Hierarchical convolutional models for automatic pneu-monia diagnosis based on X-ray images: new strategies in public health.

Conclusions: Despite some limits, our findings support the notion that deep learning methods can be used to simplify the diagnostic process and improve disease management. Background: In order to help physicians and radiologists in diagnosing pneumonia, deep learning and other artificial intelligence methods have been described in several researches to solve this task. The main objective of the present study is to build a stacked hierarchical model by combining several models in order to increase the procedure accuracy. Methods: Firstly, the best convolutional network in terms of accuracy were evaluated and described. Later, a stacked hierarchical model was built by using the most relevant features extracted by the selected two models. Finally, over the stacked model with the best accuracy, a hierarchically dependent second stage model for inner-classification was built in order to detect both inflammation of the pulmonary alveolar space (lobar pneumonia) and interstitial tissue involvement (interstitial pneumonia). Results: The study shows how the adopted staked model lead to a higher accuracy. Having a high accuracy on pneumonia detection and classification can be a paramount asset to treat patients in real health-care environments.

Multiparametric MR imaging of the prostate at 1.5-T without endorectal coil using an 8 channel pelvic phased array: Is it still a viable option?

INTRODUCTION: The purpose of our work was to evaluate the feasibility of prostate multiparametric MR imaging at 1.5-T without endorectal coil using an 8 channel pelvic phased array coil. MATERIAL AND METHODS: A total of 154 patients who underwent mp-MRI were retrospectively included. Patients received a standardized mp-MRI, compliant with 2012 European Society of Uro-Radiology guidelines, with 1·5 T magnetic field strength and an 8 channel pelvic phased-array coil. Two blinded readers graded the image quality of mp-MRI on a three-point scale and they scored the prostate lesions according to PI-RADS v2. All PI-RADS of 4 or 5 underwent biopsy. A third radiologist and a pathologist verified the correspondence between the MRI images and the results of the biopsy. RESULTS: 64 (41.6%) patients showed a Pi-rads of 4 or 5. At biopsy, 79.7% showed a Gleason score ≥7, 12.5% showed a Gleason score of 6 and 7.8% showed a negative biopsy. In the group of Pi-rads ≤ 3, 12 patients underwent a biopsy with the following results: negative biopsy in 33.3%, atypical Small Acinar Proliferation in 16.7%, prostatic intraepithelial neoplasia in 25% and indolent PCa 25%. Mp-MRI in the identification of clinically significant cancer provided a low percentage of false positive (7.8%) while in 79.7% of cases it was capable to detect clinically significant prostate cancer. In 92.2% of patients mp-MRI identified a prostate cancer with a Gleason score ≥6. The inter-reader agreement was excellent in defining both the quality of the examination and the PI-RADS category (k = 0.83 and k = 0.70, respectively). CONCLUSIONS: mp-MRI at 1.5-T without endorectal coil using an 8 channel phased array is an appropriate tool for early detection of clinically significant prostate cancer. IMPLICATIONS FOR PRACTICE: 8 channel pelvic phased array is still an appropriate tool for early detection of clinically significant prostate cancer and for obtaining a reduction in overdiagnosis of indolent PCa.

[Locally recurrent rectal cancer. Our experience]. / Recidiva locoregionale da cancro del retto operato. Esperienza personale.

The aim of this study was to describe the personal experience in the treatment of 31 patients (19 males, 12 females) with local recurrence following surgery for rectal adenocarcinoma. The exeresis of recurrence was possible in 17 patients (6 Miles, 9 Hartmann, 1 re-resection, 1 transanal resection); of these, only 6 patients reported an improvement of the quality of life. Patients surgically treated and patients with recurrence inoperable and submitted to palliative treatment (colostomy, pain control, radio- and/or chemotherapy) showed similar survival rates.

Synergistic effect between doxorubicin and a low dose of all-trans-retinoic acid in MCF-7 breast cancer cell line.

The effect of doxorubicin (DOX) used in combination with a low dose (10(-7) M) of all-trans-retinoic acid (tRA) was tested on MCF-7 breast carcinoma cell line. Both drugs are able to inhibit cell proliferation in these cells in a dose-dependent way. The combined treatment with DOX and tRA was more effective in inhibiting cell growth than each of the two compounds alone. This was evidenced in the following experimental conditions: pre-treatments with tRA, for 72 h or 18 h, before DOX incubation; post-treatment with tRA for 18 h after DOX incubation. A consistent synergism was reached by 72 h pre-treatment with tRA and also with brief pre- and post-treatments, but only if tRA was also present during DOX incubation (co-treatments). The mechanisms involved in this interaction between chemotherapeutics and differentiating agents are as yet unclear and should be evaluated further.

