Detection Of Pathological Changes Research Articles

Efficiency of machine learning algorithms and convolutional neural network for detection of pathological changes in MR images of the brain

We compare approaches for the automatic detection of pathological changes in brain MRI images that are visible to the naked eye. We analyse multi-stage approaches based on deep learning and threshold processing. A convolutional neural network was formed, a classifier was built based on the use of an ensemble of decision trees, and an algorithm was created for multi-stage image processing. Because of experimental studies, it was found that the most effective method for recognizing images of magnetic resonance imaging is an approach based on an ensemble of decision trees. With its help, 95 % of the images from the test sample were classified correctly. At the same time, using the convolutional neural network, it was possible to classify correctly all images containing the area of pathological changes. The data obtained can be used in practice for the diagnosis of brain diseases, for automating the processing of a large number of studies of magnetic resonance imaging.

Value of magnetic resonance enterography in diagnosis and treatment follow up in Crohn’s disease in children

PurposeCrohn’s disease (CD) is a chronic inflammatory disease which can affect all parts of the gastrointestinal tract. Magnetic resonance enterography (MRE) enables detection of pathologic changes in the small intestine, which are not accessible by conventional endoscopy. The aim of the study was to assess the value of MRE in imaging of small bowel lesions, their location and extent, in CD patients and its correlation with clinical and endoscopic activity. Materials and methodsMRE was performed in 108 children with CD, aged 5.5 to 18 years. The diagnosis was based on the Porto criteria. Location and clinical manifestation was evaluated according to the Paris classification. Clinical CD activity was assessed with PCDAI and endoscopic activity with SES-CD. In 36 children, control MRE was performed. ResultsThe most common endoscopic location of the disease was the colon (41.7%), terminal ileum and colon (24.1%). Inflammation as the main clinical manifestation was dominant (81.5%). In MRE, inflammatory changes were found in 40.8% of children, strictures in 11.1%. The EIA value (activity in MRE) increased along with PCDAI score and SES-CD. MRE performed during follow up, showed transmural healing in 16.7% of patients and improvement in 55.5%. ConclusionsMRE is an efficient diagnostic tool in proper characterization of disease location in pediatric CD. As positive correlation of the results of MRE with the endoscopic and clinical activity has been found, taking into account good tolerance and non-invasiveness of the procedure it can be recommended to be used in reassessment.

OCT-Diagnostik beim Glaukom: Tipps & Tricks

High-resolution optical coherence tomography (OCT) with spectral-domain or swept-source techniques has become a mainstay in glaucoma and progression diagnosis. Imaging and morphometry of ganglion cell (GCL) and retinal nerve fiber (RNF) layer thickness and Bruch's membrane based minimum neuroretinal rim width (BMO-MRW) measurement allow the detection of pathologic changes. Graphic display of these measurements facilitate a comparison with normative data. False positive (red disease) and false negative (green disease) results represent pitfalls in OCT diagnosis. Pathologies of the posterior pole either caused by glaucoma or non-glaucoma associated changes of optic disc and retina play an important role. Epiretinal gliosis, age related macular degeneration and cystoid retinal changes cause measuring artefacts. A careful inspection of OCT B-scans is mandatory to detect these changes. Highly myopic eyes, underrepresented in normative databases cause changes resembling glaucoma and challenge the OCT glaucoma diagnosis. Neurological diseases present an important differential diagnosis when atrophy of neuroretinal tissue and ganglion cells occur. The location of the atrophy and the relationship of GCL, RNF and BMO-MRW changes may help in differential diagnosis. Sensory tests and imaging of the brain are mandatory in these cases. Drusen and disc edema cause thickening of BMO-MRW and may be followed by loss of RNF and GCL. Again a close observation of OCT B-scans and fundus may help to find the correct diagnosis. Good image quality, knowledge of OCT pathologies and technique of OCT imaging may help to avoid pitfalls in OCT glaucoma diagnosis.

