The insidious onset and aggressive nature of pancreatic cancer contributes to the poor treatment response and high mortality of this devastating disease. While surgery, chemotherapy and radiation have contributed to improvements in overall survival, roughly 90% of those afflicted by this disease will die within 5 years of diagnosis. The developed ablative locoregional treatment modalities have demonstrated promise in terms of overall survival and quality of life. In this review, we discuss some of the recent studies demonstrating the safety and efficacy of ablative treatments in patients with locally advanced pancreatic cancer.

Purpose Total hip arthroplasty (THA) and partial hip arthroplasty (PHA) are performed in patients with hip joint dysfunction such as osteoarthritis or hip fractures and are associated with complications including mortality. There is a lack of evidence in the literature regarding whether the type of anesthesia (regional vs. general) is associated with increased postoperative mortality in patients undergoing hip arthroplasty. The present study compares early postoperative mortality between general or regional anesthesia administered to patients undergoing either THA or PHA. Methods A retrospective cohort was assembled using the 2015-2016 American College of Surgeons National Surgical Quality Improvement Program database. Adult patients undergoing hip arthroplasty under general or regional anesthesia were included. Patients were excluded if receiving any other type of anesthesia, as well as having an American Society of Anesthesiologists (ASA) physical status classification score ≥ 4, preoperative acute renal failure, severe congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or ascites. Adjusted odds of 30 days all-cause postoperative mortality according to the type of anesthesia were estimated by fitting multiple logistic regression models that included potential confounders and effect modifiers. Results A total of 60,897 patients were included in the study. Given that the interaction between the type of anesthesia and the type of arthroplasty was statistically significant, separated models were fitted for each type of arthroplasty. There was no evidence of an association between type of anesthesia and postoperative mortality in hip arthroplasty patients regardless of whether the arthroplasty was partial (odds ratio {OR} = 0.85; confidence interval {CI} 0.59-1.22) or total (OR = 0.68; CI 0.43-1.08). Conclusion The overall early postoperative mortality in adult hip arthroplasty patients is low in the absence of risk factors such as severe CHF, COPD, ascites, acute renal failure, and ASA score of 4 or higher. Our findings suggest there is no association between the type of anesthesia received (general vs. regional) and early postoperative mortality rates in patients undergoing hip arthroplasty, regardless of type (total vs. partial).

Background There is conflicting evidence in the literature regarding whether type of anesthesia (regional vs. general) is associated with postoperative mortality in patients undergoing hip arthroplasty. The present study compares mortality between general or regional anesthesia administered to patients undergoing either total (THA) or partial hip arthroplasty (PHA). Methods A retrospective cohort was assembled using the 2015-2016 American College of Surgeons National Surgical Quality Improvement Program database. Adult patients undergoing hip arthroplasty under general or regional anesthesia were included. Adjusted odds of 30 days all-cause postoperative mortality according to type of anesthesia were estimated by fitting multiple logistic regression models that included potential confounders and effect modifiers. Results A total of 60,897 patients were included. Given that the interaction between type of anesthesia and type of arthroplasty was statistically significant, separated models were fitted for each type of arthroplasty. There was no evidence of an association between type of anesthesia and postoperative mortality in hip arthroplasty patients regardless of whether the arthroplasty was partial (OR = 0.85; CI 0.59-1.22) or total (OR = 0.68; CI 0.43-1.08). Conclusion The overall postoperative mortality in adult hip arthroplasty patients is low. Our findings support that mortality is not different between patients receiving regional vs general anesthesia regardless of type of hip arthroplasty (total vs. partial). Key Message In patients undergoing total hip arthroplasty or partial hip arthroplasty, the use of general or regional anesthesia does not impact early postoperative mortality.

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Introduction Artificial intelligence (AI) has shown to be able to alert the radiologist to the presence of ischemic stroke secondary to large artery occlusion (LVO) as fast as 1–2 minutes from scan completion hence leading to faster diagnosis and treatment. In addition to acute LVO, AI has become increasingly used for various intracranial pathologies. In particular, accurate and timely detection of intracerebral hemorrhage (ICH) is crucial to provide prompt life‐saving interventions. Therefore, we aimed to validate a new AI application called Viz.ai ICH with the intent to improve diagnostic identification of suspected ICH. Methods We performed a retrospective database analysis of 4,203 consecutive non‐contrast brain CT reports between September 2021 to December 2021 within a single institution. The reports were made by experienced neuroradiologists who reviewed each case for the presence of ICH. Medical students reviewed the neuroradiologists’ reports and identified cases with positive findings for ICH. Each positive case was categorized based on subtype, timing, and size/volume via imaging review by a neuroradiologist. The Viz.ai ICH output was reviewed for positive cases by medical students. This AI model was validated by using descriptive analysis and assessing its diagnostic performance with Viz.ai ICH as the index test compared to the neuroradiologists’ interpretation as the gold standard. Results 387 of 4,203 non‐contrast brain CT reports were positive for ICH according to neuroradiologists. The overall sensitivity of Viz.ai ICH was 68%, specificity was 99%, positive predictive value (PPV) was 90%, and negative predictive value (NPV) was 97%. Subgroup analysis was performed based on hemorrhage subtypes of intraparenchymal, subarachnoid, subdural, and intraventricular. Sensitivities were calculated to be 86%, 57%, 56%, and 42% respectively. Further stratification revealed sensitivity improves with higher acuity and volume/size across all ICH subtypes. Meningioma was found to be a common false‐positive finding (3 of 22, 14%). Table 1 provides a summary of the results. Conclusions Our analysis seems to indicate that AI can accurately detect the presence of ICH particularly for large volume/size ICH.