Approach: An open-source online survey was conducted over 2 months with 109 anonymous respondents. The 18-item questionnaire observed whether CS was a recognized phenomenon in academia and medicine. Descriptive statistics were used to summarize the data.

Findings: Of the respondents, 87 (79.8%) were familiar with CS; 81 (74.3%) had personally experienced it, and 92 (84.4%) had observed it in peers. Most reported incidents occurred in non-academic professional workplaces (43.3% and 37%, respectively). The observations corroborated the description of the phenomenon of Career Sabotage.

Insights: The findings provide preliminary support that many professionals recognize and label a pattern of career obstruction as CS. The survey did not investigate whether those who reportedly experienced CS were disproportionately targeted by ethnicity, gender, age, ability, or sexual orientation. These questions and more should form part of future inquiry in understanding CS.

Methods: We conducted a retrospective analysis of the Trauma Quality Program Participant Use File (2017-2019), comprising 27,474 patients from 700 U.S. Trauma Centers. Self-harm/suicide injury (compared to controls) was the dependent variable; presence of metastatic cancer and current chemotherapy were the key independent variables. We adjusted for age, sex, race/ethnicity, method of payment, facility levels, and discharge year (Model 1), and Model 1 plus trauma type, injury location, stay length, comorbidities, Injury Severity Score, and Glasgow Coma Scale (Model 2). We employed chi-square analysis, Fisher's exact test, and unadjusted and adjusted logistic regression using Stata v18, setting statistical significance at P≤0.05.

Results: Of 27,474 patients, 249 (0.91%) reported suicide injuries. Significantly higher attempts were noted among patients with metastatic cancer (201 out of 249; 80.72%) and those not receiving chemotherapy (184 out of 249; 73.90%), P<0.001. Metastatic cancer was associated with higher odds of suicide injuries (unadjusted OR:2.252, 95%CI: 1.642-3.089; adjusted OR in Model 1:1.925, 95%CI:1.302-2.848). Chemotherapy was associated with lower odds of suicide injuries (unadjusted OR:0.408, 95%CI:0.307-0.541; adjusted OR in Model 1:0.444, 95%CI:0.311-0.636). However, neither metastatic cancer nor chemotherapy was significantly associated with suicide injuries in adjusted Model 2, suggesting the crucial role of other factors in influencing this risk.

Conclusion: Patients with metastatic cancer exhibited notable prevalence of suicide injuries. Findings suggested metastatic cancer was associated with higher odds, and chemotherapy with lower odds, of suicide injuries. Multifaceted factors were associated with suicide risk beyond the presence of metastatic cancer or chemotherapy status, underscoring the importance of mental health assessments and interventions in oncology care, particularly for those with advanced cancer.

Design: Retrospective cross-sectional study.

Setting: Tertiary care referral center (Clínica de Tracto Digestivo Superior, Hospital General de México "Dr. Eduardo Liceaga").

Participants: Sixteen adults undergoing esophageal substitution for benign disease between January 2012 and January 2022. Inclusion required complete clinical records and native esophageal histology; cases with malignancy or missing histology were excluded.

Methods: Archived slides from the proximal esophageal margin were reviewed with hematoxylin and eosin and Masson’s trichrome. A semi-quantitative score assessed neutrophilic infiltration, lymphocytic infiltration, collagen deposition, and granulation tissue across mucosa, submucosa, and muscularis (range 0–18), classifying profiles as low risk (≤15) or high risk (≥16). Patients were grouped by presence (CEA) or absence (SEA) of postoperative stenosis. Statistical comparisons used Fisher’s exact test and Mann–Whitney U, with medians (IQR) and exact p-values.

Results: Median total histological scores were higher in CEA than SEA (18 [17–18] vs 12 [9–15]; P=0.014). All stenosis cases were high-risk, whereas 92.3% of non-stenosis cases were low-risk (P=0.007). Individual inflammatory markers were not statistically different between groups; however, collagen deposition and granulation tissue appeared more severe among CEA patients. No meaningful differences in demographic or operative variables were observed.

