Frycase3988

PURPOSE To evaluate the diagnostic value of shear wave elastography (SWE) combined with contrast-enhanced ultrasonography (CEUS) in diagnosing thyroid imaging reporting and data system (TI-RADS) category 4a and 4b nodules. METHODS TI-RADS, SWE, and CEUS features of 71 thyroid nodules (23 benign, 48 malignant) confirmed by postoperative pathological results were retrospectively analyzed. The diagnostic efficiency of each single method and that of a combination of three methods were compared. RESULTS The sensitivity and specificity in diagnosing thyroid nodules were 70.83% and 65.22% for TI-RADS, 68.75% and 91.30% for SWE, 77.08% and 78.26% for CEUS, and 91.67% and 95.65% for TI-RADS + SWE + CEUS, respectively. The area under the curve for TI-RADS, SWE, CEUS, and TI-RADS + SWE + CEUS in diagnosing thyroid nodules were 0.680, 0.839, 0.799, and 0.937, respectively. A significant difference was observed between a combination of the three methods and any of them alone (p  less then  0.05). CONCLUSION Combining SWE and CEUS improves the differential diagnosis of TI-RADS category 4a and 4b nodules.PURPOSE To study the diastolic functions using color Doppler M-mode (CDMM) for noninvasive analysis of the intraventricular pressure difference (IVPD) in diabetic rats. METHODS Two equal groups of rats were included control and streptozotocin-induced DM (n = 15). The cardiac functions were examined monthly using conventional echocardiography and CDMM with a specific MATLAB software. Echocardiography was performed under 2% isoflurane mask inhalation. Five months thereafter, all rats were killed for macroscopic and microscopic examinations of the cardiac fibrosis. RESULTS DM rats showed higher systolic blood pressure and diastolic dysfunction, i.e., decreases in several parameters such as E, E/A, TDIs, and IVPDs, compared to the controls. Moreover, obvious cardiac fibrosis was seen in perivascular and interstitial tissues, but there were no notable differences in terms of gross lesions. CONCLUSIONS Because of the noninvasive nature of CDMM, IVPD and other conventional echocardiographic parameters can be used as reliable indicators generally for evaluating cardiac function and particularly the change in intraventricular pressure.BACKGROUND Gastroparesis is a heterogeneous disorder. Patient characteristics and treatment responsiveness may differ based on the extent of delay in gastric emptying. AIMS Characterize gastroparesis patients based on the degree of delay in gastric emptying, and assess the relationship of patient demographics, symptoms and response to therapy based on the extent of delay. METHODS 1333 solid-phase 4-h scintigraphic gastric emptying scans were reviewed. Delayed emptying was categorized on percent retention at 4 h mild (10-19%), moderate (20-29%), and severe (≥ 30%). Analyses were performed with regard to demographics, symptoms, esophagogastroduodenoscopy findings, medication use, and emergency department (ED) visits/hospitalizations. RESULTS 284 patients had delayed gastric emptying mild (42.6%), moderate (19.3%), and severe (37.3%). 79.5% were women, the mean age was 45 years (± 15), and mean symptom duration was 4.6 years (± 6.5). The main categories of gastroparesis were idiopathic and diabetes mellitus. The most commonly prescribed medications were metoclopramide, domperidone and erythromycin. Opiate use (n = 69) was associated with an increased degree of delayed gastric emptying (p = 0.03) with 50% of opiate users having very delayed gastric emptying. One-way analysis revealed that severely delayed gastric emptying correlated with both increased hospitalizations and ED visits. CONCLUSIONS Severe delay in gastric emptying is a risk factor for increased hospitalizations and ED visits. Opiate use correlates with increased severity of gastric emptying. Identifying at-risk patients, stopping opioids, and instituting a programmatic care plan for patients with severely delayed gastric emptying may reduce ED visits, hospitalizations, and healthcare costs.OBJECTIVES Loeys-Dietz syndrome (LDS) and vascular Ehlers-Danlos Syndrome (vEDS) are genetically heterogeneous heritable disorders of connective tissue. Both are multi-system disorders with dominant vascular pathology and associated gastrointestinal manifestations. AIM To summarize the abdominal manifestations found in these two disorders in a cohort of patients seen at Mayo Clinic during a period of 25 years. METHODS Data were collected via the advanced cohort explorer (ACE) of Mayo Clinic records from 1994 to 2018 in patients with vEDS or LDS confirmed by genetic testing and/or medical genetics consultation. We extracted information concerning gastrointestinal symptoms, abdominal hernias, and vascular manifestations or complications. RESULTS We identified and reviewed records of 68 vEDS and 13 LDS patients. Patients were similar in age at diagnosis and gender distribution. Gastrointestinal symptoms were frequently reported in both disorders and largely similar, although altered bowel function was more prevalent in LDS patients. Hernias were present in similar proportions of patients with vEDS and LDS; however, ventral hernias were more frequent and more likely to be postoperative in vEDS than LDS. LDS patients had more arterial aneurysms overall (76.9% LDS vs. 58% vEDS, p = 0.02) and a higher proportion required arterial repair (69.2% LDS vs. 32.7% vEDS S, p = 0.03). Co-morbidities of autonomic dysfunction, psychopathology (most commonly anxiety, depression, adjustment disorder), and allergy were more prevalent in LDS than vEDS. CONCLUSION Patients with vEDS and LDS had a propensity for gastrointestinal symptoms, abdominal