Interactive cohort exploration for spinocerebellar ataxias using synthetic cohort data for visualization

Motivation: Visualization of data is a crucial step to understanding and deriving hypotheses from clinical data. However, for clinicians, visualization often comes with great effort due to the lack of technical knowledge about data handling and visualization. The application offers an easy-to-use solution with an intuitive design that enables various kinds of plotting functions. The aim was to provide an intuitive solution with a low entrance barrier for clinical users. Little to no onboarding is required before creating plots, while the complexity of questions can grow up to specific corner cases. To allow for an easy start and testing with SCAview, we incorporated a synthetic cohort dataset based on real data of rare neurological movement disorders: the most common autosomal-dominantly inherited spinocerebellar ataxias (SCAs) type 1, 2, 3, and 6 (SCA1, 2, 3 and 6). Methods: We created a Django-based backend application that serves the data to a React-based frontend that uses Plotly for plotting. A synthetic cohort was created to deploy a version of SCAview without violating any data protection guidelines. Here, we added normal distributed noise to the data and therefore prevent re-identification while keeping distributions and general correlations. Results: This work presents SCAview, an user-friendly, interactive web-based service that enables data visualization in a clickable interface allowing intuitive graphical handling that aims to enable data visualization in a clickable interface. The service is deployed and can be tested with a synthetic cohort created based on a large, longitudinal dataset from observational studies in the most common SCAs

Percutaneous endobiliary forceps biopsy of biliary strictures for histopathologic examination

PURPOSEWe aimed to investigate the feasibility, accuracy and safety of percutaneous endobiliary cholangio-forceps biopsy of biliary strictures in our institution.METHODSA total of 13 percutaneous transhepatic endobiliary biopsies (7 men and 6 women, mean age 66.85±16.76 years) were performed between January 2015 and March 2019 using a transluminal forceps biopsy device. Technical success, rate of complications, number of biopsy specimens, procedure and fluoroscopy time, mean radiation exposure were evaluated; sensitivity and accuracy were calculated.RESULTSTechnical success, i.e., acquisition of at least three (median, 3.00; range, 3–5) macroscopic representative samples, could be achieved in all 13 biopsies. Access was gained via the right liver lobe in 12 of 13 cases (92.3%). All patients presented blood work indicative of cholestasis prior the intervention, with mean bilirubin 4.72±3.72 µmol/L, mean γ-glutamyl transferase 574.16 ± 360.92 IU/L, and median alkaline phosphatase 407 IU/L (165–1366 IU/L). In 12 of 13 cases (92.3%), biopsied material was sufficient for the pathologist to make a histopathologic diagnosis. Analysis revealed cases of malignancy in eight of 13 cases (61.5%), all of which turned out to be cases of cholangiocarcinoma. In four benign cases (30.8%), diagnosis was considered to be confirmed by further imaging or clinical follow-ups, which showed no signs of progressive disease. There was one case (7.7%) of a false-negative result with proof of malignancy in subsequent surgical tissue extraction. A calculation of diagnostic performance yielded a sensitivity rate of 88.9% and an accuracy rate of 92.3%. There was one case of minor and one case of major complication in our study collective, leading to an overall complication rate of 15.4%.CONCLUSIONPercutaneous transhepatic biliary drainage (PTBD)-based forceps biopsy via the transhepatic drainage tract in patients with biliary obstruction of unknown origin is a technically feasible and safe technique with good diagnostic value rates. The procedure should be considered in patients not suitable for endoscopic strategies with indication for establishment of PTBD

SÍTIOS ARQUEOLÓGICOS HISTÓRICOS DA ÁREA RUARAL DE PORTO ALEGRE: UM PATRIMÔNIO A SER PESQUISADO E PRESERVADO

A zona sul do Município, ainda com características rurais, tem sido alvo da expansão da malha urbana e solapada por vários tipos de empreendimentos. Área de ocupação histórica desde o final do século XVIII, relacionada à produção e ao lazer, possui remanescentes considerados patrimônio cultural relacionado à história da cidade. Este trabalho apresenta o projeto que está sendo desenvolvido sobre este patrimônio, o qual inclui o arqueológico, através de um Grupo de Trabalho da Secretaria da Cultura de Porto Alegre. Estão sendo levantados os sítios históricos caracterizados como fazendas, chácaras, casas de veraneio, olarias, entre outros, construídos entre o final do século XVIII e início do século XX. O projeto compreende estudos, ações de caráter preventivo e educativas, buscando uma valorização e fruição do patrimônio cultural histórico, arquitetônico e arqueológico relacionado à ocupação rural da cidade de Porto Alegre

The Correlation of Thyroid Hormone Levels and Anti-Thyroidal Drugs on Thyroid Size, Weight, and Ease of Surgical Dissection for Thyroidectomy for Graves\u27 Disease.

