Annotated retinal optical coherence tomography images (AROI) database for joint retinal layer and fluid segmentation

Optical coherence tomography (OCT) images of the retina provide a structural representation and give an insight into the pathological changes present in age-related macular degeneration (AMD). Due to the three-dimensionality and complexity of the images, manual analysis of pathological features is difficult, time-consuming, and prone to subjectivity. Computer analysis of 3D OCT images is necessary to enable automated quantitative measuring of the features, objectively and repeatedly. As supervised and semi-supervised learning-based automatic segmentation depends on the training data and quality of annotations, we have created a new database of annotated retinal OCT images – the AROI database. It consists of 1136 images with annotations for pathological changes (fluid accumulation and related findings) and basic structures (layers) in patients with AMD. Inter- and intra-observer errors have been calculated in order to enable the validation of developed algorithms in relation to human variability. Also, we have performed the automatic segmentation with standard U-net architecture and two state-of-the-art architectures for medical image segmentation to set a baseline for further algorithm development and to get insight into challenges for automatic segmentation. To facilitate and encourage further research in the field, we have made the AROI database openly available

Impact of prior statin therapy on community-acquired pneumonia outcomes

Pneumonija iz opće populacije značajan je uzrok morbiditeta i mortaliteta na svjetskoj razini. Postojeće terapijske strategije imaju svoje granice te se istražuju komplementarni pristupi usmjereni na modifikaciju upalnog i imunosnog odgovora domaćina. Eksperimentalno dokazani protuupalni, imunomodulatorni i drugi potencijalno korisni učinci čine statine jednom od opcija. U ovom smo članku analizirali unutar PubMed-a objavljena istraživanja povezanosti prethodne uporabe statina s mortalitetom i drugim kliničkim ishodima pneumonije iz opće populacije. Pri analizi smo poseban naglasak stavili na procjenu kontrole mogućih čimbenika posredne povezanosti. Pronašli smo 16 istraživanja (14 kohortnih i dva dizajna slučaj-kontrola), od čega je 12 zaključivalo o povoljnom učinku statina na redukciju mortaliteta kod pneumonije, dok su četiri negirala stvarnu povezanost istaknuvši učinak zdravog korisnika kao alternativno objašnjenje. Iako metodološka heterogenost analiziranih istraživanja i otvorena pitanja kontrole čimbenika posredne povezanosti sprječavaju donošenje konačnog zaključka, postojeća literatura nudi dovoljno poticaja i podataka za kvalitetan pristup budućim istraživanjima.Community-acquired pneumonia represents a significant cause of morbidity and mortality worldwide. Current therapeutic strategies have their limits, and complementary strategies focused on modifying the host\u27s inflammatory and immune response are being investigated. Because of their anti-inflammatory, immunomodulatory and other potentially beneficial effects, statins are often proposed as a possible solution. We searched the PubMed for literature examining the effect of previous statin treatment on mortality and other clinical outcomes in patients with community-acquired pneumonia. Our analysis focused on how each study controlled for potential confounders. We identified 16 studies (14 cohort and two case-control), of which 12 associated prior statin use with mortality reduction, while four denied any real association and offered healthy user effect as an alternative explanation. Although methodological heterogeneity of these studies and unresolved confounding issues disallow any final conclusion, we feel that enough quality information has been provided to warrant and guide future studies

Do we need broad immunological work-up in all patients with CIS?

BACKGROUND: The aim of this study was to determine the prevalence of altered immunological tests and their clinical significance in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). ----- PATIENTS AND METHODS: The information was gathered from medical records of patients hospitalized in the Referral Center for Demyelinating Diseases in the 2008-2010 period. All patients had ANA, ENA profile, ANCA, aCl IgG and IgM, C3, C4, CH50, anti-TPO, AST and RF antibodies tested. ----- RESULTS: From 726 patients with CIS that were reviewed, the complete battery of immunological tests was performed in 418 of them (57.6%), representing our cohort. Altered tests were found in 235 patients (56.2%); 73 (17.4%) had positive antinuclear antibodies, 14 (3.3%) had positive ENA, 47 (11.2%) had positive aCl IgG, 83 (19.8%) had positive aCl IgM, and 13 (3.1%) had anti TPO antibodies. We found no correlation between ANA, aCl IgG or IgM positivity (ANA vs aCL IgG p=0.554; ANA vs aCL IgM p=0.19; aCL IgG vs aCL IgM, p=0.155). None of the patients had any clinical manifestations other than MS symptoms. ----- CONCLUSION: These results indicate that significant number of patients with CIS have altered immunological tests but nevertheless none of them had clinical expression of any other autoimmune disease making them clinically insignificant. In conclusion there is no need to perform extensive immunological work-up in all patients with CIS. Contrary, our results argue for more focused testing rather than a battery of screening tests

Bilateral Acute Iris Transillumination (BAIT): A Rare Syndrome Possibly Associated with COVID-19 and Moxifloxacin Use. A Report of 2 Cases

