tbuckley/cabot-search huggingface dataset:
The effect of sodium glucose cotransporter-2 inhibitors on mortality and cardiovascular outcomes of patients with prostate cancer receiving luteinizing hormone releasing hormone agonists.
Authors: Zhiting Tang, Cho Han Chiang, Yu-Cheng Chang, Xin Ya See, Qian Wang, Kuan-Yu Chi, Cho Hung Chiang
Journal: Journal of Clinical Oncology (2024)

12025 Background: Luteinizing hormone releasing hormone agonists (LHRHa) are the standard of care treatment for prostate cancer but associated with an increased risk of cardiotoxicity. Recent studies suggest that sodium glucose cotransporter-2 inhibitors (SGLT2i), a class of antidiabetic drugs, reduce the risk of cardiovascular events compared to other glucose-lowering agents. We aim to investigate the potential cardioprotective effect of SGLT2i in prostate cancer patients with T2DM undergoing LHRHa therapy. Methods: We performed a retrospective, propensity score matched study using the TriNetX database, a network comprising deidentified data across more than 120 participating healthcare institutions. We included patients with prostate cancer and T2DM who were treated with LHRHa for prostate cancer and received either SGLT2i or dipeptidyl peptidase 4 inhibitors (DPP4i) for diabetes. The primary outcomes were all-cause mortality, incident hypertension, and incident major cardiovascular adverse events (MACE), which was defined as a composite of heart failure, myocardial infarction, and atrial fibrillation/flutter within 5 years of LHRHa initiation. Results: We matched 932 patients treated with an SGLT2i to patients treated with a DPP4i. The median age was 73 years for both cohorts. A total of 110 and 275 patients died in the SGLT2i and DPP4i cohorts, respectively. In Cox proportional hazard analyses, SGLT2i was associated with a reduction in the risk of all-cause mortality (Hazard ratio (HR), 0.65 [95% CI, 0.52 to 0.81]), hypertension (HR, 0.40 [95% CI: 0.22-0.70]) and major adverse cardiovascular events (HR, 0.70 [95% CI, 0.50 to 0.97]) compared to DPP4i. Similarly, SGLT2i was associated with a statistically significant reduction in heart failure and myocardial infarction. There appeared to be a tendency toward a lower risk of atrial fibrillation/flutter. Conclusions: The use of SGLT2i was associated with a lower risk of mortality, hypertension, and cardiovascular events in patients with prostate cancer and T2DM undergoing LHRHa therapy. [Table: see text]
HDL-cholesterol confers sensitivity of immunotherapy in nasopharyngeal carcinoma via remodeling tumor-associated macrophages towards the M1 phenotype
Authors: Fan Luo, Jiaxin Cao, Qun Chen, Lusha Liu, Ting Yang, Xue Bai, Wenjuan Ma, Chaozhuo Lin, Ting Zhou, Jianhua Zhan, Yan Huang, Yunpeng Yang, Hongyun Zhao, Li Zhang
Journal: Journal for ImmunoTherapy of Cancer (2024)

The sustained effectiveness of anti-programmed cell death protein-1/programmed death-ligand 1 treatment is limited to a subgroup of patients with advanced nasopharyngeal carcinoma (NPC), and the specific biomarker determining the response to immunotherapy in NPC remains uncertain. We assessed the associations between pre-immunotherapy and post-immunotherapy serum lipoproteins and survival in a training cohort (N=160) and corroborated these findings in a validation cohort (N=100). Animal studies were performed to explore the underlying mechanisms. Additionally, the relationship between high-density lipoprotein-cholesterol (HDL-C) levels and M1/M2-like macrophages, as well as activated CD8+T cells in tumor tissues from patients with NPC who received immunotherapy, was investigated. The lipoproteins cholesterol, HDL-C, low-density lipoprotein-cholesterol, triglycerides, apolipoprotein A-1 (ApoA1), and apolipoprotein B, were significantly altered after immunotherapy. Patients with higher baseline HDL-C or ApoA1, or those with increased HDL-C or ApoA1 after immunotherapy had longer progression-free survival, a finding verified in the validation cohort (p<0.05). Multivariate analysis revealed that baseline HDL-C and elevated HDL-C post-immunotherapy were independent predictors of superior PFS (p<0.05). Furthermore, we discovered that L-4F, an ApoA1 mimetic, could inhibit tumor growth in NPC xenografts. This effect was associated with L-4F's ability to polarize M2-like macrophages towards an M1-like phenotype via the activation of mitogen-activated protein kinase (MAPK) p38 and nuclear factor-κB (NF-κB) p65, thereby alleviating immunosuppression in the tumor microenvironment. Importantly, in patients with NPC with high plasma HDL-C levels, the number of M2-like macrophages was significantly decreased, while M1-like macrophages and activated CD8+T cells were notably increased in those with high HDL-C levels. Higher baseline HDL-C levels or an increase in HDL-C post-immunotherapy can enhance immunotherapeutic responses in patients with NPC by reprogramming M2-like macrophages towards the M1 phenotype. This suggests a potential role for prospectively exploring ApoA1 mimetics as adjuvant agents in combination with immunotherapy.
Technology-enhanced palliative care for patients with advanced cancer undergoing phase I therapies: A pilot randomized clinical trial (RCT).
Authors: David Hui, Ishwaria M. Subbiah, David S. Hong, Jennifer Ellefson, Josue Becerra, Vera J De la Cruz, Diana L. Urbauer, Sanjay Shete, Eduardo Bruera
Journal: Journal of Clinical Oncology (2024)

