Heart echinococcus cyst as an incidental finding: early detection might be life-saving

We present a 46-year-old female smoker who was admitted to the emergency department of our hospital due to cough with blood-tinged sputum for the last four days before admission. Using echocardiography and Multi-Detector Computed Tomography (MDCT) heart Echinococcosis was diagnosed. Echinococcosis is a severe health issue in some geographical regions of the world. Hydatid infection of the heart is rare and the clinical presentation is usually insidious but there is always the lethal hazard of cyst perforation. Early diagnosis and an integrated treatment strategy are crucial. The results of surgical treatment of heart echinococcosis are better than the conservative strategy only. Extraction of the cyst combined with chemotherapy peri or post operative aiming to decrease the recurrences, consists the lege artis method of encountering this medical entity. Surgical excision was performed and the patient had an uneventful recovery and follow up at six and twelve months

Correlation of retinopathy of prematurity with ocular growth and weight gain

Purpose: To prospectively investigate the association between retinopathy of prematurity (ROP) and ocular growth in premature infants during the earliest weeks of life, as well as the early caloric intake and ROP.Methods: premature infants in the national ROP screening were recruited and examined 1- or 2-week intervals between 30 and 38 weeks’ postmestrual age. One hundred infants with GA between 24 and 35 weeks (30.04±2.13), and BW between 550 and 2060 gr (1251±317.19) were included in the study. At each examination, the presence, stage and zone of ROP were recorded along with axial length (AL), central corneal thickness (CCT), and weight gain. Biometric parameters were measured by A-scan biometry. Study variables included gestational age (GA), birth weight (BW), AL, CCT, weight gain, relative weight (RW), and dif_AL, dif_CCT and dif_weight which is the difference between two consecutive recordings of the same infant. Multiple regression analysis models were used to determine the association between the study variables and ROP. Results: Dif_AL, dif_CCT and RW were the most appropriate variables to detect the optimal threshold points that discriminate ROP : Weekly increase of AL≤0.0095mm, weekly reduction of CCT≤0,5μm or weekly gain≤7% are associated with ROP development. Conclusions: ROP is associated with delayed ocular development, as eyes of premature infants with ROP have shorter axial lengths and thicker corneas than eyes of premature infants without ROP. The association of AL, CCT and weight gain with ROP could be of value for future development of predictive models of ROP.Στόχος: Στόχος της παρούσας διδακτορικής διατριβής είναι να αξιολογήσει τη συσχέτιση των βιομετρικών χαρακτηριστικών του οφθαλμού των πρόωρων νεογνών και του ρυθμού αύξησης βάρους με την εμφάνιση της Αμφιβληστροειδοπάθεια της Προωρότητας (ΑτΠ) .Μεθοδολογία: ‘Ολα τα πρόωρα νεογνά βάρους γέννησης <1500 γρ είτε διάρκειας κύησης <32 εβδομάδων, μεταξύ 30 και 38 εβδομάδων διορθωμένης ηλικίας κύησης, στρατολογήθηκαν στη μελέτη από τον Οκτώβριο 2013 έως τον Αύγουστο του 2015 και εξετάστηκαν κάθε 1 ή 2 εβδομάδες. Συνολικά, εκατό νεογνά ηλικίας γέννησης μεταξύ 34 και 35 εβδομάδων (30.04±2.13), και βάρους γέννησης 550 και 2060 gr (1251±317.19) συμπεριλήφθηκαν στη μελέτη. Σε κάθε εξέταση έγινε έλεγχος της ΑτΠ σύμφωνα με τις διεθνείς οδηγίες και έγινε καταγραφή της παρουσίας ή μη της πάθησης, του σταδίου και της έκτασης αυτής, καθώς και της εβδομαδιαίας θερμιδικής πρόσληψης. Η καταγραφή των βιομετρικών χαρακτηριστικών του οφθαλμού (αξονικού μήκους και κεντρικού πάχους κερατοειδούς) έγινε με βιομετρία υπερήχων Α-scan (Alcon RxP OcuScan). Παράμετροι της μελέτης αποτέλεσαν η ηλικία κύησης (GA), το βάρος γέννησης (BW), το αξονικό μήκος (AL), το κεντρικό πάχος κερατοειδούς (CCT), η αύξηση βάρους (weight gain), η σχετική αύξηση βάρους (RW), και οι εβδομαδιαίες διαφορές AL (dif_AL), CCT (dif_CCT), βάρους dif_weight που αντιστοιχούν στις διαφορές μεταξύ δυο διαδοχικών μετρήσεων. Αποτελέσματα: Dif_AL, dif_CCT and RW αποτελούν τους πιο ευαίσθητους δείκτες για τον εντοπισμό σημείων ανάπτυξης ΑτΠ. Εβδομαδιαία αύξηση αξονικού μήκους AL≤0.0095mm, εβδομαδιαία μείωσης κεντρικού πάχους κερατοειδούς CCT≤0,5μm ή εβδομαδιαία πρόσληψη βάρους weight gain ≤7% σχετίζονται με ανάπτυξη της ΑτΠ. Συμπεράσματα: Η ΑτΠ σχετίζεται με καθυστέρηση ανάπτυξη των βιομετρικών χαρακτηριστικών του οφθαλμού, καθώς πρόωρα νεογνά με ΑτΠ τείνουν να έχουν μικρότερο αξονικό μήκος και μεγαλύτερο κεντρικό κερατοειδούς σε σχέση με πρόωρα νεογνά χωρίς ΑτΠ . Η συσχέτιση του AL, CCT και της αύξησης βάρους με την ΑτΠ θα μπορούσαν να αποτελέσουν δείκτες για ανάπτυξη προγνωστικού μοντέλου ανάπτυξης της ΑτΠ

