Risk factors for recurrent urinary tract infections among women in a large integrated health care organization in the United States.

BACKGROUND: Urinary tract infections (UTIs) occur commonly and often recur. However, recent data on the epidemiology of recurrent UTI (rUTI) are scarce. METHODS: Between 01/01/2016-31/12/2020, index uncomplicated UTIs (uUTI) from office, emergency department (ED), hospital, and virtual care settings were identified from electronic health records of women at Kaiser Permanente Southern California. We defined rUTI as ≥3 UTI within 365 days or ≥2 UTI within 180 days. We determined the proportion of women with cystitis index uUTI who had rUTI and examined factors associated with rUTIs using modified multivariable Poisson regression. RESULTS: Among 374,171 women with cystitis index uUTI, 54,318 (14.5%) had rUTI. A higher proportion of women with rUTI compared to those without rUTI were age 18-27 or ≥78 years at index uUTI (19.7% vs 18.7% and 9.0% vs 6.0%, respectively), were immunocompromised, or had a positive urine culture at index uUTI. In multivariable analyses, characteristics associated with rUTI included younger or older age (48-57 vs 18-27 years aRR=0.83 [95% CI: 0.80-0.85]; ≥78 vs 18-27 years aRR=1.07 [95%CI=1.03-1.11]), Charlson Comorbidity Index (≥3 vs 0, aRR=1.12 [95%CI:1.08-1.17]), and diabetes mellitus (aRR=1.07 [95%CI:1.04-1.10]). More frequent prior year outpatient and ED encounters, oral antibiotic prescriptions, oral contraceptive prescriptions, positive culture at index uUTI, and antibiotic resistant organisms were also associated with increased risk of rUTI. CONCLUSIONS: The high risk of rUTI among women with cystitis is concerning, especially given previous reports of increasing UTI incidence. Current assessment of the epidemiology of rUTI may guide the development of preventive interventions against UTI.

Antibiotic resistance of urinary tract infection recurrences in a large U.S. integrated health care system.

BACKGROUND: Data on antibiotic resistance of uropathogens for UTI recurrences are lacking. METHODS: In a retrospective cohort of adults at Kaiser Permanente Southern California with culture-confirmed index uncomplicated UTI (uUTI) between 01/2016 and 12/2020, we examined the number and characteristics of subsequent culture-confirmed UTIs through 2021. RESULTS: We identified 148,994 individuals with a culture-confirmed index uUTI (88% female, 44% Hispanic, mean age 51 years [s.d. 19]), of whom 19% developed a subsequent culture-confirmed UTI after a median 300 days (IQR: 126-627). The proportion of UTI due to E. coli was highest for index uUTI (79%) and decreased to 73% for sixth UTI (UTI 6) (p-for trend <0.001), while the proportion due to Klebsiella spp increased from index UTI (7%) to UTI 6 (11%) (p-for-trend <0.001). Non-susceptibility to ≥1 and ≥3 antibiotic classes was observed in 57% and 13% of index uUTIs, respectively, and was higher for subsequent UTIs (65% and 20%, respectively, for UTI 6). Most commonly observed antibiotic non-susceptibility patterns included penicillins alone (12%), and penicillins, trimethoprim-sulfamethoxazole plus ≥1 additional antibiotic class (9%). CONCLUSIONS: Antibiotic non-susceptibility is common in UTIs and increases with subsequent UTIs. Continuous monitoring of UTI recurrences and susceptibility patterns are needed to guide treatment decisions.

Programmable, Self-Healable, and Photochromic Liquid Crystal Elastomers Based on Dynamic Hindered Urea Bonds for Biomimetic Flowers.

Recently, researchers have been exploring the use of dynamic covalent bonds (DCBs) in the construction of exchangeable liquid crystal elastomers (LCEs) for biomimetic actuators and devices. However, a significant challenge remains in achieving LCEs with both excellent dynamic properties and superior mechanical strength and stability. In this study, a diacrylate-functionalized monomer containing dynamic hindered urea bonds (DA-HUB) is employed to prepare exchangeable LCEs through a self-catalytic Michael addition reaction. By incorporating DA-HUB, the LCE system benefits from DCBs and hydrogen bonding, leading to materials with high mechanical strength and a range of dynamic properties such as programmability, self-healing, and recyclability. Leveraging these characteristics, bilayer LCE actuators with controlled reversible thermal deformation and outstanding dimensional stability are successfully fabricated using a simple welding method. Moreover, a biomimetic triangular plum, inspired by the blooming of flowers, is created to showcase reversible color and shape changes triggered by light and heat. This innovative approach opens new possibilities for the development of biomimetic and smart actuators and devices with multiple functionalities.

