COVID-19 has been linked to a significantly increased risk for new-onset Alzheimer’s disease (AD), a new study suggests.

The study of more than 6 million people aged 65 years or older found a 50%-80% increased risk for AD in the year after COVID-19; the risk was especially high for women older than 85 years.

However, the investigators were quick to point out that the observational retrospective study offers no evidence that COVID-19 causes AD. There could be a viral etiology at play, or the connection could be related to inflammation in neural tissue from the SARS-CoV-2 infection. Or it could simply be that exposure to the health care system for COVID-19 increased the odds of detection of existing undiagnosed AD cases.

Whatever the case, these findings point to a potential spike in AD cases, which is a cause for concern, study investigator Pamela Davis, MD, PhD, a professor in the Center for Community Health Integration at Case Western Reserve University, Cleveland, said in an interview.

“COVID may be giving us a legacy of ongoing medical difficulties,” Dr. Davis said. “We were already concerned about having a very large care burden and cost burden from Alzheimer’s disease. If this is another burden that’s increased by COVID, this is something we’re really going to have to prepare for.”

The findings were published online in Journal of Alzheimer’s Disease.
 

Increased risk

Earlier research points to a potential link between COVID-19 and increased risk for AD and Parkinson’s disease.

For the current study, researchers analyzed anonymous electronic health records of 6.2 million adults aged 65 years or older who received medical treatment between February 2020 and May 2021 and had no prior diagnosis of AD. The database includes information on almost 30% of the entire U.S. population.

Overall, there were 410,748 cases of COVID-19 during the study period.

The overall risk for new diagnosis of AD in the COVID-19 cohort was close to double that of those who did not have COVID-19 (0.68% vs. 0.35%, respectively).

After propensity-score matching, those who have had COVID-19 had a significantly higher risk for an AD diagnosis compared with those who were not infected (hazard ratio [HR], 1.69; 95% confidence interval [CI],1.53-1.72).

Risk for AD was elevated in all age groups, regardless of gender or ethnicity. Researchers did not collect data on COVID-19 severity, and the medical codes for long COVID were not published until after the study had ended.

Those with the highest risk were individuals older than 85 years (HR, 1.89; 95% CI, 1.73-2.07) and women (HR, 1.82; 95% CI, 1.69-1.97).

“We expected to see some impact, but I was surprised that it was as potent as it was,” Dr. Davis said.
 

Association, not causation

Heather Snyder, PhD, Alzheimer’s Association vice president of medical and scientific relations, who commented on the findings for this article, called the study interesting but emphasized caution in interpreting the results.

“Because this study only showed an association through medical records, we cannot know what the underlying mechanisms driving this association are without more research,” Dr. Snyder said. “If you have had COVID-19, it doesn’t mean you’re going to get dementia. But if you have had COVID-19 and are experiencing long-term symptoms including cognitive difficulties, talk to your doctor.”

Dr. Davis agreed, noting that this type of study offers information on association, but not causation. “I do think that this makes it imperative that we continue to follow the population for what’s going on in various neurodegenerative diseases,” Dr. Davis said.

The study was funded by the National Institute of Aging, National Institute on Alcohol Abuse and Alcoholism, the Clinical and Translational Science Collaborative of Cleveland, and the National Cancer Institute. Dr. Synder reports no relevant financial conflicts.

A version of this article first appeared on Medscape.com.

COVID-19 has been linked to a significantly increased risk for new-onset Alzheimer’s disease (AD), a new study suggests.

The study of more than 6 million people aged 65 years or older found a 50%-80% increased risk for AD in the year after COVID-19; the risk was especially high for women older than 85 years.

However, the investigators were quick to point out that the observational retrospective study offers no evidence that COVID-19 causes AD. There could be a viral etiology at play, or the connection could be related to inflammation in neural tissue from the SARS-CoV-2 infection. Or it could simply be that exposure to the health care system for COVID-19 increased the odds of detection of existing undiagnosed AD cases.

Whatever the case, these findings point to a potential spike in AD cases, which is a cause for concern, study investigator Pamela Davis, MD, PhD, a professor in the Center for Community Health Integration at Case Western Reserve University, Cleveland, said in an interview.

“COVID may be giving us a legacy of ongoing medical difficulties,” Dr. Davis said. “We were already concerned about having a very large care burden and cost burden from Alzheimer’s disease. If this is another burden that’s increased by COVID, this is something we’re really going to have to prepare for.”

The findings were published online in Journal of Alzheimer’s Disease.
 

Increased risk

Earlier research points to a potential link between COVID-19 and increased risk for AD and Parkinson’s disease.

For the current study, researchers analyzed anonymous electronic health records of 6.2 million adults aged 65 years or older who received medical treatment between February 2020 and May 2021 and had no prior diagnosis of AD. The database includes information on almost 30% of the entire U.S. population.

Overall, there were 410,748 cases of COVID-19 during the study period.

The overall risk for new diagnosis of AD in the COVID-19 cohort was close to double that of those who did not have COVID-19 (0.68% vs. 0.35%, respectively).

After propensity-score matching, those who have had COVID-19 had a significantly higher risk for an AD diagnosis compared with those who were not infected (hazard ratio [HR], 1.69; 95% confidence interval [CI],1.53-1.72).

Risk for AD was elevated in all age groups, regardless of gender or ethnicity. Researchers did not collect data on COVID-19 severity, and the medical codes for long COVID were not published until after the study had ended.

Those with the highest risk were individuals older than 85 years (HR, 1.89; 95% CI, 1.73-2.07) and women (HR, 1.82; 95% CI, 1.69-1.97).

“We expected to see some impact, but I was surprised that it was as potent as it was,” Dr. Davis said.
 

Association, not causation

Heather Snyder, PhD, Alzheimer’s Association vice president of medical and scientific relations, who commented on the findings for this article, called the study interesting but emphasized caution in interpreting the results.

“Because this study only showed an association through medical records, we cannot know what the underlying mechanisms driving this association are without more research,” Dr. Snyder said. “If you have had COVID-19, it doesn’t mean you’re going to get dementia. But if you have had COVID-19 and are experiencing long-term symptoms including cognitive difficulties, talk to your doctor.”

Dr. Davis agreed, noting that this type of study offers information on association, but not causation. “I do think that this makes it imperative that we continue to follow the population for what’s going on in various neurodegenerative diseases,” Dr. Davis said.

The study was funded by the National Institute of Aging, National Institute on Alcohol Abuse and Alcoholism, the Clinical and Translational Science Collaborative of Cleveland, and the National Cancer Institute. Dr. Synder reports no relevant financial conflicts.

A version of this article first appeared on Medscape.com.

COVID-19 has been linked to a significantly increased risk for new-onset Alzheimer’s disease (AD), a new study suggests.

The study of more than 6 million people aged 65 years or older found a 50%-80% increased risk for AD in the year after COVID-19; the risk was especially high for women older than 85 years.