12017 Background: Outpatient palliative care (PC) has been found to improve quality of life (QOL). It is not known if more frequent symptom monitoring and PC nursing contacts between clinic visits would offer additional benefits. We conducted a pilot RCT to examine the effect of a specialist PC referral with and without technology-enhancement (TEC) on symptoms in patients undergoing Phase I cancer therapies. Methods: This single-center parallel group RCT enrolled adult patients with advanced solid tumors prior to starting Phase I therapies and at least 1 Edmonton Symptom Assessment Scale (ESAS) symptom ≥4/10 and ESAS Global Distress Score (GDS) ≥20/90. Patients were randomized to PC alone or PC + TEC in a 1:1 ratio. Over the 12 w period, the PC group had in person or virtual outpatient visits with a PC physician, nurse, and as needed psychotherapist every 4 weeks; the PC + TEC group also received weekly symptom monitoring with ESAS electronically and weekly nursing phone call. The primary outcome was within-group change of GDS from baseline to 2 w; secondary outcomes included change in GDS over 4, 8, and 12 w, and change in QOL (FACIT-Sp) over 2, 4, 8 and 12 w. We estimated that a sample size of 50 patients per group would provide 90% power to detect a within-group GDS difference of 6 units with a 2-sided α of 2.5% and 20% attrition. Results: Between 12/15/2020 and 12/21/2022, 115 patients were enrolled and 101 were randomized (PC + TEC n = 57, PC n = 44). By 2 w, PC + TEC showed a significant within-group improvement in GDS (mean change -5 [95% CI -8.9, -1.2]; P= 0.01) but not PC alone (Table). PC+TEC group also had a significant improvement in GDS at 8 w and 12 w and in FACIT-SP at 2 w, 8 w and 12 w. PC alone group had a significant within-group improvement in GDS at 4 w and 12 w but no significant differences in QOL were detected. This study was not powered for between group comparison; however, FACIT-SP at 12 w was significantly higher in PC+TEC vs. PC alone (Table; mean difference 13.9; P= 0.02). Conclusions: Higher intensity of PC with closer monitoring showed within-group improvement in symptoms and QOL, while PC alone had some symptom reduction but no QOL improvement. Further studies are needed to confirm the QOL benefit of PC + TEC over PC alone. Clinical trial information: NCT04989556 . [Table: see text]
Role of Sex, Anxiety, and Resilience in the Association between Adverse Childhood Experiences and Irritable Bowel Syndrome
Authors: Anna H. Lee, Swapna Mahurkar-Joshi, Bruce Naliboff, Arpana Gupta, Jennifer Labus, Kirsten Tillisch, Emeran Mayer, Lin Chang
Journal: Clinical Gastroenterology and Hepatology (2024)

