bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospitalization outcomes of patients with colorectal cancer (CRC) admitted with Clostridioides difficile colitis.
Authors: Sanjeevi Aditya , Bhandari Samikchhya Keshary , Kharel Himal , Kharel Zeni , Orakzai Abdullah Ahmad , Shah Purva , Eltaher Basant , Verma Rashmi , Rao Aniket , Niu Chengu , Idoate Domench Daniel 
Published: June 2024

e15649 Background: Clostridioides difficile colitis poses a significant healthcare burden and is a leading cause of diarrheal disease. Emerging studies have suggested that certain C. difficile strains may potentially drive colonic tumorigenesis and C. difficile was more frequently isolated from colorectal cancerous lesions compared to healthy tissue. In addition, cancer patients are more likely to receive antibiotics. These factors place CRC patients at a high risk of acquiring C. difficile infection. This national inpatient sample (NIS) study aims to study the hospitalization outcomes of patients with CRC admitted with C. difficile colitis. Methods: A retrospective analysis of the NIS database from 2016 to 2020 was conducted using International Classification of Diseases (ICD-10) codes to identify hospitalizations with C. difficile colitis. STATA version SE18.0 was used for statistical analysis. We used multivariate regression analysis to calculate the effect on mortality, length of stay, ileus and cost of hospitalization of colorectal cancer along with other variables as listed below. Results: There were 246685 hospitalizations with a primary diagnosis of C. difficile colitis. Among these, 2250 patients had a secondary diagnosis of colorectal cancer. Multivariate logistic regression showed that CRC was associated with increased mortality with odds ratio (OR) of 2.24 [95% confidence interval (CI) 1.13-4.44, p-value = 0.02], ileus (OR of 1.99, 95% CI 1.16-3.41, p-value = 0.01) and cost of hospitalization (10,585$ higher than patients without CRC, p-value = 0.001). CRC was not associated with increased length of stay (OR of 1.31, 95% CI 0.63-1.99). The effect of other pertinent variables is summarized in Table 1. Conclusions: Among the analyzed variables, we observed that colorectal cancer was associated with increased mortality, ileus and total cost of hospitalization in patients admitted with C. difficile colitis. Limitations of this study include failure of the multivariate model to account for other possible variables, coding errors and risk of bias due to the retrospective nature of data. [Table: see text]
Mortality outcomes in early versus late onset colorectal cancer: A US National Inpatient Sample (NIS) analysis (2020).
Authors: Khan Muhammad Atif , Khan Shahryar , Amin Muhammad Kashif , Khan Faiza Humayun , Khan Mashal Alam , Asif Samia 
Published: June 2024

e15651 Background: Colorectal Cancer (CRC) is the third most common cancer diagnosed in the United States and contributes to significant cancer-related morbidity and mortality. An upward trend in the incidence is noticed in the population below 50 years of age. For similar reasons, U.S. Preventive Services Task Force recommended screening at the age of 45 in 2021.For the sake of this study, we categorized early onset (EO) for age 45 and below, and late onset (LO) for above 45 years per new screening criteria. We compared socioeconomic characteristics, mortality, length of stay and hospital cost between EO and LO CRC. Methods: It is a retrospective cohort study of adult patients hospitalized in 2020 with Colorectal cancer in acute care hospitals across the USA. Patients were selected from the Nationwide Inpatient Sample (NIS) database. IRB approval was not obtained as de-identified data was utilized. Our study population included all patients with a discharge diagnosis of colorectal cancer as their primary diagnosis using the International Classification of the Diseases (ICD-10). The primary outcome was in-hospital mortality, secondary outcomes were length of hospital stay and total hospitalization charges. Analysis was performed using STATA version 18.0. Univariable and Multivariable logistic regression analysis were used to adjust for potential confounders. Results: There were 32 million discharges included in the NIS database in 2020, our study included 153809 with colorectal cancer which includes 12043 in EO and 141750 in LO CRC. Both population groups are mostly similar in terms of baseline characteristics, however EO group were more likely to have Hispanic population (18.7% vs 9.5%), history of inflammatory bowel disease (2.9% vs 1.2%), family history of CRC (6.4% vs 3.8%) and smoker (15.8% vs 12.8%). Multivariable analysis revealed that Age, Sex, Charlson Comorbidity Index, Family history, Smoking, and Median household income for patients were predictors of mortality. There was no statistically significant difference found in the adjusted mortality between the two groups (odds ratio 1.08, 95% CI 0.84-1.39). Lower length of stay was noticed in the EO group (odds ratio 0.48, 95% CI 0.07-0.89). Total deaths are lower in EO than LO group (0.04% vs 0.06%). Conclusions: There is no difference in mortality in early and late onset CRC in our study. However, EO CRC is associated with shorter length of stay in hospital. EO CRC disproportionately affects non-White patients, particularly Hispanic patients. [Table: see text]
Angiogenesis inhibitors and cardiovascular outcomes in cancer: Real-world, population-based, matched cohort study.
