bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic value of laboratory markers in patients with acute pulmonary embolism
Authors: Omar Amany Omar Mohamed , Ahmed Yousef Ahmed Yousef , Elfadl Abd-Elazim Ahmed Abo , Ali Abeer Houssein , Abdelrahman Amal Abdallah , Ali Khaled Mohamed Khaled 
Published: July 2024

Abstract
Background
Acute pulmonary embolism (APE) is a serious illness. Identifying prognostic factors for APE may help in the management of those patients. This study’s objective was to evaluate the prognostic value of laboratory markers in predicting right ventricular dysfunction (RVD) and 30-day mortality in pulmonary embolism patients.

Methods
Eighty patients with APE were enrolled and followed up for 30 days. Detailed echocardiography was done to evaluate RVD. All patients were subjected to arterial blood gas analysis, complete blood count (CBC), plasma concentration of C-reactive protein (CRP), serum D-dimer level, and serum troponin I level, and the following ratio were calculated: neutrophil-to-lymphocytic ratio (NLR), platelet to lymphocytic ratio (PLR), red cell distribution width (RDW), mean platelet volume (MPV), and alveolar to arterial gradient.

Results
Our results analysis revealed significantly elevated levels of median NLR, PLR, CRP, D-dimer, and troponin in both the RVD and non-survivor groups (P value < 0.001). The blood markers that showed the highest predictive ability for right ventricular dysfunction (RVD) and 30-day mortality, as determined by receiver operating characteristic (ROC) analysis and logistic regression, were A-a O2 gradient, serum troponin, CRP, D-dimer, NLR, and PLR (P value < 0.001).

Conclusion
Evaluation of different serum markers including NLR, PLR, RDW, CRP, D-dimer, troponin, and A-a O2 gradient is a simple and available marker for predicting right ventricular dysfunction (RVD) and 30-day mortality in patients with APE.

Trial registration
ClinicalTrials.gov ID: NCT04237974.
Preliminary results from a phase II clinical study of first-line drugs combined with stereotactic body radiotherapy (SBRT) in the treatment of oligoprogressive renal cell carcinoma.
Authors: Zhang Xinyue , Liu Ruiqi , Liu Yang , Zhang Zhiling , Gao Jianming , Guo Shengjie , Han Hui , Zhou Fangjian , Dong Pei , He Liru 
Published: July 2024

4540 Background: For metastatic renal cell carcinoma (mRCC) patients (pts) with oligoprogression, escalation of systemic therapy (STE) to the next line of treatment is one of the major strategies but not the only option. Our study aimed to investigate the safety and efficacy of stereotactic body radiotherapy (SBRT) to mRCC pts with oligoprogression after first-line systemic therapy. Methods: This is a single-arm, phase II study enrolling oligoprogressive mRCC pts, defined as ≤ 3 progressive lesions with total metastases ≤ 5, who have received first-line systemic therapy for more than three months (ChiCTR2000032947). No liver or brain metastasis was allowed. Nephrotic focus was treated before or after enrollment. Pts remained on current first-line systemic therapy and received SBRT for all the oligoprogressive lesions, with 35-45Gy in 5 fractions. If oligoprogressive lesions appeared > 6 months after the end of SBRT, which were not irradiated, a second round of SBRT could be allowed. Primary endpoint was progression-free survival (PFS); secondary endpoints were local control (LC) rate, time to STE, overall survival (OS) and safety. Results: From June 2020 to Jan 2024, 30 pts were enrolled, and 27 pts (median age: 55 years; male-to-female ratio: 16:11) were evaluable for efficacy after SBRT. Most pts (74.1%) had a clear cell histology, and most pts (92.6%) were at an intermediate or a poor risk according to the International Metastatic RCC Database Consortium criteria. Sixteen pts had one progressive lesion and 11 pts had 2-3 lesions. The median time to oligoprogressive disease under first-line systemic therapy (mostly TKI monotherapy: 85.2%) was 13.6 months. The most common sites for SBRT were bone (32.4%), lymph node (23.5%) and lung (23.5%). At a median follow-up of 23.5 months, the LC rate was 97.1%. Six-month PFS, 12-month PFS, 18-month PFS, 24-month PFS and median PFS were 88.9%, 54.2%, 36.4%, 22.7% and 15.0 months, respectively. The 24-month OS and median OS were 78.5% and not reached. Grade 3-4 treatment-related adverse events (AEs) occurred in 44.4% pts, and the most common AEs were hematological toxicity (18.5%), hypertension (18.5%), and palmar-plantar erythrodysesthesia syndrome (7.4%). No SBRT-related grade 3-4 toxicity was observed. Conclusions: SBRT is a safe and an effective treatment for oligoprogressive mRCC, with a notable extension of the ongoing first-line systemic therapy. Clinical trial information: ChiCTR2000032947.
Anlotinib plus docetaxel in advanced NSCLC progressing on immunotherapy: A pooled analysis of two randomized trials.
Authors: Wu Lin , Fang Yong , Pu Xingxiang , Shou Jiawei , Xiao Zemin , Chen Jun , Xiao Maoliang , Guo Qunyi , Ma Zhongsha , Hong Wei , Wang Qianzhi , Wang Yonghui , Li Jia , Rao Chuangzhou , Jie Weng , Lu Liqin 
Published: July 2024

