Publications by authors named "Avram R"

Background: Contrast-induced acute kidney injury (CI-AKI) is a frequent complication of coronary interventions associated with an increased risk of mortality and morbidity. The optimal intravenous hydration strategy to prevent CI-AKI is not well-established. The primary objective is to determine if a tailored hydration strategy reduces the risk of CI-AKI and of major adverse cardiovascular events (MACE) in patients undergoing coronary angiography compared with a non-tailored hydration strategy.

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The practice of a microsurgeon evolves over time with experience, changes in clinical interest, and practice setting. Previous reports suggest that complication rates may be influenced by years of practice. The aim of this study was to analyze consecutive microsurgical cases performed by a single surgeon during the first half of their career in a broad microsurgical practice at a Canadian academic tertiary care center.

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To recruit enough patients to achieve adequate statistical power in clinical research, investigators often rely on financial incentives. The use of these incentives, however, remains controversial as they may cause patients to overlook risks associated with research participation. This concern is amplified in the context of plastic surgery where aesthetic procedures are often more desirable and are not typically covered by public or private insurance plans.

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Background: Early recognition of volume overload is essential for heart failure patients. Volume overload can often be easily treated if caught early but causes significant morbidity if unrecognized and allowed to progress. Intravascular volume status can be assessed by ultrasound-based estimation of right atrial pressure (RAP), but the availability of this diagnostic modality is limited by the need for experienced physicians to accurately interpret these scans.

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: Sustained virologic responses (SVRs) lead to a decrease in portal hypertension, the regression of fibrosis, and the improvement in the hepatic synthesis of procoagulant and anticoagulant factors. We aimed to assess the influence of SVR on coagulation parameters in cirrhotic patients with HCV treated with DAAs. : We performed a prospective study in the Institute of Gastroenterology and Hepatology Iasi, Romania, between January 2022 and February 2024.

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Background And Aims: Deep learning applied to electrocardiograms (ECG-AI) is an emerging approach for predicting atrial fibrillation or flutter (AF). This study introduces an ECG-AI model developed and tested at a tertiary cardiac centre, comparing its performance with clinical models and AF polygenic score (PGS).

Methods: Electrocardiograms in sinus rhythm from the Montreal Heart Institute were analysed, excluding those from patients with pre-existing AF.

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Atrial fibrillation (AF) prediction and screening are of important clinical interest because of the potential to prevent serious adverse events. Devices capable of detecting short episodes of arrhythmia are now widely available. Although it has recently been suggested that some high-risk patients with AF detected on implantable devices may benefit from anticoagulation, long-term management remains challenging in lower-risk patients and in those with AF detected on monitors or wearable devices as the development of clinically meaningful arrhythmia burden in this group remains unknown.

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Article Synopsis
  • - The article examines how artificial intelligence (AI) can enhance patient outcomes in acute cardiac care by quickly analyzing data for predicting and diagnosing heart conditions.
  • - It discusses AI's role in various diagnostic tools like echocardiography and ECGs, while also addressing regulatory issues and categorizing AI algorithms based on their risk levels.
  • - The review highlights challenges such as data quality and bias, stressing the importance of thorough validation and inclusive data, and emphasizes the need for continued research and regulation to effectively integrate AI into healthcare.
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The potential of artificial intelligence (AI) in medicine lies in its ability to enhance clinicians' capacity to analyse medical images, thereby improving diagnostic precision and accuracy and thus enhancing current tests. However, the integration of AI within health care is fraught with difficulties. Heterogeneity among health care system applications, reliance on proprietary closed-source software, and rising cybersecurity threats pose significant challenges.