Authors: Krishnan Arunkumar , Mukherjee Diptasree , Alqahtani Saleh A. , Walsh Declan 
Published: June 2024

e24024 Background: Angiogenesis inhibitors (AI) have vascular side effects and are now recognized forcardiovascular adverse events (CVAEs). Clinical trial outcomes can underestimate treatment-related adverse events due to restrictive eligibility criteria, limited sample size, and failure to anticipate specific toxicities. In contrast, observational studies have small sample sizes and insufficient adjustment of confounding covariates. In addition, prospective high-quality evidence in real-world settings is scarce. We evaluated the incidence of CVAEs in real-world populations on AI therapy. Methods: This large retrospective cohort study was conducted using the TriNetX database and included adult patients ( > 18 years) with new cancer diagnoses. We performed 1:1 propensity score matching (PSM) for demographics, BMI, nicotine dependence, comorbidities, cancer type, and medications to similar controls as cancer patients never treated with AIs. The primary outcome was the new incidence of CVAEs-like heart failure (HF), major adverse cardiovascular events (MACE; coronary artery intervention myocardial infarction, or unstable angina), arrhythmia, ischemic heart disease (IHD), venous thromboembolism (VT), and cerebrovascular events (CVE cerebral infarction, carotid intervention, stroke, transient ischemic attack). Sensitivity analysis assessed statistical robustness. Hazard ratios (HR) were calculated to compare the AI therapy association with incident CVAEs. Results: We identified 1,170,667 patients with diagnoses of colorectal, cervical, kidney, liver, nonsmall cell lung, or ovarian cancer between 2010 and 2022. Among these, 59,890 had an AI treatment history, and 110,777 did not, with a median follow-up time of 3.1 years. After PSM, both cohorts (59545 each) were well-matched. In the adjusted analysis, AI therapy was associated with higher risks of MACE (HR, 1.23; 95% CI 1.16 -1.31), HF (HR, 1.16; 95% CI 1.08 - 1.25), and VT (HR 2.07; 95% CI 1.95 - 2.19), IHD (HR 1.23; 95% CI 1.16- 1.31), arrhythmias (HR 1.19; 95% CI 1.12-1.27), CVEs (HR, 1.30; 95% CI 1.21- 1.40) at 1 year of exposure. These outcomes were still significantly higher “increased,” suggesting causation; this is an association at follow-up by increasing the lag exposure. Sensitivity analysis results were consistent, and all statistically significant associations remained unchanged. Conclusions: Angiogenesis inhibitor treatment was associated with a significantly higher risk of CVAEs and various malignancies. The increased risk ranges from approximately 1.16 to 2.07 fold, indicating a substantial elevation in risk. These findings highlight the importance of risk stratification and cardiovascular monitoring during and after AI therapy. There is an unmet need to define strategies for CVAE prevention in this high-risk population.
Impact of multiple myeloma on outcomes of acute myocardial infarction: A propensity score matched analysis.
