Timely-automatic procedure for estimating the endocardial limits of the left ventricle assessed echocardiographically in clinical practice

In this paper, we propose an analytical rapid method to estimate the endocardial borders of the left ventricular walls on echocardiographic images for prospective clinical integration. The procedure was created as a diagnostic support tool for the clinician and it is based on the use of the anisotropic generalized Hough transform. Its application is guided by a Gabor-like filtering for the approximate delimitation of the region of interest without the need for computing further anatomical characteristics. The algorithm is applying directly a deformable template on the predetermined filtered region and therefore it is responsive and straightforward implementable. For accuracy considerations, we have employed a support vector machine classifier to determine the confidence level of the automated marking. The clinical tests were performed at the Cardiology Clinic of the County Emergency Hospital Timisoara and they improved the physicians perception in more than 50% of the cases. The report is concluded with medical discussions.European Union (UE)Ministerio de Economía y Competitividad (MINECO). Españ

Occurrences of insect outbreaks in Sweden in relation to climatic parameters since 1850

This study was carried out in order to identify the main insect species responsible for forest damages (pests) in Sweden, and to explore the relationships between insect outbreaks and environmental variables (temperature, precipitation, and availability of insect host trees, including storm damaged trees). Special attention was given to changes in management practices through time, and their consequences for pest outbreaks. The occurrences of insect outbreaks were analyzed for the southern, central and northern Sweden during two periods, 1850-1950 and 1961-2014. A Principal Component Analysis was conducted for each of the three regions in order to assess which insect families and insect species caused the main forest damage. The ratio between broadleaved and coniferous trees was calculated to highlight the type of forests mostly attacked by insect pests. A Variation Partitioning Analysis was carried out to study the influence of the climatic variables (temperature and precipitation) and the volume of storm felled trees on the occurrences of insect species responsible for outbreaks. During the first period, insect outbreaks increased markedly after 1911, and remained at a high level throughout the period. The Variation Partitioning Analysis showed that this trend might have been strongly influenced by climate and storm events. However, for the second period of time an association between these variables and the insect species responsible for the main forest damage could not be distinguished, and a clear decrease in the occurrences of insect outbreaks could be noticed in comparison with the first period. Other studies clearly showed a relation between outbreaks and climate also for the second period. The inconsistency in this study between the two time periods is attributed to the different datasets used and to other processes, such as changes in forest management practice, the use of insecticides and other countermeasures.The objectives of this study were to observe the tendency of insects for a type of tree in order to calculate the ratio of attacked coniferous versus attacked broadleaved trees, to identify the main five insect families responsible for outbreaks and the most important insect species responsible for outbreaks (for each southern, central and northern Sweden, and for two periods of time: 1850-1950 and 1961-2014), and to observe how climatic variables (i.e. temperature, precipitation) and the available storm damaged trees have influenced the pests behavior over time. Sweden is a country covered mostly by forests (70%). By having large areas with forests, Sweden faces insect outbreaks to a big extent. Insects that cause damages to trees (pests) pose as serious threats to the tree’s health, and in some cases they cause tree mortality. By damaging the trees they induce large economic losses. It is therefore important to study insect outbreaks in order to understand the mechanism that leads to their outbreaks and try to take precise countermeasures against these pests. The software used displayed the results as arrows (insect species, insect families and climatic variables) and the years as circles. This analysis showed interesting results. For insect families, as well as for insect species different results were displayed for the two periods of time. For the first period (i.e. 1850-1950) the three regions of Sweden showed some resemblances, and some of the families and species were present in all three regions as important ones. There were only one or maximum two families and insect species that were the same between the two periods of time. Regarding the influence of climatic parameters on the behavior of the main insects responsible for outbreaks the analysis displayed interesting results. Throughout the first period (i.e. 1850-1950) insects were influenced to a big extent by the above variables, whereas throughout the second period (i.e. 1961-2014) the main insect species responsible for outbreaks showed no correlation with the above variables (i.e. temperature, precipitation and availability of storm felled trees). However it was difficult to make a direct comparison between the two periods due to the different datasets used in this analysis

