Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges.

Ventilator-associated pneumonia (VAP) affects up to 20% of critically ill patients and induces significant antibiotic prescription pressure, accounting for half of all antibiotic use in the ICU. VAP significantly increases hospital length of stay and healthcare costs yet is also associated with long-term morbidity and mortality. The diagnosis of VAP continues to present challenges and pitfalls for the currently available clinical, radiological and microbiological diagnostic armamentarium.

Comparison of image quality between Deep learning image reconstruction and Iterative reconstruction technique for CT Brain- a pilot study.

Background: Non-contrast Computed Tomography (NCCT) plays a pivotal role in assessing central nervous system disorders and is a crucial diagnostic method. Iterative reconstruction (IR) methods have enhanced image quality (IQ) but may result in a blotchy appearance and decreased resolution for subtle contrasts. The deep-learning image reconstruction (DLIR) algorithm, which integrates a convolutional neural network (CNN) into the reconstruction process, generates high-quality images with minimal noise.

Influence of deep learning image reconstruction algorithm for reducing radiation dose and image noise compared to iterative reconstruction and filtered back projection for head and chest computed tomography examinations: a systematic review.

Background: The most recent advances in Computed Tomography (CT) image reconstruction technology are Deep learning image reconstruction (DLIR) algorithms. Due to drawbacks in Iterative reconstruction (IR) techniques such as negative image texture and nonlinear spatial resolutions, DLIRs are gradually replacing them. However, the potential use of DLIR in Head and Chest CT has to be examined further.

Clinical role of abbreviated and ultrafast MRI in breast imaging.

Current breast cancer screening relies on mammography, digital breast tomosynthesis and breast ultrasound. In select populations, breast MRI is also of great utility. However, multiple factors limit widespread use of breast MRI for screening.

Spontaneous haemorrhagic cholecystitis secondary to the use of novel anticoagulants (rivaroxaban).

Haemorrhagic cholecystitis is a rare complication of acute cholecystitis. It carries a high risk of morbidity and mortality. Risk factors for haemorrhagic cholecystitis include cholelithiasis, trauma, malignancy and the use of anticoagulants.

Central Nervous System Disease in Patients With RET Fusion-Positive NSCLC Treated With Selpercatinib.

Introduction: Central nervous system (CNS) metastases develop in nearly half of patients with RET fusion-positive NSCLCs and cause morbidity and mortality. The selective RET inhibitor selpercatinib treats existing intracranial disease, but no studies have investigated whether early initiation of selpercatinib is associated with decreased development of CNS metastases.

Methods: A total of 61 patients with RET fusion-positive advanced NSCLC with and without CNS metastases treated with selpercatinib on the LIBRETTO-001 trial (NCT03157128) or the LIBRETTO-201 expanded access program (NCT03906331) were identified.

Differences between human and machine perception in medical diagnosis.

Deep neural networks (DNNs) show promise in image-based medical diagnosis, but cannot be fully trusted since they can fail for reasons unrelated to underlying pathology. Humans are less likely to make such superficial mistakes, since they use features that are grounded on medical science. It is therefore important to know whether DNNs use different features than humans.

Activity of Clove Oil and Chitosan Nanoparticles Incorporated PVA Nanocomposite Against Pythium aphanidermatum.

The loss of fresh produces owing to the microbial infestation is a major challenge to the global food industry. The drastic food loss caused mainly by the fungal attack demands the need for development of active packaging materials with antimicrobial properties. Many studies have already been reported on the applications of polymers like polyvinyl alcohol (PVA) engineered with antimicrobial components as active antifungal packaging materials.

Screening Breast MRI Primer: Indications, Current Protocols, and Emerging Techniques.

Breast dynamic contrast-enhanced MRI (DCE-MRI) is the most sensitive imaging modality for the detection of breast cancer. Screening MRI is currently performed predominantly in patients at high risk for breast cancer, but it could be of benefit in patients at intermediate risk for breast cancer and patients with dense breasts. Decreasing scan time and image interpretation time could increase cost-effectiveness, making screening MRI accessible to a larger group of patients.

Imaging and Management of Internal Mammary Lymph Nodes.