Three-in-One Strategy Enables Single-Component Organic Solar Cells with Record Efficiency and High Stability.

Single-component organic solar cells (SCOSCs) with covalently bonding donor and acceptor are becoming increasingly attractive because of their superior stability over traditional multicomponent blend organic solar cells (OSCs). Nevertheless, the efficiency of SCOSCs is far behind the state-of-the-art multicomponent OSCs. Herein, by combination of the advantages of three-component and single-component devices, this work reports an innovative three-in-one strategy to boost the performance of SCOSCs. In this three-in-one strategy, three independent components (PM6, D18, and PYIT) are covalently linked together to create a new single-component active layer based on ternary conjugated block copolymer (TCBC) PM6-D18-b-PYIT by a facile polymerization. Precisely manipulating the component ratios in the polymer chains of PM6-D18-b-PYIT is able to broaden light utilization, promote charge dynamics, optimize, and stabilize film morphology, contributing to the simultaneously enhanced efficiency and stability of the SCOSCs. Ultimately, the PM6-D18-b-PYIT-based device exhibits a power conversion efficiency (PCE) of 14.89%, which is the highest efficiency of the reported SCOSCs. Thanks to the aggregation restriction of each component and chain entanglement in the three-in-one system, the PM6-D18-b-PYIT-based SCOSC displays significantly higher stability than the corresponding two-component (PM6-D18:PYIT) and three-component (PM6:D18:PYIT). These results demonstrate that the three-in-one strategy is facile and promising for developing SCOSCs with superior efficiency and stability.

Acceptor-only oligomers with high coplanarity enable efficient and stable organic solar cells.

Acceptor-only oligomers are developed as guest components to construct oligomer-assisted active layers for high performance organic solar cells. Due to the high planarity and structural similarity with the host polymer donor, BDD-based acceptor-only oligomers formed an alloy phase with PM6 and optimized the phase morphology effectively, achieving a stable device displaying 18% efficiency.

Targeting EMSY-mediated methionine metabolism is a potential therapeutic strategy for triple-negative breast cancer.

Cancer stem cells (CSCs) are the most intractable subpopulation of triple-negative breast cancer (TNBC) cells, which have been associated with a high risk of relapse and poor prognosis. However, eradication of CSCs continues to be difficult. Here, we integrate the multiomics data of a TNBC cohort (n = 360) to identify vital markers of CSCs. We discover that EMSY, inducing a BRCAness phenotype, is preferentially expressed in breast CSCs, promotes ALDH+ cells enrichment, and is positively correlated with poor relapse-free survival. Mechanistically, EMSY competitively binds to the Jmjc domain, which is critical for KDM5B enzyme activity, to reshape methionine metabolism, and to promote CSC self-renewal and tumorigenesis in an H3K4 methylation-dependent manner. Moreover, EMSY accumulation in TNBC cells sensitizes them to PARP inhibitors against bulk cells and methionine deprivation against CSCs. These findings indicate that clinically relevant eradication of CSCs could be achieved with a strategy that targets CSC-specific vulnerabilities in amino acid metabolism.

Recent Advances of Benzodithiophene-Based Donor Materials for Organic Solar Cells.

Recently, the power conversion efficiency (PCE) of organic solar cells (OSCs) has increased dramatically, making a big step toward the industrial application of OSCs. Among numerous OSCs, benzodithiophene (BDT)-based OSCs stand out in achieving efficient PCE. Notably, single-junction OSCs using BDT-based polymers as donor materials have completed a PCE of over 19%, indicating a dramatic potential for preparing high-performance large-scale OSCs. This paper reviews the recent progress of OSCs based on BDT polymer donor materials (PDMs). The development of BDT-based OSCs is concisely summarized. Meanwhile, the relationship between the structure of PDMs and the performance of OSCs is further described in this review. Besides, the development and prospect of single junction OSCs are also discussed.

Doping of ZnO Electron Transport Layer with Organic Dye Molecules to Enhance Efficiency and Photo-Stability of the Non-Fullerene Organic Solar Cells.

