Nevin Manimala

Arq Bras Cardiol. 2022 Feb 7:S0066-782X2022005001217. doi: 10.36660/abc.20210069. Online ahead of print.

ABSTRACT

BACKGROUND: The Himalayan salt (HS) has become a popular alternative for the traditional table salt (TS) due to its health benefit claims, particularly for individuals with arterial hypertension. However, despite the increase in HS consumption, there is still a lack of clinical evidence to support a recommendation for its consumption by health professionals.

OBJECTIVE: This cross-over study aimed to compare the impact of HS and TS intake on systolic blood pressure (SBP) and diastolic blood pressure (DBP), and urinary sodium concentration in individuals with arterial hypertension.

METHODS: This study recruited 17 female patients with arterial hypertension who ate out no more than once a week. Participants were randomized into two groups, to receive and consume either HS or TS. Before and after each intervention, participants had their blood pressure measured and urine collected for mineral analysis. A p-value < 0.05 was considered statistically significant.

RESULTS: There were no statistically significant differences before and after the HS intervention for DBP (70mmHg vs. 68.5mmHg; p=0.977), SBP (118.5 mmHg vs. 117.5 mmHg; p= 0.932) and sodium urinary concentration (151 mEq/24h vs. 159 mEq/24; p=0.875). Moreover, the between-group analysis showed no significant differences after the intervention regarding SBP (117mmHg vs 119 mmHg; p=0.908), DBP (68.5 mmHg vs. 71mmHg; p= 0,645) or sodium urinary concentration (159 mEq/24h vs. 155 mEq/24h; p=0.734).

CONCLUSION: This study suggests that there are no significant differences on the impact of HS consumption compared to TS on blood pressure and sodium urinary concentration in individuals with arterial hypertension.

PMID:35137791 | DOI:10.36660/abc.20210069

Arq Bras Cardiol. 2022 Feb 7:S0066-782X2022005001216. doi: 10.36660/abc.20210006. Online ahead of print.

ABSTRACT

BACKGROUND: Coronary tomography angiography (CTA) has been mainly used for chest pain evaluation in low-risk patients, and few data exist regarding patients at intermediate risk.

OBJECTIVE: To evaluate the performance of serial measures of sensitive troponin and CTA in intermediate-risk patients.

METHODS: A total of 100 patients with chest pain, TIMI risk scores of 3 or 4, and negative troponin were prospectively included. All patients underwent CTA and those with coronary stenosis ≥ 50% were referred to invasive coronary angiography. Patients with coronary lesions <50% were discharged and contacted 30 days later by a telephone call to assess clinical outcomes. Outcomes were hospitalization, death, and myocardial infarction at 30 days. The comparison between methods was performed by Kappa agreement test. The performance of troponin measures and CTA for detecting significant coronary lesions and clinical outcomes was calculated. Results were considered statistically significant when p < 0.05.

RESULTS: Coronary stenosis ≥ 50% on CTA was found in 38% of patients and significant coronary lesions on coronary angiography were found in 31 patients. Two clinical events were observed. Kappa agreement analysis showed low agreement between troponin measures and CTA in the detection of significant coronary lesions (kappa = 0.022, p = 0.78). The performance of CTA for detecting significant coronary lesions on coronary angiography or for predicting clinical events at 30 days was better than sensitive troponin measures (accuracy of 91% versus 60%).

CONCLUSION: CTA performed better than sensitive troponin measures in the detection of significant coronary disease in patients with chest pain and intermediate risk for cardiovascular events.

PMID:35137790 | DOI:10.36660/abc.20210006

J Drugs Dermatol. 2022 Feb 1;21(2):135-140. doi: 10.36849/jdd.6398.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) is a growing field in dermatology and has great potential for integration into clinical practice. Our objective was to assess the perceptions of artificial intelligence in dermatology practice.

METHODS: An IRB-approved 18-question online survey was distributed by email. Patients were stratified by age to assess for statistical differences among perceptions.

