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Recurrence after colorectal cancer resection is rarely documented in the general population while a key clinical determinant for patient survival. We identified 8785 patients with colorectal cancer diagnosed between 2010 and 2013 and clinically followed up to 2020 in 15 cancer registries from seven European countries (Bulgaria, Switzerland, Germany, Estonia, France, Italy, and Spain). We estimated world age‐standardized net survival using a flexible cumulative excess hazard model. Recurrence rates were calculated for patients with initially resected stage I, II, or III cancer in six countries, using the actuarial survival method. The proportion of nonmetastatic resected colorectal cancers varied from 58.6% to 78.5% according to countries. The overall 5‐year net survival by country ranged between 60.8% and 74.5%. The absolute difference between the 5‐year survival extremes was 12.8 points for stage II (Bulgaria vs Switzerland), 19.7 points for stage III (Bulgaria vs. Switzerland) and 14.8 points for Stage IV and unresected cases (Bulgaria vs. Switzerland or France). Five‐year cumulative rate of recurrence among resected patients with stage I–III was 17.7%. As compared to the mean of the whole cohort, the risk of developing a recurrence did not differ between countries except a lower risk in Italy for both stage I/II and stage III cancers and a higher risk in Spain for stage III. Survival after colorectal cancer differed across the concerned European countries while there were slight differences in recurrence rates. Population‐based collection of cancer recurrence information is crucial to enhance efforts for evidence‐based management of colorectal cancer follow up. [ABSTRACT FROM AUTHOR]

Two totally order relations are defined on the hyperoctahedral group B n . Regarding B n as a Coxeter group of type B, we always use the natural order. By taking B n as a color permutation group, it is convenient to use the r-order. Considering B n as a colored permutation group, Moustakas proved that the Eulerian distribution on the involutions of B n is unimodal, Cao and Liu proved that it is γ -positive, they also proved that the Eulerian distribution on the fixed-point free involutions of B n is symmetric, unimodal and γ -positive. In this paper, we prove that the Eulerian distribution on the fixed-point free involutions of B n is symmetric, unimodal and γ -positive when B n is viewed as Coxeter group of type B. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer (BC) in women under 45 is rare yet often aggressive. We aim to analyze loco-regional recurrences (LR), distant recurrences (DR), second breast cancers, and mortality in young BC patients. Methods: We enrolled 776 women with non-metastatic BC ≤45 years diagnosed from 1970 to 2012. Variables included age, family history, tumor stage/grade, and treatment. We used multivariate Cox regression and competing risk models. Results: Among the participants, 37.0% were diagnosed before the age of 40. Most had stage I or II, grade II, ER- and PR-positive, HER2-negative tumors. Over a median follow-up of 8.7 years, 10.1% experienced LR, 13.7% developed DR, and 10.8% died, primarily due to BC. The majority of recurrences occurred within the first five years. Older age (>40) significantly reduced the risk of LR and DR. Advanced disease stage, certain surgical strategies, and positive margins increased DR risk. In the cohort diagnosed between 2001 and 2012, recent diagnosis, triple-negative cancer, and hormonal therapy were associated with reduced LR risk. Breast-conserving surgery appeared to offer protective effects against DR. Conclusion: This study highlights that BC in young women carries a significant risk of early recurrence, with age, tumor characteristics, and treatment modalities influencing outcomes. The findings emphasize the need for tailored treatment strategies for young BC patients, focusing on surgical precision and aggressive adjuvant therapy for high-risk cases. This research contributes valuable insights into managing BC in younger patients, aiding in improving long-term outcomes. [ABSTRACT FROM AUTHOR]

Introduction/purpose: The Collatz conjecture has been considered and the stopping time needed for the recursive transformation to end has been investigated. Methods: A statistical analysis on the stopping time has been used. Results: The statistical approach shows that the probability of finding an infinite stopping time, that is a violation of the Collatz conjecture, is extremely low. Conclusion: Picking precisely one particular atom in the Universe is still more favorable, by more than 61 orders of magnitude, than encountering an infinite total stopping time.

Abstract Background Low back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Most LBP episodes have a favourable prognosis, but recurrences within a year are common. Despite the individual and societal impact related to LBP recurrences, there is limited evidence on effective strategies for secondary prevention of LBP and successful implementation of intervention programmes in a real-world context. The aim of this study is to analyse the effectiveness of a tailored exercise and behavioural change programme (MyBack programme) in the secondary prevention of LBP; and evaluate acceptability, feasibility and determinants of implementation by the different stakeholders, as well as the implementation strategy of the MyBack programme in real context. Methods This protocol describes a hybrid type I, randomized controlled trial to evaluate the effectiveness and implementation of MyBack programme in the context of primary health care. The Behaviour Change Wheel framework and FITT-VP principles will inform the development of the behaviour change and exercise component of MyBack programme, respectively. Patients who have recently recovered from an episode of non-specific LBP will be randomly assigned to MyBack and usual care group or usual care group. The primary outcome will be the risk of LBP recurrence. The secondary outcomes will include disability, pain intensity, musculoskeletal health, and health-related quality of life. Participants will be followed monthly for 1 year. Costs data related to health care use and the MyBack programme will be also collected. Implementation outcomes will be assessed in parallel with the effectiveness study using qualitative methods (focus groups with participants and health providers) and quantitative data (study enrolment and participation data; participants adherence). Discussion To our knowledge, this is the first study assessing the effectiveness and implementation of a tailored exercise and behaviour change programme for prevention of LBP recurrences. Despite challenges related to hybrid design, it is expected that data on the effectiveness, cost-effectiveness, and implementation of the MyBack programme may contribute to improve health care in patients at risk of LBP recurrences, contributing to direct and indirect costs reduction for patients and the health system. Trial registration number NCT05841732.

Abstract Background Clostridioides difficile infections (CDIs) and recurrences (rCDIs) remain a major public health challenge due to substantial mortality and associated costs. This study aims to generate real-world evidence on the mortality and economic burden of CDI in Germany using claims data between 2015 and 2019. Methods A longitudinal and matched cohort study using retrospective data from Statutory Health Insurance (SHI) was conducted in Germany with the BKK database. Adults diagnosed with CDI in hospital and community settings between 2015 and 2018 were included in the study. Patients had a minimum follow-up of 12-months. All-cause mortality was described at 6-, 12-, and 24-months. Healthcare resource usage (HCRU) and associated costs were assessed at 12-months of follow-up. A cohort of non-CDI patients matched by demographic and clinical characteristics was used to assess excess mortality and incremental costs of HCRU. Up to three non-CDI patients were matched to each CDI patient. Results A total of 9,977 CDI patients were included in the longitudinal cohort. All-cause mortality was 32%, 39% and 48% at 6-, 12-, and 24-months, respectively, with minor variations by number of rCDIs. When comparing matched CDI (n = 5,618) and non-CDI patients (n = 16,845), CDI patients had an excess mortality of 2.17, 1.35, and 0.94 deaths per 100 patient-months, respectively. HCRU and associated costs were consistently higher in CDI patients compared to non-CDI patients and increased with recurrences. Total mean and median HCRU cost per patient during follow-up was €12,893.56 and €6,050 in CDI patients, respectively, with hospitalisations representing the highest proportion of costs. A total mean incremental cost per patient of €4,101 was estimated in CDI patients compared to non-CDI patients, increasing to €13,291 in patients with ≥ 3 rCDIs. Conclusions In this real-world study conducted in Germany, CDI was associated with increased risk of death and substantial costs to health systems due to higher HCRU, especially hospitalisations. HCRU and associated costs were exacerbated by rCDIs.