Associations of retinoids, tamoxifen and alpha-interferon 2a in human breast cancer.

We evaluated in vitro the potentiating and/or synergistic antitumor effects among retinoids (all-trans-retinoic acid, tRA, and 13-cis-retinoic acid, 13cRA), alpha-interferon 2a (alpha-IFN 2a) and tamoxifen (TAM) on both estrogen receptor positive (ER(+)) and negative (ER(-)) human breast cancer cell lines. In our experimental model, the three studied agents showed antiproliferative activity in ER(+) cell lines MCF-7 and ZR-75.1, while alpha-IFN 2a was the most effective drug in the ER(-) cell line MDA-MB-231. Retinoids and TAM exerted a strong apoptotic effect in MCF-7 cells, while such an effect was obtained in MDA-MB-231 cells by alpha-IFN 2a. The tested combinations displayed different effects in the different evaluated cell lines: i) in MCF-7 cells tRA + TAM showed additive activity, both tRA + alpha-IFN 2a and TAM + alpha-IFN 2a association displayed a synergistic effect, and a further potentiation of the antiproliferative action was detected with the triple combination; ii) in ZR-75.1 cell line an additive activity was showed by tRA + TAM and TAM + alpha-IFN 2a, while tRA + alpha-IFN 2a produced synergistic action; iii) in MDA-MB-231 cell line only alpha-IFN 2a displayed a strong antiproliferative effect, and no significant potentiation was exerted by any drug association. The feasibility and activity of such combinations have been tested in two pilot clinical trials on patients with metastatic breast cancer: both the tested associations were tolerable, with good treatment compliance and low toxicity. The different antiproliferative and apoptotic effects observed in vitro on apparently similar breast cancer cell lines prompted us to a further investigation of the mutual biological modulations of these drug combinations, in view of a better selection of patients who might potentially benefit from these treatments.

Utilización de diferentes especies de hongos como biodegradadoras de hidrocarburos: I ensayo preliminar / Utilization of different species of fungi as hydrocarbon biodegradatives: I preliminary assay

La degradación de compuestos orgánicos en la naturaleza es llevado a cabo por los microorganismos "in situ". En los últimos años se ha tratado de usar la capacidad degradativa de los hongos en la descomposición de sustancias producidas por el hombre y que son acumuladas en el medio ambiente como contaminantes. Se utilizó una mezcla de tres especies fúngicas: Alternaria alternata, Cunninghamella elegans y Phanerochaete chrysosporium), las que fueron cultivadas con los desechos de barros durante 30 días en condiciones de laboratorio. Los resultados de los análisis cromatográficos indican que la fracción aromática de la mezcla de hidrocarburos presentes en los barros utilizados ha tenido una importante degradación. Asimismo las relaciones de los isoprenoides a sus respectivos normales (Pristano nC17 y Fitano nC18) son mayores en las muestras tratadas que en la testigo, siendo ésto tambien evidencia de que hubo degradación

[Use of estrogens in post-coital contraception. Our case material of 243 cases]. / Uso degli estrogeni nella contraccezione post-coitale. Nostra casistica di 243 casi.

PIP: 294 women between 18 and 35 years of age -- without absolute contraindications to estrogen use, with regular menses, who had had intercourse from 3 days before to 2 days after presumptive ovulation -- were given ethinyl estradiol (EE) in dosages of 5 mg/day and domperidon 20 ng twice/day for 5 days between and 72 hours from intercourse. Follow-up visits 30 days later showed that only 243 women had adhered to the protocol. It was calculated that 32.9 pregnancies were statistically probable in the absence of therapy in the study group; none actually occurred. Even among the 27 women who presented not having followed the therapeutic protocol correctly, there were no pregnancies. Side-effects such as vomiting, nausea and breast tenderness occurred in 54% of the patients, even though domperidon is an efficacious anti-emetic.^ieng

Disappearance of oxytocin-induced uterine tiredness by treatment with fructose-1,6-diphosphate. Experimental evidence.

Fructose-1,6-diphosphate (FDP) is able to abolish oxytocin induced spastic inertia in rat uterus. The clinical use of FDP is suggested by observation carried out on 30 deliveries with oxytocin induction. The FDP-treated patients (5 g of FDP in 50 ml of water by intravenous infusion) showed a statistically significant decrease of time elapsed between the beginning of uterine inertia and the recovery of uterine contractions (176 +/- 25.4 min) compared to controls (562 +/- 32.5 min).