Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis.

Background: Studies examining the association of chronic kidney disease (CKD) with cancer risk have demonstrated conflicting results.

Methods: This was an individual participant data meta-analysis including 54 international cohorts contributing to the CKD Prognosis Consortium. Included cohorts had data on albuminuria [urine albumin-to-creatinine ratio (ACR)], estimated glomerular filtration rate (eGFR), overall and site-specific cancer incidence, and established risk factors for cancer.

Bias in neuromodulation studies on chronic pain.

Purpose Of Review: While bias is an integral part of human behavior, bias in clinical research studies may lead to erroneous study conclusions and potentially negative consequences affecting medical care. Bias may influence multiple stages of clinical research and is remarkably prevalent in industry-sponsored studies. Particularly challenging are neuromodulation studies involving patients with chronic pain, whereby industry sponsorship, physicians' conflicts of interest, and patient factors collide to create a highly complex medium that renders clinical research design and interpretation very intricate.

Long-Term Safety and Efficacy of Ultrathin Bioabsorbable-Polymer Sirolimus-Eluting Stents Versus Thin Durable-Polymer Everolimus-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

First-generation drug-eluting stents (DES) with thick polymers may contribute to local vascular inflammation and late stent thrombosis. Thinner-strut DES, particularly those with biodegradable polymers and ultrathin struts, aim to reduce this risk by minimizing flow disturbance and vascular injury. Nonetheless, the long-term safety and efficacy of ultrathin biodegradable polymer sirolimus-eluting stents (BP-SES) compared to durable polymer everolimus-eluting stents (DP-EES) are still uncertain.

Relationship between hypothyroidism, risk of small intestinal bacterial overgrowth, and duodenal microbiome alterations.

Context: There is an association between hypothyroidism and small intestinal bacterial overgrowth (SIBO), but the exact mechanistic link between these two conditions is not fully elucidated.

Objective: We evaluate the incidence and risks of subsequently developing SIBO, and changes in small bowel microbial populations, in subjects with hypothyroidism or autoimmune thyroiditis.

Design And Outcome Measures: Duodenal aspirates from REIMAGINE study subjects with a history of hypothyroidism (hypothyroid group, N=49) and controls (N=323) underwent 16S rRNA sequencing (MiSeq, Illumina); a subset also underwent metagenomic sequencing (NovaSeq6000, Illumina).

Efficacy of Stereotactic Ablative Body Radiotherapy (SABR) in uncommon subtypes of primary kidney cancer: An analysis from the International Radiosurgery Oncology Consortium of the Kidney.

Background: While stereotactic ablative body radiotherapy (SABR) is associated with excellent local control for primary renal cell carcinoma (RCC), outcomes based on clear-cell (ccRCC) and non-clear cell (nccRCC) histologies are not well defined.

Methods And Materials: Individual data of adult patient with biopsy confirmed primary RCC receiving SABR between 2007 and 2021 from 16 institutions in Australia, Canda, Germany, Japan and USA pooled. Patients with metastatic disease or upper tract urothelial carcinoma were excluded.

Anatomic Foundations of Surgery on the Female Perineum.

Although it is difficult to achieve expertise in surgical anatomy of the female perineum, this is essential for patient counseling, clinical decision making, and surgical safety. Education of female pelvic anatomy has often relied on historical illustrations that contain inaccuracies and omissions. Therefore, the Society of Gynecologic Surgeons Pelvic Anatomy Group was established to promote accuracy through standardization of terminology, to explore anatomy through three-dimensional magnetic resonance imaging (MRI) technology, and to disseminate knowledge through the development of a website that uses the human body as a primary source of education.

Audiological outcomes of the Cochlear Osia 2 bone conduction system implanted under expanded indications in a pediatric population.

Objective: Evaluate the audiological outcomes of the Cochlear Osia 2 Bone Conduction System implanted in children ages 5-11 years old.

Design: A pivotal, prospective, open-label, multicentre clinical trial to expand access to the Osia 2 system to children ages 5-11 years old.