Bilateral acute iris transillumination (BAIT) is a rare clinical entity, presumed to be associated with preceding upper respiratory tract infection and/or use of certain antibiotics, marked by bilateral acute loss of iris pigment epithelium with pigment dispersion in the anterior chamber and trabecular meshwork, which can cause elevated intraocular pressure and glaucoma, and with iris transillumination and sphincter paralysis which lead to photophobia and blurry vision. We report the first two cases of BAIT in our center which both had a history of preceding COVID-19 (coronavirus disease 2019) and moxifloxacin use. With more awareness, ophthalmologists might diagnose more cases, and thus gain more information regarding the link between COVID-19 and BAIT, which might be underdiagnosed since it is rare or easily misdiagnosed as some more common diseases with similar features

Differences in oligoclonal bands and visual evoked potentials in patients with radiologically and clinically isolated syndrome

The aim of this study was to determine the prevalence of cerebrospinal fluid (CSF) and visual evoked potentials (VEP) abnormalities, and ANA titers in patients with either clinically or radiologically isolated syndrome (CIS and RIS). We gathered records from 330 hospitalized patients diagnosed with CIS/RIS within a 3-year period. Symptoms, CSF findings, VEP and ANA titers were analyzed. Incomplete transverse myelitis was the presenting symptom in 32.7 %, optic neuritis in 22.7 %, brainstem/cerebellar symptoms in 19.4 %, hemispheral symptoms in 2.7 % and multifocal symptoms in 15.2 % of patients in the CIS cohort. We identified 24 (7.3 %) patients with atypical or no symptoms-RIS cohort. Positive oligoclonal bands (OCB) were found in 75.5 % patients. When we divided the patients into CIS and RIS groups, the presence of OCB was 82.4 and 44 %, respectively. VEP were performed in 87.3 % patients and prolonged latencies were found in 39.6 % of them (43.8 and 14.3 % in the CIS and RIS cohort, respectively). ANA were positive in 15.2 % (14.7 and 16 % in the CIS and RIS cohort, respectively) of patients. RIS patients had statistically significant lower percentages of positive OCB and positive VEP (P = 0.002 and 0.001, respectively). Detection of OCB and VEP still has an important role for satisfying the "no better explanation for the clinical presentation" criteria when presented with a patient with a first "radiological" demyelinating episode

Influence of Personality Traits and Organizational Justice on Job Satisfaction among Nurses

The purpose of this research was to examine whether demographic variables, personality traits, and workplace variables (working in shifts, job tenure, and perceived organizational justice) contribute the most to the prediction of job satisfaction in nurses. The survey included 161 nurses. The instruments used in this research were as follows: the Demographic Data Questionnaire, the Perceived Organizational Justice Scale, the Job Satisfaction Scale, and the NEO five-factor inventory. The study findings indicated that age, health status, distributive justice, and procedural justice positively contribute to job satisfaction among nurses, while neuroticism contributes negatively. Older nurses, those in better health, those who are satisfied with the organization’s decision-making process, and those who feel adequately rewarded for their contributions tend to be more satisfied with their jobs. Conversely, nurses with a higher level of the neuroticism personality trait tend to be less satisfied with their job. The strongest predictors of job satisfaction among nurses were found to be health status, the personality trait of neuroticism, and distributive and procedural justice, with the age of nurses being slightly less powerful but still significant

Croatian Translation and Validation of the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ)

Patient satisfaction is a crucial measure of the quality of healthcare, especially with regard to nursing services in hospital settings. Understanding and increasing patient satisfaction with nursing care is critical to improving overall healthcare and ensuring positive patient experiences during their hospital stay. The aim of this research was to evaluate the psychometric properties of the Croatian version of the Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), test the reliability and validity of the tool after translation, and investigate differences in patient satisfaction based on demographic variables, as well as their contribution to satisfaction with the quality of nursing care. After translation and adaptation, the Croatian version of the PSNCQQ was applied to 350 hospitalized patients (average age 51.19 years (range: 18–87)), of whom 194 (55.4%) were men and 156 (44.6%) were women. The results showed high internal consistency (Cronbach’s α = 0.977) and confirmed the one-factor structure of the questionnaire, explaining 70.64% of the total variance. Confirmatory factor analysis supported the unidimensional model, showing strong fit indices (χ2 = 583.047, df = 149, p < 0.001, GFI = 0.861, AGFI = 0.818, NFI = 0.936, TLI = 0.946, CFI = 0.955, RMSEA = 0.080, PCLOSE < 0.001). In conclusion, the validation of the PSNCQQ in the Croatian language increases resources for evaluating and improving the quality of nursing care. This research lays the foundation for future studies and practical applications aimed at improving patient satisfaction and nursing care outcomes in Croatia, but there are also limitations to this study, including its one-institution scope, the possible influence of factors outside the current treatment on satisfaction, and the lack of comparison with objective clinical indicators