RESULTS: 90 respondents fully completed the survey. 54 (60.0%) respondents were slightly familiar with AI, and 73 (81.1%) respondents have not incorporated AI into their clinical practice. 27.8% of respondents perceived AI as superior to a human provider&rsquo;s experience some of the time. 94.4% of respondents would at least use AI for certain scenarios. 65.6% of respondents believed that AI would help patients with analyzing and managing electronic health records. 38.9% respondents predict that AI will not decrease or increase the need for dermatologists. 51.6% of respondents felt that AI will at least somewhat enhance the dermatologists&rsquo; ability to screen skin lesions. The three dermatology areas that AI was perceived to most beneficial were malignant skin lesions, benign skin lesions, and pigmentation disorders. Age of respondents did not have a significant impact on the perceptions of AI.

CONCLUSION: Our results show that dermatologists surveyed were generally positive toward embracing AI integration into clinical practice. Further studies should be conducted to confirm these findings. J Drugs Dermatol. 2022;21(2):135-140. doi:10.36849/JDD.6398.

PMID:35133109 | DOI:10.36849/jdd.6398

J Drugs Dermatol. 2022 Feb 1;21(2):191-194. doi: 10.36849/jdd.6277.

ABSTRACT

BACKGROUND: Background: Early detection of malignant skin lesions reduces morbidity. There is increased need for a telemedicine triage tool to prioritize patients who require in-person evaluation for potential malignancy.

OBJECTIVE: To evaluate the utility of artificial intelligence (AI) in telemedicine triage and diagnosis of cutaneous lesions.

METHODS: Clinical photographs of unbiopsied skin lesions were presented to AI software and three board-certified dermatologists with 18 years average clinical experience. Diagnoses were compared with biopsy reports of the same lesions.

RESULTS: Results from 100 images revealed no significant diagnostic difference between AI and a panel of three dermatologists when using the AI top three differential diagnoses. The AI correctly identified 63% of the cases whereas the dermatology group correctly identified 64.3% of the cases (P&lt;.05). In summary, there was no statistically significant difference when evaluating lesions.

CONCLUSION: The use of artificial intelligence as a method of triaging patients with potential skin cancer is a very useful option in telemedicine, as AI identification of BCC, SCC, and melanoma did not significantly differ from board-certified dermatologists. Both dermatologists and non-dermatologists will benefit from an AI triage system, prioritizing lesions that the software deems malignant. J Drugs Dermatol. 2022;21(2):191-194. doi:10.36849/JDD.6277.

PMID:35133107 | DOI:10.36849/jdd.6277

J Biophotonics. 2022 Feb 8:e202100307. doi: 10.1002/jbio.202100307. Online ahead of print.

ABSTRACT

This study uses infrared spectrometry coupled with data analysis techniques to understand colitis-induced alterations in the molecular components of serum samples. Using samples from 18 ulcerative colitis patients and 28 healthy volunteers, we assessed features such as absorbance values at wavenumbers of 1033 cm^-1 and 1076 cm^-1 , and the ratios at 1121 cm^-1 versus 1020 cm^-1 and 1629 cm^-1 versus 1737 cm^-1 . Through the deconvolution of the amide I band, protein secondary structure analysis was performed. Colitis-induced alterations are reflected as fluctuations in the vibrational modes, and are used to identify associated spectral signatures. The results of the study show statistically significant differences in five identifying spectral signatures. Among them, the sensitivity and specificity of the spectral signature, I₁₁₂₁ /I₁₀₂₀ , were 100% and 86%, respectively. These findings resemble our earlier proof-of-concept investigations in mouse models and provide preliminary evidence that this could be a reliable diagnostic test for human patients. This article is protected by copyright. All rights reserved.

PMID:35133076 | DOI:10.1002/jbio.202100307

J Biophotonics. 2022 Feb 8:e202100334. doi: 10.1002/jbio.202100334. Online ahead of print.

