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radiation enteritis guidelines

Kathryn Jaap, Marcus Fluck, Marie Hunsinger, Jeffrey Wild, Tania Arora, Mohsen Shabahang, Joseph Blansfield
IMPORTANCE: Management of pancreatic cancer is complex, requiring coordination of multiple providers. National Comprehensive Cancer Network guidelines, developed for standardization and quality improvement, recommend a multimodal approach. OBJECTIVE: This study analyzed national rates of compliance with National Comprehensive Cancer Network recommendations, assessed factors affecting compliance, and evaluated whether compliance with evidence-based guidelines improved overall survival...
March 28, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Rondi M Kauffmann, J Blair Hamner, Philip H G Ituarte, John H Yim
BACKGROUND: Age is an important prognostic factor in papillary thyroid cancer (PTC), with better survival observed in patients < 45 years of age, regardless of stage. Although the impact of increasing age on PTC-related survival is well-known, previous studies have focused on survival relative to age 45 years only. As the number of patients entering their 7th decade of life increases, PTC-related survival in this demographic becomes increasingly important. Survival in patients ≥ 60 years specifically compared to other groups has not previously been examined...
March 22, 2018: BMC Cancer
George X Ding, Parham Alaei, Bruce Curran, Ryan Flynn, Michael Gossman, T Rock Mackie, Moyed Miften, Richard Morin, X George Xu, Timothy C Zhu
With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients...
February 22, 2018: Medical Physics
Yan-Mei Liu, Ling-Qin Ni, Sai-Sai Wang, Qian-Ling Lv, Wei-Jun Chen, Shen-Peng Ying
BACKGROUND: The objective of this study is to analyze the treatment outcome and secondary reactions in 98 patients with stage I-III cervical carcinoma who underwent postoperative radiotherapy. METHODS: From 2006 to 2014, 98 patients with stage I-III cervical carcinoma were treated with postoperative radiotherapy. The major histological type, found in 92.86% of the patients (91 cases), was squamous cell carcinoma. Patients were staged according to the 2002 TNM guidelines...
January 29, 2018: World Journal of Surgical Oncology
Sadhana Balasubramanyam, Barrett P O'Donnell, Benjamin L Musher, Pavan M Jhaveri, Michelle S Ludwig
OBJECTIVE(S): The objective of this study was to characterize the clinicopathological prognostic factors and treatment patterns for small cell carcinoma (SCC) of the colon, a rare disease without standard treatment guidelines. METHODS: We analyzed clinicopathological and treatment variables for 503 cases of histologically proven SCC colon entered into the National Cancer Database (NCDB) between 2004 and 2013. Survival curves were generated using Kaplan-Meier and compared by the log-rank test...
January 22, 2018: Journal of Gastrointestinal Cancer
Kaleena Trimpe, Michele R Shaw, Marian Wilson, Mel R Haberman
Enteral supplementation for nutritional support in pediatric oncology patients remains nonstandardized across institutions and between providers. Pediatric oncology patients frequently fail to meet their growth curve percentiles, lose weight, and/or are malnourished due to both the oncologic process as well as side effects from chemotherapy and radiation treatments. Methods of increasing weight include enteral feeding (nasogastric, nasoduodenal/jejunal, or gastrostomy), parenteral intravenous feeding, and oral supplementation...
November 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
Brian J Gebhardt, Dwight E Heron, Sushil Beriwal
PURPOSE: Clinical pathways are patient management plans that standardize evidence-based practices to ensure high-quality and cost-effective medical care. Implementation of a pathway is a collaborative process in our network, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. We investigated the peer review process and factors associated with time to completion of peer review...
September 2017: Practical Radiation Oncology
A M Lee, M J Lee
BACKGROUND: European recommendations suggest that medical students should be taught radiation safety before entering clinical practice. AIM: The aim of this study was to produce a summative assessment of radiation protection training in medical school in Ireland. MATERIALS AND METHODS: A web-based questionnaire was distributed to the 2014 intern population (n = 683) via network intern-coordinators. The survey encompassed knowledge of radiation dose in X-ray investigations, laws governing the prescribing of radiation and complications of radiation exposure to staff and patients...
