Artificial intelligence is revolutionizing everyday medical practice

Introduction This article discusses the impact of artificial intelligence (AI) on the medical field and its daily use in the practice of medicine. AI has applications in many stages of patient care, i.e.: prevention, diagnosis, personalising treatment plans, predicting disease progression and therapeutic outcomes or analysing medical images. GPs play a key role in patient care, but due to the complexity of medicine and the variety of symptoms, care and diagnosis can be time-consuming and difficult. Methods and materials The aim of this study is to explore and evaluate the potential of artificial intelligence in the process of diagnosing diseases by physicians and to provide practical suggestions and insights for its use in medical practice to improve the quality of healthcare. The methodology was based on material from PubMed and a review of the scientific literature on previous research and developments in AI in medicine.   State of knowledge Investment in artificial intelligence (AI) in medicine is growing rapidly. The role of GPs in patient care is highlighted and examples of the use of AI in everyday medical practice are given, including the role of Chatbots and the use of AI in specialised treatment.  Conclusions The conclusions of the article highlight the potential of AI in the area of physician-diagnosed diseases to reduce diagnosis time, increase accuracy of diagnoses and improve healthcare efficiency. Final diagnosis and therapy should still be determined by a qualified physician. There are areas where the doctor cannot be replaced by AI. AI cannot replace a doctor's diagnostic intelligence, empathy and rapport therefore doctors need to find a balance between these combinations to achieve better health outcomes with the highest possible care for patients.  

Influence of increased body mass index on prevalence of arterial hypertension in polish population : results of LIPIDOGRAM 2004 study

Wstęp Nadwaga i otyłość stanowią uznane czynniki ryzyka sercowo-naczyniowego i rozwoju nadciśnienia tętniczego. Brakuje danych dotyczących współwystępowania tych dwóch czynników w populacji polskiej, zwłaszcza informacji o stopniu zaawansowania nadciśnienia tętniczego w zależności od wskaźnika masy ciała (BMI). Celem pracy było określenie częstości występowania i zaawansowania nadciśnienia tętniczego w zależności od nadmiernej masy ciała ocenianej za pomocą BMI wśród osób dorosłych w Polsce. Materiał i metody Badaniem objęto 17 065 osób, w tym 59,2% kobiet i 40,8% mężczyzn w wieku 30–98 lat (śr. 55,1 roku; mediana — 54,7 roku) z terenu 16 województw Polski. Do badania kwalifikowano pacjentów kolejno zgłaszających się w okresie od 1 października 2004 roku do 20 grudnia 2004 roku do 675 wybranych losowo placówek poradni lekarza rodzinnego, niezależnie od przyczyny zgłoszenia się. Na podstawie oceny BMI (kg/m2) badanych podzielono na grupy: B0 < 18,5 kg/m2; B1 — 18,5–24,9 kg/m2; B2 — 25–29,9 kg/m2; B3 ≥ 30 kg/m2 oraz zgodnie z klasyfikacją nadciśnienia tętniczego według wytycznych ESH/ESC 2003 na grupy: NT1, NT2, NT3 oraz bez nadciśnienia tętniczego — NT0. Wyniki Nadciśnienie tętnicze dotyczyło 50,9% populacji (NT1 — 27%, NT2 — 21%, NT3 — 3%), bez istotnych różnic w częstości między płciami. Nadmierna masa ciała (BMI ≥ 25 kg/m2) dotyczyła 75% badanych (80,81% — mężczyzn, 70,38% — kobiet), przy czym nadwagę (B2) stwierdzono u 43% pacjentów (48,03% — mężczyzn, 39,16% — kobiet), a otyłość (B3) u 32% (32,78% — mężczyzn, 31,22% — kobiet). Stwierdzono obustronną zależność między wartościami BMI ≥ 25 kg/m2, a częstością występowania i stopniem zaawansowania nadciśnienia tętniczego w badanej populacji. Wnioski Nadmierna masa ciała i nadciśnienie tętnicze są chorobami często występującymi w populacji polskiej. Stwierdzono obustronną zależność między stopniem nadciśnienia tętniczego a wartością BMI, za wyjątkiem podgrup z niedowagą i prawidłową masą ciała, gdzie ryzyko nadciśnienia tętniczego jest podobne.Background Overweight and obesity are known risk factors for arterial hypertension (AH) and other cardiovascular diseases. However, the data concerning coexistence of those two risk factors and influence of BMI on the level of blood pressure are not well-established in Polish population. The aim of the study was to assess the coexistence of arterial hypertension and its severity depending on exceeded body mass index in adult population of Poland. Material and methods The investigated group consisted of 17 065 consecutive patients (59.2% women; 40.8% men) aged 30–98 (mean age — 55.1 years; median — 54.7 years) who were admitted between 01.10.2004 and 20.12.2004 to 675 primary care clinics chosen from all 16 districts of Poland. The cause of appointment was irrelevant for inclusion. Population under investigation was divided into 4 groups — according to BMI (kg/m2): B0 < 18.5 kg/m2; B1 — 18.5–24.9 kg/m2; B2 — 25–29.9 kg/m2; B3 ≥ 30 kg/m2; and depending on grade of AH (according to guidelines of ESH/ESC 2003): AH1 (mild), AH2 (moderate), AH3 (severe) and AH0 (without AH). Results Arterial hypertension was a problem in 50.9% of population (AH1 = 27%, AH2 = 21%, AH3 = 3%), with no significant differences between sexes. Overweight and obesity (BMI ≥ 25 kg/m2) was present in 75% of patients (80.81% men, 70.38% women): overweight (B2) was found in 43% of patients (48.03% men, 39.16% women) and obesity (B3) in 32% of investigated population (32.78% men, 31.22% women). Bilateral, significant correlation was found between values of BMI ≥ 25 kg/m2 and prevalence and severity of arterial hypertension in studied population. Conclusions Overweight or obesity and AH remain an important health issue in Polish population. Bilateral positive correlation between a degree of AH and BMI was found, although patients with underweight and normal BMI are the rarity — the risk of AH in these groups is similar and stable

