Segmentation of Masses on Mammograms Using Data Augmentation and Deep Learning.

The diagnosis of breast cancer in early stage is essential for successful treatment. Detection can be performed in several ways, the most common being through mammograms. The projections acquired by this type of examination are directly affected by the composition of the breast, which density can be similar to the suspicious masses, being a challenge the identification of malignant lesions. In this article, we propose a computer-aided detection (CAD) system to aid in the diagnosis of masses in digitized mammograms using a model based in the U-Net, allowing specialists to monitor the lesion over time. Unlike most of the studies, we propose the use of an entire base of digitized mammograms using normal, benign, and malignant cases. Our research is divided into four stages: (1) pre-processing, with the removal of irrelevant information, enhancement of the contrast of 7989 images of the Digital Database for Screening Mammography (DDSM), and obtaining regions of interest. (2) Data augmentation, with horizontal mirroring, zooming, and resizing of images; (3) training, with tests of six-based U-Net models, with different characteristics; (4) testing, evaluating four metrics, accuracy, sensitivity, specificity, and Dice Index. The tested models obtained different results regarding the assessed parameters. The best model achieved a sensitivity of 92.32%, specificity of 80.47%, accuracy of 85.95% Dice Index of 79.39%, and AUC of 86.40%. Even using a full base without case selection bias, the results obtained demonstrate that the use of a complete database can provide knowledge to the CAD expert.

Intervenções de Enfermagem pré-hospitalar: revisão narrativa / Pre-hospital nursing interventions: narrative review

Objetivo: Construir algoritmos de intervenção de enfermagem pré-hospitalar a vítimas de trauma. Metodologia: Revisão Narrativa da Literatura, entre 2008 e 2019, nas principais bases de dados. Dois revisores independentes realizaram a avaliação crítica, extração e síntese dos dados. A construção dos algoritmos resultou do processo interpretativo da revisão narrativa por três peritos na área. Utilizou-se o modelo teórico de Virgínia Henderson. Resultados: Obtiveram-se 17 documentos, seis foram incluídos no desenvolvimento dos metaparadigmas Saúde, Pessoa e Ambiente e 16 para a elaboração e construção de Algoritmos de avaliação, diagnóstico e intervenções de enfermagem às vítimas de trauma. Conclusões: A revisão possibilitou a operacionalização do modelo teórico de Henderson para a assistência pré-hospitalar permitindo a criação de algoritmos orientadores da prática de enfermagem. (AU)

Objective: To construct pre-hospital nursing intervention algorithms for trauma victims. Methodology: Literature Narrative Review, between 2008 and 2019, in the main databases. Two independent reviewers carried out the critical evaluation, extraction and synthesis of data. The construction of the algorithms resulted from the interpretive process of the narrative review by three experts. The theoretical model of Virginia Henderson was used. Results: Seventeen documents were obtained, six were included in the development of the metaparadigm Health, Person and Environment and 16 were included in the development and construction of assessment, diagnosis and nursing interventions algorithms for trauma victims. Conclusions: The review enabled the operationalization of Henderson's theoretical model for pre-hospital care, allowing the creation of algorithms to guide nursing practice. (AU)

Objetivo: Construir algoritmos de intervención de enfermería prehospitalaria para víctimas de traumatismos. Metodología: Revisión narrativa de literatura, entre 2008 y 2019, en las principales bases de datos. Dos revisores independientes realizaron la evaluación crítica, extracción y síntesis de los datos. La construcción de los algoritmos fue el resultado del proceso interpretativo de la revisión por parte de tres expertos. Se utilizó el modelo de Virginia Henderson. Resultados: Se obtuvieron diecisiete documentos, seis se incluyeron en el desarrollo de los metaparadigmas y 16 se incluyeron en el desarrollo y construcción de algoritmos de evaluación, diagnóstico e intervenciones de enfermería. Conclusiones: La revisión permitió la operacionalización del modelo de Henderson para la atención prehospitalaria, permitiendo la creación de algoritmos. (AU)

Seroepidemiological survey of transmissible infectious diseases in a portuguese prison establishment.