However, the investigators were quick to point out that the observational retrospective study offers no evidence that COVID-19 causes AD. There could be a viral etiology at play, or the connection could be related to inflammation in neural tissue from the SARS-CoV-2 infection. Or it could simply be that exposure to the health care system for COVID-19 increased the odds of detection of existing undiagnosed AD cases.

Whatever the case, these findings point to a potential spike in AD cases, which is a cause for concern, study investigator Pamela Davis, MD, PhD, a professor in the Center for Community Health Integration at Case Western Reserve University, Cleveland, said in an interview.

“COVID may be giving us a legacy of ongoing medical difficulties,” Dr. Davis said. “We were already concerned about having a very large care burden and cost burden from Alzheimer’s disease. If this is another burden that’s increased by COVID, this is something we’re really going to have to prepare for.”

The findings were published online in Journal of Alzheimer’s Disease.
 

Increased risk

Earlier research points to a potential link between COVID-19 and increased risk for AD and Parkinson’s disease.

For the current study, researchers analyzed anonymous electronic health records of 6.2 million adults aged 65 years or older who received medical treatment between February 2020 and May 2021 and had no prior diagnosis of AD. The database includes information on almost 30% of the entire U.S. population.

Overall, there were 410,748 cases of COVID-19 during the study period.

The overall risk for new diagnosis of AD in the COVID-19 cohort was close to double that of those who did not have COVID-19 (0.68% vs. 0.35%, respectively).

After propensity-score matching, those who have had COVID-19 had a significantly higher risk for an AD diagnosis compared with those who were not infected (hazard ratio [HR], 1.69; 95% confidence interval [CI],1.53-1.72).

Risk for AD was elevated in all age groups, regardless of gender or ethnicity. Researchers did not collect data on COVID-19 severity, and the medical codes for long COVID were not published until after the study had ended.

Those with the highest risk were individuals older than 85 years (HR, 1.89; 95% CI, 1.73-2.07) and women (HR, 1.82; 95% CI, 1.69-1.97).

“We expected to see some impact, but I was surprised that it was as potent as it was,” Dr. Davis said.
 

Association, not causation

Heather Snyder, PhD, Alzheimer’s Association vice president of medical and scientific relations, who commented on the findings for this article, called the study interesting but emphasized caution in interpreting the results.

“Because this study only showed an association through medical records, we cannot know what the underlying mechanisms driving this association are without more research,” Dr. Snyder said. “If you have had COVID-19, it doesn’t mean you’re going to get dementia. But if you have had COVID-19 and are experiencing long-term symptoms including cognitive difficulties, talk to your doctor.”

Dr. Davis agreed, noting that this type of study offers information on association, but not causation. “I do think that this makes it imperative that we continue to follow the population for what’s going on in various neurodegenerative diseases,” Dr. Davis said.

The study was funded by the National Institute of Aging, National Institute on Alcohol Abuse and Alcoholism, the Clinical and Translational Science Collaborative of Cleveland, and the National Cancer Institute. Dr. Synder reports no relevant financial conflicts.

A version of this article first appeared on Medscape.com.

An anesthesiologist is under arrest and facing criminal charges related to alleged tampering with patient IV bags at Baylor Scott & White Surgicare, a North Dallas surgical center. Raynaldo Rivera Ortiz Jr., MD, 59, is accused of injecting nerve-blocking and bronchodilating drugs into patient IV bags, resulting in at least one death and multiple cardiac emergencies.

In June, an anesthesiologist identified by Dallas ABC affiliate WFAA as Melanie Kaspar, MD, a colleague of Dr. Ortiz’s at the outpatient center, was ill and treated herself for dehydration using an IV bag of saline she had taken home from work. She died immediately after injecting the contents of the bag. According to the autopsy report, she died from a lethal dose of bupivacaine, a nerve-blocking agent often used during the administration of anesthesia. According to WFAA, Dr. Kaspar’s death was initially ruled accidental, but the Dallas County Medical Examiner has since reopened the case. 

Then in August, an 18-year-old male patient, identified in court documents as J.A., experienced a cardiac emergency during a scheduled surgery at the clinic. The teen, who according to local press coverage was undergoing nose surgery after a dirt bike accident, was transferred to a local ICU. A chemical analysis of the fluid from the saline bag that was used during his surgery found epinephrine (a stimulant that could have caused his symptoms), bupivacaine, and lidocaine.

According to court documents, an investigation by the surgical center identified about 10 additional unexpected cardiac emergencies that occurred during what should have been unremarkable surgeries, an exceptionally high rate of complications, suggesting a pattern of intentional adulteration of IV bags. These surgeries were performed between May and August.

In addition, the complaint alleges that none of the cardiac incidents occurred during Dr. Ortiz’s surgeries; however, all of the incidents occurred around the time Dr. Ortiz performed services at the facility, and no incidents occurred while he was on vacation. The incidents began 2 days after Dr. Ortiz had been notified that he was the subject of a disciplinary inquiry stemming from an incident in which he allegedly “deviated from the standard of care” during an anesthesia procedure when a patient experienced a medical emergency, according to federal officials.

The complaint also alleges that Dr. Ortiz had a history of disciplinary actions against him, including at the facility, and he complained that the center was trying to “crucify” him.

Surveillance video from the hallway of the center’s operating room shows Dr. Ortiz placing IV bags in the stainless-steel bag warmer shortly before other doctors’ patients experienced cardiac emergencies, according to the complaint. In the description of one instance captured on video, Dr. Ortiz was observed walking quickly from an operating room to the bag warmer, placing a single IV bag inside, visually scanning the empty hallway, and quickly walking away. Just over an hour later, according to the complaint, a 56-year-old woman suffered a cardiac emergency during a scheduled cosmetic surgery after a bag from the warmer was used during her procedure.

The complaint alleges that in another instance, Dr. Ortiz was observed exiting his operating room carrying an IV bag concealed in what appeared to be a paper folder, swapping the bag with another bag from the warmer, and walking away. Roughly 30 minutes later, a 54-year-old woman suffered a cardiac emergency during a scheduled cosmetic surgery after a bag from the warmer was used during her procedure. 

“Our complaint alleges this defendant surreptitiously injected heart-stopping drugs into patient IV bags, decimating the Hippocratic Oath,” said Chad E. Meacham, U.S. Attorney for the Northern District of Texas. “A single incident of seemingly intentional patient harm would be disconcerting; multiple incidents are truly disturbing. At this point, however, we believe that the problem is limited to one individual, who is currently behind bars. We will work tirelessly to hold him accountable.”

Dr. Ortiz is charged with tampering with a consumer product and with intentionally adulterating drugs. If convicted, he faces a maximum penalty of life in prison. Dr. Ortiz will make his initial appearance before U.S. Magistrate Judge Renee Toliver in Dallas Sept. 16.

