Articles: treatment.
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Recent advancements in neuroimaging and machine learning have significantly improved our ability to diagnose and categorize isocitrate dehydrogenase (IDH)-wildtype glioblastoma, a disease characterized by notable tumoral heterogeneity, which is crucial for effective treatment. Neuroimaging techniques, such as diffusion tensor imaging and magnetic resonance radiomics, provide noninvasive insights into tumor infiltration patterns and metabolic profiles, aiding in accurate diagnosis and prognostication. Machine learning algorithms further enhance glioblastoma characterization by identifying distinct imaging patterns and features, facilitating precise diagnoses and treatment planning. ⋯ Future directions should focus on refining machine learning models, integrating emerging imaging techniques, and elucidating the complex interplay between imaging features and underlying molecular processes. This review highlights the pivotal role of neuroimaging and machine learning in glioblastoma research, offering invaluable noninvasive tools for diagnosis, prognosis prediction, and treatment planning, ultimately improving patient outcomes. These advances in the field promise to usher in a new era in the understanding and classification of IDH-wildtype glioblastoma.
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Improved imaging modalities have led to an increased detection of intracranial aneurysms, many of which are small. There is uncertainty in the appropriate management of tiny aneurysms. The objective of this study was to use a large, multi-institutional NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD) to assess the frequency, safety, and efficacy of treatment of tiny, unruptured middle cerebral artery (MCA) aneurysms. ⋯ Treatment of tiny, unruptured MCA aneurysms is efficacious but may have a high rate of complications. Physicians should be cautious when deciding to treat tiny, unruptured MCA aneurysms.
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Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. ⋯ Among hospitalized patients with bloodstream infection, antibiotic treatment for 7 days was noninferior to treatment for 14 days. (Funded by the Canadian Institutes of Health Research and others; BALANCE ClinicalTrials.gov number, NCT03005145.).
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When research and management of Dupuytren's disease (DD) shift from symptom relief to preventing contractures, general practitioner (GP) care may become more central to treatment. However, the presentation and course of DD in GP care are underexplored and this has been recognized as a knowledge gap that hinders effective treatment decisions. This study is the first to map the trajectory of DD patients in GP care. ⋯ The diagnosis and management of DD in GP care are in line with the current guidelines. Less than half of the DD patients were referred to secondary care during follow-up. This may give room for preventive treatment that limits progression. Future studies should focus on the accuracy of diagnosis and the feasibility of effective treatments in GP care.
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Patients receiving standard treatment for chronic subdural hematoma have a high risk of treatment failure. The effect of adjunctive middle meningeal artery embolization on the risk of treatment failure in this population remains unknown. ⋯ Among patients with symptomatic chronic subdural hematoma, adjunctive middle meningeal artery embolization resulted in a lower risk of treatment failure than standard treatment alone, without resulting in an increased incidence of disabling stroke or death in the short term. Further study of longer-term safety outcomes is warranted. (Funded by Balt USA; STEM ClinicalTrials.gov number, NCT04410146.).