Endoscopic Management of Concomitant Malignant Biliary and Gastric Outlet Obstruction.

Concurrent malignant biliary and gastric outlet obstruction requires urgent palliative intervention to improve patient quality of life and permit systemic therapy. Traditional management has been surgical gastrojejunostomy and hepaticojejunostomy, two morbid procedures. Comparatively, endoscopic stenting can relieve both sites of obstruction with less complications and quicker recovery.

Synaptive Magnetic Resonance Imaging for Stereotactic Radiosurgery.

Introduction The Synaptive magnetic resonance imaging (MRI) system (Synaptive Medical, Toronto, Canada) is a midfield 0.5 T head-only scanner for imaging the head and neck in adults and pediatrics. The system received US FDA and Health Canada clearance for clinical use in 2020.

Genetic Assessment of Living Kidney Transplant Donors: A Survey of Canadian Practices.

Background: Kidney failure is a prevalent condition with tendency for familial clustering in up to 27% of the affected individuals. Living kidney donor (LKD) transplantation is the optimal treatment option; however, in Canada, more than 45% of LKDs are biologically related to their recipients which subjects recipients to worse graft survival and donors to higher future risk of kidney failure. Although not fully understood, this observation could be partially explained by genetic predisposition to kidney diseases.

Data characterizing a panel of biodegradable cross-linked polyester implants for sustained delivery of an anti-viral drug.

Tenofovir alafenamide (TAF) is currently administered orally to patients for treatment of chronic hepatitis B virus infection and as a part of a combination therapy for human immunodeficiency virus (HIV) infection. A long-acting delivery system could provide several advantages as a formulation strategy for this drug including improved patient adherence, convenience, more consistent drug levels and potentially fewer side effects. To date, the vast majority of polymer-based long-acting delivery systems have been prepared from poly(lactide--glycolide) [1].

Insights into Radiology Publications.

The evolution of modern medicine has been significantly driven by medical and health care research, underscoring the importance of disseminating findings to advance health care. Medical literature, encompassing various publication types such as case reports, review articles, and original research, plays a crucial role in this process by facilitating the communication and discussion of new discoveries. This review article provides a comprehensive guide to understanding and navigating radiologic publications.

Translation of dynamic contrast-enhanced imaging onto a magnetic resonance-guided linear accelerator in patients with head and neck cancer.

Background And Purpose: Magnetic resonance imaging - linear accelerator (MRI-linac) systems permit imaging of tumours to guide treatment. Dynamic contrast enhanced (DCE)-MRI allows investigation of tumour perfusion. We assessed the feasibility of performing DCE-MRI on a 1.

Factors Regulating the Potential for Freshwater Mineral Soil Wetlands to Function as Natural Climate Solutions.

There are increasing global efforts and initiatives aiming to tackle climate change and mitigate its impacts via natural climate solutions (NCS). Wetlands have been considered effective NCS given their capacity to sequester and retain atmospheric carbon dioxide (CO) while also providing a myriad of other ecosystem functions that can assist in mitigating the impacts of climate change. However, wetlands have a dual impact on climate, influencing the atmospheric concentrations of both CO and methane (CH).

Understanding the regulatory-procurement interface for medicines in Africa via publicly available information on standards, implementation, and enforcement in five countries.

Background: Substandard and falsified medicines in Africa are a major public health concern. Access to quality medical products in African countries is governed in large part by two major entities at the national level: the regulatory authority and the procurement agency. The importance of national regulators in ensuring quality medical products is well known.

Photosensitizer spatial heterogeneity and its impact on personalized interstitial photodynamic therapy treatment planning.

Significance: Personalized photodynamic therapy (PDT) treatment planning requires knowledge of the spatial and temporal co-localization of photons, photosensitizers (PSs), and oxygen. The inter- and intra-subject variability in the photosensitizer concentration can lead to suboptimal outcomes using standard treatment plans.

Aim: We aim to quantify the PS spatial variation in tumors and its effect on PDT treatment planning solutions.

Prevalence of post-acute sequelae of SARS-CoV-2 infection in people living with HIV: a systematic review with meta-analysis.