Given that glioma cells tend to infiltrate and migrate along WM tracts, leading to demyelination and axonal injuries, Diffusion Tensor Imaging (DTI) emerged as a promising tool for identifying major "high-risk areas" of recurrence within the peritumoral brain zone (PBZ) or at a distance throughout the adjacents white matter tracts. Of our systematic review is to answer the following research question: In patients with brain tumor, is DTI able to recognizes within the peri-tumoral brain zone (PBZ) areas more prone to local (near the surgical cavity) or remote recurrence compared to the conventional imaging techniques?. We conducted a comprehensive literature search to identify relevant studies in line with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. 15 papers were deemed compatible with our research question and included. To enhance the paper's readability, we have categorized our findings into two distinct groups: the first delves into the role of DTI in detecting PBZ sub-regions of infiltration and local recurrences (n = 8), while the second group explores the feasibility of DTI in detecting white matter tract infiltration and remote recurrences (n = 7). DTI values and, within a broader framework, radiomics investigations can provide precise, voxel-by-voxel insights into the state of PBZ and recurrences. Better defining the regions at risk for potential recurrence within the PBZ and along WM bundles will allow targeted therapy. [ABSTRACT FROM AUTHOR]

Recurrences or persistent symptoms after an initial episode of diverticulitis are common, yet surgical treatment is rarely performed. Current guidelines lack clear recommendations on whether or not to operate, even though recent studies suggest an improved quality of life following surgery. The aim of this study is therefore to compare quality of life in patients with recurrent or ongoing diverticulitis treated conservatively versus surgically, giving a more definitive answer to the question of whether or not to operate on these patients. A systematic literature search was conducted in EMBASE, MEDLINE and Cochrane. Only comparative studies reporting on quality of life were included. Statistical analysis included calculation of weighted mean differences and pooled odds ratios. Five studies were included; two RCT's and three retrospective observational studies. Compared to conservative treatment, the SF-36 scores were higher in the surgically treated group at each follow-up moment but only the difference in SF-36 physical scores at six months follow-up was statistically significant (MD 6.02, 95%CI 2.62–9.42). GIQLI scores were also higher in the surgical group with a MD of 14.01 (95%CI 8.15-19.87) at six months follow-up and 7.42 (95%CI 1.23–12.85) at last available follow-up. Also, at last available follow-up, significantly fewer recurrences occurred in the surgery group (OR 0.10, 95%CI 0.05–0.23, p < 0.001). Although surgery for recurrent diverticulitis is not without risk, it might improve long-term quality of life in patients suffering from recurrent- or ongoing diverticulitis when compared to conservative treatment. Therefore, it should be considered in this patient group. [ABSTRACT FROM AUTHOR]

Simple Summary: Meningiomas are the most common primary benign tumor of the central nervous system, and, despite their prevalent benign nature, they exhibit variable tendency to recur during the lifetime, even after multiple reoperations, adjuvant radiation treatment and several years, posing a significant challenge of management. While well-defined risk factors of recurrence have been identified, the topographic pattern after surgery has scarcely been investigated. Nevertheless, the possibility of theoretically predicting the site of recurrence provides a significant advantage for a multidisciplinary team during the decision-making process regarding the strategy of treatment at the first surgery. The authors performed a comprehensive and detailed systematic literature review on the topographic pattern of recurrence after surgical treatment for intracranial meningiomas. Background: While several risk factors for recurrences have been defined, the topographic pattern of meningioma recurrences after surgical resection has been scarcely investigated. The possibility of theoretically predicting the site of recurrence not only allows us to better understand the pathogenetic bases of the disease and consequently to drive the development of new targeted therapies, but also guides the decision-making process for treatment strategies and tailored follow-ups to decrease/prevent recurrence. Methods: The authors performed a comprehensive and detailed systematic literature review of the EMBASE and MEDLINE electronic online databases regarding the topographic pattern of recurrence after surgical treatment for intracranial meningiomas. Demographics and histopathological, neuroradiological and treatment data, pertinent to the topography of recurrences, as well as time to recurrences, were extracted and analyzed. Results: Four studies, including 164 cases of recurrences according to the inclusion criteria, were identified. All studies consider the possibility of recurrence at the previous dural site; three out of four, which are the most recent, consider 1 cm outside the previous dural margin to be the main limit to distinguish recurrences closer to the previous site from those more distant. Recurrences mainly occur within or close to the surgical bed; higher values of proliferation index are associated with recurrences close to the original site rather than within it. Conclusions: Further studies, including genomic characterization of different patterns of recurrence, will better clarify the main features affecting the topography of recurrences. A comparison between topographic classifications of intracranial meningioma recurrences after surgery and after radiation treatment could provide further interesting information. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a common health condition and the leading cause of years lived with disability worldwide. Most LBP episodes have a favourable prognosis, but recurrences within a year are common. Despite the individual and societal impact related to LBP recurrences, there is limited evidence on effective strategies for secondary prevention of LBP and successful implementation of intervention programmes in a real-world context. The aim of this study is to analyse the effectiveness of a tailored exercise and behavioural change programme (MyBack programme) in the secondary prevention of LBP; and evaluate acceptability, feasibility and determinants of implementation by the different stakeholders, as well as the implementation strategy of the MyBack programme in real context. Methods: This protocol describes a hybrid type I, randomized controlled trial to evaluate the effectiveness and implementation of MyBack programme in the context of primary health care. The Behaviour Change Wheel framework and FITT-VP principles will inform the development of the behaviour change and exercise component of MyBack programme, respectively. Patients who have recently recovered from an episode of non-specific LBP will be randomly assigned to MyBack and usual care group or usual care group. The primary outcome will be the risk of LBP recurrence. The secondary outcomes will include disability, pain intensity, musculoskeletal health, and health-related quality of life. Participants will be followed monthly for 1 year. Costs data related to health care use and the MyBack programme will be also collected. Implementation outcomes will be assessed in parallel with the effectiveness study using qualitative methods (focus groups with participants and health providers) and quantitative data (study enrolment and participation data; participants adherence). Discussion: To our knowledge, this is the first study assessing the effectiveness and implementation of a tailored exercise and behaviour change programme for prevention of LBP recurrences. Despite challenges related to hybrid design, it is expected that data on the effectiveness, cost-effectiveness, and implementation of the MyBack programme may contribute to improve health care in patients at risk of LBP recurrences, contributing to direct and indirect costs reduction for patients and the health system. Trial registration number: NCT05841732. Highlights: • LBP recurrences are common and account for a significant proportion of the costs and disability associated with low back pain. However, evidence on secondary prevention of LBP remains scarce. • A hybrid effectiveness-implementations design will be used to analyse the effectiveness, cost-effectiveness, and implementation of an exercise and behavior change programme in primary care. • Mixed method will used to analyze the implementation strategies. This data could inform the refinement of the implementation strategy and promote the adoption of the MyBack programme in the future. • This study data may improve the delivery of care in people at risk of recurrence and bring important benefits to individuals and society. [ABSTRACT FROM AUTHOR]

In this study, k-Oresme polynomials with negative indices, which are the generalization of Oresme polynomials, were examined and defined. By examining the algebraic properties of recently defined polynomial sequences, some important identities were given. The matrices of negative indices k-Oresme polynomials was defined. Some sum formulas were given according to this definition. [ABSTRACT FROM AUTHOR]

In this paper, we introduce dual numbers with components including Leonardo number sequences. This novel approach facilitates our understanding of dual numbers and properties of Leonardo sequences. We also investigate fundamental properties and identities associated with Leonardo number sequences, such as Binet's formula and Catalan's, Cassini's and D'ocagne's identities. Furthermore, we also introduce a dual vector with components including Leonardo number sequences and dual angles. This extension not only deepens our understanding of dual numbers, it also highlights the interconnectedness between numerical sequences and geometric concepts. In the future it would be valuable to replicate a similar exploration and development of our findings on dual numbers with Leonardo number sequences. [ABSTRACT FROM AUTHOR]

