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  1. Article: Demographics, Characteristics, and Outcomes of Male Breast Cancer Patients at the Methodist Health System, Dallas, USA.

    Nong, Huy Q / Eastwood, Darcy / Rodriguez, Kimberly / Puri, Vichin

    Cureus

    2023  Volume 15, Issue 11, Page(s) e49394

    Abstract: Breast cancer (BC) is the most common cancer in women and has been extensively studied; however, male BC (MBC) is rare with limited clinical data. Treatment options for MBC are extrapolated from clinical studies in BC in women and have traditionally ... ...

    Abstract Breast cancer (BC) is the most common cancer in women and has been extensively studied; however, male BC (MBC) is rare with limited clinical data. Treatment options for MBC are extrapolated from clinical studies in BC in women and have traditionally excluded MBC cases. Over the past decade, an increase in the incidence of MBC has been seen. The purpose of this study is to comprehensively analyze the clinical, pathological, and treatment-related characteristics of MBC cases within our institution's database. MBC cases from 2010 to 2021 at Methodist Dallas Medical Center (MDMC), Dallas, USA, were reviewed retrospectively from the electronic health record and database, and clinical information was obtained. During this time period from 2010 to 2021, there was a total of 1,784 cases of BC with only eight cases (0.45%) consisting of MBC. In our cohort, 75% of MBC cases had a family history of cancer in a first-degree relative. Additionally, 100% of all MBC cases are hormone receptor-positive. No cases of MBC had HER2/neu over-expression. Fifty percent of our MBC patients were diagnosed with locally advanced tumors or metastatic disease. The overall survival (OS) of MBC in our study was 72%.
    Language English
    Publishing date 2023-11-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.49394
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Simultaneous Liver-Kidney Transplantation.

    Puri, Vichin / Eason, James

    Current transplantation reports

    2015  Volume 2, Issue 4, Page(s) 297–302

    Abstract: In 2014, simultaneous liver kidney transplants (SLK) accounted for 8.2 % of all liver transplants performed in the USA. Prior to introduction of the model of end stage liver disease (MELD) system, SLK accounted for 2.5 % in 2001 and only 1.7 % in 1990. ... ...

    Abstract In 2014, simultaneous liver kidney transplants (SLK) accounted for 8.2 % of all liver transplants performed in the USA. Prior to introduction of the model of end stage liver disease (MELD) system, SLK accounted for 2.5 % in 2001 and only 1.7 % in 1990. Transplant centers have struggled to balance the moral and ethical aspects of SLK in the setting of organ scarcity with an algorithm that best qualifies patients for such treatment options. Few centers have even ventured into DCD territory for SLK. Advancement in immunosuppression protocols and treatment of HCV and HIV have impacted SLK over the years. Simulation modeling has allowed us to analyze the future impact of our decisions that are made today. All of these advancements have given, and will continue to give new perspectives to SLK. The purpose of this review article is to highlight these advances and bring to light the studies that have made this transplant option successful.
    Language English
    Publishing date 2015-10-06
    Publishing country Switzerland
    Document type Review ; Journal Article
    ISSN 2196-3029
    ISSN 2196-3029
    DOI 10.1007/s40472-015-0077-2
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  3. Article: Morphological Characteristics of Biliary Strictures after Liver Transplantation Visualized Using SpyGlass™ Cholangioscopy.

    Chokpapone, Yathip M / Murray, Anne R / Mehta, Ashwini P / Puri, Vichin C / Mejia, Alejandro / Mantry, Parvez

    Case reports in hepatology

    2020  Volume 2020, Page(s) 8850000

    Abstract: Biliary complications following liver transplant are common. Endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) are the main techniques used to diagnose and treat biliary complications; however, ... ...

    Abstract Biliary complications following liver transplant are common. Endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) are the main techniques used to diagnose and treat biliary complications; however, these techniques have limits to the depth of visualization. In this report, we present five cases of orthotopic liver transplant patients with biliary complications that underwent ERCP- or MRCP-guided cholangioscopy with the SpyGlass™ DS Direct Visualization System (SDDVS). The SDDVS allowed for the visualization of the morphological characteristics of biliary strictures, and images collected using the SDDVS allowed for four of the cases to be treated endoscopically. Our findings suggest that cholangioscopy with the SDDVS is a promising method to guide the endoscopic treatment of biliary complications after liver transplantation.
    Language English
    Publishing date 2020-08-03
    Publishing country United States
    Document type Case Reports
    ISSN 2090-6587
    ISSN 2090-6587
    DOI 10.1155/2020/8850000
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Improving the Standard of Care for All-A Practical Guide to Developing a Center of Excellence.