Background: Given the chronic immune activation and inflammatory milieu associated with Long COVID and HIV, we assessed the prevalence of Long COVID in adults living with HIV; and investigated whether adults living with HIV were associated with increased chance of developing Long COVID compared to adults living without HIV.

Methods: In this systematic review and meta-analysis, we searched Medline, EMBASE, CINHAL, PubMed and CENTRAL from inception until June 14th, 2024, for observational studies that measured the prevalence of Long COVID in adults living with HIV and the odds of developing Long COVID following a SARS-CoV-2 infection in people living with HIV compared to people living without HIV. Reviews, case reports, randomised control trials and editorials were excluded.

Identifying biomarker-driven subphenotypes of cardiogenic shock: analysis of prospective cohorts and randomized controlled trials.

Background: Cardiogenic shock (CS) is a heterogeneous clinical syndrome, making it challenging to predict patient trajectory and response to treatment. This study aims to identify biological/molecular CS subphenotypes, evaluate their association with outcome, and explore their impact on heterogeneity of treatment effect (ShockCO-OP, NCT06376318).

Methods: We used unsupervised clustering to integrate plasma biomarker data from two prospective cohorts of CS patients: CardShock (N = 205 [2010-2012, NCT01374867]) and the French and European Outcome reGistry in Intensive Care Units (FROG-ICU) (N = 228 [2011-2013, NCT01367093]) to determine the optimal number of classes.

Impact of Granulocyte Colony-Stimulating Factor (G-CSF) on Clinical Outcomes in Allogeneic Hematopoietic Cell Transplantation: Does Speeding Up Neutrophil Engraftment Make a Difference?

Background: Despite decades of post-allogeneic hematopoietic cell transplantation (HCT) growth factor utilization, its role remains undefined, leading to ongoing debates and research. The theoretical impacts of growth factors have been challenged in numerous studies.

Methods: In this retrospective cohort study conducted at the Princess Margaret Cancer Centre, we analyzed the clinical outcomes of 509 patients who underwent allogeneic HCT between May 1, 2019, and May 31, 2022.

Patient Management Following Percutaneous Coronary Intervention.

Percutaneous coronary intervention (PCI) is a mainstay procedure for the treatment of coronary artery disease. PCI techniques have evolved considerably since the advent of PCI in 1978, and with this evolution in techniques has come changes in the best practices for patient management following PCI. The objective of this review is to provide a comprehensive overview of key considerations in patient management following PCI.

Novel Therapies to Reduce Rehospitalization Risk in Worsening Heart Failure: Systematic Review and Network Meta-Analysis.

Background: Worsening heart failure (WHF) challenges health care with frequent rehospitalizations and reduced quality of life for patients. Despite therapeutic advances, high rehospitalization risks highlight the urgent need for new treatments.

Objectives: This study evaluated the effectiveness of initiating novel therapies during hospitalization or vulnerable phase for WHF patients to reduce rehospitalization risks and determine the optimal treatment sequence.

SGLT2i and Primary Prevention of Cancer Therapy-Related Cardiac Dysfunction in Patients With Diabetes.

Background: Specific cancer treatments can lead to cancer therapy-related cardiac dysfunction (CTRCD). Sodium glucose cotransporter-2 inhibitors (SGLT2is) can potentially prevent these cardiotoxic effects.

Objectives: This study sought to determine whether SGLT2i use is associated with a lower incidence of CTRCD in patients with type 2 diabetes mellitus (T2DM) and cancer, exposed to potentially cardiotoxic antineoplastic agents, and without a prior documented history of cardiomyopathy or heart failure.

Cardiovascular Considerations During Cancer Therapy: Gaps in Evidence and Expert Panel Recommendations.

The administration of certain cancer therapies can be associated with the development of cardiovascular toxicity or complications. This spectrum of toxicities is broad and requires nuanced approaches for prevention, identification, and management. This expert panel summarizes the consensus of opinions of diverse health care professionals in several key areas: 1) cardioprotection involves strategies aimed at the primary prevention of cancer therapy-related cardiovascular toxicity; 2) surveillance entails monitoring for cancer therapy-related cardiovascular toxicity during cancer therapy; 3) permissive cardiotoxicity is the informed continuation of cancer therapy in the presence of cardiovascular toxicity, along with the implementation of mitigating cardiovascular treatments; and 4) special considerations include the invasive management of severe cardiovascular disease in patients receiving treatments for advanced cancer and the exploration of drug-drug interactions in cardio-oncology.

