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International Journal of Gynaecology... Aug 2023
Topics: Pregnancy; Female; Humans; Cicatrix; Pregnancy, Ectopic; Hysteroscopy; Laparoscopy
PubMed: 37269103
DOI: 10.1002/ijgo.14900 -
Diagnostics (Basel, Switzerland) Sep 2023Convolutional neural network (CNN) models have been extensively applied to skin lesions segmentation due to their information discrimination capabilities. However, CNNs'...
Convolutional neural network (CNN) models have been extensively applied to skin lesions segmentation due to their information discrimination capabilities. However, CNNs' struggle to capture the connection between long-range contexts when extracting deep semantic features from lesion images, resulting in a semantic gap that causes segmentation distortion in skin lesions. Therefore, detecting the presence of differential structures such as pigment networks, globules, streaks, negative networks, and milia-like cysts becomes difficult. To resolve these issues, we have proposed an approach based on semantic-based segmentation (Dermo-Seg) to detect differential structures of lesions using a UNet model with a transfer-learning-based ResNet-50 architecture and a hybrid loss function. The Dermo-Seg model uses ResNet-50 backbone architecture as an encoder in the UNet model. We have applied a combination of focal Tversky loss and IOU loss functions to handle the dataset's highly imbalanced class ratio. The obtained results prove that the intended model performs well compared to the existing models. The dataset was acquired from various sources, such as ISIC18, ISBI17, and HAM10000, to evaluate the Dermo-Seg model. We have dealt with the data imbalance present within each class at the pixel level using our hybrid loss function. The proposed model achieves a mean IOU score of 0.53 for streaks, 0.67 for pigment networks, 0.66 for globules, 0.58 for negative networks, and 0.53 for milia-like-cysts. Overall, the Dermo-Seg model is efficient in detecting different skin lesion structures and achieved 96.4% on the IOU index. Our Dermo-Seg system improves the IOU index compared to the most recent network.
PubMed: 37761291
DOI: 10.3390/diagnostics13182924 -
International Journal of Dermatology Jun 2024
PubMed: 38859641
DOI: 10.1111/ijd.17264 -
International Journal of Environmental... Jan 2024Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and...
Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.
Topics: Male; Humans; Adolescent; Female; Prevalence; Alcoholism; Alcohol Drinking; Early Intervention, Educational; Feeding and Eating Disorders
PubMed: 38248546
DOI: 10.3390/ijerph21010083 -
The Indian Journal of Tuberculosis Oct 2023Tuberculosis continues to be a major public health concern worldwide with almost 20-40% of the world's population being affected yearly. Cutaneous Tuberculosis (TB) is a...
Tuberculosis continues to be a major public health concern worldwide with almost 20-40% of the world's population being affected yearly. Cutaneous Tuberculosis (TB) is a rare and underdiagnosed entity that manifests in about 1-1.5% of extrapulmonary tuberculosis cases worldwide. Dermoscopy is a non-invasive tool which will be a useful aid to histopathology in the confirmation of the diagnosis alongside culture, and molecular techniques. This is a cross-sectional descriptive study that was conducted at a tertiary care center in Mumbai, India. A total of 31 patients were enrolled in this study; 14 males and 17 females. The mean duration of disease was 4.3 months and the average age was 31 years. There were 10 cases of lupus vulgaris, 7 scrofuloderma, 5 papulonecrotic tuberculid (PNT), 3 tuberculosis verrucosa cutis (TBVC), and 2 cases each of erythema induratum of Bazin, lichen scrofulosorum and resolved lupus vulgaris. All the lesions demonstrated orange yellow background suggestive of dermal granuloma. Other key dermoscopic features noted include yellowish-white scales, patulous follicles, white structureless areas, milia-like cysts, white streaks, pigment globules, hairpin and linear vessels. Newer findings such as the crown of vessels and perifollicular pallor in lichen scrofulosorum, and radiating white streaks in PNT were also noted. Dermoscopy of infective granulomas such as cutaneous tuberculosis is a less explored field of dermatology. Newer dermoscopic features of each clinical variant of cutaneous TB have been described.
