Computer-aided detection of interstitial lung diseases: A texture approach

We have developed the flexible scheme for computer-aided detection (CAD) of interstitial lung diseases on chest radiographs. These schemes enable us to perform diagnostics in the broad circumstances of pneumonia and other interstitial lung diseases. It is applied in the case of children pneumonia when conditions are difficult to standardize. In the adults' case the schemes of CAD are more adaptive, as there are more characteristic interstitial lung tissue's changes to all kinds of pathological conditions. Even in the norm of drawing there are more visible and more highlighted features, leading to better results. The CAD scheme works as follows. For the first of all, we are using adopted algorithms of active contours to select the area of lungs, and then to divide this area into subareas - regions of interest (40 different ROI). Then ROIs were subjected to the 2-dimensional Daubechies wavelet transform, and only main transformation was used. For every transformation 12 texture measures were calculated. Principal component analysis (PCA) was used to extract 2 main components for each ROI, and these components were compared to predictive component region

Burden of varicella in Central and Eastern Europe : findings from a systematic literature review

Funding Information: The authors take full responsibility for the scope, direction, and content of the manuscript, and have approved the submitted manuscript. Medical writing assistance was provided by Eleanor Finn of PAREXEL International and was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. The authors wish to thank the following for contributions in development of the manuscript: Barbara J. Kuter, PhD, MPH, Global Vaccines Medical Affairs, and Tracey J. Weiss, Center for Observational and Real-World Evidence (CORE), Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Funding Information: The study was funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. Funding Information: J. Wysocki received travel grants to attend international scientific conferences and fees for lectures from Pfizer and payment from a grant sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. I. Ivaskeviciene has received a USA travel grant to attend international scientific meeting, from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth. M. Pokorn has received a research grant from Pfizer and payment for lectures from Pfizer, Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA and GSK. L. Jancoriene has received travel grants to attend international scientific conferences and fees for lectures from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, AbbVie and Pfizer and payment for a clinical study sponsored by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. J. Pluta and L.J. Wolfson are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and stockholders of Merck & Co., Inc., Kenilworth, NJ, USA. Publisher Copyright: © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Introduction: Vaccination against varicella rapidly reduces disease incidence, resulting in reductions in both individual burden and societal costs. Despite these benefits, there is no standardization of varicella immunization policies in Europe, including countries in Central and Eastern Europe (CEE). Areas covered: This systematic literature review identified publications on the epidemiology of varicella, its associated health and economic burden, and vaccination strategies within the CEE region, defined as Albania, Bosnia-Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Serbia, Slovakia, and Slovenia. Twenty-six studies were identified from a search of PubMed, Embase®, and MEDLINE® biomedical literature databases, supplemented by gray literature and country-specific/global websites. Expert commentary: Limited information exists in published studies on the burden of varicella in CEE. The wide variability in incidence rates between countries is likely explained by a lack of consistency in reporting systems. Funded universal varicella vaccination (UVV) in CEE is currently available only in Latvia as a one-dose schedule, but Hungary together with Latvia are introducing a two-dose strategy in 2019. For countries that do not provide UVV, introduction of vaccination is predicted to provide substantial reductions in cases and rates of associated complications, with important economic benefits.publishersversionPeer reviewe

Clinical and laboratory features of children with community-acquired pneumonia are associated with distinct radiographic presentations