Background & AimsAdverse childhood experiences (ACE) are associated with increased risk of irritable bowel syndrome (IBS), a female-predominant chronic abdominal disorder. Factors contributing to this association have not been well-studied. We compared sex differences in ACE for adults with and without IBS and evaluated the impact of anxiety and resilience on the relationship between ACE and IBS.MethodsSex and disease differences in total score and ACE subtypes from the ACE Questionnaire in subjects with IBS and control subjects were assessed. Cross-sectional mediation analysis determined if anxiety (Hospital Anxiety and Depression Scale) and resilience (Connor-Davidson Resilience Scale or Brief Resilience Scale) mediated the relationship between ACE and IBS.ResultsOf 798 participants studied, 368 met IBS diagnostic criteria (265 women, 103 men) and 430 were healthy control subjects (277 women, 153 men). Prevalence and number of ACE were higher in IBS versus control subjects (P < .001) but similar between IBS women and men. Household mental illness increased odds of having IBS in women (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.35–2.85; false discovery rate [FDR], 0.002) and men (OR, 2.32; 95% CI, 1.26–4.33; FDR, 0.014). Emotional abuse increased odds of having IBS in women (OR, 1.94; 95% CI, 1.23–3.09; FDR, 0.019) and sexual abuse increased odds of IBS in men (OR, 3.54; 95% CI, 1.35–10.38; FDR, 0.027). Anxiety mediated 54% (P < .001) of ACE's effect on IBS risk and resilience mediated 12%–14% (Connor-Davidson Resilience Scale, P = .008; Brief Resilience Scale, P = .018).ConclusionsBoth men and women with a history of ACE are twice as likely to have IBS than those without an ACE. Anxiety mediated the relationship between ACE and IBS in men and women and resilience mediated this relationship only in women.Graphical abstract
Diversity and representation in ADHD psychosocial treatment research: A comprehensive synthesis with data from over 10,000 participants
Authors: Brittany M. Merrill, Megan M. Hare, Jennifer Piscitello, Nicole K. Schatz, Gregory A. Fabiano, Erica L. Wells, Emily L. Robertson, Ariel M. Aloe, William E. Pelham, Fiona Macphee, Marcela Ramos, Xin Zhao, Amy R. Altszuler, Natalie Javadi, Stephanie S.J. Morris, Alyssa Smyth, Leah Ward, Heather A. Jones
Journal: Clinical Psychology Review (2024)
Reconstructive breast implant–related infections: Prevention, diagnosis, treatment, and pearls of wisdom
Authors: Alejandro Perez, Donald P. Baumann, George M. Viola
Journal: Journal of Infection (2024)

Implant-based reconstructions are increasingly utilized following mastectomy in the prevention and treatment of breast cancer. However, these implants are associated with a high rate of infection, which is a major complication that can lead to implant removal, delay in adjuvant radiation and chemotherapy, and increase in health care costs. Early clinical signs and symptoms of infection, such as erythema, warmth, and tenderness, are challenging to discern from expected postsurgical responses. Furthermore, when atypical features are present or the patient's condition does not improve on adequate antimicrobials, the clinician should be prompted to consider an alternative noninfectious etiology. Herein we highlight the key elements of the preventive, diagnostic, and multidisciplinary therapeutic approach to salvaging the infected breast implant; review several infectious disease mimickers; and provide many pearls of wisdom that the practicing clinician must be familiar with and be able to manage in an effective and successful manner.SummaryBreast implant-based reconstructive procedures after mastectomy has been historically associated with an elevated infection rate. Herein, we perform a comprehensive review on many key aspects on the prevention, diagnosis, treatment, and mimickers of these complex implant-related infections.
Neurocutaneous syndromes
Authors: De-an Qin, Jun-xia Qin
Journal: International Journal of Surgery (2024)

aDepartment of Spinal surgery, Shanxi Provincial People's Hospital, Taiyuan 030012, Shanxi, China bDepartment of Dermatology, Shanxi Provincial People's Hospital Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Published online ■ ■ *Corresponding author. Address: Department of Spinal surgery, Shanxi Provincial People's Hospital, NO. 29, Double Tower Street, Taiyuan 030012, Shanxi, China Tel: +8615034428643. E-mail address: [email protected] (De-an Qin). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/
Optimized treatment strategy for early-stage medium/high-risk hormone receptor-positive/HER2-negative breast cancer
Authors: Zhao Bi, Xiao Sun, Jia-Xian Zhao, Peng Chen, Tian-Yi Wang, Tong-Yue Ren, Yong-Sheng Wang
Journal: International Journal of Surgery (2024)