Influence of increased body mass index on prevalence of arterial hypertension in polish population - results of LIPIDOGRAM 2004 study

Wstęp Nadwaga i otyłość stanowią uznane czynniki ryzyka sercowo-naczyniowego i rozwoju nadciśnienia tętniczego. Brakuje danych dotyczących współwystępowania tych dwóch czynników w populacji polskiej, zwłaszcza informacji o stopniu zaawansowania nadciśnienia tętniczego w zależności od wskaźnika masy ciała (BMI). Celem pracy było określenie częstości występowania i zaawansowania nadciśnienia tętniczego w zależności od nadmiernej masy ciała ocenianej za pomocą BMI wśród osób dorosłych w Polsce. Materiał i metody Badaniem objęto 17 065 osób, w tym 59,2% kobiet i 40,8% mężczyzn w wieku 30-98 lat (śr. 55,1 roku; mediana - 54,7 roku) z terenu 16 województw Polski. Do badania kwalifikowano pacjentów kolejno zgłaszających się w okresie od 1 października 2004 roku do 20 grudnia 2004 roku do 675 wybranych losowo placówek poradni lekarza rodzinnego, niezależnie od przyczyny zgłoszenia się. Na podstawie oceny BMI (kg/m2) badanych podzielono na grupy: B0 < 18,5 kg/m2; B1 - 18,5-24,9 kg/m2; B2 - 25-29,9 kg/m2; B3 &#8805; 30 kg/m2 oraz zgodnie z klasyfikacją nadciśnienia tętniczego według wytycznych ESH/ESC 2003 na grupy: NT1, NT2, NT3 oraz bez nadciśnienia tętniczego - NT0. Wyniki Nadciśnienie tętnicze dotyczyło 50,9% populacji (NT1 - 27%, NT2 - 21%, NT3 - 3%), bez istotnych różnic w częstości między płciami. Nadmierna masa ciała (BMI &#8805; 25 kg/m2) dotyczyła 75% badanych (80,81% - mężczyzn, 70,38% - kobiet), przy czym nadwagę (B2) stwierdzono u 43% pacjentów (48,03% - mężczyzn, 39,16% - kobiet), a otyłość (B3) u 32% (32,78% - mężczyzn, 31,22% - kobiet). Stwierdzono obustronną zależność między wartościami BMI &#8805; 25 kg/m2, a częstością występowania i stopniem zaawansowania nadciśnienia tętniczego w badanej populacji. Wnioski Nadmierna masa ciała i nadciśnienie tętnicze są chorobami często występującymi w populacji polskiej. Stwierdzono obustronną zależność między stopniem nadciśnienia tętniczego a wartością BMI, za wyjątkiem podgrup z niedowagą i prawidłową masą ciała, gdzie ryzyko nadciśnienia tętniczego jest podobne.Background Overweight and obesity are known risk factors for arterial hypertension (AH) and other cardiovascular diseases. However, the data concerning coexistence of those two risk factors and influence of BMI on the level of blood pressure are not well-established in Polish population. The aim of the study was to assess the coexistence of arterial hypertension and its severity depending on exceeded body mass index in adult population of Poland. Material and methods The investigated group consisted of 17 065 consecutive patients (59.2% women; 40.8% men) aged 30-98 (mean age - 55.1 years; median - 54.7 years) who were admitted between 01.10.2004 and 20.12.2004 to 675 primary care clinics chosen from all 16 districts of Poland. The cause of appointment was