On Sept. 9, the Texas Medical Board suspended Dr. Ortiz’s license in connection with this investigation, noting that the panel found “an imminent peril to the public health, safety, or welfare” and that Dr. Ortiz’s “continuation in the practice of medicine poses a continuing threat to public welfare.”

“It is astounding, stunning [for the victims] to think that anyone did this intentionally,” said Bruce W. Steckler, an attorney for some of the victims, in an interview with WFAA.

Baylor Scott & White Health, which operates the surgical center, said in a statement that the North Dallas facility will remain closed as the investigation continues.

“We actively assisted authorities in their investigation and will continue to do so. We also remain focused on communicating with patients,” the health system said.

A version of this article first appeared on Medscape.com.

An anesthesiologist is under arrest and facing criminal charges related to alleged tampering with patient IV bags at Baylor Scott & White Surgicare, a North Dallas surgical center. Raynaldo Rivera Ortiz Jr., MD, 59, is accused of injecting nerve-blocking and bronchodilating drugs into patient IV bags, resulting in at least one death and multiple cardiac emergencies.

In June, an anesthesiologist identified by Dallas ABC affiliate WFAA as Melanie Kaspar, MD, a colleague of Dr. Ortiz’s at the outpatient center, was ill and treated herself for dehydration using an IV bag of saline she had taken home from work. She died immediately after injecting the contents of the bag. According to the autopsy report, she died from a lethal dose of bupivacaine, a nerve-blocking agent often used during the administration of anesthesia. According to WFAA, Dr. Kaspar’s death was initially ruled accidental, but the Dallas County Medical Examiner has since reopened the case. 

Then in August, an 18-year-old male patient, identified in court documents as J.A., experienced a cardiac emergency during a scheduled surgery at the clinic. The teen, who according to local press coverage was undergoing nose surgery after a dirt bike accident, was transferred to a local ICU. A chemical analysis of the fluid from the saline bag that was used during his surgery found epinephrine (a stimulant that could have caused his symptoms), bupivacaine, and lidocaine.

According to court documents, an investigation by the surgical center identified about 10 additional unexpected cardiac emergencies that occurred during what should have been unremarkable surgeries, an exceptionally high rate of complications, suggesting a pattern of intentional adulteration of IV bags. These surgeries were performed between May and August.

In addition, the complaint alleges that none of the cardiac incidents occurred during Dr. Ortiz’s surgeries; however, all of the incidents occurred around the time Dr. Ortiz performed services at the facility, and no incidents occurred while he was on vacation. The incidents began 2 days after Dr. Ortiz had been notified that he was the subject of a disciplinary inquiry stemming from an incident in which he allegedly “deviated from the standard of care” during an anesthesia procedure when a patient experienced a medical emergency, according to federal officials.

The complaint also alleges that Dr. Ortiz had a history of disciplinary actions against him, including at the facility, and he complained that the center was trying to “crucify” him.

Surveillance video from the hallway of the center’s operating room shows Dr. Ortiz placing IV bags in the stainless-steel bag warmer shortly before other doctors’ patients experienced cardiac emergencies, according to the complaint. In the description of one instance captured on video, Dr. Ortiz was observed walking quickly from an operating room to the bag warmer, placing a single IV bag inside, visually scanning the empty hallway, and quickly walking away. Just over an hour later, according to the complaint, a 56-year-old woman suffered a cardiac emergency during a scheduled cosmetic surgery after a bag from the warmer was used during her procedure.

The complaint alleges that in another instance, Dr. Ortiz was observed exiting his operating room carrying an IV bag concealed in what appeared to be a paper folder, swapping the bag with another bag from the warmer, and walking away. Roughly 30 minutes later, a 54-year-old woman suffered a cardiac emergency during a scheduled cosmetic surgery after a bag from the warmer was used during her procedure. 

“Our complaint alleges this defendant surreptitiously injected heart-stopping drugs into patient IV bags, decimating the Hippocratic Oath,” said Chad E. Meacham, U.S. Attorney for the Northern District of Texas. “A single incident of seemingly intentional patient harm would be disconcerting; multiple incidents are truly disturbing. At this point, however, we believe that the problem is limited to one individual, who is currently behind bars. We will work tirelessly to hold him accountable.”

Dr. Ortiz is charged with tampering with a consumer product and with intentionally adulterating drugs. If convicted, he faces a maximum penalty of life in prison. Dr. Ortiz will make his initial appearance before U.S. Magistrate Judge Renee Toliver in Dallas Sept. 16.

On Sept. 9, the Texas Medical Board suspended Dr. Ortiz’s license in connection with this investigation, noting that the panel found “an imminent peril to the public health, safety, or welfare” and that Dr. Ortiz’s “continuation in the practice of medicine poses a continuing threat to public welfare.”

“It is astounding, stunning [for the victims] to think that anyone did this intentionally,” said Bruce W. Steckler, an attorney for some of the victims, in an interview with WFAA.

Baylor Scott & White Health, which operates the surgical center, said in a statement that the North Dallas facility will remain closed as the investigation continues.

“We actively assisted authorities in their investigation and will continue to do so. We also remain focused on communicating with patients,” the health system said.

A version of this article first appeared on Medscape.com.

An anesthesiologist is under arrest and facing criminal charges related to alleged tampering with patient IV bags at Baylor Scott & White Surgicare, a North Dallas surgical center. Raynaldo Rivera Ortiz Jr., MD, 59, is accused of injecting nerve-blocking and bronchodilating drugs into patient IV bags, resulting in at least one death and multiple cardiac emergencies.

In June, an anesthesiologist identified by Dallas ABC affiliate WFAA as Melanie Kaspar, MD, a colleague of Dr. Ortiz’s at the outpatient center, was ill and treated herself for dehydration using an IV bag of saline she had taken home from work. She died immediately after injecting the contents of the bag. According to the autopsy report, she died from a lethal dose of bupivacaine, a nerve-blocking agent often used during the administration of anesthesia. According to WFAA, Dr. Kaspar’s death was initially ruled accidental, but the Dallas County Medical Examiner has since reopened the case. 

Then in August, an 18-year-old male patient, identified in court documents as J.A., experienced a cardiac emergency during a scheduled surgery at the clinic. The teen, who according to local press coverage was undergoing nose surgery after a dirt bike accident, was transferred to a local ICU. A chemical analysis of the fluid from the saline bag that was used during his surgery found epinephrine (a stimulant that could have caused his symptoms), bupivacaine, and lidocaine.

According to court documents, an investigation by the surgical center identified about 10 additional unexpected cardiac emergencies that occurred during what should have been unremarkable surgeries, an exceptionally high rate of complications, suggesting a pattern of intentional adulteration of IV bags. These surgeries were performed between May and August.

In addition, the complaint alleges that none of the cardiac incidents occurred during Dr. Ortiz’s surgeries; however, all of the incidents occurred around the time Dr. Ortiz performed services at the facility, and no incidents occurred while he was on vacation. The incidents began 2 days after Dr. Ortiz had been notified that he was the subject of a disciplinary inquiry stemming from an incident in which he allegedly “deviated from the standard of care” during an anesthesia procedure when a patient experienced a medical emergency, according to federal officials.