Agreement between cone-beam computed tomography and functional endoscopic sinus surgery for detection of pathologies and anatomical variations of the paranasal sinuses in chronic rhinosinusitis patients: A prospective study.

PurposeThe diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS).Materials and MethodsThis descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans.ResultsSignificant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%).ConclusionConsidering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.

ДОСЛІДЖЕННЯ ВПЛИВУ ПАРАМЕТРІВ ТПД НА ЕКГ СИГНАЛИ У СТАНДАРТНИХ ВІДВЕДЕННЯХ

For many years, coronary heart disease has remained the leading cause of death in the world. Electrocardiography is a common and cost-effective method for assessing the state of the cardiovascular system, but, unfortunately, routine electrocardiography does not have sufficient sensitivity and specificity to solve modern problems. Therefore, there is a question of developing models and methods for evaluating the ECG signal, which would increase the effectiveness of electrocardiographic studies for early detection of pathological changes. Using the interactive ECGSim program, changes in the node on the anterior surface of the heart were modeled by changing the main characteristics of the transmembrane action potential by ±5 and ±10 percent: the resting potential, amplitude, time of depolarization and repolarization, and the slope of the curve in the "plateau" and repolarization phases. Two indicators are proposed to evaluate the differences between the obtained curves and the ECG curves of the conditional norm: one of them indicates the trend of changes, and the second one uses absolute values and more clearly demonstrates the degree of severity of changes. The results obtained correspond to electrophysiological indicators, which indicates the validity of the proposed indicators for measuring the distances between the adapted and reference ECG curves.

Effects of thalidomide on Th17, Treg cells and TGF‐β1/Smad3 pathway in a mouse model of systemic sclerosis

To evaluate the immune regulatory and anti-fibrosis function of thalidomide (Thal) in systemic sclerosis (SSc), we investigated the effects of Thal on: (a) Th17 and Treg cell production; (b) related factors expression; and (c) transforming growth factor (TGF)-β1/Smad3 pathway, using a mouse model of SSc. Forty female BALB/c mice were randomly divided into a normal control (NC) group, SSc group (bleomycin [BLM]-induced experimental SSc), BLM+Thal (10mg/kg/day) group, BLM+Thal (20) group, and BLM+Thal (30) group. Thal was administered a day after BLM. At the end of the animal experiments, mouse tissues were collected for detection of pathological changes and hydroxyproline content. Flow cytometry, real-time polymerase chain reaction, enzyme-linked immunosorbent assay, immunohistochemistry, Western blot and other methods were used to measure Th17, Treg cell population and their related factors, as well as TGF-β1/Smad3 pathway expression. Thal treatment: (a) reduced skin, and pulmonary tissue fibrosis, inflammation score, and hydroxyproline content (P<.001) in BLM-induced SSc mice; (b) reduced the percentages of Th17 cells and associated interleukin (IL)-17A expression (both P<.05) but increased the percentages of Treg cells and its transcription factor Foxp3 expression (both P<.05); (c) correlation analysis found positive correlations between Th17/Treg ratio, the inflammatory score of the skin and pulmonary tissues, hydroxyproline content, and type I collagen messenger RNA expression (r=.8546, .8656, .6902, .6807, .8118, and .8424, respectively, P<.01); (d) Thal inhibited TGF-β1 expression and Smad3 phosphorylation (both P<.05); (e) TGF-β1 was positively correlated with the IL-17A and Th17/Treg ratio (r=.5856, P=.005; r=.6684, P=.0107, respectively). Thal can effectively prevent skin and pulmonary tissue fibrosis in a mouse model of SSc through the TGF-β1/Smad3 signaling pathway and can rectify the distortion of the Th17/Treg balance in SSc by potentially regulating Th17 and Treg cell production, as well as their related factors expression.

Retinal findings in pediatric patients with Usher syndrome Type 1 due to mutations in MYO7A gene.