Background: Clostridioides difficile infections (CDIs) and recurrences (rCDIs) remain a major public health challenge due to substantial mortality and associated costs. This study aims to generate real-world evidence on the mortality and economic burden of CDI in Germany using claims data between 2015 and 2019. Methods: A longitudinal and matched cohort study using retrospective data from Statutory Health Insurance (SHI) was conducted in Germany with the BKK database. Adults diagnosed with CDI in hospital and community settings between 2015 and 2018 were included in the study. Patients had a minimum follow-up of 12-months. All-cause mortality was described at 6-, 12-, and 24-months. Healthcare resource usage (HCRU) and associated costs were assessed at 12-months of follow-up. A cohort of non-CDI patients matched by demographic and clinical characteristics was used to assess excess mortality and incremental costs of HCRU. Up to three non-CDI patients were matched to each CDI patient. Results: A total of 9,977 CDI patients were included in the longitudinal cohort. All-cause mortality was 32%, 39% and 48% at 6-, 12-, and 24-months, respectively, with minor variations by number of rCDIs. When comparing matched CDI (n = 5,618) and non-CDI patients (n = 16,845), CDI patients had an excess mortality of 2.17, 1.35, and 0.94 deaths per 100 patient-months, respectively. HCRU and associated costs were consistently higher in CDI patients compared to non-CDI patients and increased with recurrences. Total mean and median HCRU cost per patient during follow-up was €12,893.56 and €6,050 in CDI patients, respectively, with hospitalisations representing the highest proportion of costs. A total mean incremental cost per patient of €4,101 was estimated in CDI patients compared to non-CDI patients, increasing to €13,291 in patients with ≥ 3 rCDIs. Conclusions: In this real-world study conducted in Germany, CDI was associated with increased risk of death and substantial costs to health systems due to higher HCRU, especially hospitalisations. HCRU and associated costs were exacerbated by rCDIs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Rapid growth patterns and recurrence with variable rates have been reported in the literature, making mucinous cystadenomas different from other ovarian benign neoplasms. The study aimed to predict and prevent recurrence based on the obtained results. STUDY DESIGN: In this case-control study among the 2,341 patients who underwent surgery for ovarian cysts, 221 met the inclusion criteria. The 221 patients diagnosed with mucinous cystadenoma were categorized into two groups: 14 patients (6.3%) with recurrence and 207 patients (93.7%) without recurrence. Patients in these groups were compared in terms of demographic characteristics, ovarian cyst size, operative technique, type of surgery (oophorectomy or cystectomy), Ca19-9, CA125, and CEA values of the patients, and duration of postoperative follow-up. RESULTS: The mean age was statistically lower in the group with recurrence (27±5 vs 44±14; p<0.001). The follow-up period of recurrent cases was significantly longer (6.8 ± 3.5 vs 4.9 ± 2.2 years; p=0.045). The recurrence rate was significantly higher in patients who underwent cystectomy (p<0.001; odds ratio: 22.8). When all patients were examined, cystectomy was preferred in younger patients [31 (18-65) vs 48 (18-81); p<0.001]. According to regression analysis, cystectomy alone is an independent risk factor (p=0.041). CONCLUSION: Unlike conventional ovarian cystadenomas, mucinous cystadenomas should be followed up owing to the possibility of recurrence, especially when detected at an early age. Since cystectomy is the only independent risk factor, oophorectomy should be the primary treatment for patients >40 years of age who have no desire for childbearing. [ABSTRACT FROM AUTHOR]

In this paper, we introduce dual numbers with components including Leonardo number sequences. This novel approach facilitates our understanding of dual numbers and properties of Leonardo sequences. We also investigate fundamental properties and identities associated with Leonardo number sequences, such as Binet's formula and Catalan's, Cassini's and D'ocagne's identities. Furthermore, we also introduce a dual vector with components including Leonardo number sequences and dual angles. This extension not only deepens our understanding of dual numbers, it also highlights the interconnectedness between numerical sequences and geometric concepts. In the future it would be valuable to replicate a similar exploration and development of our findings on dual numbers with Leonardo number sequences.

We determine the order of magnitude of the variance of the Fibonacci partition function. The answer is different to the most naive guess. The proof involves a diophantine system and an inhomogeneous linear recurrence. For a video summary of this paper, please visit https://youtu.be/nTeO_6Chqbo. [ABSTRACT FROM AUTHOR]

Objective: Persistent postural–perceptual dizziness (PPPD) is a syndrome described as secondary, when it is the consequence of an organic disorder (s-PPPD), or primary, when no somatic triggers can be identified. We evaluated a group of patients diagnosed as s-PPPD, with Benign Positional Paroxysmal Vertigo (BPPV) as the main somatic trigger, with the aim of identifying the predictive clinical elements of evolution towards PPPD. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: We evaluated 126 patients diagnosed with PPPD; 54 patients were classified as p-PPPD (43%) and 72 as s-PPPD (57%). Of these, 51 patients had BPPV as a somatic trigger of PPPD, and in this group, we evaluated the prevalence of some clinical features (age, sex, latency between the onset of BPPV and the final diagnosis, recurrence of BPPV and the presence of migraine headache) for comparison with a group of patients who suffered from BPPV without an evolution towards PPPD (control group). Results: In the group with PPPD secondary to BPPV, we found a significantly higher mean age and a longer latency between the onset of BPPV and the final diagnosis compared to the control group. No difference between the two groups was found regarding sex, recurrence rate and the presence of migraine headache. Conclusions: The parameters most involved as potential precipitants of PPPD after BPPV were the age of the patients and a long latency between the onset of BPPV and the final diagnosis; the mean age of the subjects who developed PPPD following BPPV was significantly higher. These findings lead us to emphasize the importance of the early identification and treatment of BPPV, especially in older patients. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to investigate the clinical characteristics of pediatric patients diagnosed with supraventricular tachycardia (SVT) and assess their shortterm prognosis. Materials and Methods: Data from 213 patients diagnosed with SVT between 2010 and 2015 at the Department of Pediatric Cardiology, Bursa Uludag University Faculty of Medicine, were retrospectively reviewed. Results: The ratio of male to female patients was 1: 1.25. Regarding treatment response and prognosis, the recurrence rate of SVT attacks was higher in males. The most common complaint at the time of diagnosis was palpitation. Furthermore, 17.8% of patients were diagnosed due to tachycardia detected during routine check-ups; almost all were under one year of age. In 56.3% of patients, the initial diagnosis was made at the pediatric emergency clinic. In acute treatment, 30% of patients were treated with vagal maneuvers; 61% had their attacks terminated, while 41% received drug therapy. Adenosine was the most used drug, and it successfully terminated attacks in 79% of patients receiving it. In the evaluation of patients' follow-ups after the initial attack, 56.3% of patients experienced recurrences, and 71% of second attacks occurred within the first three months. Prophylactic drug therapy was initiated in 94.4% of patients, with an average duration of 2.5±1.6 years. After treatment discontinuation, 75.4% of patients remained symptom-free, while 24.6% experienced SVT attacks again. Electrophysiological studies were performed in 16.9% of patients at another centers, and ablation was applied to 15.5%. Conclusion: Patients with SVT may be asymptomatic during infancy and vagal stimulation and adenosine response was quite good in acute treatment. Prophylactic medical treatment was effective in children whose weight is <15 kg and the recurrences were low after discontinuation especially in infants. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate various therapeutic approaches, identify potential predictive factors for the recurrence and development of hypothyroidism, and examine specific clinical and laboratory characteristics of patients with subacute thyroiditis (SAT) due to SARS-CoV-2 infection. Methods: We retrospectively analyzed the medical records of 226 patients with confirmed SAT diagnosed from January 2020 to November 2022. Results: The mean age was 48.01 ± 0.75 years, and the F/M ratio was 2.3/1. At the end of the follow-up period, 69 patients (32.1%) had developed hypothyroidism. Treatment duration was significantly shorter with nonsteroidal anti-inflammatory drugs (NSAIDs) (17.40 ± 2.56 days), while time-to-symptom relief was shorter with glucocorticoids (CGs). Recurrence was observed only in those treated with corticosteroid preparations (14.1%). C-reactive protein levels at treatment discontinuation were higher in patients who experienced SAT recurrence, while the coexistence of Hashimoto's thyroiditis was a significant predictive factor for the development of hypothyroidism. The TSH value at the time of treatment withdrawal >4.12 μIU/mL showed optimal sensitivity and specificity for the prediction of permanent hypothyroidism. Regarding COVID-19, 34 patients (15%) experienced related SAT, with similar clinical manifestations of the disease but a higher BMI and shorter time-to-symptom relief. Conclusion: In conclusion, GCs administration alleviated acute symptoms earlier during the onset of SAT, whereas NSAIDs had a shorter treatment duration, and both regimens could not prevent the development of delayed hypothyroidism. The clinical characteristics of SAT due to COVID-19 infections were similar to those of typical SAT disease. [ABSTRACT FROM AUTHOR]