The complaint also alleges that Dr. Ortiz had a history of disciplinary actions against him, including at the facility, and he complained that the center was trying to “crucify” him.

Surveillance video from the hallway of the center’s operating room shows Dr. Ortiz placing IV bags in the stainless-steel bag warmer shortly before other doctors’ patients experienced cardiac emergencies, according to the complaint. In the description of one instance captured on video, Dr. Ortiz was observed walking quickly from an operating room to the bag warmer, placing a single IV bag inside, visually scanning the empty hallway, and quickly walking away. Just over an hour later, according to the complaint, a 56-year-old woman suffered a cardiac emergency during a scheduled cosmetic surgery after a bag from the warmer was used during her procedure.

The complaint alleges that in another instance, Dr. Ortiz was observed exiting his operating room carrying an IV bag concealed in what appeared to be a paper folder, swapping the bag with another bag from the warmer, and walking away. Roughly 30 minutes later, a 54-year-old woman suffered a cardiac emergency during a scheduled cosmetic surgery after a bag from the warmer was used during her procedure. 

“Our complaint alleges this defendant surreptitiously injected heart-stopping drugs into patient IV bags, decimating the Hippocratic Oath,” said Chad E. Meacham, U.S. Attorney for the Northern District of Texas. “A single incident of seemingly intentional patient harm would be disconcerting; multiple incidents are truly disturbing. At this point, however, we believe that the problem is limited to one individual, who is currently behind bars. We will work tirelessly to hold him accountable.”

Dr. Ortiz is charged with tampering with a consumer product and with intentionally adulterating drugs. If convicted, he faces a maximum penalty of life in prison. Dr. Ortiz will make his initial appearance before U.S. Magistrate Judge Renee Toliver in Dallas Sept. 16.

On Sept. 9, the Texas Medical Board suspended Dr. Ortiz’s license in connection with this investigation, noting that the panel found “an imminent peril to the public health, safety, or welfare” and that Dr. Ortiz’s “continuation in the practice of medicine poses a continuing threat to public welfare.”

“It is astounding, stunning [for the victims] to think that anyone did this intentionally,” said Bruce W. Steckler, an attorney for some of the victims, in an interview with WFAA.

Baylor Scott & White Health, which operates the surgical center, said in a statement that the North Dallas facility will remain closed as the investigation continues.

“We actively assisted authorities in their investigation and will continue to do so. We also remain focused on communicating with patients,” the health system said.

A version of this article first appeared on Medscape.com.

In the past few months, “quiet quitting” has garnered increasing traction across social media platforms. My morning review of social media revealed thousands of posts ranging from “Why doing less at work could be good for you – and your employer” to “After ‘quiet quitting’ here comes ‘quiet firing.’ ”

But quiet quitting is neither quiet nor quitting.

Quiet quitting is a misnomer. Individuals are not quitting their jobs; rather, they are quitting the idea of consistently going “above and beyond” in the workplace as normal and necessary. In addition, quiet quitters are firmer with their boundaries, do not take on work above and beyond clearly stated expectations, do not respond after hours, and do not feel like they are “not doing their job” when they are not immediately available.

Individuals who “quiet quit” continue to meet the demands of their job but reject the hustle-culture mentality that you must always be available for more work and, most importantly, that your value as person and self-worth are defined and determined by your work. Quiet quitters believe that it is possible to have good boundaries and yet remain productive, engaged, and active within the workplace.

Earlier this month, NPR’s posted tutorial on how to set better boundaries at work garnered 491,000 views, reflecting employees’ difficulties in communicating their needs, thoughts, and availability to their employers. Quiet quitting refers to not only rejecting the idea of going above and beyond in the workplace but also feeling confident that there will not be negative ramifications for not consistently working beyond the expected requirements.

A focus on balance, life, loves, and family is rarely addressed or emphasized by traditional employers; employees have little skill in addressing boundaries and clarifying their value and availability. For decades, “needing” flexibility of any kind or valuing activities as much as your job were viewed as negative attributes, making those individuals less-desired employees.

Data support the quiet quitting trend. Gallup data reveal that employee engagement has fallen for 2 consecutive years in the U.S. workforce. Across the first quarter of 2022, Generation Z and younger Millennials report the lowest engagement across populations at 31%. More than half of this cohort, 54%, classified as “not engaged” in their workplace.

Why is quiet quitting gaining prominence now? COVID may play a role.

Many suggest that self-evaluation and establishing firmer boundaries is a logical response to emotional sequelae caused by COVID. Quiet quitting appears to have been fueled by the pandemic. Employees were forced into crisis mode by COVID; the lines between work, life, and home evaporated, allowing or forcing workers to evaluate their efficacy and satisfaction. With the structural impact of COVID reducing and a return to more standard work practices, it is expected that the job “rules” once held as truths come under evaluation and scrutiny.

Perhaps COVID has forced, and provided, another opportunity for us to closely examine our routines and habits and take stock of what really matters. Generations expectedly differ in their values and definitions of success. COVID has set prior established rules on fire, by forcing patterns and expectations that were neither expected nor wanted, within the context of a global health crisis. Within this backdrop, should we really believe our worth is determined by our job?

The truth is, we are still grieving what we lost during COVID and we have expectedly not assimilated to “the new normal.” Psychology has long recognized that losing structures and supports, routines and habits, causes symptoms of significant discomfort.

The idea that we would return to prior workplace expectations is naive. The idea we would “return to life as it was” is naive. It seems expected, then, that both employers and employees should evaluate their goals and communicate more openly about how each can be met.

It is incumbent upon the employers to set up clear guidelines regarding expectations, including rewards for performance and expectations for time, both within and outside of the work schedule. Employers must recognize symptoms of detachment in their employees and engage in the process of continuing clarifying roles and expectations while providing necessities for employees to succeed at their highest level. Employees, in turn, must self-examine their goals, communicate their needs, meet their responsibilities fully, and take on the challenge of determining their own definition of balance.

Maybe instead of quiet quitting, we should call it this new movement “self-awareness, growth, and evolution.” Hmmm, there’s an intriguing thought.

Dr. Calvery is professor of pediatrics at the University of Louisville (Ky.) She disclosed no relevant conflicts of interest.

A version of this article first appeared on Medscape.com.

In the past few months, “quiet quitting” has garnered increasing traction across social media platforms. My morning review of social media revealed thousands of posts ranging from “Why doing less at work could be good for you – and your employer” to “After ‘quiet quitting’ here comes ‘quiet firing.’ ”

But quiet quitting is neither quiet nor quitting.

