Segmentation of orbital and periorbital lesions detected in orbital magnetic resonance imaging by deep learning method

Purpose: Magnetic resonance imaging (MRI) has a special place in the evaluation of orbital and periorbital lesions. Segmentation is one of the deep learning methods. In this study, we aimed to perform segmentation in orbital and periorbital lesions. Material and methods: Contrast-enhanced orbital MRIs performed between 2010 and 2019 were retrospectively screened, and 302 cross-sections of contrast-enhanced, fat-suppressed, T1-weighted, axial MRI images of 95 patients obtained using 3 T and 1.5 T devices were included in the study. The dataset was divided into 3: training, test, and validation. The number of training and validation data was increased 4 times by applying data augmentation (horizontal, vertical, and both). Pytorch UNet was used for training, with 100 epochs. The intersection over union (IOU) statistic (the Jaccard index) was selected as 50%, and the results were calculated. Results: The 77th epoch model provided the best results: true positives, 23; false positives, 4; and false negatives, 8. The precision, sensitivity, and F1 score were determined as 0.85, 0.74, and 0.79, respectively. Conclusions: Our study proved to be successful in segmentation by deep learning method. It is one of the pioneering studies on this subject and will shed light on further segmentation studies to be performed in orbital MR images

SUCCESS OF ARTIFICIAL INTELLIGENCE SYSTEM IN DETERMINING ALVEOLAR BONE LOSS FROM DENTAL PANORAMIC RADIOGRAPHY IMAGES

Objectives: The aim of this study was to detect alveolar bone loss from dental panoramic radiographic images using artificial intelligence systems. Material and Methods: A total of 2276 panoramic radiographic images were used in this study. While 1137 of them belong to cases with bone destruction, 1139 were periodontally healthy. The dataset is divided into three parts as training (n=1856) , validation (n=210) and testing set (n= 210). All images in the data set were resized to 1472x718 pixels before training. A random sequence was created using the open-source python programming language and OpenCV, NumPy, Pandas, and Matplotlib libraries effectively. A pre-trained Google Net Inception v3 CNN network was used for preprocessing and data sets were trained using transfer learning. Diagnostic performance was evaluated with the confusion matrix using sensivitiy, specificity, precision, accuracy and F1 score. Results: Of the 105 cases with bone loss, 99 were detected by the AI system. Sensitivity was 0.94, specificity 0.88, precision 0.89, accuracy 0.91 and F1 score 0.91. Conclusion: The convolutional neural network model is successful in determining periodontal bone losses. It can be used as a system to facilitate the work of physicians in diagnosis and treatment planning in the future

Contribution of real-time elastography in diagnosis of polycystic ovary syndrome

PURPOSEWe aimed to assess the feasibility and reproducibility of real-time elastography (RTE) for displaying the effects of morphological changes in the ovary in polycystic ovary syndrome (PCOS).METHODSForty-eight patients diagnosed with PCOS and 48 healthy women were enrolled in the study. Ultrasonography and RTE were performed on the 3rd day of the menstrual cycle. Evaluations were performed independently by two radiologists. Ovarian volume, number of follicles, elasticity pattern, and strain ratio were measured. Elasticity patterns were assessed as hard (type 1; blue or blue-green), moderate (type 2; green or green-yellow) or soft (type 3; red or orange-red).RESULTSBoth radiologists determined the elasticity pattern as mostly type 1 in the PCOS group and type 3 in the control group (P < 0.01). The mean strain ratios obtained by the first and second radiologist were 6.1±1.8 (2.7–10.1) and 6.0±1.5 (3.0–9.0) in PCOS and 3.3±1.2 (1.7–7.2) and 3.2±0.9 (1.7–6.8) in the control group, respectively (P < 0.001). Interobserver agreement was moderate for the elasticity pattern (κ=0.48) and good for the strain ratio (intraclass correlation coefficient, 0.77). A strain ratio of 3.8 was determined as the optimized cutoff point by receiver operating curve analysis. Strain ratio was correlated with the ovarian volume and the number of detected follicles (P < 0.001).CONCLUSIONElasticity pattern and strain ratio can help identify morphological changes that make PCOS ovaries stiffer than normal ovaries

