Faculty Bibliography

OBJECTIVES/UNASSIGNED:To better understand the implications of tumor size on auditory brainstem implant (ABI) categories of auditory performance (CAP) score to facilitate more precise patient counselling. DESIGN/UNASSIGNED:Single-center retrospective chart review. SETTING/UNASSIGNED:Tertiary referral center. PARTICIPANTS/UNASSIGNED:Patients > 18 years old with neurofibromatosis type 2 who underwent ABI placement between the years 2009 and 2023 were included. Patients with prior surgical resection were excluded to reduce the potential of previous cochlear nucleus trauma confounding results. MAIN OUTCOME MEASURES/UNASSIGNED:Ipsilateral tumor volume was measured from the preoperative MRI, and the primary endpoint was the 1-year CAP score. RESULTS/UNASSIGNED: = 0.010). CONCLUSION/UNASSIGNED:Increased tumor size has a negative correlation with ultimate ABI performance. There were patients in this study with larger tumor sizes who still benefited from ABI placement. While larger tumor size should not be a contraindication for ABI placement, understanding the role tumor size can have on performance variation can serve to improve tumor management strategies and preoperative counselling.

OBJECTIVES/OBJECTIVE:To review the current evidence regarding thyroid artery embolization (TAE) for the management of benign and select malignant thyroid diseases and to present expert consensus recommendations from the North American Society for Interventional Thyroidology (NASIT) on patient selection, indications, technical considerations, safety, clinical outcomes, and the role of TAE in contemporary thyroid disease management. METHODS:A multidisciplinary consensus was developed through literature review and expert input addressing indications, technique, outcomes, and controversies, including comparisons with surgery, thermal ablation and radioactive iodine therapy. RESULTS:TAE is effective for large-volume disease (>30 mL) and substernal extension, achieving 32-73% volume reduction at 6 months with improvement in symptoms and cosmesis. In hyperthyroidism (Graves' disease and toxic multinodular goiter), euthyroid rates exceed 70% with durability up to 50 months. Preoperative use reduces operative time and blood loss. Complications are typically mild and self-limited; serious events are rare. Advances include pressure-enabled embolization and collateral flow management. CONCLUSIONS:TAE is a safe, effective, and durable option for selected patients with large symptomatic benign nodules and goiters, with additional roles in hyperthyroidism and as a surgical adjunct. Further studies are needed to standardize technique and define its role relative to other therapies.

Idasanutlin is a small molecule inhibitor that restores p53 activity, triggering apoptosis. Two trials (phase 1/2) of idasanutlin therapy in polycythemia vera patients that were intolerant or refractory to hydroxyurea resulted in substantial clinical and molecular responses. Here the long term outcomes of these patients are reported.

Pain is a pervasive and multifaceted condition that imposes a significant medical and economic burden worldwide. This burden is underscored by the urgent need for transformative, non-addictive opioid alternatives. Nanomedicine offers a promising avenue for addressing the many limitations associated with conventional pain treatments, such as off-target effects, poor bioavailability, and rapid clearance, while enabling advanced therapeutic approaches such as precise spatiotemporal control and robust delivery of biologics. In this review, we explore the convergence of nanomedicine and pain management. We examine current literature on pain and chronic pain physiology and provide collated pharmacological data on current therapeutic approaches as a reference for formulation development. Recent advancements in lipid-based, polymeric, and inorganic nanoscale drug delivery systems (NDDS) for pain are surveyed, along with their progress toward clinical translation. Strategies for enhancing the efficacy of NDDS for pain are discussed, including supramolecular depot localization methods, active and passive targeting, controlled release kinetics, and the incorporation of stimuli-responsive elements for triggered release. We identify knowledge and technical gaps limiting progression beyond sustained-release formulations toward designs exploiting pain-specific biology. Overall, this review provides a comprehensive overview of the state-of-the-art in nanomedicine-based approaches for pain management and provides a roadmap for future innovations.