8062 Background: This analysis aimed to evaluate outcomes of anlotinib plus docetaxel versus docetaxel alone in patients with advanced non-small cell lung cancer (NSCLC) after progression on immune-checkpoint inhibitors (ICIs) using the pooled data from two randomized trials (ALTER-L016; ALTER-L018). Methods: Eligible patients for this pooled analysis were aged 18-75 years and had EGFR/ALK/ROS1 wild-type advanced NSCLC progressing after first-line ICIs therapy. Patients were randomly assigned to receive anlotinib (10 mg [L016] or 12 mg [L018] once daily on days 1-14) plus docetaxel (60 mg/m2 [L016] or 75 mg/m2 [L018], on day 1 every 3 weeks) or docetaxel alone. The primary endpoint was progression-free survival (PFS). Second endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. Results: Total of 71 patients (L016, n = 39; L018, n = 32) who progressed after ICIs were included in this pooled analysis, 40 of whom had received anlotinib plus docetaxel and 31 received docetaxel. Median follow-up for all patients was 27.0 months (IQR, 17.6-31.2). A significant PFS benefit was observed with anlotinib plus docetaxel (5.4 months; 95% CI, 5.0-9.3) over docetaxel alone (2.3 months; 95% CI, 1.4-2.9), with a hazard ratio (HR) of 0.34 (95% CI, 0.18-0.63; P < 0.001). Improvement in PFS was seen across most evaluated subgroups. Anlotinib plus docetaxel induced a higher ORR (25.0% vs. 12.9%) and DCR (82.5% vs. 45.2%) over docetaxel alone. Median OS was similar between two arms (16.2 vs. 13.7 months; HR = 0.82 [0.47-1.44]; P = 0.488). Subsequent therapy with ICIs was associated with a longer OS. The incidence of grade 3 or higher treatment-related adverse events was 32.5% with anlotinib plus docetaxel and 6.5% with docetaxel. Conclusions: Anlotinib plus docetaxel demonstrated survival and response improvements compared with docetaxel alone in patients with advanced NSCLC progressing after ICIs, with a manageable safety profile. This finding suggested anlotinib plus docetaxel might be effective and safe option in this setting. Clinical trial information: NCT03726736 ; NCT03624309 .
MEK inhibitor combined with RTK inhibitor (trametinib plus anlotinib) in non-G12C KRAS-mutant non-small cell lung cancer: A new strategy.
Authors: Han Baohui , Lu Jun , Zhong Hua , Chu Tianqing , Zhang Wei , Hu Minjuan , Shi Chunlei , Xiong Liwen , Gu Aiqin , Wang Huimin , Lou Yuqing , Zhang Yanwei , Zhong Runbo , Gao Zhiqiang 
Published: July 2024

