tbuckley/cabot-search huggingface dataset:
Trends and benefits of early hip arthroplasty for femoral neck fracture in China: a national cohort study
Authors: Yuqing Wang, Qiao Jiang, Huizhong Long, Hu Chen, Jie Wei, Xiaoxiao Li, Haibo Wang, Dongxing Xie, Chao Zeng, Guanghua Lei
Journal: International Journal of Surgery (2024)

Background: Limited studies have examined the benefits of early arthroplasty within 48 h from admission to surgery for femoral neck fractures (FNFs). Using the national inpatient database, the authors aimed to investigate the trends in early arthroplasty within 48 h for FNFs in China and to assess its effect on in-hospital complications and 30-day readmission patterns. Materials and methods: This was a retrospective cohort study. Patients receiving primary total hip arthroplasty (THA) or hemiarthroplasty (HA) for FNFs in the Hospital Quality Monitoring System between 2013 and 2019 were included. After adjusting for potential confounders with propensity score matching, a logistic regression model was performed to compare the differences in in-hospital complications [i.e. in-hospital death, pulmonary embolism, deep vein thrombosis (DVT), wound infection, and blood transfusion], rates and causes of 30-day readmission between early and delayed arthroplasty. Results: During the study period, the rate of early THA increased from 18.0 to 19.9%, and the rate of early HA increased from 14.7 to 18.4% ( P &lt;0.001). After matching, 11 731 pairs receiving THA and 13 568 pairs receiving HA were included. Compared with delayed THA, early THA was associated with a lower risk of pulmonary embolism [odds ratio (OR) 0.51, 95% CI: 0.30–0.88], DVT (OR 0.59, 95% CI: 0.50–0.70), blood transfusion (OR 0.62, 95% CI: 0.55–0.70), 30-day readmission (OR 0.82, 95% CI: 0.70–0.95), and venous thromboembolism-related readmission (OR 0.50, 95% CI: 0.34–0.74). Similarly, early HA was associated with a lower risk of DVT (OR 0.70, 95% CI: 0.61–0.80) and blood transfusion (OR 0.74, 95% CI: 0.68–0.81) than delayed HA. Conclusion: Despite a slight increase, the rate of early arthroplasty remained at a low level in China. Given that early arthroplasty can significantly improve prognosis, more efforts are needed to optimize the procedure and shorten the time to surgery.
Body mass index and the risk of abdominal aortic aneurysm presence and post-operative mortality: a systematic review and dose-response meta-analysis
Authors: Yihao Wu, Hao Zhang, Deying Jiang, Fanxing Yin, Panpan Guo, Xiaoxu Zhang, Jian Zhang, Yanshuo Han
Journal: International Journal of Surgery (2024)

Background: The clinical data regarding the relationships between body mass index (BMI) and abdominal aortic aneurysm (AAA) are inconsistent, especially for the obese and overweight patients. The aims of this study were to determine whether obesity is associated with the presence of AAA and to investigate the quantitative relationship between BMI and the risk of AAA presence and post-operative mortality. Materials and Methods: PubMed, Web of Science and Embase databases were used to search for pertinent studies updated to December 2023. The pooled relative risk (RR) with 95% confidence interval (CI) was estimated by conventional meta-analysis based on random effects model. Dose-response meta-analyses using robust-error meta-regression (REMR) model were conducted to quantify the associations between BMI and AAA outcome variables. Subgroup analysis, sensitivity analysis and publication bias analysis were performed according to the characteristics of participants. Results: 18 studies were included in our study. The meta-analysis showed a higher prevalence of AAA with a RR of 1.07 in patients with obesity. The dose-response meta-analysis revealed a non-linear relationship between BMI and the risk of AAA presence. A “U” shape curve reflecting the correlation between BMI and the risk of post-operative mortality in AAA patients was also uncovered, suggesting the “safest” BMI interval [28.55, 31.05] with the minimal RR. Conclusions: Obesity is positively but nonlinearly correlated with the increased risk of AAA presence. BMI is related to AAA post-operative mortality in a “U” shaped curve, with the lowest RR observed among patients suffering from overweight and obesity. These findings offer a preventive strategy for AAA morbidity and provide guidance for improving the prognosis in patients undergone AAA surgical repair.
The United Kingdom’s First Cardio-Oncology Service
Authors: Maria Sol Andres, Theodore Murphy, Nana Poku, Muhummad Sohaib Nazir, Sivatharshini Ramalingam, John Baksi, Julian W E Jarman, Rajdeep Khattar, Rakesh Sharma, Stuart D Rosen, Alexander R Lyon
Journal: JACC CardioOncology (2024)
Efficacy and safety of neoadjuvant sintilimab in combination with FLOT chemotherapy in patients with HER2-negative locally advanced gastric or gastroesophageal junction adenocarcinoma: an investigator-initiated, single-arm, open-label, phase II study
Authors: Ning Li, Zhi Li, Qiang Fu, Bin Zhang, Jian Zhang, Xiang-Bin Wan, Chao-Min Lu, Jin-Bang Wang, Wen-Ying Deng, Yi-Jie Ma, Liang-Yu Bie, Meng-Yu Wang, Jing Li, Qing-Xin Xia, Chen Wei, Su-Xia Luo
Journal: International Journal of Surgery (2024)