ABSTRACT

Acoustic heterogeneities in biological samples are known to cause artefacts in tomographic optoacoustic (photoacoustic) image reconstruction. A statistical weighted model-based reconstruction approach was previously introduced to mitigate such artefacts. However, this approach does not reliably provide high-quality reconstructions for partial-view imaging systems, which are common in preclinical and clinical optoacoustics. In this paper, the capability of the weighted model-based algorithm is extended to generate optoacoustic reconstructions with less distortions for partial-view geometry data. This is achieved by manipulating the weighting scheme based on the detector geometry. Using partial-view optoacoustic tomography data from a tissue-mimicking phantom containing a strong acoustic reflector, tumors grafted onto mice, and a mouse brain with intact skull, the proposed partial-view-corrected weighted model-based algorithm is shown to mitigate reflection artefacts in reconstructed images without distorting structures or boundaries, compared to both conventional model-based and the weighted model-based algorithms. It is also demonstrated that the partial-view-corrected weighted model-based algorithm has the additional advantage of suppressing streaking artefacts due to the partial-view geometry itself in the presence of a very strong optoacoustic chromophore. Due to its enhanced performance, the partial-view-corrected weighted model-based algorithm may prove useful for improving the quality of partial-view multispectral optoacoustic tomography, leading to enhanced visualization of functional parameters such as tissue oxygenation. This article is protected by copyright. All rights reserved.

PMID:35133073 | DOI:10.1002/jbio.202100334

J Magn Reson Imaging. 2022 Feb 8. doi: 10.1002/jmri.28105. Online ahead of print.

ABSTRACT

BACKGROUND: Localized regions of left-right image intensity asymmetry (LRIA) were incidentally observed on T₂ -weighted (T₂ -w) and T₁ -weighted (T₁ -w) diagnostic magnetic resonance imaging (MRI) images. Suspicion of herpes encephalitis resulted in unnecessary follow-up imaging. A nonbiological imaging artifact that can lead to diagnostic uncertainty was identified.

PURPOSE: To investigate whether systematic LRIA exist for a range of scanner models and to determine if LRIA can introduce diagnostic uncertainty.

STUDY TYPE: A retrospective study using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) data base.

SUBJECTS: One thousand seven hundred fifty-three (median age: 72, males/females: 878/875) unique participants with longitudinal data were included.

FIELD STRENGTH: 3T.

SEQUENCES: T₁ -w three-dimensional inversion-recovery spoiled gradient-echo (IR-SPGR) or magnetization-prepared rapid gradient-echo (MP-RAGE) and T₂ -w fluid-attenuated inversion recovery (FLAIR) long tau fast spin echo inversion recovery (LT-FSE-IR). Only General Electric, Philips, and Siemens’ product sequences were used.

ASSESSMENT: LRIA was calculated as the left-right percent difference with respect to the mean intensity from automated anatomical atlas segmented regions. Three neuroradiologists with 37 (**), 32 (**), and 3 (**) years of experience rated the clinical impact of 30 T₂ -w three-dimensional FLAIR exams with LRIA to determine the diagnostic uncertainty. Statistical comparisons between retrospective intensity normalized T₁ m and original T₁ -w images were made.

STATISTICAL TESTS: For each image type, a linear mixed effects model was fit using LRIA scores from all scanners, regions, and participants as the outcome and age and sex as predictors. Statistical significance was defined as having a P-value <0.05.

RESULTS: LRIA scores were significantly different from zero on most scanners. All clinicians were uncertain or recommended definite diagnostic follow-up in 62.5% of cases with LRIA >10%. Individuals with acute brain pathology or focal neurologic deficits are not enrolled in ADNI; therefore, focal signal abnormalities were considered false positives.

DATA CONCLUSION: LRIA is system specific, systematic, creates diagnostic uncertainty, and impacts IR-SPGR, MP-RAGE, and LT-FSE-IR product sequences.

LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 3.

PMID:35133061 | DOI:10.1002/jmri.28105

Congenit Anom (Kyoto). 2022 Feb 8. doi: 10.1111/cga.12461. Online ahead of print.

ABSTRACT

The face is a small complex three-dimensional structure composed of various bones and essential organs. Congenital anomalies of those organs represent various deformities; therefore, their quantification has been challenging. Linear measurements, such as lengths or angles between landmarks, called conventional morphometrics, have been used to quantify their phenotypes usually using two-dimensional images, such as photographs or X-ray images. During analysis, geometric information, which refers to the relative position of each structure, is lost. Geometric morphometrics uses shape configurations, including anatomical landmarks, which can retain geometric information throughout analysis and can help visualize the results, making it tremendously advantageous compared to conventional methods. Morphometric studies investigate variations within groups, identification of group differences, simulation of the ontogeny, or association with specific organs or genetic disorders, and geometric morphometrics can be applied to these purposes using multivariate statistical methods. The calculation of high-dimensional data is usually required and has prevented geometric morphometrics from becoming a major morphometric method. However, recent developments in computer technology and software have enabled us to perform it easily with ordinary home computers, and the number of morphometric studies applying geometric morphometrics for facial congenital anomalies has been increasing recently. In this article, we introduce the concept and application of geometric morphometrics and review previous morphometric studies with geometric morphometrics regarding congenital facial anomalies. This article is protected by copyright. All rights reserved.