8542 Background: It remains as a big challenge to provide therapeutic regime for the non-G12C KRAS-mutant non-small cell lung cancer (NSCLC) patients. The strategy of co-inhibition of MEK/RTKs pathways via trametinib and anlotinib showed preliminary activity in non-G12C KRAS-mutant NSCLC. Methods: The phase I clinical trial (NCT04967079) was divided into 2 parts including part A and part B. The primary endpoint of part A was to determine the recommended phase 2 dose (RP2D) and the primary endpoint of part B was to evaluate the objective response rate (ORR). The secondary endpoints were progression-free survival (PFS), disease control rate (DCR) and safety. Results: The part A containing 13 patients showed that the RP2D is trametinib (2 mg) plus anlotinib (8 mg), the ORR is 69.2%, the PFS is 207 days, DCR is 92% and the rate of adverse events (AEs) ≥ grade 3 is 23%. The part B containing 20 patients showed high efficacy of this combinational therapy (trametinib (2 mg) plus anlotinib (8 mg)), with the ORR at 65%, the PFS is 330 days, the DCR at 100%, and the rate of AEs ≥ grade 3 at 35%. An integrative analysis for the part A plus part B (33 patients) indicated that the ORR is 66.7%, the PFS is 300 days, the DCR is 97% and the rate of adverse events (AEs) ≥ grade 3 is 30%. Conclusions: This study provides a potential combinational therapeutic strategy for those non-G12C KRAS-mutant lung cancer patients via oral administration of trametinib and anlotinib. Clinical trial information: NCT04967079 .
A phase 1b study of ensartinib in combination with platinum-based chemotherapy and bevacizumab in ALK-positive non-small cell lung cancer (NSCLC).
Authors: Concannon Kyle , Selvaggi Giovanni , Zhou Joey , Elamin Yasir Y 
Published: July 2024

8624 Background: Ensartinib is an oral tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK), which has shown systemic and central nervous system efficacy in ALK-positive non-small cell lung cancer (NSCLC) and superiority over crizotinib in the first-line setting. This single-arm phase-1b study evaluates the efficacy of ensartinib in combination with platinum-based chemotherapy and bevacizumab in ALK-positive advanced NSCLC. Methods: Patients were treated with 4 cycles of induction ensartinib, carboplatin, pemetrexed, and bevacizumab before receiving maintenance ensartinib with or without bevacizumab and/or pemetrexed until disease progression or intolerable toxicity. Prior treatment with ALK-targeting agents and the presence of asymptomatic brain metastases were allowed. The primary endpoints were to determine safety of ensartinib in combination with carboplatin, pemetrexed, and bevacizumab and to determine the recommend phase 2 dose of ensartinib in this combination. Results: Between June 22, 2021, and August 15, 2022, 6 patients were enrolled into the study and treated with at least one dose of ensartinib in combination with platinum-based chemotherapy and bevacizumab. All patients were included in safety and efficacy analyses. The median age was 54.7y, 3/6 were female, 5/6 were never smokers, the median ECOG was 1, and 3/6 had brain metastases at enrollment. Participants received a median of 2 prior lines of therapy (range 0-3) and 4/6 received prior ALK TKI therapy: 2/6 two prior ALK TKIs, 2/6 three prior ALK TKIs. As of 12/1/2022, the maximum severity adverse event (AE) was grade 2 in 1/6 patients, grade 3 in 4/6 patients, and grade 5 in 1/6 - a therapy unrelated bronchopulmonary hemorrhage. Ensartinib-related grade 1, 2, and 3 AEs occurred in 1/6, 3/6, and 2/6 respectively. Dose reductions from 225mg daily to 200mg daily occurred in 1/6 patients secondary to grade 3 transaminitis, which was subsequently well tolerated. 1/6 patients transitioned therapy after a treatment unrelated bowel perforation. The median time on trial was 9.6 months. 2/6 patients remained on treatment at time of censorship with trial durations of 22.6 and 15.8 months. 1/6 patients progressed and 2/6 patients died on treatment. Conclusions: Ensartinib in combination with platinum-based chemotherapy and bevacizumab had an acceptable safety profile and demonstrates clinical activity in treatment naïve and previously treated advanced ALK-positive NSCLC, including in patients treated with prior ALK-targeted therapies. Next phase study designs are currently being considered. Clinical trial information: 2020-0838.
Comparison of Postoperative Seizures Between Burr-Hole Evacuation and Craniotomy in Patients With Nonacute Subdural Hematomas: A Bi-Institutional Propensity Score–Matched Analysis
Authors: Ramirez-Velandia Felipe , Ranawaka Kasuni H. , Wadhwa Aryan , Salih Mira , Fodor Thomas B. , Lau Tzak S. , Pacheco-Barrios Niels , Enriquez-Marulanda Alejandro , Khan Imad S. , Vega Rafael A. , Stippler Martina , Taussky Philipp , Hong Jennifer , Ogilvy Christopher S. 
Published: July 2024

