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  1. Article ; Online: Management of Peritoneal Disease in Colorectal Cancer.

    Welten, Vanessa M / Melnitchouk, Nelya

    Hematology/oncology clinics of North America

    2022  Volume 36, Issue 3, Page(s) 569–582

    Abstract: Colorectal cancer with peritoneal involvement is traditionally recognized as having a poor prognosis, with treatment initially limited to palliative systemic chemotherapy alone. The introduction of cytoreductive surgery (CRS) in combination with ... ...

    Abstract Colorectal cancer with peritoneal involvement is traditionally recognized as having a poor prognosis, with treatment initially limited to palliative systemic chemotherapy alone. The introduction of cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy drastically altered the course of this disease entity and has demonstrated improvements in survival outcomes. Recent evidence has shown benefit of CRS but did not show benefit of HIPEC. Under the guidance of a multidisciplinary team and for appropriately selected patients, CRS is a key component of treatment that can positively alter the course of disease outcomes for patients with peritoneal involvement.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Colorectal Neoplasms/drug therapy ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced ; Peritoneal Diseases/drug therapy ; Peritoneal Neoplasms/drug therapy ; Peritoneal Neoplasms/therapy ; Prognosis ; Survival Rate
    Language English
    Publishing date 2022-05-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 93115-9
    ISSN 1558-1977 ; 0889-8588
    ISSN (online) 1558-1977
    ISSN 0889-8588
    DOI 10.1016/j.hoc.2022.02.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Global Health 101.

    Welten, Vanessa M / Dabekaussen, Kirsten F A A / Melnitchouk, Nelya

    Clinics in colon and rectal surgery

    2022  Volume 35, Issue 5, Page(s) 355–361

    Abstract: Global health is an evolving field that has been broadly defined as the promotion of health for all through transnational collaboration and research. It centers on the concepts of equity and collaboration. The focus of global health has recently ... ...

    Abstract Global health is an evolving field that has been broadly defined as the promotion of health for all through transnational collaboration and research. It centers on the concepts of equity and collaboration. The focus of global health has recently undergone a major shift toward emphasizing the importance of a systems-based approach to healthcare delivery, which considers not only the target disease but also the many contextual factors, influencing the ability to deliver care equitably to a population to reduce the burden of any particular disease. Thus, an important global health delivery framework has been established to outline this inter- and multi-disciplinary systems-based to address major global health issues and improve health for all globally. The practice of global health, whether in research or in active intervention, necessitates guiding principles to ensure ethical conduct in the transnational partnerships and efforts to advance the field. With the introduction of the United Nations' Sustainable Development Goals in 2015, there has been a major shift in response to epidemiologic transition to focus on reducing the burden of noncommunicable diseases, including cancer, which disproportionately impact low-to-middle income countries. This is true for colorectal cancer, with care challenged by significant gaps in screening, early detection, and referral systems.
    Language English
    Publishing date 2022-09-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2048635-2
    ISSN 1531-0043
    ISSN 1531-0043
    DOI 10.1055/s-0042-1746184
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Surgeon Burnout: Defining, Identifying, and Addressing the New Reality.

    Senturk, James C / Melnitchouk, Nelya

    Clinics in colon and rectal surgery

    2019  Volume 32, Issue 6, Page(s) 407–414

    Abstract: Surgeon wellness is a multidimensional commitment that encompasses occupational, mental, physical, emotional, and social domains. Loss of professional control, autonomy, and flexibility; inefficient processes; disjointed workplace relationships and goals; ...

    Abstract Surgeon wellness is a multidimensional commitment that encompasses occupational, mental, physical, emotional, and social domains. Loss of professional control, autonomy, and flexibility; inefficient processes; disjointed workplace relationships and goals; excessive administrative burdens; poor work-life balance; and frustrations with medical record and order entry systems have all been associated with burnout. Described as a syndrome of emotional exhaustion, depersonalization, and loss of a sense of personal accomplishment, burnout can have myriad untoward consequences. The strong link between surgeons' personal and professional identities can lead to a perfect storm of burnout, depression, compromised patient safety and quality of care, physician job loss and career dissatisfaction, substance abuse, damage to personal relationships, and suicide. The alarming scope of this problem cannot be confined to a single specialty or practice setting and is expected to increase without much needed changes to surgeon work practices and work environments. A heightened focus on wellness in the workplace with attention to improving workflow, scheduling, collaboration, and resource allocation is a welcome step taken by several institutions and championed by professional societies. Much more research is needed to reliably gauge the overall effectiveness of these approaches, further address the nuances of burnout as it applies specifically to surgeons, and ensure that members of the surgical workforce remain at their peak throughout the duration of their careers.
    Language English
    Publishing date 2019-09-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2048635-2
    ISSN 1531-0043
    ISSN 1531-0043
    DOI 10.1055/s-0039-1692709
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  4. Article: Global Health 101

    Welten, Vanessa M. / Dabekaussen, Kirsten F. A. A. / Melnitchouk, Nelya

    Clinics in Colon and Rectal Surgery

    (Diagnosis and Surgical Management of Colorectal Disorders in Resource-Limited Settings)

    2022  Volume 35, Issue 05, Page(s) 355–361

    Abstract: Global health is an evolving field that has been broadly defined as the promotion of health for all through transnational collaboration and research. It centers on the concepts of equity and collaboration. The focus of global health has recently ... ...

