BACKGROUND:Accurate identification of pulmonary nodules as early-stage lung cancers is crucial to decrease the number of deaths and illnesses caused by lung cancer. Artificial Intelligence has the potential to enhance diagnostic accuracy and specificity in detecting lung cancer. METHODS:Chest CT scanning from 300 patients with an age range between 40 and 80 years old were analysed comparing the pulmonary nodules detection rate (number of lung nodules) between AI-assisted reading, non-AI-assisted reading and the AI-system report standalone. Detected nodules, missed nodules (false negatives), and false-positive findings were analysed. RESULTS:AI-assisted radiologists missed significantly fewer nodules (p<0.001) and achieved an almost perfect correlation (r~1.00) with expert reference values, reducing the mean absolute error (MAE) from 9.78 to 0.46. Additionally, AI increased detection sensitivity from 60% to 98% and reduced false negatives from 3,083 to 145, optimizing both diagnostic accuracy and efficiency. CONCLUSIONS:AI-assisted reading has shown to be beneficial in the detection of lung nodules compared to relying solely on radiologist observation. This suggests that an AI-powered system for evaluating lung nodules has the potential to become a valuable assistant tool in clinical practice. By combining the skills of radiologists with AI assistance, a new approach may emerge, leading to enhanced detection of lung nodules and encouraging the integration of AI in lung cancer screening initiatives.
High-output duodenal enteroatmospheric fistulas (EAFs) are a formidable surgical challenge associated with high morbidity and mortality. Fistuloclysis, the reinfusion of proximal intestinal effluent into the distal bowel, is a management strategy aimed at preserving gut function and mitigating catabolism. We report the successful management of a 71-year-old male who developed a high-output (1,300 mL/day) duodenal EAF following a distal partial gastrectomy with Roux-en-Y reconstruction. Fistuloclysis was initiated on postoperative day seven via a feeding jejunostomy. Over a 14-day treatment period, the patient's nutritional status markedly improved, and fistula output progressively decreased to 25 mL/day. This effective effluent control resulted in the spontaneous functional closure of the tract, obviating the need for immediate surgical intervention. The patient was discharged with a granulating tract and remained recurrence-free at outpatient follow-up. This case highlights fistuloclysis as a safe and effective alternative to parenteral nutrition in managing complex duodenal EAFs. The technique was critical in reversing the patient's catabolic state, controlling fistula output, and facilitating spontaneous closure. We advocate for its early consideration in the multidisciplinary management of these challenging fistulas.
BACKGROUND:Hematological malignancies are associated to immune status alterations and an amplified systemic and local immune response, which can have a significant impact on oral health, especially concerning gingival and periodontal status. Along with cytokines, which play an important role in regulating local and systemic inflammation, oxidative stress factors also reflect a critical involvement in the evolution of periodontal alterations, especially in association to systemic conditions such as leukemia. This study aims to investigate certain inflammatory markers (such as IL-1β, IL-6, IL-17α and TGF-β) as well as oxidative stress factors (SOD, MDA, 8-OHdG), in order to identify any correlations between the two, in a comparative manner, in children with leukemia and individuals without this malignant disease. METHODOLOGY:The study evaluated inflammatory markers and oxidative stress factors both in plasma and gingival crevicular fluid of 97 children (47 in the study group, suffering from leukemia and 50 in the control group, without the oncological condition or any other inflammatory systemic disease). RESULTS:In plasma, MDA seems to be the most powerful association, rising along with increased plasmatic values of IL-1β, IL-17α and TGF-β. In GCF, SOD and 8-OHdG associate with inflammatory indicators, suggesting a complex synergy between cytokine expression and oxidative stress mechanisms. CONCLUSIONS:Our analysis showed significant associations between the evaluated inflammatory markers and oxidative stress factors, both in plasma and gingival crevicular fluid. These observations might underline a potential role of certain biomarkers to act out as indicators of a complex interconnection between inflammatory status and oxidative stress.
BACKGROUND:Eating disorders are mental health conditions characterized by unhealthy eating behaviors that adversely affect physical and emotional well-being. This study assessed the risk of eating disorders among nursing personnel, comparing exercisers and non-exercisers, and explored associations between selected factors and eating disorder risk in both groups. METHODOLOGY:A cross-sectional analytical study was conducted among nursing personnel. The risk of eating disorders was assessed using the SCOFF Questionnaire. A total of 422 participants who met the inclusion criteria and consented to participate were included. Statistical analysis was performed using STATA version 14. Descriptive statistics were used to summarize the data, and the Chi-square test was used to assess associations, with statistical significance set at p<0.05. RESULTS:A total of 422 participants were included, with a mean age of 32.98±6.38 years. Among non-exercisers, 33.22% were at risk of eating disorders compared with 24.79% among exercisers. Overall, 30.81% of participants were at risk, while 69.19% had no risk. A significant association was observed between BMI and eating disorder risk among non-exercisers (p<0.001), with a higher proportion of risk among participants with BMI≥25. CONCLUSION:The findings suggest that eating disorder risk was associated with higher BMI and marital status among non-exercisers. Regular screening, promotion of physical activity, and education on healthy dietary practices may help improve the well-being of nursing personnel.
Prostatic acinar adenocarcinomas (PAA) continue to represent a challenge in terms of incidence and efficiency of screening and targeted therapy programs. The capacity of the tumor cell population to renew itself through differentiation and activation of stem cells constitutes a mechanism of tumor protection and survival, but also of acquisition of aggressive phenotypes. In this study, we analyzed CD133 immunoexpression in 55 cases, in relation to the clinico-epidemiological and histopathological parameters of the tumors. CD133 reactions were present at the nuclear and cytoplasmic level and focally membranous in tumor and stromal cells, both from tumor areas and in the case of non-neoplastic tissue. CD133 showed significantly higher reactions in PAA diagnosed in patients in extreme age groups and with elevated serum PSA values. Immunoreactions were significantly higher in some subtypes of PAA (conventional and colloid), in advanced grading groups and with perineural and lymphovascular invasion. In addition to identifying reservoirs of cells with stem potential, CD133 can be used to identify PAA with aggressive behavior, suggesting a biological connection of the two features and the utility for stratifying patients for therapy.