BACKGROUND AND OBJECTIVES:
Postoperative seizures are a common complication after surgical drainage of nonacute chronic subdural hematomas (SDHs). The literature increasingly supports the use of prophylactic antiepileptic drugs for craniotomy, a procedure that is often associated with larger collections and worse clinical status at admission. This study aimed to compare the incidence of postoperative seizures in patients treated with burr-hole drainage and those treated with craniotomy through propensity score matching (PSM).

METHODS:
A retrospective cohort analysis was conducted on patients with surgical drainage of nonacute SDHs (burr-holes and craniotomies) between January 2017 to December 2021 at 2 academic institutions in the United States. PSM was performed by controlling for age, subdural thickness, subacute component, and preoperative Glasgow Coma Scale. Seizure rates and accompanying abnormalities on electroencephalographic tracing were evaluated postmatching.

RESULTS:
A total of 467 patients with 510 nonacute SDHs underwent 474 procedures, with 242 burr-hole evacuations (51.0%) and 232 craniotomies (49.0%). PSM resulted in 62 matched pairs. After matching, univariate analysis revealed that burr-hole evacuations exhibited lower rates of seizures (1.6% vs 11.3%; P = .03) and abnormal electroencephalographic findings (0.0% vs 4.8%; P = .03) compared with craniotomies. No significant differences were observed in postoperative Glasgow Coma Scale (P = .77) and length of hospital stay (P = .61).

CONCLUSION:
Burr-hole evacuation demonstrated significantly lower seizure rates than craniotomy using a propensity score-matched analysis controlling for significant variables.
Follow-Up Care for Brain Tumors in Low- and Middle-Income Countries: A Systematic Review of Existing Challenges and Strategies for the Future
Authors: Shakir Muhammad , Tahir Izza , Shariq Syeda Fatima , Khowaja Aly Hamza , Irshad Hammad Atif , Rae Ali I. , Hamzah Radzi , Gupta Saksham , Park Kee B. , Enam Syed Ather 
Published: July 2024

BACKGROUND AND OBJECTIVES:
Brain tumors have a poor prognosis and a high death rate. Sufficient aftercare is necessary to enhance patient results. But follow-up care provision is fraught with difficulties in low- and middle-income countries (LMICs), where a variety of variables can impede access to care. Therefore, our systematic review aimed to identify challenges to follow-up care for brain tumors and possible solutions in LMICs.

METHODS:
A thorough search of the literature was performed from the beginning until October 20, 2022, using Google Scholar, PubMed, Scopus, and CINAHL. Studies focusing on the aftercare of brain tumors in LMICs met the inclusion criteria. Two reviewers used the National Surgical, Obstetric, and Anesthesia Plan categories to identify themes, extract relevant data, and evaluate individual articles. After being discovered, these themes were arranged in Microsoft Excel to make reporting and comprehension simpler.

