Patient reported side-effects of prednisone and methotrexate in a real-world sarcoidosis population

Currently prednisone is the first-line pharmacological treatment option for pulmonary sarcoidosis. Methotrexate is used as second-line therapy and seems to have fewer side-effects. No prospective comparative studies of first-line treatment with methotrexate exist. In this study, we evaluated patient reported presence and bothersomeness of side-effects of prednisone and methotrexate in a sarcoidosis population to guide the design of a larger prospective study. During a yearly patient information meeting 67 patients completed a questionnaire on medication use; 11 patients never used prednisone or methotrexate and were excluded from further analysis. Of the remaining 56 patients, 89% used prednisone and 70% methotrexate (present or former). Significantly more side-effects were reported for prednisone than for methotrexate, 78% versus 49% (p = 0.006). In conclusion, methotrexate seems to have fewer and less bothersome side-effects than prednisone. These findings need to be confirmed in a prospective study

An interface to retrieve personal memories using an iconic visual language

Relevant past events can be remembered when visualizing related pictures. The main difficulty is how to find these photos in a large personal collection. Query definition and image annotation are key issues to overcome this problem. The former is relevant due to the diversity of the clues provided by our memory when recovering a past moment and the later because images need to be annotated with information regarding those clues to be retrieved. Consequently, tools to recover past memories should deal carefully with these two tasks. This paper describes a user interface designed to explore pictures from personal memories. Users can query the media collection in several ways and for this reason an iconic visual language to define queries is proposed. Automatic and semi-automatic annotation is also performed using the image content and the audio information obtained when users show their images to others. The paper also presents the user interface evaluation based on tests with 58 participants

Recovery of intracranial stenoses in varicella zoster virus vasculitis after long-term treatment with valacyclovir and prednisolone

BACKGROUND AND PURPOSE: Optimal treatment of intracranial stenoses in varicella zoster virus (VZV)-associated vasculitis is unknown. This study aims to evaluate the merits and potential pitfalls of a specific therapeutic strategy, initially proposed by Don Gilden in 2015. METHODS: We describe three patients with intracranial stenoses caused by VZV vasculitis successfully treated by a long-term combination of valacyclovir and prednisolone. RESULTS: All three patients were young men suffering from stroke. Only one reported a first contact to VZV in adulthood. All three presented stenoses in the intracranial part of the internal carotid artery or the proximal segments of the middle cerebral artery as well as an elevated cell count and positive VZV antibody index in cerebrospinal fluid. They received a combination therapy regimen with prednisone and valacyclovir about a minimum of one year. Intracranial stenoses improved markedly in one and almost resolved completely in the other two patients. Side effects of corticosteroid treatment occurred in two patients. CONCLUSIONS: Long-term combination treatment with prednisone and valacyclovir proved to be effective in three young men suffering from intracranial stenosis due to VZV vasculitis

Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome: a neuroradiological method to help differentiate from primary central nervous system vasculitis

BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by a prolonged, but self-limiting segmental cerebral vasoconstriction. Neurological outcomes vary, but can be severe. The clinical hallmark of RCVS is thunderclap headache, which might come along with further neurological symptoms. Distinguishing RCVS from other entities, such as primary angiitis of the central nervous system (PACNS), is of utmost importance for appropriate therapy. The angiographic response to intra-arterial nimodipine application has been suggested as an additional diagnostic criterion for RCVS but confirmatory studies are limited. We aimed to evaluate the angiographic nimodipine test. METHODS: We reviewed retrospectively the clinical and imaging data of 13 RCVS patients, who were admitted to a single German neurological department between January 2013 and December 2020. RESULTS: Out of 13 patients diagnosed with RCVS, 4 patients underwent an angiographic nimodipine test. In all 4 patients cerebral vasoconstriction completely resolved during nimodipine application. Among the four patients with a positive test, there was one individual, in whom a response was detected after a delay of 60 min. In all patients, we found a complete resolution of cerebral vasoconstriction within 12 weeks. CONCLUSION: Our findings support the usefulness of the application of nimodipine in diagnosing RCVS. Prolonged angiographic observation of the vascular response after nimodipine injection is important

Stabilized lasers for advanced gravitational wave detectors

Second generation gravitational wave detectors require high power lasers with more than 100 W of output power and with very low temporal and spatial fluctuations. To achieve the demanding stability levels required, low noise techniques and adequate control actuators have to be part of the high power laser design. In addition feedback control and passive noise filtering is used to reduce the fluctuations in the so-called prestabilized laser system (PSL). In this paper, we discuss the design of a 200 W PSL which is under development for the Advanced LIGO gravitational wave detector and will present the first results. The PSL noise requirements for advanced gravitational wave detectors will be discussed in general and the stabilization scheme proposed for the Advanced LIGO PSL will be described

Multi-layer Architecture For Storing Visual Data Based on WCF and Microsoft SQL Server Database

In this paper we present a novel architecture for storing visual data. Effective storing, browsing and searching collections of images is one of the most important challenges of computer science. The design of architecture for storing such data requires a set of tools and frameworks such as SQL database management systems and service-oriented frameworks. The proposed solution is based on a multi-layer architecture, which allows to replace any component without recompilation of other components. The approach contains five components, i.e. Model, Base Engine, Concrete Engine, CBIR service and Presentation. They were based on two well-known design patterns: Dependency Injection and Inverse of Control. For experimental purposes we implemented the SURF local interest point detector as a feature extractor and $K$-means clustering as indexer. The presented architecture is intended for content-based retrieval systems simulation purposes as well as for real-world CBIR tasks.Comment: Accepted for the 14th International Conference on Artificial Intelligence and Soft Computing, ICAISC, June 14-18, 2015, Zakopane, Polan

Sex differences in etiology and short-term outcome in young ischemic stroke patients receiving mechanical thrombectomy

BACKGROUND: Although there are well known sex differences in older patients with ischemic stroke receiving acute reperfusion treatments, there is paucity of data in younger patients. METHODS: We investigated sex-related differences in clinical presentation, stroke etiology and short-term outcomes in consecutive young patients with acute ischemic stroke (AIS) below the age of 50 years receiving mechanical thrombectomy (MT) between January 2011 and May 2021 in a tertiary stroke center. RESULTS: We identified a total of 202 young ischemic stroke patients with MT, with 51% being female. Young female AIS patients were significantly younger (39 ± 8 vs. 43 ± 7 years, p < 0.001), and presented with a trend for more severe stroke on admission (median NIHSS 12 vs. 9, p = 0.065), compared to males, respectively. Young female AIS patients had higher rates of embolic strokes of determined or undetermined sources in the anterior circulation, while young male AIS patients suffered more often strokes of arterio-arterial embolism. Complete reperfusion (TICI score 3) was achieved significantly less often in young female AIS patients (69% vs. 83%, p = 0.006), and in-hospital mortality was 2-times higher (5% vs. 2%, p = 0.271) compared to males. CONCLUSIONS: Young female AIS patients receiving MT have higher rates of severe embolic strokes and less often complete reperfusion due to different occlusion sites and stroke etiology compared to males

Matching Shape Graphs

Graphs are important structures to model complex relationships such as chemical compounds, proteins, geometric or hierarchical parts, and XML documents. Given a query graph, indexing has become a necessity to retrieve similar graphs quickly from large databases. We propose a novel technique for indexing databases, whose entries can be represented as graph structures. Our method starts by representing the topological structure of a graph as well as that of its subgraphs as vectors in which the components correspond to the sorted laplacian eigenvalues of the graph or subgraphs. By doing a nearest neighbor search around the query spectra, similar but not necessarily isomorphic graphs are retrieved