    Series title Diagnosis and Surgical Management of Colorectal Disorders in Resource-Limited Settings
    Abstract Global health is an evolving field that has been broadly defined as the promotion of health for all through transnational collaboration and research. It centers on the concepts of equity and collaboration. The focus of global health has recently undergone a major shift toward emphasizing the importance of a systems-based approach to healthcare delivery, which considers not only the target disease but also the many contextual factors, influencing the ability to deliver care equitably to a population to reduce the burden of any particular disease. Thus, an important global health delivery framework has been established to outline this inter- and multi-disciplinary systems-based to address major global health issues and improve health for all globally. The practice of global health, whether in research or in active intervention, necessitates guiding principles to ensure ethical conduct in the transnational partnerships and efforts to advance the field. With the introduction of the United Nations' Sustainable Development Goals in 2015, there has been a major shift in response to epidemiologic transition to focus on reducing the burden of noncommunicable diseases, including cancer, which disproportionately impact low-to-middle income countries. This is true for colorectal cancer, with care challenged by significant gaps in screening, early detection, and referral systems.
    Keywords equity ; collaboration ; capacity ; sustainability ; noncommunicable disease
    Language English
    Publishing date 2022-09-01
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2048635-2
    ISSN 1530-9681 ; 1531-0043
    ISSN (online) 1530-9681
    ISSN 1531-0043
    DOI 10.1055/s-0042-1746184
    Database Thieme publisher's database

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  5. Article ; Online: Medical Prophylaxis of Post-Surgical Crohn's Disease Recurrence: Towards Timely Anti-TNF Therapy.

    Fields, Adam C / Melnitchouk, Nelya

    Digestive diseases and sciences

    2018  Volume 64, Issue 1, Page(s) 7–8

    MeSH term(s) Crohn Disease ; Humans ; Immunotherapy ; Postoperative Period ; Recurrence ; Tumor Necrosis Factor-alpha
    Chemical Substances Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2018-08-10
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-018-5236-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Promoting Female Leadership in Academic Surgery: Disrupting Systemic Gender Bias.

    Welten, Vanessa M / Dabekaussen, Kirsten F A A / Davids, Jennifer S / Melnitchouk, Nelya

    Academic medicine : journal of the Association of American Medical Colleges

    2022  Volume 97, Issue 7, Page(s) 961–966

    Abstract: Gender bias is a pervasive issue in academic surgery and is characterized by familiar patterns previously described in the business world. In this article, the authors illuminate gender bias patterns in academic surgery identified in prior in-depth ... ...

    Abstract Gender bias is a pervasive issue in academic surgery and is characterized by familiar patterns previously described in the business world. In this article, the authors illuminate gender bias patterns in academic surgery identified in prior in-depth interviews with female surgical department chairs across the United States. The 4 main gender bias patterns drawn from the business world and illuminated with data from the interviews are (1) prove-it-again, (2) tightrope or double-blind dilemma, (3) maternity wall or benevolent bias, and (4) tug-of-war. The authors propose steps to disrupt systemic gender bias issues recognized in the academic surgery community. The proposed steps are informed by guidance from surgical diversity task forces, by existing literature, and by the authors' own experiences in the field. The steps are divided into 3 main categories: education, structured mentorship, and transparency. The proposed changes include improving training and recognition of unconscious bias, establishing level-appropriate and deliberate mentorship across all stages of training and practice, standardizing promotional requirements, and eliminating outdated standards that contribute to the gender pay gap. Although this article addresses gender bias in academic surgery, the proposed steps toward change can promote equity across the surgical community as a whole and extend to other underrepresented groups in the field.
    MeSH term(s) Faculty, Medical ; Female ; Humans ; Leadership ; Male ; Mentors ; Physicians, Women ; Pregnancy ; Sexism ; United States
    Language English
    Publishing date 2022-06-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000004665
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  7. Article ; Online: Concordance of MRI With Pathology for Primary Staging of Rectal Cancer in Routine Clinical Practice: A Single Institution Experience.

    Kikano, Elias G / Matalon, Shanna A / Eskian, Mahsa / Lee, Leslie / Melnitchouk, Nelya / Bleday, Ron / Khorasani, Ramin

    Current problems in diagnostic radiology

    2023  Volume 53, Issue 1, Page(s) 68–72

    Abstract: Purpose: MRI is the preferred imaging modality for primary staging of rectal cancer, used to guide treatment. Patients identified with clinical stage I disease receive upfront surgical resection; those with clinical stage II or greater undergo upfront ... ...