Topics: Male; Female; Humans; Adult; Tuberculosis, Cutaneous; Lupus Vulgaris; Cross-Sectional Studies; India
PubMed: 37968058
DOI: 10.1016/j.ijtb.2023.05.020 -
Injury May 2024Traumatic rib fracture is associated with a high morbidity rate and identifying patients at risk of developing pulmonary complications (PC) can guide management and...
BACKGROUND
Traumatic rib fracture is associated with a high morbidity rate and identifying patients at risk of developing pulmonary complications (PC) can guide management and potentially decrease unnecessary intensive care admissions. Therefore, we sought to assess and compare the utility of a physiologic parameter, vital capacity (VC), with the admission radiologic findings (RibScore) in predicting PC in patients with rib fractures.
METHODS
This is a single-center retrospective review (2015-2018) of all adult (≥18 years) patients admitted to a Level I trauma center with traumatic rib fracture. Exclusion criteria included no CT scan and absence of VC within 48 h of admission. The cohort was stratified into two groups based on presence or absence of PC (pneumonia, unplanned intubation, unplanned transfer to the intensive care unit for a respiratory concern, or the need for a tracheostomy). Multivariable logistic regression models were constructed to identify predictors of PC.
RESULTS
A total of 654 patients met the inclusion criteria of whom 70 % were males. The median age was 51 years and fall (48 %) was the most common type of injury. A total of 36 patients (5.5 %) developed a pulmonary complication. These patients were more likely to be older, had a higher ISS, and were more likely to require a tube thoracostomy placement. On multivariable logistic regression, first VC ≤30 % (AOR: 4.29), day 1 VC ≤30 % (AOR: 3.61), day 2 VC ≤30 % (AOR: 5.54), Δ(Day2-Day1 VC) (AOR: 0.96), and RibScore ≥2 (AOR: 3.19) were significantly associated with PC. On discrimination analysis, day 2 VC had the highest area under the receiver operating characteristic curve (AuROC), 0.81, and was superior to first VC and day 1 VC in predicting PC. There was no statistically significant difference in predicting PC between day 2 VC and RibScore. On multivariable analysis, first VC ≤30 %, day 1 VC ≤30 %, day 2 VC ≤30 %, and admission RibScore ≥2 were associated with prolonged hospital and ICU LOS.
CONCLUSION
VC and RibScore emerged as independent predictors of PC. However, VC was not found to be superior to RibScore in predicting PC. Further prospective research is warranted to validate the findings of this study.
Topics: Male; Adult; Humans; Middle Aged; Female; Rib Fractures; Pneumonia; Hospitalization; Wounds, Nonpenetrating; ROC Curve; Retrospective Studies
PubMed: 38521636
DOI: 10.1016/j.injury.2024.111508 -
Toxics Sep 2023The evidence linking the use of household pesticides and the risk of lymphoma is scanty.
BACKGROUND
The evidence linking the use of household pesticides and the risk of lymphoma is scanty.
METHODS
We explored the hypothesis in a population-based case-control study on lymphoma conducted in Sardinia, Italy, in 1998-2004, including 325 cases and 465 population controls and data on lifetime frequency, seasonality, and years of use of household insecticides and potential confounders. We calculated the risk of lymphoma (all subtypes) and its major subtypes associated with using household insecticides in three time windows (up to 1978, from 1979-2001, and 2002 onwards) with unconditional logistic regression adjusting by age, sex, education, and occupational exposure to pesticides.
RESULTS
Household insecticides did not increase risk of lymphoma (all subtypes), Hodgkin's lymphoma, B-cell lymphoma, and the major B-cell lymphoma subtypes. The risk of multiple myeloma (MM) but not the other subtypes showed a non-significant upward trend ( = 0.203) with increasing quartiles of days of use in the time window when propoxur was the most popular household insecticide.
CONCLUSIONS
Our results suggest no association between the household use of insecticides and the risk of lymphoma. Further studies are warranted to confirm or discard an association between MM risk and the use of propoxur.