irrelevant for inclusion. Population under investigation was divided into 4 groups - according to BMI (kg/m2): B0 < 18.5 kg/m2; B1 - 18.5-24.9 kg/m2; B2 - 25-29.9 kg/m2; B3 &#8805; 30 kg/m2; and depending on grade of AH (according to guidelines of ESH/ESC 2003): AH1 (mild), AH2 (moderate), AH3 (severe) and AH0 (without AH). Results Arterial hypertension was a problem in 50.9% of population (AH1 = 27%, AH2 = 21%, AH3 = 3%), with no significant differences between sexes. Overweight and obesity (BMI &#8805; 25 kg/m2) was present in 75% of patients (80.81% men, 70.38% women): overweight (B2) was found in 43% of patients (48.03% men, 39.16% women) and obesity (B3) in 32% of investigated population (32.78% men, 31.22% women). Bilateral, significant correlation was found between values of BMI &#8805; 25 kg/m2 and prevalence and severity of arterial hypertension in studied population. Conclusions Overweight or obesity and AH remain an important health issue in Polish population. Bilateral positive correlation between a degree of AH and BMI was found, although patients with underweight and normal BMI are the rarity - the risk of AH in these groups is similar and stable

Serum antinuclear autoantibodies are associated with measures of oxidative stress and lifestyle factors:analysis of LIPIDOGRAM2015 and LIPIDOGEN2015 studies

Introduction: Oxidative stress is one of many factors suspected to promote antinuclear autoantibody (ANA) formation. Reactive oxygen species can induce changes in the antigenic structure of macromolecules, causing the immune system to treat them as “neo-antigens” and start production of autoantibodies. This study was designed to evaluate the relationship between oxidative stress markers, lifestyle factors and the detection of ANA. Material and methods: We examined measures of oxidative stress indices of free-radical damage to lipids and proteins, such as total oxidant status (TOS), concentration of protein thiol groups (PSH), and malondialdehyde (MDA), activity of superoxide dismutase (SOD) in 1731 serum samples. The parameters of the non-enzymatic antioxidant system, such as total antioxidant status (TAS) and uric acid (UA) concentration, were also measured and the oxidative stress index (OSI-index) was calculated. All samples were tested for the presence of ANA using an indirect immunofluorescence assay (IIFA). Results: The presence of ANA in women was associated with lower physical activity (p = 0.036), less frequent smoking (p = 0.007) and drinking of alcohol (p = 0.024) accompanied by significant changes in SOD isoenzymes activity (p &lt; 0.001) and a higher uric acid (UA) concentration (p &lt; 0.001). In ANA positive males we observed lower concentrations of PSH (p = 0.046) and increased concentrations of MDA (p = 0.047). Conclusions: The results indicate that local oxidative stress may be associated with increased probability of ANA formation in a sex-specific manner.</p

