Purpose
To assess the role of atrial fibrillation (AF) on complicating inpatient outcomes of radical prostatectomy (RP).
Materials and methods
We identified patients treated with RP during 2012–2014 ...within National Inpatient Sample (NIS) database. Length of stay, cost of hospitalization, and in-hospital complications were compared between patients with or without diagnosis of AF. Propensity score matching methods and multivariable regression analysis were used to adjust for potential confounders and a trend analysis was conducted.
Results
Patients with AF had a significantly longer hospital stay (coefficient 0.19, 95% CI 0.09–0.29,
P
< 0.001) and higher cost (coefficient 0.10, 95% CI 0.06–0.15,
P
< 0.001). Post-operative cardiac complications were significantly higher for patients with AF (OR 16.38, 95% CI 7.72–34.74,
P
< 0.001), while no differences were found in other complications between the two groups. Similar results were shown in propensity score matching methods. The cardiac complications after laparoscopic RP (OR: 37.71, 95% CI 1.85–768.73,
P
= 0.018) and open RP (OR: 16.78, 95% CI 1.41–199.51,
P
= 0.026) were significantly higher than robot-assisted RP (RARP) in patients with AF. The results of trend study indicated that postoperative cardiac complication rates showed a trend of decreasing year by year while the prevalence of AF was rising.
Conclusions
Perioperative AF is associated with increased cardiac complications, longer hospital stay and higher cost in PCa patients undergoing RP. RARP may be a preferred choice for patients with AF. Attention should be paid to this special patient population. Reasonable pre-operative risk stratification and standardized management should be done to decrease perioperative complications.
Background
Survival differences between left‐sided colon cancer (LSCC) and right‐sided colon cancer (RSCC) has been previously reported with mixed results, with various study periods not accounting ...for other causes of mortality.
Purpose
We sought to assess the trends in colon cancer cause‐ specific survival (CSS) and overall survival (OS) based on sidedness.
Method
Fine‐Gray competing risk and Cox models were used to analyze Surveillance, Epidemiology, and End Results (SEER) population‐based cohort from 1975 to 2019. Various interval periods were identified based on the timeline of clinical adoption of modern chemotherapy (1975–1989, interval period A; 1990–2004, B; and 2005–2019, C).
Results
Of the 227,637 patients, 50.1% were female and 46.2% were RSCC. RSCC was more common for African Americans (51.5%), older patients (age ≥65; 51.4%), females (50.4%), while LSCC was more common among Whites (53.1%; p < 0.001), younger patients (age 18–49, 64.6%; 50–64, 62.3%; p < 0.001), males (58.1%; p < 0.001). The Median CSS for LSCC and RCC were 19.3 and 16.7 years respectively for interval period A (1975–1989). Median CSS for interval periods B and C were not reached (more than half of the cohort was still living at the end of the follow‐up period). Adjusted CSS was superior for LSCC versus RSCC for the most recent interval period C (HR 0.89; 0.86–0.92; p < 0.001). LSCC consistently showed superior OS for all study periods. Stage stratification showed worse CSS for localized and regional LSCC in the earlier study periods, but the risk attenuated over time. However, left sided distant disease had superior CSS per stage for all interval periods. OS was better for LSCC irrespective of stage, with gradual improvement over time.
Conclusion
LSCC was associated with superior survival compared to right sided tumors. With the adoption of modern chemotherapy regimens, prognosis between LSCC and RSCC became more divergent in favor of LSCC. Colon cancer clinical trials should strongly consider tumor sidedness as an enrollment factor.
Background
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and the coronavirus 19 (COVID‐19) pandemic have had a lasting impact on the care of cancer patients. The impact on patients ...with gastrointestinal (GI) malignancies remains incompletely understood. We aimed to assess the impact of COVID‐19 on mortality, length of stay (LOS), and cost of care among patients with GI malignancies, and identify differences in outcomes based on primary tumor site.
Methods
We analyzed discharge encounters collected from the National Inpatient Sample (NIS) between March 2020 and December 2020 using propensity score matching (PSM) and COVID‐19 as the treatment effect.
Results
Of the 87,684 patient discharges with GI malignancies, 1892 were positive for COVID‐19 (C+) and eligible for matching in the PSM model. Following PSM analysis, C+ with GI tumors demonstrated increased incidence of mortality compared to their COVID‐19‐negative (C‐) counterparts (21.3% vs. 11.9%, p < 0.001). C+ patients with colorectal cancer (CRC) had significantly higher mortality compared to those who were C‐ (40% vs. 24%; p = 0.035). In addition, C+ patients with GI tumors had a longer mean LOS (9.4 days vs. 6.9 days; p < 0.001) and increased cost of care ($26,048.29 vs. $21,625.2; p = 0.001) compared to C‐ patients. C+ patients also had higher odds of mortality secondary to myocardial infarction relative to C‐ patients (OR = 3.54, p = 0.001).
Conclusions
C+ patients with GI tumors face approximately double the odds of mortality, increased LOS, and increased cost of care compared to their C‐ counterparts. Outcome disparities were most pronounced among patients with CRC.
Background: The empirical dietary inflammatory pattern (EDIP) is a hypothesis-driven dietary pattern used to assess the inflammatory potential of diet in the US population. Food-frequency ...questionnaire responses are used to build regression models comparing this dietary information to circulating inflammatory profiles, to help determine which food groups have more or less inflammatory potential on specific individuals. We will eventually use this tool in a cancer patient intervention to modify inflammation and improve chances of survival.
