Organs In Patients Research Articles

Comparative Analysis of Artificial Intelligence (AI) Languages in Predicting Sequential Organ Failure Assessment (SOFA) Scores.

The Sequential Organ Failure Assessment (SOFA) score plays a crucial role in intensive care units (ICUs) by providing a reliable measure of a patient's organ function or extent of failure. However, the precise assessment is time-consuming, and daily assessment in clinical practice in the ICU can be challenging. Realistic scenarios in an ICU setting were created, and the data mining precision of ChatGPT 4.0 Plus, Bard, and Perplexity AI were assessed using Spearman's as well as the intraclass correlation coefficients regarding the accuracy in determining the SOFA score. The strongest correlation was observed between the actual SOFA score and the score calculated by ChatGPT 4.0 Plus (r correlation coefficient 0.92) (p<0.001). In contrast, the correlation between the actual SOFA and that calculated by Bard was moderate(r=0.59, p=0.070), while the correlation with Perplexity AI was substantial, at 0.89, with a p<0.001. The interclass correlation coefficient analysis of SOFA with those of ChatGPT 4.0 Plus, Bard, and Perplexity AI was ICC=0.94. Artificial intelligence (AI) tools, particularly ChatGPT 4.0 Plus, show significant promise in assisting with automated SOFA score calculations via AI data mining in ICU settings. They offer a pathway to reduce the manual workload and increase the efficiency of continuous patient monitoring and assessment. However, further development and validation are necessary to ensure accuracy and reliability in a critical care environment.

IS2aR, a computational tool to transform voxelized reference phantoms into patient-specific whole-body virtual CTs for peripheral dose estimation

BackgroundThe risk of radiogenic cancer induction due to radiotherapy depends on the dose received by the patient's organs. Knowing the position of all organs is needed to assess this dose in a personalized way. However, radiotherapy planning computed tomography (pCT) scans contain truncated patient anatomy, limiting personalized dose evaluation. PurposeTo develop a simple and freely available computational tool that adapts an ICRP reference computational phantom to generate a patient-specific whole-body CT for peripheral dose computations. MethodsVarious bone-segmentation methods were explored onto fifteen pCTs, and the one with the highest Sørensen-Dice coefficient was implemented. The reference phantom is registered to the pCT, obtaining a registration transform matrix, which is then applied to create the whole-body virtual CT. Additional validation involved a comparison of absorbed doses to organs delineated on both the pCT and the virtual CT. ResultsA dedicated graphical user interface was designed and implemented to house the developed functions for i) selecting a registration region on which automatic bone segmentation and rigid registration will occur, ii) displaying the results of these processes under selectable views, and iii) exporting the final patient-specific whole-body CT. This software was termed IS2aR. The tested whole-body virtual CT generated by IS2aR fulfilled our requirements. ConclusionsIS2aR is a user-friendly computational software to create a personalized whole-body CT containing the original structures in the reference phantom. The personalized dose deposited in peripheral organs can be estimated further to assess second cancer induction risk in epidemiological studies.

ANALYSIS OF URINE MICROALBUMIN LEVELS ON SERUM CREATININE IN PATIENTS WITH DIABETES MELLITUS IN THE CLINICAL LABORATORY OF MEDAN PRODIA

Diabetes Mellitus is a degenerative disease that requires regular control. This disease occurs due to the pancreas not being able to produce enough insulin and/or when the body cannot produce insulin effectively so that it can cause various complications in the patient's organs. The purpose of this study was to determine the levels of Urine Microalbumin and Serum Creatinine at Prodia Clinical Laboratory Jl. Lt. Gen. S. Parman No. 17/223 G Medan. This research was conducted from August to October 2022 at the Clinical Laboratory of Prodia Medan. This type of research is descriptive Cross Sectional. This examination uses Immunoturbidimetric and Enzymatic Colorimetric methods with a total sample of 100 samples or the total of the population. The results of the research conducted showed that the number of Diabetes Mellitus patients at the Prodia Clinical Laboratory in Medan with gender as many as 48 men (48%) and 52 women (52%) samples. Normal Urine Microalbumin levels were 30 samples (30%) and High Urine Microalbumin levels were 70 samples (70%). Normal creatinine levels were 47 samples (47%) and abnormal creatinine levels were 53 samples (53%).