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Article Synopsis
  • Large language models (LLMs) have significant potential in improving cardiovascular care and research by simplifying complex medical information and enhancing patient-physician communication.
  • They can automate tasks such as summarizing articles and analyzing unstructured data like medical notes, which could transform how data is interpreted in the field.
  • However, challenges exist, including biases and the need for careful validation, so it's important for cardiovascular professionals to understand both the capabilities and limitations of LLMs.
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The coronary angiogram is the gold standard for evaluating the severity of coronary artery disease stenoses. Presently, the assessment is conducted visually by cardiologists, a method that lacks standardization. This study introduces DeepCoro, a ground-breaking AI-driven pipeline that integrates advanced vessel tracking and a video-based Swin3D model that was trained and validated on a dataset comprised of 182,418 coronary angiography videos spanning 5 years.

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Article Synopsis
  • * Participants from the VOICE-COVID-II trial reported that HF patients and older users struggled more with using the technology, showing lower agreement in responses than younger participants and caregivers.
  • * The findings suggest that younger individuals and caregivers can help improve the use of voice-assisted technology in healthcare settings, particularly for older adults and those with comorbidities like heart failure.
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Article Synopsis
  • The review focuses on the significant role of AI in cardiology, particularly its advances and real-world use.
  • It examines the issue of data bias that can affect the reliability and broader implementation of AI tools in heart health.
  • A case study is presented to illustrate the complexities of tackling these biases, with the aim of helping researchers and clinicians create fair and effective AI solutions for diverse patient populations.
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Inherited arrhythmia disorders account for a significant proportion of sudden cardiac death, particularly among young individuals. Recent advances in our understanding of these syndromes have improved patient diagnosis and care, yet certain clinical gaps remain, particularly within case ascertainment, access to genetic testing, and risk stratification. Artificial intelligence (AI), specifically machine learning and its subset deep learning, present promising solutions to these challenges.

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Article Synopsis
  • * AI technologies are being applied across various areas such as wearables, electrocardiograms, and genetics, achieving unprecedented detection accuracy for diseases like valvular heart disease and cardiomyopathies.
  • * While the number of studies is increasing, rigorous validation is needed to ensure effectiveness and equity, with ongoing trials focused on demonstrating real-world improvements in patient outcomes.
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Article Synopsis
  • Recent advancements in AI for cardiovascular care are promising for improving diagnosis, treatment, and patient outcomes, with 10% of FDA-approved clinical AI algorithms dedicated to this area.
  • The review highlights the use of multimodal inputs and generative AI in cardiology, indicating a shift toward more complex and effective healthcare solutions.
  • It emphasizes the importance of careful implementation, ethical considerations, and rigorous evaluation to ensure AI enhances patient care and supports healthcare providers effectively.
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Importance: Congenital long QT syndrome (LQTS) is associated with syncope, ventricular arrhythmias, and sudden death. Half of patients with LQTS have a normal or borderline-normal QT interval despite LQTS often being detected by QT prolongation on resting electrocardiography (ECG).

Objective: To develop a deep learning-based neural network for identification of LQTS and differentiation of genotypes (LQTS1 and LQTS2) using 12-lead ECG.

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Background: Continuous monitoring for atrial fibrillation (AF) using photoplethysmography (PPG) from smartwatches or other wearables is challenging due to periods of poor signal quality during motion or suboptimal wearing. As a result, many consumer wearables sample infrequently and only analyze when the user is at rest, which limits the ability to perform continuous monitoring or to quantify AF.

Objectives: This study aimed to compare 2 methods of continuous monitoring for AF in free-living patients: a well-validated signal processing (SP) heuristic and a convolutional deep neural network (DNN) trained on raw signal.

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Background:  Autologous breast reconstruction offers superior long-term patient reported outcomes compared with implant-based reconstruction. Universal adoption of free tissue transfer has been hindered by procedural complexity and long operative time with microsurgery. In many specialties, co-surgeon (CS) approaches are reported to decrease operative time while improving surgical outcomes.

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Eosinophilic enteritis (EoN), a subtype of eosinophilic gastrointestinal disease, is a rare and complicated inflammatory condition affecting the small intestine. This case report discusses a 42-year-old patient who presented with acute gastrointestinal symptoms including diarrhea, nausea, and vomiting. Initial laboratory investigations revealed leukocytosis, peripheral eosinophilia, and distinctive imaging findings, prompting further evaluation.

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