Tag: pubmed

Retina. 2023 Nov 6. doi: 10.1097/IAE.0000000000003990. Online ahead of print.

ABSTRACT

PURPOSE: Manual extraction of spectral domain optical coherence tomography (SD-OCT) reports is time- and resource-intensive. This study aimed to develop an optical character recognition (OCR) algorithm for automated data extraction from Cirrus SD-OCT macular cube reports.

METHODS: SD-OCT monocular macular cube reports (n=675) were randomly selected from a single-center database of patients from 2020-2023. Image processing and bounding box operations were performed, and Tesseract (an OCR library) was used to develop the algorithm, OCTess. The algorithm was validated using a separate test dataset.

RESULTS: The long short-term memory (LSTM) deep learning version of Tesseract achieved the best performance. After re-verifying all discrepancies between human and algorithmic data extractions, OCTess achieved accuracies of 100.00% and 99.98% in the training (n=125) and testing (n=550) datasets, while the human error rate was 1.11% (98.89% accuracy) and 0.49% (99.51% accuracy) in each, respectively. OCTess extracted data in 3.1 seconds, compared to 94.3 seconds for human evaluators.

CONCLUSION: We developed an OCR and machine learning algorithm that extracts SD-OCT data with near-perfect accuracy, which is more accurate and efficient compared to a human. This algorithm can be used for efficient construction of large-scale SD-OCT datasets for researchers and clinicians.

PMID:37948741 | DOI:10.1097/IAE.0000000000003990

Wiad Lek. 2023;76(10):2295-2301. doi: 10.36740/WLek202310125.

ABSTRACT

OBJECTIVE: The aim: To substantiate the use of data on patients’ lifestyle, parameters of blood glucose, heart rate, blood pressure and bread units to build a mathematical model for predicting fasting blood glucose level in diabetes mellitus patients to improve existing measures for diabetes prevention.

PATIENTS AND METHODS: Materials and methods: An open database consisting of the studied parameters of 359 people was used in the research. The linear regression method was used to predict fasting blood glucose level in diabetes mellitus patients. The statistical software IBM SPSS Statistics Version 23 was chosen for calculations.

RESULTS: Results: To calculate the coefficients of the linear regression equation, stepwise elimination of parameters was chosen. The analysis of the coefficients of influence of independent variables on dependent showed that the greatest effect on the change in glucose level had value of consumed bread units. The model for women diagnosed with type 2 diabetes showed the highest accuracy.

CONCLUSION: Conclusions: Mathematical modeling made it clear that any malnutrition or health disorders can lead to a significant change in glucose levels. The obtained models consist of a number of parameters, some of which might depend on the presence of concomitant diseases. Further studies should focus on the optimal combination of various parameters taking into account methods of treating comorbidities.

PMID:37948729 | DOI:10.36740/WLek202310125

Wiad Lek. 2023;76(10):2258-2262. doi: 10.36740/WLek202310119.

ABSTRACT

OBJECTIVE: The aim: To study the quality of life of patients with periodontal disease.

PATIENTS AND METHODS: Materials and methods: The study was conducted among 189 patients, including 87 men and 102 women. Research methods – clinical method, question¬naire survey (study of the quality of life related to oral health (oral health-related quality of life – OHRQoL, ОНІР-14), medical and statistical analysis using an application package Statistica 10.0 (StatSoft, Inc., USA) and Microsoft Office Excel 2010.

RESULTS: Results: According to the results of periodontal examination, it was found that 29,1% of patients suffer from acute gingivitis, acute periodontitis – 48,1%, chronic periodontitis – 21,7%. According to the results of patients’ self-assessment of the quality of life associated with oral health, a good lifestyle can be stated. Almost 50% of patients said that the most tangible problems associated with the health of their oral cavity are functional disorders (31,7%), oral pain, and difficulty eating (16,6%). Psychological problems were reported by 16,3% of respondents, among whom one-third noted a feeling of irritability and tension, dissatisfaction with eating, and also noted limitations in communication with people, and the need to interrupt food intake during its intake due to oral problems.

CONCLUSION: Conclusions: Periodontal tissue diseases reduce the quality of life of patients. Assessing the quality of life related to oral health is essential to determine the effectiveness of measures aimed at improving and preserving public health.

