Frank J. Rutar
University of Nebraska Medical Center
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Featured researches published by Frank J. Rutar.
Annals of Vascular Surgery | 2008
Dustin J. Weiss; Iraklis I. Pipinos; G. Mathew Longo; Thomas G. Lynch; Frank J. Rutar; Jason M. Johanning
With the increasing complexity of endovascular procedures, concern has grown regarding patient radiation exposure. Abdominal aortic aneurysm (AAA) repair represents the most common complex endovascular procedure currently performed by vascular specialists. Our study evaluates the patient radiation dose received during endovascular AAA repair. Over a 3-month period we prospectively monitored the radiation dose in a series of consecutive patients undergoing endovascular AAA repair. All patients underwent standard endovascular AAA repair with one of two commercially available grafts using the GE OEC 9800 unit. Direct measurement of maximum radiation dose at skin level (peak skin dose, PSD) was recorded using GAFCHROMIC radiographic dosimetry film. Indirect measurements of radiation dose (fluoroscopy time and dose-area-product [DAP]) were recorded with the C-arm dosimeter. A total of 12 consecutive patients undergoing standard endovascular AAA repair were evaluated. Mean PSD was 0.75 Gy (range 0.27-1.25). Mean total fluoroscopy time was 20.6 min (range 12.6-34.2) with an average of 92% spent in standard fluoroscopy and 8% spent in cinefluoroscopy. Regarding total fluoroscopy time, 49% was spent in normal field of view and 51% in magnified view. Mean DAP was 15,166 cGy x cm(2) (range 5,207-24,536). PSD correlated with DAP (r = 0.9, p < 0.05) but not total fluoroscopy time (r = 0.18, p > 0.05). PSD also correlated with body mass index (BMI; r = 0.82, p < 0.05). Obese patients had a mean PSD of 1.1 Gy compared to 0.5 Gy in nonobese patients. PSD of all patients was well below the accepted 2.0 Gy threshold for skin injury. PSD correlated with DAP but not total fluoroscopy time. PSD also correlated with BMI, and the mean PSD was significantly increased in obese compared to nonobese patients. Despite the complexity and duration of endovascular AAA repair, the procedure can be performed safely without excessive radiation exposure.
Seminars in Oncology | 2003
Maribeth A. Hohenstein; Samuel C. Augustine; Frank J. Rutar; Julie M. Vose
Radioimmunotherapy with radiolabeled anti-CD20 antibodies is a promising new treatment approach for low-grade non-Hodgkins lymphoma. However, the administration of radiolabeled antibodies presents some added complexity. At the University of Nebraska Medical Center (Omaha, NE), an institutional model has been developed that ensures the efficient and safe delivery of tositumomab and iodine I 131 tositumomab (Bexxar; Corixa Corp, South San Francisco, CA and GlaxoSmithKline, Philadelphia, PA). An integrated, multidisciplinary treatment team is responsible for managing all aspects of treatment. Using this model, it is possible to administer tositumomab and iodine I 131 tositumomab safely and effectively in the outpatient setting. Patients can usually be released immediately after treatment. Guidelines and instructions for patient release have been developed and validated and are provided herein. These instructions ensure that radiation exposure of family members and caregivers who are exposed to the patient is maintained as low as reasonably achievable and well within regulatory limits.
