Citations

Fungal rhinosinusitis (FRS) can be classified into invasive and non-invasive forms, with the fungal ball (FB) representing a common non-invasive type with generally favorable outcomes post-operatively. The clinical presentation of FB can vary and be non-specific, and it is important to consider a wide differential diagnosis for sinonasal masses, including malignancy. We present the case of a 74-year-old female presenting with a two-year history of nasal obstruction and drainage. She has a history of breast cancer and prior maxillomandibular surgery, and imaging showed a poorly defined mass in the right maxillary sinus with possible hemorrhagic and/or proteinaceous content. Rigid nasal endoscopy revealed a friable mass, and endoscopic sinus surgery findings were consistent with FB. This case exemplifies the need to consider a broad set of differential diagnoses when evaluating sinonasal masses, especially if the patient has a prior malignancy or maxillomandibular surgical history, including FB and metastases to the paranasal sinuses. Given the presence of non-specific symptoms, it is important to consider early imaging for patients with distorted anatomy and a history of malignancy. Endoscopic sinus surgery, with high success rates, is the gold-standard treatment for FB.

Silver foam dressings have been extensively used in the management of burn injuries; however, its application in children requires elucidation. A literature search was conducted from database inception to October 2023. Eligible studies reported paediatrics patients under 21 years of age receiving silver dressings for burns or scalds. This review was registered prospectively with PROSPERO (CRD42023470239). 18 studies met the inclusion criteria with a total of 701 patients. The pooled mean time to re-epithelisation (TTRE) was 12.9 days (95% CI: 11.2, 14.6, I2 = 94%). The pooled mean duration of hospitalisation was 9.8 days (95% CI: 3.9, 15.7; I2 = 100%). Mean number of total dressing changes per patient was 3.6 (95% CI: 2.2, 4.9; I2 = 99%). There were a total of 98 complications, including 30 (30.6%) infections, 29 (29.6%) surgical requirements, 14 (14.3%) hypertrophic scarring, 17 (17.3%) escalations of care, 5 (5.1%) burn depth progression, and 3 (3.1%) others. Silver foam dressings appear as a safe and effective approach in terms of healing rate and dressing change frequency for selected paediatric patients with burn injuries. Despite the promising results, further comparative studies are required to evaluate the selection criteria and long-term effect of silver foam dressing.

ABSTRACTRationalePatient reported outcome (PRO) measures are a critical tool to understand the patient's experience of their illness. Our institution collects PRO measures for patients receiving spine care through several modalities, including direct patient outreaches.Aims and ObjectivesWe designed a quality project to increase the total number of patient outreaches within 1 year, without increasing program resources or costs, by utilizing a return‐to‐work program.MethodSpine PRO collection rate data was extracted from the electronic health record by a data science analyst. This data included how many direct patient outreaches were completed each month and the average number of patient outreaches being completed by the patient outreach representative. For the balancing measure, full‐time equivalent costs were monitored throughout the baseline and pilot periods.ResultsDuring the 6‐month baseline period, 3477 patient outreaches were made, representing 14.5% of possible outreaches. During the first 3‐month post‐intervention remeasure period, 6272 patient outreaches were made, an increase of 55.44%. During the second 3‐month post‐intervention period, 9099 outreaches were made, an increase of 38.21% from the first remeasure. There was no increase in cost to the program related to the project.ConclusionThis increase in patient outreaches by return‐to‐work employees will translate to improvement in overall PRO collection rates, which may ultimately improve individual and population health care delivery.

We evaluated the energy consumption of a 3T MRI using a central monitoring system, focusing on hospital energy costs during peak winter months from 2021 to 2023. We analyzed consumption during non-productive phases like end-of-day standby and assessed their impact. For active use, we compared standard and AI-enhanced protocols on phantoms, scheduling high-demand protocols during off-peak hours to benefit from lower energy prices. Standard protocols consumed 3.4 to 15 kWh, while optimized protocols used 2.3 to 10.6 kWh, reducing consumption by 32% on average. Savings per scan ranged from EUR 0.03 to EUR 3.7. The electrical consumption of a brain MRI protocol is equivalent to that of 3–4 knee protocols or 2–3 lumbar spine protocols. Using AI-optimized protocols and management, 41 protocols can be completed in 12 h, up from 30, reducing daily costs by EUR 2.38 to EUR 29.18. Annually, AI-optimized protocols could save 7900 to 8800 kWh per MRI unit, totaling 10,500 to 11,600 MWh across France’s MRI fleet, equivalent to the yearly consumption of about 4700 to 5300 people. Optimizing MRI resource use can expand patient access while significantly reducing the associated energy footprint. These findings support the implementation of more sustainable practices in medical imaging without compromising care quality.

Abstract INTRODUCTION We aimed to compare gait between individuals with Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and cognitively unimpaired (CU) individuals and to evaluate the association between gait and regional amyloid beta (Aβ) burden in AD and DLB. METHODS We included 420 participants (70 AD, 70 DLB, 280 CU) in the Mayo Clinic Study of Aging (MCSA). Gait was assessed using a pressure‐sensor walkway. Aβ deposition was analyzed with Pittsburgh compound B (PiB) positron emission topography (PET). RESULTS The DLB group had reduced stride velocity, step length, and stride width variability, as well as increased double support percentage (%DS) and variability in step length, swing time, and step time compared to the AD and CU groups. Aβ burden was not associated with any gait outcomes. DISCUSSION This study provides additional evidence that gait differs between AD and DLB. Larger studies are needed to investigate associations between Aβ burden and gait outcomes in dementia. Highlights Gait was more impaired in dementia than in cognitively unimpaired (CU) controls. Compared with Alzheimer's disease (AD), Dementia with Lewy bodies (DLB) had more impaired pace, variability, and postural control. Step length and double support (%) distinguished DLB and AD with moderate accuracy.