Chest radiographs from children with community-acquired pneumonia (CAP) were categorized into three distinct presentations and each presentation was correlated to clinical and laboratory findings. Children < 59 months with CAP presenting to pediatric emergency rooms during two years were enrolled prospectively in eight centers across Europe. Clinical and laboratory data were documented and radiographs obtained from patients. Of the 1107 enrolled patients, radiographs were characterized as 74.9% alveolar CAP, 8.9% non-alveolar CAP, and 16.3% clinical CAP. Alveolar CAP patients had significantly higher rates of fever (90.7%), vomiting (27.6%), and abdominal pain (18.6%), while non-alveolar CAP patients presented more with cough (96.9%). A model using independent parameters that characterize alveolar, non-alveolar, and clinical CAP demonstrated that alveolar CAP patients were significantly older (OR = 1.02) and had significantly lower oxygen saturation than non-alveolar CAP patients (OR = 0.54). Alveolar CAP patients had significantly higher mean WBC (17,760 ± 8539.68 cells/mm3) and ANC (11.5 ± 7.5 cells/mm3) than patients categorized as non-alveolar CAP (WBC 15,160 ± 5996 cells/mm3, ANC 9.2 ± 5.1 cells/mm3) and clinical CAP (WBC 13,180 ± 5892, ANC 7.3 ± 4.7). CONCLUSION: Alveolar CAP, non-alveolar CAP, and clinical CAP are distinct entities differing not only by chest radiographic appearance but also in clinical and laboratory characteristics. Alveolar CAP has unique characteristics, which suggest association with bacterial etiology

A Randomized Phase 4 Study of Immunogenicity and Safety After Monovalent Oral Type 2 Sabin Poliovirus Vaccine Challenge in Children Vaccinated with Inactivated Poliovirus Vaccine in Lithuania.

BACKGROUND: Understanding immunogenicity and safety of monovalent type 2 oral poliovirus vaccine (mOPV2) in inactivated poliovirus vaccine (IPV)-immunized children is of major importance in informing global policy to control circulating vaccine-derived poliovirus outbreaks. METHODS: In this open-label, phase 4 study (NCT02582255) in 100 IPV-vaccinated Lithuanian 1-5-year-olds, we measured humoral and intestinal type 2 polio neutralizing antibodies before and 28 days after 1 or 2 mOPV2 doses given 28 days apart and measured stool viral shedding after each dose. Parents recorded solicited adverse events (AEs) for 7 days after each dose and unsolicited AEs for 6 weeks after vaccination. RESULTS: After 1 mOPV2 challenge, the type 2 seroprotection rate increased from 98% to 100%. Approximately 28 days after mOPV2 challenge 34 of 68 children (50%; 95% confidence interval, 38%-62%) were shedding virus; 9 of 37 (24%; 12%-41%) were shedding 28 days after a second challenge. Before challenge, type 2 intestinal immunity was undetectable in IPV-primed children, but 28 of 87 (32%) had intestinal neutralizing titers ≥32 after 1 mOPV2 dose. No vaccine-related serious or severe AEs were reported. CONCLUSIONS: High viral excretion after mOPV2 among exclusively IPV-vaccinated children was substantially lower after a subsequent dose, indicating induction of intestinal immunity against type 2 poliovirus

Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for influenza vaccination in children

<p>Abstract</p> <p>Background</p> <p>Influenza vaccination in infants and children with existing health complications is current practice in many countries, but healthy children are also susceptible to influenza, sometimes with complications. The under-recognised burden of disease in young children is greater than in elderly populations and the number of paediatric influenza cases reported does not reflect the actual frequency of influenza.</p> <p>Discussion</p> <p>Vaccination of healthy children is not widespread in Europe despite clear demonstration of the benefits of vaccination in reducing the large health and economic burden of influenza. Universal vaccination of infants and children also provides indirect protection in other high-risk groups in the community. This paper contains the Central European Vaccination Advisory Group (CEVAG) guidance statement on recommendations for the vaccination of infants and children against influenza. The aim of CEVAG is to encourage the efficient and safe use of vaccines to prevent and control infectious diseases.</p> <p>Summary</p> <p>CEVAG recommends the introduction of universal influenza vaccination for all children from the age of 6 months. Special attention is needed for children up to 60 months of age as they are at greatest risk. Individual countries should decide on how best to implement this recommendation based on their circumstances.</p

Comparative epidemiologic characteristics of pertussis in 10 Central and Eastern European countries, 2000-2013