Journal of The American Pharmaceutical Association | 2002
Samuel C. Augustine; Jeffrey P. Norenberg; David Colcher; Julie M. Vose; Lisa S. Gobar; Valorie J. Dukat; Maribeth A. Hohenstein; Frank J. Rutar; David A. Jacobson; Margaret A. Tempero
OBJECTIVE To describe the application of pharmaceutical care practices in the administration of new therapeutic radiopharmaceuticals used in the treatment of non-Hodgkins lymphoma (NHL). PRACTICE DESCRIPTION At the Antibody Labeling Facility at the University of Nebraska Medical Center, the nuclear pharmacist provides support in the formulation, preparation, and quality testing of radiopharmaceuticals. The nuclear pharmacist also provides direct patient care by assisting in the administration of radiopharmaceuticals, monitoring patients during their infusions, and counseling patients on radioimmunotherapy and radiation safety. PRACTICE INNOVATION Expanding the role of the nuclear pharmacist in treating patients with NHL using radiolabeled monoclonal antibodies (MABs). INTERVENTIONS The nuclear pharmacist provides specialized pharmaceutical care by being involved in planning patient care, administering diagnostic and therapeutic radiopharmaceuticals, performing individualized patient dose calculations, monitoring patients, and counseling patients. MAIN OUTCOME MEASURES Number of patients treated with radiolabeled MABs. RESULTS Since January 1996, 85 patients with NHL have been treated using 131I-tositumomab (Corixa, GlaxoSmithKline), an anti-B1 MAB, under various clinical research protocols requiring specialized pharmaceutical care. The nuclear pharmacist on the team provided direct patient care, assisting with the administration of diagnostic and therapeutic radiopharmaceuticals under a collaborative agreement with a nuclear medicine physician or a radiation oncologist. Other pharmaceutical care activities performed include calculating individual patient doses, obtaining medication histories, counseling patients on their therapy and on radiation safety after early release, and monitoring patients for adverse effects during medication infusion. Patients have responded favorably to nontraditional nuclear pharmacy activities. CONCLUSION The nuclear pharmacist has become an important member of the health care team that provides a new and unique therapy for patients with NHL. To date, the nuclear pharmacist, in collaboration with the nuclear medicine physician or the radiation oncologist, has successfully administered the tositumomab and 131I-tositumomab combination therapy without significant incident.
Catheterization and Cardiovascular Interventions | 2018
Andrew M. Goldsweig; Kevin F. Kennedy; Dhaval Kolte; J. Dawn Abbott; Paul C. Gordon; Barry L. Sharaf; Frank W. Sellke; Afshin Ehsan; Neel R. Sodha; Frank J. Rutar; Herbert D. Aronow
Transcatheter aortic valve replacement (TAVR) exposes patients to radiation.
Journal of The American Pharmacists Association | 2003
Samuel C. Augustine; David Colcher; Frank J. Rutar; Jeffrey P. Norenberg; Kao Vang
1. TechneScan MAG3 kit [package insert]. St. Louis, Mo: Mallinckrodt Inc; 2000. 2. OctreoScan kit [package insert]. St. Louis, Mo: Mallinckrodt Inc; 2000. 3. Weber DA, Paras P, Harris CC, et al. Initial testing and quality control for radionuclide dose calibrators. Committee on Standardization of Nuclear Medicine Instrumentation, American College of Nuclear Physicians. Nucl Med Commun. 1986;7:555-65. 4. Calhoun JM, Golas DB, Harris SG. Effects of varying geometry on dose calibrator response: cobalt-57 and technetium-99m. J Nucl Med. 1987;28:1478-83. 5. Chu RYL, Simon WE. Quality control testing of dose calibrators. J Nucl Med Technol. 1996;24:124-8. 6. Zimmerman BE, Coursey BM, Cessna JT. Correct use of dose calibrator values. J Nucl Med. 1998;38:575. 7. Dansereau RN, Methe BM. Dose variance associated with calibration and administration of radiopharmaceuticals. Am J Health Syst Pharm. 2001;58:580-4. 8. 10 CFR 35.50 (b) (4). 9. 10 CFR 35.60 (b).
The Journal of Nuclear Medicine | 2001
Frank J. Rutar; Samuel C. Augustine; David Colcher; Jeffry A. Siegel; David A. Jacobson; Margaret A. Tempero; Valorie J. Dukat; Maribeth A. Hohenstein; Lisa S. Gobar; Julie M. Vose
Clinical Lymphoma, Myeloma & Leukemia | 2001
Frank J. Rutar; Samuel C. Augustine; Mark S. Kaminski; Richard Wahl; Jeffry A. Siegel; David Colcher
Journal of Vascular Surgery | 2016
Hernan Hernandez; Iraklis I. Pipinos; Sara A. Myers; Jung Chien; Frank J. Rutar; Kendra K. Schmid; Gregory I. Gordon
Journal of The American College of Surgeons | 2016
Hernan Hernandez; Sara A. Myers; Iraklis I. Pipinos; Jung Chien; Frank J. Rutar; Kendra K. Schmid; Gregory I. Gordon
Annales De Chirurgie Vasculaire | 2008
Dustin J. Weiss; Iraklis I. Pipinos; G. Mathew Longo; Thomas G. Lynch; Frank J. Rutar; Jason M. Johanning