Differential Diagnosis of Cysts and Granulomas Supported by Texture Analysis of Intraoral Radiographs.

The aim of this study was to evaluate whether textural analysis could differentiate between the two common types of lytic lesions imaged with use of radiography. Sixty-two patients were enrolled in the study with intraoral radiograph images and a histological reference study. Full textural analysis was performed using MaZda software. For over 10,000 features, logistic regression models were applied. Fragments containing lesion edges were characterized by significant correlation of structural information. Although the input images were stored using lossy compression and their scale was not preserved, the obtained results confirmed the possibility of distinguishing between cysts and granulomas with use of textural analysis of intraoral radiographs. It was shown that the important information distinguishing the aforementioned types of lesions is located at the edges and not within the lesion.

The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial.

Despite proven efficacy of cardiac rehabilitation (CR) in reducing the all-cause mortality in patients after myocardial revascularization, the penetration of CR, due to patient-related factors and referral rates remains limited. To improve the outcomes, home-based tele-rehabilitation (TR) has been proposed recently. In theory TR enhances the effects of standard CR procedures due to implementation of an intelligent monitoring system designed to ensure optimal training through on-demand transmission of vital signs, aimed at motivating the patients through daily schedule reminders, setting daily goals and creating a platform for mutual feedback. Several meta-analyses assessing various studies comparing these two methods (CR and TR) have proven that they are at least equally effective, with some of the research showing superiority of TR. Although there was a small sample size, lack of long-term follow-up, reporting effects of TR itself, no integration with tools designed for coaching, motivating and promoting a healthy lifestyle constitutes an important limitation. The latter carries a hopeful prognosis for improvement when utilizing a broad-spectrum approach, especially with use of dedicated technological solutions exploiting the fact of a large and yet rapidly increasing penetration of smartphones, mobile PCs and tablets in the population. The above-mentioned findings worked as the basis and rationale for commencing the RESTORE project aimed at developing and delivering state-of-the-art, comprehensive TR for patients after myocardial revascularization and evaluating its molecular aspect in view of how it influences the atherosclerosis progression attenuation. This paper presents the current state and rationale behind the project based on up-to-date TR efficacy data.

Spiral drawing time as a measure of bradykinesia.

BACKGROUND AND PURPOSE: Bradykinesia, which is commonly defined as slowness of movements, is one of the cardinal signs of Parkinson's disease (PD) and parkinsonian syndromes. Simple clinical rating scales are used commonly to measure bradykinesia in routine clinical practice although this kind of assessment is biased. The aim of the study was to evaluate the time of spiral drawing as a measure of bradykinesia. MATERIAL AND METHODS: Fifty-four patients with PD and 39 healthy age- and sex-matched volunteers were examined. The severity of parkinsonism was assessed using UPDRS and bradykinesia was assessed using instrumental methods: the BRAIN test, Nine-Hole Peg Board (NHPB) test and Quantitative Tremor Analysis on the Graphic Digitizing Tablet (QTAGDT). QTAGDT registers patients' hand movements during the spiral drawing task and generates several data characterizing tremor and the spiral drawing time as an additional result. RESULTS: The spiral drawing time was significantly longer in PD patients when compared to normal controls (p <0.001). The bradykinesia assessment using the spiral drawing time showed a significant correlation with the clinical rating score of the UPDRS (R = 0.64, p = 0.001) and with the results of other instrumental methods: the BRAIN Test and NHPB test (R = -0.52, p = 0.0007, R = 0.55, p = 0.03, respectively). Hand tremor seemed to have no impact on bradykinesia assessment, and the new method was found to be highly test-retest reliable (R = 0.95, p < 0.0001). CONCLUSION: The spiral drawing time is a simple, quick and objective assessment of upper limb bradykinesia.

Quantitative tremor measurement with the computerized analysis of spiral drawing.

BACKGROUND AND PURPOSE: There are several instrumental and clinical methods to assess hand tremor. The clinical methods, e.g. rating scales, have the advantage that they are available to most clinicians; however, they require experience, and are not as repeatable as instrumental methods. The study describes the use of a method based on a digitizing tablet and artificial neuronal networks in the assessment of tremor. The Automated Computer Tremor Score (ACTS) is based on spiral drawings on a graphic digitizing tablet. The aim of the study was to evaluate a new method and compare it with the standardized methods of tremor assessment. MATERIAL AND METHODS: A hundred and one patients with idiopathic Parkinson's disease (IPD) and 52 patients with essential tremor (ET) were examined. All subjects were asked to draw an Archimedes spiral on the graphic tablet. The drawn spirals were evaluated using ACTS and clinically by three independent raters according to a ten-point scale. Tremor was additionally assessed using the volumetric method. The Automated Computer Tremor Score correlated considerably with tremor rates provided by every rater (r=0.68 vs. r=0.76, p<0.0001), and with measures obtained using the volumetric method (r=0.63, p=0.01 and r=0.56, p= 0.03). ACTS also correlated with ADL score among ET patients (r=0.56, p=0.0004). CONCLUSIONS: The study shows that neuronal networks may be taught to rate tremor severity analogically to human rating and automated scoring may be a useful method in clinical practice.