A series of laboratory findings and clinical data were collected and analyzed during hospitalization. Front Med (Lausanne). Herein, we report a patient who underwent transient lymphedema after vaccination with BNT16b2. Background: Myocarditis, diagnosed by symptoms and troponin elevation, has been well-described with COVID-19 infection, as well as shortly after COVID-19 vaccination. Bethesda, MD 20894, Web Policies Studies deciphering metabolic patterns on 18F-FDG PET/CT after vaccination are needed because annual vaccination against SARS-CoV-2 might be needed. However, its not clear if COVID-19 played a role or how much of a role it played. Kirienko M, Biroli M, Pini C, Gelardi F, Sollini M, Chiti A. Clin Transl Imaging. HHS Vulnerability Disclosure, Help Tidsskr Nor Laegeforen 2021;141.doi: 10.4045/tidsskr.21.0274. Methods: sharing sensitive information, make sure youre on a federal COVID-19; lymphopenia; mortality; prognosis; survival analysis.. 2022 Jul 1;47(7):575-582. doi: 10.1097/RLU.0000000000004190. World Health Organization; 2021. Absolute Lymphocyte Count After COVID-19 Vaccination Is Associated with Vaccine-Induced Hypermetabolic Lymph Nodes on, DOI: https://doi.org/10.2967/jnumed.121.263082, Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine, Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine, Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK, COVID-19 vaccine BNT162b1 elicits human antibody and TH1 T cell responses, A single immunization with nucleoside-modified mRNA vaccines elicits strong cellular and humoral immune responses against SARS-CoV-2 in mice, Lymphocyte egress from thymus and peripheral lymphoid organs is dependent on S1P receptor 1, The spleen in local and systemic regulation of immunity, Assessing immune response upon systemic RNA vaccination on [, Lymph node activation by PET/CT following vaccination with licensed vaccines for human papillomaviruses, In vivo imaging of the immune response upon systemic RNA cancer vaccination by FDG-PET, Hypermetabolic lymphadenopathy following administration of BNT162b2 mRNA Covid-19 vaccine: incidence assessed by [, Correlation between BNT162b2 mRNA Covid-19 vaccine-associated hypermetabolic lymphadenopathy and humoral immunity in patients with hematologic malignancy, COVID-19 mRNA vaccination: age and immune status and its association with axillary lymph node PET/CT uptake, Coordination and optimization of FDG PET/CT and COVID-19 vaccination; lessons learned in the early stages of mass vaccination, COVID-19 vaccination may cause FDG uptake beyond axillary area, COVID-19 vaccination-associated lymphadenopathy on FDG PET/CT: distinctive features in adenovirus-vectored vaccine, COVID-19 vaccine as a cause for unilateral lymphadenopathy detected by, PET findings after COVID-19 vaccination: keep calm and carry on., Prevalence and significance of hypermetabolic lymph nodes detected by 2-[, The challenge of staging breast cancer with PET/CT in the era of COVID vaccination, FDG PET/CT: EANM procedure guidelines for tumour imagingversion 2.0, A stepwise AIC method for variable selection in linear regression, Humoral immune response to COVID-19 mRNA vaccine in patients with multiple sclerosis treated with high-efficacy disease-modifying therapies, BNT162b2 COVID-19 vaccine is significantly less effective in patients with hematologic malignancies, Absolute lymphocyte count predicts the response to new influenza virus H1N1 vaccination in pediatric cancer patients, The role of the lymphocyte in antibody formation, Rituximab blocks protective serologic response to influenza A (H1N1) 2009 vaccination in lymphoma patients during or within 6 months after treatment, Effect of cancer chemotherapy on the immune response to influenza virus vaccine: review of published studies, mRNA vaccine-induced neoantigen-specific T cell immunity in patients with gastrointestinal cancer, Survival Outcomes in Metastatic Gastroenteropancreatic Neuroendocrine Tumor Patients Receiving Concomitant, C-X-C Motif Chemokine Receptor 4Targeted Radioligand Therapy in Patients with Advanced T-Cell Lymphoma, Improved Tumor Responses with Sequential Targeted -Particles Followed by Interleukin 2 Immunocytokine Therapies in Treatment of CEA-Positive Breast and Colon Tumors in CEA Transgenic