Need For Additional Treatment Research Articles

Residual Disease Activity and Burden of Disease in Canadian Patients with Axial Spondyloarthritis: Results from a Multi-registry Analysis (UNISON-Axial SpA).

There is a key knowledge gap in quantifying residual disease activity in Canadian patients with axial spondyloarthritis (axSpA). The objective of this study was to evaluate and describe residual disease activity and burden of disease in Canadian patients with axSpA. This was an observational, retrospective analysis of data extracted from the Rhumadata™ (Québec), SPondyloArthritis Research Consortium of Canada (SPARCC, East/Atlantic and West regions, and Ontario), and FOllow-up Research Cohort of Ankylosing SpondyliTis (FORCAST, Alberta) registries. The primary endpoint was proportion of patients who failed to achieve sustained low disease activity (LDA) at 12 months; LDA was defined as a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score <3 and sustained LDA defined as achieving LDA at both 6 and 12 months after the most recent change in treatment. Analyses included outcomes by treatment class (nonsteroidal anti-inflammatory drugs [NSAIDs], tumor necrosis factor inhibitor, or interleukin-17 inhibitor). A total of 980 patients (Rhumadata™, N=488; SPARCC, N=239; FORCAST, N=253) were included. Nearly half of patients with axSpA from Rhumadata™/Québec (49.5%) and FORCAST/Alberta (55.3%) and 65.8% of those from SPARCC/Ontario failed to achieve LDA (BASDAI <3) at 6 months after treatment initiation. At 12 months, failure to achieve sustained LDA rose to 62.0% in Rhumadata™/Québec, 65.1% in FORCAST/Alberta, and 81.0% in SPARCC/Ontario. Pain persisted in nearly half of all patients. This analysis demonstrated that most Canadians with axSpA failed to achieve sustained LDA after 12 months of initiating their latest therapy and confirms a high unmet need for additional treatments.

PANOMEN-3 grading score is reliable in predicting pituitary adenoma behavior and prognosis: a single center cohort study.

Pituitary adenomas (PAs) comprise a heterogeneous group of diseases: a scoring system to guide prognosis and therapy is still missing. We assessed a retrospective single-center cohort of 401 patients with PAs followed over the last two decades using a newly developed Pituitary Society grading system, PANOMEN-3. A high initial grade of the adenoma predicted a worse long-term outcome despite multimodal treatments (grade 3, disease remission OR 0.49, 95%CI [0.27; 0.84], p = 0.01). The grade could predict tumor behavior following surgery: a higher grade at baseline predicted relapses after disease remission (grade 3 vs grade 1/2, p = 0.01) and a higher postoperative grade predicted the need for additional treatments in case of persisting disease (grade 2/3 vs grade 1, p = 0.02). A score downgrade obtained with primary medical predicted the reduction of additional interventions and long-term biochemical control. When considering CD patients, both a lower initial grade (grade 2 vs grade 3, p < 0.01) and preoperative eucortisolism (p = 0.04) reduced recurrence risk. Contrarily to the whole-cohort analysis, grade predicted the surgical outcome in non-functioning pituitary adenomas and in acromegaly. Our data suggest for the first time that PANOMEN-3 grade system could be useful in everyday clinical practice, aiding physicians in both improving follow-up strategies for patients in remission and in the management of persisting disease for all pituitary adenomas. Especially for CD, a high initial grade could encourage clinicians to institute preoperative medical treatment and to adopt a closer follow-up schedule in cured cases.

The use of Intravenous Magnesium Sulfate as early therapy in paediatric asthma: A breakthrough in the making?

