Notes

NKG2D Increases Double-Negative T Mobile Damaging B Tissues.
options, including immunotherapy for metastatic colorectal cancer (CRC). 2020 Hepatobiliary Surgery and Nutrition. All rights reserved.One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLM) has been demonstrated to improve the prognosis of these patients. Loco-regional approaches such as surgical resection and tumor ablation (operative and percutaneous) can provide patients with a chance at long-term disease control and even cure in select populations. Patient selection is important in defining the most suitable treatment option for CRLM in order to provide the best possible survival benefit while avoiding unnecessary interventions and aders in choosing the most suitable imaging approach for patients with CRLM. 2020 Hepatobiliary Surgery and Nutrition. All rights reserved.An increasing number of patients with colorectal cancer (CRC) are presenting with synchronous disease to the liver. The optimal surgical approach for this complex patient group is controversial, but ultimately depends on individual patient characteristics and institutional practices. Surgical strategies include the traditional staged approach, a combined colorectal and liver resection, or a liver-first reverse approach. In this review, the authors will provide an overview of each strategy, including case examples demonstrating the benefits of the more recently described liver-first approach, while arguing for individualized planning and multidisciplinary discussion for every patient. 2020 Hepatobiliary Surgery and Nutrition. All rights reserved.Background Patients with advanced hepatobiliary cancer (HBC) have a dismal prognosis and limited treatment options. Immunotherapy has been considered as a promising treatment, especially for cancers not amenable to surgery. Methods Between 2004, and 2015, patients diagnosed with hepatocellular carcinoma (HCC), intra- and extrahepatic cholangiocarcinoma and gallbladder cancer (GBC) were identified in the National Cancer Database. learn more Results Among 249,913 patients with HBC, only 585 (0.2%) patients received immunotherapy. Among patients who received immunotherapy, most patients were diagnosed between 2012 and 2015, had private insurance, as well as an income ≥$46,000 and were treated at an academic facility. The use of immunotherapy among HBC patients varied by diagnosis (HCC, 67.7%; bile duct cancer, 14%). On multivariable analysis, a more recent period of diagnosis (OR 1.80, 95% CI 1.44-2.25), median income >$46,000 (OR 1.43, 95% CI 1.11-1.87), and higher tumor stage (stage III, OR 2.22, 95% CI 1.65-3.01; stage IV, OR 3.24, 95% CI 2.41-4.34) were associated with greater odds of receiving immunotherapy. Conclusions Overall utilization of immunotherapy in the US among patients with HBC was very low, yet has increased over time. Certain socioeconomic factors were associated with an increased likely of receiving immunotherapy, suggesting disparities in access of patients with lower socioeconomic status. 2020 Hepatobiliary Surgery and Nutrition. All rights reserved.Background Previous research has demonstrated that specific radiographic criteria, including the presence of calcifications and the enhancement pattern on computed tomography (CT) imaging, correlates with clinicopathologic features and outcomes of patients with gastroenteropancreatic neuroendocrine tumors (NET). We sought to investigate whether these radiographic characteristics were prognostic among patients with neuroendocrine liver metastases (NELM) undergoing surgical resection. Methods The preoperative contrast-enhanced CT scans of all patients who underwent resection of NELM at a single institution between 2000-2015 were retrospectively reviewed. The presence of calcifications was determined on non-contrast phase imaging. Enhancement on the arterial phase scan was categorized as hyperenhancing, hypoenhancing, or mixed. Relevant clinicopathologic characteristics as well as recurrence-free survival (RFS) and overall survival (OS) were compared between groups. Results Among 82 patients who underwent resectstics, RFS (P=0.618) or OS (P=0.268). Conclusions Radiographic characteristics on contrast-enhanced CT are not associated with the outcomes of patients undergoing resection of NELM. Future investigations should evaluate the prognostic impact of functional neuroendocrine imaging. 2020 Hepatobiliary Surgery and Nutrition. All rights reserved.The aim of the study was to evaluate the job satisfaction of official veterinarians working in the field of animal welfare control and identify both positive features and challenges of their work. An electronic questionnaire was designed to evaluate job satisfaction. The questionnaire was responded to by 73 of the 98 Finnish official veterinarians working in the field of animal welfare control. The Spearman's rank correlation coefficient was used to evaluate the relation between stress and different work-related factors. More than half of the respondents reported work-related stress or fatigue. Threatening situations, disturbed work-private life balance and a high amount of overtime work were found to be frequent underlying causes of stress. Fieldwork, especially when working alone, was perceived as the most challenging part of the work. Of the respondents, three out of four performed animal welfare inspections mainly alone. Although the respondents reported getting additional help to perform an inspection most of the times they needed it, a wish to work in a pair was highlighted. The results of the present study indicate that official veterinarians often experience work-related stress and fatigue. By testing interventions shown to be beneficial, such as providing adequate support within the work community, decreasing the workload and enabling inspections to be done in pairs, job satisfaction could be improved. Copyright © 2020 Väärikkälä, Hänninen and Nevas.
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