Quiet quitting is a misnomer. Individuals are not quitting their jobs; rather, they are quitting the idea of consistently going “above and beyond” in the workplace as normal and necessary. In addition, quiet quitters are firmer with their boundaries, do not take on work above and beyond clearly stated expectations, do not respond after hours, and do not feel like they are “not doing their job” when they are not immediately available.

Individuals who “quiet quit” continue to meet the demands of their job but reject the hustle-culture mentality that you must always be available for more work and, most importantly, that your value as person and self-worth are defined and determined by your work. Quiet quitters believe that it is possible to have good boundaries and yet remain productive, engaged, and active within the workplace.

Earlier this month, NPR’s posted tutorial on how to set better boundaries at work garnered 491,000 views, reflecting employees’ difficulties in communicating their needs, thoughts, and availability to their employers. Quiet quitting refers to not only rejecting the idea of going above and beyond in the workplace but also feeling confident that there will not be negative ramifications for not consistently working beyond the expected requirements.

A focus on balance, life, loves, and family is rarely addressed or emphasized by traditional employers; employees have little skill in addressing boundaries and clarifying their value and availability. For decades, “needing” flexibility of any kind or valuing activities as much as your job were viewed as negative attributes, making those individuals less-desired employees.

Data support the quiet quitting trend. Gallup data reveal that employee engagement has fallen for 2 consecutive years in the U.S. workforce. Across the first quarter of 2022, Generation Z and younger Millennials report the lowest engagement across populations at 31%. More than half of this cohort, 54%, classified as “not engaged” in their workplace.

Why is quiet quitting gaining prominence now? COVID may play a role.

Many suggest that self-evaluation and establishing firmer boundaries is a logical response to emotional sequelae caused by COVID. Quiet quitting appears to have been fueled by the pandemic. Employees were forced into crisis mode by COVID; the lines between work, life, and home evaporated, allowing or forcing workers to evaluate their efficacy and satisfaction. With the structural impact of COVID reducing and a return to more standard work practices, it is expected that the job “rules” once held as truths come under evaluation and scrutiny.

Perhaps COVID has forced, and provided, another opportunity for us to closely examine our routines and habits and take stock of what really matters. Generations expectedly differ in their values and definitions of success. COVID has set prior established rules on fire, by forcing patterns and expectations that were neither expected nor wanted, within the context of a global health crisis. Within this backdrop, should we really believe our worth is determined by our job?

The truth is, we are still grieving what we lost during COVID and we have expectedly not assimilated to “the new normal.” Psychology has long recognized that losing structures and supports, routines and habits, causes symptoms of significant discomfort.

The idea that we would return to prior workplace expectations is naive. The idea we would “return to life as it was” is naive. It seems expected, then, that both employers and employees should evaluate their goals and communicate more openly about how each can be met.

It is incumbent upon the employers to set up clear guidelines regarding expectations, including rewards for performance and expectations for time, both within and outside of the work schedule. Employers must recognize symptoms of detachment in their employees and engage in the process of continuing clarifying roles and expectations while providing necessities for employees to succeed at their highest level. Employees, in turn, must self-examine their goals, communicate their needs, meet their responsibilities fully, and take on the challenge of determining their own definition of balance.

Maybe instead of quiet quitting, we should call it this new movement “self-awareness, growth, and evolution.” Hmmm, there’s an intriguing thought.

Dr. Calvery is professor of pediatrics at the University of Louisville (Ky.) She disclosed no relevant conflicts of interest.

A version of this article first appeared on Medscape.com.

In the past few months, “quiet quitting” has garnered increasing traction across social media platforms. My morning review of social media revealed thousands of posts ranging from “Why doing less at work could be good for you – and your employer” to “After ‘quiet quitting’ here comes ‘quiet firing.’ ”

But quiet quitting is neither quiet nor quitting.

Quiet quitting is a misnomer. Individuals are not quitting their jobs; rather, they are quitting the idea of consistently going “above and beyond” in the workplace as normal and necessary. In addition, quiet quitters are firmer with their boundaries, do not take on work above and beyond clearly stated expectations, do not respond after hours, and do not feel like they are “not doing their job” when they are not immediately available.

Individuals who “quiet quit” continue to meet the demands of their job but reject the hustle-culture mentality that you must always be available for more work and, most importantly, that your value as person and self-worth are defined and determined by your work. Quiet quitters believe that it is possible to have good boundaries and yet remain productive, engaged, and active within the workplace.

Earlier this month, NPR’s posted tutorial on how to set better boundaries at work garnered 491,000 views, reflecting employees’ difficulties in communicating their needs, thoughts, and availability to their employers. Quiet quitting refers to not only rejecting the idea of going above and beyond in the workplace but also feeling confident that there will not be negative ramifications for not consistently working beyond the expected requirements.

A focus on balance, life, loves, and family is rarely addressed or emphasized by traditional employers; employees have little skill in addressing boundaries and clarifying their value and availability. For decades, “needing” flexibility of any kind or valuing activities as much as your job were viewed as negative attributes, making those individuals less-desired employees.

Data support the quiet quitting trend. Gallup data reveal that employee engagement has fallen for 2 consecutive years in the U.S. workforce. Across the first quarter of 2022, Generation Z and younger Millennials report the lowest engagement across populations at 31%. More than half of this cohort, 54%, classified as “not engaged” in their workplace.

Why is quiet quitting gaining prominence now? COVID may play a role.

Many suggest that self-evaluation and establishing firmer boundaries is a logical response to emotional sequelae caused by COVID. Quiet quitting appears to have been fueled by the pandemic. Employees were forced into crisis mode by COVID; the lines between work, life, and home evaporated, allowing or forcing workers to evaluate their efficacy and satisfaction. With the structural impact of COVID reducing and a return to more standard work practices, it is expected that the job “rules” once held as truths come under evaluation and scrutiny.

Perhaps COVID has forced, and provided, another opportunity for us to closely examine our routines and habits and take stock of what really matters. Generations expectedly differ in their values and definitions of success. COVID has set prior established rules on fire, by forcing patterns and expectations that were neither expected nor wanted, within the context of a global health crisis. Within this backdrop, should we really believe our worth is determined by our job?

The truth is, we are still grieving what we lost during COVID and we have expectedly not assimilated to “the new normal.” Psychology has long recognized that losing structures and supports, routines and habits, causes symptoms of significant discomfort.

The idea that we would return to prior workplace expectations is naive. The idea we would “return to life as it was” is naive. It seems expected, then, that both employers and employees should evaluate their goals and communicate more openly about how each can be met.

It is incumbent upon the employers to set up clear guidelines regarding expectations, including rewards for performance and expectations for time, both within and outside of the work schedule. Employers must recognize symptoms of detachment in their employees and engage in the process of continuing clarifying roles and expectations while providing necessities for employees to succeed at their highest level. Employees, in turn, must self-examine their goals, communicate their needs, meet their responsibilities fully, and take on the challenge of determining their own definition of balance.