Background: The addition of immune checkpoint inhibitors to neoadjuvant chemotherapy in operable advanced gastric or gastroesophageal junction (G/GEJ) cancer aroused wide interest. This study was designed to assess the efficacy and safety of neoadjuvant sintilimab, a programmed cell death protein-1 (PD-1) inhibitor, in combination with fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy for HER2-negative locally advanced G/GEJ cancer. Methods: Eligible patients with clinical stage cT4 and/or cN+M0 G/GEJ cancer were enroled in this phase II study. Patients received neoadjuvant sintilimab (200 mg every 3 weeks) for three cycles plus FLOT (50 mg/m 2 docetaxel, 80 mg/m 2 oxaliplatin, 200 mg/m 2 calcium levofolinate, 2600 mg/m 2 5-fluorouracil every 2 weeks) for four cycles before surgery, followed by four cycles of adjuvant FLOT with same dosages after resection. The primary endpoint was the pathological complete response (pCR) rate. Results: Thirty-two patients were enroled between August 2019 and September 2021, with a median follow-up of 34.8 (95% CI, 32.8–42.9) months. Thirty-two (100%) patients received neoadjuvant therapy, and 29 underwent surgery with an R0 resection rate of 93.1%. The pCR (TRG0) was achieved in 5 (17.2%; 95% CI, 5.8–35.8%) patients, and the major pathological response was 55.2%. Twenty-three (79.3%) patients had T downstaging, 21 (72.4%) had N downstaging, and 19 (65.5%) had overall TNM downstaging. Six (20.7%) patients experienced recurrence. Patients achieving pCR showed better event-free survival (EFS), disease-free survival (DFS), and overall survival (OS) than non-pCR. The estimated 3-year EFS rate, 3-year DFS rate, and 3-year OS rate were 71.4% (95% CI, 57.2–89.2%), 78.8% (95% CI, 65.1–95.5%), and 70.9% (95% CI, 54.8–91.6%), respectively. The objective response rate and disease control rate were 84.4% (95% CI, 68.3–93.1%) and 96.9% (95% CI, 84.3–99.5%), respectively. Twenty-five (86.2%) received adjuvant therapy. The main grade ≥3 treatment-related adverse events (TRAEs) were lymphopenia (34.4%), neutropenia (28.1%), and leukopenia (15.6%). no patients died from TRAE. The LDH level exhibited a better predictive value to pathological responses than PD-L1 and MSI status. Conclusions: The study demonstrated an encouraging efficacy and manageable safety profile of neoadjuvant sintilimab plus FLOT in HER2-negative locally advanced G/GEJ cancer, which suggested a potential therapeutic option for this population.
High incidence of gallstones after Roux-en-Y reconstruction gastrectomy in gastric cancer: a multicenter, long-term cohort study
Authors: Baoping Zhang, Peng Nie, Yanyan Lin, Zelong Ma, Guogang Ma, Yongjin Wang, Yuhu Ma, Jinyu Zhao, Jinduo Zhang, Ping Yue, Ningzu Jiang, Xianzhuo Zhang, Liang Tian, Linzhi Lu, Jinqiu Yuan, Wenbo Meng
Journal: International Journal of Surgery (2024)