Dysfunkcja śródbłonka u chorych z niedoczynnością przytarczyc

Background: It is well known that hypothyroidism promotes the premature onset of subclinical atherosclerosis. This condition is defined by endothelial dysfunction (ED) and increased arterial stiffness (AS) and leads to augmentation of peripheral vascular resistance. Aim: To assess the presence and severity of ED and to follow its evolution under therapy in three groups of hypothyroid patients, we used three different noninvasive methods: carotidian intima–media thickness (IMT), flow mediated vasodilatation (FMD), and AS. Methods: The study group consisted of 56 young, hypothyroid women without associated cardiovascular pathology or risk factors for atherosclerosis. We selected our patients in order to have normal IMT (< 0.9 mm) and assessed the basal diameter of the brachial artery and the alterations of FMD and of AS parameters: pulse wave velocity (PWV) and augmentation index (AIx). Results: We found, in all patients, a reduced basal diameter of brachial artery, pathological patterns of FMD, and increased values of PWV and AIx, compared to controls, in relation with the severity of thyroid dysfunction. We documented an improvement of ED after therapy with L-thyroxin. Conclusions: ED, documented in hypothyroid patients by means of three noninvasively methods, was strongly related to the severity of thyroid disease. We detected, in all three subgroups, significant alterations of FMD and AS, even in the absence of structural changes, documented by a normal IMT. ED improved consistently after restoring the euthyroid state.  Wstęp: Powszechnie wiadomo, że niedoczynność tarczycy przyczynia się do przedwczesnego rozwoju bezobjawowej miażdżycy. To zaburzenie, definiowane jako dysfunkcja śródbłonka (ED) i zwiększenie sztywności tętnic (AS), prowadzi do wzrostu obwodowego oporu naczyniowego. Cel: Badanie przeprowadzono w celu oceny obecności i nasilenia ED oraz obserwowania jego ewolucji w trakcie leczenia w trzech grupach chorych z niedoczynnością tarczycy. Zastosowano trzy różne nieinwazyjne metody: pomiary grubości kompleksu błony środkowej i wewnętrznej tętnicy szyjnej (IMT), zależnego od przepływu rozszerzenia naczyń (FMD) oraz AS. Metody: Badana grupa obejmowała 56 młodych kobiet z niedoczynnością tarczycy, u których nie występowały powiązane choroby sercowo-naczyniowe ani czynniki ryzyka miażdżycy. Wybrano pacjentki z prawidłowymi wartościami IMT (< 0,9 mm) i oceniono wyjściową średnicę tętnicy ramiennej, zmiany FMD i parametry AS: szybkość fali tętna (PWV) oraz wskaźnik wzmocnienia (AIx). Wyniki: U wszystkich chorych stwierdzono obniżoną średnicę wyjściową tętnicy ramiennej, patologiczne FMD i zwiększone wartości PWV oraz AIx w porównaniu z osobami z grupy kontrolnej. Te zmiany wiązały się z nasileniem dysfunkcji tarczycy. Wykazano poprawę w zakresie czynności śródbłonka po leczeniu L-tyroksyną. Wnioski: Dysfunkcja śródbłonka, potwierdzona u chorych z niedoczynnością tarczycy za pomocą trzech nieinwazyjnych metod badania, była silnie związana ze stopniem ciężkości choroby tarczycy. We wszystkich trzech podgrupach stwierdzono istotne zmiany FMD i AS, nawet w przypadku niewystępowania zmian strukturalnych (prawidłowy wynik pomiaru IMT). Po przywróceniu stanu eutyreozy następowała wyraźna poprawa czynności śródbłonka.

Aspects of diastolic dysfunction in patients with new and recurrent depression.

ObjectiveThe main objective of this study was to evidence the potential impact of the intensity, duration and recurrence of depression on the development of arterial stiffness (AS) leading to left ventricular hypertrophy (LVH) and diastolic dysfunction (DD) in patients with new onset depression (NOD) and recurrent depression (RD) in comparison to 33 control subjects without depression. Another aim was to identify potential predictive factors regarding the occurrence of diastolic dysfunction (DD).MethodsOur study group included 58 patients diagnosed with NOD and 128 diagnosed with RD, without any previously diagnosed significant heart diseases. The intensity of depression was evaluated by means of the Montgomery-Asberg Depression Rating Scale (MADRS). Assessment of pulse wave velocity (PWV), left ventricular mass index (LVMI) and echocardiographic parameters characterizing DD were performed for each patient.ResultsThe cardiology evaluations suggested an increased prevalence of AS in all patients, of significantly higher rate than in controls (pConclusionsIn our study, diastolic dysfunction was a common finding among patients with RD, but it was also noted, to a lesser extent, in those suffering with NOD. DD was associated with altered AS, and strongly correlated with the intensity and the duration of depressive symptoms. The two latter factors, together with an increased PWV, were strong predictors for the occurrence of DD

Timely-Automatic Procedure for Estimating the Endocardial Limits of the Left Ventricle Assessed Echocardiographically in Clinical Practice

In this paper, we propose an analytical rapid method to estimate the endocardial borders of the left ventricular walls on echocardiographic images for prospective clinical integration. The procedure was created as a diagnostic support tool for the clinician and it is based on the use of the anisotropic generalized Hough transform. Its application is guided by a Gabor-like filtering for the approximate delimitation of the region of interest without the need for computing further anatomical characteristics. The algorithm is applying directly a deformable template on the predetermined filtered region and therefore it is responsive and straightforward implementable. For accuracy considerations, we have employed a support vector machine classifier to determine the confidence level of the automated marking. The clinical tests were performed at the Cardiology Clinic of the County Emergency Hospital Timisoara and they improved the physicians perception in more than 50% of the cases. The report is concluded with medical discussions

Spontaneous Hematomas and Deep Vein Thrombosis during the Recovery from a SARS-CoV-2 Infection: Case Report and Literature Review

