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Although cardiac amyloidosis contributes significantly to the morbidity and mortality associated with systemic disease, new tools are available to assist with diagnosis, prognosis, and management.
New imaging methods have proven to be considerably valuable in the identification of cardiac amyloid infiltration. For treating clinicians, a diagnostic algorithm for patients with suspected amyloidosis with or without cardiomyopathy is shown to help classify disease and to direct appropriate genetic testing and management. For patients with light chain disease, recently introduced treatments adopted from multiple myeloma therapies have significantly extended progression-free and overall survival as well as organ response. In addition, new medical interventions are now available for those with transthyretin amyloidosis. Although cardiac amyloidosis contributes significantly to the morbidity and mortality associated with systemic disease, new tools are available to assist with diagnosis, prognosis, and management.
This study evaluates the ability of several machine learning (ML) algorithms, developed using volumetric and texture data extracted from baseline
F-FDG PET/CT studies performed initial staging of patient with esophageal cancer (EC), to predict survival and histopathology.
The initial staging
F-FDG PET/CT images obtained on newly diagnosed EC patients between January 2008 and June 2019 were evaluated using LIFEx software. A region of interest (ROI) of the primary tumor was created and volumetric and textural features were obtained. A significant relationship between these features and pathological subtypes, 1-year, and 5-year survival was investigated. Due to the nonhomogeneity of the data, nonparametric test (The Mann-Whitney U test) was used for each feature, in pairwise comparisons of independent variables. A p value of < 0.05 was considered significant. Receiver operating curve (ROC) analysis was performed for features with p < 0.05. Correlation between the significant features was evaluated with Spearman correlation test; features with correlation coefficient < 0.8 were evaluated with several ML algorithms.
In predicting survival in a 1-year follow-up J48 was obtained as the most successful algorithm (AUC 0.581, PRC 0.565, MCC 0.258, acc 64.29%). 5-year survival results were more promising than 1-year survival results with (AUC 0.820, PRC 0.860, MCC 271, acc 81.36%) by logistic regression. It is revealed that the most successful algorithm was naive bayes (AUC 0.680 PRC 0.776, MCC 0.298, acc 82.66%) in the histopathological discrimination.
Texture analysis with ML algorithms could be predictive of overall survival and discriminating histopathological subtypes of EC.
Texture analysis with ML algorithms could be predictive of overall survival and discriminating histopathological subtypes of EC.
This meta-analysis was designed to assess the association between two loco-regional therapies, regionalnodal irradiation (RNI) and axillary lymph node dissection (ALND), and breast cancer-related lymphoedema (BCRL).
We searched PubMed, Science Direct, Embase, and BMJ databases for clinical studies published between January 1, 2010 and January 1, 2020, which assessed risk factors and incidence/prevalence of BCRL. Two investigators independently selected articles to extract relative data and calculate corresponding exact binomial 95% confidence intervals (CIs). In total, 93 articles were reviewed, from which 19 studies were selected. The extracted data were pooled using a random-effects mixed model.
The incidence of lymphedema in the selected studies ranged from 3% to 36.7%, with a pooled incidence of 14.29% (95% CI 13.79-14.79). The summary odds ratio/risk ratio (OR/RR) of ALND vs. read more no-ALND was 3.67 (95% CI 2.25-5.98) with a heterogeneity (I
) of 81% (P < 0.00001). After excluding the studies with an abnormally high risk of lymphedema from self-reporting, the summary hazard ratio (HR) was 2.99 (95% CI 2.44-3.66) with no heterogeneity (I
= 0%, P = 0.83). The summary OR/RR of patients with vs. without radiotherapy (RT) was 1.82 (95% CI 0.92-3.59), but the RR of RT to breast/chest vs. both axillary and supraclavicular areas was 2.66 (95% CI 0.73-9.70).
Regional nodal irradiation has a significantly higher risk for developing lymphedema than irradiation of the breast/chest wall. Axillary dissection and axillary RT have a similar risk for early-onset of breast cancer-related lymphoedema, although the risk trends higher for axillary dissection.
Regional nodal irradiation has a significantly higher risk for developing lymphedema than irradiation of the breast/chest wall. Axillary dissection and axillary RT have a similar risk for early-onset of breast cancer-related lymphoedema, although the risk trends higher for axillary dissection.Amazonian's forensic experts usually experience considerable difficulties in the identification of drowned bodies rescued from the rivers of the Amazon basin, since they are frequently found skeletonized by the action of the cadaverous ichthyofauna. In these circumstances, especially when the soft tissues are completely absent, bones and teeth may represent the unique source of information for the identification of the body. This work reports a case of positive identification of a body skeletonized by scavenger ichthyofauna. The identification was performed by comparing computerized delineation of the dental characteristics of the cadaver with those observed in a smiling photograph of the victim. This report also highlights the ferocity of Cetopsis candiru (candiru cobra), Cetopsis coecutiens (candiru-açu) and Calophysus macropterus (piracatinga).The primary medico-legal investigation goal in deaths due to animal attacks is distinguishing between animal-related injuries and potential homicidal wounds. We report the case of a 49-year-old male found dead in his farm's pigsty, where a sow and her piglets were present. At the postmortem examination, numerous, severe blunt force injuries were observed on the body, with special regard to the upper extremities where massive injuries involving soft tissues, bones, and regional vessels, tendons, and nerves were present. The death resulted from severe bleeding from massive upper extremities injuries due to a domestic pig attack. Domestic pigs are usually placid but they can become aggressive if disturbed and attack humans producing severe injuries due to trampling, kicking and biting. Knowing the relevant anatomy, pattern of attack, and morphologies of wounds produced by particular animals can distinguish animal attacks from homicides, as well as attempt to identify the type of animal involved in an unwitnessed attack.