Background: Roux-en-Y reconstruction is a common anastomosis technique during gastrectomy in gastric cancer. There is a lack of studies on gallstones after Roux-en-Y reconstruction gastrectomy. This study investigated the incidence and potential risk factors associated with gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Methods: The study analyzed data from gastric cancer who underwent radical gastrectomy and Roux-en-Y reconstruction at two hospitals between January 2014 and December 2020. The patients fall into distal and total gastrectomy groups based on the extent of gastrectomy. The cumulative event probability curve was plotted using the Kaplan-Meier, and differences in gallstone between groups were evaluated using the Log-Rank. Propensity score matching (PSM) was applied to construct a balanced total versus distal gastrectomies cohort. A Cox regression was employed to analyze the risk factors for gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Further subgroup analysis was performed. Results: 531 patients were included in this study, 201 in the distal gastrectomy group and 330 in the total gastrectomy. During the follow-up, there were 170 cases (32.02%) of developed gallstones, 145 cases of gallstones constituting 85.29% of all gallstones within two years after gastrectomy. Then, to reduce the impact of bias, a 1: 1 propensity score matching analysis was performed on the two groups of patients. A total of 344 patients were evaluated, with each subgroup comprising 172 patients. In the matched population, the Cox regression analysis revealed that females, BMI ≥ 23 kg/m 2 , total gastrectomy, No.12 lymph node dissection, and adjuvant chemotherapy were risk factors for gallstones after Roux-en-Y reconstructive gastrectomy. Subgroup analysis revealed a significantly higher incidence of gallstones after open total gastrectomy than after open distal gastrectomy. Conclusion: Significantly higher incidence of gallstones within two years after Roux-en-Y reconstructive gastrectomy for gastric cancer. Patients with these risk factors should be followed closely after gastrectomy to avoid symptomatic gallstones.
Efficacy and safety of stem cell therapy in patients with dilated cardiomyopathy: An umbrella review of systematic reviews
Authors: Jun Ran, Arkadiusz Dziedzic, Israa Habeeb Naser, Ramaiah Itumalla, Jeetendra Kumar Gupta, Sarvesh Rustagi, Prakasini Satapathy, Mahalaqua Nazli Khatib, Shilpa Gaidhane, Quazi Syed Zahiruddin, Abhay M Gaidhane, Ranjit Sah
Journal: International Journal of Surgery (2024)

Background: Stem cell therapy (SCT) has emerged as a potential therapeutic avenue, with various cell types being explored for their efficacy in treating dilated cardiomyopathy (DCM). However, the safety and efficacy of these therapies have been the subject of numerous systematic reviews. This umbrella review aims to consolidate the existing evidence on stem cell interventions for DCM, providing a comprehensive overview of the current research landscape. Methods: This review was conducted following the JBI and PRISMA guidelines. Systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating the safety and efficacy of SCT for DCM were included. Outcomes such as 6-minute walk test (6-MWT), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), major adverse cardiovascular events (MACE), New York Heart Association (NYHA), and quality of life (QoL), among others, were considered. A literature search was executed across databases like PubMed, Embase, Web of Science, and Cochrane Database up to 7 October 2023. The quality of the included reviews was assessed using the JBI Checklist for Systematic Reviews and Research Syntheses. Data synthesis was carried out in both narrative and tabular formats, with the GRADE criteria guiding the determination of evidence certainty. Results: Nine systematic reviews met the inclusion criteria. LVEF found to be significantly improved with SCT. LVEDD and LVEDV assessments yielded mixed results, with some reviews observing significant changes. Left ventricular end-systolic volume showed consistent reductions across multiple studies. B-type natriuretic peptide concentrations post-interventions were explored in several studies, with mixed findings. Health-related quality of life (HRQL) showed varied results, with some studies noting improvements and others finding no significant differences. NYHA classifications and 6-MWT results indicated potential benefits from stem cell treatments. SCT was observed to be generally safe. The certainty of evidence was low or very low for most of outcomes. Conclusion: SCT showed has shown promise in treating DCM, with many studies highlighting its safety and potential benefits. Nonetheless, the existing data has its limitations due to biases in the RCTs studies. To truly establish the benefits of SCT for DCM, future high-quality RCTS, are crucial.
Nonsurgical risk factors for marginal ulcer following Roux-en-Y gastric bypass for obesity: a systematic review and meta-analysis of 14 cohort studies
Authors: Yi Liang, Chunyun Wang, Lebin Yang, Kewei Yang, Shulun Zhang, Wenbiao Xie
Journal: International Journal of Surgery (2024)

Marginal ulcer (MU) is a common complication of Roux-en-Y Gastric Bypass (RYGB). The primary goal of this meta-analysis was to identify potential risk factors for MU post-RYGB.
Healthcare associated infection management in 62 intensive care units for patients with congenital heart disease in China, a survey study
Authors: Xiaofeng Wang, Shuo Li, Da Huo, Shilin Wang, Wenlong Wang, Hongxia He, Qian Zhang, Jiantao Li, Xu Wang
Journal: International Journal of Surgery (2024)