Background: The frequent occurrence of thromboembolic events in patients infected with the severe acute respiratory syndrome CoV2 (SARS-CoV-2) virus is a well-recognized fact in the medical literature, but less data is available about possible hemorrhagic incidents. Methods: We report the case of a 76-year-old patient who suffered from a mild COVID-19 infection in September 2021 and after four weeks, experienced a completely spontaneous popliteal hematoma followed by deep vein thrombosis (DVT). Therapy with low molecular weight heparins (LMWH) was started, but subsequently, the patient developed a massive sub-pectoral and calf hematoma leading to moderate post-hemorrhagic anemia and acute kidney injury. This patient was treated completely conservatively. Conclusions: Considering the continuous spread of the infection with various, continuously evolving strains of this virus and the extended use of LWMH in clinical practice, such cases were seldom described in the medical literature, but should be considered as a potential cause for hemorrhagic events

Correspondence between Aortic and Arterial Stiffness, and Diastolic Dysfunction in Apparently Healthy Female Patients with Post-Acute COVID-19 Syndrome

(1) Background: Abnormally increased arterial and aortic stiffness (AS and AoS), which are often associated with diastolic dysfunction (DD), represent common alterations in COVID-19. In this study, we aimed to assess, by transthoracic echocardiography (TTE) and pulse-wave velocity (PWV), the frequency of these dysfunctions in patients with post-acute COVID-19 syndrome and to highlight potential correlations between their severity and multiple clinical and laboratory parameters. (2) Methods: In total, 121 women were included in our study, all of whom were younger than 55 and had been diagnosed with post-COVID-19 syndrome. Of those women, 67 also had metabolic syndrome (MS) (group A), whereas the other 54 did not (group B); 40 age-matched healthy subjects were used as controls (group C). (3) Results: Patients in group A had worse values of indexes characterizing AS and AoS and had more frequent DD compared to those from group B and group C (p < 0.0001). The statistical analysis evidenced significant associations between these indexes and the time that had elapsed since COVID-19 diagnosis, the factors that characterize the severity of the acute disease and those that specify MS. Multivariate regression analysis identified the following as the main independent predictors for DD: values of the AoS index, the C-reactive protein, and the triglyceride–glucose index. (4) Conclusions: Altered AS, AoS, and DD are common in patients with post-COVID-19 syndrome, especially with concurrent MS, and these parameters are apparently associated not only with the severity and time elapsed since COVID-19 diagnosis but also with MS

Correspondence between Aortic and Arterial Stiffness, and Diastolic Dysfunction in Apparently Healthy Female Patients with Post-Acute COVID-19 Syndrome

(1) Background: Abnormally increased arterial and aortic stiffness (AS and AoS), which are often associated with diastolic dysfunction (DD), represent common alterations in COVID-19. In this study, we aimed to assess, by transthoracic echocardiography (TTE) and pulse-wave velocity (PWV), the frequency of these dysfunctions in patients with post-acute COVID-19 syndrome and to highlight potential correlations between their severity and multiple clinical and laboratory parameters. (2) Methods: In total, 121 women were included in our study, all of whom were younger than 55 and had been diagnosed with post-COVID-19 syndrome. Of those women, 67 also had metabolic syndrome (MS) (group A), whereas the other 54 did not (group B); 40 age-matched healthy subjects were used as controls (group C). (3) Results: Patients in group A had worse values of indexes characterizing AS and AoS and had more frequent DD compared to those from group B and group C (p &lt; 0.0001). The statistical analysis evidenced significant associations between these indexes and the time that had elapsed since COVID-19 diagnosis, the factors that characterize the severity of the acute disease and those that specify MS. Multivariate regression analysis identified the following as the main independent predictors for DD: values of the AoS index, the C-reactive protein, and the triglyceride&ndash;glucose index. (4) Conclusions: Altered AS, AoS, and DD are common in patients with post-COVID-19 syndrome, especially with concurrent MS, and these parameters are apparently associated not only with the severity and time elapsed since COVID-19 diagnosis but also with MS

ARRHYTHMIAS IN ACUTE AND PERSISTENT DEPRESSION IN PATIENTS WITH MYOCARDIAL INFARCTION

ABSTRACT. Acute and persistent depression is recognized as a risk factor for coronary artery disease. Significant depressive symptoms are found in 40-65 percent of patients with myocardial infarction. Depression is often persistent and exacerbates cardiac symptoms. It increases the frequency of arrhythmias, angina, morbidity and mortality (through sudden cardiac death). The therapy with serotonin reuptake inhibitor antidepressants improves depression and has favorable effects on the severity of cardiovascular symptoms, on morbidity and mortality. Keywords: acute and persistent depression, arrhythmias, myocardial infarction. REZUMAT. Depresia acută și persistentă este recunoscută ca un factor de risc pentru boala coronariană. La aproximativ 40-65% dintre pacienţii cu infarct miocardic, identificăm simptome semnificative de depresie. Depresia este frecvent persistentă și exacerbează simptomele cardiace. Crește frecvenţa aritmiilorși a anginei, morbiditatea și mortalitatea (prin moarte subită). Terapia cu antidepresive, de tipul inhibitorilor recaptării serotoninei, ameliorează depresia și are efect favorabil asupra simptomelor cardiovasculare, a morbidităţii și a mortalităţii. Cuvinte cheie: depresie acută și pesistentă, aritmii, infarct miocardic