Maybe instead of quiet quitting, we should call it this new movement “self-awareness, growth, and evolution.” Hmmm, there’s an intriguing thought.

Dr. Calvery is professor of pediatrics at the University of Louisville (Ky.) She disclosed no relevant conflicts of interest.

A version of this article first appeared on Medscape.com.

Key clinical point: Statin exposure reduces the risk for and improves the prognosis of gastric cancer.

Major finding: The statin-exposed vs -nonexposed population showed a significantly reduced incidence (odds ratio [OR] 0.78; P < .001) and improved prognosis (OR 0.78; P = .002) of gastric cancer.

Study details: This was a meta-analysis of 19 studies that analyzed the correlation between statin exposure and the occurrence and progression of gastric cancer.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lou D et al. Association between statins' exposure with incidence and prognosis of gastric cancer: An updated meta-analysis. Expert Rev Clin Pharmacol. 2022; 1-12 (Aug 15). Doi: 10.1080/17512433.2022.2112178

Key clinical point: Statin exposure reduces the risk for and improves the prognosis of gastric cancer.

Major finding: The statin-exposed vs -nonexposed population showed a significantly reduced incidence (odds ratio [OR] 0.78; P < .001) and improved prognosis (OR 0.78; P = .002) of gastric cancer.

Study details: This was a meta-analysis of 19 studies that analyzed the correlation between statin exposure and the occurrence and progression of gastric cancer.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lou D et al. Association between statins' exposure with incidence and prognosis of gastric cancer: An updated meta-analysis. Expert Rev Clin Pharmacol. 2022; 1-12 (Aug 15). Doi: 10.1080/17512433.2022.2112178

Key clinical point: Statin exposure reduces the risk for and improves the prognosis of gastric cancer.

Major finding: The statin-exposed vs -nonexposed population showed a significantly reduced incidence (odds ratio [OR] 0.78; P < .001) and improved prognosis (OR 0.78; P = .002) of gastric cancer.

Study details: This was a meta-analysis of 19 studies that analyzed the correlation between statin exposure and the occurrence and progression of gastric cancer.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Lou D et al. Association between statins' exposure with incidence and prognosis of gastric cancer: An updated meta-analysis. Expert Rev Clin Pharmacol. 2022; 1-12 (Aug 15). Doi: 10.1080/17512433.2022.2112178

Key clinical point: The presence of myosteatosis along with increased systemic inflammatory response markers, such as neutrophil-to-lymphocyte ratio (NLR), serves as an independent prognostic indicator in patients with resectable gastric cancer.

Major finding: Co-occurrence of myosteatosis and an NLR of > 2.3 was significantly associated with worse disease-free survival (hazard ratio [HR] 2.77; P = .001) and overall survival (HR 3.31; P < .001).

Study details: This single-center retrospective observational study included 280 patients with gastric cancer who underwent total or partial gastrectomy with curative intent.

Disclosures: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. The authors declared no conflicts of interest.

Source: Lascala F et al. Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study. Eur J Clin Nutr. 2022 (Sep 8). Doi: 10.1038/s41430-022-01201-7

Key clinical point: The presence of myosteatosis along with increased systemic inflammatory response markers, such as neutrophil-to-lymphocyte ratio (NLR), serves as an independent prognostic indicator in patients with resectable gastric cancer.

Major finding: Co-occurrence of myosteatosis and an NLR of > 2.3 was significantly associated with worse disease-free survival (hazard ratio [HR] 2.77; P = .001) and overall survival (HR 3.31; P < .001).

Study details: This single-center retrospective observational study included 280 patients with gastric cancer who underwent total or partial gastrectomy with curative intent.

Disclosures: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. The authors declared no conflicts of interest.

Source: Lascala F et al. Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study. Eur J Clin Nutr. 2022 (Sep 8). Doi: 10.1038/s41430-022-01201-7

Key clinical point: The presence of myosteatosis along with increased systemic inflammatory response markers, such as neutrophil-to-lymphocyte ratio (NLR), serves as an independent prognostic indicator in patients with resectable gastric cancer.

Major finding: Co-occurrence of myosteatosis and an NLR of > 2.3 was significantly associated with worse disease-free survival (hazard ratio [HR] 2.77; P = .001) and overall survival (HR 3.31; P < .001).

Study details: This single-center retrospective observational study included 280 patients with gastric cancer who underwent total or partial gastrectomy with curative intent.

Disclosures: This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil. The authors declared no conflicts of interest.

Source: Lascala F et al. Prognostic value of myosteatosis and systemic inflammation in patients with resectable gastric cancer: A retrospective study. Eur J Clin Nutr. 2022 (Sep 8). Doi: 10.1038/s41430-022-01201-7

Key clinical point: A shorter gastric observation time during index esophagogastroduodenoscopy (EGD; preceding gastric cancer diagnosis) serves as an important predictor of the occurrence of interval advanced gastric cancer.

Major finding: A shorter observation time (<3 min; adjusted odds ratio 2.27;  95% CI 1.20-4.30) at preceding endoscopy was independently associated with an increased risk for interval advanced gastric cancer.

Study details: Findings are from a retrospective nested case-control study that included 1257 patients diagnosed with gastric cancer within 6-36 months of “cancer-negative” index EGD, of which 102 patients had advanced gastric cancer.

Disclosures: This study was supported by the Research Fund of the Korean Society of Gastroenterology and a National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TJ et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol. 2022 (Sep 5). Doi: 10.1016/j.cgh.2022.08.027

Key clinical point: A shorter gastric observation time during index esophagogastroduodenoscopy (EGD; preceding gastric cancer diagnosis) serves as an important predictor of the occurrence of interval advanced gastric cancer.

Major finding: A shorter observation time (<3 min; adjusted odds ratio 2.27;  95% CI 1.20-4.30) at preceding endoscopy was independently associated with an increased risk for interval advanced gastric cancer.

Study details: Findings are from a retrospective nested case-control study that included 1257 patients diagnosed with gastric cancer within 6-36 months of “cancer-negative” index EGD, of which 102 patients had advanced gastric cancer.

Disclosures: This study was supported by the Research Fund of the Korean Society of Gastroenterology and a National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TJ et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol. 2022 (Sep 5). Doi: 10.1016/j.cgh.2022.08.027

Key clinical point: A shorter gastric observation time during index esophagogastroduodenoscopy (EGD; preceding gastric cancer diagnosis) serves as an important predictor of the occurrence of interval advanced gastric cancer.

Major finding: A shorter observation time (<3 min; adjusted odds ratio 2.27;  95% CI 1.20-4.30) at preceding endoscopy was independently associated with an increased risk for interval advanced gastric cancer.

Study details: Findings are from a retrospective nested case-control study that included 1257 patients diagnosed with gastric cancer within 6-36 months of “cancer-negative” index EGD, of which 102 patients had advanced gastric cancer.

Disclosures: This study was supported by the Research Fund of the Korean Society of Gastroenterology and a National Research Foundation of Korea grant funded by the Korea government. The authors declared no conflicts of interest.