BACKGROUND: Patients with Graves\u27 Disease often have a larger thyroid size than patients without thyroid disease. These patients also have elevated T3 and T4 with decreased TSH. PURPOSE: We evaluate whether these thyroid labs, the use of antithyroid agents, or the size of a thyroid on ultrasound, correlate with the pathological size of a thyroid in patients who undergo total thyroidectomy for Graves\u27 Disease. We further determine whether these parameters affect perioperative complications. RESEARCH DESIGN: A retrospective review of patients undergoing total thyroidectomy for Graves\u27 Disease was performed from January 2004 to December 2016 in a single institution. STUDY SAMPLE: 392 patients were included in the study. DATA COLLECTION AND/OR ANALYSIS: Univariate analyses were performed to compare thyroid size on US and pathology as well as weight to preoperative thyroid hormone values and medical comorbidities. Spearman rank correlation and ANOVA were used to identify factors associated with thyroid weight, total pathology size, and differences in size. Multivariate analysis was also performed to evaluate for correlation between thyroid function and perioperative complications. RESULTS: We found that elevated pre-operative T3 levels were associated with larger pathologic size ( CONCLUSIONS: These findings may allow for more accurate preoperative planning and intraoperative expectations in patients with Graves\u27 Disease

Improved Overall Well-Being After Breast Conserving Therapy Using Three-Dimensional Bioabsorbable Markers and Tissue Rearrangement, a Single Institution\u27s Preliminary Experience.

Tissue rearrangement (TR) is a basic oncoplastic technique to reshape the breast after breast conserving therapy (BCT). Tissue rearrangement can be combined with three-dimensional bioabsorbable markers (3DBM) as an easily adaptable technique to provide volume replacement and focused radiation. Since 3DBM can take time for absorption and symptoms related to its use have not been fully assessed, we evaluate patient\u27s overall satisfaction and well-being after TR with 3DBM is performed. We surveyed patients receiving BCT with adjuvant radiotherapy using BREAST-QTM BCT satisfaction and physical well-being surveys comparing patients receiving BCT alone to BCT with TR and/or 3DBM. Of 68 patients, 56 underwent BCT alone, 10 had BCT with TR + 3DBM, and 2 had BCT with TR. No significant difference was seen in physical well-being

Thyroidectomy Remains a Safe Option for Graves\u27 Disease.

Total thyroidectomy (TT) or near-TT (NTT) is often recommended over medical management for the treatment of Graves\u27 disease (GD). We assess the safety within surgical subspecialties at our institution for TT/NTT in GD patients. A retrospective review of patients undergoing TT/NTT for GD was performed from 2004 to 2016. Patient factors, thyroid size, surgeon subspecialty, and intraoperative/postoperative outcomes were all reviewed. Multivariate analyses were used to determine risk factors for complications. A total of 383 patients underwent TT/NTT. Two hundred thirty-three patients underwent TT/NTT by otolaryngology (n = 233, 60.8%), surgical oncology (n = 140, 36.6%), general surgery (n = 8, 2.1%), and unknown (n = 2, 0.5%). On multivariate analysis, surgical duration was longer for males

Incidence of polyp formation following bariatric surgery.

BACKGROUND: Multiple studies have linked obesity to an increased risk of cancer. The correlation is so strong that the national cancer prevention guidelines recommend weight loss for patients with obesity to reduce their risk of cancer. Bariatric surgery has been shown to be very effective in sustained weight loss. However, there have been mixed findings about bariatric surgery and its effects on the risk of colorectal cancer. OBJECTIVE: This study sought to examine bariatric surgery patients and their risk of pre-cancerous or cancerous polyps to elucidate any risk factors or associations between bariatric surgery and colorectal cancer. SETTING: A retrospective review of the academic medical center\u27s bariatric surgery database was performed from January 2010 to January 2017. Patients who underwent medical or surgical weight loss and had a subsequent colonoscopy were included in the study. Positive colonoscopy findings were described as malignant or premalignant polyps. METHODS: A total of 1777 patients were included, with 1360 in the medical group and 417 in the surgical group. Data analysis included patient demographics, co-morbidities, procedure performed, surgical approach, weight loss, and colonoscopy findings. A multivariate analysis was used to determine whether an association exists between weight loss and incidence of colorectal polyps, and if so, whether the association different for medical versus surgical weight loss. RESULTS: A higher percentage of body mass index (BMI) reduction was seen in the surgical group. An overall comparison showed average reductions in BMI of 27.7% in the surgical group and 3.5% in the medical group (P \u3c .0001). Patients with the greatest reduction in BMI, regardless of medical or surgical therapy, showed a lower incidence of precancerous and cancerous polyps (P = .041). CONCLUSION: This study offers a unique approach in examining the incidence of colorectal polyps related to obesity. Patients with the greatest reduction in their BMI, more common in the surgical group, had a lower incidence of precancerous and cancerous polyps