Methods: EDIP scores were calculated for 4 models from 24hr recalls reported by 67 women noncancer controls that had signed an informed consent prior to participation. The Luminex Human Chemokine Multiplex Assay was used to measure 11 chemokines and cytokines. As seen in previous studies, we first derived a model, EDIP-Limited (EDIP-L), by using a reduced rank regression model of all 17 food groups followed by a multivariable regression analysis to identify a dietary pattern that predicts concentrations of two inflammatory biomarkers: IL-6 and TNF-a. We derived a secondary EDIP score using a new model, EDIP-All Inclusive (EDIP-AI), which included the same 17 food groups to predict all 11 circulating biomarkers in our panel. Lastly, we developed two additional EDIP models to test how the biomarker predication may change when we regrouped our food variables from 17 to 14 groupings. EDIP-Limited New (EDIP-LN) used 14 new food groups derived from the same 24hr recalls, only predicting IL-6 and TNF-a. EDIP-All New (EDIP-AN) used those same 14 food groups with all 11 biomarkers.
Results: In this study, we optimize models for EDIP and report the differences in EDIP scores based on the inflammatory biomarkers and food groups used in analysis. Briefly, the components of EDIP-L were not significant. After including all the biomarkers, the components of EDIP-AI were: “fruit juice” (p = 0.0009), “snacks” (p = 0.0008), “leafy green vegetables” (p = 0.0074), “low-energy beverages” (p = 0.0098), “red meat” (p = 0.0038), “fruit” (p = 0.0002) and “whole wheat grains” (p = 0.0138). Similarly, after reorganizing our food items into 14 food groups, the components of EDIP-LN were not significant. However, components of EDIP-AN were: “fruit juice” (p = 0.0107), “snacks” (p = 0.0116) and “fruit” (p = 0.0026).
Conclusions: Findings demonstrate the EDIP scores differ based on the inflammatory biomarkers and food groups used in the analysis on the same noncancer controls. Depending on the methods used, an individual’s diet may be considered more pro- or anti-inflammatory. This study provides insight into the inflammatory potential of an individual’s diet and the factors that may affect how we calculate this potential.
Colorectal cancer (CRC) is the third most common malignancy worldwide. It is projected to increase by 3.2 million new cases and account for 1.6 million deaths by 2040. Mortality is largely due to ...limited treatment options for patients who present with advanced disease. Thus, the development of effective and tolerable therapies is crucial. Chemotherapy has been the backbone of systemic treatment of advanced CRC, but utility has been limited because of invariable resistance to therapy, narrow mechanisms of action, and unfavorable toxicity profile. Tumors that are mismatch repair-deficient have demonstrated remarkable response to immune checkpoint inhibitor therapy. However, most CRC tumors are mismatch repair-proficient and represent an unmet medical need. Although
amplification occurs only in a few cases, it is associated with left-sided tumors and a higher incidence of brain metastasis. Numerous combinations of
inhibitors have demonstrated efficacy, and antibody-drug conjugates against
represent innovative strategies in this area. The
protein has been classically considered undruggable. Fortunately, new agents targeting
mutation represent a paradigm shift in the management of affected patients and could lead the advancement in drug development for the more common
mutations. Furthermore, aberrant DNA damage response is present in 15%-20% of CRCs, and emerging innovative combinations with poly (ADP-ribose) polymerase (PARP) inhibitors could improve the current therapeutic landscape. Multiple novel biomarker-driven approaches in the management of patients with advanced CRC tumors are reviewed in this article.
The implementation of blockchain technology in supply chain finance (BcSCF) offers a conducive way for entrepreneurial financing. Extending the resource-based view (RBV), a traditional perspective ...approach is espoused to trigger scholarly discussions, pining the development of research fronts on Blockchain-as-a-Service (BaaS) in addressing small and medium-sized enterprises (SME) financing constraints. This paper suggests that, despite the operational challenges of blockchains and the necessity to focus on core business activities, BaaS is promising, with significant efforts in terms of cost-savings, efficiency, and reliability with reduced risks. This study provides insight on BaaS contributions to fostering entrepreneurial finance as well as contributing to the literature on the accomplishments of BaaS within BcSCF provisions for particularly Ghanaian SMEs. Therefore, detailed studies into the viability of technologically-enabled types of SME finance are essential, necessitating more research. Resultantly, some forward-thinking research issues for researchers in the disciplines of innovation, technology, entrepreneurship, finance, and decision science have been presented.
Biologically synthesized metallic nanoparticles for catalytic activities in wastewater treatment applications is regarded as a safer alternative to usual physical and chemical methods due to their ...cost-effectiveness, environmental friendliness and easy handling. Recently, research into nanotechnological applications of catalytic and wastewater treatment processes has increased exponentially because of its numerous benefits. This work reviews and summarizes several articles published from 2014 till now concerning biosynthesized nanoparticles and their applications in treating pollutants from wastewater. This review shows that biosynthesized nanoparticles using plant, algae and fungi, microorganisms, enzymes and other biomaterials and polymers have been efficient in removing heavy metals, pathogenic bacteria and organic pollutants, such as dyes, from synthetic wastewaters. This review looks in further detail at significant contributions of biosynthesized nanoparticles in treating pollutants from real wastewater samples, establishing their potency in large-scale real wastewater treatment plants. Comparatively, it is demonstrated that biosynthesized nanoparticles are very promising candidates to treat various contaminants found in wastewater than chemically synthesized nanoparticles, due to smaller sizes in general, good stability, high surface area charge and better photoluminescence emission properties of biosynthesized nanoparticles. Further discussed are the future opportunities of these biosynthesized nanoparticles in contaminant removal. Overall, this review aims to project a rapid developmental path showing a broad overview of recent nanobiotechnologies, applications, and prospects for researchers in nanotechnological fields in wastewater treatment.
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