Precision Neuroprognostication,Surgical Thresholds in Trauma,and Right Ventricular Protection

This narrative review evaluates the emerging role of Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT) in assessing cerebral glucose metabolism after global ischemia-reperfusion injury. The authors synthesize preclinical and clinical data, highlighting how regional abnormalities in cerebral glucose uptake correlate with injury severity and functional recovery.

However, the clinical utility of PET/CT in this setting remains strictly hypothesis-generating. The evidence is heavily constrained by small sample sizes, heterogeneous imaging protocols, uncertain optimal timing, high costs, radiation exposure, and the logistical challenges of transporting highly unstable, critically ill patients to the PET scanner.

This systematic review and Bayesian meta-analysis compared early surgical evacuation against conservative medical management for patients presenting with traumatic intracerebral hematomas (tICH). By utilizing a Bayesian framework, the study quantified the probability of superior functional outcomes and mortality reduction associated with early intervention.

The analysis highlights that while early surgery effectively mitigates mass effect and controls refractory intracranial pressure (ICP), the absolute benefit is highly dependent on hematoma volume, localization, and the patient's baseline neurological status, with smaller lesions showing no benefit from aggressive surgical intervention.

This systematic review of 60 studies evaluated pathological complete response (pCR) and tumor regression grade (TRG) in patients with resectable esophagogastric cancer undergoing neoadjuvant chemotherapy (CT) or chemoradiotherapy (CRT). CRT achieved significantly higher pCR rates (mean 33%) compared to CT alone (22%), with immunotherapy-enhanced protocols reaching up to 50% pCR.

While achieving a pCR or major TRG response was consistently associated with superior overall and disease-free survival, the clinical heterogeneity across histological subtypes (squamous cell carcinoma vs. adenocarcinoma) and treatment intensities remains a major challenge for clinical standardization.