Background: Presently, there are few published reports on postoperative radiation therapy for oropharyngeal and oral cavity cancers treated with IMRT/VMAT technique. This study aimed to assess the oncological outcomes of this population treated with postoperative VMAT in our institution, with a focus on loco-regional patterns of failure. Material and methods: Between 2011 and 2019, 167 patients were included (40% of oropharyngeal cancers, and 60% of oral cavity cancers). The median age was 60 years. There was 64.2% of stage IV cancers. All patients had both T and N surgery. 34% had a R1 margin, 42% had perineural invasion. 72% had a positive neck dissection and 42% extranodal extension (ENE). All patients were treated with VMAT with simultaneous integrated boost with three dose levels: 66Gy in case of R1 margin and/or ENE, 59.4-60Gy on the tumor bed, and 54Gy on the prophylactic areas. Concomittant cisplatin was administrated concomitantly when feasible in case of R1 and/or ENE. Results: The 1- and 2-year loco-regional control rates were 88.6% and 85.6% respectively. Higher tumor stage (T3/T4), the presence of PNI, and time from surgery >45 days were significant predictive factors of worse loco-regional control in multivariate analysis (p=0.02, p=0.04, and p=0.02). There were 17 local recurrences: 11 (64%) were considered as infield, 4 (24%) as marginal, and 2 (12%) as outfield. There were 9 regional recurrences only, 8 (89%) were considered as infield, and 1 (11%) as outfield. The 1- and 2-year disease-free survival (DFS) rates were 78.9% and 71.8% respectively. The 1- and 2-year overall survival (OS) rates were 88.6% and 80% respectively. Higher tumor stage (T3/T4) and the presence of ENE were the two prognostic factors significantly associated with worse DFS and OS in multivariate analysis. Conclusion: Our outcomes for postoperative VMAT for oral cavity and oropharyngeal cancers are encouraging, with high rates of loco-regional control. However, the management of ENE still seems challenging. [ABSTRACT FROM AUTHOR]

In this study, we have examined q− central Delannoy numbers and their Cauchy products. We have given some related equalities using the properties of recurrence relations. Moreover, using quantum integers, we have obtained the fundamental identities provided by Cauchy products of central Delannoy numbers.

Abstract Introduction Despite HLA-B27-associated uveitis is one of the most frequent etiologies of uveitis worldwide, there are scarce studies on the clinical spectrum of this disease and the implications of therapeutic strategies used in the Latin-American population, with none conducted in Colombia. Thus, this study aimed to describe the clinical characteristics of a cohort of patients with positive HLA-B27-associated uveitis in Colombia and evaluate the impact of systemic treatment on the recurrence rate. Methods We retrospectively reviewed 490 clinical charts of patients with uveitis, searching for those with positive HLA-B27-associated uveitis over eight years in a referral center in Bogotá, Colombia. We used descriptive statistics to summarize demographic and clinical characteristics and conducted a Chi-square test, Fisher Exact test, Spearman correlation, and Mann–Whitney test to assess associations between treatment strategies and the recurrences rate. Results We analyzed 39 patients (59% females) with positive HLA-B27-associated uveitis, with a median age at the first consultation of 44.5 years (Range: 2–80) and a mean follow-up time of 86.4 weeks (1.65 years). Most patients had unilateral uveitis (53.8%) and an anterior anatomical diagnosis (76.6%); two had anterior chamber fibrinous reaction, and only one had hypopyon. Most patients did not show associated systemic symptoms (66.7%). Topical corticosteroids, NSAIDs, methotrexate, mydriatics, and adalimumab were the most used treatments. The most common complications included cataracts, posterior synechiae, and macular edema. We identified that the rate of recurrences decreases over time (r = -0.6361, P = 0.002571), and this decrease seems to be associated with the initiation of disease-modifying antirheumatic drugs (DMARDs) in chronic and recurrent cases. Conclusion The clinical spectrum of HLA-B27-associated uveitis in Colombian patients is distinct from other latitudes. Notably, we found a female predominance, older age at presentation, higher frequency of bilateral and vitreous involvement, and lower frequency of concomitant systemic diseases. Additionally, our results suggest that DMARDs such as methotrexate and biologic agents are good therapeutic options to avoid recurrences in chronic and recurrent cases.

This paper gives a detailed study of a new generation of dual Jacobsthal and dual Jacobsthal-Lucas numbers using dual numbers. Also some formulas, facts and properties about these numbers are presented. In addition, a new dual vector called the dual Jacobsthal vector is presented. Some properties of this vector apply to various properties of geometry which are not generally known in the geometry of dual space. Finally, this study introduces the dual Jacobsthal and the dual Jacobsthal-Lucas numbers with coefficients of dual numbers. Some fundamental identities are demonstrated, such as the generating function, the Binet formulas, the Cassini's, Catalan's and d'Ocagne identities for these numbers.

Hava Izci,1 Gilles Macq,2 Tim Tambuyzer,2 Harlinde De Schutter,2 Hans Wildiers,1,3 Francois P Duhoux,4 Evandro de Azambuja,5 Donatienne Taylor,6 Gracienne Staelens,7 Guy Orye,8 Zuzana Hlavata,9 Helga Hellemans,10 Carine De Rop,11 Patrick Neven,1,3 Freija Verdoodt2 1KU Leuven - University of Leuven, Department of Oncology, Leuven, B-3000, Belgium; 2Belgian Cancer Registry, Research Department, Brussels, Belgium; 3University Hospitals Leuven, Multidisciplinary Breast Center, Leuven, B-3000, Belgium; 4Department of Medical Oncology, King Albert II Cancer Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium; 5Institut Jules Bordet and l’Université Libre de Bruxelles (U.L.B), Brussels, Belgium; 6CHU UCL Namur, Site Sainte-Elisabeth, Namur, Belgium; 7Multidisciplinary Breast Center, General Hospital Groeninge, Kortrijk, Belgium; 8Department of Obstetrics and Gynecology, Jessa Hospital, Hasselt, Belgium; 9Department of Medical Oncology, CHR Mons-Hainaut, Mons, Hainaut, Belgium; 10Department of Obstetrics and Gynaecology, AZ Delta, Roeselaere, Belgium; 11Department of Obstetrics and Gynaecology, Imelda Hospital, Bonheiden, BelgiumCorrespondence: Hava Izci, KU Leuven, Department of oncology, Herestraat 49 Box 7003-06, Leuven, 3000, Belgium, Email hava.izci@kuleuven.bePurpose: High-quality population-based cancer recurrence data are scarcely available, mainly due to complexity and cost of registration. For the first time in Belgium, we developed a tool to estimate distant recurrence after a breast cancer diagnosis at the population level, based on real-world cancer registration and administrative data.Methods: Data on distant cancer recurrence (including progression) from patients diagnosed with breast cancer between 2009– 2014 were collected from medical files at 9 Belgian centers to train, test and externally validate an algorithm (i.e., gold standard). Distant recurrence was defined as the occurrence of distant metastases between 120 days and within 10 years after the primary diagnosis, with follow-up until December 31, 2018. Data from the gold standard were linked to population-based data from the Belgian Cancer Registry (BCR) and administrative data sources. Potential features to detect recurrences in administrative data were defined based on expert opinion from breast oncologists, and subsequently selected using bootstrap aggregation. Based on the selected features, classification and regression tree (CART) analysis was performed to construct an algorithm for classifying patients as having a distant recurrence or not.Results: A total of 2507 patients were included of whom 216 had a distant recurrence in the clinical data set. The performance of the algorithm showed sensitivity of 79.5% (95% CI 68.8– 87.8%), positive predictive value (PPV) of 79.5% (95% CI 68.8– 87.8%), and accuracy of 96.7% (95% CI 95.4– 97.7%). The external validation resulted in a sensitivity of 84.1% (95% CI 74.4– 91.3%), PPV of 84.1% (95% CI 74.4– 91.3%), and an accuracy of 96.8% (95% CI 95.4– 97.9%).Conclusion: Our algorithm detected distant breast cancer recurrences with an overall good accuracy of 96.8% for patients with breast cancer, as observed in the first multi-centric external validation exercise.Keywords: machine learning, breast cancer, distant metastases, recurrences, algorithm, administrative data