Evaluation of the effect of silicone implants in a breast radiotherapy treatment: A Monte Carlo approach

Since 2020, breast cancer is the most common among women, and in South America, Brazil presents the highest rates. After mastectomy and breast reconstruction, commonly silicone breast implants are used to replace the removed breast tissue, and radiation therapy is performed to reduce its recurrence in the remaining tissues and nearby lymph nodes. The Monte Carlo simulation using the MCNP6.2 code accompanied by a female virtual anthropomorphic phantom (FASH3) were utilized to simulate the radiation therapy scenario. These tools were used to determine the absorbed doses in the patient's organs and tissues, evaluating the effect of the breast silicone prosthesis on the dose distribution, applying a dose of 50.4 Gy in a LINAC Varian 2100c with a 6 MV beam. The eye lens and the gonads suffered the highest effects of scattered radiation by the silicone prosthesis, increasing the absorbed dose values by 2.10% and 1.51%, respectively, when compared to normal breast tissue.

Examining the frequency of musculoskeletal manifestations in patients with thyroid dysfunction

Thyroid disorders affect body organs. This study was conducted aiming to examine the frequency of skeletal muscle manifestations in patients with thyroid dysfunction. This descriptive study's statistical population comprised 200 patients with thyroid disorders referred to the endocrinology clinic of Rafsanjan University of Medical Sciences from March 21, 2018, to September 23, 2018, who were included in the study by the census method. The research checklist included information from the complete physical evaluation of each patient's organs and demographic characteristics. Chi-square and Fisher's exact tests were used to analyze the data. The mean age of the examined patients was 39.25 ± 14.43 years. Of the 200 patients, 23 (11.5%) were male and 177 (88.5%) were female. Joint pain was found in 121 people (60.5%), morning stiffness in 45 people (22.5%), limited joint mobility in 44 people (22.0%), adhesive capsulitis in 25 people (12.5%), carpal tunnel syndrome in 24 people (0.12%), trigger finger disorder in 20 people (10.0%), and two patients (1.0%) experienced tarsal tunnel. No musculoskeletal manifestations were reported in 74 individuals (0.37%) with thyroid disorders. There was a significant relationship between musculoskeletal manifestations accompanying thyroid disorders and gender (P = 0.001), level of education (P &lt; 0.001), and occupation (P = 0.002). The findings of this study indicated the comorbidity of musculoskeletal disorders and thyroid dysfunction. Therefore, patients with thyroid dysfunction should be screened for musculoskeletal complaints and, if necessary, receive appropriate treatment.

Метод оценки радиационного риска медицинского облучения при прохождении компьютерной томографии детей и подростков на основе данных протоколов сканирования

Computed tomography (CT) scan is a fairly accurate and reliable method for diagnosing various diseases, however, based on irradiation of the patient with ionizing radiation, it can lead to an excess risk of developing malignant neoplasms. According to the safety standards of the International Atomic Energy Agency, no patient can be exposed to medical radiation unless he or she has been informed of the risks associated with radiation exposure. This requirement is also contained in the Russian Radiation Safety Standards (NRB-99/2009). Radiation risk is estimated on the basis of calculated values of equivalent doses in the patient's organs and tissues using radiation risk models of the International Commission on Radiological Protection. This article is devoted to the improvement of the method for calculating equivalent doses in the organs and tissues of patients with computed tomography scan for further assessment of radiation risks. For 15 modern computed tomography scanners, with different geometry of patient scanning, the data necessary for calculating the equivalent doses in organs and tissues based on the parameters of the children's phantom were updated. The coefficients of conversion of the surrogate measure of the patient's radiation dose for the entire CT scan study, namely, the value of the "Dose Length Product" (DLP), into the values of equivalent doses in individual organs and tissues exposed to radiation were determined. The results of the calculation are given for five typical scan areas: chest, abdomen, pelvis, head and neck. In the course of simulation numerical modeling, organs and tissues with the highest equivalent doses were determined during CT scan examinations of children and adolescents. Unlike adult patients, for children and adolescents, the dose load on the surface of the bone is significantly lower and does not stand out in any of the considered types of CT scan examinations. It should be noted that with CT scan of the cervical spine, due to the specifics of the geometry of scanning new types of tomography scanners, the dose load on the thyroid gland of boys increased. The dose conversion factors obtained in this paper with estimates of standard deviations make it possible to assess the radiation risks of children and adolescents during examinations on modern CT scanners and optimize their dose loads.

СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ И НАПРАВЛЕНИЯ ИСПОЛЬЗОВАНИЯ 3D-МОДЕЛИРОВАНИЯ В ОТОРИНОЛАРИНГОЛОГИИ

Today the development of 3D technologies, the spread and improvement of 3D printers, as well as the development and application of new printing materials have contributed to the widespread introduction of 3D printing in medicine. There are many options for using 3D technologies, however, one of the most commonly used areas is preoperative planning. Modern imaging techniques are an important component of the preoperative stage in surgical practice. Using a personalized 3D model the surgeon in detail works out on it the optimal surgical approach, the most important stages of the upcoming operation, taking into account the individual anatomical features of the structure of the area of interest. The realism and practical significance of the operation on a 3D model is achieved due to the complete identity of the area of surgical interest with the patient's organs on a 1:1 scale. The purpose of this review was to present up-to-date information on the possibilities and prospects of using 3D printing in planning surgical interventions in otorhinolaryngology, using 3D modeling technologies in teaching students at the Department of Ear, Nose and Throat Diseases of Belarusian State Medical University. Thus, the prospects for 3D technologies are very large-scale, and they will undoubtedly become one of the most dynamic areas in medicine in the future.

OA24 Airway obstruction in an adolescent: relapsing polychondritis

OA24 Airway obstruction in an adolescent: relapsing polychondritis

Nanotechnology applications in rheumatology.

Nanomedicine (NM) is the medical use of nanotechnology (NT). NT is the study and control of nanoscale structures (between approximately 1 and 100nm). Nanomaterials are created by manipulating atoms and molecules at the nanoscale, resulting in novel physical and chemical properties. With its targeted tissue delivery capabilities, NT has enabled molecular modulation of the immune response and underlying inflammatory responses in individuals with rheumatic diseases (RD). NM has enabled targeted drug delivery, reduced adverse effects on non-target organs, raised drug concentration in synovial tissue, and slowed the progression of immune-mediated RD such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Thus, NM has evolved in rheumatology prevention, diagnosis, and therapy. Animal models have proven superior outcomes to conventional techniques of treating specific illnesses. Nanodiamond (ND) immunomodulatory applications have been proposed as an alternative to traditional nanoparticles in the diagnosis and treatment of RA due to their small size and ability to be removed from the body without causing harm to the patient's organs, such as the liver. However, human clinical NM needs more research. We conducted a literature review to assess the present role of NM in clinical rheumatology, describing its current and future applications in the diagnosis and treatment of rheumatic diseases.

Monte Carlo study of organ doses and related risk for cancer in Algeria from scattered neutrons in prostate treatment involving 3D-CRT

The present study aimed to evaluate organ doses and related risk for cancer from scattered neutrons involving 3D Conformational Radiotherapy (3D−CRT) for patients with prostate cancer in Algeria based on Monte Carlo technique and to estimate the secondary cancer risks. To this purpose, a detailed geometric Monte Carlo (MC) modeling of the LINAC Varian 2100C combined with a computational whole-body phantom was carried out. The neutron equivalent doses were calculated in-field and out-of field of patient's organs using the phase-space method. The obtained neutron equivalent doses were used to estimate the Lifetime Attributable Risks (LARs) for cancer incidence in out of field organs. LARs was evaluated assuming Biological Effects of Ionizing Radiation VII (BEIR VII) risk model for exposure age in the range 35–70 years, according to the interval's age of treated patients in Algeria. The baselines cancer risks and survival data were associated with the statistical data for the Algerian population. The results showed that the neutrons equivalent doses per prescribed dose (Photon Dose) mostly depend on the distance of organs from the treated volume. The highest and lowest equivalent doses of 1.18 mSv/Gy and 0.25 mSv/Gy were recorded in the bladder and heart, respectively. The highest estimated lifetime attributable risk per 100,000 population was found for 35 yrs’ exposure age in colon 49.94, lung 16.63 and stomach 11.17. The lowest risks were found for 70 yrs’ age, in spine 0.06 and thyroid 0.14. The results showed that LARs values decrease with the increase of the exposure age and cancer incidence risk is lower than the baseline cancer risk incidence for all organs. The present study may help in providing a database on the impact of radiotherapy-induced secondary cancer incidence during 3D-CRT for prostate cancer in Algeria.