Study Sample: Children aged 5-11 years old who presented with either (1) a conductive or mixed hearing loss where the pure tone average bone conduction threshold (measured at 500, 1000, 2000, and 3000 Hz) was ≤ 55 dB HL or (2) single-sided deafness where the ear to be implanted had a profound sensorineural hearing loss and the pure tone average air conduction threshold (measured at 500, 1000, 2000, and 3000 Hz) in the contralateral ear was ≤ 20 dB HL.

Scoping review of family caregiver roles in cancer clinical trial decision-making.

BackgroundCancer clinical trials are vital for improving treatments. Clinical trial decision-making has been examined from the perspectives of patients and oncologists, but caregiver perspectives on clinical trials and roles in patient enrollment decisions remain understudied.MethodsThis scoping review assessed the state of current research on caregiver roles in cancer trial enrollment decision-making.

Decentralized community-integrated research sites drive higher randomization rates: insights from a large-scale neurodegenerative disease trial.

Introduction: Recruitment and retention remain critical challenges in clinical trials, particularly in neurodegenerative diseases, which require large participant populations, rigorous screening, and prolonged follow-up periods. Care Access is a global research site management organization that operates clinical trial sites employing various operational models. This study evaluates the operational performance of Care Access site models-including traditional sites, hub-and-spoke, and decentralized community-integrated research (DCIR) sites-within a Phase 3 neurodegenerative disease trial, focusing on their relative efficiency in recruitment, randomization, and retention.

COVID-19-Induced Flare of Hereditary Angioedema in a Twelve-Year-Old Female Patient.

Hereditary angioedema (HAE) is a rare disorder characterized by recurrent episodes of angioedema, most often due to a deficiency or dysfunction of C1 esterase inhibitor. This deficiency leads to an accumulation of bradykinin, a pro-inflammatory peptide that increases vascular permeability and causes localized swelling. Although some HAE flares occur spontaneously, known triggers include trauma, stress, and infection.

Addition of metronidazole to cefazolin for antibiotic prophylaxis at hysterectomy: a weighted analysis.

Background: The relationship between perioperative antibiotic choice and surgical site infection (SSI) associated with hysterectomy warrants more investigation on a national scale.

Methods: This was a retrospective cohort study utilizing data from the Premier Healthcare Database. Overall, 242,349 patients were identified using CPT codes who underwent hysterectomy for benign indications between January 2000 and March 2020.

Real-world observations of GLP-1 receptor agonists and SGLT-2 inhibitors as potential treatments for Alzheimer's disease.

Introduction: Glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors have potential beneficial effects in Alzheimer's disease (AD).

Methods: We conducted pharmacoepidemiologic studies using two large-scale real-world databases. We fitted covariate-adjusted Cox models to compare the risks of AD among initiators of GLP-1 receptor agonists, SGLT-2 inhibitors, and DPP-4 inhibitors.

PSMA-1-DOTA Potentially for Effective Targeted Radioligand Therapy of Prostate Cancer.

Purpose: While PSMA-targeted radioligand therapy (RLT) has shown remarkable efficacy for treating end-stage prostate cancer, the α-emitting RLT often results in severe salivary gland toxicity, limiting its use. Various strategies to mitigate this side effect have been attempted with limited success. Accordingly, this study introduced a new PSMA-targeting ligand with more favorable binding characteristics than the existing ligands.

Impact of routine repeat echocardiograms in patients hospitalized with acute decompensated heart failure without clear secondary cause.

Transthoracic echocardiography (TTE) at the time of acute decompensated heart failure (ADHF) may reveal significant structural and hemodynamic abnormalities that can guide clinical management. However, the impact of routine repeat TTE in uncomplicated ADHF re-admissions is yet to be established. We studied patients with repeat TTE at the time of rehospitalization for ADHF to determine downstream clinical impact.

Pain localization and response to botulinum toxin in cervical dystonia.

Introduction: Pain is a common symptom of cervical dystonia (CD). The mainstay of treatment of CD is botulinum toxin, which is known to have benefits in relieving pain. We aimed to characterize the locations of pain in patients with CD, and to assess what factors may predict pain reduction following botulinum toxin injection.