Bi, Zhao; Sun, Xiao; Zhao, Jia-Xian; Chen, Peng; Wang, Tian-Yi; Ren, Tong-Yue; Wang, Yong-Sheng Author Information
Evaluation of two-stage hepatectomy using portal vein embolization for colorectal liver metastasis: a retrospective nationwide cohort survey in Japan
Authors: Takayuki Shimizu, Taku Aoki, Mitsuru Ishizuka, Katsunori Sakamoto, Toru Beppu, Goro Honda, Kenjiro Kotake, Masakazu Yamamoto, Keiichi Takahashi, Itaru Endo, Kiyoshi Hasegawa, Michio Itabashi, Yojiro Hashiguchi, Yoshihito Kotera, Shin Kobayashi, Tatsuro Yamaguchi, Soichiro Natsume, Ken Tabuchi, Hirotoshi Kobayashi, Kensei Yamaguchi, Kimitaka Tani, Satoshi Morita, Masaru Miyazaki, Kenichi Sugihara, Yoichi Ajioka
Journal: International Journal of Surgery (2024)

Introduction: Two-stage hepatectomy (TSH) enables patients to undergo surgery for colorectal liver metastasis (CRLM) which one-stage hepatectomy cannot remove. Although the outcome of TSH has been reported, there is no original report from Japan. The aim of this retrospective study was to evaluate the outcome of TSH in Japanese patients with CRLM. Methods: We conducted a retrospective cohort study using the nationwide database that included clinical information of 12,519 patients treated with CRLM between 2005 and 2017 in Japan. The primary outcome measure was overall survival. The second outcome measure was progression-free survival. Fisher’s exact test, chi-squared test and Mann-Whitney U test were conducted to examine an intergroup difference. Univariate and multivariate analyses were performed using Cox regression model. Survival analysis was performed by Kaplan–Meier method and log-rank test. Results: Of the database, 53 patients undergoing TSH using portal vein embolization (PVE) were identified and analyzed. Their morbidity and in-hospital mortality rate at the second hepatectomy were 26.4% and 0.0%. The mean observation period was 21.8 months. The estimated 1-, 3- and 5-year overall survival rate were 92.5%, 70.8% and 34.7%. Multivariate analyses showed that more than 10 liver nodules significantly increased the mortality risk by 4.2-fold (95%CI 1.224-14.99, P = 0.023). Survival analysis revealed that repeat hepatectomy for disease progression after TSH was superior to chemotherapy in overall survival (mean: 49.6 vs. 18.7, months, P = 0.004). Conclusion: In the Japanese cohort, TSH was confirmed to be a safety procedure with acceptable survival outcome. More than 10 liver nodules may be a predictor for unfavorable outcome of patients with CRLM undergoing TSH. Furthermore, repeat hepatectomy can be a salvage treatment for resectable intrahepatic recurrence after TSH.
Associations of cholecystectomy with the risk of gastroesophageal reflux disease: a mendelian randomization study
Authors: Jin Qian, Huawei Xu, Jun Liu, Yihu Zheng
Journal: International Journal of Surgery (2024)

Background: Cholecystectomy is the standard surgery for patients with gallbladder disease, but the impact of cholecystectomy on gastroesophageal reflux disease (GERD) is not clear. Methods: The authors obtained genetic variants associated with cholecystectomy at a genome-wide significant level ( P -value &lt;5×10 -8 ) as instrumental variables (IVs) and performed Mendelian randomization to explore the relationship with GERD. Results: The Inverse Variance Weighted analysis (IVW) showed that the risk of GERD in patients after cholecystectomy increased (OR=2.19; 95% CI: 1.18–4.09). At the same time, the analysis results of weighted median (OR=2.30; 95% CI: 1.51–3.48) and weighted mode (OR=2.21; 95% CI: 1.42–3.45) were also consistent with the direction of the IVW analysis and were statistically significant ( P &lt;0.05). Conclusions: This study shows that patients who have undergone cholecystectomy are a susceptible population of GERD.
VP4-2024: First-in-class PD-1/IL-2 bispecific antibody fusion protein IBI363 in patients (pts) with advanced solid tumors: First-in-human phase I study
Authors: X. Bai, Y. Chen, Y. Chen, X. Liang, H. Wang, Y. Sun, Q. Chu, Y. Pan, J. Cui, J. Fang, W. Zhang, Q. Xu, J. Zhang, X. Liu, G. Dai, L. Kang, N. Li, M. Fang, H. Zhou, T. Liang
Journal: Annals of Oncology (2024)
Substitute or coexistence? mediastinoscopy-assisted versus thoracoscope-assisted esophagectomy in esophageal cancer - a meta-analysis of perioperative outcomes and long-term survival
Authors: Pinhao Fang, Jianfeng Zhou, Yixin Liu, Zhiwen Liang, Yushang Yang, Siyuan Luan, Xin Xiao, Xiaokun Li, Hanlu Zhang, Qixin Shang, Longqi Chen, Xiaoxi Zeng, Yong Yuan
Journal: International Journal of Surgery (2024)