To describe retinal alterations detected by swept-source optical coherence tomography (SS-OCT) in paediatric patients with Usher syndrome type 1 (USH1) and to compare these findings to previously published reports. Thirty-two eyes from 16 patients (11 males and 5 females) with a genetic diagnosis of USH1 because of MYO7A mutations underwent SS-OCT. Patients ranged in age from 4 to 17 years (mean, 11,13 ± 4,29). The subfoveal and macular area were analysed with SS-OCT at 1050 nm using 12 radial scans of 12.0 mm. Structural abnormalities were evaluated and correlated with best-corrected visual acuity (BCVA). The most common qualitative retinal abnormality was external layer damage in macular area. Specific alterations included external limiting membrane loss/disruption (27 eyes; 84.4%), disruption of the Myoid zone (27 eyes; 84.4%); Ellipsoid zone disruption (28 eyes; 87.5%), and loss of the outer segments (29 eyes; 90.6%). The damage of the retinal pigment epithelium was divided according to the loss of the different layers: phagosome zone (30 eyes; 93.8%), melanosome zone (29 eyes; 90.6%) and mitochondria zone (0 eyes; 0%). The presence of cystoid macular oedema (CMO) was significantly correlated with alterations in photoreceptors. Disruption or absence of the myoid and ellipsoid zones of the photoreceptors were the only variables independently associated with decreased BCVA. The findings of this study suggest that the physiopathologic basis of early-stage Usher syndrome (USH) may be changes in the outer retinal layer, particularly the photoreceptors, which in turn may cause alterations-such as CMO-in the inner retinal layers. Accordingly, monitoring the condition of photoreceptors during follow-up may be advisable for the early detection of pathologic changes.

Effect and mechanism of citral against methicillin-resistant Staphylococcus aureus in vivo.

Citral is an active component of many plant extracts, and it is a safe additive used in food and cosmetics. A previous study showed that citral has a good antibacterial effect against methicillin-resistant Staphylococcus aureus (MRSA) in vitro, but its in vivo anti-infective activity has not been studied. Anti-MRSA activity and the preliminary mechanism of citral against MRSA were investigated in MRSA-infected KM mice. The ED50 was calculated using Karber's method. Groups were selected for inflammatory and oxidative stress level tests, and lung and liver tissues were counterstained with HE for detection of pathological changes. Cytokines and oxidative factors were evaluated using the ELISA method (one-way ANOVA computed using SPSS 19.0.). With the increase in the concentration of citral, the survival rate of MRSA-infected mice increased accordingly. The ED50 values of citral for intramuscular injection and intragastric administration were 0.09 and 0.26 g kg-1 respectively. Citral significantly reduced cytokines (IL-1β, IL-6, TNF-α) and oxidative factors (malondialdehyde and hydroxyl radicals) of MRSA-infected mice, whereas it increased gluthtione and superoxide dismutase levels. Citral can reduce the lung inflammatory infiltrates infected by MRSA. Citral exerted a dose-dependent anti-MRSA effect and ameliorated MRSA-induced abnormal changes in inflammation and oxidative stress. This indicates that citral has the potential for development as a new anti-MRSA drug. © 2019 Society of Chemical Industry.

