Charles J. Puza

Early Stage Melanoma and Hematopoietic Stem Cell Transplantation Outcomes

structure encroaching at least 0.5 mm into the arterial lumen or having a thickness greater than 50% of the surrounding intima-media thickness. Table I exhibits the anthropometric, clinical, and biochemical data of participants. To our best knowledge, this is the first study to evaluate the presence of femoral atherosclerotic plaques as a screening test for atherosclerosis in patients with psoriasis. The prevalence of femoral plaques but not carotid plaques was significantly higher in the patients with psoriasis than in age-, sex-, and body mass indexematched controls (P .006), whereas the prevalence of femoral plaques among the patients was 2-fold higher than that of carotid plaques (P .008) (Fig 1). According to the present findings, ultrasound study of femoral arteries is more useful than the study of carotid arteries to identify atherosclerosis in patients with psoriasis.

Does the number of sentinel lymph nodes removed affect the false negative rate for head and neck melanoma

Head and neck (HN) cutaneous melanoma is associated with worse disease‐free survival compared to non‐HN cutaneous melanoma, possibly due to inadequate staging. We aim to determine if a higher yield of sentinel lymph nodes (SLNs) affected rates of sentinel lymph node biopsy (SLNB) positivity.

Timing and Number of Cutaneous Squamous Cell Carcinomas in Transplant Recipients

This cohort study of 3652 recipients of solid organ transplants examines the timing and number of cutaneous squamous cell carcinomas that developed after transplantation.

Examining the Incidence and Presentation of Melanoma in the Cardiothoracic Transplant Population

Importance The immunosuppression vital to maintaining transplanted organs comes with an increased incidence of cutaneous neoplasms. Understanding the genesis of malignant melanoma (MM) in transplant subpopulations is necessary for adequate disease surveillance. Objective To determine the incidence and timing of presentation of MM in the cardiothoracic (heart and/or lung) transplant (CTT) population. Design, Setting, and Participants This was a retrospective cohort study of 1164 patients who underwent a CTT from 2001 through 2016 with a median follow-up time of 4.3 years. The study was performed at a single academic, tertiary referral center. The retrospective database was used to identify 1164 patients who underwent a CTT at Duke University Hospital from 2001 to 2016. Ten patients were excluded from the study owing to a history of MM, resulting in 1154 patients in the study. Five patients who developed MM after CTT were identified. Exposures Exposures included tacrolimus, prednisone, and mycophenolate mofetil. Main Outcomes and Measures The primary outcome measurement was the MM incidence. Secondary outcomes included time to diagnosis and survival. Results Five of 1154 patients who underwent a CTT (0.4%) developed biopsy-proven MM at a median follow-up time of 4.3 years after transplantation at a median age of 64.5 years (range, 31.0-74.0 years). Of the 1154 patients, 923 (80%) were men. Their mean (SD) age range was 63.8 years (27.2-68.2 years). Four patients (80%) presented with stage I disease while 1 (20%) presented with stage IV disease at a median time of 2.5 years (range, 0.1-5.3 years) after transplant compared with a median time of 6.2 years (range, 0.9-8.7 years) in Duke University’s renal transplant population at a median follow-up time of 6.6 years. Two patients died after transplant, 1 owing to complications of the transplant and 1 owing to metastatic MM. Conclusions and Relevance Representing one of the largest reported studies of patients with CTT developing MM, our findings suggest that the CTT population experiences an incidence of MM similar to that of other solid organ transplant recipients and with a median of 2.5 years from transplant to melanoma diagnosis. While the small scale of our study prevents far-reaching conclusions, further study is warranted to better understand the incidence, timing, and clinical ramifications of melanomagenesis in the CTT population.

The impact of transplant rejection on cutaneous squamous cell carcinoma in renal transplant recipients

The incidence of cutaneous squamous cell carcinoma (cSCC) is markedly increased in renal transplant recipients compared with that of the nontransplant population.

Evaluation of the Heat Sink Effect After Transarterial Embolization When Performed in Combination with Thermal Ablation of the Liver in a Rabbit Model

PurposeTo assess the contribution of the heat sink effect when combining thermal ablation with transarterial embolization (TAE).Materials and MethodsRadiofrequency ablation (RFA) or microwave ablation (MWA) were performed in the liver of non-tumor bearing rabbits. Three perfusion groups were used: rabbits that were killed then immediately ablated (non-perfused liver group to simulate embolized tumor with no heat sink), rabbits that underwent hepatic TAE followed by ablation (embolized liver group), and rabbits that underwent ablation while alive (normally perfused liver control group). For each perfusion group, 8 RFAs and 8 MWAs were performed. Probes were inserted using ultrasound guidance to avoid areas with major blood vessels. During ablation, temperatures were obtained from a thermocouple located 1xa0cm away from the ablation probe to assess heat conduction. With MWA, temperatures were also measured from the antennae tip.ResultsFor RFA, embolization of normal liver did not increase temperature conduction when compared to the control group. However, temperature conduction was significantly increased in the non-perfused group (simulating embolized tumor) compared to controls (pu2009=u20090.007). For MWA, neither embolization nor non-perfusion increased temperature conduction compared to controls. With MWA, the probe tip temperature was significantly higher in the non-perfused group compared to the control and embolized group.ConclusionsIn non-perfused tissue simulating tumor, RFA demonstrated modest enhancement of temperature conduction, whereas MWA did not. Embolization of normal liver did not affect RFA or MWA. Findings suggest that heat sink mitigation plays a limited role with combination embolization-ablation therapies, albeit more with RFA than MWA.

The changing landscape of dermatology practice: melanoma and pump-probe laser microscopy

To present current melanoma diagnosis, staging, prognosis, and treatment algorithms and how recent advances in laser pump-probe microscopy will fill in the gaps in our clinical understanding. Expert opinion and significantly cited articles identified in SCOPUS were used in conjunction with a pubmed database search on Melanoma practice guidelines from the last 10xa0years. Significant advances in melanoma treatment have been made over the last decade. However, proper treatment algorithm and prognostic information per melanoma stage remain controversial. The next step for providers will involve the identification of patient population(s) that can benefit from recent advances. One method of identifying potential patients is through new laser imaging techniques. Pump-probe laser microscopy has been shown to correctly identify nevi from melanoma and furthermore stratify melanoma by aggressiveness. The recent development of effective adjuvant therapies for melanoma is promising and should be utilized on appropriate patient populations that can potentially be identified using pump-probe laser microscopy.

Correction to: The changing landscape of dermatology practice: melanoma and pump-probe laser microscopy

The published online version contains mistake. Warren S. Warren was not included in the author group section. Corrected author group section is shown above.