Objectives: All patients with congenital heart disease (CHD) receive postoperative management in ICUs. Infection prevention and control (IPC) has a significant impact on prognosis. This study provides a preliminary understanding of the fundamental aspects of IPC in ICUs following CHD surgery in China. Methods: From September to October 2023, we initiated a survey on HAI management in hospitals that perform CHD surgeries independently. The questionnaires were jointly completed by the ICU physicians and IPC personnel. Duplicate or unqualified questionnaires were excluded from the study. The contents of our questionnaires covered hospital and ICU capacity, performance of the infection control department, HAI surveillance, implementation of IPC measures, and antimicrobial stewardship (AMS). Qualified questionnaires were compared according to the volume of annual CHD surgeries performed in different ICUs. Group 1 was defined as volume &gt; 300 cases and group 2 was defined as volume ≤300 cases. Results: 62 of the 118 questionnaires were completed, with a response rate of 53%. The CHD surgical volume in 2022 of the 62 hospitals was 36342, accounting for 52% of the annual CHD surgical volume (69672) across the country. The postoperative infection rates obtained from the 15 ICUs varied from 1.3% to 15%, with a median rate of 4.5%. A total of 16 ICUs provided data on drug-resistant bacteria, Klebsiella pneumoniae exhibiting the highest frequency. More than 95% of ICUs have established complete HAI management systems. Information-based HAI surveillance was conducted in 89% of ICUs. Approximately 67% of ICUs stopped prophylactic antibiotics within 48 hours after surgery. In complex cases, carbapenems were administered empirically in 89% of ICUs. Group 1 had an advantage over group 2 in preventing multidrug-resistant organisms (all instruments should be used alone 100% vs. 86%, P =0.047; cleaning and disinfection of environmental surfaces, 100% vs. 81%, P =0.035; antibiotic consumption control 85% vs. 61%, P =0.044) and in preventing surgical site infections (perioperative blood glucose monitoring, 88% vs. 67%, P =0.048). However, Group 1 did not perform well in preventing catheter-related bloodstream infection (delayed catheter removal due to convenience of laboratory tests, 31% vs. 6%, P =0.021) and catheter-associated urinary tract infection (delayed catheter removal due to muscle relaxant administration, 88% vs. 58%, P =0.022). Conclusions: A relatively complete HAI management system has been established throughout the country in ICUs for CHD patients. Information-based surveillance of HAI needs to be promoted, and actions should be taken to facilitate the implementation of IPC measures and AMS bundles. Training and feedback are critical for implementing IPC measures.
Extracellular vesicles purified from serum-converted human platelet lysates offer strong protection after cardiac ischaemia/reperfusion injury
Authors: Dora Livkisa, Tzu-Hsin Chang, Thierry Burnouf, Andreas Czosseck, Nhi Thao Ngoc Le, Gleb Shamrin, Wei-Ting Yeh, Masao Kamimura, David J. Lundy
Journal: Biomaterials (2024)

Extracellular vesicles (EVs) from cultured cells or bodily fluids have been demonstrated to show therapeutic value following myocardial infarction. However, challenges in donor variation, EV generation and isolation methods, and material availability have hindered their therapeutic use. Here, we show that human clinical-grade platelet concentrates from a blood establishment can be used to rapidly generate high concentrations of high purity EVs from sero-converted platelet lysate (SCPL-EVs) with minimal processing, using size-exclusion chromatography. Processing removed serum carrier proteins, coagulation factors and complement proteins from the original platelet lysate and the resultant SCPL-EVs carried a range of trophic factors and multiple recognised cardioprotective miRNAs. As such, SCPL-EVs protected rodent and human cardiomyocytes from hypoxia/re-oxygenation injury and stimulated angiogenesis of human cardiac microvessel endothelial cells. In a mouse model of myocardial infarction with reperfusion, SCPL-EV delivery using echo-guided intracavitary percutaneous injection produced large improvements in cardiac function, reduced scar formation and promoted angiogenesis. Since platelet-based biomaterials are already widely used clinically, we believe that this therapy could be rapidly suitable for a human clinical trial.
All-cause and cause-specific mortality in patients with Behçet disease versus the general population
Authors: Se Rim Choi, Anna Shin, You-Jung Ha, Yun Jong Lee, Eun Bong Lee, Eun-So Lee, Eun Ha Kang
Journal: British Journal of Dermatology (2024)