COMORBIDITIES IN PATIENTS WITH MIASTENIA GRAVIS

The purpose of this work was to study comorbid conditions in patients with myasthenia gravis. Materials and methods: 182 patients with myasthenia gravis aged from 18 to 83 were examined. 147 (80.8%) of then were diagnosed to have generalized form of myasthenia and 35 (19.2%) had ocular form myasthenia. Clinical and neurological examination included present complaints, past medical history, social history, neurological examination. To evaluate the clinical form of myasthenia, the MGFA classification was used. For data processing, the methods of parametric and non-parametric statistics were applied. Among the patients there were 128 (70.3%) women and 54 (29.7%) men, the women to men ration was 2.37: 1. Median age was 52.0 (34.0; 65.0) years. The proportion of patients who, in their routine practice, had CT or MRI of the anterior mediastinal system, made up 74.2% of the total sample and did not differ significantly depending on the form, class or subclass of myasthenia.&#x0D; Results: Among patients with the class I of myasthenia gravis, there were no individuals who had thymoma and/or thymectomy, unlike the patients with generalized myasthenia. A significant proportion of thymic and/or thymectomy was recorded in patients with class II (28.9% and 25.0% respectively). The proportion of thymoma and thymectomy in the patients significantly differed based on the myasthenia form (significantly more in patients with generalized form compared to those with ocular form, p = 0.003 and p = 0.009, respectively). The proportion of thymoma and thymectomy history significantly differed among patients with different classes of generalized myasthenia (class II-IV (p = 0.008 and p = 0.018 respectively) and their subclasses (p = 0.006 and p = 0.009, respectively), while they were registered in each class and subclass of generalized myasthenia.&#x0D; Attention should be paid to the fact that the proportion of thymoma in the general sample was greater than the proportion of thymectomy (19.2% versus 15.9%). This suggests an inadequate level of surgical care for myasthenia patients, even to those who are shown with such treatment (patients with thymoma).&#x0D; The proportion of autoimmune diseases among patients with myasthenia class I (ocular form) significantly exceeded the corresponding level in patients with generalized myasthenia - 45.7% vs. 15.0% (p &lt;0.001).&#x0D; The incidence of total concomitant pathology among all patients was 130.8% (95.0% CI 121.6-140.0%) and was slightly higher in the generalized form of myasthenia (134.7% (95.0% CI 123.6 -145.7%)) compared with the ocular form - 114.3% (95.0% CI 100.9-127.7%), p&gt; 0.05.&#x0D; One patient had from 0 to 6 concomitant diseases, on the average of 1.0 (0; 2.0) by the median value.&#x0D; Cardiovascular diseases, 34.1% (95% CI 27.2 - 41.0), rank the first place in the frequency of the concomitant diseases among the examined patients. The diseases of the gastrointestinal tract (namely, gastritis, ulcers of the stomach and duodenum, chronic holistic, chronic pancreatitis at the stage of remission, etc.) and autoimmune thyroiditis (20.9% (95% CI 15, 0-26.8) have the second highest rate, eye diseases (not related to the myasthenia) are (15.9% (95% CI 10.6 - 21.3)) ranked the third.&#x0D; No differences in the incidence of concomitant pathology, apart from autoimmune diseases, between forms, classes and subclasses of myasthenia were detected (p&gt; 0.05).&#x0D; Conclusions. The proportion of visualization of the anterior mediastinum in patients with myasthenia gravis is far from being sufficient. This test is supposed to be done for absolutely all patients with myasthenia gravis for early detection of pathological changes of thymus. In the structure of the comorbidities in patients with myasthenia gravis cardiovascular, gastrointestinal and autoimmune thyroiditis have been found out to prevail. This should be taken into account when selecting treatment. Autoimmune thyroiditis was recorded in 45.7% of patients with ocular and in 20.9% of patients with generalized myasthenia that may indicate a systemic autoimmune disorder whose causative relationships require further in-depth study.

High-resolution computed tomography findings in young infants with cystic fibrosis detected by newborn screening

OBJECTIVE:High-resolution computed tomography (HRCT) allows the early detection of pathological changes in the lung structure, and reproducible scoring systems can be used to quantify chest computed tomography (CT) findings in patients with cystic fibrosis (CF). The aim of the study was to describe early HRCT findings according to a validated scoring system in infants with CF diagnosed by newborn screening (NBS).METHODS:This cross-sectional study included infants with CF diagnosed by NBS who were born between January 2013 and January 2017 and who underwent HRCT scanning within the first year after diagnosis when they were clinically stable. The CT scans were evaluated using the modified Bhalla score.RESULTS:Thirty-two subjects underwent HRCT scanning. The mean total-modified Bhalla score was 3.6±2.1, and 93.8% of the scans were abnormal. Pseudomonas aeruginosa airway colonization was associated with increased modified Bhalla score values. Bronchial wall thickening was the most common feature (90.6%), followed by bronchial collapse/consolidation (59.4%), mosaic attenuation/perfusion (50%), bronchiectasis (37.5%) and mucus plugging (15.6%). Bronchial wall thickening was diffuse in most of the patients.CONCLUSION:A substantial proportion of infants diagnosed with CF after detection by NBS already showed evidence of lung disease. P. aeruginosa colonization was associated with increased Bhalla scores, highlighting the importance of this CF pathogen in early structural lung disease. The presence of bronchial wall thickening at such a young age may reflect the presence of airway inflammatory processes. The detection and quantification of structural abnormalities with the modified Bhalla score may aid in the identification of lung disease before it is clinically apparent.

