Articles: cations.
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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.
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Classical biomedical data science models are trained on a single modality and aimed at one specific task. However, the exponential increase in the size and capabilities of the foundation models inside and outside medicine shows a shift toward task-agnostic models using large-scale, often internet-based, data. Recent research into smaller foundation models trained on specific literature, such as programming textbooks, demonstrated that they can display capabilities similar to or superior to large generalist models, suggesting a potential middle ground between small task-specific and large foundation models. This study attempts to introduce a domain-specific multimodal model, Congress of Neurological Surgeons (CNS)-Contrastive Language-Image Pretraining (CLIP), developed for neurosurgical applications, leveraging data exclusively from Neurosurgery Publications. ⋯ This study presents a pioneering effort in building a domain-specific multimodal model using data from a medical society publication. The results indicate that domain-specific models, while less globally versatile, can offer advantages in specialized contexts. This emphasizes the importance of using tailored data and domain-focused development in training foundation models in neurosurgery and general medicine.
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Recent studies have proposed computed tomography (CT) criteria for posterior ligamentous complex (PLC) injury: disrupted if ≥2 CT findings, indeterminate if single finding, and intact if 0 CT findings. The study aims to validate the CT criteria for PLC injury externally. ⋯ This study externally validates the previously proposed CT criteria for PLC injury. A total of ≥2 positive CT findings or 0 CT findings can be used as criteria for a disrupted PLC (B-type injury) or intact PLC (A-type injuries), respectively, without added MRI. A single CT finding implies indeterminate PLC status and the need for further MRI assessment. The CT criteria will potentially guide MRI indications and treatment decisions for neurologically intact thoracolumbar burst fractures.
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Diagnosing ventriculostomy-related infection (VRI), a common complication after external ventricular drainage (EVD), is challenging and often associated with delayed initiation of antibiotic therapy. We aimed to develop a stewardship score to help in the decision of antibiotic therapy initiation when VRI is suspected. ⋯ The VERI score is a robust, predictive tool for assessing the risk of VRI in patients with EVD, potentially guiding more judicious use of antibiotic therapy in the intensive care unit setting.