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  • 文章类型: Journal Article
    从晚期钆增强心脏磁共振图像(LGE-CMR)中自动识别心肌瘢痕受到图像噪声和伪影(诸如与运动和部分体积效应有关的那些)的限制。本文提出了一种新颖的联合深度学习(JDL)框架,该框架通过利用同时学习的心肌分割来消除非感兴趣区域的负面影响来改善此类任务。与以前将疤痕检测和心肌分割视为单独或并行任务的方法相比,我们提出的方法引入了一个消息传递模块,在该模块中,心肌分割的信息直接传递给引导瘢痕检测器。这个新设计的网络将有效地利用来自两个相关任务的联合信息,并使用所有可用的心肌分割源来有益于疤痕识别。我们证明了JDL对LGE-CMR图像自动左心室(LV)瘢痕检测的有效性,在改善缺血性和非缺血性心脏病患者的风险预测以及改善心力衰竭患者对心脏再同步化治疗(CRT)的反应率方面具有巨大潜力。实验结果表明,我们提出的方法优于多种先进的方法,包括常用的两步分割分类网络,和多任务学习方案,其中子任务间接交互。
    Automated identification of myocardial scar from late gadolinium enhancement cardiac magnetic resonance images (LGE-CMR) is limited by image noise and artifacts such as those related to motion and partial volume effect. This paper presents a novel joint deep learning (JDL) framework that improves such tasks by utilizing simultaneously learned myocardium segmentations to eliminate negative effects from non-region-of-interest areas. In contrast to previous approaches treating scar detection and myocardium segmentation as separate or parallel tasks, our proposed method introduces a message passing module where the information of myocardium segmentation is directly passed to guide scar detectors. This newly designed network will efficiently exploit joint information from the two related tasks and use all available sources of myocardium segmentation to benefit scar identification. We demonstrate the effectiveness of JDL on LGE-CMR images for automated left ventricular (LV) scar detection, with great potential to improve risk prediction in patients with both ischemic and non-ischemic heart disease and to improve response rates to cardiac resynchronization therapy (CRT) for heart failure patients. Experimental results show that our proposed approach outperforms multiple state-of-the-art methods, including commonly used two-step segmentation-classification networks, and multitask learning schemes where subtasks are indirectly interacted.
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  • 文章类型: Case Reports
    急性非结石性胆囊炎(AAC)是在没有胆结石的情况下胆囊的炎症性疾病。AAC与包括川崎病(KD)在内的各种系统性疾病有关。我们报告了一例5岁男性被带到急诊科(ED),有发烧和呕吐的病史四天。他被承认为KD案件。然后,我们发现他有AAC,随着发烧消退,静脉注射免疫球蛋白(IVIG)得到了很好的管理,C反应蛋白(CRP)降低,反复的腹部超声显示胆囊厚度减少,没有任何冠状动脉瘤的证据。
    Acute acalculous cholecystitis (AAC) is an inflammatory disease of the gallbladder in the absence of gallstones. AAC has been linked to various systemic illnesses including Kawasaki disease (KD). We report a case of a five-year-old male brought to the emergency department (ED) with a history of fever and vomiting for four days. He was admitted as a case of KD. Then, we discovered that he had AAC, which was well managed by intravenous immunoglobulin (IVIG) as the fever subsided, C-reactive protein (CRP) decreased, and repeated abdominal ultrasound showed a decrease in gallbladder thickness without any evidence of coronary artery aneurysms.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    背景:自身免疫性大疱性疾病(AIBD)是临床上表现为皮肤和粘膜大疱和囊泡的器官特异性皮肤起泡疾病。皮肤屏障完整性的丧失使患者易于感染。坏死性筋膜炎(NF),文献中没有充分记录AIBD罕见但严重的感染性并发症.
