Limitation of imaging in identifying iatrogenic aortic coarctation following thoracic endovascular aortic repair

A 21-year-old male suffered blunt trauma from a motor vehicle accident causing thoracic aorta tear. The smallest available stent graft was deployed. Definitive repair was later performed using a 22 × 22 × 116 mm Talent Thoracic Stent Graft. The postoperative course was uneventful. Seventeen months later, he presented with dizziness, chest pain, acute renal failure, malignant hypertension, and troponin elevation. Computed tomography (CT) angiogram and transesophageal echocardiogram did not reveal any dissection, stent stenosis or collapse. Cardiac catheterization showed normal coronary arteries but a 117 mm Hg gradient across the stent graft. Iatrogenic coarctation of the aorta was confirmed with a second measurement during arch angiogram. A Palmaz stent was deployed over the distal end of the previous stent graft with complete resolution of symptoms and gradual normalization of kidney function. This case report demonstrates a need for wider availability and selecting appropriate stent graft in treating traumatic aortic injuries in young patients. It is the first case report of the inability of current imaging modalities in confirming stent collapse. Pressure gradient is a useful tool in confirming stent collapse when clinical scenario does not match CT findings

COVID-19 Concerns among Physicians who treat cancer survey in the United States, Cross-sectional study March/April 2020

We have provided the survey instrument, data, and the SAS program(s) which generate the calculated variables and statistical analyses as described in the manuscript(s). A. Filename: COVID19_us_oncologist_survey_data3.csv Short description: Data set B. Filename: COVID19AndOncologistsSurvey_REDCapSurvey.pdf Short Description: PDF of survey as presented to participants in REDCap online C. Filename: Covid19_oncologist_analysis_emot_health_final_UPLOAD.sas Short Description: SAS code (9.4) to generate variables and statistical analysis for Thomaier et al., 2020. NOTE: Variables dem_1, dem_3, dem_4, dem_5, and dem_17 have been removed from this public version of the dataset to protect participant privacy. These correspond to age, transgender status, race, ethnicity, and state of residence/practice. To obtain a complete raw dataset, please contact the lead investigator to be vetted for access to that data.Cross-sectional anonymous online survey among physicians treating individuals with cancer in the United States during the initial phase of the COVID-19 pandemic (March 27, 2020 – April 10, 2020). Recruitment: Snowball convenience sampling through social media (Twitter, Facebook, LinkedIn). Eligibility criteria: ≥18 years, able to read/write in English, and being a physician (MD or DO) currently residing and providing cancer treatment in the United States. Data collected and stored in REDCap.This research was supported in part by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant UL1TR002494 as well as the National Cancer Institute P30 Cancer Center Support Grant, grant CA77598. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences or the National Cancer Institute

Emotional health concerns of oncology physicians in the United States: Fallout during the COVID-19 pandemic.

IntroductionCancer care is significantly impacted by the Coronavirus Disease 2019 (COVID-19) pandemic. Our objective was to evaluate the early effects of the pandemic on the emotional well-being of oncology providers across the United States and explore factors associated with anxiety and depression symptoms.Materials and methodsA cross-sectional survey was administered to United States cancer-care physicians recruited over a two-week period (3/27/2020-4/10/2020) using snowball-convenience sampling through social media. Symptoms of anxiety and depression were measured using the Patient Health Questionnaire (PHQ-4).ResultsOf 486 participants, 374 (77.0%) completed the PHQ-4: median age was 43 years; 63.2% female; all oncologic specialties were represented. The rates of anxiety and depression symptoms were 62.0% and 23.5%, respectively. Demographic factors associated with anxiety included female sex, younger age, and less time in clinical practice. Perception of inadequate personal protective equipment (68.6% vs. 57.4%, p = 0.03) and practicing in a state with more COVID-19 cases (65.8% vs. 51.1%, p = 0.01) were associated with anxiety symptoms. Factors significantly associated with both anxiety and depression included the degree to which COVID-19 has interfered with the ability to provide treatment to cancer patients and concern that patients will not receive the level of care needed for non-COVID-19 illness (all p-values ConclusionThe perceived degree of interference with clinical practice along with personal concerns about COVID-19 were significantly associated with both anxiety and depression among oncology physicians in the United States during the COVID-19 pandemic. Our findings highlight factors associated with and sources of psychological distress to be addressed to protect the well-being of oncology physicians

Perceptions of COVID-19 and Health Survey in the United States, Cross-sectional study April 2020

Cross-sectional anonymous online survey among individuals with and without cancer in the United States during the initial phase of the COVID-19 pandemic (April 3, 2020 – April 11, 2020). NOTE: To protect the identity of participants, the variables dem_1, dem_3, and dem_17 - which correspond to exact age, transgender status, and state of residence - have been removed from this public data set. Please contact the principal investigator if you require the full data set with these variables included for your research

Perspectives of cancer patients and their health during the COVID-19 pandemic.

IntroductionThe immunosuppressive nature of some cancers and many cancer-directed treatments may increase the risk of infection with and severe sequelae from Coronavirus Disease 2019 (COVID-19). The objective of this study was to compare concerns about COVID-19 among individuals undergoing cancer treatment to those with a history of cancer not currently receiving therapy and to those without a cancer history.MethodsWe conducted a cross-sectional anonymous online survey study of adults currently residing in the United States. Participants were recruited over a one-week period (April 3-11, 2020) using promoted advertisements on Facebook and Twitter. Groups were compared using chi-squared tests, Fisher's exact tests, and t-tests.Results543 respondents from 47 states provided information on their cancer history and were included in analyses. Participants receiving active treatment reported greater concern about infection from the SARS-CoV-2 coronavirus (pConclusionsPatients undergoing active treatment for cancer were most concerned about the short-term effects of the COVID-19 pandemic on the logistics as well as potential efficacy of ongoing cancer treatment, longer term effects, and overarching societal concerns that the population at large is not as concerned about the public health implications of SARS-CoV-2 infection