Conclusion: In this exploratory study, a composite histopathological score identified patients at increased risk of postoperative anastomotic stenosis. The approach may support risk stratification and surveillance in gastrointestinal reconstructive surgery and warrants external validation.

Methods: We conducted a cross-sectional study and included all consecutive patients enrolled in several clinical research studies. We performed the following autonomic dysfunction markers: heart rate variability, heart rate, systolic and diastolic blood pressure changes during NASA Lean Test, cardiopulmonary exercise testing and a Composite-Autonomic-Symptom-Score (COMPASS)-31 scale. We used linear regression to calculate the contribution of each dysautonomia measure on symptom burden as measured by the modified COVID-19 Yorkshire scale.

Results: We included 100 patients for this study. Our sample population had a mean age of 56+/–11 years, included 53% minorities, and 32% were women. Dysautonomia, as defined by an abnormal COMPASS-31, was seen in 82% (95% confidence interval [CI] 72-89) of our study population, while cardiovascular resting dysautonomia, as represented by an abnormal heart rate variability, was seen in 60% (95% CI 48-70) of our study population. Orthostatic hypotension was observed in 12% of our study population, and postural orthostatic tachycardia syndrome (POTS) was found in 10% of our study population. In our adjusted analysis, we found that the beta coefficient for the COMPASS-31 score (0.37) was significant on changes in a self-reported long COVID symptom burden. The orthostatic intolerance and gastrointestinal domains of the COMPASS-31 were associated with the highest long COVID symptom burden.

Conclusion: Dysautonomia is common in long COVID patients and contributes to the overall symptoms seen in long COVID. Identifying dysautonomia has important diagnostic and therapeutic implications.

Methods: Patients with histologically confirmed cervical SCC scheduled for concurrent chemoradiation were recruited (75 cases, alongside 75 age-matched apparently healthy controls, N = 150). Blood samples were collected before treatment and 6 weeks post-external beam radiotherapy to assess serum SCC-Ag levels, which were correlated with tumor stage and grade. Age-matched apparently healthy controls were also phlebotomized at baseline and 12 weeks later to determine normal SCC-Ag levels. Serum SCC-Ag was analyzed using Alinity i SCC reagent and analyzer (Abbott Laboratories, Chicago, IL, USA). The manufacturer's reference value for SCC-Ag is ≤1.5 ng/ml. Treatment response was assessed via pre- and post-treatment abdominopelvic computed tomography scans and classified as either complete or partial response. Data analysis was performed using SPSS v22.0, and logistic regression was used to evaluate predictors of treatment response. A P value <0.05 was considered statistically significant.

Results: The mean age was 55.1 ± 11.6 years for cases and 55.5 ± 11.4 years for controls. Among cervical cancer patients, the median pre-treatment SCC-Ag level was 7.4 ng/ml, and post-treatment was 1.2 ng/ml, both significantly higher than in controls (0.4 ng/ml and 0.5 ng/ml, respectively). Vaginal bleeding was the most common symptom (94.7%), and 68% presented with locally advanced disease. SCC histology was confirmed in 94.7% of cases, and 61% showed either complete or partial treatment response. Median SCC-Ag levels were significantly associated with disease stage (P<0.001) but not with tumor grade (P=0.159). Logistic regression identified tumor size as a significant predictor of treatment response, while pre-treatment SCC-Ag and SCC-Ag reduction rate were not.

Conclusion: Serum SCC-Ag levels were normal among all healthy controls and some patients with prior treatment. SCC-Ag correlated with disease stage but was not predictive of treatment response in patients undergoing chemoradiation. Tumor size was the only significant predictor of treatment response.

Methods: We utilized retrospective data from the ACS-TQP from 2017-2019 (N=27,531). The outcome was the report of physical abuse/assault-related trauma (no/yes). We focused on adults (aged ≥ 18 years) diagnosed with moderate to severe physical trauma (Injury Severity Scale: 9-75) who either had metastatic cancer (exposure) or were currently receiving chemotherapy (intervention), adjusting for predisposing factors and need for care factors based on Anderson's Model of Health Service Utilization. We used descriptive statistics, Fisher's exact test, chi-square analysis, and logistic regression using Stata.v18, with a statistical significance of P≤0.05.