Background: Recurrence or persistence of tuberculous lymphadenitis even after treatment occurs due to paradoxical immune response, non-tubercular mycobacterial (NTM) infection, drug resistance tuberculosis or because of misdiagnosis. In these situations sometimes the patients are asked to continue category-1 more than six months on the basis repeat fine needle aspiration cytology (FNAC) findings. This study evaluated the cause of persistence or appearance of new lymph node after anti-TB category-1. Methods: This observational study was done from January, 2013 to March, 2014 after getting ethical clearance from Bangabandhu Sheikh Mujib Medical University (BSMMU). Patients who had persistent or new lymphadenitis after completing anti-TB category-1 for six months were selected. After analysis of treatment records, patients were selected for either FNAC or biopsy with local surgical clearance. Cyto/histopathological analysis, AFB stain (LED fluorescent), AFB culture (MGIT and L-J media) and GeneXpert test was done. Follow-up of the patients were done after two weeks and six months of FNA/surgery. Results: Thirty-two patients (M/F=11/21) with mean age 25(±12) years were investigated. Altogether 26 cases (81.25%) were confirmed as tuberculous lymphadenitis and six (18.75%) were non-tuberculous (03 lymphomas, 01 sarcoidosis, 01 reactive lymphadenitis and 01 pyogenic abscess). Among the TB patients, granuloma was present in 23 cases (88.46%) (FNA-07, biopsy-16). Twenty-three (88.46%) cases were GeneXpert positive, comprising 21 rifampicin sensitive and 02 rifampicin resistant. One rifampicin resistant case was confirmed by culture and the remaining 25 were culture negative. One case was AFB stain positive and no NTM was found in AFB culture. After surgery, rapid healing was observed within two weeks among tuberculous lymphadenitis patients. Conclusions: Persistent granuloma after anti-TB category-1 does not indicate active tuberculosis if it is culture negative. It may occur due to immunological reaction against dead bacilli in deep seated sinus. Local surgical clearance results rapid recovery and other diagnosis should be excluded without further continuation of anti-TB category-1. [ABSTRACT FROM AUTHOR]

The aim of this study is to define an algorithm for the management of odontogenic keratocysts (OKCs) in order to reduce the recurrence rate (RR), morbidity and to analyse relapse risk factors. This article is a 10-years retrospective study on 67 patients treated for odontogenic keratocysts with different surgical options established on clinical and radiological evaluations. Recurrence free survival (RFS) and relapse risk factors were analysed with Kaplan-Meier method and log-rank tests, with a confidence interval set at 95 %. A literature research was performed using PubMed to find the most relevant and recent papers about the argument. Fifty-five subjects were included: 38 out of 55 patients presented the disease only once, while the others 17 patients presented at least one relapse. The total amount of histological examined lesions and relative surgical procedures was 75. More aggressive treatments showed lower recurrence rate but higher morbidity; more conservative ones had better functional and aesthetic outcomes but higher recurrence rate. Considering the literature, conservative treatments plus adjuvant procedures can reduce the RR. The recurrence rate was estimated to be 25.3 % with a median time to relapse of 24 months. Multilocularity resulted a negative prognostic factor significantly associated with recurrence free survival (p = 0.048). According to our results and to the literature, we propose a management algorithm from diagnosis to treatment of the OKCs based on dimensions and internal arrangement of lesions, type (primary lesion or recurrence), presence of bony erosions, noble structure/teeth involvement. Multilocularity represented a statistically significant risk factor for relapse. [ABSTRACT FROM AUTHOR]

In this study, we have examined q- central Delannoy numbers and their Cauchy products. We have given some related equalities using the properties of recurrence relations. Moreover, using quantum integers, we have obtained the fundamental identities provided by Cauchy products of central Delannoy numbers. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether a seasonal distribution of the frequency of exudative age-related macular degeneration (wet AMD) recurrences exists. Methods: In total, 129 eyes with 171 recurrences in patients suffering from wet AMD were included in the study. All the patients had been treated with intravitreal anti-VEGF injections according to Pro Re Nata treatment regimen. Recurrence was defined as the re-detection of sub-retinal fluid, intraretinal fluid, and/or sub-macular hemorrhage in optical coherence tomography scans, after at least two consecutive monthly examinations with a "dry" macula. The year was divided in three 4-month periods (zone A: June–September, zone B: October–January, and zone C: February–May) based on the weather conditions prevailing in each period. Mean temperature and hours of sunlight exposure were the main weather markers recorded. Results: Eighty-two recurrences (48%) occurred during the period June–September, 50 (29.2%) during the period October–January, and 39 (22.8%) during the period February–May (Chi-square = 17.5, p < 0.001). Among the groups, neither patients' age (78 ± 8 years A, 76 ± 7 years B, and 79 ± 8 years C, p = 0.15) nor gender status (40% men A, 36% men B, and 51% men C, p = 0.35) differed significantly. Mean temperature was 27.6 ± 1.8 °C, 15.1 ± 4.6 °C, and 16.5 ± 4.4 °C in zones A, B, and C, respectively. Hours (h) of sunlight exposure (average hours/month) were 344 ± 34 h, 188 ± 42 h, and 223 ± 57 h in zones A, B, and C. Conclusion: We demonstrated that the frequency of wet AMD recurrences is significantly elevated during the warmer months, possibly due to the higher levels of UV radiation and mean temperature. Further research is necessary to validate our findings. [ABSTRACT FROM AUTHOR]

Introduction: Despite HLA-B27-associated uveitis is one of the most frequent etiologies of uveitis worldwide, there are scarce studies on the clinical spectrum of this disease and the implications of therapeutic strategies used in the Latin-American population, with none conducted in Colombia. Thus, this study aimed to describe the clinical characteristics of a cohort of patients with positive HLA-B27-associated uveitis in Colombia and evaluate the impact of systemic treatment on the recurrence rate. Methods: We retrospectively reviewed 490 clinical charts of patients with uveitis, searching for those with positive HLA-B27-associated uveitis over eight years in a referral center in Bogotá, Colombia. We used descriptive statistics to summarize demographic and clinical characteristics and conducted a Chi-square test, Fisher Exact test, Spearman correlation, and Mann–Whitney test to assess associations between treatment strategies and the recurrences rate. Results: We analyzed 39 patients (59% females) with positive HLA-B27-associated uveitis, with a median age at the first consultation of 44.5 years (Range: 2–80) and a mean follow-up time of 86.4 weeks (1.65 years). Most patients had unilateral uveitis (53.8%) and an anterior anatomical diagnosis (76.6%); two had anterior chamber fibrinous reaction, and only one had hypopyon. Most patients did not show associated systemic symptoms (66.7%). Topical corticosteroids, NSAIDs, methotrexate, mydriatics, and adalimumab were the most used treatments. The most common complications included cataracts, posterior synechiae, and macular edema. We identified that the rate of recurrences decreases over time (r = -0.6361, P = 0.002571), and this decrease seems to be associated with the initiation of disease-modifying antirheumatic drugs (DMARDs) in chronic and recurrent cases. Conclusion: The clinical spectrum of HLA-B27-associated uveitis in Colombian patients is distinct from other latitudes. Notably, we found a female predominance, older age at presentation, higher frequency of bilateral and vitreous involvement, and lower frequency of concomitant systemic diseases. Additionally, our results suggest that DMARDs such as methotrexate and biologic agents are good therapeutic options to avoid recurrences in chronic and recurrent cases. [ABSTRACT FROM AUTHOR]

This paper gives a detailed study of a new generation of dual Jacobsthal and dual Jacobsthal-Lucas numbers using dual numbers. Also some formulas, facts and properties about these numbers are presented. In addition, a new dual vector called the dual Jacobsthal vector is presented. Some properties of this vector apply to various properties of geometry which are not generally known in the geometry of dual space. Finally, this study introduces the dual Jacobsthal and the dual Jacobsthal-Lucas numbers with coefficients of dual numbers. Some fundamental identities are demonstrated, such as the generating function, the Binet formulas, the Cassini's, Catalan's and d'Ocagne identities for these numbers. [ABSTRACT FROM AUTHOR]

Intracranial hemangiopericytomas are rare vascular tumours, account for less than 1% of all primary tumours of the central nervous system. This tumour usually found outside of CNS i.e., lower extremities and retroperitoneum. Treatment is surgery followed by radiotherapy to decrease chances of recurrences. This is a case report of a young female diagnosed with intracranial hemangiopericytoma in 2021 at our hospital-Acharya Tulsi Regional Cancer Institute, Bikaner. [ABSTRACT FROM AUTHOR]