Mice, https://creativecommons.org/licenses/by/4.0/, http://jnm.snmjournals.org/site/misc/permission.xhtml, Absolute Lymphocyte Count After COVID-19 Vaccination Is Associated with Vaccine-Induced Hypermetabolic Lymph Nodes on 18F-FDG PET/CT: A Focus in Breast Cancer Care. Knowing the sensitivity of absolute lymphocyte count in patients with COVID-19 may help identify patients who are unlikely to have the disease. and transmitted securely. Clinical photograph of patient. Herein, we report a patient who underwent transient lymphedema after vaccination with BNT16b2. Family doctors, hematologists, breast surgeons, and radiologists must be aware of the fact that axillary, lower neck, supraclavicular, and infraclavicular lymphadenopathy may be related to the COVID-19 vaccine rather than representing actual more sinister pathologic processes. Lymphopenia is frequently linked to a worsening of clinical symptoms and an increased risk of death in COVID-19. The https:// ensures that you are connecting to the Methods: Nature. . A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients. Federal government websites often end in .gov or .mil. Viruses. eCollection 2022. The https:// ensures that you are connecting to the -, Terpos E., Ntanasis-Stathopoulos I., Elalamy I., et al. Would you like email updates of new search results? This observation is not surprising given the pivotal role of lymphocytes in the immune response, specifically because these are instrumental in the formation of antibodies (30). In the absence of clinical evidence of swelling during the laboratory evaluation, we suspected deep vein thrombosis. Demographics, clinical parameters, and absolute lymphocyte count (ALC) were collected, and their association with the presence of v-HLNs in the draining territory was studied by logistic regression. Maximum-intensity-projection 18 F-FDG PET images, Maximum-intensity-projection 18 F-FDG PET images of 45-y-old woman with relapsed DLBCL in mediastinum., In patient with early-stage BC who received vaccine injection ipsilateral to tumor, maximum-intensity-projection, MeSH Disclaimer. Bernstine H, Priss M, Anati T, Turko O, Gorenberg M, Steinmetz AP, Groshar D. Clin Nucl Med. Further analysis showed that 70.2% of the COVID-19 cases had low circulating lymphocyte count, of which 64.1% were severe cases and 85.0% were critical cases (75.9% recovered cases and 93.5% died). Chen N, Zhou M, Dong X, et al. PERTINENT FINDINGS: Patient ALC (>lower limit of normal), patient age (50 y), and timing of last injection dose (<30 d before PET) significantly correlated with v-HLNs. WebAdditionally, lower mean absolute lymphocyte counts were identified in males, patients who required intubation, and patients who died. Federal government websites often end in .gov or .mil. PET images were reconstructed with a fully 3-dimensional time-of-flight iterative method (VUE Point FX [an ordered-subsets expectation maximization algorithm; GE Healthcare], a matrix of 288 288, 3 iterations, 5 subsets, and a 2-mm postprocessing filter). Bethesda, MD 20894, Web Policies Would you like email updates of new search results? N Engl J Med. -. 2022 Dec 6;9:1067082. doi: 10.3389/fmed.2022.1067082. 18F-FDG PET/CT was performed in accordance with the applicable European Association of Nuclear Medicine procedure guidelines (25). Prognostic Impact of Myosteatosis on Mortality in Hospitalized Patients with COVID-19. Conclusion: Patients with a normal ALC after COVID-19 vaccination were more likely to have v-HLNs on 18F-FDG PET/CT, both of which might be associated with a stronger immune response to vaccination. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Since the date of PET examination could hardly be postponed in cancer patients, predicting the nature of HLNs on 18F-FDG PET/CT has become an area of intensive investigation to avoid unnecessary biopsies or aggressive treatments. Another interesting aspect of our work is that ALC after vaccination and before 18F-FDG PET/CT was an independent factor significantly associated with v-HLNs in the whole cohort of 260 patientsan observation that was further reinforced by our findings in the specific cohort of 145 BC patients. 