Neuroretinal rim (NRR) measurement can aid the diagnosis of glaucoma. A few studies reported that Cirrus optical coherence tomography (OCT) had NRR segmentation errors. The current study investigated ...segmentation success of NRR in myopic eyes using the Cirrus built-in software and to determine the number of acquisitions required to identify NRR thinning. Right eye of 87 healthy adult myopes had an optic disc scanned using Cirrus HD-OCT for five successive acquisitions. A masked examiner evaluated 36 radial line images of each scan to screen for segmentation errors using the built-in software at the Bruch's membrane opening (BMO) and/or internal limiting membrane (ILM). Participants with three accurate NRR acquisitions had their average NRR thickness determined. This result was compared with average of the two acquisitions and the first acquisition. Among 435 OCT scans of the optic disc (87 eyes × 5 acquisitions), 129 (29.7%) scans had segmentation errors that occurred mainly at the ILM. The inferior-temporal and superior meridians had slightly more segmentation errors than other meridians, independent of axial length, amount of myopia, or presence of peripapillary atrophy. Sixty-five eyes (74.7%) had at least three accurate NRR measurements. The three acquisitions had high reliability in NRR thickness in the four quadrants (intraclass correlation coefficient > 0.990, coefficient of variation < 3.9%). NRR difference between the first acquisition and the average of three acquisitions was small (mean difference 2 ± 13 μm, 95% limits of agreement within ± 30 μm) among the four quadrants. Segmentation errors in NRR measurements appeared regardless of axial length, amount of myopia, or presence of peripapillary atrophy. Cirrus segmentation lines should be manually inspected when measuring NRR thickness.
To systematically analyze fractures in the extremities that were missed in the initial radiological report, primarily on plain radiographs, in the emergency department (ED).
From January 2003 to June ...2004, 2407 new patients were confirmed to have fractures in the extremities in the ED. A total of 3081 fractures were confirmed. In the initial radiological reports, 115 fractures in 108 patients were missed. One musculoskeletal radiologist and one emergency radiologist independently carried out a second review of these images. The easily missed fracture sites were recorded. The possible reasons for misinterpretation were determined by consensus.
The most frequent location for missed fractures, expressed as a percentage of all fractures in the same location, was the foot (7.6%), followed by the knee (6.3%), elbow (6.0%), hand (5.4%), wrist (4.1%), hip (3.9%), ankle (2.8%), and shoulder (1.9%). The average percentage for all missed fractures was 3.7%. On the second review, 70% of the initially missed fractures were identified. Analysis of the possible reasons for missed fractures showed the most common reason was subtlety of the fracture.
The overall percentage of missed fractures in the extremities was 3.7%. Only 33% of the initially missed fractures were attributed to radiographically imperceptible lesions. Adequate training for physicians and radiologists in the ED may reduce the rate of missed fractures.
Abstract
Introduction
The impact of Vitamin D supplementation on weight loss has been demonstrated in several randomized controlled trials (RCT), but there is still lack of consensus regarding its ...efficacy. This study aims to assess the efficacy and safety of Vitamin D in weight reduction in terms of changes in weight loss, BMI, neck circumference, mid-upper arm circumference, waist circumference, waist-thigh ratio, waist-to-hip ratio, and percent body fat, as well as reported adverse effects.
Methodology
MEDLINE (PubMed), Google Scholar, WHO database, Herdin, Cochrane Database and EMBASE were searched for literature published from 2005–2020. A systematic search was conducted for RCTs on the efficacy of Vitamin D (alone or in combination with Calcium, or with a weight-loss program, or with both) in weight loss among participants 18–75 years old with above-normal BMI, and with a study duration of 4–12 weeks. Sixteen RCTs were included in this systematic review and meta-analysis. Screening and selection were based on the eligibility criteria, while appraisal included checking for the risk of bias, assessing the validity of the results of the study, and its methodological quality. Outcomes of eligible studies were obtained directly from the studies, if available, or summarized and calculated from the available data. For continuous data, mean differences were compared.
Results
When compared with placebo, Vitamin D supplementation showed a significant reduction in weight loss (mean difference MD = −0.92; 95% confidence interval 95% CI, −1.52 to −0.31; P=0.003), BMI (MD = −0.52; 95% CI: −0.73 to −0.31; P=0.02), waist circumference (MD = −1.35; 95% CI: −2.21 to −0.33 P=0.0006) and percent body fat (MD = −0.82; 95% CI; −1.40 to −0.25; P=0.005) but no significant effect on reduction of waist-to-hip ratio (MD = −0.01, 95% CI; −0.01 to 0.00; P=0.17). None of the studies reported outcomes for neck circumference, mid-upper arm circumference, and waist-thigh ratio. Heterogeneity was addressed using random effects model in analysis. Out of the 16 studies included, only two reported adverse events, which include constipation after intake of Vitamin D and calcium supplements and other multiple non-serious adverse events.
Conclusion and recommendations
Vitamin D as an adjunct showed a significant effect on weight loss, BMI reduction, decrease in waist circumference and percent body fat among adults after a short-term intake of oral Vitamin D, thus Vitamin D supplementation may be recommended as an adjunct treatment for weight loss among adults, but the study results should be used with caution as significant heterogeneity was observed. Further conduction of local RCTs and meta-analysis is recommended for further elucidation of data in order to determine its efficacy among Filipinos.