hernias, and aneurysm formation, but repair for arterial rupture was more prevalent in LDS than EDS.The original version of the article was published with errors in the text. The corrections are given below.Upon publication, it was noted that five of the on-line supplementary figures had incorrect figure figure legend associations. These were supplementary Figs. 6, 7, 14, 15, and 23.PURPOSE Dysphagia has a large impact on the society because it is a risk factor of malnutrition and aspiration pneumonia, and therefore, it is necessary to elucidate the entire mechanism of dysphagia. In this study, we propose a segmentation method of cervical intervertebral disks (CIDs) in videofluorography (VF) by use of patch-based convolutional neural network (CNN), our multi-channelization (MC) method and image feature selection. METHODS Twenty image filters are individually applied to a VF frame image to generate feature images. One color image, called a multi-channelized image, is generated by setting three selected feature images to its red, green and blue channels. Patch-based CNN is applied to the MC image, and the segmentation accuracy of CIDs is evaluated by the pixel-based F-measure. The combination of the three feature images is optimized by the simulated annealing method. RESULTS The proposed method was applied to actual VF dataset consisting of 19 patients and 39 healthy participants. The segmentation accuracy was 59.3% in the F-measure when Sobel and morphological top-hat filters were selected in MC, whereas it was 56.2% when original frame images were used. CONCLUSION The experimental results demonstrated that the proposed method was able to segment CIDs from actual VF and also that the MC method was able to increase the segmentation accuracy by approximately 3%. In this study, LeNet was used as CNN. One of our future tasks is to use other CNNs.Interpersonal theories have suggested that depressive symptoms influence and are influenced by peer relationships, but little is known about how depressive symptoms-peer relationships associations change with age. This study examined the longitudinal associations between both group- and dyadic-level peer relationships and depressive symptoms in a community sample of Chinese youth (n = 2179; 47.9% girls) from grades 6 to 9. Results demonstrated correlations between stable trait-like components of peer acceptance/rejection and depressive symptoms, with no dynamic state-like associations being observed. The results also suggested that conflict with friends operated as a consistent interpersonal risk for subsequent depressive symptoms across late childhood to middle adolescence. Support from friends was not significantly associated with depressive symptoms in early adolescence, but influenced and was influenced by depressive symptoms in middle adolescence. This study highlights that depressive symptoms are associated with youth's peer social status and friendship in different ways and that the interactions between friendship and depressive symptoms get strengthened with the transition to adolescence.BACKGROUND The pre-treatment neutrophil-lymphocyte ratio (NLR) has been reported to be a predictive factor for pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) in breast cancer patients. However, whether the dynamic change of post-treatment neutrophil to lymphocyte ratio (delta-NLR) can better predict the same outcome remains unclear. MATERIALS AND METHODS We retrospectively analyzed 242 consecutive patients affected by breast cancer and candidates of NACT. The complete blood cell counts before and after NACT were evaluated to calculate NLR. The relationships between delta-NLR and pCR, along with other clinical-pathological characteristics were analyzed. Univariate and multivariate analyses were performed using a logistic regression model. click here RESULTS Of the 242 patients, 65 (26.9%) achieved a pCR. Pre-treatment NLR and post-treatment NLR were not significantly associated with pCR if analyzed separately in multivariate analyses. However, when combining together, patients with delta-NLR  less then  0 profile achieved a significantly higher rate of pCR compared to those with delta-NLR ≥ 0 (OR 2.84, 95% CI 1.35-5.96, p = 0.006). Additionally, the predictive value of delta-NLR was independent from common prognostic factors such as Ki-67, and molecular subtypes. CONCLUSIONS Delta-NLR, rather than pre-treatment or post-treatment NLR is associated with pCR rate, suggesting that the dynamic change of NLR may be an important factor predicting the response to NACT in breast cancer patients.BCR-ABL1 tyrosine kinase inhibitors (TKIs) have dramatically improved survival outcomes in patients with chronic phase chronic myeloid leukemia (CML-CP) and are associated with a manageable safety profile. However, long-term TKI administration can lead to cardiovascular or renal adverse events. One goal in discontinuation of TKIs was reduction of adverse events, but it is unclear whether chronic toxicities are ameliorated as a result. In this study, we evaluated changes in estimated glomerular filtration rate (eGFR) in patients with CML-CP before and after TKI discontinuation. Long-term TKI treatment appears to induce renal toxicity, as eGFR at the time of TKI discontinuation correlated with the duration of TKI treatment (r = - 0.478, p = 0.005). Patients who received imatinib as first-line treatment exhibited lower eGFR levels than those treated with dasatinib or nilotinib, which may be correlated with long-term treatment (p = 0.027). After TKI discontinuation, no significant increases in eGFR were seen either in patients with treatment-free remission (66.