse post-operative outcomes to understand if dyspnoea is a significant prognostic predictor of in-hospital mortality in patients with stage IV cancer who underwent emergent surgery in the United States. Methods: We performed a search of the 2014 National Surgical Quality Improvement Program database (NSQIP) for patients with a diagnosis of malignancy (ICD-9 Codes 145.00-200.00). Cases were divided into two groups: metastatic cancer and non-metastatic cancer. Demographical data including preoperative, intraoperative and postoperative factors, as well as data regarding complications and comorbidities were compared between these two groups. Independent t-testing was used to compare continuous variables. Chi-square testing was used to compare categorical variables. Multiple logistic regression was used to assess for predictors of mortality in metastatic cancer. Mortality was adjusted for demographics, comorbid conditions and perioperative factors. Results: Referring to the NSQIP database, a total of 80,275 cancer patients were analysed, 11.8% (9,423) of whom had metastatic cancer. Dyspnoea at rest/moderate exertion (OR 5.7/2.4; 95% CI 2.7/1.6-11.9/3.7; p < 0.0001) were found to be the biggest predictors of in-hospital mortality in stage IV cancer patients who underwent emergent surgery. Conclusion: Dyspnoea at rest and with moderate exertion may be used as predictors of in-hospital mortality for metastatic cancer patients undergoing emergent surgery.
Language	English
Publishing date	2020-09-24
Publishing country	England
Document type	Journal Article
ISSN	1754-6605
ISSN	1754-6605
DOI	10.3332/ecancer.2020.1112
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Article: Use of a dynamic tissue system and biological xenograft in complex traumatic wound closure.

Collins, Reagan A / Dang, Michael / McReynolds, Shirley / Puckett, Yana / Ronaghan, Catherine A

Journal of wound care

2023 Volume 32, Issue Sup9, Page(s) S12–S15

Abstract: Objective: Asymmetrical dimensions and nonlinear margins of a multilayered traumatic wound often preclude healing via primary intention. We present the case of an otherwise healthy 21-year-old male who sustained trauma following a boating accident.: ... ...

Abstract	Objective: Asymmetrical dimensions and nonlinear margins of a multilayered traumatic wound often preclude healing via primary intention. We present the case of an otherwise healthy 21-year-old male who sustained trauma following a boating accident. Method: The patient sustained three lacerations to the posterior thighs from the boat propeller. The most extensive wound measured 25×10×6cm of muscle extrusion with a divot fracture involving the posterior femur. Results: Primary closure and restoration of muscle biomechanics was achieved using a combination of a dynamic tissue system (DTS) and porcine urinary bladder matrix (PUBM) xenograft. After 24 days of treatment in hospital, the patient was discharged without the need for home health, outpatient wound care, or ongoing negative pressure wound therapy. The patient recovered full function of the legs and was cleared for participation in all activities. Conclusion: This complex traumatic boat propeller injury presented many challenges, including a transverse orientation on the extremity, degree of muscle injury/extrusion, and significant soft tissue loss. The combined application of a DTS with PUBM biological xenograft achieved a primary myocutaneous closure without the need for skin graft or flap reconstruction by plastic surgery.
MeSH term(s)	Humans ; Male ; Swine ; Animals ; Heterografts ; Transplantation, Heterologous ; Plastic Surgery Procedures ; Transplants ; Fractures, Bone
Language	English
Publishing date	2023-09-08
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1353951-6
ISSN	0969-0700
ISSN	0969-0700
DOI	10.12968/jowc.2023.32.Sup9.S12
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Article ; Online: Epidemiology of mucopolysaccharidoses (MPS) in United States: challenges and opportunities.

Puckett, Yana / Mallorga-Hernández, Alejandra / Montaño, Adriana M

Orphanet journal of rare diseases

2021 Volume 16, Issue 1, Page(s) 241

Abstract: Background: Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US) ...