    方法:我们介绍一例51岁男性NF患者,最初误诊为带状疱疹。鉴于当地的地位,CT成像,和实验室参数,做出NF诊断,并对患者进行紧急手术清创。在进一步的发展中,偏远地区出现了新的大疱,并进行了周边活检,直接免疫荧光以及局部状态,病人的年龄,和非典型的介绍,最初诊断为大疱性表皮松解症。鉴别诊断为大疱性类天疱疮(BP)和大疱性系统性狼疮。在文学中,发现并审查了9个其他描述的病例。
    结论:由于其临床表现不明确,坏死性筋膜炎本身表现为经常误诊的软组织感染。免疫抑制患者的实验室参数改变通常会导致NF的误诊和宝贵的时间损失。在生存中起着重要作用。鉴于AIBD表现为皮肤完整性丧失和免疫抑制治疗,这些患者可能比一般人群更容易患NF.
    Autoimmune bullous diseases (AIBD) are organ-specific skin blistering diseases clinically manifesting as bullae and vesicles of the skin and mucous membranes. The loss of skin barrier integrity renders patients susceptible to infection. Necrotizing fasciitis (NF), a rare yet severe infectious complication of AIBD has been insufficiently documented in the literature.
    We present a case of a 51-year-old male patient with NF initially misdiagnosed as herpes zoster. Given the local status, CT imaging, and laboratory parameters, NF diagnosis was made and the patient was taken for an urgent surgical debridement. In a further development, new bullae in remote areas erupted and a perilesional biopsy, direct immunofluorescence as well as local status, the patient\'s age, and atypical presentation, imposed an initial diagnosis of epidermolysis bullosa acquisita. Differential diagnoses were bullous pemphigoid (BP) and bullous systemic lupus. In the literature, 9 other described cases were found and are reviewed.
    Due to its unspecific clinical picture, necrotizing fasciitis itself presents a frequently misdiagnosed soft tissue infection. Altered laboratory parameters in immunosuppressed patients often lead to misdiagnosing of NF and loss of precious time, which plays a major role in survival. Given the manifestation of AIBD as loss of skin integrity and immunosuppressive therapy, these patients could be more predisposed to NF than the general population.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    Human T-lymphotropic virus (HTLV) 1 and 2 infections can lead to neurological diseases, mainly in HIV/HTLV 1 coinfected. Furthermore, HTLV 1 infection in HIV/AIDS patients has also been associated with AIDS progression. Despite this, HTLV 1/2 infections are not of mandatory notification in Brazil. Here, we describe the prevalence of HTLV 1/2 in HIV/AIDS patients from Paraíba state, Brazil, as well as the sociodemographic characteristics of the coinfected individuals.
    Information about HIV viral load and TCD4 lymphocyte count were obtained from patients\' records. Data on the patients\' sociodemographic characteristics were obtained by interview conducted after signing the informed consent form. The serological diagnosis for HTLV 1/2 was performed by Enzyme-Linked Immunosorbent Assay (ELISA) and Western Blot (WB).
    A total of 401 HIV/AIDS patients participated in the study, of whom about 1.5% (6/401) were positive for antibodies against HTLV, specifically for HTLV 1, evaluated by both ELISA and WB. No risk factors were found associated with HIV/HTLV 1/2 coinfection.
    We report a 1.5% prevalence of HTLV 1 infection in HIV/AIDS patients from Paraíba state. Although we have not identified risk factors associated with HTLV 1, we describe the most observed sociodemographic characteristics in HIV/HTLV 1 coinfection.
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  • 文章类型: Journal Article
    Campylobacter concisus has been described as the etiological agent of periodontal disease, inflammatory bowel diseases, and enterocolitis. It is also detected in healthy individuals. There are differences between strains in healthy individuals and affected ones by production of two exototoxins. In this mini review authors discuss major facts about cultivation, isolation, virulence and immune response to C. concisus.