Results: We found 0.19% of 27,531 overall patients reported assault-related trauma, with 16,261 (0.16%) among those with moderate to severe trauma. Among these, a substantial majority with metastatic cancer reported assault-related trauma compared to those without metastatic cancer (84.62% vs. 15.38%; P value: 0.040). Patients receiving chemotherapy reported less frequent assault-related trauma than those not receiving it (26.92% vs. 73.08%; P value = 0.045). In the adjusted model, patients with metastatic cancer had significantly higher odds of reporting assault-related trauma than those without metastatic cancer (OR:7.847; 95% CI: 1.021-60.337; P<0.05). Chemotherapy was associated with a lower adjusted odds of assault-related trauma (OR 0.31, 95% CI: 0.08–1.14), but this did not reach statistical significance.

Conclusion: In this large trauma cohort, metastatic cancer was associated with higher odds of assault-related trauma, while chemotherapy showed a reduced risk only in unadjusted analyses. Our findings highlight the higher vulnerability of patients with metastatic cancer and support further investigation into potential protective associations with active treatment.

Aims: This study analyzed two decades of mortality data to examine the trends, patterns, and disparities in cancer-related and cancer with HF-related deaths across the United States (US).

Methods: Mortality data from 1999 to 2020 were obtained using CDC WONDER, identifying cancer and cancer with HF-related deaths in adults age ≥25 years via ICD-10 codes. Demographic and regional distributions of mortality were analyzed utilizing statistical methods. Joinpoint regression analysis was used to determine trends in age-adjusted mortality rates (AAMR) and annual percentage changes (APC).

Results: Between 1999 and 2020, there were 13,880,876 cancer-related deaths in the US, including 567,657 with HF listed as a cause of death. The AAMR for cancer-related deaths decreased from 343.7 to 252.4 per 100,000 (APC: –1.61% [95% CI: –1.70, –1.57] from 1999 to 2018, then –0.62% to 2020). Cancer with HF-related deaths initially declined (AAMR: 15.0 to 10.2 from 1999–2013) but increased from 2013 to 2020 (APC: +6.03%). Males had higher mortality rates than females for both conditions. Cancer-related mortality was highest among non-Hispanic (NH) Whites and Hispanics, while cancer with HF-related mortality was highest among NH Whites and NH American Indians/Alaska Natives. Geographically, the South had the most cancer-related deaths (37.3%), while the Midwest led in cancer with HF-related deaths (4.5%).

Conclusions: Cancer-related mortality has declined overall, whereas mortality for cancer with co-existing heart failure has risen since 2013 after an initial decline. Disparities persist, with the highest burden in NH Whites, males, and those in rural or underserved areas. The findings underscore the need for focused interventions aimed at reducing mortality related to cancer and cancer with heart failure, particularly among the vulnerable population.

Methods: The study conducted a retrospective analysis of the clinical records of 26 patients treated at the state-owned public utility enterprise on the right of economic ownership "Multi-speciality City Hospital No. 1" of Astana (Kazakhstan) during the period from January 1, 2016 to December 31. 2023.

Results: The mean age of patients was 49.5 years, of whom 69.1% were female. The most common complaints were throbbing tinnitus, hearing impairment, and dizziness. Regional metastases were observed in 15.4% of cases, and one case (3.8%) had a malignant form of paraganglioma with distant metastases to the liver. Most patients (84.6%) underwent surgery with transmastoidal access. Preoperatively, most patients had hearing impairment, both conductive and sensorineural types, as well as mixed. After treatment, deafness on the tumor side was diagnosed in six patients (23%). In the immediate postoperative period, the facial nerve function (I–II degree) was preserved in more than one-third of patients, and significant dysfunction (V-VI degree) was observed in 17.4% of patients. Early postoperative complications were observed in 13% of patients. Recurrence of tumor growth was detected in two patients (7.7%).

Conclusion: This study demonstrates that surgical treatment, complemented by preoperative embolization, is an effective approach for managing middle ear paragangliomas, significantly reducing the risk of bleeding and improving postoperative outcomes.