Effectiveness of polymyxin B hemoperfusion for sepsis depends on the baseline SOFA score: a nationwide observational study

BackgroundPolymyxin B hemoperfusion (PMX) aims to treat septic shock by removing endotoxin from the patient’s blood. However, the relationship between the severity of the patient's organ damage and the survival benefit of PMX treatment is not clear.MethodsWe analyzed the efficacy of PMX on adult sepsis patients using the propensity score matching method and the Japanese Diagnosis Procedure Combination (DPC) national inpatient database from April 2018 to March 2020. We stratified the patients into five categories based on their baseline Sequential Organ Failure Assessment (SOFA) score and compared the mortality between PMX-treated and non-treated groups in each category. We also compared continuous hemodiafiltration (CHDF)-, ventilator- and noradrenaline-free days between the groups.ResultsOf 44,177 patients included in the study, 2191 received PMX. After 1:1 propensity score matching, we created matched cohorts of 2033 pairs. PMX significantly improved the survival of the patients in the SOFA score categories of 7–9 and 10–12. On the other hand, there was no significant difference in the survival rate in SOFA score categories of 0–6, 13–15, and 16–24. In analyzing organ support-free days, PMX was also beneficial in the 7–9 and 10–12 SOFA categories compared to other categories.ConclusionAnalysis of a large-scale Japanese inpatient database found a significant association between PMX efficacy and baseline SOFA score. This result indicates higher efficacy in patients with medium SOFA scores in the range of 7–12. The result provides a promising hypothesis for selecting appropriate patients for PMX and should be validated in future RCTs.

Геморрагический инфаркт яичка как осложнение COVID-19 (SARS-CoV-2)

Introduction. Statistically, adult patients with testicular infarction make up 7-10% of the population of all acute urological pathology. This is one of the urological nosologies, which is а part of a group of diseases called acute scrotum . Ischemic heart attack occurs as a result of an acute violation of the blood supply to the testicle from the testicular artery. Hemorrhagic infarction usually occurs as a result of impaired microcirculation or embolization of the arteries and arterioles of the testicle and is most often segmental in nature. Conditions associated with increased blood clotting also create conditions for vein obstruction with subsequent tissue necrosis in any organ, including in the testicles. It is known that COVID-19 (SARS-COV-2) causes a pathological increase in blood clotting in the patient's body and it's most dangerous complication is thrombosis in various blood vessels of the patient's organs, which often causes acute ischemia of these organs and even death in patients with COVID 19. Materials and methods. The authors consider 3 similar clinical observations of hemorrhagic testicular infarction in patients suffering from COVID-19 (SARS-COV-2) and who were in the specialized COVID department of the city hospital of Pyatigorsk (Russia, Stavropol Territory). All 3 patients were aged from 67 to 88 years and had a concomitant pathology from the cardiovascular system in the form of arterial hypertension, as well as type 2 diabetes mellitus. The authors provide one case in detail, since all 3 cases followed the same clinical scenario. Clinical observation: Patient B. 66 years old, who was in a specialized COVID department with a diagnosis of: Coronovirus infection caused by COVID 19 (confirmed), moderate form of UO7. 1, community-acquired bilateral lobar pneumonia, acute respiratory distress syndrome, respiratory failure. Concomitant diseases: atherosclerotic cardiosclerosis, arterial hypertension, type 2 diabetes mellitus. The patient received therapy for the underlying disease, but on the 9th day of his stay in the hospital, he had an acute hemorrhagic infarction of the left testicle. The diagnosis was confirmed by laboratory and instrumental examination. An emergency left-sided orchectomy was performed, and the diagnosis was confirmed histologically. Similar clinical situations were observed in two other patients with the same outcome. Conclusions. Hemorrhagic testicular infarction in patients with COVID-19 in our clinical observation can be considered as a complication of COVID-19, or as its clinical manifestation in the organs of the male reproductive system.