The solution-processed zinc oxide (ZnO) electron transport layer (ETL) always exhibits ubiquitous defects, and its photocatalytic activity is detrimental for the organic solar cell (OSC) to achieve high efficiency and stability. Herein, an organic dye molecule, PDINN-S is introduced, to dope ZnO, constructing a hybrid ZnO:PDINN-S ETL. This hybrid ETL exhibits improved electron mobility and conductivity, particularly post-light exposure. The catalytic activity of ZnO is also effectively suppressed.Consequently, the efficiency and photo-stability of inverted non-fullerene OSCs are synergistically enhanced. The devices based on PM6:Y6/PM6:BTP-eC9 active layer with ZnO:PDINN-S as ETL give impressive power conversion efficiencies (PCEs) of 16.78%/17.59%, significantly higher than those with pure ZnO as ETL (PCEs = 15.31%/16.04%). Moreover, ZnO:PDINN-S-based device shows exceptional long-term stability under continuous AM 1.5G illumination (T80 = 1130 h) , overwhelming the reference device (T80 = 455 h). In addition, Incorporating PDINN-S into ZnO alleviate mechanical stress within the inorganic lattice, making ZnO:PDINN-S ETL more suitable for the fabrication of flexible devices. Overall, doping ZnO with organic dye molecules offers an innovative strategy for developing multifunctional and efficient hybrid ETL of the non-fullerene OSCs with excellent efficiency and photo-stability.

N-Type Small Molecule Electron Transport Layers with Excellent Surface Energy and Moisture Resistance Siloxane for Non-Fullerene Organic Solar Cells.

Electron transport layers (ETLs) generally contain polar groups for enhancing performance and reducing the work function. Nevertheless, the polar group with high surface energy may cause inferior interfacial compatibility, which challenges the ETLs to balance stability and performance. Here, two conjugated small molecules of ETLs with low surface energy siloxane, namely PDI-Si and PDIN-Si, are synthesized. The siloxane with low surface energy not only enhances the interfacial compatibility between ETLs and active layers but also improves the moisture-proof stability of the device. Impressively, the amine-functionalized PDIN-Si can simultaneously exhibit conspicuous n-type self-doping properties and outstanding moisture-proof stability. The optimization of interfacial contact and morphology enables the PM6:Y6-based OSC with PDIN-Si to achieve a power conversion efficiency (PCE) of 15.87%, which is slightly superior to that of classical ETL PDINO devices (15.27%), and when the PDIN-Si film thickness reaches 28 nm, the PCE remains at 13.19% (≈83%), which indicates that PDIN-Si has satisfactory thickness insensitivity to facilitate roll-to-roll processing. Excitingly, after 120 h of storage in an environment with humidity above 45%, the unencapsulated device with PDIN-Si as ETL remains at 75% of the initial PCE value, while the device with PDINO as ETL is only 50%.

Ionic Liquids: An Ideal Solvent for Tuning the UCST Phase Behavior of Polymer Gels.

Liquid-liquid phase separation (LLPS) is a common stimulus-responsive phenomenon widely studied and applied in constructing intelligent systems such as microfluidic valves, smart windows, and biosensors. However, LLPS in an aqueous solution has limited applicability confined to a narrow temperature range within 0-100 °C. In addition, for easy exploitation of thermoresponsive behavior, phase separation must be stable and accurately predictable under varying conditions. This study proposes a gel system exhibiting UCST phase behavior using ionic liquids (ILs) and hydrophilic polymers, whose phase transition temperature can be linearly tuned within a wide range (from subzero to over 100 °C) by varying the mixing ratio of ILs in their blends. Similar to the mixing of ILs with structurally similar cations, mixing ILs containing different anions proved to be an effective ideal random mixing method based on experimental results and molecular dynamics simulations. This mixing mechanism of ILs accounts for the linear regulation of the UCST of the ionogels when the mixing ratio of ILs in their blends varies. Moreover, the unique feature of ILs was further demonstrated using other hydrophilic polymer networks and multiple combinations of ILs, suggesting the generality of this strategy for UCST regulation in the ionogels.

Enhancing the Conductivity of PEDOT:PSS Films by the Confinement of Ice Crystals.