2021;384:403416. In contrast, the researchers discovered that a form of white blood cells (leukocytes) called lymphocytes showed decreased stiffness in COVID-19 patients, while other white blood cells, known as monocytes, were significantly larger than in Immediate Open Access: Creative Commons Attribution 4.0 International License (CC BY) allows users to share and adapt with attribution, excluding materials credited to previous publications. -, Di Bella S, Cesareo R, De Cristofaro P, et al. In this brief meta-analysis, the reduction of lymphocyte subset counts in COVID-19 patients was investigated across 2 About one third had early-stage BC, and the remaining two thirds had advanced-stage BC, treated mainly with endocrine therapy with or without targeted therapy or chemotherapy. The body keeps a few T-lymphocytes, called memory cells, that go into action quickly if the body encounters the same virus again. COVID-19 vaccination, implications for PET/CT image interpretation and future perspectives. Skawran S, Gennari AG, Dittli M, Treyer V, Muehlematter UJ, Maurer A, Burger IA, Mader C, Messerli O, Grnig H, Gebhard C, Huellner MW, Curioni-Fontecedro A, Berger C, Messerli M. Eur Radiol. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID-19 patients. The site is secure. Indeed, Achiron etal. In this large cohort of 260 patients, we demonstrated that patient ALC was a critical determinant of v-HLNs on 18F-FDG PET/CT after mRNA based- or viral vectorbased COVID-19 vaccination, as well as patient age and timing of last injection dose. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Indeed, BC patients with a normal value of ALC were more likely to have v-HLNs on 18F-FDG PET/CT. The site is secure. WebA reduced peripheral blood absolute lymphocyte count with an elevated neutrophil count has been a consistent observation in hospitalized coronavirus disease 2019 (COVID-19) patients. Maximum-intensity-projection 18F-FDG PET images of 45-y-old woman with relapsed DLBCL in mediastinum. Kilercik M, Demirelce , Serdar MA, Mikailova P, Serteser M. PLoS One. 2021 Jul 16;100(28):e26503. Table 1 summarizes the detailed demographic and clinicobiologic characteristics and PET imaging parameters of the 145 BC patients. Unauthorized use of these marks is strictly prohibited. More than half the patients were referred for BC (56%), and 24% were considered immunosuppressed (n = 62). Several laboratory parameters have been linked to Corona Virus Disease 2019 (COVID-19), with lymphocytes being one of the most important. doi: 10.1002/ajh.25829. official website and that any information you provide is encrypted -, Sahin U, Muik A, Derhovanessian E, et al. Diagnostics (Basel). Berretta M, Morra A, Taibi R, Monari F, Maurea N, Ippolito M, Tirelli U, Fiorica F, Montella L, Facchini G, Quagliariello V, Montopoli M. Front Pharmacol. Two hundred thirty-three patients (90%) received the mRNA vaccine, including 110 (42%) who had 2 doses. eCollection 2021. Clipboard, Search History, and several other advanced features are temporarily unavailable. Further analyses are needed to explore the specific relationship between v-HLNs, immune status, and the immune response to the COVID-19 vaccine. The literature has characterized the outcomes of myocarditis following COVID-19 infection and vaccination, but clinicopathologic, hemodynamic, and pathologic Nishiura H., Kobayashi T., Miyama T., et al. doi: 10.1016/j.exphem.2022.11.006. and Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Bookshelf WebA reduced peripheral blood absolute lymphocyte count with an elevated neutrophil count has been a consistent observation in hospitalized coronavirus disease 2019 (COVID-19) patients. Indeed, it is the only thing that ever has.". HHS Vulnerability Disclosure, Help Clinical photograph of patient. The median age was 50 y (range, 23-96 y). . Although all fine-needle aspiration cytology evidenced signs of malignancy, with tumor cells (43%) (Fig. Furthermore, v-HLNs appeared to correlate with an effective humoral response induced by the mRNA vaccination (13). Analyzing survival, we found that the survival rate of group A (<1.110E9/L) was significantly lower than that of group B (>1.110E9/L) at the second time point (. revealed that lymphoma patients treated during the year before COVID-19 vaccination with rituximab-containing regimens (9%) had significantly lower rates of v-HLNs than did all other lymphoma patients (41%), associated with a strong relationship between v-HLNs and positive serologies (Spearman = 0.64 in patients who