Internal mammary lymph nodes (IMLNs) account for approximately 10%-40% of the lymphatic drainage of the breast. Internal mammary lymph nodes measuring up to 10 mm are commonly seen on high-risk screening breast MRI examinations in patients without breast cancer and are considered benign if no other suspicious findings are present. Benign IMLNs demonstrate a fatty hilum, lobular or oval shape, and circumscribed margins without evidence of central necrosis, cortical thickening, or loss of fatty hilum.

Acute undifferentiated leukemia: data on incidence and outcomes from a large population-based database.

Acute undifferentiated leukemia (AUL) is rare and defined by the absence of bona fide myeloid and lymphoid markers. Little is known about its incidence, survival and optimal management in the recent time period. Based on a case observed in our clinic, we queried the Surveillance, Epidemiology, and End Results database between 2000 and 2016.

A conserved Toll-like receptor-to-NF-κB signaling pathway in the endangered coral Orbicella faveolata.

Herein, we characterize the Toll-like receptor (TLR)-to-NF-κB innate immune pathway of Orbicella faveolata (Of), which is an ecologically important, disease-susceptible, reef-building coral. As compared to human TLRs, the intracellular TIR domain of Of-TLR is most similar to TLR4, and it can interact in vitro with the human TLR4 adapter MYD88. Treatment of O.

Systematic review of use of β-blockers in sepsis.

Background And Aims: We proposed a review of present literature and systematic analysis of present literature to summarize the evidence on the use of β-blockers on the outcome of a patient with severe sepsis and septic shock.

Material And Methods: Medline, EMBASE, Cochrane Library were searched from 1946 to December 2013. The bibliography of all relevant articles was hand searched.

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis.

Background: Shoulder pain is the third leading musculoskeletal complaint seen by general practitioners. Physical therapy is often the first line of intervention in this population; however, there is limited description of what constitutes effective physical therapy treatment. No study has examined the effectiveness of therapeutic exercise across all painful shoulder conditions.

Operating room sound level hazards for patients and physicians.

Hypothesis: Exposure to certain new surgical instruments and operating room devices during procedures could cause hearing damage to patients and personnel.

Background: Surgical instruments and related equipment generate significant sound levels during routine usage. Both patients and physicians are exposed to these levels during the operative cases, many of which can last for hours.

Toxic metabolic encephalopathy after parathyroidectomy with methylene blue localization.

Objective: To determine the correlation between methylene blue use and toxic metabolic encephalopathy in patients undergoing surgery for primary hyperparathyroidism.

Study Design And Setting: A retrospective study of 193 patients was performed to collect demographic, perioperative, and postoperative data. Patients were divided into two groups: Group A (postoperative neurological sequelae) and Group B (no neurological sequelae).

Comparison of incidence of invasive Streptococcus pneumoniae disease among children before and after introduction of conjugated pneumococcal vaccine.

Objectives: The objective was to determine whether there has been a significant decrease in the incidence of invasive Streptococcus pneumoniae disease in the Louisville, KY, area since heptavalent pneumococcal conjugate vaccine was introduced in the winter of 1999-2000. A secondary objective was to collect demographic data regarding invasive S. pneumoniae disease in the Louisville, KY, area during the 1997-2002 period.

The development of cutaneous lesions during follow-up of patients with primary neuritic leprosy.

Background: Primary neuritic leprosy (PNL) is a rare form of leprosy where the characteristic skin lesions are absent. Investigations of apparently normal skin from the areas of sensory change have revealed microscopic evidence of nerve involvement. Clinical studies have found that a proportion of patients develop visible skin lesions during follow-up.

Mutant huntingtin impairs axonal trafficking in mammalian neurons in vivo and in vitro.

Recent data in invertebrates demonstrated that huntingtin (htt) is essential for fast axonal trafficking. Here, we provide direct and functional evidence that htt is involved in fast axonal trafficking in mammals. Moreover, expression of full-length mutant htt (mhtt) impairs vesicular and mitochondrial trafficking in mammalian neurons in vitro and in whole animals in vivo.

Histological changes in the nerve, skin and nasal mucosa of patients with primary neuritic leprosy.

Primary neuritic leprosy (PNL) presents as a peripheral neuropathy with no visible skin patches and skin smears negative for acid fast bacilli. The pathogenesis of PNL is poorly understood. The aim of the study was to document the histological changes in the nerve, apparently normal skin and nasal mucosa in PNL and to study its significance to the pathogenesis of leprosy lesions.