Deep Learning-Based Meniscus Tear Detection From Accelerated MRI

Magnetic Resonance Imaging (MRI) is an exceptional diagnostic tool known for its ability to provide superior soft tissue contrast. Despite its proven efficacy, traditional MRI methods have some inherent limitations, including relatively longer scan times and the requirement for specialized expertise in data analysis. These factors can, at times, create challenges in the widespread adoption of MRI in certain research and clinical scenarios. Deep learning (DL) methods for MRI reconstruction and analysis offer a promising solution to address this issue. While these DL techniques have been validated using standard image quality metrics, they fall short in assessing clinically relevant details. This hinders their clinical reliability and practical application. Although radiologists have previously compared the diagnostic equivalence of accelerated DL-reconstructed images to conventional ones for evaluating knee internal derangement, it remains uncertain whether DL detectors can accurately identify clinically important details when reconstruction models are used. Furthermore, the artifacts or hallucinations generated by DL reconstructions in knee MRI have not been examined in a clinical setting. Thus, this study aims to determine the performance of DL detectors on retrospectively accelerated DL-reconstructed knee MRI, comparing them to conventional imaging and expert evaluations for detecting meniscal tears. Our investigation yields three significant contributions. First, an in-depth analysis of DL reconstruction highlights the presence of hallucinations in the femur, tibia, and false positive artifacts, indicating that the overall reconstruction quality does not directly affect pathological features. Second, the results of DL detectors demonstrate that their performance aligns well with image quality assessment metrics and expert scores. This finding validates the reliability of the detection outcomes. Finally, we propose an integrated (i.e. reconstruction + detection) process for meniscal tears on fastMRI+ data and achieved state-of-the-art results with average precision scores of 0.69 and 0.67 at 4– and 8-fold accelerations, respectively

Calcium dobesilate may improve hemorheology in patients undergoing coronary artery bypass grafting

Background: Calcium dobesilate is an angioprotective agent that has positive effects on hemorheological parameters. It is an antioxidant that increases endothelial-derived vasodilator substance secretion, there are none that analyze its effects during the postoperative period of patients undergoing myocardial revascularization

Calcium dobesilate may improve hemorheology in patients undergoing coronary artery bypass grafting Dobesilato de cálcio pode melhorar hemorreologia em pacientes submetidos à cirurgia de revascularização miocárdica

BACKGROUND: Calcium dobesilate is an angioprotective agent that has positive effects on hemorheological parameters. It is an antioxidant that increases endothelial-derived vasodilator substance secretion, there are none that analyze its effects during the postoperative period of patients undergoing myocardial revascularization. OBJECTIVE: We aimed to determine the effects of calcium dobesilate on hemorheological parameters, such as reduced glutathione and malondialdehyde in patients with ischemic heart disease undergoing myocardial revascularization in the postoperative period. METHODS: One hundred and thirty-four patients operated for coronary heart disease were included in this study. Hemorheological, oxidant and antioxidant parameters were measured two days after surgery and after a period of treatment with calcium dobesilate. Then, 500 mg of calcium dobesilate was given twice a day to one group of 68 patients for three months. The control group was composed of 66 patients who did not receive this medication. RESULTS: The increase in the erythrocyte deformability index was found to be significant compared with both the pretreatment values and with the 1st and 2nd values of the control group after calcium dobesilate administration, whereas there were no significant changes in blood viscosity, glutathione (GSH) or malondialdehyde (MDA) values after the calcium dobesilate administration. The same improvement in the CCS class was observed in patients regardless of they received the calcium dobesilate treatment. CONCLUSION: In the present investigation, the same improvement in the CCS class was observed in patients regardless of they received the calcium dobesilate treatment. Improvements with calcium dobesilate were statistically significant only in the increase in erythrocyte flexibility.<br>ANTECEDENTES: O dobesilato de cálcio é um agente angioprotetor que tem efeitos positivos sobre os parâmetros hemorreológicos. É um antioxidante que aumenta a secreção endotelial derivada da substância vasodilatadora, não há nada que analisar os seus efeitos durante o período pósoperatório de pacientes submetidos a revascularização do miocárdio. OBJETIVO: Nosso objetivo foi determinar os efeitos de dobesilato de cálcio sobre os parâmetros hemorreológicos, tais como glutationa reduzida e malondialdeído em pacientes com doença cardíaca isquêmica submetidos a revascularização do miocárdio no pós-operatório. MÉTODOS: Cento e trinta e quatro pacientes operados por doença cardíaca coronária foram incluídos neste estudo. Parâmetros de oxidante, hemorreológicos e de antioxidantes foram medidos dois dias após a cirurgia e após um período de tratamento com o dobesilato de cálcio. Em seguida, 500 mg de dobesilato de cálcio foi administrado duas vezes por dia para um grupo de 68 pacientes durante três meses. O grupo controle foi composto por 66 pacientes que não receberam essa medicação. RESULTADOS: O aumento do índice de deformabilidade dos eritrócitos foi considerado significativo comparado com ambos os valores pré-tratamento e com os 1º e 2º valores do grupo controle após a administração dobesilato de cálcio, enquanto que não houve alterações significativas na viscosidade do sangue, na glutationa (GSH) ou malondialdeído (MDA) após a administração dobesilato de cálcio. A mesma melhoria na classe CCS foi observada em pacientes independentemente de terem recebido tratamento com dobesilato de cálcio. CONCLUSÃO: Na presente investigação, a mesma melhora na classe CCS foi observada em pacientes independentemente de terem recebido o tratamento com dobesilato de cálcio

COMPARISON OF ANALGESIC EFFECTS OF SINGLE DOSE AND DIVIDED DOSES INTRAARTICULAR BUPIVACAINE, FENTANYL AND PREDNISOLONE ADMINISTRATION IN ARTHROSCOPIC KNEE SURGERY

Objective: We aimed to compare the perioperative hemodynamic and postoperative analgesic effects of i.a. administration of single dose and in two separate doses of bupivacaine+fentanyl+prednisolone combination through a catheter for supplying an effective postoperative analgesia after arthroscopic knee surgery and to help early mobilization

Analysis of mortality in low-risk patients undergoing coronary artery bypass grafting : cardiovascular topic

AIM: The aims of this study were to determine the early mortality rate in low-risk coronary artery bypass graft (CABG) patients and examine the causes of death, to identify problems that could be avoided in future surgeries. METHODS: All low-risk patients (EuroSCORE ≤ 2) who died after CABG were included. Their peri-operative information was meticulously studied by internal and independent external reviewers to identify causes of death, which were classified as: cardiac or non-cardiac; and a further division as: (1) non-preventable, (2) preventable (technical error), and (3) preventable (system error). RESULTS: Early mortality was 0.93% (24/2 570). Eleven patients (45.8%) were classified as preventable deaths. In six of them the main problem was identified as graft thrombosis, which was secondary to a technical error of either the harvesting or anastomosis of the left internal mammarian artery. There were also five system errors identified as delays in the treatment of an identified and potentially reversible problem. CONCLUSIONS: Correction of technical and system errors, such as harvesting of the left internal mammarian artery, haemostasis during surgery, and establishing standard protocols for the transfer of patients from ward to intensive care units will eventually lead to improvement in both the quality of care and patient outcomes, even in low-risk groups