Carley Demchuk

2 Introduction: Hiatal hernia (HH) is associated with gastroesophageal reflux (GER) and/or GER disease (GERD) and may contribute to idiopathic pulmonary fibrosis (IPF). We hypothesized that HH evaluated by computed tomography (CT) is more common in IPF than asthma or COPD, and correlates with abnormal GER by pH probe testing.

The Thoracic Oncology Program Database Project was created to serve as a comprehensive, verified, and accessible repository for well-annotated cancer specimens and clinical data to be available to researchers within the Thoracic Oncology Research Program. This database also captures a large volume of genomic and proteomic data obtained from various tumor tissue studies. A team of clinical and basic science researchers, a biostatistician, and a bioinformatics expert was convened to design the database. Variables of interest were clearly defined and their descriptions were written within a standard operating manual to ensure consistency of data annotation. Using a protocol for prospective tissue banking and another protocol for retrospective banking, tumor and normal tissue samples from patients consented to these protocols were collected. Clinical information such as demographics, cancer characterization, and treatment plans for these patients were abstracted and entered into an Acce...

(47), e2414, doi:10.3791/2414 (2011). The Thoracic Oncology Program Database Project was created to serve as a comprehensive, verified, and accessible repository for well-annotated cancer specimens and clinical data to be available to researchers within the Thoracic Oncology Research Program. This database also captures a large volume of genomic and proteomic data obtained from various tumor tissue studies. A team of clinical and basic science researchers, a biostatistician, and a bioinformatics expert was convened to design the database. Variables of interest were clearly defined and their descriptions were written within a standard operating manual to ensure consistency of data annotation. Using a protocol for prospective tissue banking and another protocol for retrospective banking, tumor and normal tissue samples from patients consented to these protocols were collected. Clinical information such as demographics, cancer characterization, and treatment plans for these patients were abstracted and

Racial disparities in utilization of surgical therapy for lung cancer exist in the United States. Videos of standardized patients (SPs) can help identify factors that influence physicians' surgical risk estimation. We hypothesized that physician race and SP race in videos influence surgeon decision making. Four race-neutral clinical vignettes representing lung resection candidates were paired with risk-level concordant short silent videos of SPs. Vignette/video combinations were classified as low or high risk. Trainees and practicing thoracic surgeons read a race-neutral vignette, provided an initial estimate of the percent risk of major surgical complications, viewed a video randomized to black or white SP, provided a final estimate of risk, and scored the likelihood that they would recommend surgery. Changes in risk estimates were assessed. Participants included 113 surgeons (38 practicing surgeons, 75 trainees); 76 were white non-Hispanic (67%), 37 were in other self-identifi...

In recent years, there has been tremendous growth and interest in translational research, particularly in cancer biology. This area of study clearly establishes the connection between laboratory experimentation and practical human application. Though it is common for laboratory and clinical data regarding patient specimens to be maintained separately, the storage of such heterogeneous data in one database offers many benefits as it may facilitate more rapid accession of data and provide researchers access to greater numbers of tissue samples. The Thoracic Oncology Program Database Project was developed to serve as a repository for well-annotated cancer specimen, clinical, genomic, and proteomic data obtained from tumor tissue studies. The TOPDP is not merely a library-it is a dynamic tool that may be used for data mining and exploratory analysis. Using the example of non-small cell lung cancer cases within the database, this study will demonstrate how clinical data may be combined w...

1. Korean J Neurogastroenterol Motil. 2007 Jun;13(1):15-20. Korean. ... Gastroesophageal Reflux Disease in Patients with Unexplained Chronic Cough. ... Hwang IJ, Jung HC, Shi GD, Yoon JH, Choi JH, Song HU, Oh JH, Kwon CI, Hwang SG, Park PW, Rim KS, Hong SP.

There were over 220,000 people diagnosed with lung cancer and over 160,000 people dying of lung cancer during 2010 alone in the United States. In order to arrive at better control, prevention, diagnosis, and therapeutics for lung cancer, we must be able to personalize the approach towards the disease. Mind-mapping has existed for centuries for physicians to properly think about various "flows" of personalized medicine. We include here the epidemiology, diagnosis, histology, and treatment of lung cancer-in particular, non-small cell lung cancer. As we have new molecular signatures for lung cancer, this is further detailed. This review is not meant to be a comprehensive review, but rather its purpose is to highlight important aspects of lung cancer diagnosis, management, and personalized treatment options.

A significant minority of patients with Idiopathic Pulmonary Fibrosis (IPF) display features of autoimmunity without meeting criteria for overt connective tissue disease. A link between IPF and other immune-mediated processes, such as hypothyroidism, has not been reported. In this investigation we aim to determine whether hypothyroidism is associated with IPF and if outcomes differ between IPF patients with and without hypothyroidism. A retrospective case-control analysis was conducted. Of 311 patients referred to the University of Chicago Interstitial Lung Disease Center with an initial diagnosis of IPF, 196 met inclusion criteria and were included in the final analysis. Each case was matched 1:1 by age, gender and race to a control with chronic obstructive pulmonary disease. Hypothyroidism was identified in 16.8% of cases and 7.1% of controls (OR 2.7; 95% CI 1.31-5.54; p=0.01). Among patients with IPF, hypothyroidism was associated with reduced survival time (p<0.001) and was found to be an independent predictor of mortality in multivariable Cox regression analysis (HR 2.12; 95% CI 1.31-3.43; p=0.002). A secondary analysis of two IPF clinical trial datasets supports these findings. Hypothyroidism is common among patients with IPF, with a higher prevalence than in those with COPD and that of the general population. The presence of hypothyroidism also predicts mortality in IPF, a finding that may improve future prognostication models. More research is needed to determine the biologic link between IPF and hypothyroidism, and how the presence of thyroid disease may influence disease progression.