Authors: Bekoju Kanchhi , Kansakar Sajog , Shikhrakar Shreeja , Guragain Ashish , Chudy-Onwugaje Dilichukwu , Winn Soe , Neupane Niraj 
Published: June 2024

e24027 Background: Patients with multiple myeloma (MM) are at increased risk of cardiovascular events secondary to its complications and adverse effects of pharmacotherapy. However, data on in-hospital outcomes of MM on acute myocardial infarction (AMI) is limited due to the clinical scenario being relatively uncommon. Thus, we conducted a retrospective study to investigate the in-hospital outcomes and resource utilization of AMI admissions in MM patients. Methods: We extracted data from the National Inpatient Sample (NIS) Database from 2016 to 2020. We included all admissions ≥18 years old with a principal diagnosis of AMI with and without co-morbid MM using International Classification of Diseases Tenth Revision (ICD-10) codes. Propensity score matching was performed to balance hospital characteristics, patient demographics and comorbidities between the two groups. Univariate logistic regression was performed in the balanced cohorts. The primary outcome was inpatient mortality. Analysis was performed using STATA-MP, version 14.2. Results: A total of 3,191,049 hospitalizations for AMI were identified between 2016 and 2020, of which 6,565 (0.21%) had co-morbid MM. After propensity score matching, compared to those without MM, admissions for AMI with MM had higher odds ratio (OR) of mortality (OR 1.51, 95% CI 1.1-2.08, p = 0.01). Similar rates of complications such as respiratory failure, cardiogenic shock, stroke and vascular complications were seen between the two cohorts. However, acute kidney injury was more common in patients with MM (OR 1.81, 95% CI 1.52-2.14, p < 0.01). Compared to those without MM, admissions for AMI with MM were less likely to undergo coronary angiogram (OR 0.73, 95% 0.63-0.86, p < 0.01), percutaneous coronary intervention (PCI) (OR 0.71, 95% CI 0.60-0.84, p < 0.01) or coronary artery bypass grafting (CABG) (OR 0.52, 95% CI 0.37-0.71, p < 0.01). There was no difference in the length of stay but median hospitalization charges were higher in the cohort with MM ($ 54,125 vs $ 58,493, p < 0.01). Conclusions: Despite similar complication rates, patients with multiple myeloma (MM) who presented with acute myocardial infarction (AMI) experienced higher in-hospital mortality compared to those without MM. One plausible explanation is that patients with MM were less likely to undergo definitive management procedures such as coronary angiogram, percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG) during their admission, as observed in our study. Alternatively, MM might independently predict worse outcomes for AMI. Further research is needed to understand the interplay between AMI and MM, as well as to identify factors contributing to disparities in outcomes and intervention rates between patients with and without MM.
Establishing palliative care in tribal and rural Indian setting: A participatory action research approach.
Authors: Kahkasha Dr. , Varshney Saurabh , Bhatnagar Sushma 
Published: June 2024

e24085 Background: We established a palliative care center in the tribal area of Santhal Pargana, India, under a tertiary care facility, as a crucial step in addressing the palliative needs of oncology patients. This study assesses the center's inaugural year, focusing on referral patterns, morphine consumption, and pain management. Methods: Data from all patients visiting the palliative care outpatient department (OPD) in 2023 were prospectively collected and analyzed. The study focused on key palliative care indicators, including morphine consumption, patient referrals, and the mean Numeric Rating Scale (NRS) pain score after initial consultation. The PAR approach was utilized to tailor services to the community's needs. Results: The center observed an increase in patient referrals, from 8 new patients in January to 19 by December. The patient demographic primarily comprised individuals with head and neck cancer (43%), followed by breast cancer (28%) and gall bladder cancer (12%), alongside other types such as cervix, sarcomas, lung, and adult hematolymphoid malignancies. Bone metastasis was present in 46 (55.4%) patients at initial presentation. Morphine consumption demonstrated a notable rise, from 840 mg in May to 2860 mg in December, totaling 9800 mg for the year. The mean NRS pain score improved significantly from 6.5 in January to 4.3 post-initial consultation. The center maintained an overall median of 3 consultations per patient, and bereavement support was provided to 13 (15.7%) patients. Conclusions: The integration of the Participatory Action Research approach, specifically the CTC-5, was instrumental in the successful initiation and expansion of palliative care services within the center. The structured training, mentorship, and organizational restructuring, facilitated by the program, were crucial in establishing a modest palliative care infrastructure. This comprehensive approach not only enhanced care delivery but also ensured the sustainability and adaptability of palliative services, effectively addressing the gap in palliative care in rural, tribal settings.
