Pooled safety analysis and management of sotorasib-related adverse events in KRAS G12C-mutated advanced non-small cell lung cancer.

Introduction: We describe the safety of sotorasib monotherapy in patients with KRAS G12C-mutated advanced non-small cell lung cancer (NSCLC) and discuss practical recommendations for managing key risks.

Methods: Incidence rates of treatment-related adverse events (TRAEs) were pooled from 4 clinical trials: CodeBreaK 100 (NCT03600883), CodeBreaK 101 (NCT04185883), CodeBreaK 105 (NCT04380753), and CodeBreaK 200 (NCT04303780) and graded according to CTCAE v5.0.

FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs.

Background: Despite fractional flow reserve (FFR)-guided deferral of revascularization, recurrent events in patients with diabetes or after myocardial infarction remain common. This study aimed to assess the association between FFR-negative but high-risk nonculprit lesions and clinical outcomes.

Methods: This is a patient-level pooled analysis of the prospective natural-history COMBINE (OCT-FFR) study (Optical Coherence Tomography Morphologic and Fractional Flow Reserve Assessment in Diabetes Mellitus Patients) and PECTUS-obs study (Identification of Risk Factors for Acute Coronary Events by OCT After STEMI and NSTEMI Patients With Residual Non- Flow Limiting Lesions).

Maternal, delivery and neonatal outcomes in women with cervical cancer. A study of a population database.

Importance: Cervical cancer is the fourth most common cancer among women globally and a significant cause of cancer-related deaths. Understanding the impact of cervical cancer diagnosed during pregnancy on maternal, delivery, and neonatal outcomes is crucial for improving clinical management and outcomes for affected women and their children.

Objective: To determine the effects of cervical cancer diagnosed during pregnancy on maternal, delivery, and neonatal outcomes using a population based, American database.

Transarterial Radioembolisation with Y90 Resin Microspheres and the Effect of Reimbursement Criteria in France: Final Results of the CIRT-FR Prospective Observational Study.

Purpose: This analysis of the CIRSE Registry for SIR-Spheres Therapy in France, CIRT-FR, reports on real-world outcomes of transarterial radioembolisation (TARE) with Y90 resin microspheres for hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRLM) patients in France, focusing on safety, effectiveness and health-related quality of life (HRQoL). Results on patients treated based on national reimbursement criteria are discussed here.

Methods: Prospective, multicentre, observational study of HCC and CRLM patients treated between August 2017 and July 2020 with TARE Y90 resin microspheres.

Global, regional, and national burden of primary liver cancer attributable to metabolic risks: an analysis of the Global Burden of Disease Study 1990-2021.

Background: The global burden of metabolic diseases is increasing, but estimates of their impact on primary liver cancer are uncertain. We aimed to assess the global burden of primary liver cancer attributable to metabolic risk factors, including high body mass index (BMI) and high fasting plasma glucose (FPG) levels, between 1990 and 2021.

Methods: The total number and age-standardized rates of deaths and disability-adjusted life years (DALYs) from primary liver cancer attributable to each metabolic risk factor were extracted from the Global Burden of Disease Study 1990-2021.

Incidence, Prediction, and Prevention of Fractures After Kidney Transplantation: A Systematic Review Protocol.

Background: Kidney transplant recipients are uniquely exposed to the disordered bone metabolism associated with chronic kidney disease beginning before transplantation followed by chronic corticosteroid use after transplantation. Previous efforts to synthesize the rapidly accruing evidence regarding estimation and management of fracture risk in kidney transplant recipients are outdated and incomplete.

Objective: To synthesize the evidence informing the overall incidence, patient-specific risk prediction, and methods of prevention of fractures in patient living with a kidney transplant.

Canadian Consensus Recommendations for Predictive Biomarker Testing in Gastric and Gastroesophageal Junction Adenocarcinoma.

Gastric cancer is common globally and has a generally poor prognosis with a low 5-year survival rate. Targeted therapies and immunotherapies have improved the treatment landscape, providing more options for efficacious treatment. The use of these therapies requires predictive biomarker testing to identify patients who can benefit from their use.

Management of Ductal Carcinoma In Situ: An Ontario Health (Cancer Care Ontario) Clinical Practice Guideline.

(1) Background: To make recommendations on the most effective therapy options for Ductal Carcinoma of the Breast (DCIS) patients; (2) Methods: MEDLINE, EMBASE, Cochrane Library, PROSPERO databases, and main relevant guideline websites were searched. Draft versions of the guideline went through formal internal and external reviews, with a final approval by the Program in Evidence Based Care and the DCIS Expert Panel. The Grading of Recommendations, Assessment, Development, and Evaluation approach was followed; (3) Results: Based on the current evidence from the systematic review and this guideline authors' clinical opinions, initial draft recommendations were developed to improve the management of patients with DCIS.

Hemoglobin A1c and abdominal obesity as predictors of diabetes and ASCVD in individuals with prediabetes in UK Biobank: a prospective observational study.

Objectives: Whether "prediabetes" merits particular clinical attention beyond the management of associated risk factors is controversial, particularly given the expansion of the definition of prediabetes from HbA1c 6.0-6.4% to 5.

Randomized Trials Using Provincial Health Numbers for Group Assignment.

Purpose: Using data from Ontario, Canada, this report shows how provincial government-assigned health card numbers can be used for individual-level randomization in large pragmatic trials. We describe how health card numbers are assigned and analyze the distribution of health card digits in a trial setting. We then provide an example of how they can be used for randomization and discuss the methodological and practical considerations of the approach.

TransCatheter aortic valve implantation and fractional flow reserve-guided percutaneous coronary intervention versus conventional surgical aortic valve replacement and coronary bypass grafting for treatment of patients with aortic valve stenosis and complex or multivessel coronary disease (TCW): an international, multicentre, prospective, open-label, non-inferiority, randomised controlled trial.