Rapid developments in organic electronics demand highly conductive and freestanding (PEDOT:PSS) films. However, the synthesis of highly conductive PEDOT:PSS films requires toxic reagents, such as high-concentration acids and bases. Herein, an eco-friendly and cost-effective strategy is reported for improving the conductivity of PEDOT:PSS films through the confinement of ice crystals. The crystallization of water swelled by the film facilitated the phase separation of PEDOT and PSS, and the excess PSS in the skin layer is effectively removed. Moreover, under the confinement effect, the carrier mobility of the film is enhanced through the formation of a well-crystallized PEDOT molecular morphology. A detailed elucidation of aggregate structure evolution in PEDOT:PSS films during annealing, solvent post-treatment, and subsequent confined crystallization is presented herein. After multiple water crystallization cycles, the conductivity of the PEDOT:PSS film increased by over 85%, achieving a maximum of 2564 ± 142 S cm-1 . Finally, compared to post-treatment with dimethyl sulfoxide (DMSO), the current strategy can improve the Seebeck coefficient by 5.6% and the power factor by 139%.

Multiomics of HER2-low triple-negative breast cancer identifies a receptor tyrosine kinase-relevant subgroup with therapeutic prospects.

To provide complementary information and reveal the molecular characteristics and therapeutic insights of HER2-low breast cancer, we performed this multiomics study of hormone receptor-negative (HR-) and HER2-low breast cancer, also known as HER2-low triple-negative breast cancer (TNBC), and identified 3 subgroups: basal-like, receptor tyrosine kinase-relevant (TKR), and mesenchymal stem-like. These 3 subgroups had distinct features and potential therapeutic targets and were validated in external data sets. Interestingly, the TKR subgroup (which exists in both HR+ and HR- breast cancer) had activated HER2 and downstream MAPK signaling. In vitro and in vivo patient-derived xenograft experiments revealed that pretreatment of the TKR subgroup with a tyrosine kinase inhibitor (lapatinib or tucatinib) could inhibit HER2 signaling and induce accumulated expression of nonfunctional HER2, resulting in increased sensitivity to the sequential HER2-targeting, Ab-drug conjugate DS-8201. Our findings identify clinically relevant subgroups and provide potential therapeutic strategies for HER2-low TNBC subtypes.

Case Report: Hemorrhagic Fever with Renal Syndrome Complicated by Bilateral Subdural Hematoma.

Hemorrhagic fever with renal syndrome (HFRS) is an acute, natural focal disease worldwide. Bilateral subdural hematoma (BSH) is a rare occurrence in patients with HFRS. A 51-year-old man was admitted with fever, headache, lower back pain, and reduced urine volume. The patient was diagnosed with HFRS accompanied by BSH, as evidenced by IgM and IgG antibodies for hantavirus that were positive, and abnormal blood test results and computed tomographic head scan. He recovered and was discharged after symptomatic treatment. Hemorrhagic fever with renal syndrome might present rare clinical manifestations with BSH. The early identification of this condition is crucial to an improved prognosis.

Association of metabolic syndrome conditions with risk of second primary uterine cancer in breast cancer survivors.

PURPOSE: Uterine cancer risk is high in breast cancer survivors. Although breast cancer and uterine cancer share some common epidemiological risk factors, association of metabolic syndrome with incident uterine cancer in breast cancer survivors is under-studied. We evaluated the association of metabolic syndrome conditions with second primary uterine cancer in breast cancer survivors. METHODS: In this retrospective cohort study, 37,303 breast cancer patients diagnosed between 2008 and 2020 at Kaiser Permanente Southern California, an integrated healthcare system, were included. Data on cancer-related variables, sociodemographic, and clinical variables were extracted from KPSC's Surveillance, Epidemiology, and End Results (SEER)-affiliated cancer registry and electronic health records, as appropriate. Patients were followed from breast cancer diagnosis until 12/31/2021 for incident uterine cancer. Proportional hazards regression was used to report association [HR (95% CI)] between metabolic conditions and uterine cancer. RESULTS: More than half (53.1%) of the breast cancer survivors had 1-2 metabolic conditions; 19.4% had 3 + , while 27. 5% had no metabolic conditions. Median time to follow-up was 5.33 years and 185 (0.5%) patients developed second primary uterine cancer. Obesity was associated with an elevated uterine cancer risk in the adjusted model [HR (95% CI) 1.64 (1.20-2.25)]. Having 1-2 metabolic conditions (versus none) was not associated with increased uterine cancer risk [adjusted HR (95% CI) 1.24 (0.85-1.82)]; however, there was an increased uterine cancer risk with 3 + metabolic conditions [adjusted HR (95% CI) 1.82 (1.16-2.87)]. CONCLUSION: Although not statistically significant, we found a trend demonstrating greater uterine cancer risk by increasing numbers of metabolic syndrome conditions in breast cancer survivors.