A cross-sectional study was conducted in 151 (71.6%) of 211 male inmates of a regional Portuguese prison in order to establish the seroprevalence for viral hepatitis (HAV, HBV, HCV), human immunodeficiency virus (HIV), syphilis and herpes simplex virus (HSV-1 and HSV-2) and to analyze some psychosocial and criminal characteristics. Mean age was 34 years. Anti-HAV was positive in 69.5% (n = 105) and in 34.4% (n = 52) for anti-HCV. One (0.7%) person had HBsAg and 29 (19.2%) had laboratory markers of past HBV infection. Non-immune inmates for HBV were 40.4% (n = 61). Syphilis was diagnosed in 6.0% (n = 9). The rate of HIV infection was 6.6% (n = 10; all HIV-1). The seropositivity of HSV-2 was 19.9% (n = 30) and of HSV-1 was 82.1% (n = 124). Alcohol dependence was reported by 26.5% (n = 40). Excluding tobacco and prescription medication, 73.5% (n = 111) reported drug use in prison. The most commonly used drugs were: cannabis (100%; n = 111) followed by heroin (56.7%; n = 63). Anti-HCV rate was noteworthy. The HIV infection rate (6.6%) in this regional prison is at least 13 to 22 times greater than in general population. As the inmate return to the community increases the risk of disease exposure for the general population, early detection and counseling is urgently needed for prisoners.

Seroepidemiological survey of transmissible infectious diseases in a portuguese prison establishment

A cross-sectional study was conducted in 151 (71.6 percent) of 211 male inmates of a regional Portuguese prison in order to establish the seroprevalence for viral hepatitis (HAV, HBV, HCV), human immunodeficiency virus (HIV), syphilis and herpes simplex virus (HSV-1 and HSV-2) and to analyze some psychosocial and criminal characteristics. Mean age was 34 years. Anti-HAV was positive in 69.5 percent (n = 105) and in 34.4 percent (n = 52) for anti-HCV. One (0.7 percent) person had HBsAg and 29 (19.2 percent) had laboratory markers of past HBV infection. Non-immune inmates for HBV were 40.4 percent (n = 61). Syphilis was diagnosed in 6.0 percent (n = 9). The rate of HIV infection was 6.6 percent (n = 10; all HIV-1). The seropositivity of HSV-2 was 19.9 percent (n = 30) and of HSV-1 was 82.1 percent (n = 124). Alcohol dependence was reported by 26.5 percent (n = 40). Excluding tobacco and prescription medication, 73.5 percent (n = 111) reported drug use in prison. The most commonly used drugs were: cannabis (100 percent; n = 111) followed by heroin (56.7 percent; n = 63). Anti-HCV rate was noteworthy. The HIV infection rate (6.6 percent) in this regional prison is at least 13 to 22 times greater than in general population. As the inmate return to the community increases the risk of disease exposure for the general population, early detection and counseling is urgently needed for prisoners.

Spondylodiscitis associated with recurrent Serratia bacteremia due to a transjugular intrahepatic portosystemic shunt (TIPS): a case report.

We report a case of spondylodiscitis caused by multiresistant Serratia marcescens in a cirrhotic patient who had several Serratia bacteremias after the placement of a transjugular intrahepatic portosystemic shunt (TIPS) device. We concluded that an endovascular stent that can not be removed makes management of recurrent bacteremia difficult. Furthermore, back pain due to bacteremia is indicative of spondylodiscitis. Serratia marcescens can be an aggressive pathogen, causing spinal infection.

Spondylodiscitis associated with recurrent Serratia bacteremia due to a transjugular intrahepatic portosystemic shunt (TIPS): a case report

We report a case of spondylodiscitis caused by multiresistant Serratia marcescens in a cirrhotic patient who had several Serratia bacteremias after the placement of a transjugular intrahepatic portosystemic shunt (TIPS) device. We concluded that an endovascular stent that can not be removed makes management of recurrent bacteremia difficult. Furthermore, back pain due to bacteremia is indicative of spondylodiscitis. Serratia marcescens can be an aggressive pathogen, causing spinal infection.