Asthma is a major non-communicable chronic disease, affecting 262.41 million people worldwide in 2019.1 South Asia, High-Income North America and Western Europe reported a high prevalence rate of 39.87 million, 35.61 million, and 27.04 million respectively.1 According to a study by Serebrisky et al, exposure to road traffic makes children more susceptible to asthma symptoms, complications, and hospitalizations.2 This study also emphasized the role of indoor air pollution and exposure to environmental tobacco smoke as potential risk factors for childhood asthma. Intravenous magnesium sulfate (IV Mg) is being explored as the preferred second-line bronchodilator treatment for asthma exacerbations in children unresponsive to initial inhaled therapies. A recent study by DeLaroche et al. compared the management of asthma exacerbation in children who were given early vs delayed IV Mg.3 Early administration of IV Mg was linked to a prompter delivery of bronchodilators and corticosteroids and was safe and effective without influencing the number of return paediatric emergency department visits or hospitalizations. Extensive research on Pubmed revealed multiple studies advocating for the effectiveness of IV Mg in improving lung function, decreasing the risk of hospitalizations, and minimizing the need for additional treatment in children with acute asthma.4 Thus, this therapy should be explored as a less costly management option in reducing hospital burden, healthcare cost and hospital readmission. IV Mg should be administered at a 25-50 mg/kg dose, but therapeutic drug concentrations might also be attained by larger doses of 50-75 mg/kg.5 Moreover, IV Mg is less costly but more effective compared to standard treatment for acute paediatric asthma, and could therefore be a revolutionary therapy in resource-deprived countries. Other potential second-line therapies for treating asthma exacerbations in children include parenteral beta-2 agonists, aminophylline, terbutaline, and intravenous salbutamol.5 However, there is a paucity of well-designed clinical trials comparing the potency and safety profiles of IV Mg with other second-line therapies. This is worsened by inconsistencies in outcome parameters such as clinical rating scales. The side effects of second-line bronchodilator treatments also need to be researched further. Until IV Mg is proven to be safer and more effective than other second-line agents by substantial and consistent evidence, this drug should not be recommended as the most suitable treatment option after bronchodilators and corticosteroids have failed as first-line therapies.

Clinical characteristics and treatment response of treatment requiring retinopathy of prematurity (ROP) in Big Premature Infants in Turkiye: BIG-ROP Study Group Report No 2 (BIG-ROP STUDY)

ObjectiveThis study evaluated the clinical characteristics and treatment outcomes of bigger premature infants treated for retinopathy of prematurity (ROP).MethodsA retrospective, multicentre study analysed data from 33 ROP centres in Türkiye. Infants with gestational ages (GA) of 32–37 weeks and birth weights (BW) >1500 g who required ROP treatment were included. Patient demographics, clinical details, treatments, responses and complications were recorded. Descriptive statistics were calculated after excluding cases with missing or erroneous data.ResultsThe study included 365 eyes of 365 infants. The average GA at birth was 33±1 weeks, with a mean BW of 1896±316 g. Of these, 83.6% had type 1 ROP, and 16.4% had aggressive ROP (A-ROP). Treatment-requiring ROP (TR-ROP) occurred at an average postmenstrual age of 39.0±4.6 weeks. Among 170 infants with TR-ROP at their first exam, 81.2% were screened at 4 weeks postpartum. Reactivation of ROP was observed in 5.4% of the primary laser photocoagulation (LPC) group and 23.9% of the primary anti-vascular endothelial growth factor (VEGF) group (p<0.001). Reactivation and progression to stage 4–5 were more frequent in A-ROP cases (p=0.012; p=0.008). The need for additional treatment was significantly higher in cases of A-ROP, zone 1 disease or stage 4–5 disease (p<0.001). Anti-VEGF therapy demonstrated superior single-treatment success rates in A-ROP eyes compared with laser LPC (85.7% vs 60%, p=0.03). Infants requiring additional treatments also had higher rates of respiratory distress syndrome (RDS), maternal premature rupture of membranes (PROM) and non-ophthalmological surgical interventions (p<0.05).ConclusionBigger premature infants in low and middle-income countries should be screened earlier than 4 weeks after birth. A-ROP, zone 1 disease and stage 4–5 disease have higher reactivation risks. Primary anti-VEGF therapy was associated with a greater need for retreatment. Maternal PROM, RDS and surgical interventions also increase retreatment risk. Limitations include retrospective design and lack of smaller preterm comparisons, potentially limiting generalisability.