BackgroundPresently, there are few published reports on postoperative radiation therapy for oropharyngeal and oral cavity cancers treated with IMRT/VMAT technique. This study aimed to assess the oncological outcomes of this population treated with postoperative VMAT in our institution, with a focus on loco-regional patterns of failure.Material and methodsBetween 2011 and 2019, 167 patients were included (40% of oropharyngeal cancers, and 60% of oral cavity cancers). The median age was 60 years. There was 64.2% of stage IV cancers. All patients had both T and N surgery. 34% had a R1 margin, 42% had perineural invasion. 72% had a positive neck dissection and 42% extranodal extension (ENE). All patients were treated with VMAT with simultaneous integrated boost with three dose levels: 66Gy in case of R1 margin and/or ENE, 59.4-60Gy on the tumor bed, and 54Gy on the prophylactic areas. Concomittant cisplatin was administrated concomitantly when feasible in case of R1 and/or ENE.ResultsThe 1- and 2-year loco-regional control rates were 88.6% and 85.6% respectively. Higher tumor stage (T3/T4), the presence of PNI, and time from surgery >45 days were significant predictive factors of worse loco-regional control in multivariate analysis (p=0.02, p=0.04, and p=0.02). There were 17 local recurrences: 11 (64%) were considered as infield, 4 (24%) as marginal, and 2 (12%) as outfield. There were 9 regional recurrences only, 8 (89%) were considered as infield, and 1 (11%) as outfield. The 1- and 2-year disease-free survival (DFS) rates were 78.9% and 71.8% respectively. The 1- and 2-year overall survival (OS) rates were 88.6% and 80% respectively. Higher tumor stage (T3/T4) and the presence of ENE were the two prognostic factors significantly associated with worse DFS and OS in multivariate analysis.ConclusionOur outcomes for postoperative VMAT for oral cavity and oropharyngeal cancers are encouraging, with high rates of loco-regional control. However, the management of ENE still seems challenging.

AimThis study aimed to evaluate the capacity of a genetic risk score (GRS) for coronary artery disease (CAD) independent of classical cardiovascular risk factors to assess the risk of recurrence in patients with first myocardial infarction. The secondary aim was to determine the predictive value of this GRS.MethodsWe performed a meta-analysis of individual data from three studies, namely, a prospective study including 75 patients aged

Objective: To study the epidemiological, clinical and evolutionary characteristics of autoimmune dysthyroidism in the endocrinology-diabetes department of the CNHU-HKM. Material and method: This was a descriptive and analytical cross-sectional study of patients seen for thyroid pathology in the endocrinology diabetology department over a 10-year period. Patients with at least one abnormal TSH and positive anti-thyroid antibodies were included. Results: Over the study period, we recorded 2883 consultants, 347 of them having thyroid diseases, including 69 cases of autoimmune dysthyroidism divided into 54 cases of Graves' disease and 15 cases of Hashimoto's disease. Autoimmune dysthyroidism represented 2.39% of consultations and 19.89% of thyroid disorders. Graves' disease and Hashimoto's disease accounted for 1.87% (54 cases) and 0.52% (15 cases) of consultations respectively. Autoimmune dysthyroidism was more frequent in the 30-40 and 40-50 age groups. The most frequent symptoms of Graves' disease were asthenia (94.4%), weight loss (87.0%) and tachycardia (85.2%). In Hashimoto's disease, the main symptoms were asthenia (86.66%), goiter (66.6%) and weight gain (60%). High initial R-TSH antibody levels and iatrogenic hypothyroidism were found to be factors associated with extended follow-up of Graves' disease beyond 18 months. Conclusion: Autoimmune dysthyroidism is a frequent condition, with Graves' disease predominating. Their evolution under therapy is influenced by clinical, biological and ultrasonographic factors. [ABSTRACT FROM AUTHOR]

In this paper, we define a function Q which gives the sequence of partial sums of the Fibonacci quaternion sequence (Q n). We provide an identity about Q k which is the sequence obtained by applying Q to (Q n) k -times. [ABSTRACT FROM AUTHOR]

Papillary thyroid carcinoma is the most common thyroid malignant tumor and usually has a fine prognosis. The most common metastatic site is the cervical lymph node, and distant metastasis is rare. This report describes a female patient with papillary thyroid carcinoma who presented with multiple metastases in the cervical lymph nodes, breast, and spine. The patient's disease course lasted 11 years, and eventually metastatic cancer led to the patient's death. We also analyzed the survival rate and median survival time of papillary thyroid carcinoma with multiple organ metastases using data in the literature. [ABSTRACT FROM AUTHOR]

We study recurrence relations satisfied by the moments λn (z) of discrete linear functionals whose first moment satisfies a holonomic differential equation. We consider all cases when the order of the ODE is less or equal than 3. [ABSTRACT FROM AUTHOR]

Background: Surgery is an essential part of hidradenitis suppurativa (HS) treatment. Understanding and reducing surgical recurrence are crucial to obtaining the best results in patients' treatment. Objective: The aim of the study was to characterize surgical recurrences in a cohort of patients with HS treated with wide excision and second-intention healing. Methods: A prospective nested case-control study was conducted. A cohort of patients with HS treated with wide excision and second-intention healing was monitored for 68 weeks. The surgical procedure was classified as case (recurrence) or control (no recurrence). The type of recurrence was classified according to the elementary lesion in tunnel or abscess and inflammatory nodule (AN) recurrence. Sociodemographic and clinical data likely related to recurrence and the type of recurrence were evaluated. Results: Sixty-three patients were included, receiving a total of 82 surgical procedures. The mean age of the patients was 36.18 years, and the surgical site presented a Hurley stage II severity in 79.26% (65/82) of the interventions. Tunnel recurrence was observed in 8.5% (7/82) and AN recurrence in 15.85% (13/82) of the interventions. Obesity was associated with a higher risk of recurrence, for both tunnel and AN recurrence. Hurley III at the surgical site, a history of pilonidal sinus, and higher International Hidradenitis Suppurativa Severity Score System (IHS4) after surgery and at week 68 increased the risk of tunnel recurrence. Conclusion: We propose classifying surgical recurrence based on the elemental type of lesion. Tunnel recurrence could originate in the depth of the surgical scar and could be associated with both surgical site factors and inflammatory load. AN recurrence could originate in the borders of the surgical scar and may particularly benefit from preoperative ultrasound. [ABSTRACT FROM AUTHOR]