    Abstract Purpose: MRI is the preferred imaging modality for primary staging of rectal cancer, used to guide treatment. Patients identified with clinical stage I disease receive upfront surgical resection; those with clinical stage II or greater undergo upfront neoadjuvant therapy. Although clinical under-/over-staging may have consequences for patients and presents opportunities for organ preservation, the correlation between clinical and pathologic staging in routine clinical practice within a single institute has not been fully established.
    Methods: This retrospective, Institutional Review Board-approved study, conducted at a National Cancer Institute-Designated Comprehensive Cancer Center with a multi-disciplinary rectal cancer disease center, included patients undergoing rectal MRI for primary staging January 1, 2018-August 30, 2020. Data collection included patient demographics, initial clinical stage via MRI report, pathologic diagnosis, pathologic stage, and treatment. The primary outcome was concordance of overall clinical and pathologic staging. Secondary outcomes included reasons for mismatched staging.
    Results: A total 105 rectal adenocarcinoma patients (64 males, mean age 57 ± 12.7 years) had staging MRI followed by surgical resection. A total of 28 patients (27%) had mismatched under-/over- staging. Ten patients (10%) were understaged with mismatched T stage group (clinical stage I, pathologic stage II), five (5%) were understaged with mismatched N stage group (clinical stage I, pathologic stage III), and 13 (12%) were overstaged (clinical stage II-III, pathologic stage 0-I). Treatment matched concordance between clinical and pathologic stages was 86%.
    Conclusion: MRI for primary rectal cancer staging has high concordance with pathology. Future studies to assess strategies for reducing clinically relevant understaging would be beneficial.
    MeSH term(s) Male ; Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/therapy ; Rectal Neoplasms/pathology ; Rectum/diagnostic imaging ; Neoadjuvant Therapy ; Neoplasm Staging ; Magnetic Resonance Imaging/methods
    Language English
    Publishing date 2023-08-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 198954-6
    ISSN 1535-6302 ; 0363-0188
    ISSN (online) 1535-6302
    ISSN 0363-0188
    DOI 10.1067/j.cpradiol.2023.08.016
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  8. Article: Surgeon Burnout: Defining, Identifying, and Addressing the New Reality

    Senturk, James C. / Melnitchouk, Nelya

    Clinics in Colon and Rectal Surgery

    (Surgeon Health)

    2019  Volume 32, Issue 06, Page(s) 407–414

    Abstract: Surgeon wellness is a multidimensional commitment that encompasses occupational, mental, physical, emotional, and social domains. Loss of professional control, autonomy, and flexibility; inefficient processes; disjointed workplace relationships and goals; ...

    Series title Surgeon Health
    Abstract Surgeon wellness is a multidimensional commitment that encompasses occupational, mental, physical, emotional, and social domains. Loss of professional control, autonomy, and flexibility; inefficient processes; disjointed workplace relationships and goals; excessive administrative burdens; poor work–life balance; and frustrations with medical record and order entry systems have all been associated with burnout. Described as a syndrome of emotional exhaustion, depersonalization, and loss of a sense of personal accomplishment, burnout can have myriad untoward consequences. The strong link between surgeons' personal and professional identities can lead to a perfect storm of burnout, depression, compromised patient safety and quality of care, physician job loss and career dissatisfaction, substance abuse, damage to personal relationships, and suicide. The alarming scope of this problem cannot be confined to a single specialty or practice setting and is expected to increase without much needed changes to surgeon work practices and work environments. A heightened focus on wellness in the workplace with attention to improving workflow, scheduling, collaboration, and resource allocation is a welcome step taken by several institutions and championed by professional societies. Much more research is needed to reliably gauge the overall effectiveness of these approaches, further address the nuances of burnout as it applies specifically to surgeons, and ensure that members of the surgical workforce remain at their peak throughout the duration of their careers.
    Keywords burnout ; wellness ; well-being ; practice improvement ; surgeon
    Language English
    Publishing date 2019-09-07
    Publisher Thieme Medical Publishers
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2048635-2
    ISSN 1530-9681 ; 1531-0043
    ISSN (online) 1530-9681
    ISSN 1531-0043
    DOI 10.1055/s-0039-1692709
    Database Thieme publisher's database

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  9. Article ; Online: Reply: Do big data solve the problems?

    Fields, Adam C / Lu, Pamela / Melnitchouk, Nelya

    Surgery

    2019  Volume 166, Issue 2, Page(s) 233–234

    MeSH term(s) Appendectomy ; Big Data ; Humans ; Infections ; Laparoscopy
    Language English
    Publishing date 2019-04-19
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2019.02.018
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  10. Article ; Online: Reply: Does retrieval bag use during laparoscopic appendectomy reduce postoperative infection?

    Fields, Adam C / Lu, Pamela / Melnitchouk, Nelya

    Surgery

    2019  Volume 166, Issue 1, Page(s) 128

    MeSH term(s) Appendectomy ; Humans ; Infections ; Laparoscopy ; Postoperative Complications
    Language English
    Publishing date 2019-04-19
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2019.02.017
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