Use of Eltrombopag in Patients with Chronic Idiopathic Thrombocytopenic Purpura: A Single Center Experience

This study aimed to evaluate the efficacy and safety of eltrombopag in the outpatient clinic of the Department of Hematology, Uludag University Faculty of Medicine. Treatment responses and demographic characteristics of 25 patients diagnosed with refractory chronic immune thrombocytopenia (ITP) and receiving eltrombopag between January 2011 and March 2014 were analyzed retrospectively. Both platelet ≥30,000/mm³ and ≥50,000/mm³ values were considered as responses. Prolonged response was defined as the maintenance of platelet 50,000/mm³ values for 12 weeks or longer without the need for any additional treatment, and sustained response was defined as the maintenance of platelet 50,000/mm³ and at least 2 times the baseline values without the need for additional treatment. Twenty-five patients were evaluated. Ten patients (40%) had an initial platelet value of

Efficacy and safety of a new mechanical balloon-based flow diverter in the treatment of intracranial aneurysms.

Flow diverters (FDs) are the first-line treatment of intracranial aneurysms (IAs). A groundbreaking mechanical balloon-based FD device was developed to enhance the precise landing and deployment efficiency for FDs. To investigates the efficacy and safety of this innovative device in a prospective cohort. This study was a prospective multicenter observational study conducted between September 2019 and November 2021. Patients diagnosed with unruptured IAs and treated with this innovative FD device alone were included. The immediate implantation success rate, the successful aneurysm occlusion rate (Raymond I-II or OKM C-D), the complete occlusion rate (Raymond I or OKM D), and the parent artery stenosis rate (>50%) at follow-up were evaluated as the evaluation index of efficacy. The mortality rate, adverse events (AEs), neurological AEs, and serious adverse events (SAEs) were evaluated as the evaluation index of safety. A total of 128 patients were included, and all of the FD deployments were successful (success rate reached 100%). At the 12-month mark, 91.4% (117/128) of patients achieved successful occlusion, 85.9% (110/128) achieved complete occlusion, and only 0.8% (1/128) exhibited parent artery stenosis >50% (without need for additional treatment). During the follow-up, there were no reported mortalities or cerebral hemorrhage, while 6 neurological adverse events (4.69%) and 4 SAEs (3.1%) were observed. The mechanical balloon-based FD showed a remarkable occlusion rate alongside minimal ischemic and hemorrhagic adverse events compared with existing FDs. This innovative mechanical balloon-based design may be an important direction for future FD design.

A COMPARATIVE STUDY OF MAGNASIUM SULFATE IN TREATING PEDIATRIC ACUTE BRONCHIOLITIS

Background: Acute bronchiolitis is a common respiratory disease in children that often necessitates hospitalization. Treatments for this condition include bronchodilators and supportive care. Although magnesium sulfate and hypertonic saline have been proposed as possible therapies, it is yet unknown how successful they are in comparison. This study aimed to compare the clinical efficacy, safety, and impact on respiratory outcomes of nebulized magnesium sulfate versus hypertonic saline in treating pediatric acute bronchiolitis. Methods: A prospective cohort study was conducted at Bannu Medical College, MTI Bannu, from January to December 2023. A total of 120 children (ages 2 months to 2 years) diagnosed with acute bronchiolitis were randomly assigned into two groups: Group A received nebulized magnesium sulfate (0.1cc/kg of 50% solution) every 8 hours for 24 hours, while Group B received nebulized hypertonic saline (3%, 4cc) every 8 hours for 24 hours. Both groups received standard supportive care. Primary outcomes included improvements in respiratory distress scores, oxygen saturation, wheezing, and respiratory rate. Secondary outcomes assessed hospital stay duration, side effects, and the need for additional treatment. Data were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables, with statistical significance set at p&lt;0.05. Results: Both treatments significantly improved respiratory distress scores and oxygenation. However, Group A (magnesium sulfate) showed greater reductions in wheezing and respiratory rate compared to Group B (hypertonic saline) (p&lt;0.05). Additionally, hospital stay duration was shorter in Group A (mean±SD: 3.2±0.9 days) compared to Group B (3.8±1.1 days, p=0.03). No severe side effects were observed in either group. Conclusion: Nebulized magnesium sulfate demonstrated superior efficacy in improving respiratory distress and reducing hospital stay duration compared to hypertonic saline, suggesting its potential as a more effective treatment option for pediatric acute bronchiolitis. These findings highlight the need for further large-scale randomized controlled trials to confirm these results and refine treatment protocols.