Relationship Between Anti-DFS70 Autoantibodies and Oxidative Stress

Background: The anti-DFS70 autoantibodies are one of the most commonly and widely described agent of unknown clinical significance, frequently detected in healthy individuals. It is not known whether the DFS70 autoantibodies are protective or pathogenic. One of the factors suspected of inducing the formation of anti-DFS70 antibodies is increased oxidative stress. We evaluated the coexistence of anti-DFS70 antibodies with selected markers of oxidative stress and investigated whether these antibodies could be considered as indirect markers of oxidative stress.Methods: The intensity of oxidative stress was measured in all samples via indices of free-radical damage to lipids and proteins such as total oxidant status (TOS), concentrations of lipid hydroperoxides (LPH), lipofuscin (LPS), and malondialdehyde (MDA). The parameters of the non-enzymatic antioxidant system, such as total antioxidant status (TAS) and uric acid concentration (UA), were also measured, as well as the activity of superoxide dismutase (SOD). Based on TOS and TAS values, the oxidative stress index (OSI) was calculated. All samples were also tested with indirect immunofluorescence assay (IFA) and 357 samples were selected for direct monospecific anti DFS70 enzyme-linked immunosorbent assay (ELISA) testing.Results: The anti-DFS70 antibodies were confirmed by ELISA test in 21.29% of samples. Compared with anti-DFS70 negative samples we observed 23% lower concentration of LPH (P = .038) and 11% lower concentration of UA (P = .005). TOS was 20% lower (P = .014). The activity of SOD was up to 5% higher (P = .037). The Pearson correlation showed weak negative correlation for LPH, UA, and TOS and a weak positive correlation for SOD activity.Conclusion: In samples positive for the anti-DFS70 antibody a decreased level of oxidative stress was observed, especially in the case of samples with a high antibody titer. Anti-DFS70 antibodies can be considered as an indirect marker of reduced oxidative stress or a marker indicating the recent intensification of antioxidant processes.</p

Analysis of the impact of sex and age on the variation in the prevalence of antinuclear autoantibodies in Polish population : a nationwide observational, cross-sectional study

The detection of antinuclear autoantibody (ANA) is dependent on many factors and varies between the populations. The aim of the study was first to assess the prevalence of ANA in the Polish adult population depending on age, sex and the cutoff threshold used for the results obtained. Second, we estimated the occurrence of individual types of ANA-staining patterns. We tested 1731 patient samples using commercially available IIFA using two cutoff thresholds of 1:100 and 1:160. We found ANA in 260 participants (15.0%), but the percentage of positive results strongly depended on the cutoff level. For a cutoff threshold 1:100, the positive population was 19.5% and for the 1:160 cutoff threshold, it was 11.7%. The most prevalent ANA-staining pattern was AC-2 Dense Fine speckled (50%), followed by AC-21 Reticular/AMA (14.38%) ANA more common in women (72%); 64% of ANA-positive patients were over 50 years of age. ANA prevalence in the Polish population is at a level observed in other highly developed countries and is more prevalent in women and elderly individuals. To reduce the number of positive results released, we suggest that Polish laboratories should set 1:160 as the cutoff threshold. © 2021, The Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Fadi Charchar" is provided in this record*