PMID:37948723 | DOI:10.36740/WLek202310119

Wiad Lek. 2023;76(10):2239-2244. doi: 10.36740/WLek202310116.

ABSTRACT

OBJECTIVE: The aim: The study of cytomorphological and cytogenetic features of the buccal epithelium of residents of apartments who complained of unpleasant odors in their homes.

PATIENTS AND METHODS: Materials and methods: The state of buccal epithelium in residents of multi-story buildings was studied. A total of 237 individuals were examined, 117 males and 120 females, aged from 6 to 81 years. Buccal cells were collected using a sterile spatula and stained with a 2.5% solutionofaceto-orcein and 1% light green. The preparations were examined using a light microscope OPTON Axioskop (Germany) with oil immersion at a magnification of x1000. Statistical processing of the data was performed using IBMSPSS Statistics 29.0.0.0 (t-Student criterion; Mann-Whitney; ANOVA: Tukey; T3-Dunnett), with p≤0.05.

RESULTS: Results: Cytomorphological and cytogenetic abnormalities, compared to physiological limits, were mainly manifested as karyorrhexis, nuclear doubling, the appearance of epitheliocytes with perinuclear vacuoles, or nuclear vacuolization. The frequency of micronuclei was observed in the range of (0.3-2.8 ‰). The highest micronucleus index (per 1000 cells, ‰) was observed among males aged 15-39 years and females over 65 years old. In both sexes, the lowest micronucleus indices were found in the age group of 6-14 years.

CONCLUSION: Conclusions: in the «sick building» an increase in the frequency of micronucleus occurrence among males and females was observed simultaneously with increasing age.

PMID:37948720 | DOI:10.36740/WLek202310116

Wiad Lek. 2023;76(10):2195-2199. doi: 10.36740/WLek202310110.

ABSTRACT

OBJECTIVE: The aim: To investigate clinical and pathohistological manifestations of acute kidney injury among patients with drug poisoning (overdose).

PATIENTS AND METHODS: Materials and methods: A cohort retrospective analysis of medical data of 86 patients treated in 2017-2021 with a diagnosis of “acute drug poisoning” com¬plicated by the development of acute kidney injury syndrome was conducted. A forensic medical examination of deceased patients (7 persons) was carried out. Histological samples were examined using an microscope OPTON Axioskop (Germany) in transmitted light, at magnifications of 100 and 400 times. Statistical analysis of the obtained data was carried out using the IBM SPSS Statistics 29.0.0.0 program, Pearson’s correlation analysis was used, p≤0.05.

RESULTS: Results: Acute renal failure in drug poisoning occurs under the influence of prerenal (hypoxia, r=0,66, р=0,0021; hypovolemia, r=0,61, р=0,0333) and renal factors (toxic effect of chemical components of the drug and rhabdomyolysis, r=0,743, р=0,0034). In the tissue samples, erythrocyte stasis in the capillaries, general fullness of blood vessels, signs of the sludge effect and small diapedesis hemorrhages were found; vasculitis and perivascular sclerosis are noted; foci of mononuclear infiltration of the stroma, focal edema, necrosis and interstitial fibrosis; desquamation, degenerative-dystrophic changes of the nephrothelium, tubular atrophy were found; hyaline casts in separate tubules; focal glomerular changes with segmental increase of the mesangial matrix and proliferation of endothelial cells, atrophy and hyalinosis of individual glomeruli were noted.

CONCLUSION: Conclusions: The multifactorial effect of opioids is confirmed by microcirculation disorders, vascular, interstitial, tubular and glomerular changes in the kidneys.

PMID:37948714 | DOI:10.36740/WLek202310110

Wiad Lek. 2023;76(10):2161-2168. doi: 10.36740/WLek202310105.

ABSTRACT

OBJECTIVE: The aim: To substantiate the model of the Regional Center for Cardiology and Cardiac Surgery (RCCCS) based on the principles of public-private partnership (PPP).

PATIENTS AND METHODS: Materials and methods: A systematic approach and analysis, medical-statistical and sociological method, expert assessment and method of conceptual modelling.