RISK ASSESSMENT FOR EXPERIMENTAL WASTE CONDEMNATION FROM CHICKEN CHALLENGED WITH VARIANT IB VIRAL STRAIN

infectious bronchitis virus is an acute and economically important viral disease of chickens. IB is a member of the Coronaviridae family it is an acute disease of respiratory and urogenital tract of chickens. Some IBV strains can cause acute nephritis and urolithiasis associated with the high mortality rate in chickens; considering (IBV) which can affect avian and represent a risk for public health, classified as risk group 2. This study, take place in isolators to detect of experimental waste condemnation after challenge variant IB strain in 3 weeks specific pathogen-free vaccinated birds and non-vaccinated control. Samples (kidneys and lungs) were collected for the detection of pathological changes. No Histopathological lesions were observed, nor virus was detected in the following challenge. This work was designed to apply biosecurity and biosafety parameter which including biological waste decontamination and disinfection in order to judge about any residual living virus after challenge test

Role of magnetic resonance imaging as a diagnostic tool in evaluation of painful hip joint, and early detection of pathological changes, helpful to prognosticate and influence therapeutic decisions

Background: Magnetic Resonance Imaging (MRI) is a well-established imaging technique, which are available at most larger hospitals today. Due to the combination of this high contrast and the fact that it is a non-ionizing radiation, MRI is often used for investigation of a large range of pathologies in almost all parts of the body. This study was performed to describe the MRI features in various types of lesions causing painful hip joint, as well as identify the common lesions seen in painful hip joint and to analyse the severity and extent of the underlying lesion in various conditions of hip joint pain, and early detection of pathological changes helpful to prognosticate and influence therapeutic decisions.Methods: This descriptive study was done on 50 patients with complaints of hip joint pain were included into the study. Appropriate MRI sequences and multi-planar imaging performed for every patient.Results: Out of the 50 patients included in the study, 74% of them were males who were predominantly affected with hip pain. The most common age group which was affected was 51-60 years (20%) and 21-30 years (20%). The most common pathology amongst the patients was Avascular necrosis of femoral head seen in 44% of the patients, osteoarthritis was seen in 54 patients, Tuberculosis in 5 patients, 2 had Perthe’s disease, joint effusion was observed in 6 patients.Conclusions: MRI of the hip joint is an informative, diagnostic, non-invasive, rapid and accurate imaging modality for the assessment of hip pain and sufficient imaging modality for delineation of different hip joint pathology.

Time-resolved quantitative inter-eye comparison of cardiac cycle-induced blood volume changes in the human retina.

We describe a low-cost, easy to use binocular instrument to acquire retinal video sequences of both eyes simultaneously. After image registration, cardiac cycle-induced pulsatile light attenuation changes can be measured quantitatively with high spatial and temporal resolution. Parameters such as amplitude, pulse form, and time shift between light attenuation changes can be calculated and compared between eye sides. Deviation from inter-eye symmetry can be not only an early sign of beginning eye diseases such as glaucoma but also a sign of pathological changes in the carotid arteries; hence, this method can improve the early detection of pathological changes. Important features compared to existing monocular instruments are a narrow band light source with the wavelength close to the peak of the blood extinction, and a proportional relationship of image intensity and light intensity, which are the main requirements for quantitative evaluation.

Regulation of the IL-33/ST2 pathway contributes to the anti-inflammatory effect of acupuncture in the ovalbumin-induced murine asthma model.