Development and Evaluation of Advanced Image Analysis Techniques for Pediatric Deep Vein Thrombosis Imaging Scans

Deep vein thrombosis (DVT) is a condition, which results from atherosclerosis and the possible formation of a blood clot (thrombus) in a deep vein leading to obstruction of blood flow. DVT is considered a major cardiovascular health risk and its early detection is considered crucial to patient survival and well-being. The present work describes the development and evaluation of two image analysis techniques for the identification of DVT in children. The first technique is based on entropy thresholding and the second on active contours. The robustness and sensitivity of these techniques have been evaluated both quantitatively as well as qualitatively. Towards that purpose error parameters were calculated using phantom and real patient images. The usefulness of our techniques was evaluated by specialist radiologists. The suggested algorithms were developed with the Matlab (R) simulation environment. Thus the present work has been implemented towards the improvement of pediatric patients&apos; well-being and at the same time achieve early DVT prognosis

Enhancing Personalized Educational Content Recommendation through Cosine Similarity-Based Knowledge Graphs and Contextual Signals

The extensive pool of content within educational software platforms can often overwhelm learners, leaving them uncertain about what materials to engage with. In this context, recommender systems offer significant support by customizing the content delivered to learners, alleviating the confusion and enhancing the learning experience. To this end, this paper presents a novel approach for recommending adequate educational content to learners via the use of knowledge graphs. In our approach, the knowledge graph encompasses learners, educational entities, and relationships among them, creating an interconnected framework that drives personalized e-learning content recommendations. Moreover, the presented knowledge graph has been enriched with contextual signals referring to various learners’ characteristics, such as prior knowledge level, learning style, and current learning goals. To refine the recommendation process, the cosine similarity technique was employed to quantify the likeness between a learner’s preferences and the attributes of educational entities within the knowledge graph. The above methodology was incorporated in an intelligent tutoring system for learning the programming language Java to recommend content to learners. The software was evaluated with highly promising results

Association between iron deficiency and febrile seizures

ObjectiveThe relationship between iron status and febrile seizures has been examined in various settings, mainly in the Developing World, with conflicting results. The aim of this study was to investigate any association between iron deficiency and febrile seizures (FS) in European children aged 6–60 months.DesignProspective, case–control study.SettingGreek population in Thessaloniki.Patients50 patients with febrile seizures (cases) and 50 controls (children presenting with fever, without seizures).InterventionsNone.Main outcome measuresHaematologic parameters (haemoglobin concentration, haematocrit, mean corpuscular volume, red cell distribution width), plasma iron, total iron-binding capacity, plasma ferritin, transferrin saturation and soluble transferrin receptors were compared in cases and controls.ResultsPlasma ferritin was lower (median [range]: 42.8 (3–285.7) vs 58.3 (21.4–195.3 ng/ml; p = 0.02) and Total Iron Binding Capacity (TIBC) higher (mean [Standard Deviation] 267 [58.9] vs 243 [58.45] ?g/dl, p = 0.04) in cases than in controls. Results were similar for 12 complex FS cases (ferritin 30 (3–121 vs 89 (41.8–141.5 ng/lL; TIBC 292.92 [68.0] vs 232.08 [36.27] ?g/dL). Iron deficiency, defined as ferritin &lt;30 ng/ml, was more frequent in cases (24%) than controls (4%; p = 0.004). Ferritin was lower and TIBC higher in 18 with previous seizures than in 32 with a first seizure although haemoglobin and mean cell haemoglobin concentration were higher.ConclusionsEuropean children with febrile seizures have lower Ferritin than those with fever alone, and iron deficiency, but not anaemia, is associated with recurrence. Iron status screening should be considered as routine for children presenting with or at high risk for febrile seizures

Predictors of atrial fibrillation recurrence in patients with long-lasting atrial fibrillation

BACKGROUND: Limited data are available on the predictors of atrial fibrillation (AF) recurrence in patients with chronic AF.OBJECTIVES: To evaluate potential clinical, echocardiographic and electrophysiological predictors of AF recurrence after internal cardioversion for long-lasting AF.METHODS: A total of 99 consecutive patients (63 men and 36 women, mean age 63.33 +/- 9.27 years) with long-standing AF (52.42 +/- 72.02 months) underwent internal cardioversion with a catheter that consisted of two defibrillating coils. Shocks were delivered according to a step-up protocol. Clinical follow-up and electrocardiographic recordings were performed on a monthly basis for a 12-month period or whenever patients experienced symptoms suggestive of recurrent AF.RESULTS: Ninety-three patients (93.94 %) underwent a successful uncomplicated cardioversion, with a mean atrial defibrillation threshold of 10.69 +/- 6.76 J. Immediate reinitiation of AF was observed in 15 patients (15.78 %) of whom a repeated cardioversion restored sinus rhythm in 13 cases. Early recurrence of AF (within one week) was observed in 12 of 93 patients (12.90 %). At the end of the 12-month follow-up period, during which seven patients were lost, 42 of the 86 remaining patients (48.84 %) were still in sinus rhythm. Multivariate regression analysis showed that left atrial diameter (OR 1.126, 95 % CI 1.015 to 1.249; P=0.025) and mitral A wave velocity (OR 0.972, 95 % CI 0.945 to 0.999; P=0.044) were significant and independent predictors of AF recurrence, whereas age, left ventricular ejection fraction and AF cycle length were not predictive of arrhythmia recurrence.CONCLUSION: The present study showed that the left atrial diameter and mitral A wave velocity are the only variables associated with AF recurrence after successful cardioversion