Relationship between anti-DFS70 autoantibodies and oxidative stress

Background: The anti-DFS70 autoantibodies are one of the most commonly and widely described agent of unknown clinical significance, frequently detected in healthy individuals. It is not known whether the DFS70 autoantibodies are protective or pathogenic. One of the factors suspected of inducing the formation of anti-DFS70 antibodies is increased oxidative stress. We evaluated the coexistence of anti-DFS70 antibodies with selected markers of oxidative stress and investigated whether these antibodies could be considered as indirect markers of oxidative stress. Methods: The intensity of oxidative stress was measured in all samples via indices of free-radical damage to lipids and proteins such as total oxidant status (TOS), concentrations of lipid hydroperoxides (LPH), lipofuscin (LPS), and malondialdehyde (MDA). The parameters of the non-enzymatic antioxidant system, such as total antioxidant status (TAS) and uric acid concentration (UA), were also measured, as well as the activity of superoxide dismutase (SOD). Based on TOS and TAS values, the oxidative stress index (OSI) was calculated. All samples were also tested with indirect immunofluorescence assay (IFA) and 357 samples were selected for direct monospecific anti DFS70 enzyme-linked immunosorbent assay (ELISA) testing. Results: The anti-DFS70 antibodies were confirmed by ELISA test in 21.29% of samples. Compared with anti-DFS70 negative samples we observed 23% lower concentration of LPH (P =.038) and 11% lower concentration of UA (P =.005). TOS was 20% lower (P =.014). The activity of SOD was up to 5% higher (P =.037). The Pearson correlation showed weak negative correlation for LPH, UA, and TOS and a weak positive correlation for SOD activity. Conclusion: In samples positive for the anti-DFS70 antibody a decreased level of oxidative stress was observed, especially in the case of samples with a high antibody titer. Anti-DFS70 antibodies can be considered as an indirect marker of reduced oxidative stress or a marker indicating the recent intensification of antioxidant processes. © The Author(s) 2022. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Fadi Charchar” is provided in this record*

Serum antinuclear autoantibodies are associated with measures of oxidative stress and lifestyle factors - analysis of LIPIDOGRAM2015 and LIPIDOGEN2015 studies

Introduction: Oxidative stress is one of many factors suspected to promote antinuclear autoantibody (ANA) formation. Reactive oxygen species can induce changes in the antigenic structure of macromolecules, causing the immune system to treat them as “neo-antigens” and start production of autoantibodies. This study was designed to evaluate the relationship between oxidative stress markers, lifestyle factors and the detection of ANA. Material and methods: We examined measures of oxidative stress indices of free-radical damage to lipids and proteins, such as total oxidant status (TOS), concentration of protein thiol groups (PSH), and malondialdehyde (MDA), activity of superoxide dismutase (SOD) in in 1731 serum samples. The parameters of the non-enzymatic antioxidant system, such as total antioxidant status (TAS) and uric acid concentration (UA), were also measured and the oxidative stress index (OSI -index) was calculated. All samples were tested for the presence of ANA using an indirect immunofluorescence assay (IIFA). Results: The presence of ANA in women was associated with lower physical activity (p=0.036), less frequent smoking (p=0.007) and drinking of alcohol (p=0.024) accompanied by significant changes in SOD isoenzymes activity (p&lt;0.001) and a higher uric acid (UA) concentration (p&lt;0.001). In ANA positive males we observed lower concentrations of PSH (p=0.046) and increased concentrations of MDA (p=0.047). Conclusions: The results indicate that local oxidative stress may be associated with increased probability of ANA formation in a sex-specific manner

MODIL &#8212; wieloośrodkowe, randomizowane badanie porównujące moexipril i diltiazem w monoterapii i terapii skojarzonej nadciśnienia tętniczego