RESULTS: Results: A comprehensive medical and social study of the morbidity rate of the population of the Kyiv region (Ukraine) with circulatory system diseases (CSD), as well as an analysis of the activities of the cardiological service of the Kyiv region in 2010-2019, have been made. Deficiencies in the organisation of medical care were identified, and strategic directions for its improvement were substantiated. The results of a sociological survey of CSD patients, cardiologists and experts – health care organisers have been analysed. According to the results of the expert assessment, health care institutions (HCI) providing cardiac care to the population in the Kyiv region are not ready to work under the conditions of the market economy; there is no appropriate regulatory framework, economic and legal independence of HCI, there is no market strategy for the development of HCI.

CONCLUSION: Conclusions: The model of RCCCS, based on the principles of PPP being a medical institution of a new organisational and legal form, is capable of providing high-quality and affordable highly specialised medical care of the third level to the population with diseases of the circulatory system at the regional level.

PMID:37948709 | DOI:10.36740/WLek202310105

Wiad Lek. 2023;76(10):2150-2155. doi: 10.36740/WLek202310103.

ABSTRACT

OBJECTIVE: The aim: To reveal the peculiarities of functioning disorders in everyday life and the need for rehabilitation in the patients with stable ischemic heart disease (IHD).

PATIENTS AND METHODS: Materials and methods: Used 346 medical cards of inpatients with stable (IHD), Department of Cardiology and Cardiorehabilitation, Kyiv City Clinical Hospital No. 4. Research methods: collection, grouping, analysis and generalization of data from doctors’ records, medical-statistical, graphical.

RESULTS: Results: It was established that the structure of hospitalized morbidity cases of IHD consisted of 34.7% of angina pectoris and 65.3% of cardiosclerosis. IHD was accompanied by other diseases in 92.8% of cases. It has been proven that among all cases, those with a moderate severity of functional impairment pre¬vail (25.0-49.0%). 28.9% of the patients have contraindications to physical cardiorehabilitation. The remaining the patients need a complex of rehabilitation measures, including physical rehabilitation, and patients with contraindications may use other components of cardiorehabilitation programs.

CONCLUSION: Conclusions: It has been proven that patients with coronary heart disease, with or without comorbidities, experience impaired functions, reduced activity and participation in everyday life, as well as pain syndromes and painful sensations. This indicates the need for cardiac rehabilitation in the acute and post-acute periods.

PMID:37948707 | DOI:10.36740/WLek202310103

Ann Am Thorac Soc. 2023 Nov 10. doi: 10.1513/AnnalsATS.202306-520OC. Online ahead of print.

ABSTRACT

RATIONALE: Follow-up of emphysema patients treated with endobronchial valves is limited to 3-12 months after treatment in prior reports. To date, no comparative data exist between treatment and controls with a longer follow-up.

OBJECTIVE: To assess the durability of the Spiration® Valve System (SVS) in patients with severe heterogeneous emphysema over a 24-month period.

METHODS: EMPROVE, a multicenter, randomized controlled trial, presents a rigorous comparison between treatment and control groups for up to 24 months. Lung function, respiratory symptoms, and quality-of-life (QOL) measures were assessed.

RESULTS: A significant improvement in forced expiratory volume in 1 second was maintained at 24 months in the SVS treatment vs. control group. Similarly, significant improvements were maintained in several QOL measures, including St. George’s Respiratory Questionnaire and the COPD Assessment Test. Patients in the SVS treatment group experienced significantly less dyspnea than those in the control group, as indicated by the modified Medical Research Council Dyspnea Scale score. Adverse events at 24 months did not significantly differ between the SVS treatment and control groups. Acute COPD exacerbation rates in the SVS treatment and control groups were 13.7% (14/102) and 15.6% (7/45), respectively. Pneumothorax rates in the SVS treatment and control groups were 1.0% (1/102) and 0.0% (0/45), respectively.

CONCLUSIONS: SVS treatment resulted in statistically significant and clinically meaningful durable improvements in lung function, respiratory symptoms, and QOL, as well as a statistically significant reduction in dyspnea, for at least 24 months, while maintaining an acceptable safety profile.

CLINICAL TRIAL REGISTRATION: NCT01812447 Primary Source of Funding: This study was funded by Olympus Corporation.

PMID:37948704 | DOI:10.1513/AnnalsATS.202306-520OC

J Neurosurg Pediatr. 2023 Nov 10:1-7. doi: 10.3171/2023.9.PEDS23198. Online ahead of print.