Background: Patients with severe aortic stenosis present frequently (∼50%) with concomitant obstructive coronary artery disease. Current guidelines recommend combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) as the preferred treatment. Transcatheter aortic valve implantation (TAVI) and fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) represent a valid treatment alternative.

In Vivo Optical Coherence Tomography Detection of Repetitive Plaque Erosion Leading to Healed Plaques and Lesion Progression.

Plaque erosion is the second most common cause of acute coronary syndromes (ACS). Small studies using optical coherence tomography (OCT) have shown favorable outcomes in select patients with plaque erosion treated conservatively without stent implantation. Unlike plaque rupture, the role of plaque erosion in the formation of healed plaques and subsequent flow-limiting coronary stenoses is less certain.

Small bowel obstruction secondary to impacted pancreatic necrosum through a spontaneous duodenal fistula: a first in the literature.

A 58-year-old man presented with alcohol-induced acute pancreatitis. Imaging revealed complete necrosis of the pancreatic parenchyma. After initial non-operative management, the patient developed a duodenal ulcer and an upper gastrointestinal bleed and later spontaneously formed a fistula between the pancreas and the first segment of the duodenum.

Clinical Outcome Patterns of Use of Radium-223 in Patients with Metastatic Castration-Resistant Prostate Cancer.

Radium-223 dichloride (radium-223) is a bone-targeting radioisotope therapy that aids in the survival of patients with metastatic castration-resistant prostate cancer (mCRPC) to bones. This study aimed to describe the clinical characteristics and outcomes of patients with mCRPC treated with radium-223 in a real-world setting. This was a retrospective study of patients with mCRPC treated with radium-223 between 2016 and 2020 at the London Health Sciences Centre in London, Canada.

Surgeon versus radiologist: an inter-rater reliability analysis of the CLOSE checklist for preoperative CT sinus assessment.

Purpose: To assess the inter-rater agreement of the Cribriform plate, Lamina papyracea, Onodi cell, Sphenoid sinus pneumatization, and Ethmoidal artery (CLOSE) checklist results among rhinology & skull-base surgeons and a head and neck-neuroradiology specialist for pre-operative computed tomography (CT) sinus assessment.

Methods: This retrospective cross-sectional study reviewed 50 patients who underwent endoscopic sinus surgery (ESS) in the period between January 2013 and March 2014 at the Royal Victoria Hospital in Montreal, Canada. According to the CLOSE checklist, the CT scans were evaluated independently by one surgeon and one radiologist using the InteleRadiology Picture Archiving and Communication System (IntelePACS).

Cardioprotective effects of l-glutamine in an ischemic rat heart model.

Introduction: l-glutamine has been shown to have cardioprotective effects in models of ischemia-reperfusion injury. Its potential cardioprotective effects when given before and during early reperfusion, however, have not been studied.

Methods: This study hypothesized that l-glutamine administered before and after myocardial ischemia provides better cardioprotection than when administered after ischemia only.

Reduction in Postoperative Right Ventricular Echocardiographic Indices Predicts Longer Duration of Vasoactive Support After Cardiac Surgery.

Objectives: To assess perioperative right ventricular (RV) echocardiographic indices and their relationship to vasopressor and inotropic support in cardiac surgical patients. The authors hypothesized that a reduction in echocardiographic parameters of RV function would be associated with a longer duration of vasopressor and inotropic support in the intensive care unit (ICU).

Design: A prospective observational study.

Machine learning outperforms the Canadian Triage and Acuity Scale (CTAS) in predicting need for early critical care.

Study Objective: This study investigates the potential to improve emergency department (ED) triage using machine learning models by comparing their predictive performance with the Canadian Triage Acuity Scale (CTAS) in identifying the need for critical care within 12 h of ED arrival.

Methods: Three machine learning models (LASSO regression, gradient-boosted trees, and a deep learning model with embeddings) were developed using retrospective data from 670,841 ED visits to the Jewish General Hospital from June 2012 to Jan 2021. The model outcome was the need for critical care within the first 12 h of ED arrival.

Guidelines for Orbital Defect Assessment and Patient-Specific Implant Design: Introducing OA (Orbital Assessment Algorithm).

Study Design: This study presents a review of the evolutionary development in reconstructive orbital surgery over the past 3 decades. Additionally, it proposes the Orbital Assessment Algorithm (OA) to enhance decision-making for intraorbital reconstruction of post-traumatic orbital deformities.

Objective: The objective of this paper is to provide insights into modern post-traumatic orbital reconstruction from a surgeon's perspective, with a specific focus on adult patients.

Baculovirus Expressing Tumor Growth Factor-β1 (TGFβ1) Nanoshuttle Augments Therapeutic Effects for Vascular Wound Healing: Design and In Vitro Analysis.

One of the major challenges in vascular tissue regeneration is effective wound healing that can be resolved by an innovative targeted nanoshuttle that delivers growth factors to blood vessels. This study investigates the production and efficacy of transforming growth factor-β1 (TGFβ1) gene delivery using poly(lactic--glycolic acid) (PLGA) baculovirus (BV) nanoshuttles (NSs). They exhibited an encapsulation efficiency of 86.

Variance in the composition and number of VLDL and LDL particles with increasing triglyceride or increasing ApoB concentrations.

Objective: The importance of any enhanced atherogenicity of triglyceride (TG)-rich lipoproteins (TRLs) will depend on the relative abundance of these particles compared with LDL or total apolipoprotein (apo)B. Accordingly, we determined the contribution that TRLs make to total apoB as TG or apoB concentrations increase. We also describe compositional changes in TRLs as TG or apoB increase to assess whether VLDL-C is a valid proxy for VLDL-apoB.