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Usefulness of whole blood viscosity estimated by de Simeone's formula to predict left ventricular thrombus formation within one year following acute anterior myocardial infarction

Dursun, Ihsan/0000-0001-7503-7949WOS: 000550220500004PubMed: 32444531BACKGROUND: Despite improvements in treatment of ST-segment myocardial infarction (STEMI), thrombus formation in the left ventricle is still a concerning complication that may lead to systemic thromboembolism and stroke. OBJECTIVES: To evaluate the predictive value of estimated whole blood viscosity (WBV) for left ventricular thrombus development in patients surviving an acute anterior myocardial infarction (AAMI). MATERIALS & METHODS: Seven hundred eighty AAMI patients who were treated percutaneously were enrolled consecutively. Serial echocardiographic examinations were performed within 24h of admission, before hospital discharge, and at 1, 3, 6 and 12 months following hospital discharge. WBV was calculated according to de Simones formula. RESULTS: One hundred patients (12.8%) developed thrombus formation within one year following AAMI. Patients with left ventricular thrombus (LVT) had significantly higher WBV values. Supramedian values of WBV at both low (0.5 sec(-1)) and high (208 sec(-1)) shear rates were found to be an independent predictor of LVT development. CONCLUSION: As an easily accessible parameter, WBV might be a useful predictor of LVT formation within one year following acute anterior myocardial infarction

Association Between C-Reactive Protein to Albumin Ratio and Left Ventricular Thrombus Formation Following Acute Anterior Myocardial Infarction

Cirakoglu, Omer Faruk/0000-0002-1815-437X; Yilmaz, Ahmet Seyda/0000-0003-3864-4023WOS: 000542354100001PubMed: 32567322Left ventricular thrombus (LVT) is associated with inflammatory response in survivors with anterior ST-elevation myocardial infarction (STEMI). the C-reactive protein to albumin ratio (CAR) has been proposed as a marker of inflammation. However, there is a lack of data with respect to the role of CAR in LVT development. We investigated the relationship between CAR and LVT development in patients with anterior STEMI treated percutaneously; 955 consecutive patients were enrolled and LVT was observed in 126 (13.2%) patients. Clinical, demographic, and laboratory parameters were recorded. the CAR was significantly higher in patients with LVT (12.6 [8.6-16.1] vs 18.1 [11.5-23],P1 diseased arteries, higher total protein level, neutrophil count, and peak creatine kinase myocardial band activity. in conclusion, the CAR may be useful as a simple tool for predicting LVT development among survivors of anterior STEMI

Food impaction in older age: Think about an eosinophilic esophagitis

Eozinofilik özofajit özofagusun inşamatuvar hastalığıdır. Genellikle genç erişkin yaşta görülür. İleri yaşta nadiren görülmektedir. Eozinofilik özofajit, özofagusun yiyeceklere karşı esnemesini ve uyumunu azaltır. Bu nedenle esas semptom disfajidir. Özellikle gıdaların takılmasına neden olur. Bu yazıda, ileri yaşta gıda takılması ile gelen bir vaka sunduk. Özet olarak, ileri yaşta gıda takılması ile başvuran hastalarda nadir olmasına karşın eozinofilik özofajit akılda tutulmalıdır.Eosinophilic esophagitis is an inflammatory disease of esophagus. It is generally seen in childhood and young population. It is not common in advanced age. Eosinophilic esophagitis decreases the ability of the esophagus to stretch and accommodation against foods. Therefore, the major symptom in adults with eosinophilic esophagitis is difficulty in swallowing solid food (dysphagia). Therefore, food stuck in the esophageal lumen is the specific manifestation when swallowing. He- rein, we reported a patient in old age presented with food impaction. In conclusion, eosinophilic esophagitis is a rare entity that must be considered in elderly patients complaining food impaction