Automated blood volume estimation in surgical drains for clinical decision support.

OBJECTIVE: Monitoring Jackson Pratt and Hemovac drains plays a crucial role in assessing a patient's recovery and identifying potential postoperative complications. Accurate and regular monitoring of the blood volume in the drain is essential for making decisions about patient care. However, transferring blood to a measuring cup and recording it is a challenging task for both patients and doctors, exposing them to bloodborne pathogens such as the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). To automate the recording process with a non-contact approach, we propose an innovative approach that utilizes deep learning techniques to detect a drain in a photograph, compute the blood level in the drain, estimate the blood volume, and display the results on both web and mobile interfaces. MATERIALS AND METHODS: Our system employs semantic segmentation on images taken with mobile phones to effectively isolate the blood-filled portion of the drain from the rest of the image and compute the blood volume. These results are then sent to mobile and web applications for convenient access. To validate the accuracy and effectiveness of our system, we collected the Drain Dataset, which consists of 1,004 images taken under various background and lighting conditions. RESULTS: With an average error rate of less than 5% in milliliters, our proposed approach achieves highly accurate blood level detection and estimation, as demonstrated by our trials on this dataset. The system also exhibits robustness to variations in lighting conditions and drain shapes, ensuring its applicability in different clinical scenarios. CONCLUSIONS: The proposed automated blood volume estimation system can significantly reduce the time and effort required for manual measurements, enabling healthcare professionals to focus on other critical tasks. The dataset and annotations are available at: https://www.kaggle.com/datasets/ayenahin/liquid-volume-detection-from-drain-images and the code for the web application is available at https://github.com/itsjustaplant/AwesomeProject.git.

COMT rs4680 and DRD2 rs6275 variants and their association with YMRS scores in children with early-onset bipolar disorder

Background and objectives: Bipolar disorder (BD) is a clinical status with at least one manic, hypomanic or mixed attacks. Genetic factors take part significantly in early-onset BD (EOBD). Dopamine receptors (DRD) act in neurological mechanisms like motivation, learning, memory, and, control of neuroendocrine signaling. DRD2 receptor has been reported to influence the stability of DRD2 transcript. Catechol-O-Methyl transferase (COMT) inactivates catecholamines and Val158Met variation on COMT has effects on COMT activity. This study aims to explore DRD2 and COMT variants in the clinical development of EOBD.MethodsIn this case-control study, 102 EOBD patients and 168 healthy control subjects were used. DRD2 rs6275 and COMT Val158Met variations were detected by real-time polymerase chain reaction (RT-PCR). Young Mania Rating Scale (YMRS) was utilized to determine the EOBD severity.ResultsFor DRD2 rs6275 and COMT Val158Met polymorphisms, no significant relationship was observed in the genotype and allele frequencies between patient and control groups. Nevertheless, TT genotype carriers of DRD2 rs6275 polymorphism demonstrated significantly increased YMRS scores when compared with CC and CT genotype carriers (p = 0.039). Nevertheless, no significant difference was observed between COMT Val158Met genotypes and YMRS scores.ConclusionsWe suggest that the DRD2 rs6275 TT variant can be associated with symptom severity in children with EOBD and can have a clinical significance in EOBD pathogenesis. However, these results need to be confirmed with larger samples of patient and control groups. (AU)

BDNF Val66Met polymorphism is associated with negative symptoms in early-onset schizophrenia spectrum and other psychotic disorders

Abstract Background and Objectives. To investigate the clinical characteristics of adolescents with early-onset full psychotic disorders either with Brain-derived neurotrophic factor (BDNF) Val66Met (rs6265) or DRD2/ANKK1 Taq1A (rs1800497) polymorphisms.

Tp-e interval and Tp-e/QT ratio in patients with celiac disease / Intervalo Tp-e y ratio Tp-e/QT en pacientes con celiaquía

Objectives. Celiac disease is a chronic immune-mediated disease of the small intestine. It has been known that dilated cardiomyopathy and ischemic coronary artery disease have become more frequent in patients with celiac disease. The aim of the study was to assess Tp-e interval and Tp-e/QT ratio in patients with celiac disease. Material and methods. This study was conducted at a single center in collaboration with gastroenterology and cardiology clinics. Between January 2014 and June 2015, a total of 76 consecutive patients were enrolled (38 patients with celiac disease and 38 control subjects). Tp-e interval, Tp-e/QT and Tp-e/QTc ratio were measured from the 12-lead electrocardiogram. Results. Tp-e interval (64.2±11.0 vs. 44.5±6.0; p<0.001), Tp-e/QT ratio (0.18±0.02 vs. 0.13±0.02; p<0.001) and Tp-e/QTc ratio (0.16±0.02 vs. 0.11±0.01; p<0.001) were significantly higher in patients with celiac disease than control subjects. There was a significant positive correlation between Tp-e/QTc ratio and disease duration in patients with celiac disease (r=0.480, p=0.003) and also there was a significant positive correlation between Tp-e/QTc ratio and erythrocyte sedimentation rate (r=0.434, p<0.001). Conclusions. Our study showed that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in patients with celiac disease. Whether these changes increase the risk of ventricular arrhythmia deserve further studies (AU)