Oral potentially malignant disorders (OPMDs) such as leukoplakia and erythroplakia may harbor dysplasia or progress to oral squamous cell carcinoma (OSCC), yet visual inspection alone is unreliable for risk assessment. Cytology offers a minimally invasive adjunct, but conventional approaches depend on manual feature extraction and subjective review. Herein we report a deep learning (DL) object detection model that directly classifies four cell phenotypes: differentiated squamous epithelial (DSE) cells, small round (SR) cells, leukocytes, and lone nuclei. The DL model produced cytology-derived parameters that correlated strongly with histopathologic diagnoses across 692 subjects with OPMDs, OSCC, and healthy controls, including declining DSE cell proportion and increasing SR cells and leukocytes with disease severity (p < 0.0001). The oral cancer numerical index (OCNI) achieved AUROC values up to 0.99 for malignant versus healthy lesions, with excellent reliability (intra-class correlation coefficient ≥ 0.96). This reproducible, minimally invasive test provides a robust platform for early detection and surveillance of OPMDs.

Peritoneal cavity fluid and mesothelial surfaces host distinct resident macrophage populations, among which include the well-described Gata6⁺ large cavity macrophages (LCMs) in peritoneal fluid. Here, we reveal that LCMs arise from two separable differentiation pathways. In the quantitatively minor pathway, monocytes gave rise to LYVE1⁺ LCMs but few Gata6⁺ LCMs. This pathway did not require the transcription factor Gata6 but was severely impaired in mice bearing three mutations in the -165 kb Zeb2 enhancer (Zeb2

PURPOSE/UNASSIGNED:To determine whether nasal intramucosal 5-fluorouracil (5-FU) injection improves outcomes after external dacryocystorhinostomy (DCR) in pediatric patients with nasolacrimal duct obstruction (NLDO). METHODS/UNASSIGNED:Multi-center retrospective non-comparative case series review of all DCR cases with intra-operative 5- FU injection performed between 2014 and 2023 on all patients age < 18 years. Each case was reviewed to determine if the patients had epiphora recurrence following surgery with 5-FU injection. RESULTS/UNASSIGNED:Sixteen pediatric patients with NLDO (19 eyes) underwent DCR and nasal intramucosal injections of 5-FU intra-operatively. One had a lost stent. Ten (53%) eyes were in patients with craniofacial syndromes. In all patients with the use of 5-FU there was no recurrence of tearing. Eight of the patients (42%) had already had at least one or two failed stents prior in which recurrence had occurred. There were no post-operative complications. CONCLUSION/UNASSIGNED:Adjuvant intramucosal 5-FU demonstrated a 100% success rate of epiphora not recurring following pediatric DCR without any complications in this small sample size, particularly in patients with increased risk of recurrence.

BACKGROUND:Oral cavity cancer represents a public health challenge in Latin America and the Caribbean (LAC), where exposure to modifiable risk factors such as tobacco and alcohol remains high and inequalities in access to health services contribute to delayed diagnosis and poor outcomes. This study aimed to develop consensus-based recommendations to strengthen the prevention and early detection of oral cavity cancer and oral potentially malignant disorders in LAC. METHODS:A multi-phase study using a Delphi approach was conducted. An initial qualitative survey with regional experts identified barriers, facilitators, and priority actions for oral cavity cancer prevention and early detection. Preliminary recommendations were refined through feasibility assessment by international advisors and subsequently evaluated in a quantitative Delphi round using a Likert scale. RESULTS:Twenty-four experts from 12 LAC countries participated in the Delphi process, including research investigators, clinicians, and health service managers. The panel had a mean age of 49.4 (SD 10.3) years and included 41.7 % women. Seven recommendations achieved consensus, addressing key domains of oral cavity cancer control including primary prevention interventions, screening of high-risk individuals, establishment of structured referral pathways, improved surveillance systems, and expansion of access to diagnostic services in underserved populations. High levels of agreement were observed across all recommendations. CONCLUSIONS:These consensus-based recommendations provide a regionally informed framework to guide oral cavity cancer prevention and early detection strategies in LAC. Strengthening coordinated actions across the continuum of care, including primary prevention, screening, referral, and diagnostic capacity, may contribute to reducing diagnostic delays and improving outcomes in the region.

Alston's singing mouse has emerged as an intriguing model for the comparative study of vocal control. New work on the species sets the stage to understand the proximate mechanisms and evolutionary roots of novel acoustic communication traits.