Orthorexia nervosa in breast cancer survivors: The role of disease characteristics and psychological aspects (GOIRC 02-2019).
Authors: Barbieri Elena , Moscetti Luca , Toss Angela , Cortesi Laura , Cuoghi Costantini Riccardo , Molinaro Alessia , Ferrari Silvia , Dominici Massimo 
Published: June 2024

e24092 Background: Orthorexia Nervosa (ON), although not yet considered as a full-blown psychopathological disorder, is defined as altered thoughts and behaviours related to healthy eating and its prevalence is increasing in general population. Surviving cancer is a condition that may affect patients behaviour and mental status leading to beliefs that may affect everyday life to avoid cancer recurrence. Among these, eating behaviour is mostly represented in cancer survivors. The aim of the present study is to evaluate the prevalence and characteristics of ON among breast cancer (BC) survivors. Methods: This observational study enrols adult patients attending the outpatient clinic at the Oncology Division of Modena University Hospital. Patients with a BC diagnosis that have concluded the surgical, radiotherapy and chemo and/or targeted therapy treatment phase were considered eligible. Ongoing hormonal adjuvant therapy was permitted. Socio-demographic, clinical variables (stage, year of diagnosis, hormone receptor status, HER2 status, proliferation index, treatment) were collected on an anonymized database. Moreover, three psychometric measurements were administered to patients: the Hospital Anxiety-Depression Scale (HADS), the Personality Inventory for DSM-5 Brief Form (PID-5-BIF) and the ORTO-R, a 6-item self-administered tool that is the most used scale to measure ON. Results: Data were collected from 137 patients. Mean age was 62.4 years and (± 10.3) and the mean BMI was 26.3 (± 5.2). Sixty-six percent of patients were diagnosed with stage I disease, 28% with stage II and 6% with stage III disease. Thirty percent of patients received adjuvant chemotherapy, 89% hormonal therapy and 15.5% anti-HER2 targeted therapy. The ORTO-R mean score was 12.2 ± 3.8. The prevalence of psychiatric symptoms at the HADS was 36.5%. The ORTO-R score was found to correlate negatively to age of patients (the older, the less the score at ORTO-R, p = 0.001) and positively to 3 of the constructs of personality at the PID-5-BF, disinhibition, psychoticism and negative affect. Interestingly, ORTO-R was poorly associated to cancer variables, such as stage, hormone receptors, treatments, phenotype (luminal, HER2 positive, triple negative), lifestyle and psychiatric symptomatology. Conclusions: Eating behaviours among cancer patients may be influenced by psychological aspects and need to be addressed during follow-up. Further investigations are needed to evaluate correlation with BC specific characteristics.[Table: see text]
Fulvestrant with or without the cyclin-dependent kinase 7 (CDK7) inhibitor samuraciclib in advanced hormone receptor positive (HR+) breast cancer after CDK4/6 inhibition: Phase II SUMIT-BC study.