Lay Summary Behçet disease (BD) is a multisystem vasculitis (inflammation of the blood vessels) of unknown origin that commonly results in oral and genital ulcers, uveitis (eye inflammation) and skin lesions. BD is most prevalent in people from the Mediterranean to East Asia, affecting 0.4% of people in this area. Most lesions go away with time, but more severe forms that involve the cardiovascular and neurological systems can lead to death. It is estimated that people with BD have 1.4 times the risk of dying than the general population. Using large insurance databases in Korea, we investigated the risk of death in people with BD versus age- and sex-matched controls (i.e. people without the disease) from the general population. We found that patients with BD had a 28% greater risk of death than controls over 11.9 years of follow-up, with the highest risk being in first year after diagnosis. Top causes of death in people with BD included cancer, and cardiovascular, gastrointestinal, neurological, genitourinary, respiratory and infectious disease. Further analyses of the data showed that the risk of death in BD is affected by age and sex. In particular, younger patients were more susceptible to death as a result of cardiovascular disease and women were more susceptible to dying of gastrointestinal disease. Our study suggests that there could be an increased risk of death within the first year of being diagnosed with BD and highlights how BD is a systemic disease (i.e. the involvement of any internal organ system could lead to an increase in mortality). Finally, there were unique patterns of cause-specific deaths across subgroups of people with BD.
Prenatal phthalate exposure and adverse birth outcomes in the USA: a prospective analysis of births and estimates of attributable burden and costs
Authors: Leonardo Trasande, Morgan E Nelson, Akram Alshawabkeh, Emily S Barrett, Jessie P Buckley, Dana Dabelea, Anne L Dunlop, Julie B Herbstman, John D Meeker, Mrudula Naidu, Craig Newschaffer, Amy M Padula, Megan E Romano, Douglas M Ruden, Sheela Sathyanarayana, Susan L Schantz, Anne P Starling, Ghassan B Hamra, PB Smith, KL Newby, LP Jacobson, DJ Catellier, R Gershon, D Cella, J Cordero, F Tylavsky, A Mason, Q Zhao, N Bush, KZ LeWinn, K Lyall, H Volk, R Schmidt, JM Kerver, C Barone, C Fussman, N Paneth, M Elliott, R Nguyen, S Swan, C Karr
Journal: The Lancet Planetary Health (2024)

BackgroundPhthalates are synthetic chemicals widely used in consumer products and have been identified to contribute to preterm birth. Existing studies have methodological limitations and potential effects of di-2-ethylhexyl phthalate (DEHP) replacements are poorly characterised. Attributable fractions and costs have not been quantified, limiting the ability to weigh trade-offs involved in ongoing use. We aimed to leverage a large, diverse US cohort to study associations of phthalate metabolites with birthweight and gestational age, and estimate attributable adverse birth outcomes and associated costs.MethodsIn this prospective analysis we used extant data in the US National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program from 1998 to 2022 to study associations of 20 phthalate metabolites with gestational age at birth, birthweight, birth length, and birthweight for gestational age z-scores. We also estimated attributable adverse birth outcomes and associated costs. Mother–child dyads were included in the study if there were one or more urinary phthalate measurements during the index pregnancy; data on child's gestational age and birthweight; and singleton delivery.FindingsWe identified 5006 mother–child dyads from 13 cohorts in the ECHO Program. Phthalic acid, diisodecyl phthalate (DiDP), di-n-octyl phthalate (DnOP), and diisononyl phthalate (DiNP) were most strongly associated with gestational age, birth length, and birthweight, especially compared with DEHP or other metabolite groupings. Although DEHP was associated with preterm birth (odds ratio 1·45 [95% CI 1·05–2·01]), the risks per log10 increase were higher for phthalic acid (2·71 [1·91–3·83]), DiNP (2·25 [1·67–3·00]), DiDP (1·69 [1·25–2·28]), and DnOP (2·90 [1·96–4·23]). We estimated 56 595 (sensitivity analyses 24 003–120 116) phthalate-attributable preterm birth cases in 2018 with associated costs of US$3·84 billion (sensitivity analysis 1·63– 8·14 billion).InterpretationIn a large, diverse sample of US births, exposure to DEHP, DiDP, DiNP, and DnOP were associated with decreased gestational age and increased risk of preterm birth, suggesting substantial opportunities for prevention. This finding suggests the adverse consequences of substitution of DEHP with chemically similar phthalates and need to regulate chemicals with similar properties as a class.FundingNational Institutes of Health.
Immunological response to fractional-dose yellow fever vaccine administered during an outbreak in Kinshasa, Democratic Republic of the Congo: results 5 years after vaccination from a prospective cohort study
Authors: Reena H Doshi, Patrick K Mukadi, Rebecca M Casey, Gabriel M Kizito, Hongjiang Gao, Beatrice Nguete U, Janeen Laven, Lilliane Sabi, Didine K Kaba, Jean-Jacques Muyembe-Tamfum, Terri B Hyde, Steve Ahuka-Mundeke, J Erin Staples
Journal: The Lancet Infectious Diseases (2024)