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Introduction: Randomized phase III trials showed that using trifluridine/tipiracil (FTD/TPI) in patients with pre-treated metastatic colorectal cancer (mCRC) conferred survival benefit versus placebo. Here, we investigated the effectiveness and safety of FTD/TPI and sought to identify prognostic factors among the mCRC population in Hong Kong., Methods: A non-interventional, retrospective, multicenter cohort study enrolled patients with mCRC who received FTD/TPI in seven public hospitals in Hong Kong between 2016 and 2020. Overall survival (OS) was the primary endpoint; treatment duration and occurrence of neutropenia were secondary endpoints. We also performed a post hoc analysis to identify factors influencing OS and treatment duration., Results: Overall, 456 patients were included (median age, 64.0 years; 57.5% men). Approximately half (225/456; 49.3%) had RAS wild-type tumors; the median treatment duration was 12.4 weeks (95% confidence interval [CI] 11.1-13.1). Median OS was 7.59 months (95% CI 7.00-8.21). Overall, 289 (63.4%) patients developed neutropenia of any grade and 159 (34.9%) developed grade ≥ 3 neutropenia. Neutropenia at 1 month occurred in 193 (43.1%) patients. The use of granulocyte colony-stimulating factor for neutropenia was reported for 42 (9.2%) patients. The development of neutropenia, absolute neutrophil count decrease of ≥ 2 grades in 1 month, absence of liver metastasis, and RAS wild-type status were associated with significantly longer OS and, except for RAS wild-type status (not analyzed), longer treatment duration (p < 0.05 for all comparisons)., Conclusion: Our data show that treatment with FTD/TPI offers survival benefits in patients with refractory mCRC in Hong Kong consistent with randomized controlled trials and other real-world studies. Furthermore, the prognosis in patients receiving FTD/TPI appears to be significantly better in those who develop neutropenia, with RAS wild-type status, or those without liver metastases, despite a higher rate of dose reduction in the real-world setting., Competing Interests: Declarations. Conflict of Interest: Karen Hoi-Lam Li has received support for meeting attendance and travel from Taiho Pharma Asia Pacific Pte. Ltd. Ka-On Lam has received speaking honoraria from Amgen Inc., Astellas Pharma Inc., AstraZeneca PLC, Bayer AG, Bristol Myers Squibb, Daiichi Sankyo Co. Ltd., Eli Lilly and Co., GSK PLC, Merck & Co. Inc., Novartis AG, F. Hoffmann-La Roche Ltd., Sanofi, and Taiho Pharma Asia Pacific Pte. Ltd. Ka-On Lam has also received meeting and travel support from Merck & Co. Inc. and Taiho Pharma Asia Pacific Pte. Ltd. and advisory board honoraria from Amgen Inc., Astellas Pharma Inc., and GSK PLC. Roland Ching-Yu Leung, Vikki Tang and Thomas Chung-Cheung Yau have no conflicts of interest to disclose. No payment or honoraria have been received by any author for this article. Ethical Approval: The study protocol was reviewed for ethics, science and compliance with the Declaration of Helsinki, ICH GCP guidelines, local regulations, Hospital Authority and university policies. The protocol, encompassing the use of CDARS data from all participating centers, was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster before any data collection occurred (IRB reference number UW 19-460). The requirement for informed consent was waived owing to the anonymous nature of the data., (© 2024. The Author(s).)