Source: Kim TJ et al. Interval advanced gastric cancer after negative endoscopy. Clin Gastroenterol Hepatol. 2022 (Sep 5). Doi: 10.1016/j.cgh.2022.08.027

Key clinical point: Laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) lead to similar long-term outcomes and postoperative complications in patients with upper third clinical stage I gastric cancer.

Major finding: Patients who underwent LPG and LTG showed no significant difference in the 3-year overall survival (92.6% and 92.3%, respectively; P = .74), recurrence-free survival (both 85.3%; P = .72), early complication (eg, surgical site infection; P = .31), and late complication (eg, anastomotic stenosis; P = .31) rates.

Study details: This retrospective study propensity score-matched patients with upper third clinical stage I gastric cancer who underwent LTG (n = 28) and those who underwent LPG (n = 28).

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Yamamoto M et al. Laparoscopic proximal gastrectomy with novel valvuloplastic esophagogastrostomy vs laparoscopic total gastrectomy for stage I gastric cancer: A propensity score matching analysis. J Gastrointest Surg. 2022 (Aug 29). Doi: 10.1007/s11605-022-05404-y

Key clinical point: Laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) lead to similar long-term outcomes and postoperative complications in patients with upper third clinical stage I gastric cancer.

Major finding: Patients who underwent LPG and LTG showed no significant difference in the 3-year overall survival (92.6% and 92.3%, respectively; P = .74), recurrence-free survival (both 85.3%; P = .72), early complication (eg, surgical site infection; P = .31), and late complication (eg, anastomotic stenosis; P = .31) rates.

Study details: This retrospective study propensity score-matched patients with upper third clinical stage I gastric cancer who underwent LTG (n = 28) and those who underwent LPG (n = 28).

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Yamamoto M et al. Laparoscopic proximal gastrectomy with novel valvuloplastic esophagogastrostomy vs laparoscopic total gastrectomy for stage I gastric cancer: A propensity score matching analysis. J Gastrointest Surg. 2022 (Aug 29). Doi: 10.1007/s11605-022-05404-y

Key clinical point: Laparoscopic proximal gastrectomy (LPG) and laparoscopic total gastrectomy (LTG) lead to similar long-term outcomes and postoperative complications in patients with upper third clinical stage I gastric cancer.

Major finding: Patients who underwent LPG and LTG showed no significant difference in the 3-year overall survival (92.6% and 92.3%, respectively; P = .74), recurrence-free survival (both 85.3%; P = .72), early complication (eg, surgical site infection; P = .31), and late complication (eg, anastomotic stenosis; P = .31) rates.

Study details: This retrospective study propensity score-matched patients with upper third clinical stage I gastric cancer who underwent LTG (n = 28) and those who underwent LPG (n = 28).

Disclosures: No source of funding was reported. The authors declared no conflicts of interest.

Source: Yamamoto M et al. Laparoscopic proximal gastrectomy with novel valvuloplastic esophagogastrostomy vs laparoscopic total gastrectomy for stage I gastric cancer: A propensity score matching analysis. J Gastrointest Surg. 2022 (Aug 29). Doi: 10.1007/s11605-022-05404-y

Key clinical point: Modern perioperative chemotherapy (PC) combined with minimally invasive surgery (MIS) improves lymph node yield and long-term survival without affecting postoperative morbidity in operable gastric cancer.

Major finding: Compared with surgery in 2005-2010, that in 2016-2021 and 2011-2015 was associated with adjusted hazard ratios (95% CI) for overall 3-year mortality of 0.37 (0.20-0.68) and 1.02 (0.63-1.66), respectively. Surgery in 2016-2021 vs 2005-2010 led to significantly increased median lymph node yield (23 vs 17; P < .001) but similar major complication rates (15.5% vs 12.3%; P = .736).

Study details: This real-world retrospective study included 181 patients with gastric or esophagogastric junction adenocarcinoma who underwent curative intent surgery in years 2005-2010 (open surgery+adjuvant therapy; n = 65), 2011-2015 (PC+MIS adopted; n = 58), and 2016-2021 (PC+MIS standard practice; n = 58).

Disclosures: This study was sponsored by the Instrumentarium Science Foundation, Helsinki, Finland, among others. The authors declared no conflicts of interest.

Source: Junttila A et al. Implementation of multimodality therapy and minimally invasive surgery: Short- and long-term outcomes of gastric cancer surgery in medium-volume center. J Gastrointest Surg. 2022 (Aug 24). Doi: 10.1007/s11605-022-05437-3

Key clinical point: Modern perioperative chemotherapy (PC) combined with minimally invasive surgery (MIS) improves lymph node yield and long-term survival without affecting postoperative morbidity in operable gastric cancer.

Major finding: Compared with surgery in 2005-2010, that in 2016-2021 and 2011-2015 was associated with adjusted hazard ratios (95% CI) for overall 3-year mortality of 0.37 (0.20-0.68) and 1.02 (0.63-1.66), respectively. Surgery in 2016-2021 vs 2005-2010 led to significantly increased median lymph node yield (23 vs 17; P < .001) but similar major complication rates (15.5% vs 12.3%; P = .736).

Study details: This real-world retrospective study included 181 patients with gastric or esophagogastric junction adenocarcinoma who underwent curative intent surgery in years 2005-2010 (open surgery+adjuvant therapy; n = 65), 2011-2015 (PC+MIS adopted; n = 58), and 2016-2021 (PC+MIS standard practice; n = 58).

Disclosures: This study was sponsored by the Instrumentarium Science Foundation, Helsinki, Finland, among others. The authors declared no conflicts of interest.

Source: Junttila A et al. Implementation of multimodality therapy and minimally invasive surgery: Short- and long-term outcomes of gastric cancer surgery in medium-volume center. J Gastrointest Surg. 2022 (Aug 24). Doi: 10.1007/s11605-022-05437-3

Key clinical point: Modern perioperative chemotherapy (PC) combined with minimally invasive surgery (MIS) improves lymph node yield and long-term survival without affecting postoperative morbidity in operable gastric cancer.

Major finding: Compared with surgery in 2005-2010, that in 2016-2021 and 2011-2015 was associated with adjusted hazard ratios (95% CI) for overall 3-year mortality of 0.37 (0.20-0.68) and 1.02 (0.63-1.66), respectively. Surgery in 2016-2021 vs 2005-2010 led to significantly increased median lymph node yield (23 vs 17; P < .001) but similar major complication rates (15.5% vs 12.3%; P = .736).

Study details: This real-world retrospective study included 181 patients with gastric or esophagogastric junction adenocarcinoma who underwent curative intent surgery in years 2005-2010 (open surgery+adjuvant therapy; n = 65), 2011-2015 (PC+MIS adopted; n = 58), and 2016-2021 (PC+MIS standard practice; n = 58).