Incident Myocardial Infarction, Heart Failure, and Oncologic Outcomes in Breast Cancer Survivors.

Background: Cardiovascular disease (CVD) is associated with higher rates of incident cancer. Data are scarce regarding the association of incident CVD with oncologic outcomes after a cancer diagnosis.

Objectives: This study sought to determine whether incident myocardial infarction (MI) or heart failure (HF) in breast cancer survivors is associated with oncologic outcomes.

Spatial distribution and subtype-specific expression patterns of Nectin-4 in muscle-invasive bladder cancer.

Objective: To investigate the expression patterns of Nectin-4, the target molecule of the antibody-drug conjugate enfortumab vedotin (EV), in relation to histological and molecular subtypes of urothelial bladder cancer (UBC).

Patients And Methods: We assessed the protein expression patterns of Nectin-4 in a spatially organised tissue microarray containing 1386 tissue cores from 314 consecutive patients with UBC who underwent radical cystectomy (2005-2018). Results were correlated with clinicopathological and follow-up data, as well as with different spatial locations (tumour central vs tumour-normal interface and primary tumour vs lymph node [LN] metastases).

The use of a ChatGPT-4-based chatbot in teledermatology: A retrospective exploratory study.

Background And Objectives: Integration of artificial intelligence in healthcare, particularly ChatGPT, is transforming medical diagnostics and may benefit teledermatology. This exploratory study compared image description and differential diagnosis generation by a ChatGPT-4 based chatbot with human teledermatologists.

Patients And Methods: This retrospective study compared 154 teledermatology consultations (December 2023-February 2024) with ChatGPT-4's performance in image descriptions and diagnoses.

Impact of obesity on outcome in children diagnosed with cancer in Canada: A report from Cancer in Young People in Canada.

Background: Childhood obesity can result in adverse health outcomes. The objectives of this study were to describe the prevalence of obesity and determine the association between obesity at cancer diagnosis and event-free survival (EFS) and overall survival (OS) in children diagnosed with cancer in Canada.

Methods: The authors conducted a retrospective cohort study using the Cancer in Young People in Canada database, including all children with newly diagnosed cancer aged 2-18 years across Canada from 2001 to 2020.

Serratia Infections in Burn Care.

Serratia marcescens is an opportunistic nosocomial pathogen with significant implications for burn care due to its multidrug resistance, virulence, and ability to colonize hospital environments. This retrospective study, conducted at an American Burn Association Verified Burn Centre, reviewed 22 cases of S. marcescens infections from 2015 to 2020.

Overview of Molecular Prognostication for Common Solid Tumor Histologies - What the Surgeon Should Know.

Study Design: Narrative Literature review.

Objective: To provide a general overview of important molecular markers and targeted therapies for the most common neoplasms (lung, breast, prostate and melanoma) that metastasize to the spine and offer guidance on how to best incorporate them in the clinical setting.

Methods: A narrative review of the literature was performed using PubMed, Google Scholar, Medline databases, as well as the histology-specific National Comprehensive Cancer Network guidelines to identify relevant articles limited to the English language.

Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease: An International, Multicenter Delphi Study.

Study Design: Delphi study.

Objective: The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.

Methods: A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons.

A Critical Appraisal of the Application of Frailty and Sarcopenia in the Spinal Oncology Population.

Study Design: Systematic review and clinimetric analysis.

Objectives: Frailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we sought to identify frailty and sarcopenia tools applied in spinal oncology and appraise their clinimetric properties.

Advanced Radiotherapy Technologies in Spine Tumors: What the Surgeon Needs to Know.

Study Design: Narrative review of existing literature.

Objectives: Significant technological advancements in radiotherapy planning and delivery have enabled new radiotherapy techniques for the management of spine tumors. The objective of this study was to provide a comprehensive summary of these treatment techniques for practicing spine surgeons.