Abstract	Background: Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US), showing considerable variation by country. This study aimed to identify MPS incidence and prevalence in the US at a national and state level to guide clinicians and policy makers. Methods: This retrospective study examined all diagnosed cases of MPS from 1995 to 2015 in the US using the National MPS Society database records. Data included year of birth, patient geographic location, and MPS variant type. US population information was obtained from the National Center for Health Statistics. The incidence and prevalence rates were calculated for each disease. Incidence rates were calculated for each state. Results: We obtained information from 789 MPS patients during a 20-year period. Incidence of MPS in the US was found to be 0.98 per 100,000 live births. Prevalence was found to be 2.67 per 1 million. MPS I, II, and III had the highest incidence rate at birth (0.26/100,000) and prevalence rates of 0.70-0.71 per million. Birth incidences of MPS IV, VI, and VII were 0.14, 0.04 and 0.027 per 100,000 live births. Conclusions: This is the most comprehensive review of MPS incidence and prevalence rates in the US. Due to the large US population and state fragmentation, US incidence and prevalence were found to be lower than other countries. Nonetheless, state-level studies in the US supported these figures. Efforts should be focused in the establishment of a national rare disease registry with mandated reporting from every state as well as newborn screening of MPS.
MeSH term(s)	Humans ; Incidence ; Infant, Newborn ; Mucopolysaccharidoses/epidemiology ; Mucopolysaccharidosis I ; Prevalence ; Retrospective Studies ; United States/epidemiology
Language	English
Publishing date	2021-05-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2225857-7
ISSN	1750-1172 ; 1750-1172
ISSN (online)	1750-1172
ISSN	1750-1172
DOI	10.1186/s13023-021-01880-8
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Article ; Online: Epidemiology of mucopolysaccharidoses (MPS) in United States

Yana Puckett / Alejandra Mallorga-Hernández / Adriana M. Montaño

Orphanet Journal of Rare Diseases, Vol 16, Iss 1, Pp 1-

challenges and opportunities

2021 Volume 10

Abstract: Abstract Background Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United ... ...

Abstract	Abstract Background Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US), showing considerable variation by country. This study aimed to identify MPS incidence and prevalence in the US at a national and state level to guide clinicians and policy makers. Methods This retrospective study examined all diagnosed cases of MPS from 1995 to 2015 in the US using the National MPS Society database records. Data included year of birth, patient geographic location, and MPS variant type. US population information was obtained from the National Center for Health Statistics. The incidence and prevalence rates were calculated for each disease. Incidence rates were calculated for each state. Results We obtained information from 789 MPS patients during a 20-year period. Incidence of MPS in the US was found to be 0.98 per 100,000 live births. Prevalence was found to be 2.67 per 1 million. MPS I, II, and III had the highest incidence rate at birth (0.26/100,000) and prevalence rates of 0.70–0.71 per million. Birth incidences of MPS IV, VI, and VII were 0.14, 0.04 and 0.027 per 100,000 live births. Conclusions This is the most comprehensive review of MPS incidence and prevalence rates in the US. Due to the large US population and state fragmentation, US incidence and prevalence were found to be lower than other countries. Nonetheless, state-level studies in the US supported these figures. Efforts should be focused in the establishment of a national rare disease registry with mandated reporting from every state as well as newborn screening of MPS.
Keywords	Incidence ; Prevalence ; Newborn screening ; Rare disease registry ; Medicine ; R
Subject code	150
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Increased in-hospital mortality and emergent cases in patients with stage IV cancer.

Majdinasab, Elleana J / Puckett, Yana / Pei, Kevin Y

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2020 Volume 29, Issue 6, Page(s) 3201–3207

Abstract: Background: Cancer patients in the USA are still being treated with aggressive, life-prolonging interventions. Palliative care services remain vastly underutilized despite surges in both quality and quantity of programs. We evaluated surgical outcomes ... ...

Abstract	Background: Cancer patients in the USA are still being treated with aggressive, life-prolonging interventions. Palliative care services remain vastly underutilized despite surges in both quality and quantity of programs. We evaluated surgical outcomes of metastatic cancer patients to question whether palliative care may be a better option. Study design: We queried the 2014 National Surgical Quality Improvement Program database (NSQIP) for patients with a diagnosis of malignancy (ICD 9 Codes 145.00 to 200.00). Cases were divided into metastatic and non-metastatic cancer. Demographic data including preoperative, intraoperative, and postoperative factors, as well as complications and comorbidities were compared between these two groups. Independent t testing was used to compare continuous variables. Chi-square testing was used to compare categorical variables. Multiple logistic regression was used to assess for predictors of mortality in metastatic cancer. Results: A total of 80,275 cancer patients were analyzed, 11.8% (9423) of whom had metastatic disease. In-hospital mortality rate was found to be 4 times higher among patients with metastatic cancer (2.1% vs. 0.5%; P = < 0.0001). Of those metastatic cancer patients that died while in hospital, 18.5% had an emergency surgery performed. After adjusting for confounders, dyspnea at rest/moderate exertion (OR 5.7/2.4; 95% CI 2.7/1.6 to 11.9/3.7; P < 0.0001) was found to be the most significant predictor of in hospital mortality in stage IV cancer patients. Conclusion: Aggressive treatment in advanced cancer patients contributes to alarmingly high in-hospital mortality. Improved, deliberate communication of palliative care options with patients is exceedingly conducive to enhancing end-of-life cancer care.
MeSH term(s)	Female ; Hospital Mortality/trends ; Humans ; Male ; Neoplasm Staging
Language	English
Publishing date	2020-10-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-020-05837-8
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