Methods: We present a case of malignant transformation of LPD, confirmed by histology and imaging, occurring over two decades. This patient was originally diagnosed with uterine atypical smooth muscle tumor but developed frank malignancy during follow-up. An increasingly malignant aggressive disease course resulted in ultimate development of liver and lung metastases almost 23 years after original diagnoses, resulting in her demise. A comprehensive literature review was performed, and 213 cases of LPD were described, including the present case. Patients were divided into G1 (reportedly benign), G2 (malignant at presentation), and G3 (malignant transformation).

Results: Compared to G1, G2 at presentation were more likely to be symptomatic (73%/88%), larger sized (4.1/8.4 cm), and older aged (38/44). In G1, G2, and G3, the average age was 38.5, 44.3, and 37.5 years, respectively; while the disease specific survival was 100%, 71%, and 40%, respectively. The mean number of surgeries performed in G1, G2, and G3 was 1.6, 1.8, and 3.8, respectively. Hormone receptors were found in 24.4% of cases. The mean reported follow-up time in G1, G2, and G3, respectively, was 44.9, 13.1, and 70.5 months. This suggests with longer follow-up, even apparently benign tumors may develop malignancy. The transformation time to malignancy in G3 was 77.8 months, which is more than the average reported follow-up in G1 (44.9 months).

Conclusions: LPD is a potentially malignant condition with long latency prior to transformation. Lifelong surveillance should be considered even in cases originally presumed to be benign. Loss of hormone receptor expression may serve as a marker for this transformation. Circulating Tumor DNA (ctDNA) levels may be associated with development of hematogenous metastases and may be a useful biomarker.

This case series includes three patients with incomplete spinal cord injury, American Spinal Injury Association Impairment Scale, Grade-D, who underwent individualized multimodal pelvic floor rehabilitation programs. Interventions targeted urinary, bowel, and sexual dysfunctions using pelvic floor muscle training, biofeedback, electrical stimulation, tibial nerve stimulation, and sensory retraining strategies. All three patients demonstrated notable improvements in bladder and bowel continence, voluntary voiding, and sexual function. Subjective reports indicated enhanced functional independence and quality of life. Pelvic floor rehabilitation shows promise as an effective therapeutic option for managing neurogenic pelvic floor dysfunction in patients with incomplete spinal cord injury. Further randomized controlled trials are warranted to establish its efficacy and define optimal intervention protocols.

Purpose: To investigate the effects of different ranges of TSH on sustained attention in SCH.

Methods: Included in the study were 136 participants that were divided into four groups: Group 1, 35 healthy individuals; Group 2, 33 newly diagnosed patients with SCH; Group 3, 36 patients on LT-4 with uncontrolled or elevated TSH; Group 4, 32 euthyroid patients (ongoing LT-4). Laboratory measurements and clinical assessment were done. Rapid visual processing (RVP) task was performed on standardized battery (Cambridge Automated Neuropsychological Test Battery).

Results: There was significant impairment in sustained attention (P=<0.05) in Group 2 patients who had neuropsychological symptoms and SCH diagnosed with a TSH range of ≥2.5mIU/L.

Conclusion: Our findings encourage screening for sustained attention along with thyroid profile in those who report neuropsychological symptoms. TSH mean range of ≥2.5 mIU/L was established as a more reasonable threshold for evaluating sustained attention and initiating LT-4 in SCH.

Design: Cross-sectional study.

Setting: Publicly available data on a cohort of women in pregnancy.

Participants: Pregnant women from the cohort.

Methods: The cross-classification of diagnosis by two criteria was evaluated. The individual time-point criterion had a binary outcome (GDM yes/no), while the unified criterion had the four aforementioned outcomes.

Results: Within the low risk (non-GDM) category by the individual time-point criterion, 1 in 85 women would have been deemed at high risk by the unified criterion. More importantly, within the high risk (GDM) category by the individual time-point criterion, 1 in 2 women would have been deemed at low risk by the unified criterion.

Conclusion: The standard criterion is not equivalent to the unified criterion in terms of risk estimation. This is important as the unified criterion correlates with area under the GTT curve known to be associated with glucose excursion and is predictive of the net effect of insulin resistance and beta-cell function.