Funding Acknowledgement
Type of funding sources: None. Effect of Vit D on waist circumference
To develop a computer-aided diagnosis (CAD) algorithm with setting-independent features and artificial neural networks to differentiate benign from malignant breast lesions.
Two sets of breast ...sonograms were evaluated. The first set contained 160 lesions and was stored directly on the magnetic optic disks from the ultrasonographic (US) system. Four different boundaries were delineated by four persons for each lesion in the first set. The second set comprised 111 lesions that were extracted from the hard-copy images. Seven morphologic features were used, five of which were newly developed. A multilayer feed-forward neural network was used as the classifier. Reliability, extendability, and robustness of the proposed CAD algorithm were evaluated. Results with the proposed algorithm were compared with those with two previous CAD algorithms. All performance comparisons were based on paired-samples t tests.
The area under the receiver operating characteristic curve (A(z)) was 0.952 +/- 0.014 for the first set, 0.982 +/- 0.004 for the first set as the training set and the second set as the prediction set, 0.954 +/- 0.016 for the second set as the training set and the first set as the prediction set, and 0.950 +/- 0.005 for all 271 lesions. At the 5% significance level, the performance of the proposed CAD algorithm was shown to be extendible from one set of US images to the other set and robust for both small and large sample sizes. Moreover, the proposed CAD algorithm was shown to outperform the two previous CAD algorithms in terms of the A(z) value.
The proposed CAD algorithm could effectively and reliably differentiate benign and malignant lesions. The proposed morphologic features were nearly setting independent and could tolerate reasonable variation in boundary delineation.
Abstract The success of gene therapy relies on a safe and effective gene delivery system. In this communication, we describe the use of folate grafted PEI600 –CyD (H1 ) as an effective ...polyplex-forming plasmid delivery agent with low toxicity. The structures of the polymer and polyplex were characterized, and the in vitro transfection efficiency, cytotoxicity, and in vivo transfection of H1 were examined. We found that folate molecules were successfully grafted to PEI600 –CyD. At N / P ratios between 5 and 30, the resulting H1 /DNA polyplexes had diameters less than 120 nm and zeta potentials less than 10 mV. In various tumor cell lines examined (U138, U87, B16, and Lovo), the in vitro transfection efficiency of H1 was more than 50%, which could be improved by the presence of fetal bovine serum or albumin. The cytotoxicity of H1 was significantly less than high molecular weight PEI-25 kDa. Importantly, in vivo optical imaging showed that the efficiency of H1 -mediated transfection (50 μg luciferase plasmid (pLuc), N / P ratio = 20/1) was comparable to that of adenovirus-mediated luciferase transduction (1 × 109 pfu) in melanoma-bearing mice, and it did not induce any toxicity in the tumor tissue. These results clearly show that H1 is a safe and effective polyplex-forming agent for both in vitro and in vivo transfection of plasmid DNA and its application warrants further investigation.
'Cleft sign' of severe lipohypertrophy Ng, C M; Chui, O L; Tiu, S C
Hong Kong medical journal = Xianggang yi xue za zhi,
10/2015, Letnik:
21, Številka:
5
Journal Article
Recent reviews recommended the use of the aldosterone/renin ratio (ARR) to screen for primary hyperaldosteronism. However, widely different cutoff levels have been proposed, and test characteristics ...of ARR under different conditions of sampling are not known. We conducted a retrospective review among 45 subjects with carefully validated diagnoses of primary hyperaldosteronism and 17 subjects with essential hypertension to study the utility of ARR. Sixty-two patients with 75 sets of plasma renin activity (PRA), aldosterone, and ARR values from a postural study and 48 sets of values from a saline suppression test were analyzed. Ninety-four percent of these subjects underwent investigations because of hypokalemic hypertension.
ARR yielded larger areas under the curve in the receiver-operating-characteristics curve than PRA or aldosterone under all conditions of testing. Our results confirmed the superiority of ARR to either aldosterone or PRA alone as a diagnostic test for primary hyperaldosteronism.
ARR cutoff levels were significantly affected by the condition of testing. Depending on posture and time of day, it varied from 13.1–35.0 ng/dl per ng/ml·h in our study population. When using ARR for screening primary hyperaldosteronism, posture and time of sampling should be standardized both within and between centers to minimize variability in cutoff levels.
When Staphylococcus aureus is repeatedly positive in blood cultures even under effective antibiotics therapy (vancomycin, teicoplanin, or rifampin), computed tomography scan and sonography should be ...performed early to exclude mycotic aneurysm of the deeply seated arteries, especially in patients with abdominal aortic calcification. Before 1990, the most common causative organism of suprarenal aortic mycotic aneurysm was Salmonella; since 1990, it has been gram-positive cocci (i.e., Streptococcus and Staphylococcus) rather than gram-negative bacilli (i.e., Salmonella), possibly because of the more invasive procedures performed in clinical settings, but this hypothesis needs further investigation.
PDF