RESULTS:
A total of 27 studies were included in the review. Among the studies included, the most frequently cited barriers to follow-up care were financial constraints (54%), long-distance travel (42%), and a lack of awareness about the importance of follow-up care (25%). Other challenges included preference for traditional or alternative medications (4%) and high treatment costs (8%). Proposed strategies included implementing mobile clinics (20%), establishing a documentation system (13%), and educating patients about the importance of follow-up care (7%).

CONCLUSION:
In LMICs, several issues pertaining to personnel, infrastructure, service delivery, financing, information management, and governance impede the provision of follow-up treatment for patients with brain tumors. As established by the suggested techniques found in the literature, addressing these issues will necessitate concurrent action by stakeholders, legislators, health ministries, and government agencies.
The Era of Radial-Specific Catheters: A Multicenter Comparison of the Armadillo and RIST Catheters in Transradial Procedures
Authors: El Naamani Kareem , Roy Joanna M. , Momin Arbaz A. , Teichner Eric M. , Sioutas Georgios S. , Salem Mohamed M. , Gaskins Wendell , Saadat Nazanin , Nguyen Alyssa Mai , Tjoumakaris Stavropoula I. , Gooch M. Reid , Rosenwasser Robert H. , Srinivasan Visish , Jankowitz Brian T. , Burkhardt Jan-Karl , Jabbour Pascal M. 
Published: July 2024

BACKGROUND AND OBJECTIVES:
As the radial approach is gaining popularity in neurointervention, new radial-specific catheters are being manufactured while taking into consideration the smaller size of the radial artery, different trajectories of angles into the great vessels from the arm, and subsequent force vectors. We compared outcomes of transradial procedures performed using the Armadillo catheter (Q'Apel Medical Inc.) and the RIST radial guide catheter (Medtronic).

METHODS:
This is a retrospective multicenter study comparing outcomes of transradial neuroendovascular procedures using the Armadillo and RIST catheters at 2 institutions between 2021 and 2024.

RESULTS:
The study comprised 206 patients, 96 of whom underwent procedures using the Armadillo and 110 using the RIST. Age and sex were comparable across cohorts. In most procedures, 1 target vessel was catheterized (Armadillo: 94.8% vs 89.1%, P = .29) with no significant difference between cohorts. The use of an intermediate catheter was minimal in both cohorts (Armadillo 5.2% vs RIST: 2.7%, P = .36), and the median number of major vessel catheterization did not significantly differ between cohorts (Armadillo: 1 [1-4] vs RIST: 1 [0-6], P = .21). Failure to catheterize the target vessel was encountered in 1 case in each cohort (Armadillo: 1.0% vs RIST: 0.9%, P = .18), and the rate did not significantly differ between cohorts. Similarly, the rate of conversion to femoral access was comparable between cohorts (Armadillo: 2.1% vs RIST: 1.8%, P = .55). There was no significant difference in access site complications (Armadillo: 1% vs RIST: 2.8%, P = .55) or neurological complications (Armadillo: 3.1% vs RIST: 5.5%, P = .42) between cohorts.

CONCLUSION:
No significant difference in successful catheterization of target vessels, procedure duration, triaxial system use, complication rates, or the need for transfemoral cross-over was observed between both catheters. Both devices offer high and comparable rates of technical success and low morbidity rates.
Comparative Analysis of Endoscope Obscuration With Utilization of an Endonasal Access Guide for Endonasal Skull Base Surgery
Authors: Barkhoudarian Garni , Zhou David , Avery Michael B. , Khan Usman , Mallari Regin Jay , Emerson Josh , Griffiths Chester , Kelly Daniel F. 
Published: July 2024

BACKGROUND AND OBJECTIVES:
In endoscopic endonasal approaches (EEAs) for skull base pathologies, endoscope view obscuration remains a persistent, time-consuming, and distracting issue for surgeons and may result in increased operative time. The endonasal access guide (EAG) has been demonstrated as a possible adjunct to minimize these events. However, to date, there have been no comparative studies performed and the potential time savings by using EAGs have yet to be quantified. This cohort study aimed to determine the operative efficiency benefits of the EAG in EEA operations.

