The Role and Future of Artificial Intelligence in Robotic Image-Guided Interventions.

Artificial intelligence and robotics are transforming interventional radiology, driven by advancements in computer vision, robotics and procedural automation. Historically focused on diagnostics, AI now also enhances procedural capabilities in IR, enabling future robotic systems to handle complex tasks such as catheter manipulation or needle placement with increasing precision and reliability. Early robotic systems in IR demonstrated improved accuracy in both vascular and percutaneous interventions, though none were equipped with automatic decision-making.

Role of Robotics in Image-Guided Trans-Arterial Interventions.

The integration of robotic systems in image-guided trans-arterial interventions has revolutionized the field of Interventional Radiology (IR), offering enhanced precision, safety, and efficiency. These advancements are particularly impactful for acute conditions such as stroke, pulmonary embolism, and STEMI, where timely intervention is critical. Robotic platforms like the CorPath GRX and Magellan allow for remote navigation and catheter-based interventions, making it possible to extend specialized services to remote and underserved areas.

Image-Guided Robotic Interventions for Musculoskeletal Disease.

Image-guided robotic interventions have revolutionized the treatment of musculoskeletal (MSK) diseases, combining the precision of robotics with advanced imaging to improve procedural accuracy and patient outcomes. This review delves into the evolution, current applications, and future prospects of robotic systems in managing MSK disorders. Special attention is given to the integration of various imaging modalities, the clinical impact on patient care, and the ongoing challenges that need to be addressed to enhance the adoption and efficacy of these technologies.

Hyperbaric oxygen therapy for treatment of vascular occlusion after permanent dermal filler injection.

Introduction: Arterial vascular occlusion is a rare complication of dermal filler injection. This case report describes the successful use of hyperbaric oxygen therapy in a patient with vascular occlusion after a permanent dermal filler was injected.

Case Report: A 51-year-old woman underwent an injection of non-resorbable polymethylmethacrylate microspheres into her nasolabial folds.

How many stroke survivors develop problematic spasticity requiring pharmacological therapy? An international (Europe and USA) observational study protocol.

Introduction: Current care plans for stroke survivors typically focus on acute management, resulting in many stroke survivors being discharged to their communities without adequate follow-up, despite their often experiencing significant post-stroke complications, such as post-stroke spasticity (PSS). While studies have explored the incidence and prevalence of PSS, little is known about how early PSS develops and how many stroke survivors develop 'problematic' PSS that would benefit from pharmacological treatment.

Methods And Analysis: EPITOME is a prospective, international, observational, epidemiological study of participants (aged 18-90 years) who develop paresis within days 3-14 of a first-ever stroke that occurred within the past 4 weeks.

Multimodal transesophageal echocardiography in the surgical resection of patients with hepatocellular carcinoma and inferior vena cava tumor thrombus.

Background: The incidence and mortality rate of hepatocellular carcinoma (HCC) are increasing globally. HCC with inferior vena cava tumor thrombus (HCCIVCTT) represents an advanced stage of the disease. Research suggests that for patients with advanced HCCIVCTT, liver resection combined with thrombectomy is a safe and feasible option that can provide moderate survival benefit.

Rethinking the rise of early onset gastrointestinal cancers: a call to action.

Since the early 1990s, there has been a dramatic rise in gastrointestinal cancers diagnosed in patients under age 50 for reasons that remain poorly understood. The most significant change has been the increase in incidence rates of early-onset colorectal cancer, especially rates of left-sided colon and rectal cancers. Increases in gastric, pancreatic, and other gastrointestinal cancer diagnoses have further contributed to this trend.

Patient Perspective on Robotic-Assisted Total Joint Arthroplasty.

Background: Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear.

Comorbidities And Reducing InEquitieS (CARES): Feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients.

Background: Black individuals with cancer have a higher prevalence of comorbidities and a worse cancer prognosis than other racial groups in the US. As part of a quality improvement project, we aimed to demonstrate feasibility of self-monitoring and community health worker (CHW) support among managing comorbidities for Black individuals with breast or prostate cancer.

Methods: In a single arm, pre-post study, we enrolled patients with diabetes and/or hypertension who identified as Black and were diagnosed with 1) stage 0-IV breast cancer, or 2) prostate cancer and on long-term androgen-deprivation therapy.

Comparative Safety of Istradefylline Among Parkinson Disease Adjunctive Therapies: A Systematic Review and Meta-analysis of Randomized Controlled Studies.

Introduction: Adjunctive therapies to treat OFF episodes resulting from long-term levodopa treatment in Parkinson disease (PD) are hampered by safety and tolerability issues. Istradefylline offers an alternative mechanism (adenosine A2A receptor antagonist) and therefore potentially improved tolerability.

Methods: A systematic review of PD adjuncts published in 2011 was updated to include randomized controlled trials published from January 1, 2010-April 15, 2019.

External Validation of SHAPE Score: A Score to Predict Low-Risk Lower Gastrointestinal Bleeding in the Emergency Department.

Lower gastrointestinal bleeding (LGIB) frequently leads to emergency department (ED) visits and hospitalizations, encompassing a spectrum of outcomes from spontaneous resolution to intrahospital mortality. The purpose of this study was to validate a scoring system designed to identify cases of low-risk LGIB, allowing for safe discharge from the ED. A retrospective analysis of all gastrointestinal bleeding cases presented at three EDs in 2020 was conducted, focusing specifically on patients with LGIB.