Abstract 1936: Circulating epithelial tumor cells as a biomarker to predict treatment failure of radiotherapy in breast and prostate cancer

Abstract Background: In primary breast and prostate cancer, radiotherapy is an integral part of the treatment toolbox. However, despite the significant reduction in local relapses in both breast and prostate cancer, distant relapses still occur in a considerable number of patients. Therefore, biomarkers are urgently needed to identify patients at increased risk of developing metastatic disease. Distant metastases arise from cells released from the primary tumor that are capable of forming metastatic tumors in distant organs, ultimately leading to fatal outcomes. Methods: We have therefore used the maintrac® approach to monitor and characterize circulating epithelial tumor cells (CETC/CTC) numbers during radiotherapy and to correlate them with treatment outcomes. Results: In breast cancer, an increase in CETC/CTC numbers during the course of radiotherapy was highly predictive of relapse, particularly in the neoadjuvant setting, with a hazard ratio of 4.886 (p&amp;lt;0.01). This finding suggests that an increase in CETC/CTC during radiotherapy in breast cancer patients previously treated with neoadjuvant chemotherapy indicates the need for additional treatment following radiotherapy.In prostate cancer, where radiotherapy is increasingly used without surgery due to the advanced age and frailty of patients and the considerable side effects of prostatectomy, adjuvant radiotherapy was administered to 12 patients. Among these, two patients showed an increase in CETC/CTC numbers from mid-treatment to the end of radiotherapy, and both experienced relapse.In patients receiving definitive radiotherapy without surgery, cell counts were available for 27 individuals. Of these, 8 showed an increase in CETC/CTC numbers. Three of the 8 patients experienced relapse, while 5 have remained in complete remission for up to 8 years despite increasing cell numbers. Additionally, 1 out of 19 patients with decreasing cell numbers experienced a local relapse.Although patients with increasing CETC/CTC counts from mid-treatment to the end of radiotherapy had a significantly higher risk of relapse, not all of them experienced relapse. Other cell characteristics, such as PD-L1 expression, might also play a crucial role. In fact, the fraction of PD-L1-positive cells increased from before to after radiotherapy in patients who experienced relapse during adjuvant radiotherapy but decreased in patients who remained in complete remission. This pattern was similarly observed in patients undergoing definitive radiotherapy. Conclusion: These results highlight the potential of monitoring both CETC/CTC numbers and their characteristics as a prognostic tool. This approach could help identify patients who require more intensive adjuvant treatment, which may contribute to improved treatment outcomes in the future. Citation Format: Dorothea Schott, Matthias Maurer, Monika Pizon, Katharina Pachmann. Circulating epithelial tumor cells as a biomarker to predict treatment failure of radiotherapy in breast and prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1936.

Comorbid Infections in Spondyloarthritis: the Current State of the Problem

Comorbid infections (CI) in immuno-inflammatory rheumatic diseases (IIRDs) are associated with significant morbidity and mortality and, in addition, involve significant costs in the health care system due to the need for additional treatment and hospitalization. The development of CI requires the temporary cancellation of ongoing immunosuppressive therapy, which can lead to an exacerbation of IIRD. High activity of rheumatic disease and treatment with immunosuppressive drugs may increase the risk of CI. Of particular interest is the study of the frequency, structure and risk factors in patients with spondyloarthritis (SpA) — ankylosing spondylitis (AS) and psoriatic arthritis (PsA), especially in the aspect of the increasing use of biologics or targeted (b/tsDMARD) modifying disease agents and contradictory literature data.

An Audit of Narrative Reports Compared to Structured Pathology Reporting for Cutaneous Squamous Cell Carcinoma.