Leuconostoc mesenteroides WHH1141 ameliorates ovalbumin-induced food allergy in mice.

Food allergy (FA) is acknowledged as a significant public health and food safety issue, due to its manifestation as an amplified immune reaction to food antigens. Recently, probiotics within Lactobacillus and Bifidobacterium have been highlighted as a promising strategy against allergic disease by modulating the balance of Th1/Th2 responses. However, the allergy-alleviating effects of probiotic Leuconostoc mesenteroides strains are unknown. Therefore, this study investigated the potentials of eleven L. mesenteroides strains on the Th1/Th2 balance in vitro by evaluating the expression patterns of interferon-gamma (IFN-γ) (Th1 cytokine) and interleukin-4 (IL-4) (Th2 cytokine) in mesenteric lymph node-derived lymphocytes from ovalbumin (OVA)-sensitized mice. Among strains, WHH1141 incubation caused the highest IFN-γ/IL-4 ratio. Oral administration of WHH1141 (1 × 109  CFU/mL) in the OVA-induced FA mouse model for 40 days improved the weight loss and FA pathological symptoms and normalized the serum immunoglobulin E levels. Meanwhile, the OVA-induced elevated gene expressions of cytokines (IL-4, IL-5, and IL-13) and tight-junction proteins (ZO-1 and Occludin) and levels of cytokines (IL-4, IL-5, and IL-13) and histamine in the jejunum were restored by WHH1141. Furthermore, WHH1141 reversed the reduced gut microbial diversity and short-chain fatty acid (SCFA) levels, specifically increased Bacteroidota abundance, and decreased Firmicutes abundance in OVA-induced mice. Overall, these findings suggest that WHH1141 exerts FA-alleviating effects on OVA-induced mice, which is involved with the inhibition of the jejunal Th2 immune responses and the modulation of gut microbiome composition and SCFA productions. PRACTICAL APPLICATION: Leuconostoc mesenteroides WHH1141 with FA-alleviating potentials may be considered a promising approach in the mitigation of FA symptoms.

Regulating the Sequence Structure of Conjugated Block Copolymers Enables Large-Area Single-Component Organic Solar Cells with High Efficiency and Stability.

Single-component organic solar cells (SCOSCs) based on conjugated block copolymers (CBCs) by covalently bonding a polymer donor and polymer acceptor become more and more appealing due to the formation of a favorable and stable morphology. Unfortunately, a deep understanding of the effect of the assembly behavior caused by the sequence structure of CBCs on the device performance is still missing. Herein, from the aspect of manipulating the sequence length and distribution regularity of CBCs, we synthesized a series of new CBCs, namely D18(20)-b-PYIT, D18(40)-b-PYIT and D18(60)-b-PYIT by two-pot polymerization, and D18(40)-b-PYIT(r) by traditional one-pot method. It is observed that precise manipulation of sequence length and distribution regularity of the polymer blocks fine-tunes the self-assembly of the CBCs, optimizes film morphology, improves optoelectronic properties, and reduces energy loss, leading to simultaneously improved efficiency and stability. Among these CBCs, the D18(40)-b-PYIT-based device achieves a high efficiency of 13.4 % with enhanced stability, which is an outstanding performance among SCOSCs. Importantly, the regular sequence distribution and suitable sequence length of the CBCs enable a facile film-forming process of the printed device. For the first time, the blade-coated large-area rigid/flexible SCOSCs are fabricated, delivering an impressive efficiency of 11.62 %/10.73 %, much higher than their corresponding binary devices.

Risk of Subsequent Breast Cancer in Women with Early Stage HER2-Positive Breast Cancer in a Large Community Health Plan.