    Vivian, Elaina / Brooks, Mary Rachel / Longoria, Raquel / Lundberg, Laurie / Mallow, Jenifer / Shah, Jimmy / Vo, Allison / Mejia, Alejandro / Tarnasky, Paul / Puri, Vichin

    Healthcare (Basel, Switzerland)

    2021  Volume 9, Issue 6

    Abstract: Pancreatic surgery is one of the more challenging procedures performed by surgeons. The operations are technically complex and have historically been accompanied by a substantial risk for mortality and postoperative complications. Other pancreatic ... ...

    Abstract Pancreatic surgery is one of the more challenging procedures performed by surgeons. The operations are technically complex and have historically been accompanied by a substantial risk for mortality and postoperative complications. Other pancreatic pathologies require advanced therapeutic procedures that are highly endoscopist-dependent, requiring specific, knowledge-based training for optimal outcomes. An increase in diagnosed pancreatic pathologies every year reinforces a critical need for experienced surgeons, gastroenterologists/endoscopists, hospitals, and support personnel in the management of complex pancreatic cases and thus, well-designed Centers of Excellence (CoE). In this paper, we outline the framework for a Pancreas CoE across three developmental domains: (1) establishing the foundation; (2) formalizing the program; (3) solidifying the CoE status. This framework can likely be translated to any disease or procedure-specific service-line and facilitate the development of a successful CoE.
    Language English
    Publishing date 2021-06-21
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare9060777
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  5. Article ; Online: Management of bleeding from gastric remnant after Roux-en-Y gastric bypass.

    Puri, Vichin / Alagappan, Annamalai / Rubin, Moshe / Merola, Stephen

    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

    2012  Volume 8, Issue 1, Page(s) e3–5

    MeSH term(s) Female ; Gastrectomy/methods ; Gastric Bypass ; Gastric Stump/surgery ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/surgery ; Humans ; Middle Aged ; Obesity, Morbid/surgery ; Postoperative Complications/surgery
    Language English
    Publishing date 2012-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2274243-8
    ISSN 1878-7533 ; 1550-7289
    ISSN (online) 1878-7533
    ISSN 1550-7289
    DOI 10.1016/j.soard.2010.08.015
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  6. Article: Radium implant treatment of a birthmark at infancy and its association with malignancy.

    Annamalai, Alagappan / Puri, Vichin / Mehta, Sanjay

    The American surgeon

    2011  Volume 77, Issue 3, Page(s) 372–373

    MeSH term(s) Aged ; Brachytherapy/adverse effects ; Breast Neoplasms/etiology ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Carcinoma, Ductal, Breast/etiology ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Ductal, Breast/surgery ; Female ; Hemangioma/congenital ; Hemangioma/radiotherapy ; Humans ; Infant ; Skin Neoplasms/congenital ; Skin Neoplasms/radiotherapy
    Language English
    Publishing date 2011-03
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
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    Uk I Zs.106: Show issues Location:
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  7. Article ; Online: Outcomes of vascular resection in pancreaticoduodenectomy: single-surgeon experience.

    Menon, Vijay G / Puri, Vichin C / Annamalai, Alagappan A / Tuli, Richard / Nissen, Nicholas N

    The American surgeon

    2013  Volume 79, Issue 10, Page(s) 1064–1067

    Abstract: Extension of pancreatic adenocarcinoma into adjacent vasculature often necessitates resection of the portal vein (PV) and/or superior mesenteric vein (SMV) during pancreaticoduodenectomy (PD). The vein is reconstructed primarily by end-to-end anastomosis ...