Publisher Copyright: © 2016 Heininger et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.We undertook an epidemiological survey of the annual incidence of pertussis reported from 2000 to 2013 in ten Central and Eastern European countries to ascertain whether increased pertussis reports in some countries share common underlying drivers or whether there are specific features in each country. The annual incidence of pertussis in the participating countries was obtained from relevant government institutions and/or national surveillance systems. We reviewed the changes in the pertussis incidence rates in each country to explore differences and/or similarities between countries in relation to pertussis surveillance; case definitions for detection and confirmation of pertussis; incidence and number of cases of pertussis by year, overall and by age group; population by year, overall and by age group; pertussis immunization schedule and coverage, and switch from whole-cell pertussis vaccines (wP) to acellular pertussis vaccines (aP). There was heterogeneity in the reported annual incidence rates and trends observed across countries. Reported pertussis incidence rates varied considerably, ranging from 0.01 to 96 per 100,000 population, with the highest rates generally reported in Estonia and the lowest in Hungary and Serbia. The greatest burden appears for the most part in infants (<1 year) in Bulgaria, Hungary, Latvia, Romania, and Serbia, but not in the other participating countries where the burden may have shifted to older children, though surveillance of adults may be inappropriate. There was no consistent pattern associated with the switch from wP to aP vaccines on reported pertussis incidence rates. The heterogeneity in reported data may be related to a number of factors including surveillance system characteristics or capabilities, different case definitions, type of pertussis confirmation tests used, public awareness of the disease, as well as real differences in the magnitude of the disease, or a combination of these factors. Our study highlights the need to standardize pertussis detection and confirmation in surveillance programs across Europe, complemented with carefully-designed seroprevalence studies using the same protocols and methodologies.publishersversionPeer reviewe

