Effective Treatment of Intestinal Behçet's Disease with Long-Term, Low-Dose Clarithromycin

A 51-year-old man was referred for body weight loss and lower right abdominal pain. Total colonoscopy revealed discrete and round ulceration at the ileocecal valve, and he was diagnosed with intestinal Behçet's disease (BD). By treatment with glucocorticoid, colchicine and salazosulfapyridine, the symptoms and ulceration were improved, but cessation of glucocorticoid resulted in relapse of ulceration at the terminal ileum. Long-term, low-dose treatment with clarithromycin (CAM) was implemented for chronic respiratory infections. Furthermore, we expected that this CAM treatment would also be effective in BD. During this long-term, low-dose treatment with CAM, discrete ulceration at the terminal ileum was never revealed by follow-up total colonoscopy once or twice per year for 7 years. No reports have described the effectiveness of this treatment in patients with intestinal BD; however, we confirm that long-term treatment with low-dose CAM might have clinical benefits for patients with intestinal BD

Multiple Vital-sign Based Infection Screening Outperforms Thermography Independent of the Classification Algorithm

Goal: Thermography based infection screening at international airports plays an important role in the prevention of pandemics. However, studies show that thermography suffers from low sensitivity and specificity. To achieve higher screeningaccuracy, we developed a screening system based on the acquisition of multiple vital-signs. This multi-modal approach increases accuracy, but introduces the need for sophisticated classification methods. This paper presents a comprehensive analysis of the multi-modal approach to infection screening from a machine learning perspective. Methods: We conduct an empirical study applying six classification algorithms to measurements from the multi-modal screening system and comparing their performance among each other, as well as to the performance of thermography. In addition, we provide an information theoretic view on the use of multiple vital-signs for infection screening. The classification methods are tested using the same clinical data which has beenanalysed in our previous study using linear discriminant analysis. A total of 92 subjects were recruited for influenza screening using the system, consisting of 57 inpatients diagnosed to have seasonal influenza and 35 healthy controls. Results: Our study revealedthat the multi-modal screening system reduces the misclassification rate by more than 50% compared to thermography. At the same time, none of the multi-modal classifiers needed more than 6 ms for classification, which is negligible for practical purposes. Conclusion: Among the tested classifiers k-nearest neighbours, support vector machine and quadratic discriminant analysis achieved the highest cross-validated sensitivity score of 93%. Significance: Multi-modal infection screening might be able to address the shortcomings of thermography

Vital-SCOPE: Design and Evaluation of a Smart Vital Sign Monitor for Simultaneous Measurement of Pulse Rate, Respiratory Rate, and Body Temperature for Patient Monitoring

Consistent vital sign monitoring is critically important for early detection of clinical deterioration of patients in hospital settings. Mostly, nurses routinely measure and document the primary vital signs of all patients 2‐3 times daily to assess their condition. To reduce nurse workload and thereby improve quality of patient care, a smart vital sign monitor named “Vital‐SCOPE” for simultaneous measurement of vital signs was developed. Vital-SCOPE consists of multiple sensors, including a reflective photo sensor, thermopile, and medical radar, to be used in simultaneous pulse rate, respiratory rate, and body temperature monitoring within 10 s. It was tested in laboratory and hospital settings. Bland-Altman and Pearson’s correlation analyses were used to compare the Vital-SCOPE results to those of reference measurements. The mean difference of the respiratory rate between respiratory effort belt and Vital-SCOPE was 0.47 breaths per minute with the 95% limit of agreement ranging from −7.4 to 6.5 breaths per minute. The Pearson’s correlation coefficient was 0.63 (P<0.05). Moreover, the mean difference of the pulse rate between electrocardiogram and Vital-SCOPE was 3.4 beats per minute with the 95% limit of agreement ranging from −13 to 5.8 beats per minute; the Pearson’s correlation coefficient was 0.91 (P<0.01), indicating strong linear relationship