    Abstract Extension of pancreatic adenocarcinoma into adjacent vasculature often necessitates resection of the portal vein (PV) and/or superior mesenteric vein (SMV) during pancreaticoduodenectomy (PD). The vein is reconstructed primarily by end-to-end anastomosis of vein remnants or venoplasty or by use of autologous or synthetic vein grafts. The objective of this study was to review outcomes in patients undergoing PD for pancreatic adenocarcinoma, specifically comparing the short- and long-term outcomes between the patients undergoing vascular resection and those undergoing standard PD. All patients undergoing PD for pancreatic adenocarcinoma by a single surgeon between 2007 and 2012 were reviewed. Of the 61 patients identified, 18 patients underwent vascular resection of the PV (four patients), SMV (10 patients), or both (four patients). The remaining 43 patients had standard PD. Demographic, perioperative, pathological, and long-term outcomes data were collected and both vascular and standard groups were compared. Both groups had similar demographics. The vascular group had significantly longer operative times (529 vs 406 minutes; P < 0.01) with a trend to greater estimated blood loss (0.64 vs 0.53 L; P = 0.06). Pathological analysis showed no difference between the two groups with regard to lymph node status/ratio and rate of R0 resection (94 vs 91%; P = 0.57); however, the size of the tumor was significantly greater in the vascular group (4.2 vs 3 cm; P < 0.01). Short-term outcomes were similar in the vascular group and standard group, respectively, with no difference in pancreatic fistula rate (6 vs 7%; P = 1.0), transfusion rate (44 vs 35%; P = 0.57), and median length of stay (8 vs 7 days; P = 0.10), and there was no 30-day mortality in either group. Based on Kaplan-Meier methods, the median recurrence-free survival was 18 versus 23 months (P = 0.37) in the vascular and standard groups, respectively, and the overall survival was almost identical in both groups, each with a median of 31 months (P = 0.91). In our experience, mesenteric and PV resection during PD was performed safely and without compromise of short- or longer-term outcomes. It can be performed safely and patients have no significant difference in perioperative outcomes or overall survival.
    MeSH term(s) Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Aged ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Mesenteric Veins/pathology ; Mesenteric Veins/surgery ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/methods ; Portal Vein/pathology ; Portal Vein/surgery ; Postoperative Complications/epidemiology ; Survival Rate ; Treatment Outcome
    Language English
    Publishing date 2013-10
    Publishing country United States
    Document type Comparative Study ; Evaluation Studies ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
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  8. Article ; Online: A simple algorithm for drain management after pancreaticoduodenectomy.

    Nissen, Nicholas N / Menon, Vijay G / Puri, Vichin / Annamalai, Alagappan / Boland, Brendan

    The American surgeon

    2012  Volume 78, Issue 10, Page(s) 1143–1146

    Abstract: Pancreatic fistula (PF) continues to be the Achilles' heel of pancreaticoduodenectomy (PD) with both morbidity and mortality linked to its occurrence. The optimal drain management strategy after PD remains unclear. We evaluated drain amylase (DA) levels ... ...

    Abstract Pancreatic fistula (PF) continues to be the Achilles' heel of pancreaticoduodenectomy (PD) with both morbidity and mortality linked to its occurrence. The optimal drain management strategy after PD remains unclear. We evaluated drain amylase (DA) levels on postoperative Day (POD) 0 to 5 in 76 consecutive patients undergoing PD to determine the patterns associated with PF. Of these 76 patients, eight patients (11%) developed Grade A, B, or C PF by International Study Group of Pancreatic Fistula criteria. POD 1 DA levels correlated closely with PF rates when high (greater than 5000 U/L, 100% PF rate) and low (less than 100 U/L, 2% PF rate). In patients with intermediate POD 1 DA (100 to 5000 U/L), 42 and 74 per cent had low DA levels on POD 3 and 5, respectively, and the PF rate was four of 31 (13%). Overall, the temporal pattern of decreasing DA levels after PD correlates closely with the risk of PF, and only two patients (5%) developed PF after early DA levels had normalized. Based on these data, we propose an algorithm of monitoring DA daily with drain removal when the level is less than 100 U/L. In our patient group drain removal would have occurred on a mean of 1.8 days and median 1 day after surgery.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Algorithms ; Amylases ; Drainage ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Fistula/epidemiology ; Pancreatic Fistula/etiology ; Pancreatic Fistula/prevention & control ; Pancreaticoduodenectomy/adverse effects ; Postoperative Care/methods
    Chemical Substances Amylases (EC 3.2.1.-)
    Language English
    Publishing date 2012-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.106: Show issues Location:
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