Bronchial asthma is a chronic airway inflammatory disease which has three main pathological features: airway hyperresponsiveness (AHR), airway remodelling, and chronic inflammation. Acupuncture is known to be an effective integrative medical therapy that has been used in the treatment of several chronic diseases, including bronchial asthma. The aim of the current study was to evaluate the effects of acupuncture on inflammation and regulation of the IL-33/ST2 pathway in a mouse model of asthma. The murine asthma model was established by both injection and inhalation of ovalbumin (OVA). Within 24 hours of the last OVA challenge, lung function was assessed by measurement of the airway resistance (RL) and lung dynamic compliance (Cdyn). Pulmonary tissues were collected for the detection of pathological changes and mucus secretion. Serum levels of tumour necrosis factor α (TNF-α), interleukin (IL)-1β, IL-33 and sST2 (secreted ST2) were detected by ELISA. Th17 cell proportions and counts in bronchoalveolar lavage fluid (BALF) were analysed by flow cytometry. The results showed that AHR, chronic inflammation and mucus secretion were significantly suppressed by acupuncture treatment. RL decreased while Cdyn increased after acupuncture treatment. There was an apparent decrease in the serum concentrations of certain pro-inflammatory cytokines, such as TNF-α, IL-1β and IL-33, and an increase in sST2 level compared with untreated asthmatic mice. Acupuncture also reduced the CD4 +IL-17A+ cell proportion and counts in BALF. Acupuncture effectively protects lung function and attenuates airway inflammation in the OVA-induced mouse model of asthma, which supports the role of acupuncture as a potential therapy in asthma treatment.

Остеотропный диагностический радио­фармацевтический лекарственный препарат на основе золедроновой кислоты «Резоскан, 99mTс». Предварительные результаты сравнительных клинических исследований

Purpose: Clinical trials involving study of functions, assessment of drug and radiation safety of the radiopharmaceutical drug “Rezoscan, 99mTc” in comparison with the “Technefor, 99mTc”.&#x0D; Material and methods: Clinical studies of RP “Rezoscan, 99mTc” were carried out using a diagnostic gamma camera Toshiba. The study involved 25 patients: 2 patients diagnosed with prostate cancer, 3 patients diagnosed with cervical cancer, 15 patients diagnosed with breast cancer and 5 patients diagnosed with coronary artery disease without cancer, who underwent osteoscintigraphy to identify osteoporosis foci and who signed an informed consent to participate in the study. To study the functional properties of RP “Rezoscan, 99mTc”, we studied its pharmacokinetics and evaluated the quality of visualization of pathological foci in bone tissue. To assess drug safety the patient was monitored for 15 days with an assessment of acute and delayed reactions to intravenous administration. Radiation safety of the RP was estimated using values of absorbed radiation doses of organs and effective doses to patients [1]. To the same patients the radiopharmaceutical preparations “Rezoscan, 99mTc” and “Technefor, 99mTc” were injected sequentially in one day.&#x0D; Results: According to the pharmacokinetics study, the accumulation of RP “Rezoscan, 99mTc” in the skeleton in 2 hours reaches 40 % of the administered amount. At the same time, a relatively rapid excretion of the drug from the soft tissues takes place, which makes it possible to clearly visualize the condition of the bone system and to reveal pathological changes with coefficients of differential accumulation (CDA) bone/soft tissues of about 10. Comparative studies of the functional characteristics of RP “Rezoscan, 99mTc” and “Technefor, 99mTc” showed the advantage of the new drug in the early detection of pathological changes in bone tissue with the metastatic skeletal lesion. In all cases in the study with RP “Rezoscan, 99mTc”on scintigrams in 15 patients with a verified diagnosis of breast cancer, the pathological foci of hyperfixation RP, which are typical for metastatic bone lesions, were visualized. In the same patients, examined with the help of the RP “Technefor, 99mTc”, pathological foci in the skeleton were visualized only in 13 cases.&#x0D; According to the results of studies of patients with RP “Rezoscan, 99mTc” accuracy was 0.8, sensitivity – 0.9, specificity – 0.6. According to the study of patients of the same group with RP “Technefor, 99mTc” defined: the accuracy is 0.8, sensitivity – 0.8 and specificity – 0.4.&#x0D; Based on the results of monitoring the condition of patients for 15 days, acute and delayed reactions to intravenous administration of the drug were not detected. The estimate of the absorbed radiation dose values of RP “Rezoscan, 99mTc” in organs and tissues of patients, as well as effective doses of irradiation allow us to suggest that the introduced RP activity and patient dose do not go beyond the previously established reference levels.&#x0D; Conclusions: The radiopharmaceutical “Rezoscan, 99mTc” can be used for the early detection of pathological foci of bone tissue.

