Oncolog, Volume 37, Issue 02, April-June 1992

The primacy of patient welfare Potential doubling time of tumors may be the key to accurate prognosis, appropriate treatment Cognitive deficits in survivors of childhood cancershttps://openworks.mdanderson.org/oncolog/1038/thumbnail.jp

Is there a post-PPH syndrome?

BACKGROUND: Despite early studies reporting significant decreases in postoperative pain and morbidity with the procedure for prolapse and hemorrhoids (PPH) compared to traditional hemorrhoidectomy, certain complications and long-term efficacy remain uncertain. This study was performed to assess the prevalence of usage of PPH and the observed postoperative complaints and complications. METHODS: A questionnaire was mailed to national and international members of the American Society of Colon and Rectal Surgeons (ASCRS) and the accumulated data were reviewed. RESULTS: The rate of response to the 2,642 questionnaires was 28.5% (n=754). Of the 754 respondents, 531 (70.4%) had performed PPH and 451 (84.9%) continued to perform PPH. The most commonly reported postoperative complaint was delayed postoperative pain. Pain lasting for months was reported by 15.1% of respondents. Persistent bleeding was reported by 34.5%, and 40.9% felt there is a post-PPH syndrome. CONCLUSIONS: Some long-term studies critically examining PPH have come to fruition. A majority of respondents continued to perform PPH. Nearly half of these agreed that there is a post-PPH syndrome relating to postoperative morbidities. The most disturbing morbidity was lasting perineal pain of unexplained etiology demanding challenging management. Persistent bleeding from hemorrhoidal disease distal to the staple line requires further management and raises the question as to the use of PPH as a permanent remedial procedure

Two-vessel off-pump coronary artery bypass grafting by left thoracotomy in a complex redo case

Introduction: The left thoracotomy approach is an alternative technique for coronary revascularization to avoid complications associated with re-sternotomy, such as injury to patent grafts, right ventricle, aorta, during re-sternotomy. Situations such as calcification of the ascending aorta and previous mediastinitis favor the use of the left thoracotomy approach. Revascularization of the circumflex territory via a lateral thoracotomy has been reported previously. However, reports of revascularization of the LAD combined with circumflex artery territory via left thoracotomy approach are rare. We successfully performed an off-pump CABG by left thoracotomy in a complex redo case to revascularize the LAD and obtuse marginal branch (OM) in an 83 year-old-man who had CABG and AVR in the past with a heavily calcified ascending aorta. Case Report: 83-year-old caucasian male History of CABG 20 years ago, redo CABG in the following year due to graft failure, and an AVR with a mechanical valve 12 years ago, and multiple coronary interventions. Presented with unstable angina. Echo showed normal LV function Due to his history of early stent re-stenosis and location of the disease, he was considered not suitable for repeat PCI. CT Scan showed severe calcification of the ascending aorta (left), and mild disease on the descending aorta. Presented at Chest 2013. Chicago IL.October 26-31, 2013

Looking at Catholic schools’ responses to the COVID-19 pandemic through the lens of Catholic Social Teaching Principles

The current COVID-19 crisis has significantly impacted all teachers throughout the country, in particular, those teaching in urban schools. The urgent nature of this crisis has brought new challenges to urban Catholic school educators specifically, and their ability to enact and model Catholic Social Teachings which include; respect for the life and dignity of the human person, the call to care for family and community, solidarity in uniting the human community, the dignity of work and the rights of workers, providing persons with rights that ensure decent lives such as an education, preferential option for the poor, and care for all creation. Using critical theory and narrative analysis, this paper examines how 31 urban Catholic school teachers perceive and address the impact of COVID-19 on teaching and learning in their classrooms. Analysis of these teacher’s narratives illustrate how Catholic Social Teachings are foundational to their response to the current situation. The conceptual framework and methodology of the research, and findings are presented. A key aim of this paper is to provide some concrete examples of the current urban Catholic school landscape and practice recommendations for all teachers, particularly those working alongside marginalized communities