August 2017: Irish Journal of Medical Science
Matthew Kappus, Sarah Diamond, Ryan T Hurt, Robert Martindale
Intestinal failure (IF) is a state in which the nutritional demands of the body are not met by the gastrointestinal absorptive surface. It is a long-recognized complication associated with short bowel syndrome, which results in malabsorption after significant resection of the intestine for many reasons or functional dysmotility. Etiologies have included Crohn's disease, vascular complications, and the effects of radiation enteritis, as well as the effects of intestinal obstruction, dysmotility, or congenital defects...
September 2016: Current Gastroenterology Reports
Melanie Machiels, Sanne J Wouterse, Elisabeth D Geijsen, Rob M van Os, Roel J Bennink, Hanneke Wm van Laarhoven, Maarten Ccm Hulshof
INTRODUCTION: Definitive chemoradiotherapy (dCRT) is standard care for localised inoperable/unresectable oesophageal tumours. Many surgical series have reported on distribution of lymph node metastases (LNM) in resected patients. However, no data is available on the distribution of at-risk LN regions in this more unfavourable patient group. This study aimed to determine the spread of LNM using FDG-PET/CT, to compare it with the distribution in surgical series and to define its impact on the definition of elective LN irradiation (ENI)...
August 2016: Journal of Medical Imaging and Radiation Oncology
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Spinal cord stimulation is currently approved to treat chronic intractable pain of the trunk and limbs. However, such implantable electronic devices are vulnerable to external electrical currents and magnetic fields. Within the hospitals and modern operating rooms (ORs), there is an abundance of electrical devices and other types of equipment that could interfere with such devices. Despite the increasing number of patients with neuromodulation implantable devices, there are no written guidelines available or consensus of cautions for such patients undergoing unrelated surgery...
2016: Surgical Neurology International
Loris Pironi, Jann Arends, Federico Bozzetti, Cristina Cuerda, Lyn Gillanders, Palle Bekker Jeppesen, Francisca Joly, Darlene Kelly, Simon Lal, Michael Staun, Kinga Szczepanek, André Van Gossum, Geert Wanten, Stéphane Michel Schneider
BACKGROUND & AIMS: Chronic Intestinal Failure (CIF) is the long-lasting reduction of gut function, below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth. CIF is the rarest organ failure. Home parenteral nutrition (HPN) is the primary treatment for CIF. No guidelines (GLs) have been developed that address the global management of CIF. These GLs have been devised to generate comprehensive recommendations for safe and effective management of adult patients with CIF...
April 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Nikhil G Thaker, Laurie Sturdevant, Anuja Jhingran, Prajnan Das, Marc E Delclos, Gary B Gunn, Mary Frances McAleer, Welela Tereffe, Seungtaek L Choi, Steven J Frank, William J Simeone, Wendi Martinez, Stephen M Hahn, Robin Famiglietti, Deborah A Kuban
PURPOSE: Academic centers increasingly find a need to define a comprehensive peer-review program that can translate high-quality radiation therapy (RT) to community network sites. In this study, we describe the initial results of a quarterly quality audit program that aims to improve RT peer-review and provider educational processes across community sites. MATERIALS AND METHODS: An electronic tool was used by community-based certified member (CM) sites to enter clinical treatment information about patients undergoing peer review...
April 2016: Journal of Oncology Practice
T E Brown, V Getliffe, M D Banks, B G M Hughes, C Y Lin, L M Kenny, J D Bauer
BACKGROUND/OBJECTIVES: Evidence-based practice guidelines are available to assist in the decision making for nutrition interventions in patients with head and neck cancer. Re-assessment of guideline recommendations is important with changing demographics, new treatment regimens, advancing radiotherapy techniques, such as helical intensity-modulated radiotherapy, and the emergence of new literature. The aim of this study was to validate the updated high-risk category definition in our local hospital protocol for the swallowing and nutrition management of patients with head and neck cancer to determine the ongoing predictive ability for identifying proactive gastrostomy requirement in a new cohort...