Retinal thinning associates with nigral dopaminergic loss in de novo Parkinson disease

To analyze the relationship between retinal thinning and nigral dopaminergic loss in de novo Parkinson disease (PD). Forty-nine patients with PD and 54 age-matched controls were analyzed. Ophthalmologic examination and macula optical coherence tomography scans were performed with additional microperimetry, N-(3-[18F]fluoropropyl)-2-carbomethoxy-3-(4-iodophenyl) nortropane PET, and 3T MRI scans were done in patients with PD only. Retinal layer thickness and volume were measured in subfields of the 1-, 2.22-, and 3.45-mm Early Treatment of Diabetic Retinopathy Study circle and compared in patients with PD and controls. Correlation of inner retinal layer thinning with microperimetric response was examined in patients with PD, and the relationships between retinal layer thickness and dopamine transporter densities in the ipsilateral caudate, anterior and posterior putamen, and substantia nigra were analyzed. Retinal layer thinning was observed in the temporal and inferior 2.22-mm sectors (false discovery rate-adjusted p < 0.05) of drug-naive patients with PD, particularly the inner plexiform and ganglion cell layers. The thickness of these layers in the inferior 2.22-mm sector showed a negative correlation with the Hoehn and Yahr stage (p = 0.032 and 0.014, respectively). There was positive correlation between macular sensitivity and retinal layer thickness in all 3.45-mm sectors, the superior 2.22-mm sector, and 1-mm circle (p < 0.05 for all). There was an association between retinal thinning and dopaminergic loss in the left substantia nigra (false discovery rate-adjusted p < 0.001). Retinal thinning is present in the early stages of PD, correlates with disease severity, and may be linked to nigral dopaminergic degeneration. Retinal imaging may be useful for detection of pathologic changes occurring in early PD.

Disturbances in intraventricular conduction in children with end-stage renal disease on peritoneal dialysis: A pilot study

The progression of chronic kidney disease is accompanied by multi-organ disorders, among which cardiovascular diseases have the status of a serious clinical problem. The body surface potential mapping (BSPM) technique is a non-invasive method which enables the detection of pathological changes in the bioelectrical activity of the heart. The aim of this study was to identify possible disturbances in the intraventricular conduction system in peritoneally dialyzed children. Cardiac examination consisted of 12-lead electrocardiography, echocardiography and BSPM. The evaluation of disturbances in the cardio-electrical field was performed by comparing the qualitative and quantitative features of the heart potentials on the isopotential map. Data was collected from 10 children treated with automatic peritoneal dialysis (APD) (mean age: 13.6 ±2.3 years) and 26 healthy children. The maps of dialyzed children showed a shift in positive isopotentials toward the left lower part of the thorax, while negative values were observed in its left upper part. A distribution of lines on the isopotential maps revealed disturbances in the stimulation spread within the heart ventricles, especially within the anterior fascicle of the left bundle branch of His. Intraventricular conduction disturbances were observed in the left bundle branch of His in the peritoneally dialyzed children. The body surface potential mapping was a more sensitive method in identifying the early stage of conduction disturbances within the heart ventricles than 12-lead electrocardiography. Further research involving a larger population of dialyzed children is planned.