Purpose: Clinical outcomes have improved for women with early stage, HER2-positive breast cancer following the FDA approval of adjuvant trastuzumab use in 2006. However, only limited information exists on such patients' outcomes in real-world settings outside of clinical trials. We examined the risk of subsequent breast cancer in women with HER-2 positive disease, and the impact of trastuzumab use, in a large California community-based health plan. Patients and Methods: A cohort of 3550 women with HER2-positive breast cancer (stages I-III) from 2009-2017 were followed through December 2018. We calculated subsequent breast cancer (SBC) rates overall and by trastuzumab use. Multivariable Cox proportional hazards modeling was used to compute hazard ratios (HR) and 95% confidence intervals (CI) for SBC by trastuzumab use. Results: Within the cohort diagnosed with HER2-positive disease, 81% received adjuvant trastuzumab. After 4.1 mean years follow-up (maximum 10 years), the risk of SBC was 22% lower with adjuvant trastuzumab use (hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.66-0.92) compared with non-use. The cumulative incidence of SBC precipitously rose two years after diagnosis and by the 10th year, the cumulative incidence was 31% among those who had trastuzumab therapy versus 34% without this therapy. Conclusion: In community practice settings, the cumulative incidence of SBC in patients with early stage HER2-positive BC was 31% at 10 years in a cohort treated with adjuvant trastuzumab. Trastuzumab use was associated with a 22% reduced risk of developing SBC. This residual disease burden suggests breast cancer outcomes may be improved with further treatment given the advent of next-generation HER2-targeted therapies.

Clinical Risk Scores to Predict Nonsusceptibility to Trimethoprim-Sulfamethoxazole, Fluoroquinolone, Nitrofurantoin, and Third-Generation Cephalosporin Among Adult Outpatient Episodes of Complicated Urinary Tract Infection.

Background: Clinical risk scores were developed to estimate the risk of adult outpatients having a complicated urinary tract infection (cUTI) that was nonsusceptible to trimethoprim-sulfamethoxazole (TMP-SMX), fluoroquinolone, nitrofurantoin, or third-generation cephalosporin (3-GC) based on variables available on clinical presentation. Methods: A retrospective cohort study (1 December 2017-31 December 2020) was performed among adult members of Kaiser Permanente Southern California with an outpatient cUTI. Separate risk scores were developed for TMP-SMX, fluoroquinolone, nitrofurantoin, and 3-GC. The models were translated into risk scores to quantify the likelihood of nonsusceptibility based on the presence of final model covariates in a given cUTI outpatient. Results: A total of 30 450 cUTIs (26 326 patients) met the study criteria. Rates of nonsusceptibility to TMP-SMX, fluoroquinolone, nitrofurantoin, and 3-GC were 37%, 20%, 27%, and 24%, respectively. Receipt of prior antibiotics was the most important predictor across all models. The risk of nonsusceptibility in the TMP-SMX model exceeded 20% in the absence of any risk factors, suggesting that empiric use of TMP-SMX may not be advisable. For fluoroquinolone, nitrofurantoin, and 3-GC, clinical risk scores of 10, 7, and 11 predicted a ≥20% estimated probability of nonsusceptibility in the models that included cumulative number of prior antibiotics at model entry. This finding suggests that caution should be used when considering these agents empirically in patients who have several risk factors present in a given model at presentation. Conclusions: We developed high-performing parsimonious risk scores to facilitate empiric treatment selection for adult outpatients with cUTIs in the critical period between infection presentation and availability of susceptibility results.

The novel HLA-C*12:368 allele, identified by Sanger dideoxy nucleotide sequencing in a Chinese individual.

HLA-C*12:368 differs from HLA-C*12:03:01:01 by one nucleotide in exon 4.

Effects of ketorolac on complications and postoperative pancreatic fistula in patients undergoing pancreatectomy.

BACKGROUND: There are conflicting data on the risk of postoperative pancreatic fistula (POPF) associated with postoperative NSAID use. The primary objective of this multi-center retrospective study was to assess the relationship between ketorolac use and POPF. The secondary objective was to assess for effect of ketorolac use on overall complication rate. METHODS: Retrospective chart review of patients undergoing pancreatectomy from January 1, 2005-January 1, 2016 was performed. Data on patient factors (age, sex, comorbidities, previous surgical history etc.), operative factors (surgical procedure, estimated blood loss, pathology etc.), and outcomes (morbidities, mortality, readmission, POPF) were collected. The cohort was compared based on ketorolac use. RESULTS: The study included 464 patients. Ninety-eight (21%) patients received ketorolac during the study period. Ninety-six (21%) patients were diagnosed with POPF within 30 days. There was a significant association between ketorolac use and clinically relevant POPF (21.4 vs. 12.7%) (p = 0.04, 95% CI [1.76, 1.04-2.97]). There was no significant difference in overall morbidity or mortality between the groups. DISCUSSION: Though there was no overall increase in morbidity, there was a significant association between POPF and ketorolac use. The use of ketorolac after pancreatectomy should be judicious.