Background The aim of the study was to compare efficacy of moexipril or diltiazem in monotherapy and in combination antihypertensive therapy. Materials and methods 182 patients aged 30 do 70 years with mild to moderate essential hypertension were studied. If blood pressure was between 90 and 110 mm Hg for diastolic and between 140 and 190 mm Hg for systolic after 1 week run-in placebo phase, patients were randomized to receive moexipril in dose 7,5 mg/d or diltiazem in dose 120 mg/d, once a day. After 2 weeks, in case of poor blood pressure control patients were randomized second time to receive doubled dose of the drug in monotherapy or combination therapy with low dose of moexipril and diltiazem. Treatment was continued for next 8 weeks with blood pressure control after 4 and 8 weeks. Results Mean basic blood pressure was 160,6 &plusmn; 11,3 / 99,7 &plusmn; &plusmn; 5,2 mm Hg in moexipril group and 159,6 &plusmn; 10,5/98,7 &plusmn; &plusmn; 5,3 mmHg in diltiazem group. After 2 weeks treatment with low dose moexipril blood pressure decreased by 17/8 mm Hg (p < 0,001) and with diltiazem by 14/5 mm Hg. Efficacy (blood pressure below 140/90 mm Hg) of low dose moexipril was 45% and of low dose diltiazem 33%. Efficacy of combination therapy was significantly higher than monotherapy with doubled dose (33% vs 8% in moexipril group and 39% vs 23% in diltiazem group. Theoretically estimated effectiveness of antihypertensive strategy from low dose of calcium chanel blocker or ACE inhibitor to combination therapy with these drugs was 54,4%, and method from low dose to increased dose of single drug was 40,4 %. Side effects (hypothension, weakness, headache, dizziness and allergic skin reaction were noted in 3 patients. Conclusions Diltiazem SR and moexipril were proved to be effective, safe and well tolerated antihypertensive agents both in monotherapy and combination treatment. Combination therapy with low dose of calcium chanel blocker and ACE inhibitor is more effective than monotherapy with high dose of one of these drugs.Wstęp Celem badania było porównanie skuteczności hipotensyjnej moexiprilu i diltiazemu w monoterapii oraz terapii skojarzonej tymi lekami. Materiał i metody Badaniami objęto 182 pacjentów z nadciśnieniem tętniczym pierwotnym łagodnym lub umiarkowanym w wieku 30&#8211;70 lat, u których po tygodniu stosowania placebo ciśnienie rozkurczowe wynosiło 90&#8211;110 mm Hg włącznie i ciśnienie skurczowe 140&#8211;190 mm Hg włącznie. Pacjentów pochodzących z 6 ośrodków klinicznych w Polsce randomizowano do grupy otrzymującej moexipril w dawce 7,5 mg/d lub diltiazem 120 mg/d, 1 raz na dobę. Po 2 tygodniach, przy niewystarczającej reakcji hipotensyjnej, pacjentów ponownie randomizowano do grupy otrzymującej podwojoną dawkę leku hipotensyjnego w monoterapii lub do podgrupy otrzymującej terapię skojarzoną. Leczenie kontynuowano przez następne 8 tygodni, oceniając efekt hipotensyjny po 4 i 8 tygodniach. Wyniki Średnie wyjściowe ciśnienie tętnicze wynosiło 160,6 &plusmn; 11,3/99,7 &plusmn; 5,2 mm Hg w grupie leczonej moexiprilem i 159,6 &plusmn; 10,5/98,7 &plusmn; 5,3 mm Hg w grupie leczonej diltiazemem. Po 2 tygodniach leczenia uzyskano istotne obniżenie ciśnienia o 17/8 mm Hg (p < 0,001) pod wpływem moexiprilu oraz o 14/5 mm Hg (p < 0,001) po diltiazemie. Skuteczność hipotensyjna małej dawki moexiprilu wynosiła 45% i była większa niż małej dawki diltiazemu (33%). Skuteczność hipotensyjna po dodaniu drugiego leku była większa niż po zwiększeniu dawki leku w monoterapii i wynosiła 33% vs 8% w grupie leczonej wyjściowo moexiprilem oraz 39% vs 23% w grupie leczonej wyjściowo diltiazemem. Wyliczona teoretycznie skuteczność strategii leczenia hipotensyjnego od małej dawki inhibitora konwertazy lub antagonisty wapnia do terapii skojarzonej tymi lekami wynosiła 54,4%, a postępowania od małej do dużej dawki jednego z tych leków &#8212; 40,4%. Działania niepożądane w postaci hipotonii, osłabienia, bólów i zawrotów głowy oraz skórnej reakcji alergicznej zanotowano u 3 pacjentów. Wnioski Diltiazem SR i moexipril są skutecznymi, bezpiecznymi i dobrze tolerowanymi lekami zarówno w monoterapii, jak i skojarzonej terapii hipotensyjnej. Leczenie skojarzone niską dawką inhibitora konwertazy i antagonisty wapnia skuteczniej normalizuje ciśnienie krwi niż monoterapia podwojoną dawką jednego z tych leków