Predictive value of magnetic resonance imaging diffusion parameters using artificial intelligence in low-and intermediate-risk prostate cancer patients treated with stereotactic ablative radiotherapy: A pilot study.

INTRODUCTION: To investigate the predictive value of the pre-treatment diffusion parameters of diffusion-weighted magnetic resonance imaging (DW-MRI) using artificial intelligence (AI) for prostate-specific antigen (PSA) response in patients with low- and intermediate-risk prostate cancer (PCa) treated with stereotactic ablative radiotherapy (SABR). METHODS: Retrospective evaluation was performed for 30 patients using pre-treatment multi-parametric MR image datasets between 2017 and 2021. MR-based mean- and minimum apparent diffusion coefficients (ADCmean, ADCmin) were calculated for the intraprostatic dominant lesion. Therapeutic response was assessed using PSA levels. Predictive performance was assessed by the receiver operating characteristic (ROC) analysis. Statistics performed with a significance level of p ≤ 0.05. RESULTS: No biochemical relapse was detected after a median follow-up of twenty-three months (range: 3-50), with a median PSA of 0.01 ng/ml (range: 0.006-2.8) at the last examination. Significant differences were observed between the pre-treatment ADCmean, ADCmin parameters, and the group averages of patients with low and high 1-year-PSA measurements (p < 0.0001, p < 0.0001). In prediction, the random forest (RF) model outperformed the decision tree (DT) and support vector machine (SVM) models by yielding area under the curves (AUC), with 0.722, 0.685, and 0.5, respectively. CONCLUSION: Our findings suggest that pre-treatment MR diffusion data may predict therapeutic response using the novel approach of machine learning in PCa patients treated with SABR. IMPLICATIONS FOR PRACTICE: Clinicians shall measure and implement the evaluation of the suggested parameters (ADCmin, ADCmean) to provide the most accurate therapy for the patient.

Severe exacerbations and mortality in COPD patients: A retrospective analysis of the database of the Hungarian National Health Insurance Fund.

INTRODUCTION: COPD is one of the most common pulmonary diseases and one of the leading causes of death worldwide. Exacerbations of COPD include acute worsening that could lead to hospitalization and death. In this study, our objective was to investigate the natural course of moderate and severe exacerbations (SAE) and mortality in the Hungarian population in the past decade. METHODS: A retrospective financial database analysis was performed to examine the risk of additional SAEs and death after the first ever SAE in COPD patients, using the financial database of the Hungarian National Health Insurance Fund (NHIF). Patients were enrolled between 2009.01.01. and 2019.12.31. if they had received at least one inhaled drug (LABA, LAMA, ICS or SABA/SAMA) and had been hospitalized for a COPD exacerbation (ICD-10 code J44). RESULTS: A total of 63,037 patients with COPD were enrolled after their first SAE. Of them, 27,095 patients suffered at least one subsequent SAE, and 32,120 patients died during the 10-year follow-up. The median survival was 4.7 years. The risk of subsequent hospitalizations increased significantly after each SAE, with hazard ratios ranging from 1.65 to 5.01. The risk for mortality was increased after each SAE, but did not increase further with the number of SAEs. Moreover, the risk for subsequent SAE and death increased with moderate exacerbations; however, this risk did not increase further with each event. CONCLUSIONS: Despite a relevant improvement in COPD treatment, the natural course of exacerbations remained unchanged. This result highlights the importance of preventing exacerbations and the need for more research to better predict them.

The intestinal mycobiota: a year of observation about the incidence of yeast's isolation in fecal samples.

BACKGROUND: Yeast's presence, especially Candida's species, in the intestinal tract is now considered as part of the normal microbial human flora; however, fungal colonization of the colon may induce to fungal infections, becoming a risk not only in immunocompromised patients but also in normalcompetent subjects. The purpose of this epidemiological study was to evaluate the real incidence of yeasts into the fecal samples both from healthy outpatients and from inpatients, except those from wards concerning immunosuppressive and pediatrics pathologies. METHODS: Between September 2014 and October 2015, 685 stool's samples (383 from inpatients and 302 from outpatients) were subjected to culture test on Sabouraud Dextrose Agar and yeasts collected were identified by a semi-automated system Vitek2 (bioMérieux). RESULTS: Percentage of isolation was of 64% (N.=437) in the total fecal samples examined (59% in outpatients and 67% in inpatients) and the most frequently isolated was Candida albicans (63% N.=275) in both populations (60% in outpatients and 65% in inpatients). CONCLUSIONS: These data testify the constant presence in the human gut of a fungal community that, according to us, could be defined as intestinal "mycobiota". This study wishes to be a contribution to discover the relationship established between human and yeasts and to evaluate the colonizing or pathogenetic role performed by these microorganisms.

Uso de la electrocirugía en gestantes portadoras de patología premaligna del cérvix uterino, 1998-2008: Hospital Docente Ginecoobstétrico de Guanabacoa / Use of electrosurgery in pregnant women with uterine cervical premalignant disease, 1998-2008: teaching Hospital of Guanabacoa Ginecoobstétrico

Objetivo: Determinar la eficacia de la electrocirugía como medio diagnóstico y de tratamiento en las lesiones premalignas de alto grado (LIE-AG) de las gestantes que acudieron a la consulta de patología de cuello del Hospital docente Ginecoobstétrico de Guanabacoa en el período de enero 1998 a diciembre 2008...

Papel de la electrocirugía en el carcinoma invasor del cérvix Hospital Materno de Guanabacoa 1998-2008 / Role of electrosurgery in invasive carcinoma of the cervix Guanabacoa Maternity Hospital 1998-2008

Introducción: el cancer de cuello uterino continúa siendo un problema de salud en el mundo y es la causa de morbimortalidad en la mujer que más predomina en los tiempos actuales en paises en desarrollo. Objetivo general: Describir el uso de la electrocirugía en el carcinoma invasor del cérvix durante el período enero 1998 a diciembre 2008 en el hospital materno de Guanabacoa, Método: se realizó un estudio retrospectivo y descriptivo de 39 pacientes a quienes se le realizó biopsia escisional, con radiocirugía en el...