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Li, Richard Jay

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Li

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Richard Jay

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Li, Richard Jay
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    Advanced nodal stage predicts venous thromboembolism in patients with locally advanced non-small cell lung cancer
    (Elsevier BV, 2016) Li, Richard Jay; Hermann, Gretchen; Baldini, Elizabeth; Chen, Aileen; Jackman, David M; Kozono, David; Nguyen, Paul; Nohria, Anju; Powell, Graham; Mak, Raymond
    Objectives: Patients with non-small cell lung cancer (NSCLC) are known to be at high risk for venous thromboembolism (VTE), but previous studies have not specifically analyzed locally advanced disease. We performed a retrospective VTE risk analysis in a cohort of locally advanced NSCLC treated with definitive intent including radiation therapy. Materials and Methods: The cohort consisted of 629 patients with stage II-III NSCLC treated at a single institution from January 2003 to December 2012. All patients received treatment with curative intent, including radiation therapy. Fine and Gray’s competing-risks regression model, accounting for death and distant metastasis as competing risks, was used to identify significant predictors of VTE risk, and cumulative incidence estimates were generated using the competing-risks model. Results and Conclusion: At a median follow-up of 31 months, 127 patients developed a VTE, with 80% of events occurring in the first year after treatment initiation. 1-year and 3-year overall cumulative incidence estimates were 13.5% and 15.4%, respectively. On univariate analysis, stage IIIB and N3 nodal disease were associated with increased VTE risk. In the final multivariable model, N3 nodal disease was associated with increased VTE risk (Hazard ratio 1.64; 95% CI 1.06-2.54; p=0.027). In conclusion, patients with locally advanced NSCLC are at high risk for VTE, especially in the first year after treatment initiation, with a 1-year cumulative incidence of 13.5%. N3 nodal staging was associated with significantly higher VTE risk compared to N0-N2 staging.
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    Medial Epicondyle Morphology in Elite Overhead Athletes: A Closer Look Using 3-Dimensional Computer Simulation
    (SAGE Publications, 2014) Makhni, Eric C.; Khanna, Krishn; Simpson, Michael T.; Redler, Lauren H.; Anakwenze, Oke A.; Li, Richard Jay; Ahmad, Christopher S.
    Background: Prior studies have attempted to determine morphological characteristics of the medial epicondyle in overhead athletes, but no study has reported on precise quantitative differences between elite overhead athletes and control patients. Hypothesis: The medial epicondyle in overhead athletes is larger in volume than those of control patients. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Computer simulation modeling from advanced (computed tomography/magnetic resonance imaging) imaging of the elbow of 37 patients (22 elite overhead athletes, 15 control patients) was performed to provide detailed assessment of the morphological characteristics of the medial epicondyle. Several quantitative metrics regarding the medial epicondyle were measured and compared across both cohorts, including that of epicondyle width (medial-lateral), height (superior-inferior), thickness (anterior-posterior), volume, percentage cortical volume, and morphology of the inferior slope of the epicondyle. Results: The medial epicondyle in overhead athletes was significantly larger than that found in nonathlete controls (4976 vs 3682 mm3; P = .001). There was no significance between the 2 cohorts in medial-lateral width (16.8 vs 16.6 mm; P = .68), but there was a difference in anterior-posterior thickness (16.96 vs 14.40 mm; P = .001) and superior-inferior height (39.55 vs 35.86 mm; P = .09) in athletes versus controls. The epicondyle volume was 97.9% cortical bone in athletes compared with 82.3% in control patients (P < .001). There were no differences in the morphology of the inferior epicondyle slope between the 2 groups. Conclusion: The medial epicondyle in overhead athletes is larger in volume and anterior-posterior thickness than those of control patients. Additionally, the medial epicondyle is comprised nearly entirely of cortical bone in overhead athletes. Clinical Relevance: These quantitative findings support the theory of adaptive remodeling in skeletally immature overhead athletes.