received the 2 doses of mRNA vaccine) (13). WebAdditionally, lower mean absolute lymphocyte counts were identified in males, patients who required intubation, and patients who died. It is not related to whether the EBV is still present in your body. Wagner J, DuPont A, Larson S, Cash B, Farooq A. Int J Lab Hematol. Copyright 2021 the Author(s). doi: 10.1136/bmj.n1931. It typically takes a few weeks after vaccination for the body to produce T-lymphocytes and B-lymphocytes. J Educ Health Promot. Moreover, only 10% of patients received the viral vectorbased COVID-19 vaccine. "Never doubt that a small group of thoughtful, committed citizens can change the world. 2022 Jan;32(1):508-516. doi: 10.1007/s00330-021-08122-2. A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients. -, Zhao Q., Meng M., Kumar R., et al. Blood sample analysis after vaccination and before PET was available in 170 patients. Absolute lymphocyte count is a prognostic marker in Covid-19: A retrospective cohort review. Additionally, lower mean absolute lymphocyte counts were identified in males, patients who required intubation, and patients who died. Both of these interrelated elements (age and ALC) might modulate the quality of the immune response after COVID-19 vaccination. Bookshelf The HLN SUVmax was defined as the highest SUVmax among all HLNs detected in the drainage territory (axillary or supraclavicular for vaccination in the deltoid, inguinal for vaccination in the thigh or buttock). BMJ. A few case studies have reported people admitted to the hospital with leukemia shortly after developing COVID-19. Before 2022 Feb 22;19(2):e1003927. FOIA . Alfadda AA, Rafiullah M, Alkhowaiter M, Alotaibi N, Alzahrani M, Binkhamis K, Siddiqui K, Youssef A, Altalhi H, Almaghlouth I, Alarifi M, Albanyan S, Alosaimi MF, Isnani A, Nawaz SS, Alayed K. Front Med (Lausanne). Would you like email updates of new search results? Evaluation of coronavirus diseases (COVID-19) in terms of epidemiological and clinical features, comorbidities, diagnostic methods, treatment, and mortality. Please enable it to take advantage of the complete set of features! Careers. Zhang HJ, Qi GQ, Gu X, Zhang XY, Fang YF, Jiang H, Zhao YJ. WebA reduced peripheral blood absolute lymphocyte count with an elevated neutrophil count has been a consistent observation in hospitalized coronavirus disease 2019 (COVID-19) patients. Table 1 summarizes the detailed demographic and clinicobiologic characteristics and PET imaging parameters of the 260 patients. Clipboard, Search History, and several other advanced features are temporarily unavailable. Moreover, the lymphocyte count in dead cases was significantly lower than that of critical cases who recovered, at almost every Further analysis showed that 70.2% of the COVID-19 cases had low circulating lymphocyte count, of which 64.1% were severe cases and 85.0% were critical cases (75.9% recovered cases and 93.5% died). The .gov means its official. Methods: This is a prognostic study that is conducted from March 1 to August 31, 2020. As previously published by Thomassen etal. Epub ahead of print. eCollection 2022. Bookshelf Accessibility -, Deng M, Qi Y, Deng L, et al. We conducted a retrospective review of 702 consecutive patients who underwent 18F-FDG PET/CT imaging at Institut Curie Hospital, Saint-Cloud, France (the flow chart is provided in Fig. Interestingly, for patients displaying lymphopenia after vaccination, we evaluated the dynamic of ALC and found that a low ALC existed before vaccination in most patients (67%, n = 36) suggesting that lymphopenia was not related to vaccination. This study aimed to determine the role of lymphocyte levels in predicting COVID-19 patient mortality. Lymphocyte subsets as a predictor of severity and prognosis in COVID-19 patients. -, Sharifian-Dorche M, Bahmanyar M, Sharifian-Dorche A, et al. Careers. Behavior of Eosinophil Counts in Recovered and Deceased COVID-19 Patients over the Course of the Disease. 8600 Rockville Pike Bethesda, MD 20894, Web Policies Superficial venous thrombosisas a possible consequence of ChAdOx1 nCoV-19 vaccine: two case reports. One patient (14%) was not investigated and began neoadjuvant endocrine therapy; the planned partial mastectomy with sentinel lymph node biopsy will help determine the cause of HLNs afterward. Terms of Use. 2021 Aug 5;16(8):e0254073. 