Purpose: Limited treatment options exist for patients with metastatic castration-resistant prostate cancer (mCRPC) after the failure of taxane-based chemotherapy and novel hormonal therapy. Here, we report the safety and efficacy of ifosfamide and mesna in patients with mCRPC after the failure of taxane-based chemotherapy and novel hormonal therapy (NCT06236789). Materials and Methods: Patients with histologically confirmed prostate cancer who had failed taxane-based chemotherapy and novel hormonal therapy received ifosfamide 2,500 mg/m2 and mesna 1,500 mg/m2 on days 1–3, repeated every 21 days. Safety, objective response rate, disease control rate, reduction in serum prostate-specific antigen (PSA) concentration by >50% (PSA50) or >90% (PSA90), radiographic progression-free survival (rPFS), and overall survival (OS) were analyzed. Results: A total of 47 patients with mCRPC were included in the study. The median number of lines of treatment was 5 (range, 3 to 7). All patients were previously administered docetaxel and novel hormonal therapies including abiraterone (51.1%) and/or enzalutamide (61.7%). Thirty-eight patients (80.9%) were administered cabazitaxel. The objective response and disease control rates were 21.3% and 80.9%, respectively. PSA50 and PSA90 were achieved in 31.9% and 10.6%, respectively. During a median follow-up duration of 54.3 months, rPFS and OS were 5.0 and 9.0 months, respectively. All the patients experienced treatment-related adverse events of any grades; however, no new safety signs were detected. Genomic biomarker analysis revealed that alterations in the TP53 pathway were associated with inferior rPFS and OS. Conclusion Ifosfamide and mesna showed appreciable efficacy and manageable safety profiles in heavily treated patients with mCRPC.

Acute pancreatitis (AP) is a common disorder characterized by the inflammation of the exocrine pancreas in dogs, and the severity of the clinical signs of pancreatitis varies greatly. Therefore, the diagnosis of pancreatitis is challenging. The canine pancreatic lipase immunoreactivity test (SNAP cPL; IDEXX Laboratories Inc., USA) is rapid and relatively accurate in diagnosing pancreatitis. The purpose of this study was to evaluate the positivity rate of the SNAP cPL test in dogs regarding the severity of gastrointestinal (GI) signs and concurrent diseases. Electronic medical records of dogs were reviewed. For retrospective classification, 80 dogs with GI signs who underwent the SNAP cPL test were enrolled. Additionally, concurrent diseases on the day of the SNAP cPL test were reviewed. A positive SNAP cPL test result was observed in 26 of the 80 dogs (32.5%) with GI signs. The severity of GI signs using a scoring system and the positivity rate of SNAP cPL were statistically related. Furthermore, dogs with concurrent chronic kidney disease had a significantly higher positivity rate of SNAP cPL than those without chronic kidney disease. This information might help clinicians to decide whether a SNAP cPL test is needed.

Acute pancreatitis (AP) is a common disorder characterized by the inflammation of the exocrine pancreas in dogs, and the severity of the clinical signs of pancreatitis varies greatly. Therefore, the diagnosis of pancreatitis is challenging. The canine pancreatic lipase immunoreactivity test (SNAP cPL; IDEXX Laboratories Inc., USA) is rapid and relatively accurate in diagnosing pancreatitis. The purpose of this study was to evaluate the positivity rate of the SNAP cPL test in dogs regarding the severity of gastrointestinal (GI) signs and concurrent diseases. Electronic medical records of dogs were reviewed. For retrospective classification, 80 dogs with GI signs who underwent the SNAP cPL test were enrolled. Additionally, concurrent diseases on the day of the SNAP cPL test were reviewed. A positive SNAP cPL test result was observed in 26 of the 80 dogs (32.5%) with GI signs. The severity of GI signs using a scoring system and the positivity rate of SNAP cPL were statistically related. Furthermore, dogs with concurrent chronic kidney disease had a significantly higher positivity rate of SNAP cPL than those without chronic kidney disease. This information might help clinicians to decide whether a SNAP cPL test is needed.