Looking at Catholic Schools\u27 Responses to the COVID-19 Pandemic Through the Lens of Catholic Social Teaching Principles

The current COVID-19 crisis has significantly impacted all teachers throughout the country, in particular, those teaching in urban schools. The urgent nature of this crisis has brought new challenges to urban Catholic school educators specifically, and their ability to enact and model Catholic Social Teachings which include; respect for the life and dignity of the human person, the call to care for family and community, solidarity in uniting the human community, the dignity of work and the rights of workers, providing persons with rights that ensure decent lives such as an education, preferential option for the poor, and care for all creation. Using critical theory and narrative analysis, this paper examines how 31 urban Catholic school teachers perceive and address the impact of COVID-19 on teaching and learning in their classrooms. Analysis of these teacher’s narratives illustrate how Catholic Social Teachings are foundational to their response to the current situation. The conceptual framework and methodology of the research, and findings are presented. A key aim of this paper is to provide some concrete examples of the current urban Catholic school landscape and practice recommendations for all teachers, particularly those working alongside marginalized communities

Lessons from the Field: Catholic School Educators and COVID-19

Teachers are regularly tasked with planning for long-term academic and formative goals for entire classes and individual students. This planning involves designing and developing effective routines, creating detailed lesson plans, and tracking authentic assessment of students. Skilled teachers are accustomed to predictable expectations and outcomes in the familiar contexts of classrooms; yet, COVID-19 undermined the ability of teachers to plan. Using a case study and narrative analysis approach, this paper examines how 32 urban Catholic school teachers experienced the transition to remote instruction. Data analysis produced a template broadly aligned with Rush et al’s (2014) framework for effective, emergency, online school professional development curriculum during an emergency. A key aim of this paper is to provide some concrete recommendations for school level crisis preparation planning, implementing online learning platforms, matching needs and resources, communicating with parents, and using social media during this pandemic

Educating Others: A Vocation Promoting Meaning, Purpose and the Universal Apostolic Preferences

Teaching as discerned vocation in urban Catholic schools has the potential to provide a far-reaching, integrative space for enacting the Universal Apostolic Preferences. This research explores the reflections of 31 novice teachers, enrolled in the Urban Catholic Teacher Corps (UCTC), a Jesuit university program in the northeast. This program supports the development and formation of novice teachers through graduate education, living in community, full-teaching responsibilities in an urban Catholic school, mentoring, coaching, and professional development. Teachers completed an online interview that elicited responses about what it means to lead a life of meaning and purpose and the factors that contribute to leading a life of meaning and purpose. Responses illustrated intentionality and planning with the aim of leading a life that was beyond-the self. Finally, the Universal Apostolic Preferences of “Walking with the Excluded” and “Journey with Youth to Create a Hope-filled Future” resonated in all responses. Findings suggest that teaching as discerned vocation in urban Catholic schools offers a far-reaching space for not only enacting integrative Universal Apostolic Preferences as teachers commit to taking up this work as vocation, but also serving as a model for evangelizing students, families, and communities to take up this work

Use of Heparin Derivatives in Overweight and Obese Pediatric Patients

There is a high prevalence of childhood obesity which is a risk factor for developing thromboembolic events. Here we review the efficacy and safety data available of for heparin derivatives in the overweight or obese pediatric patients. A comprehensive literature search of 7 databases were conducted in a systematic approach. 11 of 180 studies were included. 9 studies evaluated the use of enoxaparin, 1 evaluated dalteparin, and 1 described fondaparinux in a case study. Dose adjustments were made to achieve therapeutic anti-factor Xa measurements, but was inconsistently performed. Dose reductions of 12.9-37.3% from baseline occurred with the treatment studies of enoxaparin, and a 27.3% increase from prophylactic indications was noted. 5 thromboembolic events were seen. 15 bleeding events were reported, 1 of which required surgery and blood products. Trends couldn\u27t be made with the other 2 products due to limited evidence. Heparin derivatives may need to be initiated at modified doses