Coronary Cannulation Following Transcatheter Aortic Valve Replacement With Self-Expanding Evolut FX+ System: The CANNULATE TAVR II Study.

•The CANNULATE TAVR II is the first prospective study evaluating coronary cannulation following implantation of the self-expanding Evolut FX+ valve, offering a direct comparison with patients treated using the previous-generation Evolut FX platform.•A novel geometric analysis using preprocedural and postprocedural computed tomography imaging was introduced to assess the spatial relationship between valve apertures and coronary ostia, incorporating the left coronary artery-right coronary artery angle and coronary height differences.•Mean time for the cannulation of the right coronary artery was faster with the newer Evolut FX+ platform compared to the previous generation, despite an experienced operator performing the procedures.

County-level modeled extreme heat risk and premature all-cause mortality related to cardio-kidney-metabolic syndrome in the United States: A cross-sectional analysis.

Background: The aim of this study was to evaluate the association between extreme heat waves and age adjusted cardio-kidney-metabolic (CKM) all-cause mortality rate in the US.

Methods: In this cross-sectional study, the county level age adjusted CKM premature (age < 65 years) all-cause mortality rate (CKM aaMR) was collected from the Center for Diseases Control (CDC) WONDER (Wide-ranging Online Data for Epidemiologic Research) (2010-2019). The primary exposure was the 2023 US Federal Emergency Management Agency heat wave risk index (HWRI), a marker of extreme heat event frequency.

Systematic characterization of cell type-specific master metabolic regulators in Alzheimer's disease.

Alzheimer's disease (AD) exhibits metabolic heterogeneity; yet, the consequences on metabolic dynamics in a cell-type-specific manner and the underlying metabolite-sensor network basis remain unclear. Here, we show that neurons exhibit a striking decrease in energy and lipid-related metabolic activity, contrasted by an increase in microglial metabolism associated with neuroinflammation. To identify brain cell-type specific master metabolic regulators underlying the metabolic alterations of AD, we introduce scFUMES (ingle ell nctional tabolite-ensor), an algorithm integrating single-cell RNA sequencing, interactomics (protein-protein interactions), genomics, transcriptomics, and metabolomics from large human brain biobanks.

Palliative Care Resource Utilization in Patients With Prion Disease.

Background And Objectives: Timely access to palliative care, a specialty focusing on improving quality of life for patients with serious medical conditions, is central to patients with prion disease. To optimize evidence-informed utilization of palliative care resources, we systematically evaluated the frequency of clinical features amenable to supportive care, the frequency and patterns of referral to specialty palliative care, and the methods of palliative care delivery in patients with prion disease across a multicenter health care system.

Methods: A retrospective review was conducted on electronic medical records of patients diagnosed with definite (neuropathologically or genetically confirmed) or probable prion disease (meeting established clinical criteria for Creutzfeldt-Jakob disease) in inpatient and outpatient settings from January 2012 to August 2023 across the Mayo Clinic enterprise.

Surgery versus surveillance: A quality-of-life analysis of patients with moderately dilated aortic root or ascending aorta.

Objectives: The impact of diagnosis and management of ascending thoracic aortic aneurysm (ATAA) on patients' quality of life (QoL) is not well characterized. This study aims to compare QoL with surgery versus surveillance in patients with moderate ATAAs.

Methods: Treatment In Thoracic Aortic aNeurysm: Surgery versus Surveillance is a multicentre randomized trial for patients with ATAA between 5.

Defining the Learning Curve in Minimally Invasive Cardiac Surgery: A Systematic Review and Meta-Analysis.

Background: Minimally invasive cardiac surgery (MICS) has become a popular approach due to its potential benefits such as improved cosmesis, faster recovery, shorter hospital stays, and cost effectiveness compared to traditional median sternotomy. However, there have been some concerns regarding procedural efficiency and surgical outcomes especially in the early phase of the learning curve of these procedures.

Methods: In March 2025, a systematic review was conducted using MEDLINE, Embase, the Cochrane Library and Google Scholar databases to identify potential studies that quantitively assessed the learning curve in MICS using pre-defined metrics based on surgical times and/or clinical outcomes.