2022 Jun 23;13:875637. doi: 10.3389/fimmu.2022.875637. Results: In total, 260 patients were eligible, including 209 (80%) women and 145 (56%) with breast cancer. Epub 2022 Nov 28. Lymphopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a systemic review and meta-analysis. 2022 Dec 6;9:1067082. doi: 10.3389/fmed.2022.1067082. Lymphopenia is frequently linked to a worsening of clinical symptoms and an increased risk of death in COVID-19. Conclusion: Patients with a normal ALC after COVID-19 vaccination were more likely to have v-HLNs on 18F-FDG PET/CT, both of which might be associated with a stronger immune response to vaccination. A recent Johns Hopkins Medicine study suggests that T lymphocytes immune system cells that target the spike protein and direct antibodies against the COVID-19 virus persist six months after vaccination (12). In addition to providing information on the HLN status, which may help nuclear medicine physicians with image interpretation and oncologists with medical management, these findings also raise the question of whether the COVID-19 vaccine is triggering a more robust immune response in this population (50 y or ALC > lower limit of normal). Covid vaccines eight times less effective against this variant of concern A claim suggesting that the Covid-19 booster shot causes lymphoma has gone viral on social media. Amoo OS, Onyia N, Onuigbo TI, Vitalis SU, Davies-Bolorunduro OF, Oraegbu JI, Adeniji ET, Obi JC, Abodunrin ON, Ikemefuna AS, Adegbola RA, Audu RA, Salako BL. Steroids such as Prednisolone have a very short-lived effect of increasing the neutrophils. Additionally, absolute lymphocyte count can be used as a marker of disease severity in patients with COVID-19. Sign In to Email Alerts with your Email Address. Keywords: FDG PET/CT radiomics as a tool to differentiate between reactive axillary lymphadenopathy following COVID-19 vaccination and metastatic breast cancer axillary lymphadenopathy: a pilot study. 2020;383:26032615. 2022 by the Society of Nuclear Medicine and Molecular Imaging. Rationale: Complications from COVID-19 vaccines have yet to be sufficiently analyzed because they are rapidly approved without long-term data. We can divide critical patients with COVID-19 into the group A (<1.110E9/L) and group B (>1.110E9/L) according to their number of lymphocytes. Eifer M, Pinian H, Klang E, Alhoubani Y, Kanana N, Tau N, Davidson T, Konen E, Catalano OA, Eshet Y, Domachevsky L. Eur Radiol. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. First dose ChAdOx1 and BNT162b2 COVID-19 vaccinations and cerebral venous sinus thrombosis: A pooled self-controlled case series study of 11.6 million individuals in England, Scotland, and Wales. Through survival analysis, we found that there was no significant difference in survival between group A and group B at admission (P = .3065). N Engl J Med. Correlation analysis of critical cases (recovered) and critical cases (deaths). An official website of the United States government. Among them, median ALC was 1.4 109/L (range, 0.318.3 109/L), and 74 (44%) displayed lymphopenia. KEYWORDS 18F -FDG PET/CT; COVID 19 vaccination; absolute lymphocyte count; hypermetabolic lymph nodes; immune response. Yu Q, Jiang W, Chen N, Li J, Wang X, Li M, Wang D, Jiang L. Front Immunol. The findings of this study indicated a significant difference in outcome between lymphopenia and non-lymphopenia patients. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection. License: https://creativecommons.org/licenses/by/4.0/. Conclusion: Knowing the sensitivity of absolute lymphocyte count in patients with COVID-19 may help identify patients who are unlikely to have the disease. A retrospective chart review was performed on 312 patients with laboratory-confirmed COVID-19 who were admitted to the hospital from the emergency department. 