The Thoracic Oncology Program Database Project was created to serve as a comprehensive, verified, and accessible repository for well-annotated cancer specimens and clinical data to be available to researchers within the Thoracic Oncology Research Program. This database also captures a large volume of genomic and proteomic data obtained from various tumor tissue studies. A team of clinical and basic science researchers, a biostatistician, and a bioinformatics expert was convened to design the database. Variables of interest were clearly defined and their descriptions were written within a standard operating manual to ensure consistency of data annotation. Using a protocol for prospective tissue banking and another protocol for retrospective banking, tumor and normal tissue samples from patients consented to these protocols were collected. Clinical information such as demographics, cancer characterization, and treatment plans for these patients were abstracted and entered into an Acce...

Hiatal hernia (HH) is associated with gastro-oesophageal reflux (GOR) and/or GOR disease and may contribute to idiopathic pulmonary fibrosis (IPF). We hypothesised that HH evaluated by computed tomography is more common in IPF than in asthma or chronic obstructive pulmonary disease (COPD), and correlates with abnormal GOR measured by pH probe testing. Rates of HH were compared in three cohorts, IPF (n=100), COPD (n=60) and asthma (n=24), and evaluated for inter-observer agreement. In IPF, symptoms and anti-reflux medications were correlated with diffusing capacity of the lung for carbon monoxide (D(L,CO)) and composite physiologic index (CPI). HH was correlated with pH probe testing in IPF patients (n=14). HH was higher in IPF (39%) than either COPD (13.3%, p=0.00009) or asthma (16.67%, p=0.0139). The HH inter-observer κ agreement was substantial in IPF (κ=0.78) and asthma (κ=0.86), and moderate in COPD (κ=0.42). In IPF, HH did not correlate with lung function, except in those on anti-reflux therapy, who had a better D(L,CO) (p<0.03) and CPI (p<0.04). HH correlated with GOR as measured by DeMeester scores (p<0.04). HH is more common in IPF than COPD or asthma. In an IPF cohort, HH correlated with higher DeMeester scores, confirming abnormal acid GOR. Presence of HH alone was not associated with decreased lung function.

ABSTRACT Interstitial Lung DiseaseSESSION TYPE: Original Investigation SlidePRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 04:15 PMPURPOSE: Our objective was to evaluate the safety and efficacy of the addition of tacrolimus to conventional immunosuppressive therapy in patients with progressive connective tissue disease-related interstitial lung disease (CTD-ILD).METHODS: We included patients from our ILD database with progressive CTD-ILD despite treatment with prednisone and an additional immunosuppressive agent. Demographics, clinical features, lung function, radiographic images, pathologic findings and adverse advents were reviewed. Response to therapy was assessed by percent change in forced vital capacity (FVC) and difference in six-minute walk test (6MWT) distance before tacrolimus treatment as compared to the best lung function during treatment.RESULTS: Eleven patients were included; three had undifferentiated connective tissue disease and eight had an idiopathic inflammatory myopathy. Pathologic and/or radiographic findings showed organizing pneumonia and/or nonspecific interstitial pneumonia in nine patients and usual interstitial pneumonia in two patients. Tacrolimus was added as an adjunctive agent to standard immunosuppressive therapy in doses of 1 mg BID to 6 mg BID, targeting a serum trough level of 5-10 ng/mL. Length of tacrolimus treatment ranged from 2 to 98 months (mean 34.8 months ± 30.0, median 29 months). The mean of the percent change in FVC was 8.36% ± 10.69 with a median improvement of 6%. Eight of eleven patients had an improvement in FVC ranging from 3 to 32%; the remaining three patients experienced a decrease in FVC by 1 to 3%. Eight of eleven patients performed a 6MWT pre and post-tacrolimus treatment. Five of eight patients had an improvement in their 6MWT distance while three walked a shorter distance (mean change in distance was 52.3 meters ± 119.5, median improvement of 30.2 meters). No patient had a life-threatening adverse event. Most common side effects included hypertension, hyperglycemia and pulmonary infections. No patient had a sustained elevation in creatinine.CONCLUSIONS: This case series demonstrates that tacrolimus can be efficacious and is well tolerated as an adjunctive therapy to corticosteroids and an additional immunosuppressive agent.CLINICAL IMPLICATIONS: Tacrolimus should be considered in patients with progressive CTD-ILD.DISCLOSURE: The following authors have nothing to disclose: Leah Witt, Carley Demchuk, James Curran, Mary StrekNo Product/Research Disclosure Information.

There were over 220,000 people diagnosed with lung cancer and over 160,000 people dying of lung cancer during 2010 alone in the United States. In order to arrive at better control, prevention, diagnosis, and therapeutics for lung cancer, we must be able to personalize the approach towards the disease. Mind-mapping has existed for centuries for physicians to properly think about various "flows" of personalized medicine. We include here the epidemiology, diagnosis, histology, and treatment of lung cancer-in particular, non-small cell lung cancer. As we have new molecular signatures for lung cancer, this is further detailed. This review is not meant to be a comprehensive review, but rather its purpose is to highlight important aspects of lung cancer diagnosis, management, and personalized treatment options.