Objetivos. La enfermedad celíaca (EC) o celiaquía, es una enfermedad crónica del intestino delgado inmuno-mediada. Es bien sabido que la cardiomiopatía dilatada y la cardiopatía isquémica se han hecho frecuentes en los pacientes celíacos. El objetivo de este estudio fue evaluar el intervalo Tp-e y el ratio Tp-e/QT ratio en los pacientes con celiaquía. Material y métodos. Este estudio se realizó en un único centro, en colaboración con los clínicos de gastroenterología y cardiología. Entre enero de 2014 y junio de 2015 se incluyeron a un total de 76 pacientes consecutivos (38 pacientes con celiaquía y 38 sujetos control). Se midieron el intervalo Tp-e y los ratios Tp-e/QT y Tp-e/QTc a partir del electrocardiograma de 12 derivaciones. Resultados. El intervalo Tp-e (64,2±11 vs. 44,5±6; p<0,001), el ratio Tp-e/QT (0,18±0,02 vs. 0,13±0,02; p<0,001) y el ratio Tp-e/QTc (0,16±0,02 vs. 0,11±0,01; p<0,001) fueron significativamente superiores en los sujetos celíacos con respecto a los controles. Se observó una correlación significativa entre el ratio Tp-e/QTc y la duración de la enfermedad en los pacientes celíacos (r=0,48; p=0,003), y también una correlación positiva significativa entre el ratio Tp-e/QTc y la tasa de sedimentación eritrocitaria (r=0,434; p<0,001). Conclusiones. Nuestro estudio reflejó que el intervalo Tp-e y los ratios Tp-e/QT y Tp-e/QTc se incrementaron en los pacientes celíacos. El hecho de que dichos cambios incrementen o no el riesgo de arritmia ventricular justifica la realización de estudios futuros (AU)

Short-term levosimendan treatment protects rat testes against oxidative stress

The objective of this study was to evaluate the effect of short-term levosimendan exposure on oxidant/antioxidant status and trace element levels in the testes of rats under physiological conditions. Twenty male Wistar albino rats were randomly divided into two groups of 10 animals each. Group 1 was not exposed to levosimendan and served as control. Levosimendan (12 µg/kg) diluted in 10 mL 0.9% NaCl was administered intraperitoneally to group 2. Animals of both groups were sacrificed after 3 days and their testes were harvested for the determination of changes in tissue oxidant/antioxidant status and trace element levels. Tissue malondialdehyde (MDA) was significantly lower in the levosimendan group (P < 0.001) than in the untreated control group and superoxide dismutase and glutathione peroxidase (GSH-Px) levels were significantly higher in the levosimendan group (P < 0.001). Carbonic anhydrase, catalase and GSH levels were not significantly different from controls. Mg and Zn levels of testes were significantly higher (P < 0.001) and Co, Pb, Cd, Mn, and Cu were significantly lower (P < 0.001) in group 2 compared to group 1. Fe levels were similar for the two groups (P = 0.94). These results suggest that 3-day exposure to levosimendan induced a significant decrease in tissue MDA level, which is a lipid peroxidation product and an indicator of oxidative stress, and a significant increase in the activity of an important number of the enzymes that protect against oxidative stress in rat testes.

In-Pentetreotide uptake in a follicular adenoma of the thyroid gland: a pitfall for In-Pentetreotide scintigraphy

Se realizó gammagrafía de receptores de la somatostatina usando 111In-pentetreotide en un paciente con sospecha de un tumor neuroendocrino de páncreas. La gammagrafía con 111In-pentetreotide demostró una captación discreta del radiotrazador en la cabeza del páncreas y captación focal en el lóbulo superior derecho del tiroides. La captación del trazador en la imagen planar de 24 horas era más alta comparada con la imagen de 4 horas, y disminuyó después de 48 horas. El tejido del tiroides normal y los trastornos del tiroides, tales como cánceres, tiroiditis de Hashimoto y adenomas, a menudo demuestran una captación creciente de 111In-pentetreotide, dando como resultado la interpretación de un posible falso positivo en pacientes con tumor neuroendocrino. Añadiendo una imagen planar de 48 horas se contribuye al diagnóstico diferencial entre lesiones benignas o malignas, como en el actual caso, donde la captación disminuyó en un adenoma después de 48 horas

A patient with suspicion of a neuroendocrine tumor of the pancreas underwent a somatostatin receptor scintigraphy using 111In-Pentetreotide. 111In-pentetreotide scintigraphy showed discrete uptake of the radiotracer in the head of the pancreas and focal uptake in the right upper thyroid lobe. Tracer uptake in the 24h planar image was higher compared to the 4h image, and decreased after 48 hours. Normal thyroid tissue and thyroid disorders, such as cancers, Hashimoto's thyroiditis, and adenomas often show increased uptake of 111In-pentetreotide resulting in a possible false positive interpretation in patients with neuroendocrine tumor. Adding a 48h planar image might contribute to the differential diagnosis between benign or malignant lesions, as in the present case where the uptake decreased in an adenoma after 48 hours

An unusual presentation of polyarteritis nodosa: A case report / Una manifestación poco usual de la poliarteritis nodosa: Reporte de un caso

Polyarteritis nodosa with gallbladder involvement is a rare condition. Autosomal dominant polycystic kidney disease is also a rare condition and rarely complicated. We describe an extremely rare case of Polyarteritis nodosa, involving gallblader and ureter without obstruction, in a patient with autosomal dominant polycystic kidney disease. To the best of the authors' knowledge, such a case has not been reported previously.

La periarteritis nodosa con compromiso de la vesícula es una condición rara. La enfermedad poliquística renal autosómica dominante es también una condición rara y raramente complicada. Describimos un caso extremadamente raro de poliarteritis nodosa, con compromiso de la vesícula y el uréter sin obstrucción, en un caso de enfermedad poliquística renal autosómica dominante. Al leal saber y entender de los autores, no ha sido reportado antes un caso como éste.