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  • 文章类型: Journal Article
    Global infectious pandemics can affect the psychology and behavior of human beings. Several tools were developed to evaluate the psychological impact of such outbreaks. The present study aimed to examine the psychometric properties of the Arabic translated version of Fear of Illness and Virus Evaluation scale (FIVE). FIVE is a 35-item tool consisting of four subscales that measure Fears about Contamination and Illness, Fears about Social Distancing, Behaviors Related to Illness and Virus Fears and Impact of Illness and Virus Fears. The tool was translated into Arabic by using a forward-backward translation. The online questionnaire contained the following sections: demographics, FIVE, Fear of COVID-19 Scale (FCV-19S) and face validity questions. Non-probability convenient sampling technique was used to recruit participants via a mobile instant messaging application. Reliability, concurrent validity, face validity and factor analysis were examined. The data consisted of 509 adult participants who reside in Saudi Arabia. The internal consistency of the Arabic FIVE subscales was high (0.84-0.91) with strong concurrent validity indicated by positive correlations of FIVE subscales with FCV-19S. Factor analysis suggested slightly different factor structures (Fears of Getting Sick, Fears that Others Get Sick, Fears of the Impact on Social Life and Behaviors Related to Illness and Virus Fears). Our data showed a better fit using the proposed structures. The Arabic version of the FIVE showed robust validity and reliability qualities to assess fear of COVID-19 on Arabic adult population.
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  • 文章类型: Journal Article
    在COVID-19大流行期间,出现了不同的压力来源。特别是,预计恐惧会对个体产生重大的心理负担,并影响可能阻碍康复工作的不安全行为或减轻病毒的行为.然而,关于在研究和临床环境中捕获它们的措施的性质知之甚少。为了解决这个差距,我们评估了一种新的对疾病和病毒恐惧的心理测量特性,并测试了其对未来痛苦发展的预测价值。我们从大型横断面调查小组中抽取了450名智利成年参与者的随机样本,并邀请他们参加这项为期35天的深入纵向研究。其中,163在向他们清楚解释了测量时间表的苛刻性质之后,最终参加了研究。对于这个最终的样本,我们计算了不同的验证性因素分析(CFA)来评估仪器的初步建议结构。互补,我们对项目进行了内容分析,以定性地提取其潜在结构,这也通过CFA进行了实证检验。结果表明,原始结构不能很好地拟合数据;然而,在内容分析的基础上提出了新的结构。总的来说,改良后的仪器在所有子量表中都显示出良好的可靠性,其内部与Cronbach的阿尔法的一致性范围为0.814至0.913,而重测相关性范围为0.715至0.804。关于其收敛有效性,在基线时,恐惧得分较高的个体在抑郁和创伤后应激症状方面得分也较高.此外,基线时更高的恐惧预测7天后创伤后应激症状评分更高.这些结果为有效性提供了证据,可靠性,和秤的预测性能。由于该量表是免费的,并且可能不受COVID-19的限制,因此它可能会朝着理解当前和未来大流行的心理影响迈出一步,或其他类似特征的威胁生命的健康状况。局限性,实际意义,并对未来的研究方向进行了讨论。
    Distinct sources of stress have emerged during the COVID-19 pandemic. Particularly, fear is expected to generate significant psychological burden on individuals and influence on either unsafe behavior that may hinder recovery efforts or virus-mitigating behaviors. However, little is known about the properties of measures to capture them in research and clinical settings. To resolve this gap, we evaluated the psychometric properties of a novel measure of fear of illness and viruses and tested its predictive value for future development of distress. We extracted a random sample of 450 Chilean adult participants from a large cross-sectional survey panel and invited to participate in this intensive longitudinal study for 35 days. Of these, 163 ended up enrolling in the study after the demanding nature of the measurement schedule was clearly explained to them. For this final sample, we calculated different Confirmatory Factor Analyses (CFA) to evaluate the preliminary proposed structure for the instrument. Complementarily, we conducted a content analysis of the items to qualitatively extract its latent structure, which was also subject to empirical test via CFA. Results indicated that the original structure did not fit the data well; however, the new proposed structure based on the content analysis did. Overall, the modified instrument showed good reliability through all subscales both by its internal consistency with Cronbach\'s alphas ranging from 0.814 to 0.913, and with test-retest correlations ranging from 0.715 to 0.804. Regarding its convergent validity, individuals who scored higher in fears tended to also score higher in depressive and posttraumatic stress symptoms at baseline. Furthermore, higher fears at baseline predicted a higher score in posttraumatic stress symptomatology 7 days later. These results provide evidence for the validity, reliability, and predictive performance of the scale. As the scale is free and multidimensional potentially not circumscribed to COVID-19, it might work as a step toward understanding the psychological impact of current and future pandemics, or further life-threatening health situations of similar characteristics. Limitations, practical implications, and future directions for research are discussed.
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