The aim of this work is to consider the bicomplex third-order Jacobsthal numbers and to present some properties involving this sequence, including the Binet-style formulae and the generating functions. Furthermore, Cassini's identity and d'Ocagne's identity for this type of bicomplex numbers are given, and a different way to find the nth term of this sequence is stated using the determinant of a four-diagonal matrix whose entries are bicomplex third-order Jacobsthal numbers. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine whether autotransfusion of salvaged blood with single leukoreduction is associated with post-transplant tumor recurrence in patients with advanced hepatocellular carcinoma (HCC). Background: Previous studies have consistently demonstrated the safety of autotransfusion of salvaged and leukoreduced blood during liver transplantation for HCC. However, the effects of this technique remained unknown for advanced HCC. Methods: Of 349 patients who underwent living donor liver transplantation for advanced HCC: 74 of 129 without autotransfusion were matched with 74 of 220 with autotransfusion using propensity score based on tumor biology, allogeneic transfusion, and others. Survival analysis was performed with death as a competing risk event. The primary outcome was HCC recurrence. Results: Recipients in autotransfusion group received 811 (497–1247) mL of salvaged blood with single leukoreduction. In the matched cohort, cumulative overall recurrence probability at 1/2/5 years after transplantation was 24.6%/ 38.3%/39.7% for nonautotransfusion group and 16.2%/23.1%/32.5% for autotransfusion group. There were no significant differences between the 2 groups in overall recurrence [hazard ratio (HR) = 0.72 (0.43–1.21)], intrahepatic recurrence [HR = 0.70 (0.35–1.40)], and extrahepatic recurrence [HR = 0.82 (0.46–1.47)]. Also, there were no significant differences in overall death [HR = 0.57 (0.29–1.12)], HCC-related death [HR = 0.59 (0.29–1.20)], and HCC-unrelated death [HR = 0.48 (0.09–2.65)]. Conclusions: When allogeneic transfusion was matched, autotransfusion was not significantly related to HCC recurrence, with more favorable probabilities for autotransfusion, in patients with advanced HCC. Thus, blood salvage and autotransfusion could be safely used with single leukoreduction, without double-filtered leukoreduction, during liver transplantation for HCC with potential benefits from avoiding allogeneic red blood cell transfusion. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the patterns, predictors, and survival of recurrent disease following esophageal cancer surgery. Background: Survival of recurrent esophageal cancer is usually poor, with limited prospects of remission. Methods: This nationwide cohort study included patients with distal esophageal and gastroesophageal junction adenocarcinoma and squamous cell carcinoma after curatively intended esophagectomy in 2007 to 2016 (follow-up until January 2020). Patients with distant metastases detected during surgery were excluded. Univariable and multivariable logistic regression were used to identify predictors of recurrent disease. Multivariable Cox regression was used to determine the association of recurrence site and treatment intent with postrecurrence survival. Results: Among 4626 patients, 45.1% developed recurrent disease a median of 11 months postoperative, of whom most had solely distant metastases (59.8%). Disease recurrences were most frequently hepatic (26.2%) or pulmonary (25.1%). Factors significantly associated with disease recurrence included young age (≤65 y), male sex, adenocarcinoma, open surgery, transthoracic esophagectomy, nonradical resection, higher T-stage, and tumor positive lymph nodes. Overall, median postrecurrence survival was 4 months [95% confidence interval (95% CI): 3.6–4.4]. After curatively intended recurrence treatment, median survival was 20 months (95% CI: 16.4–23.7). Survival was more favorable after locoregional compared with distant recurrence (hazard ratio: 0.74, 95% CI: 0.65–0.84). Conclusions: This study provides important prognostic information assisting in the surveillance and counseling of patients after curatively intended esophageal cancer surgery. Nearly half the patients developed recurrent disease, with limited prospects of survival. The risk of recurrence was higher in patients with a higher tumor stage, nonradical resection and positive lymph node harvest. [ABSTRACT FROM AUTHOR]

Background: Little attention has been paid to playing position as a risk factor for recurrence after arthroscopic Bankart repair (ABR) in soccer players. Purpose: To compare return to sport, functional outcomes, and recurrence after ABR between goalkeepers and field position players in soccer. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective comparative cohort study was performed in soccer players who underwent ABR between January 2017 and December 2019. The minimum clinical follow-up was 2 years. Functional outcomes included the Rowe score, visual analog scale (VAS) for pain, and shoulder-dependent sports ability measured with the Athletic Shoulder Outcome Scoring System (ASOSS). The difference between the post- and preoperative scores was calculated; rate and level of return to sport, recurrent instability, and revisions were also evaluated according to position played. Results: A total of 70 position players and 11 goalkeepers met the study criteria. Postoperative functional outcomes were significantly improved in both groups as compared with baseline (P <.001 for both), although the position players achieved significantly greater pre- to postoperative improvement (ΔVAS, –2 vs 0 points [ P =.029]; ΔRowe, 45 vs 30 points [ P =.046]; ΔASOSS, 45 vs 40 points [ P =.028]). While all players returned to soccer, only 55% (n = 6) of goalkeepers returned to the same level versus 93% of field players (P =.003). The overall rate of recurrent instability was 8.6% but was significantly higher among goalkeepers (27.2% vs 5.7%; P =.049), and the odds of goalkeepers having a recurrence were significantly higher than field position players (odds ratio, 8.5 [95% CI, 1.2-57.2]; P =.027). Conclusion: Although the results of ABR were generally favorable in all soccer players, goalkeepers had significantly worse functional outcomes, a lower rate of return to the same level of sport, and a higher recurrence rate as compared with field position players. [ABSTRACT FROM AUTHOR]

Summary. Erysipelas is considered as one of the most dangerous diseases, which in most cases is caused by a bacterial pathogen and manifests itself in the form of inflammation of the skin with varying intensity and symptoms of endogenous intoxication. Early detection of the disease and the prescription of pathogenetically sound treatment – the key to success in the treatment of this pathology. The aim of the study – to establish the features of modern erysipelas. Materials and Methods. The study used data from literature sources and processed 147 case histories from archival documents. The comparison groups were comparable by age, sex, localization of inflammatory foci, disease multiplicity, disease severity, seasonality. In this work we followed the clinical classification of erysipelas according to V. L. Cherkasov. The obtained data were processed on personal computers by the EXCEL-2003 application package. Results. Patients were divided into three groups: with primary, with recurrent and repeated erysipelas. Women predominated among the patients. The largest number of patients was hospitalized in summer and spring – 47 patients, in summer – 73, in autumn – 15 and in winter – 12, so in the summer-autumn period erysipelas develops more than three or four times more often (81.6 %) than in winter-spring (18.3 %). According to the multiplicity of the disease, the division is as follows: primary erysipelas – 101 (68.7 %), significantly predominates over other forms, recurrent – 30 (20.5 %) and repeated – 16 (10.8 %). The severity of the disease in 58.5% of respondents was moderate. Among clinical forms, erythematous form was diagnosed in 49.7 % of patients, erythematous-bullous – in 24.5 %, erythematous-hemorrhagic and bullous-hemorrhagic – in 25.8 %. Conclusions. Erysipelas was more common in women, had a clear summer-autumn seasonality. Primary erythema infection is registered mainly, the erythematous form is much more often than hemorrhagic. Moderate to severe prevails over mild and severe. Most often, the inflammatory process affects the lower extremities. The clinical picture is characterized by intoxication syndrome. Complications develop infrequently, and only local

Cervical cancer is the most common gynecologic malignancy and the fourth most common cancer in women worldwide. Over the last two decades, minimally invasive surgery (MIS) emerged as the mainstay in the surgical management of cervical cancer, bringing advantages such as lower operative morbidity and shorter hospital stay compared to open surgery while maintaining comparable oncologic outcomes in numerous retrospective studies. However, in 2018, a prospective phase III randomized controlled trial, “Laparoscopic Approach to Carcinoma of the Cervix (LACC)”, unexpectedly reported that MIS was associated with a statistically significant poorer overall survival and disease-free survival compared to open surgery in patients with early-stage cervical cancer. Various hypotheses have been raised by the authors to try to explain these results, but the LACC trial was not powered to answer those questions. In this study, through an exhaustive literature review, we wish to explore some of the potential causes that may explain the poorer oncologic outcomes associated with MIS, including the type of MIS surgery, the size of the lesion, the impact of CO2 pneumoperitoneum, prior conization, the use of uterine manipulator, the use of protective measures, and the effect of surgical expertise/learning curve.

The clinical impact of smoking on atrial fibrillation (AF) recurrences after pulmonary vein isolation (PVI) have contradictory results in previous studies, performed on Asian populations. Smoking habit and other cardiovascular risk-factors were assessed in patients who underwent their first radiofrequency PVI for symptomatic AF. The study aims to assess the clinical impact of smoking on AF recurrences after PVI in a contemporary European cohort of patients. The study included 186 consecutive patients (135 males [72.6%]) with a mean age of 63.4 ± 9.7 years. Current smokers resulted 29 (15.7%). No statistically significant baseline differences were detected between current smokers and non-current smokers. After a follow-up of 418 ± 246 days, AF recurrence was higher in currently smoking patients vs. non-currently smoker patients, the latter intended as a combination between previous smokers and never smokers (34.5% vs. 14% p = 0.01). A previous smoking habit was not associated with increased risk of AF recurrence when compared with patients who never smoked (13.2% vs. 14.6%, p = 0.23), while a current smoking habit impacted on AF recurrence in comparison with previous smokers (p = 0.01) and never smokers (p = 0.04). The increased incidence of AF recurrence in current smokers was consistent also considering only paroxysmal AF (31.4% vs 9.6%, p = 0.012) or persistent AF (50% vs 31.2%, p = 0.03). Smoking (HR =2.96 95% CI 1.32–6.64) and persistent AF (HR =2.64 95% CI 1.22–5.7) resulted independent predictors of AF recurrence. Cigarette smoking is associated with an increased risk of AF recurrences after PVI, both in paroxysmal and in persistent AF. Clinical impact of smoking on atrial fibrillation recurrences after catheter ablation. CV: cardiovascular. AF: atrial fibrillation; PVI: pulmunary vein isolation; HR: hazard risk. [Display omitted] • The clinical impact of smoking on AF recurrences after ablation have contradictory results in studies based exclusively on Asian populations. • In our cohort of European AF patients who underwent PVI, smoke increased the risk of AF recurrences, both in paroxysmal and in persistent AF. • Smoking resulted an independent predictor of AF recurrence. [ABSTRACT FROM AUTHOR]