Disclosures: This study was sponsored by the Instrumentarium Science Foundation, Helsinki, Finland, among others. The authors declared no conflicts of interest.

Source: Junttila A et al. Implementation of multimodality therapy and minimally invasive surgery: Short- and long-term outcomes of gastric cancer surgery in medium-volume center. J Gastrointest Surg. 2022 (Aug 24). Doi: 10.1007/s11605-022-05437-3

Key clinical point: Lymph node ratio (LNR) may serve as an independent prognosis predictor in patients with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NACT).

Major finding: Patients with a low vs high LNR had significantly longer 3-year overall survival (OS; 81.9% vs 18.5%; P < .001) and progression-free survival (PFS; 72.6% vs 13.5%; P < .001) rates. Multivariate analysis revealed LNR to be the only independent predictive factor for both OS (adjusted hazard ratio [aHR] 6.90; P < .001) and PFS (aHR 5.58; P < .001).

Study details: This retrospective study included 148 patients with LAGC who underwent NACT and radical gastrectomy and were categorized to have a low (≤30%; n = 103) or high (>30%; n = 45) LNR.

Disclosures: This study was sponsored by the National Natural Science Foundation of China and the Natural Science Foundation of Hubei Province. The authors declared no conflicts of interest.

Source: Jiang Q et al. Lymph node ratio is a prospective prognostic indicator for locally advanced gastric cancer patients after neoadjuvant chemotherapy. World J Surg Oncol. 2022;20(1):261 (Aug 17). Doi: 10.1186/s12957-022-02725-9

Key clinical point: Lymph node ratio (LNR) may serve as an independent prognosis predictor in patients with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NACT).

Major finding: Patients with a low vs high LNR had significantly longer 3-year overall survival (OS; 81.9% vs 18.5%; P < .001) and progression-free survival (PFS; 72.6% vs 13.5%; P < .001) rates. Multivariate analysis revealed LNR to be the only independent predictive factor for both OS (adjusted hazard ratio [aHR] 6.90; P < .001) and PFS (aHR 5.58; P < .001).

Study details: This retrospective study included 148 patients with LAGC who underwent NACT and radical gastrectomy and were categorized to have a low (≤30%; n = 103) or high (>30%; n = 45) LNR.

Disclosures: This study was sponsored by the National Natural Science Foundation of China and the Natural Science Foundation of Hubei Province. The authors declared no conflicts of interest.

Source: Jiang Q et al. Lymph node ratio is a prospective prognostic indicator for locally advanced gastric cancer patients after neoadjuvant chemotherapy. World J Surg Oncol. 2022;20(1):261 (Aug 17). Doi: 10.1186/s12957-022-02725-9

Key clinical point: Lymph node ratio (LNR) may serve as an independent prognosis predictor in patients with locally advanced gastric cancer (LAGC) after neoadjuvant chemotherapy (NACT).

Major finding: Patients with a low vs high LNR had significantly longer 3-year overall survival (OS; 81.9% vs 18.5%; P < .001) and progression-free survival (PFS; 72.6% vs 13.5%; P < .001) rates. Multivariate analysis revealed LNR to be the only independent predictive factor for both OS (adjusted hazard ratio [aHR] 6.90; P < .001) and PFS (aHR 5.58; P < .001).

Study details: This retrospective study included 148 patients with LAGC who underwent NACT and radical gastrectomy and were categorized to have a low (≤30%; n = 103) or high (>30%; n = 45) LNR.

Disclosures: This study was sponsored by the National Natural Science Foundation of China and the Natural Science Foundation of Hubei Province. The authors declared no conflicts of interest.

Source: Jiang Q et al. Lymph node ratio is a prospective prognostic indicator for locally advanced gastric cancer patients after neoadjuvant chemotherapy. World J Surg Oncol. 2022;20(1):261 (Aug 17). Doi: 10.1186/s12957-022-02725-9

Key clinical point: A reduction in the treatment cycle number of adjuvant chemotherapy with S-1 (Tegafur+ 5-chloro-2-4-dihydroxypyridine+oxonic acid) or capecitabine/oxaliplatin (CAPOX) in gastric cancer results in poorer survival outcomes.

Major finding: The 5-year overall survival rates in patients who received S-1 gradually increased from 48.4% to 55.4%, 64.1%, 71.1%, and 77.9% with an increase in cycle number from ≤5 to ≥8 cycles (P < .0001), with the same trend being observed with CAPOX (≤4 to ≥8 cycles: 43.5%, 45.3%, 47.1%, 55.3%, and 67.2%; P < .0001).

Study details: This retrospective study included 20,552 patients with gastric cancer who received 12-month S-1 (n = 13,614) or 6-month CAPOX (n = 6938) adjuvant chemotherapy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kim TH et al. Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer. 2022;22(1):948 (Sep 3). Doi: 10.1186/s12885-022-10006-7

Key clinical point: A reduction in the treatment cycle number of adjuvant chemotherapy with S-1 (Tegafur+ 5-chloro-2-4-dihydroxypyridine+oxonic acid) or capecitabine/oxaliplatin (CAPOX) in gastric cancer results in poorer survival outcomes.

Major finding: The 5-year overall survival rates in patients who received S-1 gradually increased from 48.4% to 55.4%, 64.1%, 71.1%, and 77.9% with an increase in cycle number from ≤5 to ≥8 cycles (P < .0001), with the same trend being observed with CAPOX (≤4 to ≥8 cycles: 43.5%, 45.3%, 47.1%, 55.3%, and 67.2%; P < .0001).

Study details: This retrospective study included 20,552 patients with gastric cancer who received 12-month S-1 (n = 13,614) or 6-month CAPOX (n = 6938) adjuvant chemotherapy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kim TH et al. Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer. 2022;22(1):948 (Sep 3). Doi: 10.1186/s12885-022-10006-7

Key clinical point: A reduction in the treatment cycle number of adjuvant chemotherapy with S-1 (Tegafur+ 5-chloro-2-4-dihydroxypyridine+oxonic acid) or capecitabine/oxaliplatin (CAPOX) in gastric cancer results in poorer survival outcomes.

Major finding: The 5-year overall survival rates in patients who received S-1 gradually increased from 48.4% to 55.4%, 64.1%, 71.1%, and 77.9% with an increase in cycle number from ≤5 to ≥8 cycles (P < .0001), with the same trend being observed with CAPOX (≤4 to ≥8 cycles: 43.5%, 45.3%, 47.1%, 55.3%, and 67.2%; P < .0001).

Study details: This retrospective study included 20,552 patients with gastric cancer who received 12-month S-1 (n = 13,614) or 6-month CAPOX (n = 6938) adjuvant chemotherapy.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kim TH et al. Analysis of treatment outcomes according to the cycles of adjuvant chemotherapy in gastric cancer: A retrospective nationwide cohort study. BMC Cancer. 2022;22(1):948 (Sep 3). Doi: 10.1186/s12885-022-10006-7