Imaging of temporomandibular joint abnormalities in juvenile idiopathic arthritis with a focus on developing a magnetic resonance imaging protocol.

Inflammation and damage in the temporomandibular joint (TMJ) often develop without clinical symptoms but can lead to severe facial growth abnormalities and impaired health-related quality of life, making early diagnosis of TMJ changes crucial to identify. Inflammatory and osteochondral changes detectable through magnetic resonance imaging (MRI) occur in TMJs of approximately 40% of children with juvenile idiopathic arthritis (JIA), and no other imaging modality or physical method of examination can reliably detect these changes. Therefore contrast-enhanced MRI is the diagnostic standard for diagnosis and interval monitoring of JIA. However the specific usage of MRI for TMJ arthritis is not standardized at present. There is a recognized need for a consensus effort toward standardization of an imaging protocol with required and optional sequences to improve detection of pathological changes and shorten study time. Such a consensus imaging protocol is important for providing maximum information with minimally necessary sequences in a way that allows inter-site comparison of results of clinical trials and improved clinical management. In this paper we describe the challenges of TMJ imaging and present expert-panel consensus suggestions for a standardized TMJ MRI protocol.

Oxycodone is safe and effective for general anesthesia.

In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0.075 mg/kg during induction and 0.05 mg/kg during maintenance). The use of oxycodone during general anesthesia and the postoperative pain scores were recorded. Safety was evaluated by the measurement of hemodynamic changes (blood pressure, heart rate), the detection of pathologic changes in the electrocardiogram, changes of the peripheral oxygen saturation, and by the assessment of adverse effects. There was no significant change in peripheral oxygen saturation or the electrocardiogram during or while recovering from general anesthesia. Heart rate changed only slightly from reversal to recovery (73.3/min versus 78.3/min, p < 0.05) and from prior intubation to recovery (72.5/min versus 78.3/min, p < 0.05). Systolic and diastolic blood pressure did not change significantly from the time points "after intubation" to "after incision," and "during recovery." Fifty-nine percent (n = 49) of patients' records revealed pain scores with a maximum of 3 on a numeric rating scale (NRS) of 0 to10 during the postoperative period. In 45 percent of patients (n = 37), further analgesics such as acetaminophen, dipyrone, or additional doses of oxycodone were used. No severe adverse events were recorded. According to data from 93 percent of patients (n = 77), nausea scores were less than 3 on a NRS of 0 to 10. Oxycodone can be used as the sole opioid in orthopedic surgery with good intra- and postoperative efficacy and safety; ie, without clinically relevant changes in hemodynamic and respiratory parameters.

Oxycodone is safe and effective for general anesthesia.

In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0.075 mg/kg during induction and 0.05 mg/kg during maintenance). The use of oxycodone during general anesthesia and the postoperative pain scores were recorded. Safety was evaluated by the measurement of hemodynamic changes (blood pressure, heart rate), the detection of pathologic changes in the electrocardiogram, changes of the peripheral oxygen saturation, and by the assessment of adverse effects. There was no significant change in peripheral oxygen saturation or the electrocardiogram during or while recovering from general anesthesia. Heart rate changed only slightly from reversal to recovery (73.3/min versus 78.3/min, p < 0.05) and from prior intubation to recovery (72.5/min versus 78.3/min, p < 0.05). Systolic and diastolic blood pressure did not change significantly from the time points "after intubation" to "after incision," and "during recovery." Fifty-nine percent (n = 49) of patients' records revealed pain scores with a maximum of 3 on a numeric rating scale (NRS) of 0 to10 during the postoperative period. In 45 percent of patients (n = 37), further analgesics such as acetaminophen, dipyrone, or additional doses of oxycodone were used. No severe adverse events were recorded. According to data from 93 percent of patients (n = 77), nausea scores were less than 3 on a NRS of 0 to 10. Oxycodone can be used as the sole opioid in orthopedic surgery with good intra- and postoperative efficacy and safety; ie, without clinically relevant changes in hemodynamic and respiratory parameters.