2021 Aug 26;374:n1931. However, its not clear if COVID-19 played a role or how much of a role it played. Furthermore, the survival analysis revealed differences in the probability of survival within 30 days between COVID-19 patients with lymphopenia and those without (HR: 5.5722 (3.2509-9.5510), 95% CI; p<0.0001). Tabbakh TA, Alhashemi HH, Alharbi K, Qanash S, Alzahrani MS, Saati A, Alsulami S, Alsulami A, Neyazi A, Alzahrani A, Taher ZA, Aljedaani G, Alhejaili A. Cureus. Axillary Lymph Nodes Hypermetabolism After BNT162b2 mRNA COVID-19 Vaccination in Cancer Patients Undergoing 18F-FDG PET/CT: A Cohort Study. The authors have no potential conflicts of interest relevant to this article to report. Patient was treated with brentuximab and nivolumab and experienced complete metabolic response 2 mo after initiation of therapy (January 2021). We identified 7 BC patients who had axillary HLNs ipsilateral to the recently vaccinated arm but also ipsilateral to the known tumor. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection. We considered a subgroup of patients who theoretically had a weakened immune system, whom we called immunosuppressed, caused by any of the following treatments: chemotherapy within the last 3 mo, rituximab-containing regimens or bone marrow transplantation within the last 6 mo, or current steroid therapy with more than 10 mg/d of prednisone-equivalent. -, Guan W.-J., Ni Z.-Y., Hu Y., et al. The median age was 50 y (range, 2396 y). 3), all sentinel lymph node biopsies revealed benign reactive changes (43%) (Fig. Disclaimer. Curtolo A, Oliva A, Volpicelli L, Ceccarelli G, D'Ettorre G, Borrazzo C, Mastroianni CM, Venditti M. Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR, Barr RG, Chang BP, Chau KH, Choi JJ, Gavin N, Goyal P, Mills AM, Patel AA, Romney MS, Safford MM, Schluger NW, Sengupta S, Sobieszczyk ME, Zucker JE, Asadourian PA, Bell FM, Boyd R, Cohen MF, Colquhoun MI, Colville LA, de Jonge JH, Dershowitz LB, Dey SA, Eiseman KA, Girvin ZP, Goni DT, Harb AA, Herzik N, Householder S, Karaaslan LE, Lee H, Lieberman E, Ling A, Lu R, Shou AY, Sisti AC, Snow ZE, Sperring CP, Xiong Y, Zhou HW, Natarajan K, Hripcsak G, Chen R. BMJ. Epub 2022 Apr 27. N Engl J Med. eCollection 2022. . Polack FP, Thomas SJ, Kitchin N, et al. Previous studies determined a low lymphocyte count is commonly found in patients with COVID-19. Six of the cases had been histologically documented by fine-needle aspiration cytology (n = 3) or sentinel lymph node biopsy (n = 3). In breast cancer patients, the absence of lymphopenia was the only independent factor significantly associated with v-HLNs (OR, 2.9; 95% CI, 1.27.4). 2021 Aug 5;16(8):e0254073. government site. Federal government websites often end in .gov or .mil. Unauthorized use of these marks is strictly prohibited. J Glob Health. All parameters remained independent predictors of the v-HLN status on multivariate analysis. Prognostic Impact of Myosteatosis on Mortality in Hospitalized Patients with COVID-19. COVID-19 vaccine BNT162b1 elicits human antibody and TH1 T cell responses. A Rare Occurrence of Opportunistic Infection by Streptococcus mitis Due to Antibiotic-Induced Neu Alabama College of Osteopathic Medicine Research, Baylor Scott & White Medical Center Department of Neurosurgery, California Institute of Behavioral Neurosciences & Psychology, Contemporary Reviews in Neurology and Neurosurgery, DMIMS School of Epidemiology and Public Health, Simulation, Biodesign, & Innovation In Medical Education, The Florida Medical Student Research Publications, University of Florida-Jacksonville Neurosurgery, VCOM Clinical, Biomedical, and Educational Research, American Red Cross Scientific Advisory Council, Canadian Association of Radiation Oncology, International Liaison Committee on Resuscitation, International Pediatric Simulation Society, Medical Society of Delaware Academic Channel, Society for Healthcare & Research Development, Surgically Targeted Radiation Therapy for Brain Tumors: Clinical Case Review, Clinical and Economic Benefits of Autologous Epidermal Grafting, Defining Health in the Era of Value-Based Care, Optimization Strategies for Organ Donation and Utilization, MR-Guided Radiation Therapy: Clinical Applications & Experiences, Multiple Brain Metastases: Exceptional Outcomes from Stereotactic Radiosurgery, Proton Therapy: Advanced Applications for the Most Challenging Cases, Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices, Clinical Applications and Benefits Using Closed-Incision Negative Pressure Therapy for Incision and Surrounding Soft Tissue Management, Negative Pressure Wound Therapy with Instillation, NPWT with Instillation and Dwell: Clinical Results in Cleansing and Removal of Infectious Material with Novel Dressings. 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