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Manzer H.,University of South Florida | Nanjappa S.,emoffitt Cancer Center And Research Institute | Greene J.,University of South Florida
Infectious Diseases in Clinical Practice | Year: 2016

Bone-Anchored hearing aids (BAHA implants) have been shown to result in increased auditory capabilities and subsequently higher life quality in patients with hearing loss. Complications surrounding the implants are typically minor; however, the presence of the implant can cause serious infections in patients who have cancer or are otherwise immunocompromised. This article details on one such interesting case, in which tissue surrounding the BAHA implant of a neutropenic patient was infected by Staphylococcus epidermidis. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Nanjappa S.,H. Lee Moffitt Cancer Center and Research Institute | De Clue C.,University of South Florida | Gajanan G.,H. Lee Moffitt Cancer Center and Research Institute | Pabbathi S.,H. Lee Moffitt Cancer Center and Research Institute | And 2 more authors.
Infectious Diseases in Clinical Practice | Year: 2016

Thoracic empyema with or without an associated bronchopleural fistula (BPF) is one of the most common complications after a pneumonectomy. We discuss the case of a 72-year-old gentleman with stage III poorly differentiated squamous cell carcinoma of the lung, who underwent right thoracoscopic pneumonectomy and mediastinal lymphadenectomy. Postoperatively, he developed a BPF and empyema with quinolone-resistant Pseudomonas aeruginosa. Subsequently, he underwent a right thoracoscopic drainage and debridement of the chest cavity followed by repair of the BPF with omental pouch. He was then treated with intravenous tigecycline and meropenemfor 20 dayswith gradual clinical improvement. We discuss the pathophysiology of empyema, microorganisms involved, and the role of appropriate antibiotic therapy. We also describe various preoperative and intraoperative strategies to prevent the development of empyema and how both medical and surgical interventions play an important role in the management of these patients. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


DeVito N.,emoffitt Cancer Center And Research Institute | Henderson E.,emoffitt Cancer Center And Research Institute | Han G.,Yale University | Reed D.,emoffitt Cancer Center And Research Institute | And 8 more authors.
PLoS ONE | Year: 2015

Solitary fibrous tumor (SFT) is a mesenchymal neoplasm of fibrous origin. The 2013WHOclassification of soft tissue tumors defines malignant forms as hypercellular,mitotically active (>4 mitosis/10 high-power fields), with cytological atypia, tumor necrosis, and/or infiltrativemargins.With an IRB-approved protocol, we investigated patient records and clinicopathologic data fromour Sarcoma Database to describe the clinical characteristics of both benignand malignant SFT. All pathology specimens were reviewed by two pathologists. Descriptive statistics and univariate/multivariate survival analysis were performed. Patient records andSocial Security Death Index were used to evaluate vital status. Of 82 patients, 47 (57%) were women and 73 (89%) were Caucasian.Median age was 62 years (range, 20 to 89). Thirtytwo (39%) patients succumbed to the disease. Primary tumor site was lung/pleura in 28 (34%), abdomen/pelvis in 23 (28%), extremity in 13 (16%), and head/neck in 9 (11%)patients. Pathology was described as benign in 42 (51%) and malignant in 40 (49%) patients. Compared to benign SFT, malignant histology is associated with larger tumor size, highermitotic counts, metastatic disease at diagnosis, and greater use of chemotherapy and radiation therapy. Gender, age, and tumor site were not significantly different between benign andmalignant subtypes. By univariate analysis, only benign vs. malignant variant and complete resection positively impacted overall survival (P = 0.02 and P<0.0001, respectively). In themultivariable analysis of overall survival, receiving chemotherapy or not receiving surgery were two variables significantly associated with higher failure rate in overall survival: patientswith chemotherapy vs. no chemotherapy (P = 0.003, HR = 4.55, with 95%CI: 1.68-12.34) and patients without surgery vs. with surgery (P = 0.005, HR = 25.49, with 95%CI: 2.62-247.57). Clear survival differences exist between benign and malignant SFT. While surgery appears to be the best treatment option for benign and malignant SFT, better systemic therapiesare needed to improve outcomes of patients with metastatic, malignant SFT. © 2015 DeVito et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Kreahling J.M.,emoffitt Cancer Center And Research Institute | Altiok S.,emoffitt Cancer Center And Research Institute
Cancer Control | Year: 2015

Background: Predictive assays for cancer treatment are not new technology, but they have failed to meet the criteria necessary for standardized use in clinical decision-making. Methods: The authors summarize the use of predictive assays and the challenges and values associated with these assays in the clinical setting. Results: Predictive assays commercially available in the clinical setting are not standardized, have significant obstacles to overcome, and cannot be relied upon by health care professionals due to the limited value these assays provide to the decision-making process for the treatment of patients. Conclusions: A method that more closely recapitulates the human tumor microenvironment and accurately predicts response with high reproducibility would be beneficial to patient outcomes and quality of life. © 2015, H. Lee Moffitt Cancer Center and Research Institute. All rights reserved.


Judson P.L.,emoffitt Cancer Center And Research Institute | Al Sawah E.,emoffitt Cancer Center And Research Institute | Marchion D.C.,emoffitt Cancer Center And Research Institute | Xiong Y.,emoffitt Cancer Center And Research Institute | And 10 more authors.
International Journal of Gynecological Cancer | Year: 2012

Objective: Most women with advanced-stage epithelial ovarian cancer (OVCA) ultimately develop chemoresistant recurrent disease. Therefore, a great need to develop new, more active, and less toxic agents and/or to optimize the efficacy of existing agents exists. Methods: In this study, we investigated the activity of Avemar, a natural, nontoxic, fermented wheat germ extract (FWGE), against a range of OVCA cell lines, both alone and in combination with cisplatin chemotherapy and delineated the molecular signaling pathways that underlie FWGE activity at a genome-wide level. Results: We found that FWGE exhibited significant antiproliferative effects against 12 human OVCA cell lines and potentiated cisplatin-induced apoptosis. Pearson correlation of FWGE sensitivity and gene expression data identified 2142 genes (false discovery rate < 0.2) representing 27 biologic pathways (P < 0.05) to be significantly associated with FWGE sensitivity. A parallel analysis of genomic data for 59 human cancer cell lines matched to chemosensitivity data for 2,6-dimethoxy-p-benzoquinone, a proposed active component of FWGE, identified representation of 13 pathways common to both FWGE and 2,6-dimethoxy-p-benzoquinone sensitivity. Conclusions: Our findings confirm the value of FWGE as a natural product with anticancer properties that may also enhance the activity of existing therapeutic agents. Furthermore, our findings provide substantial insights into the molecular basis of FWGE's effect on human cancer cells. Research Highlights: & Fermented wheat germ extract has significant antiproliferative effects on OVCA cell lines and may enhance the effect of cisplatin-induced cell death. • Genome-wide expression data reveal that FWGE sensitivity in ovarian cancer cells was associated with 2142 genes, representing 27 biologic pathways. • The known safety and tolerability of FWGE supports the clinical evaluation of this natural product in patients with ovarian cancer. Copyright © 2012 by IGCS and ESGO.

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