ABSTRACT

OBJECTIVE: Multimodality treatment has been shown to be the optimal management strategy for pediatric arteriovenous malformations (AVMs). Deep AVMs represent a subset of AVMs for which optimal management may be achieved with a combination of radiosurgery and highly selective embolization, in the absence of compelling features requiring operative intervention. The objective of this study was to identify predictors of good functional outcomes in pediatric patients with deep AVMs.

METHODS: A retrospective cohort study of the outcomes of 79 patients with deep AVMs from January 1988 through December 2021 was performed. Deep AVMs were defined as those with the majority of the nidus centered in the basal ganglia, thalamus, or brainstem. Collected data included patient demographics and presenting symptoms, presenting modified Rankin Scale (mRS) score, radiographic findings and outcomes, management strategy, complications, and clinical outcomes as indicated by follow-up mRS score. A good outcome was defined as a follow-up mRS score ≤ 2, while a poor outcome was defined as a follow-up mRS score ≥ 3. Statistical analysis was performed to identify factors associated with functional outcomes.

RESULTS: With a mean follow-up duration of 85.6 months, there was a 72.2% angiographic obliteration rate, with 75.9% of patients having a good clinical outcome (mRS score ≤ 2). Presenting symptoms and radiographic characteristics were not significantly associated with long-term functional outcomes. There was a significantly higher rate of posttreatment hemorrhage in patients with a poor versus good outcome (11.8% vs 0%, p = 0.010). On multivariate logistic regression analysis, poor long-term functional outcome was only associated with poor presenting mRS score (p = 0.002).

CONCLUSIONS: Satisfactory angiographic obliteration rates and good long-term functional outcomes can be achieved for deep AVMs, with stereotactic radiosurgery as the cornerstone of multimodality treatment.

PMID:37948702 | DOI:10.3171/2023.9.PEDS23198

J Neurosurg. 2023 Nov 10:1-11. doi: 10.3171/2023.8.JNS23667. Online ahead of print.

ABSTRACT

OBJECTIVE: The pathophysiology of posthemorrhagic hydrocephalus (PHH) is not well understood, but recent data suggest blood components play a significant role. This study aimed to understand the timing of membrane attack complex (MAC) activation after intraventricular hemorrhage (IVH) and the effect of MAC inhibition on PHH development.

METHODS: This study was composed of four parts. First, 24 young adult male rats underwent stereotactic intraventricular injection of autologous blood or saline and MRI on day 1, 3, or 7 after hemorrhage. Second, 18 rats underwent intraventricular injection of saline, autologous blood with aurin tricarboxylic acid (ATA) in vehicle, or autologous blood with vehicle and underwent serial MRI studies on days 1 and 3 after hemorrhage. Third, 12 rats underwent intraventricular injections as above and MRI 2 hours after hemorrhage. Finally, 24 rats underwent the intraventricular injections as above, as well as serial MRI studies on days 1, 7, 14, and 28 after hemorrhage. The MR images were used to calculate ventricular volume and iron deposition. Open field testing was performed to assess functional outcomes. Outcomes on day 28 were reported as a ratio to the animal’s baseline values and normalized via log-transformation. Statistical analysis included the Shapiro-Wilk tests for normality and t-tests and 1-way analysis of variance for 2 and 3 groups of continuous variables, respectively.

RESULTS: MAC was found within the hematoma 1 day after hemorrhage and persisted until day 7. Administration of ATA resulted in similar intraventricular hematoma volumes compared to vehicle 2 hours after hemorrhage. At 1 and 3 days after hemorrhage, ATA administration resulted in significantly smaller ventricular volumes and less hemolysis within the hematoma than in the vehicle animals. Administration of ATA also resulted in significantly smaller ventriculomegaly and less iron deposition in the periventricular area than in the vehicle rats 28 days after hemorrhage. Functionally, ATA rats were significantly faster, traveled longer distances, and spent less time resting than vehicle rats at 28 days.

CONCLUSIONS: MAC was activated early and persisted within the hematoma until day 7 after IVH. MAC inhibition attenuated hemolysis in the clot and ventriculomegaly acutely after IVH. One month after hemorrhage, MAC inhibition attenuated ventriculomegaly and iron accumulation and improved functional outcomes.

PMID:37948699 | DOI:10.3171/2023.8.JNS23667