Background: Currently, mediastinoscopy-assisted esophagectomy (MAE) and thoracoscope-assisted esophagectomy (TAE) represent two prevalent forms of minimally invasive esophagectomy extensively employed in the management of esophageal cancer (EC). The aim of this meta-analysis is to assess and compare these two surgical approaches concerning perioperative outcomes and long-term survival, offering valuable insights for refining surgical strategies and enhancing patient outcomes in this field. Methods: Adhering to PRISMA guidelines, the authors systematically searched PubMed, Web of Science, Cochrane Library, Embase, and CNKI databases until 1 March 2024, for studies comparing MAE and TAE. Outcomes of interest included perioperative outcomes (intraoperative outcomes, postoperative recovery, postoperative complications) and survival rates. Statistical analyses were performed using RevMan 5.4, with heterogeneity dictating the use of fixed or random-effects models. Results: A total of 21 relevant studies were finally included. MAE was associated with significantly shorter operation times [mean difference (MD)=−59.58 min, 95% CI: −82.90 to −36.26] and less intraoperative blood loss (MD=−68.34 ml, 95% CI: −130.45 to −6.23). However, MAE resulted in fewer lymph nodes being dissected (MD=−3.50, 95% CI: −6.23 to −0.78). Postoperative recovery was enhanced following MAE, as evidenced by reduced hospital stays and tube times. MAE significantly reduced pulmonary complications [odds ratio (OR)=0.59, 95% CI: 0.44, 0.81] but increased the incidence of recurrent laryngeal nerve injury (OR=1.84, 95% CI: 1.30, 2.60). No significant differences were observed in anastomotic leakage, chylothorax, cardiac complications, wound infections, and gastric retention between MAE and TAE. The long-term survival outcomes showed no statistical difference [hazard ratio (HR)=1.05, 95% CI: 0.71, 1.54]. Conclusions: MAE offers advantages in reducing operation time, blood loss, and specific postoperative complications, particularly pulmonary complications, with a shorter recovery period compared to TAE. However, it poses a higher risk of recurrent laryngeal nerve injury and results in fewer lymph nodes being dissected. No difference in long-term survival was observed, indicating that both techniques have distinct benefits and limitations. These findings underscore the need for personalized surgical approaches in EC treatment, considering individual patient characteristics and tumor specifics.
Comprehensive deep learning-based assessment of living liver donor CT angiography: from vascular segmentation to volumetric analysis
Authors: Namkee Oh, Jae-Hun Kim, Jinsoo Rhu, Woo Kyoung Jeong, Gyu-Seong Choi, Jong Man Kim, Jae-Won Joh
Journal: International Journal of Surgery (2024)

Background: Precise preoperative assessment of liver vasculature and volume in living donor liver transplantation is essential for donor safety and recipient surgery. Traditional manual segmentation methods are being supplemented by deep learning (DL) models, which may offer more consistent and efficient volumetric evaluations. Methods: This study analyzed living liver donors from Samsung Medical Center using preoperative CT angiography data between April 2022 and February 2023. A DL-based 3D residual U-Net model was developed and trained on segmented CT images to calculate the liver volume and segment vasculature, with its performance compared to traditional manual segmentation by surgeons and actual graft weight. Results: The DL model achieved high concordance with manual methods, exhibiting Dice Similarity Coefficients of 0.94±0.01 for the right lobe and 0.91±0.02 for the left lobe. The liver volume estimates by DL model closely matched those of surgeons, with a mean discrepancy of 9.18 mL, and correlated more strongly with actual graft weights (R-squared value of 0.76 compared to 0.68 for surgeons). Conclusion: The DL model demonstrates potential as a reliable tool for enhancing preoperative planning in liver transplantation, offering consistency and efficiency in volumetric assessment. Further validation is required to establish its generalizability across various clinical settings and imaging protocols.