Real-time tracking of organ-shape and vessel-locations for surgical navigation using MEMS tri-axis magnetic sensors

Laparoscopic surgery is less invasive to patients; however, fatal bleeding occurs when a surgeon misinterprets the anatomical location of the blood vessels. Therefore, we have proposed a location tracking system by generating an artificial magnetic field around a patient and attaching MEMS magnetic sensor nodes to certain locations of the patient's organs for real-time tracking of the organ shape and vessel locations. This paper presents the detailed system design and configuration. The results suggest that a high spatial resolution of 1–2 mm may be achieved by static and ultralow-frequency magnetic fields for rotation recognition of each sensor node and noise cancelation of the entire system. The algorithm for creating the navigation ‘map’ has been investigated from both efficiency and accuracy perspectives, which is essential for practical applications of the above system in surgical navigation.

Comparison of species, virulence genes and clones of Aeromonas isolates from clinical specimens and well water in Okinawa Prefecture, Japan.

To reveal the sources of Aeromonas infection in Okinawa Prefecture of Japan, the species, virulence genes and clones of strains isolated from clinical specimens and well water were compared. The properties of both isolates were investigated by sequencing of rpoD, detection of 10 virulence genes using PCR and genotyping with pulsed-field gel electrophoresis. In all, 68 clinical and 146 well water strains of Aeromonas were isolated and the main species were A. caviae, A. dhakensis, A. hydrophila and A. veronii biovar sobria. Aeromonas dhakensis possessed various virulence genes; however, A. caviae possessed only fla. The same or similar clones were distributed in certain areas of Okinawa and one clone had survived several months in the biliary system of two patients, respectively. Although the same Aeromonas clone was not isolated from clinical and well water samples, our study revealed the detected patterns of virulence genes in both isolates, the distribution of identical/similar clones in the Okinawan environment and long-time survival in patient's organs. We investigated the association between Aeromonas patients and well water exposure. This study provides the properties of species, virulence genes and clones of Aeromonas isolated from samples of these origins.

Ergonomic evaluation and performance of a new handle for laparoscopic tools in surgery

This paper presents a new handle for instruments used in laparoscopic surgery. This new handle has been designed to provide the best ergonomic and usability features required in this kind of surgical interventions. The main novelty of this handle is that the opening and closing motion of the end-effector is operated with the thumb using a lever located on the top of the handle. This enables the surgeon to reach the patient's organs without adopting extremely awkward postures. In order to demonstrate its advantages, the handle has been tested and compared with another commercial handle in terms of efficiency, effectiveness, and satisfaction. To this end, volunteers have been selected for participation in the experimental evaluation, which comprised two types of surveys: objective and subjective. Electromyography and goniometric studies provide objective parameters for evaluation. Questionnaires are used for the subjective assessment. Outstanding results include the lower level of pain reported by the individuals working with the new handle, as well as the reduction in the hyperflexion of the wrist. Compared with the conventional handle, electromyography reveals that no muscle load is increased when working with the new handle. The results of the subjective survey show that volunteers expressed a significant preference for the new handle, demonstrating an improvement in the ergonomic characteristics.

Calculation of Absorption Dose Value using MIRD Method with Cobalt 57 MIBI for Four Body Organs

MIRD has developed methods, assumptions, models, and mathematical formulae for estimating internal radiation doses from the injected radiopharmaceuticals into the body. This study aims to determine the radiopharmaceutical distribution of Cobalt 57 MIBI in patients identified as having breast cancer by using an oncology examination with MIRD method on 4 patient's organs with some time variations. The four organs of the patient's body are the heart, thyroid, kidney, and liver. The MIRD method developed to calculate the absorption dose of each organ is the product of the cumulative activity and the S factor of each organ studied. The results showed that the highest uptake dose in these patients was in the thyroid and kidney organs, and then followed by the heart and liver. These results indicate that the thyroid and kidney organs are the most vulnerable organs by the method of injecting radiopharmaceutical doses into the body of breast cancer patients.