May 2016: European Journal of Clinical Nutrition
Heikki Joensuu, Mikael Eriksson, Juhani Collan, Marja H Balk, Serge Leyvraz, Michael Montemurro
PURPOSE: Gastrointestinal stromal tumor (GIST) has been considered radiation-resistant, and radiotherapy is recommended only for palliation of bone metastases in current treatment guidelines. No registered prospective trial has evaluated GIST responsiveness to radiotherapy. PATIENTS AND METHODS: Patients with GIST progressing at intra-abdominal sites or the liver were entered to this prospective Phase II multicenter study (identifier NCT00515931). Metastases were treated with external beam radiotherapy using either conformal 3D planning or intensity modulated radiotherapy and conventional fractionation to a cumulative planning target volume dose of approximately 40 Gy...
August 2015: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Gautam Kalyantanda, Lyudmila Shumyak, Lennox Kenneth Archibald
Cronobacter is a class of Enterobacteriaceae that cause infections in neonates, especially those born prematurely. Over 90% of these infections have been linked epidemiologically to powdered infant formula (PIF). Contamination of PIF can occur at manufacture, reconstitution, or storage of reconstituted product. Intrinsic properties that enable Cronobacter to cause disease include resistance to heat, ultraviolet radiation, oxygen radicals, stomach acids, and pasteurization; an ability to utilize sialic acid (a nutrition additive to PIF that facilitates the organism's growth and survival), and an exceptional affinity for biofilms in enteral feeding tubes...
2015: Frontiers in Pediatrics
Martin Lorenzetti, Herculano Carvalho, Maria Cattoni, Antonio Gonçalves-Ferreira, José Pimentel, Joao Antuñes
BACKGROUND: Transoval biopsy of cavernous sinus (CS) lesions is the last non-invasive diagnostic option in those 15% of patients in whom etiology remains unclear in spite of extensive neuroradiological imaging, clinical assessment, and laboratory evaluation. However, there are no guidelines defining indications and the most appropriate technique for this procedure. CASE DESCRIPTION: We present four patients in whom we performed X-ray and neuronavigation-assisted transoval CS biopsies using tip-cut needles...
2014: Surgical Neurology International
Martin P Smith, Douglas S Katz, Tasneem Lalani, Laura R Carucci, Brooks D Cash, David H Kim, Robert J Piorkowski, William C Small, Stephanie E Spottswood, Mark Tulchinsky, Vahid Yaghmai, Judy Yee, Max P Rosen
The most common cause of acute right lower quadrant (RLQ) pain requiring surgery is acute appendicitis (AA). This narrative's focus is on imaging procedures in the diagnosis of AA, with consideration of other diseases causing RLQ pain. In general, Computed Tomography (CT) is the most accurate imaging study for evaluating suspected AA and alternative etiologies of RLQ pain. Data favor intravenous contrast use for CT, but the need for enteric contrast when intravenous contrast is used is not strongly favored...
June 2015: Ultrasound Quarterly
Malolan S Rajagopalan, Karen M Xu, Jeff F Lin, Paniti Sukumvanich, Thomas C Krivak, Sushil Beriwal
BACKGROUND: Vaginal cancer is an uncommon entity for which concurrent chemoradiation (CCRT) may be used based on small retrospective series and extrapolation from cervical cancer. We explored the adoption rate of CCRT and determined its impact on survival. METHODS: Patients entered into the National Cancer Data Base (NCDB) diagnosed with vaginal cancer from 1998 to 2011 who received definitive radiation therapy were included. Univariate/multivariable exploratory analyses of factors associated with CCRT were performed...
December 2014: Gynecologic Oncology
Jessie K Edwards, Leah J McGrath, Jessie P Buckley, Mary K Schubauer-Berigan, Stephen R Cole, David B Richardson
BACKGROUND: Traditional regression analysis techniques used to estimate associations between occupational radon exposure and lung cancer focus on estimating the effect of cumulative radon exposure on lung cancer. In contrast, public health interventions are typically based on regulating radon concentration rather than workers' cumulative exposure. Estimating the effect of cumulative occupational exposure on lung cancer may be difficult in situations vulnerable to the healthy worker survivor bias...
November 2014: Epidemiology
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