Lung cancer remains the leading cause of cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer, with nearly half of all patients diagnosed at an advanced stage. Immune checkpoint inhibitors (ICIs) harness the host immune system to combat malignant cells. ICIs, which target programmed death-ligand 1 (PD-L1), programmed cell death 1 (PD-1), and cytotoxic T-cell lymphocyte-4 (CTLA-4), have transformed the treatment landscape for advanced NSCLC. While a subset of patients experiences a long-term durable response, most patients will develop disease progression. New drugs targeting novel pathways are being tested in clinical trials to improve the efficacy of immunotherapy and overcome resistance patterns. This review aims to summarize the currently available ICIs for advanced NSCLC and describe emerging immunotherapies with recently published data from phase I/II clinical trials.

Abstract Background: The trajectory of metastatic castration-sensitive prostate cancer varies based on disease presentation and biology. While proteomic profiling studies of primary prostate tissue have linked protein expression with metastatic progression and prognosis, few studies have explored biological changes after treatment and their associations with response. Therefore, we conducted proteomic profiling of patients with oligometastatic castration-sensitive prostate cancer (omCSPC) treated with stereotactic ablative radiotherapy (SABR) or observation in the ORIOLE phase 2 randomized clinical trial (RCT). Methods Plasma from omCSPC patients in the ORIOLE trial was collected at baseline (day 1), day 90, and day 180. Protein abundance was quantified using the Olink Explore Assay. Differential expression from baseline to day 90 or 180 in each treatment arm was analyzed using a 2-sided t-test with Benjamini-Hochberg correction. Changes in protein expression at day 90 and 180 were compared with a Pearson correlation. Pathway enrichment was performed via gene set enrichment analysis (GSEA) using Reactome, KEGG, and Hallmark gene sets. Associations with progression-free survival (PFS) were analyzed using Kaplan-Meier and log-rank tests. Results In total, 1,472 proteins were assayed across 130 samples from 46 patients over 3 time points. Significant changes in expression post-SABR were noted at day 90 and 180 compared to baseline (using adjusted p-value cutoff of 0.05). At day 90, four proteins (FCRL1, CD22, TCL1A, FCER2) were downregulated; at day 180, only FCRL1, a Fc receptor-like gene family preferentially expressed in B cells, remained downregulated. No significant expression changes were found in the observation arm. Differential expression of proteins during follow-up were associated with PFS. In particular, LTO1, a maturation factor of ABCE1 important for ribosomal biogenesis and translation, was overexpressed at both day 90 and 180 post-SABR, and overexpression was associated with improved PFS at day 90 (median 24.5 mo vs 6 mo; p=0.017) and day 180 (median 33 mo vs 6 mo; p=0.043). These associations were absent in the observation arm. For proteins differentially expressed in the SABR arm at day 90, several signaling pathways were significantly enriched for patients with prolonged PFS, including positive enrichment of unfolded protein response (UPR) (p=0.008) and IL-4/IL-13 (p=0.009). At 180 days, several pathways were enriched for patients with prolonged PFS including negative enrichment of CTLA4 inhibitory signaling (p=0.005) and CD28 co-stimulation (p=0.008). Conclusion Proteomic analysis in omCSPC patients from the ORIOLE trial reveals significant expression changes at days 90 and 180 after SABR. B-cell signaling proteins were selectively downregulated in the SABR arm, and pathways associated with protein translation and immune response were enriched post-SABR for patients with prolonged PFS. Further research will explore connections to genomic and transcriptomic changes, with additional validation needed. Citation Format: Jarey H. Wang, Amol Shetty, Yang Song, Noura Radwan, Soha Bazyar, Xiaolei Shi, Theodore L. DeWeese, Daniel Y. Song, Ryan M. Phillips, Matthew P. Deek, Philip Sutera, Ana P. Kiess, Phuoc T. Tran. Proteomic profiling of oligometastatic castration-sensitive prostate cancer treated with stereotactic ablative radiotherapy. [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Targeted Therapies in Combination with Radiotherapy; 2025 Jan 26-29; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(2_Suppl):Abstract nr B031.

Abstract Studies suggest varying atherosclerotic cardiovascular disease (ASCVD) prevalence across arterial beds. Factors such as smoking expedite ASCVD progression in the abdominal aorta, while diabetes accelerates plaque development in lower limb arteries, and hypertension plays a significant role in ASCVD development in the coronary and carotid arteries. Moreover, superficial femoral atherosclerosis advances slower compared with atherosclerosis in coronary and carotid arteries. Furthermore, femoral atherosclerosis exhibits higher levels of ossification and calcification, but lower cholesterol concentrations compared with atherosclerotic lesions of other vascular beds. Such disparities exemplify the diverse progression of ASCVD across arterial beds, pointing towards differential mechanistic pathways in each vascular bed. Hence, this review summarizes current literature on immune-inflammatory mechanisms in various arterial beds in ASCVD to advance our understanding of this disease in an aging society with increased need of vascular bed and patient-specific treatment options.