Articles: cations.
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Patients older than 65 years have unique needs and treatment outcomes goals. The objective of this study was to evaluate the impact of Geriatric Surgery Verification (GSV) initiative in oncology patients ≥65 years undergoing major abdominal surgeries. ⋯ The GSV initiative intervention in geriatric oncology patients undergoing major abdominal surgeries was associated with reducing postoperative institutionalization and change in primary residence disposition. Further studies to explore different mechanisms within GSV that lead to improved outcomes in geriatric oncologic population will be informative.
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While acute myocardial infarction (AMI) is widely recognized as the primary cause of Cardiogenic Shock (CS), Non-AMI related CS has been excluded from the majority of CS studies. Information on its prognostic factors remains largely understudied, and it is necessary to focus on these patients to identify the specific risk factors. In this study, we aimed to build and validate a predictive nomogram and risk classification system. ⋯ For non-AMI associated CS, a predictive nomogram and risk classification system were developed and validated, and the nomogram demonstrated good performance in prognostic prediction and risk stratification.
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Monitoring of electrocorticography for the purpose of detecting spreading depolarization (SD) events is becoming increasingly used both for research and clinical applications. Although such monitoring bears many similarities to standard long-term epilepsy monitoring, there are a number of differences that neurosurgeons need to be aware of when initiating such a program. In addition, most of the focus in SD monitoring has been on traumatic and vascular conditions, where invasive monitoring is used commonly, but electrocorticography is not commonly used. ⋯ It is also recognized that this is a rapidly evolving field and that new advances may disrupt these approaches and that there is a diversity of opinion on these topics, even among SD experts. Nonetheless, the general approach to SD monitoring has now been in use for >15 years and is the basis for several active and proposed clinical trials (NCT05337618, NCT04966546), so an understanding from a neurosurgical perspective of the rationale and approach to monitoring is warranted. In this review, we will consider the potential indications for SD monitoring in clinical trials or clinical care, the methodology for recording and interpreting, and finally some potential therapeutic approaches that are being considered in patients with clinically detected SD.
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Endovascular transmural targeting of cervical and cranial perivascular structures is a novel approach for minimally invasive delivery of therapeutics. Components of the autonomic nervous system are in close anatomic proximity to major cervical vasculature and, therefore, represent potential targets for intervention. The superior cervical ganglion (SCG) is a discrete structure of interest for this approach, as sympathetic blockade may have therapeutic effects for various conditions. Variability of SCG location and its relationship to large cervical vessels, and the feasibility of endovascular transmural targeting has not been elucidated. ⋯ This is the first anatomical study to provide pertinent targeting information for endovascular transmural access to the SCG using computed tomography angiography. In most cases, endovascular transmural access to the SCG is anatomically feasible from the proximal cervical ICA.