Australia introduced structured pathology reporting guidelines for non-melanoma skin cancer (NMSC) including cutaneous squamous cell carcinoma (cSCC) in 2023 to encourage accurate histological assessment and recording of well recognised adverse prognostic factors that inform prognosis and the need for additional treatment. Deaths from cutaneous squamous cell carcinoma (cSCC) are increasing. Identifying high-risk cSCC (HRcSCC) cases early is critical, and the pathologist has a central role to play. To establish the completeness of cSCC pathology reports under existing practice before 2023. Pathology reports for a consecutive series of cSCC referred to a University Hospital multidisciplinary team (MDT) during 2022 were audited against the new guidelines. Of 156 cSCC cases referred to MDT, 87 met inclusion criteria. All macroscopic criteria were consistently reported (95%-100%). Most microscopic criteria (margin status, histological subtype, histological grade, perineural invasion [PNI] and anatomic extent of invasion) were consistently included (94%-100%); however, lymphovascular invasion (LVI) (80%), depth of invasion (DOI) (33%) and satellitosis/in transit metastasis (SITM) (0%) were notable omissions. Critical prognostic factors were frequently omitted from narrative reports. While most narrative-style reports for cSCC contain most of the main prognostic criteria, the use of structured reports may improve the completeness of cSCC pathology reporting.

From laparoscopic to robot-assisted extravesical ureteral reimplantation: evolution of a new standard treatment for pediatric vesicoureteral reflux.

This paper aimed to compare laparoscopic (LEVUR) vs. robot-assisted (REVUR) Lich Gregoir extravesical ureteral reimplantation (UR) in children with vesicoureteral reflux (VUR). The charts of all patients with moderate to high-grade VUR (3 to 5), who received LEVUR or REVUR over a 10-year period (2014-2024), were retrospectively reviewed. Seventy-six patients (40 girls and 36 boys), with median age of 5.7 years (range 2-11) and moderate to high-grade VUR, were enrolled. VUR was unilateral in 55/76 (72.3%) and bilateral in 21/76 (27.7%). Patients were grouped according to the MIS approach and pathology side. The median operative time (OT) of unilateral non-dismembered UR was similar in LEVUR (65 min) and REVUR (50 min) (P=0.56). REVUR was faster than LEVUR in unilateral dismembered (90 vs. 120 min) (P=0.001) and bilateral UR (105 vs. 160 min) (P=0.001). The radiographic VUR resolution rate was similar between REVUR and LEVUR (97.8% vs. 96.7%) (P=0.89). Two patients (2.6%) reported low-grade persistent reflux without need for additional treatments. Mild bladder dysfunction developed in 2/21 (9.5%) undergoing bilateral UR (Clavien-Dindo 2). REVUR is technically easier, faster and provides better ergonomics compared to LEVUR. The postoperative outcomes are excellent in both techniques, with success rates higher than 95%. Complications developed after bilateral reimplantation in patients who had previous history of bladder dysfunction. Given the robot availability, we believe that the best indication for LEVUR remains unilateral reflux without need for ureteral tapering. In unilateral refluxing megaureter, para-ureteral diverticulum or bilateral cases, REVUR represents the best choice.

Order of Consonant Production as a Predictor of Speech Outcomes After Primary Palatoplasty.

Reliable early prediction of long-term speech outcomes after primary palatoplasty has not been explored. This study aimed to (1) clarify the relationship between the pattern of initial consonant production and postoperative speech outcome in patients with cleft palate (CP), and (2) investigate whether differences exist in the order pattern of initial consonant production by CP presence. Consecutive children who underwent primary CP surgery between 2001 and 2016 at our hospital were retrospectively analyzed; 42 and 38 children were assigned to the CP and non-CP groups, respectively. The production order of the main Japanese consonants/k/,/g/,/t/, and/d/ was analyzed, and 3 groups were created: type td, where t/d precedes k/g; type kg, where k/g precedes t/d; and type same, where t/d and k/g occur simultaneously. We compared consonant patterns between groups and assessed the association between these patterns and the incidence of velopharyngeal insufficiency (VPI), abnormal articulations, and the need for additional treatment in the CP group. At both 4 and 7 years, the likelihood of having VPI was significantly higher in type kg children than in type td children. Velar consonants did not precede alveolar consonants in the non-CP group. Significantly more type kg patients received additional treatment than type td (P < 0.001) and type same (P = 0.003) groups. Patients with normal velopharyngeal function acquired alveolar consonants (td) before velar consonants (kd), indicating that those who first produced velar consonants were more likely to present with VPI or require additional treatment.