Clinical trials have demonstrated conclusively the non-inferiority of breast-conserving surgery followed by breast radiation therapy (BCT) compared with mastectomy for the treatment of early-stage invasive breast cancer (BC). The definition of the required surgical margin to ensure adequate removal of the cancer by BCT to obtain an acceptable low local recurrence (LR) rate remains controversial. Meta-analyses published by Houssami et al. in 2010 and 2014 demonstrated significantly lower LR rates for patients with a negative margin compared with those with positive (ink on tumour) or close (defined as ≤1 mm or ≤2 mm) margins. Neither meta-analysis addressed whether 'no ink on tumour' was adequate to define a negative margin because of a lack of data. Nevertheless, in 2014, the Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) with advice from pathologists reviewed these data together and published guidelines recommending that a margin of 'no ink on tumour' was sufficient to define a clear margin in BCT. Subsequently, clinical practice has varied with some national and international bodies endorsing 'no ink on tumour', whilst others have recommended a ≥1 mm margin as acceptable margins for BCT. A more recent meta-analysis conducted by Bundred and colleagues in 2022 did have sufficient data to compare 'no ink on tumour' and 1 mm and concluded that 1 mm rather than 'no ink on tumour', should be used as a minimum negative margin, and recommended that international guidelines be revised. The current review presents a balanced assessment of the evidence relating margin width and local recurrence after BCT. This review concludes that guidelines should consider re-defining a negative margin as ≥1 mm rather than 'no ink on tumour' in the context of BCT, recognising there will be variation to tailor therapy for any individual patient situation to ensure optimal patient care. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the side effects and causes of discontinuation of either combined oral contraceptives or dienogest (DNG) used to prevent recurrence in patients with surgically confirmed endometriosis. Methods We retrospectively analyzed the medical records of 213 women with endometriosis who had been treated with combined oral contraceptives (ethinyl estradiol 0.02 mg/drospirenone 3 mg [EE/DRSP]) or DNG 2 mg for 12 months or more. The side effects reported by the patients, laboratory parameters, causes of discontinuation of medication, and recurrence rates were evaluated one, two, three, four, and five years after starting medication (Y1, Y2, Y3, Y4, and Y5). Results EE/DRSP were administered to 59 patients, while DNG was administered to 154 patients. The mean durations of postoperative use of EE/DRSP and DNG were 44.5 ± 22.6 months and 23.6 ± 13.5 months, respectively. The prevalence of side effects was 27.1%, 19.0%, 10.0%, 10.5%, and 7.4% in the EE/DRSP group and 29.2%, 15.7%, 14.0%, 23.1%, and 0.0% in the DNG group at Y1, Y2, Y3, Y4, and Y5, respectively. The discontinuation rates were 1.7%, 1.7%, 4.0%, 0.0%, and 7.4% at Y1, Y2, Y3, Y4, and Y5, respectively, in the EE/DRSP group and 10.4%, 3.3%, 4.0%, 3.8%, and 0.0% at the same times in the DNG group. The recurrence rates were less than 4% in both the groups. Conclusions The side effects of commonly prescribed postoperative hormone treatments were relatively mild, and the occurrence of side effects decreased with continuous administration. Further, the long-term use of postoperative hormone treatments is likely to prevent recurrence of endometriosis after surgery.

This meta-analysis aimed to evaluate the effectiveness of intensive follow-up after curative intent treatment for five common solid tumours, in terms of survival and treatment of recurrences. A systematic literature search was conducted, identifying comparative studies on follow-up for colorectal, lung, breast, upper gastro-intestinal and prostate cancer. Outcomes of interest were overall survival (OS), cancer specific survival (CSS), and treatment of recurrences. Random effects meta-analyses were conducted, with particular focus on studies at low risk of bias. Fourteen out of 63 studies were considered to be at low risk of bias (8 colorectal, 4 breast, 0 lung, 1 upper gastro-intestinal, 1 prostate). These studies showed no significant impact of intensive follow-up on OS (hazard ratio, 95% confidence interval) for colorectal (0.99; 0.92–1.06), breast 1.06 (0.92–1.23), upper gastro-intestinal (0.78; 0.51–1.19) and prostate cancer (1.00; 0.86–1.16). No impact on CSS (hazard ratio, 95% confidence interval) was found for colorectal cancer (0.94; 0.77–1.16). CSS was not reported for other cancer types. Intensive follow-up increased the rate of curative treatment (relative risk; 95% confidence interval) for colorectal cancer recurrences (1.30; 1.05–1.61), but not for upper gastro-intestinal cancer recurrences (0.92; 0.47–1.81). For the other cancer types, no data on treatment of recurrences was available in low risk studies. For colorectal and breast cancer, high quality studies do not suggest an impact of intensive follow-up strategies on survival. Colorectal cancer recurrences are more often treated locally after intensive follow-up. For other cancer types evaluated, limited high quality research on follow-up is available. • Intensive follow-up after surgery for colorectal and breast cancer has little impact on survival. • Colorectal cancer recurrences are more often treated locally after intensive follow-up. • High quality research on follow-up for other cancers is scarce. [ABSTRACT FROM AUTHOR]

Let E k be the normalized Eisenstein series of weight k on SL 2 (Z) . Let φ k be the polynomial that encodes the j-invariants of non-elliptic zeros of E k . In 2001, Gekeler observed that the polynomials φ k seem to be irreducible (and verified this claim for k ≤ 446 ). We show that φ k is irreducible for infinitely many k. [ABSTRACT FROM AUTHOR]

Background Outpatient parenteral antibiotic treatment (OPAT) programs are increasingly used to manage infective endocarditis (IE), but current criteria for indicating OPAT are markedly conservative. We aimed to investigate whether more liberal criteria for indicating OPAT in IE can be safely used. Methods This was a prospective multicenter nationwide cohort study (2008–2018). Rates of readmission, recurrences, and 1-year mortality were compared between hospital-based antibiotic treatment (HBAT) and OPAT. Risk factors for readmission and mortality in OPAT patients were investigated by logistic regression. Patients did not fulfill OPAT-GAMES (Grupos de Apoyo al Manejo de la Endocarditis en ESpaña) criteria if they had any of the following: cirrhosis, severe central nervous system emboli, undrained abscesses, severe conditions requiring cardiac surgery in nonoperable patients, severe postsurgical complications, highly difficult-to-treat microorganisms, or intravenous drug use. Results A total of 2279 HBAT patients and 1268 OPAT patients were included. Among OPAT patients, 307 (24.2%) did not fulfill OPAT-GAMES criteria. Overall, OPAT patients presented higher rates of readmission than HBAT patients (18.2% vs 14.4%; P = .004), but no significant differences were found in the propensity analysis. Patients not fulfilling OPAT-GAMES criteria presented significantly higher rates of readmission than HBAT and OPAT-GAMES (23.8%, 14.4%, 16.4%; P  < .001), whereas no significant differences were found in mortality (5.9%, 8%, 7.4%; P  = .103) or recurrences (3.9%, 3.1%, 2.5%; P  = .546). Not fulfilling OPAT-GAMES criteria was associated with higher risk of readmission (odds ratio [OR], 1.43; 95% CI, 1.03–1.97; P  = .03), whereas cardiac surgery was associated with lower risk (OR, 0.72; 95% CI, 0.53–0.98; P  = .03). Conclusions OPAT-GAMES criteria allow identification of IE patients at higher risk of long-term complications to whom OPAT cannot be safely administered. [ABSTRACT FROM AUTHOR]