Mental health (MH) comorbidities are prevalent among people with epilepsy (PWE), but many experience challenges accessing care. To address this, suggestions have been made to integrate MH care into epilepsy care settings, yet the current approaches, benefits, and implementation determinants to MH care integration are unclear. This review aims to synthesize existing integrated MH care models for PWE to inform the development and planning of future initiatives. We searched Embase, Medline, PsycINFO, and Cochrane for articles that described any activity within a health care setting that addressed MH as routine care for PWE. Year of publication was restricted to 2000 onward. At least two authors reviewed articles and extracted data. Barriers, facilitators, and future recommendations were identified through thematic synthesis using NVivo. Study quality was assessed for articles reporting clinical outcomes. Following review of 7520 abstracts and 596 full-text articles, 65 met eligibility criteria and were included. Most (k = 43, 66%) described routine MH screening, with 11 reporting on uptake and acceptability, which was generally high. Interventions included psychological interventions (k = 23, 35%), psychoeducation (k = 9, 14%), and pharmacotherapy (k = 6, 9%). Thirteen articles (20%) reported on changes in MH outcomes, all of which indicated some improvements in MH, but 33% were rated as poor quality. Thirty-four (52%) articles reported on barriers and facilitators, and 34 (37%) articles provided recommendations for future initiatives. Overall, diverse approaches to integrated MH care for PWE were identified, with promising uptake, acceptability, and impacts on MH outcomes. Qualitative analysis informed a proposed framework for future integrated MH care initiatives. The framework outlines fundamental components of care activities, such as MH screening, psychoeducation, and care pathways, as well as key facilitators for their establishment (e.g., policies, infrastructure, staffing) and effective delivery (e.g., staff incentives, acceptability, evaluation)., (© 2025 The Author(s). Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Accurate staging of nodal involvement in pediatric sarcoma patients is important to determine correct systemic and local therapy, with the goal to reduce subsequent recurrences. However, differences in lymph node staging strategies, definitions, and treatment protocols between the Children's Oncology Group (COG), European paediatric Soft tissue sarcoma Study Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS) complicate comparisons. In this article, we aim to establish internationally recognized recommendations for lymph node assessment and treatment of children and adolescents diagnosed with rhabdomyosarcoma (RMS) and non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) according to the Consensus Conference Standard Operating Procedure methodology., (© 2025 Wiley Periodicals LLC.)

Objectives: Fecal calprotectin (FC) is a marker commonly used in the diagnosis and follow-up of inflammatory bowel diseases (IBD). However, other gastrointestinal conditions, like H. pylori (HP) infection, can result in increased neutrophil activity as well. We set out to assess the impact of HP infection on FC and downstream gastrointestinal care via a retrospective study., Methods: In this study, we collected data from two institutions in Brooklyn, NY, in a high immigrant density community. We reviewed data from patients who underwent esophagogastroduodenoscopy (EGD) between January 2017 and October 2022. Patients aged 6-18 years old with an FC level 6 months prior to EGD and HP testing were included., Results: Of 129 patients, 37 (28.7%) tested positive for HP infection. The mean FC level was significantly elevated in HP-positive patients (241.2, confidence interval [CI]: 161.0-321.3) as compared with HP-negative patients (88.1, CI: 59.1-117.0) (p < 0.001). Patients with higher FC levels were also more likely to undergo colonoscopies (p = 0.003)., Discussion: HP infection is associated with increased calprotectin, and calprotectin increases in HP patients are associated with an increased risk of colonoscopy., (© 2025 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Low-grade gliomas and reactive piloid gliosis can present with overlapping features on conventional histology. Given the large implications for patient treatment, there is a need for effective methods to discriminate these morphologically similar but clinically distinct entities. Using routinely available stains, we hypothesize that a limited panel including SOX10, p16, and cyclin D1 may be useful in differentiating mitogen-activated protein (MAP) kinase-activated low-grade gliomas from piloid gliosis. Reviewers blinded to clinical and pathologic data reviewed and quantified immunohistochemical expression patterns across 20 cases of piloid gliosis and 37 cases of MAP kinase-activated low-grade gliomas, including pilocytic astrocytoma and ganglioglioma. The majority of MAP kinase-activated low-grade glioma cases demonstrated extensive immunoreactivity for at least 2 of the 3 immunohistochemical markers, whereas none of the gliosis cases demonstrated significant immunoreactivity for more than one individual immunohistochemical marker. SOX10 and p16 demonstrated the highest individual sensitivity whereas cyclin D1 demonstrated the highest individual specificity to discriminate neoplastic from nonneoplastic cases in this cohort. A composite panel score based on significant immunoreactivity of at least 2 of the 3 markers provided specificity and a positive predictive value of 100% in differentiating MAP kinase-activated low-grade glioma from gliosis, as 0/20 (0%) of gliosis cases were scored positive compared with 24/37 (65%) of MAP kinase-activated low-grade glioma cases. We conclude that while the immunoreactivity of these markers may be suggestive of a low-grade glioma diagnosis, SOX10, p16, and cyclin D1 should be applied in combination to maximize diagnostic value., Competing Interests: Conflicts of Interest and Source of Funding: K.Y.Z. was supported by the Johns Hopkins Opportunities for Pathology Trainees in Cancer Research, National Cancer Institute, NIH (T32 CA193145). E.G. and C.G.L. were supported by the UCSF Training Program in Translational Brain Tumor Research, National Cancer Institute, NIH (T32 CA151022). For the remaining authors none were declared., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.)