Authors: Pernas Sonia , Hinojo Carmen , Pascual Javier , Aksoy Sercan , Clack Glen , McIntosh Stuart 
Published: June 2024

TPS1126 Background: CDK7 enhances oncogene transcription and upregulates anti-apoptotic genes, accelerates the cell cycle via CDK phosphorylation, and activates estrogen receptors (ERs) that can drive resistance to hormonal therapy in cancer. CDK7 inhibition therefore represents a potential anticancer strategy in cancer. Samuraciclib (CT7001) is a small molecule, ATP competitive, selective oral inhibitor of CDK7 that inhibits these key effects of CDK7. Samuraciclib had a favorable safety profile and showed clinical activity when combined with fulvestrant in a phase I study in patients with HR+/HER2− advanced breast cancer (BC) who had previously been treated with a CDK4/6 inhibitor. Patients with no detectable TP53 mutation in ctDNA at baseline and those without baseline liver metastases appeared to have better outcomes. The instant release capsule formulation of samuraciclib used in this study released large amounts of samuraciclib high in the gastrointestinal (GI) tract, which may have contributed to the observed low grade GI adverse events, which were managed with prophylaxis and counselling (1). Methods: A phase 2 open-label randomized study has been designed to evaluate the efficacy, safety, pharmacokinetics (PK), and quality of Life (QoL) of samuraciclib combined with fulvestrant compared to fulvestrant monotherapy (SUMIT-BC; NCT05963984). Eligible patients (n=60) are ≥18 years, have histologically or cytologically confirmed ER+/HER2− advanced or metastatic BC not amenable to resection or radiotherapy of curative intent, have received an aromatase inhibitor combined with a CDK4/6 inhibitor in the adjuvant or advanced setting, are receiving a luteinizing hormone-releasing hormone agonist if pre/perimenopausal, and have RECIST v1.1 evaluable disease. Prior SERD, mTOR inhibition, or chemotherapy for advanced BC are not permitted. All patients undergo baseline Guardant360 ctDNA analysis to establish TP53 and other mutation status. Patients are randomized 1:1:1 to fulvestrant alone (500 mg IM administered on days 1, 15 and 29 and then monthly), fulvestrant and samuraciclib 240 mg QD, or fulvestrant and samuraciclib 360 mg QD. In preparation for phase 3 development, a novel single tablet formulation of samuraciclib is used, which may enhance GI tolerability. Patients undergo RECIST v1.1 evaluation at baseline, every 8 weeks until week 48, and every 12 weeks thereafter. The primary endpoint is clinical benefit response at 24 weeks. Secondary endpoints are tolerability, progression free survival, overall response rate, duration of response, and PK of fulvestrant and samuraciclib. QoL (Functional Assessment of Cancer Therapy - Breast questionnaire [FACT-B]) and correlations between TP53 mutation and efficacy/safety will be assessed. 1. Coombes et al. Nature Comms 2023. Clinical trial information: NCT05963984 .
Genetic Background Strongly Influences the Impact of Carrying the Thr92Ala-DIO2 Polymorphism in the Male Mouse
Authors: Gabriel de Almeida Guilherme , Bolin Anaysa P , Batistuzzo Alice , Fonseca Tatiana L , Ribeiro Miriam O , Bianco Antonio C 
Published: June 2024

Abstract
About half of the world population carries at least one allele of the Ala92-DIO2, which slows down the activity of the type 2 deiodinase (D2), the enzyme that activates T4 to T3. Carrying the Ala92-DIO2 allele has been associated with increased body mass index and insulin resistance, but this has not been reproduced in all populations. To test if the genetic background affects the impact of this polymorphism, here we studied the genetically distant C57Bl/6J (B6) and FVB/N (FVB) mice carrying the Ala92-Dio2 allele as compared to control mice carrying the Thr92-Dio2 allele. Whereas B6-Ala92-Dio2 and B6-Thr92-Dio2 mice—fed chow or high-fat diet—behaved metabolically similar in studies using indirect calorimetry, glucose- and insulin tolerance tests, and measuring white adipose tissue (WAT) weight and liver steatosis, major differences were observed between FVB-Ala92-Dio2 and FVB-Thr92-Dio2 mice: carrying the Ala92-Dio2 allele (on a chow diet) resulted in hypercholesterolemia, smaller WAT pads, hepatomegaly, steatosis, and transcriptome changes in the interscapular brown adipose tissue (iBAT) typical of ER stress and apoptosis. Acclimatization at thermoneutrality (30 °C) eliminated most of the metabolic phenotype, indicating that impaired adaptive (BAT) thermogenesis can be involved. In conclusion, the metabolic impact of carrying the Ala92-Dio2 allele depends greatly on the genetic background of the mouse, varying from no phenotype in B6 mice to a major phenotype in FVB mice. These results will help the planning of future clinical trials studying the Thr92Ala-DIO2 polymorphism and may explain why some clinical studies performed in different populations across the globe have obtained inconsistent results.