Challenging Extraction and Replacement of an Eight-year-old Nanostim Leadless Pacemaker and AVEIR Implant.

Leadless pacemakers (LPs) are emerging options for bradyarrhythmias. However, extraction can be risky if the device is in an unfavorable position. We present a challenging case of a Nanostim LP (NLP) (Abbott Medical Inc.

Prevention and Management of Posterior Wound Complications Following Oncologic Spine Surgery: Narrative Review of Available Evidence and Proposed Clinical Decision-Making Algorithm.

Study Design: Narrative Review.

Objective: Contextualized by a narrative review of recent literature, we propose a wound complication prevention and management algorithm for spinal oncology patients. We highlight available strategies and motivate future research to identify optimal and individualized wound management for this population.

Opioid-Sparing Protocols in Hand Surgery: Successes and Opportunities.

The opioid epidemic has been a defining crisis in American health care. Many attempts to address the epidemic have focused on issues around opioid prescribing. Legislation at the state and federal levels has been passed; however, the results from these policies have been mixed.

Beta-Blockers in Patients with Myocardial Infarction and Preserved Left Ventricular Ejection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The benefit of beta-blockers (BBs) for myocardial infarction (MI) patients with a preserved left ventricular ejection fraction (LVEF) is uncertain. While beneficial for a reduced LVEF, their efficacy with a preserved LVEF, especially with modern revascularization, is unclear. A PRISMA-guided systematic review and meta-analysis utilized PubMed and EMBASE.

The PANDA score: External validation and modification of a simple upfront prediction tool for poor outcomes despite successful stroke thrombectomy.

Background: While endovascular thrombectomy (EVT) has become standard of care for patients' acute ischemic stroke (AIS) due to large vessel occlusion (LVO), many patients still suffer profound neurological disability, also termed futile recanalization (FR). The BAND score, which incorporates baseline disability, age, stroke severity, and treatment time window, is derived as a simple tool for upfront prediction of FR prior to EVT. This study aims to externally validate the BAND score and to incorporate upfront imaging biomarkers into the prediction tool.

The Impact of Leadership Training on Burnout and Fulfillment Among Direct Reports.

Goal: Burnout, decreased professional fulfillment, and resultant attrition across the medical professions are increasingly recognized as threats to sustainable and cost-effective healthcare delivery. While the skill level of leaders as perceived by their direct reports has been correlated with rates of burnout and fulfillment, no studies, to our knowledge, have directly evaluated whether intervention via leadership training impacts burnout and fulfillment among direct reports. The goal of this study was to evaluate the effectiveness of a leadership training intervention on direct reports' perceptions of the leadership skills of supervising residents and subsequently on the well-being of the direct reports.

Celiac trunk angiography with balloon occlusion of splenic artery for diagnosis and treatment of splenic steal syndrome.

Splenic steal syndrome (SSS) post liver transplant is a potential cause of graft dysfunction in the setting of peripheral hepatic arterial bed resistance and redirection of blood flow to a dominant splenic artery resulting in reduction of hepatic arterial inflow. We report utilization of balloon occlusion of the proximal splenic artery as an objective measure to confirm the diagnosis of SSS in a patient with orthotopic liver transplant followed by successful treatment with proximal splenic artery embolization using Gelfoam and Amplatzer vascular plug. Written informed consent for the publication of this case report was obtained from the patient.

Trends in Medicare Coverage of Overactive Bladder Medications in the United States.

Importance: Strong evidence demonstrates long-term cognitive decline associated with anticholinergics. While prevalent among older populations, medical management of overactive bladder (OAB) is dictated by insurance coverage rather than medical provider and patient preferences.

Objective: The aim of this study was to assess Medicare insurance plan coverage for select OAB medications and evaluate coverage of preferred medications to medications with a greater risk of cognitive dysfunction.

Ischemic Jejunitis as a Late Complication of Roux-en-Y Gastric Bypass.

The rising prevalence of obesity has led to a substantial investment in the advancement of treatment options for the disease and its comorbid conditions including lifestyle, pharmacologic, and procedural interventions. In this study, we describe a patient with a history of Roux-en-Y gastric bypass who was diagnosed with ischemic jejunitis on upper endoscopy because of the development of an internal hernia, a known late complication of bariatric surgery. This case highlights the diagnostic utility of endoscopy in postgastric bypass complications and the need for safer alternatives to surgery that have the potential to achieve significant weight loss such as bariatric endoscopic therapies.

Pixels to precision: Neuroradiology's leap into 3D printing for personalized medicine.

The realm of precision medicine, particularly its application within various sectors, shines notably in neuroradiology, where it leverages the advancements of three-dimensional (3D) printing technology. This synergy has significantly enhanced surgical planning, fostered the creation of tailor-made medical apparatus, bolstered medical pedagogy, and refined targeted therapeutic delivery. This review delves into the contemporary advancements and applications of 3D printing in neuroradiology, underscoring its pivotal role in refining surgical strategies, augmenting patient outcomes, and diminishing procedural risks.