Resiliency is a Predictor of Clinical Outcomes in a Chronic Pain Cohort

BACKGROUND: Multidimensional strategies to improve pain have advanced the understanding of pain and pain treatment, yet the examination of biopsychosocial factors and associated treatments within pain management has not reached the mainstream. OBJECTIVE: The objective of this study was to explore whether psychological variables added to routinely collected medical information were associated with clinical outcomes and the need for additional treatments after an initial chronic pain intervention. STUDY DESIGN: This prospective, observational study recruited patients during their initial pain management visits and followed them until they returned to the clinic for additional pain management. SETTING: A private, multispecialty orthopedic clinic in Tallahassee, Florida. METHODS: Patients were seeking treatment for their chronic pain. They completed a series of psychological evaluations, including the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale 7 (GAD-7), Avoidance-Endurance Questionnaire (AEQ), and Connor-Davidson Resilience Scale 10 (CD-RISC-10), in addition to answering lifestyle/behavioral questions. Chart reviews were performed at least one year from the patients’ initial visits to understand the response to initial treatment and subsequent clinical management of their pain conditions. RESULTS: One hundred fifty-two patients completed the full assessment, and 118 returned at least once to the clinic for continued medical care and were included in the models. A previous history of opioid use at the initial visit was a significant positive predictor of change in pain (P = 0.049). The CD-RISC-10 score was a significant negative predictor of the need for additional treatment at the patient’s follow-up visit (P = 0.040). Thirteen percent of the cohort reported at least moderate symptoms of anxiety, and 26% of the cohort reported at least moderate symptoms of depression. LIMITATIONS: The limitations of this study were a lack of quantified opioid use and a reliance on self-reported measures. CONCLUSION: The inclusion of a resiliency measure along with established psychological instruments appears to add clinical value when managing patients with chronic pain. This study adds to the growing body of evidence that depicts resiliency as an important predictor of clinical outcomes. KEY WORDS: Behavioral health; pain management; anxiety; depression; resilience, chronic pain; mental health

Long-Term Treatment Outcomes with a Single 0.19 Mg Fluocinolone Acetonide Implant in Non-Infectious Uveitis – A Real-World Study

ABSTRACT Purpose To evaluate time to first additional treatment following intravitreal 0.19 mg fluocinolone acetonide (FAc) in non-infectious uveitis with posterior segment involvement (NIU-PS) in a real-world setting. Methods Prospective observational study on 37 eyes (30 patients) with chronic or recurrent NIU-PS, treated with FAc after achieving control – indicated by absence of vitreous haze or clearly visible posterior pole. Over a median follow-up of 48.0 ± 0.0 months, we assessed time to and number of additional treatments, inflammatory activity, central subfield macular thickness (CSMT), visual acuity (VA) and intraocular pressure (IOP). Results Restricted mean time to first adjuvant treatment was 31.9 ± 2.97 months, with 52.8% requiring no additional treatment ≥ 48 months. VA remained stable (baseline 0.56 ± 0.44 logMAR, p = 0.86). A negative correlation was found between the number of prior steroid implants (DEX-I) and time to additional treatment (r = −0.44, p = 0.001). For up to 24 months, FAc reduced anterior chamber flare (0.44 ± 0.81 to 0.00 ± 0.00, p < 0.001), vitreous haze (0.28 ± 0.51 to 0.00 ± 0.00, p = 0.01), and CSMT (407.1 ± 135.9 µm at baseline to 324.2 ± 75.7 µm at M24, p = 0.001). Within 48 months, ocular hypertension (≥25 mmHg) occurred in 22.2% of eyes (8/36), with 19.4% (7/36) requiring new-onset IOP-lowering drops. Conclusion FAc demonstrated efficacy in managing low-grade NIU-PS, reducing the need for additional treatments and controlling intraocular inflammation for an average of 32 months.