Acute pancreatitis (AP) is a common disorder characterized by the inflammation of the exocrine pancreas in dogs, and the severity of the clinical signs of pancreatitis varies greatly. Therefore, the diagnosis of pancreatitis is challenging. The canine pancreatic lipase immunoreactivity test (SNAP cPL; IDEXX Laboratories Inc., USA) is rapid and relatively accurate in diagnosing pancreatitis. The purpose of this study was to evaluate the positivity rate of the SNAP cPL test in dogs regarding the severity of gastrointestinal (GI) signs and concurrent diseases. Electronic medical records of dogs were reviewed. For retrospective classification, 80 dogs with GI signs who underwent the SNAP cPL test were enrolled. Additionally, concurrent diseases on the day of the SNAP cPL test were reviewed. A positive SNAP cPL test result was observed in 26 of the 80 dogs (32.5%) with GI signs. The severity of GI signs using a scoring system and the positivity rate of SNAP cPL were statistically related. Furthermore, dogs with concurrent chronic kidney disease had a significantly higher positivity rate of SNAP cPL than those without chronic kidney disease. This information might help clinicians to decide whether a SNAP cPL test is needed.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Acute pancreatitis (AP) is a common disorder characterized by the inflammation of the exocrine pancreas in dogs, and the severity of the clinical signs of pancreatitis varies greatly. Therefore, the diagnosis of pancreatitis is challenging. The canine pancreatic lipase immunoreactivity test (SNAP cPL; IDEXX Laboratories Inc., USA) is rapid and relatively accurate in diagnosing pancreatitis. The purpose of this study was to evaluate the positivity rate of the SNAP cPL test in dogs regarding the severity of gastrointestinal (GI) signs and concurrent diseases. Electronic medical records of dogs were reviewed. For retrospective classification, 80 dogs with GI signs who underwent the SNAP cPL test were enrolled. Additionally, concurrent diseases on the day of the SNAP cPL test were reviewed. A positive SNAP cPL test result was observed in 26 of the 80 dogs (32.5%) with GI signs. The severity of GI signs using a scoring system and the positivity rate of SNAP cPL were statistically related. Furthermore, dogs with concurrent chronic kidney disease had a significantly higher positivity rate of SNAP cPL than those without chronic kidney disease. This information might help clinicians to decide whether a SNAP cPL test is needed.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.

Acute pancreatitis (AP) is a common disorder characterized by the inflammation of the exocrine pancreas in dogs, and the severity of the clinical signs of pancreatitis varies greatly. Therefore, the diagnosis of pancreatitis is challenging. The canine pancreatic lipase immunoreactivity test (SNAP cPL; IDEXX Laboratories Inc., USA) is rapid and relatively accurate in diagnosing pancreatitis. The purpose of this study was to evaluate the positivity rate of the SNAP cPL test in dogs regarding the severity of gastrointestinal (GI) signs and concurrent diseases. Electronic medical records of dogs were reviewed. For retrospective classification, 80 dogs with GI signs who underwent the SNAP cPL test were enrolled. Additionally, concurrent diseases on the day of the SNAP cPL test were reviewed. A positive SNAP cPL test result was observed in 26 of the 80 dogs (32.5%) with GI signs. The severity of GI signs using a scoring system and the positivity rate of SNAP cPL were statistically related. Furthermore, dogs with concurrent chronic kidney disease had a significantly higher positivity rate of SNAP cPL than those without chronic kidney disease. This information might help clinicians to decide whether a SNAP cPL test is needed.

Objective: To investigate the feasibility of using a deep learning-based analysis of auscultation data to predict significant stenosis of arteriovenous fistulas (AVF) in patients undergoing hemodialysis requiring percutaneous transluminal angioplasty (PTA). Materials and Methods: Forty patients (24 male and 16 female; median age, 62.5 years) with dysfunctional native AVF were prospectively recruited. Digital sounds from the AVF shunt were recorded using a wireless electronic stethoscope before (pre-PTA) and after PTA (post-PTA), and the audio files were subsequently converted to mel spectrograms, which were used to construct various deep convolutional neural network (DCNN) models (DenseNet201, EfficientNetB5, and ResNet50). The performance of these models for diagnosing ≥ 50% AVF stenosis was assessed and compared. The ground truth for the presence of ≥ 50% AVF stenosis was obtained using digital subtraction angiography. Gradient-weighted class activation mapping (Grad-CAM) was used to produce visual explanations for DCNN model decisions. Results: Eighty audio files were obtained from the 40 recruited patients and pooled for the study. Mel spectrograms of “pre-PTA” shunt sounds showed patterns corresponding to abnormal high-pitched bruits with systolic accentuation observed in patients with stenotic AVF. The ResNet50 and EfficientNetB5 models yielded an area under the receiver operating characteristic curve of 0.99 and 0.98, respectively, at optimized epochs for predicting ≥ 50% AVF stenosis. However, GradCAM heatmaps revealed that only ResNet50 highlighted areas relevant to AVF stenosis in the mel spectrogram. Conclusion Mel spectrogram-based DCNN models, particularly ResNet50, successfully predicted the presence of significant AVF stenosis requiring PTA in this feasibility study and may potentially be used in AVF surveillance.