Tymai

Tymai – ko gero, plačiausiai skambanti pastaruoju metu tema. Susirgusiųjų skaičius didėja vos ne kiekvieną dieną. Tymai tapo įvairiausių mūsų visuomenės sluoksnių karštų debatų tema. Kas atsitiko? Kodėl liga, kurią įsivaizdavome suvaldę, vėl grįžo į mūsų visuomenę? Aptarkime kertinius faktus apie tymus. Tymai – ūmi, itin užkrečiama virusinė infekcija, plintanti oro lašiniu būdu ir pasireiškianti karščiavimu, katariniais reiškiniais, bėrimu. Palyginti neseniai tymai buvo laikomi viena iš „privalomų“ vaikų infekcinių ligų, nes visi vaikai jais persirgdavo. Tymai buvo ir viena pagrindinių vaikų mirties priežasčių: iki pradedant plataus masto tymų skiepijimo programas, pasaulyje nuo tymų kasmet mirdavo 6–8 mln. sirgusiųjų, 1996 m. nuo tymų mirė apie 1 mln. sirgusiųjų. Pasaulio sveikatos organizacijos (PSO) duomenimis, tymai ir šiandien tebėra pagrindinė mirčių priežastis tarp visų skiepijimais valdomų ligų. Mirtingumas nuo tymų didžiausias besivystančiose šalyse, manoma, kad jose itin sunkią tymų eigą sąlygoja nepalankios gretutinės būklės, tokios kaip prasta mityba, vitaminų stoka, išsekimas, tačiau tymų protrūkių pasitaiko ir išsivysčiusiose šalyse, neišskiriant ir Lietuvos. Pastaraisiais metais įvairiose Europos šalyse registruojami tymų protrūkiai. PSO duomenimis [1], Europos regione tymais sirgo daugiau nei 82,5 tūkst. asmenų. Užkrečiamųjų ligų ir AIDS centro duomenimis [2], per tris mėnesius (2019 m. sausio 1 d.–kovo 29 d.) Lietuvoje iš viso užregistruota 310 susirgimų tymais. Per visus 2018 m. tymais Lietuvoje susirgo 30 žmonių. Vienintele šių protrūkių priežastimi įvardijami skiepijimo sutrikimai.Tymai – ko gero, plačiausiai skambanti pastaruoju metu tema. Susirgusiųjų skaičius didėja vos ne kiekvieną dieną. Tymai tapo įvairiausių mūsų visuomenės sluoksnių karštų debatų tema. Kas atsitiko? Kodėl liga, kurią įsivaizdavome suvaldę, vėl grįžo į mūsų visuomenę? Aptarkime kertinius faktus apie tymus. Tymai – ūmi, itin užkrečiama virusinė infekcija, plintanti oro lašiniu būdu ir pasireiškianti karščiavimu, katariniais reiškiniais, bėrimu. Palyginti neseniai tymai buvo laikomi viena iš „privalomų“ vaikų infekcinių ligų, nes visi vaikai jais persirgdavo. Tymai buvo ir viena pagrindinių vaikų mirties priežasčių: iki pradedant plataus masto tymų skiepijimo programas, pasaulyje nuo tymų kasmet mirdavo 6–8 mln. sirgusiųjų, 1996 m. nuo tymų mirė apie 1 mln. sirgusiųjų. Pasaulio sveikatos organizacijos (PSO) duomenimis, tymai ir šiandien tebėra pagrindinė mirčių priežastis tarp visų skiepijimais valdomų ligų. Mirtingumas nuo tymų didžiausias besivystančiose šalyse, manoma, kad jose itin sunkią tymų eigą sąlygoja nepalankios gretutinės būklės, tokios kaip prasta mityba, vitaminų stoka, išsekimas, tačiau tymų protrūkių pasitaiko ir išsivysčiusiose šalyse, neišskiriant ir Lietuvos. Pastaraisiais metais įvairiose Europos šalyse registruojami tymų protrūkiai. PSO duomenimis [1], Europos regione tymais sirgo daugiau nei 82,5 tūkst. asmenų. Užkrečiamųjų ligų ir AIDS centro duomenimis [2], per tris mėnesius (2019 m. sausio 1 d.–kovo 29 d.) Lietuvoje iš viso užregistruota 310 susirgimų tymais. Per visus 2018 m. tymais Lietuvoje susirgo 30 žmonių. Vienintele šių protrūkių priežastimi įvardijami skiepijimo sutrikimai

Skiepijimas nuo COVID-19

SARS-CoV-2 virusinė infekcija sukėlė didžiausią mūsų laikų pandemiją. Infekcija, kilusi Kinijoje, greitai paplito visuose žemynuose. Per kiek daugiau nei metus pasaulyje užregistruota beveik pusantro šimto milijonų susirgimų, daugiau nei trys milijonai žmonių nuo šios infekcijos mirė. XXI amžiaus pradžioje didžiavomės suvaldytomis infekcijomis, tačiau SARS-CoV-2 virusinė infekcija, sukelianti COVID-19 ligą, privertė žmoniją peržiūrėti daug mūsų visuomenės gyvenimo aspektų, prisiminti pagrindinius epidemiologijos ir infekcijų kontrolės dėsnius, juos taikyti didžiausiu mastu.SARS-CoV-2 virusinė infekcija sukėlė didžiausią mūsų laikų pandemiją. Infekcija, kilusi Kinijoje, greitai paplito visuose žemynuose. Per kiek daugiau nei metus pasaulyje užregistruota beveik pusantro šimto milijonų susirgimų, daugiau nei trys milijonai žmonių nuo šios infekcijos mirė. XXI amžiaus pradžioje didžiavomės suvaldytomis infekcijomis, tačiau SARS-CoV-2 virusinė infekcija, sukelianti COVID-19 ligą, privertė žmoniją peržiūrėti daug mūsų visuomenės gyvenimo aspektų, prisiminti pagrindinius epidemiologijos ir infekcijų kontrolės dėsnius, juos taikyti didžiausiu mastu