Toward real-time margin assessment in breast-conserving surgery with hyperspectral imaging

Margin assessment in breast-conserving surgery (BSC) remains a critical challenge, with 20-25% of cases resulting in inadequate tumor resection, increasing the risk of local recurrence and the need for additional treatment. In this study, we evaluate the diagnostic performance of hyperspectral imaging (HSI) as a non-invasive technique for assessing resection margins in ex vivo lumpectomy specimens. A dataset of over 200 lumpectomy specimens was collected using two hyperspectral cameras, and a classification algorithm was developed to distinguish between healthy and tumor tissue within margins of 0 and 2 mm. The proposed approach achieved its highest diagnostic performance at a 0 mm margin, with a sensitivity of 92%, specificity of 78%, accuracy of 83%, Matthews correlation coefficient of 68%, and an area under the curve of 89%. The entire resection surface could be imaged and evaluated within 10 minutes, providing a rapid and non-invasive alternative to conventional margin assessment techniques. These findings represent a significant advancement toward real-time intraoperative margin assessment, highlighting the potential of HSI to enhance surgical precision and reduce re-excision rates in BCS.

Relationship of Retinal Zone and Plus Severity with the Requirement of Re-Treatment in Bevacizumab-Treated Eyes for Retinopathy of Prematurity

Introduction: The aim of this study was to investigate the relationship between the location of retinal vascularization and plus severity with re-treatment rates in intravitreal bevacizumab (IVB)-treated eyes. Methods: For this retrospective, observational study, 200 eyes treated with IVB for type 1 retinopathy of prematurity (ROP) and aggressive-ROP were included. The pretreatment retinal vascularization was evaluated by analyzing quantitative measurements of optic disc-to-fovea distance (DFD), disc diameter, and shortest and longest distance between the optic disc and ridge of wide-field fundus photographs (WFPs). Plus severity was qualified in five grades such as normal, pre-plus, mild plus, moderate plus, and severe plus by evaluating WFPs. Re-treatments up to 60 weeks of postmenstrual age (PMA) were evaluated. Re-treated eyes up to first month after initial treatment were labeled as early re-treatment group and re-treated eyes after the first month of initial treatment up to 60 weeks of PMA were labeled as middle-term re-treated group. Results: Thirty-six percentage of eyes had zone I, 64% of eyes had zone II disease, and 42% eyes had mild plus disease. Forty-three (21.5%) eyes of 23 infants underwent re-treatment prior to 60 weeks of PMA. Thirteen eyes and 30 eyes were in the early- and middle-term re-treated groups, respectively. In middle-term re-treated group, 27 (13.5%) eyes re-treated for progressive reactivated disease, and 3 (1.5%) eyes re-treated for prophylactic purposes. Advanced pretreatment retinal vascularization and high birth weight were negatively associated with the re-treatment rate (p = 0.016, odds ratio = 0.774; p = 0.041, odds ratio = 0.999, respectively). There was a positive association between the re-treatment rate and pretreatment plus severity (p = 0.044, odds ratio = 1.449). The lower ratio of shortest distance between the optic disc and ridge to DFD was considered as an independent predictive variable for higher rate of re-treatment (p = 0.002; odds ratio: 0.450). Conclusion: The location of retinal vascularization and plus disease showed a wide distribution in bevacizumab-treated eyes. Graded evaluation of retinal vascularization and plus severity may help predict the need for additional treatment. Unresponsiveness to the initial treatment, increased fibrotic activity, progressive reactivated stage 2–3 ROP, extraretinal new vessels, and prophylactic purposes were the main re-treatment indications.

Preliminary Evaluation of Nontransecting Anastomotic Urethroplasty for Pelvic Fracture Urethral Injury: Insights From a Comparison With Excision and Primary Anastomosis.