Editors' note: To harvest?: A reality-based ethical dilemma and fictional dialogue

In the humanities section article “To harvest?: A reality-based ethical dilemma and fictional dialogue,” Drs. Smith and Riggs debate the ethics of harvesting a patient's organs if their surrogate wants the organs donated but reports that the patient did not want to be an organ donor and then later revokes the comment about the patient not wanting to be a donor. They question whether the surrogate's willingness to consent should override the possibility that the patient previously dissented and whether a statement made in passing that an individual does not want to be an organ donor represents informed dissent. Dr. Sethi notes that it is challenging to distinguish between uninformed and informed dissent when one cannot speak directly to the individual involved to ascertain whether they were competent and knowledgeable at the time of the dissent. However, he proposes that it may be helpful to interview the patient's other family members about the issue of dissent. Drs. Smith and Riggs voice appreciation for Dr. Sethi's thoughtful response and comment that it is helpful to contemplate ethical controversies in a hypothetical context to be better prepared to address them in real life. In the humanities section article “To harvest?: A reality-based ethical dilemma and fictional dialogue,” Drs. Smith and Riggs debate the ethics of harvesting a patient's organs if their surrogate wants the organs donated but reports that the patient did not want to be an organ donor and then later revokes the comment about the patient not wanting to be a donor. They question whether the surrogate's willingness to consent should override the possibility that the patient previously dissented and whether a statement made in passing that an individual does not want to be an organ donor represents informed dissent. Dr. Sethi notes that it is challenging to distinguish between uninformed and informed dissent when one cannot speak directly to the individual involved to ascertain whether they were competent and knowledgeable at the time of the dissent.

"Oncofertility" procedures in children and adolescents.

One of the most important elements associated with increase in oncological outcome in children is fertility preservation for future. It is obvious that chemo and radio therapy used in cancer treatment aim to destroy tumor cells, but they also impact healthy tissues. The nega-tive influence of these types of therapy can be observed in every patient's organ. One of the most serious complication of oncological treatment is reproductive impairment. This determinates directly mental and social state of the patient as well as quality of life after the treatment, particularly in adolescent. Commonly used methods of fertility preservation in female children are: freezing ovarian tissue or unfertilized oocytes. Among male children freezing of testicular tissue or ejaculated sperm are conducted. Described methods of fertility preservation among children and adolescents are on the experimental stage and none of them provide 100% effectiveness.

FEATURES OF DIAGNOSTICS OF PERFORATIONS OF HOLLOW ORGANS IN PATIENTS WITH INFECTIOUS DISEASES

The purpose of the study was to study the peculiarities of the diagnosis of perforations of hollow organs in patients with infectious diseases. The medical history of 113 patients treated in two hospitals of St. Petersburg in 2001–2011 was analyzed. It has been established that in infectious patients the symptoms of perforations of hollow organs are “blurred” against the background of vivid clinical manifestations of infectious diseases. Diagnostic laparoscopy (sensitivity 100%) and survey radiography of the abdominal cavity organs (sensitivity 86.5%) are the most informative of instrumental methods of research.

A novel 3D printing method for accurate anatomy replication in patient-specific phantoms.

A novel 3D printing method has been developed, which employs human CT images to construct patient specific phantoms by controlling the filament extrusion rate. An in-house software was developed comprising pixel-by-pixel (PbP) reading of the Hounsfield Units (HU) values in the original patient DICOM images and their sufficiently accurate 3D printed replication in the phantom produced. The PbP method was applied to two sets of anonymized patients' CT chest and skull images. The respective patient specific phantoms were 3D printed and then CT scanned and compared to the actual patient images. The chest phantom images were also compared to those of another phantom created employing the older variable infill density method (VID). The results clearly indicated a significant improvement both visually and in the phantom HU values achieved. In contrast to other methods published, its major advantages are: (a) no need for manual contouring and 3D modeling of a patient's organs, (b) wider density range, and (c) significantly better simulation of the organs' HU.