PMID:35133047 | DOI:10.1111/cga.12461

Ophthalmic Physiol Opt. 2022 Feb 8. doi: 10.1111/opo.12950. Online ahead of print.

ABSTRACT

PURPOSE: Longitudinal changes in priority rehabilitation needs, vision-related activity limitation and importance of visual goals were evaluated in a sample of people with a visual impairment over a year following entry to low vision rehabilitation services in England.

METHODS: Participants were adults with newly registered visual impairment within Leicestershire. Priority scores, indicating the level of rehabilitative need, were determined from the importance and difficulty scores of the 48 goals of the Participation and Activity Inventory (PAI). Rasch analysis of the difficulty and importance scores examined activity limitation and importance separately. PAI outcome measures were assessed on entry to rehabilitation services and at 4 and 12 months thereafter.

RESULTS: Forty-eight participants (mean age 74.2, SD 14.1 years) completed three visits. Overall, there was a statistically significant reduction in the perceived need for rehabilitation over time (p < 0.001, η_p² = 0.29), driven by reduced perceived difficulty (p < 0.001, η_p² = 0.32) but stable importance (p = 0.73) of goals, with most change occurring between baseline and 4 months. PAI goals with greatest rehabilitative need at study entry were reading, mobility and writing, and these remained of highest priority over time. The greatest priority score decrease was for the goal ‘Hobbies and crafts’. The largest decrease in importance was for ‘Mobility outdoors’, whereas ‘Relationship with loved ones’ increased most.

CONCLUSIONS: Despite a decline in the perceived need for rehabilitation over the study period, there remains a need for continued support and intervention at 12 months following registration with rehabilitation services, particularly for the key goals of reading, writing and mobility. Early identification and support for individuals’ important but difficult goals could prevent such goals being relinquished. Goals concerning relationships and communication became more important over time, indicating that re-evaluation of needs at follow-up is necessary to inform ongoing service provision.

PMID:35133019 | DOI:10.1111/opo.12950

Int J Cancer. 2022 Feb 8. doi: 10.1002/ijc.33959. Online ahead of print.

ABSTRACT

Cyclin-dependent-kinase-4/6 inhibitor (CDKi) plus endocrine therapy (ET) is standard of care for patients with advanced hormone receptor (HR)-positive, HER2-negative breast cancer (BC). The Breast Medical Oncology database at MD Anderson Cancer Center (MDACC) was analyzed to assess effectiveness of the CDKi palbociclib plus ET compared to ET alone. From a total of 5402 advanced HR+ HER2- BC patients referred to MDACC between 1997 and 2020, we identified eligible patients who received palbociclib in combination with first- (n=778) and second-line (n=410) ET. We further identified “control” patients who received ET alone in the first- (n=2452) and second-line (n=1183) settings. Propensity score matching analysis was conducted to balance baseline demographic and clinical characteristics between palbociclib and control cohorts to assess the effect of palbociclib treatment on progression-free survival (PFS) and overall survival (OS). For propensity-matched-cohort in the first-line setting (n=708), palbociclib group had significantly longer median PFS (17.4 vs. 11.1 months; p<0.0001) compared to controls. Median OS (44.3 vs. 40.2 months) did not show a statistically significant benefit in the first line setting. However, in the second-line setting, with 380 propensity-matched-cohort, the palbociclib group had significantly longer PFS (10 vs 5 months, p<0.0001) as well as OS (33 vs 24 months; p < 0.022), compared to controls. We conclude that in this single center analysis of a large cohort of metastatic HR+ HER2- BC patients, palbociclib in combination with ET was associated with improved PFS in both first- and second-line settings and OS in the second-line setting compared with ET alone cohort.

PMID:35133007 | DOI:10.1002/ijc.33959