To evaluate the feasibility and surgical and patient-reported outcomes of nontransecting anastomotic urethroplasty (NTAU) for male patients with pelvic fracture urethral injury (PFUI) compared with excision and primary anastomosis (EPA), the current mainstay surgical approach. This retrospective study analyzed 233 male PFUI patients treated with EPA (n = 223) or NTAU (n = 10) from 2008 to 2024 by a single surgeon (AH). NTAU involves preserving urethral continuity and maintaining bilateral bulbar artery integrity while excising scar tissue and achieving tension-free urethral anastomosis. Anatomical success was defined as the ability to pass a 17Fr flexible cystourethroscope through the anastomotic site without resistance and no need for additional treatments. Postoperative functional outcomes were assessed using validated patient-reported measures, including the LUTS-specific quality-of-life (QOL) questionnaire, the Sexual Health Inventory for Men (SHIM), and the EuroQol Visual Analog Scale (EQ-VAS). Although the median follow-up period was significantly shorter for NTAU (12 vs. 69 months, p < 0.0001), the anatomical success rate was 100% for NTAU and 94.6% for EPA, with no significant difference between the groups (p = 0.45). No significant differences were observed in the perioperative complication rate (p = 0.54). The changes in LUTS-QOL, SHIM, and EQ-VAS scores from preoperative to postoperative assessments were also comparable, indicating similar patient-reported outcome improvements in both groups (p = 0.71, p = 0.16, p = 0.92, respectively). NTAU has the potential to achieve surgical and patient-reported outcomes comparable to EPA. Further studies are warranted to validate its long-term benefits and define its optimal indications.

Clinical efficacy and safety assessment of tedizolid using therapeutic drug monitoring.

Clinical efficacy and safety assessment of tedizolid using therapeutic drug monitoring.

Transoral Robotic Approach for Pharyngeal Schwannoma

Introduction: Schwannomas are a common condition encountered in clinical ENT practice, but they are rarely found in the pharyngeal or laryngeal regions. Materials and Methods: In this report, we share our experience using the transoral robotic approach to treat a schwannoma located on the lateral pharyngeal wall, with the surgery being performed exclusively using transoral robotic surgery (TORS). It is important to be aware of any pseudocystic lesions in this area, as they can lead to unpredictable anatomopathological outcomes. Results and Conclusions: Our technique allows us to achieve complete resection of the tumor, facilitating rapid recovery for the patient without the need for additional treatment.

MAGI3 enhances sensitivity to sunitinib in renal cell carcinoma by suppressing the MAS/ERK axis and serves as a prognostic marker

Clear cell renal cell carcinoma (ccRCC) exhibits considerable heterogeneity, with approximately 25% of localized cases susceptible to relapse, highlighting the challenge of the absence of reliable predictive biomarkers for personalized treatment. Meanwhile, metastatic renal cell carcinoma is characterized by unfavorable survival rates, and although Sunitinib offers partial benefits, the clinical advantages are often constrained by drug resistance and adverse side effects. Here, MAGI3 was associate with ccRCC progression, as identified through comprehensive bioinformatics analysis of clinical datasets. A low level of MAGI3 emerged as a high-risk factor for ccRCC, indicating its potential as a prognostic marker. Individuals with MAGI3 expression in middle-to-low levels displayed a significantly poorer survival rate, indicating a need for additional treatment even in the early stages of ccRCC. Furthermore, patients with MAGI3 expression in middle-to-high levels exhibited increased sensitivity to Sunitinib compared to those with lower MAGI3 levels, suggesting that individuals with MAGI3 expression at middle levels may potentially benefit from Sunitinib treatment even in the early stages of ccRCC. Through its interaction with the MAS receptor, MAGI3 has been identified as a regulator of cell proliferation and a determinant of Sunitinib resistance in ccRCC, operating via the Ang-(1-7)/MAS/ERK axis. The loss of MAGI3 expression in ccRCC patients activated the ERK signaling pathway, contributing to both cancer progression and Sunitinib resistance. Therefore, our study not only highlight MAGI3’s pivotal role in ccRCC progression and Sunitinib resistance, but also reinforces MAGI3’s prospective value as a predictive marker.