PubMed: 37755762
DOI: 10.3390/toxics11090752 -
Prehospital Emergency Care 2024Early pelvic binder placement in the field stabilizes pelvic fractures and tamponades potential hemorrhage within the pelvis. Despite known risk factors for pelvic... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Early pelvic binder placement in the field stabilizes pelvic fractures and tamponades potential hemorrhage within the pelvis. Despite known risk factors for pelvic fracture, it remains challenging to quickly triage and correctly apply a pelvic binder. We aim to develop a prediction model that exclusively uses prehospital criteria to inform the decision to place a pelvic binder.
METHODS
The trauma registry was used to identify all trauma patients admitted to an urban Level I trauma center between January 2013 and December 2017. Variables collected included patient demographics, mechanism of injury, prehospital vital signs, and the presence of a pelvic fracture. Participants were randomly assigned to a training group (70%) or a validation group (30%). Univariate analyses were used to identify significant predictors for use in multivariate predictive models.
RESULTS
A total of 8,480 (65% male; median age 49; median ISS 9) and 3,676 (65% male; median age 48; median ISS 9) trauma patients were randomly assigned to the training and validation groups, respectively. Univariate analysis showed significant likelihood of pelvic fracture associated with female sex, hemodynamic instability (initial systolic blood pressure < 90 mmHg), blunt injury type, specific mechanisms of injury (motor vehicle collision, motorcycle collision, pedestrian struck by motor vehicle, crushing injury, and riding an animal), impact location, and position in vehicle. Multivariate models adjusting for blunt type injury, hemodynamic instability, impact location, and position in vehicle showed that presence of two or more of these risk factors is significantly associated with presence of pelvic fracture.
CONCLUSION
Establishing select prehospital criteria for the empiric application of pelvic binders for patients in the field with blunt injuries, hemodynamic instability, frontal or side motor vehicle collision impact, and non-front seat passenger may improve outcomes among patients with pelvic fractures.
Topics: Humans; Male; Female; Middle Aged; Emergency Medical Services; Retrospective Studies; Fractures, Bone; Pelvic Bones; Wounds, Nonpenetrating; Vascular Diseases; Injury Severity Score
PubMed: 37171847
DOI: 10.1080/10903127.2023.2213316 -
JAAD Case Reports Jan 2024
PubMed: 38204881
DOI: 10.1016/j.jdcr.2023.10.016 -
Dermatology Practical & Conceptual Jan 2024Pigmented eccrine poroma (PEP) is a unique variant of a benign adnexal tumor known as eccrine poroma. Distinguishing PEPs from other pigmented lesions can be challenging...
INTRODUCTION
Pigmented eccrine poroma (PEP) is a unique variant of a benign adnexal tumor known as eccrine poroma. Distinguishing PEPs from other pigmented lesions can be challenging due to overlapping clinical and dermoscopic features.
OBJECTIVES
To provide a comprehensive analysis of the dermoscopic, confocal (RCM), and histological features of PEPs.
METHODS
We undertook a retrospective study of the clinical, dermoscopic, RCM and histopathological features of PEPs that were surgically excised and histopathologically recognized. Data on epidemiological, clinical, dermoscopic, RCM and histopathological features were collected from the databases of the Skin Cancer Unit, IRCCS Policlinico di Sant' Orsola, between January 2021 and May 2023.
RESULTS
The study population consisted of 61 patients, including 34 females (55.7%) and 27 males (44.3%). Dermoscopic examination of 61 PEPs revealed the presence of irregular borders (55.7%), milia-like cysts (50.8%), brown pseudo-network (41%), cerebriform pattern (34.4%), comedo-like openings (29.5%), atypical vessels (26.2%), glomerular vessels (18%), fingerprint-like perifollicular structures (8.2%), dots (4.9%) and dotted vessels (4.9%). RCM imaging was collected from 11 cases and showed mostly well-defined tumor nests with small cells in 100% of cases, bright structures in the upper dermis representing melanocytes and melanophages (63.6%), dark round spaces within the tumor nests (54.5%), well-demarcated borders of the nest (45.5%) and dilated and prominent vessels in upper dermis (27.3%). Histopathological pattern analysis revealed PEP sensu stricto (PEPss) as the most frequent (54.1%).
CONCLUSIONS
The distinctive dermoscopic patterns, along with the confocal features aid in the differentiation from other pigmented lesions.
PubMed: 38364398
DOI: 10.5826/dpc.1401a88