METHODS:
Analysis of EEA operative videos from an EAG cohort (n = 20) and a control cohort (n = 20) was performed, assessing 12-minute segments in the first, middle, and last third of each operation. The first segment in each cohort was selected before EAG placement, serving as an internal control. Every endoscope lens soiling instance was counted (measured as cleaning actions per minute), timed (obscuration time %), and identified as a withdrawal, irrigation, or other cleaning action. Perioperative variables including skull base repair and postoperative cerebrospinal fluid leakage were assessed.

RESULTS:
Within the EAG cohort, obscuration time was reduced in the middle and last third compared with the first third (3.73% [CI: 2.39-5.07] vs 12.97% [CI: 10.24-15.70], P < .001; 4.19% [CI: 2.83-5.55] vs 12.97% [CI: 10.24-15.70], P < .001) and cleaning actions were also significantly reduced by EAG (0.69/min [CI: 0.39-0.99] vs 1.67/min [CI: 1.34-2.00], P = .001; 0.66/min [CI: 0.35-0.97] vs 1.67/min [CI: 1.34-2.00], P < .001). Between the control and EAG cohorts, there was no significant difference between obscuration time and cleaning actions in the first third (9.33% vs 12.97%, P = .086; 1.34/min vs 1.67/min, P = .151) or in the middle third (6.24% vs 3.73%, P = .140; 0.80/min vs 0.69/min, P = .335), but there was a significant difference in the last third (9.25% [CI: 6.95-11.55] vs 4.19% [CI: 2.83-5.55], P < .001; 0.95/min [CI: 0.73-1.17] vs 0.66/min [CI: 0.35-0.97], P = .018).

CONCLUSION:
EAG significantly reduces lens obscurations and cleaning events, particularly during the intradural portion of operations. This technology may offer a greater time-saving impact with patients undergoing long EEA operations.
Presentation and Management of Granulomatous Mastitis in the United States: Results of an American Society of Breast Surgeons Registry Study
Authors: Kapoor Nimmi S. , Ryu Howon , Smith Linda , Zou Jingjing , Mitchell Katrina , Blair Sarah L. 
Published: July 2024

Abstract
Background
Granulomatous mastitis (GM) is a benign, chronic, inflammatory disease lacking clear treatment guidelines. The purpose of this American Society of Breast Surgeons (ASBrS) prospective, multisite registry was to characterize the presentation of GM and identify treatment strategies associated with symptom resolution and optimal cosmesis.

Methods
ASBrS members entered data into a registry on patient demographics, treatment, symptoms, and cosmesis over a 1-year period. Initial symptoms were graded as mild, moderate, or severe. The Chi-square test and logistic regression were used to identify factors related to symptom improvement and cosmesis.

Results
Overall, 112 patients with a mean age of 36 years were included. More patients were Hispanic (49.1%) and from the Southwest (41.1%), and management included observation (4.5%), medical (70.5%), surgical (5.4%), or combination treatment (19.6%). Immunosuppression was used in 83 patients (74.1%), including 43 patients who received intralesional steroid injections. Patients with severe symptoms were more likely to undergo surgical intervention compared with those with mild or moderate symptoms (21.4% vs. 0% and 7.5%, respectively; p = 0.004). Within 1 year, 85 patients (75.9%) experienced symptom improvement and/or resolution at a median of 3 months. Receipt of immunosuppressive therapy was predictive of improvement or resolution at 1 month (odds ratio 4.22; p = 0.045). One-year physician-assessed cosmesis was excellent or good for 20/35 patients (57.1%) and was not associated with type of treatment or symptom severity.

Conclusion
Although GM can have a protracted course, the majority of patients in this registry resolved within 1 year, with good cosmetic result. Treatment with immunosuppression appears to be most beneficial, and a symptom-based algorithm may be helpful to guide treatment.