A decision support system for the detection of cutaneous fungal infections using artificial intelligence.

Cutaneous fungal infections are one of the most common skin conditions, hence, the burden of determining fungal elements upon microscopic examination with periodic acid-Schiff (PAS) and Gomori methenamine silver (GMS) stains, is very time consuming. Despite some morphological variability posing challenges to training artificial intelligence (AI)-based solutions, these structures are favored potential targets, enabling the recruitment of promising AI-based technologies. Herein, we present a novel AI solution for identifying skin fungal infections, potentially providing a decision support system for pathologists.

The Implications of a Dermatopathologist's Report on Melanoma Diagnosis and Treatment.

An accurate and comprehensive histopathology report is essential for cutaneous melanoma management, providing critical information for accurate staging and risk estimation and determining the optimal surgical approach. In many institutions, a review of melanoma biopsy specimens by expert dermatopathologists is considered a necessary step. This study examined these reviews to determine the critical primary histopathology Breslow score in which a histopathology review would be most beneficial.

MYC Induces Immunotherapy and IFNγ Resistance Through Downregulation of JAK2.

Immunotherapy has revolutionized the treatment of advanced melanoma. Because the pathways mediating resistance to immunotherapy are largely unknown, we conducted transcriptome profiling of preimmunotherapy tumor biopsies from patients with melanoma that received PD-1 blockade or adoptive cell therapy with tumor-infiltrating lymphocytes. We identified two melanoma-intrinsic, mutually exclusive gene programs, which were controlled by IFNγ and MYC, and the association with immunotherapy outcome.

White epidermal nevus as an early sign of tuberous sclerosis complex-A case series.

Tuberous sclerosis complex (TSC) is a rare genetic disease with neurocutaneous manifestations, often presenting initially to the dermatology clinic. We report a cohort of neonates who presented with a novel finding of white epidermal nevus and were eventually diagnosed with TSC. White epidermal nevus may be yet another dermatological finding that may aid in the early diagnosis of TSC.

Evaluation of the polymerase chain reaction-based T-cell receptor β clonality test in the diagnosis of early mycosis fungoides.

Background: T-cell receptor (TCR) clonality may help establish a diagnosis of mycosis fungoides (MF). Routine clonality analysis is performed by using a polymerase chain reaction TCR- gamma assay, yet with this method, 10% to 50% of T-cell lymphomas escape detection. TCR- beta gene rearrangement is an additional assay.

Basal cell carcinoma induced by therapeutic radiation for tinea capitis-clinicopathological study.

Aims: An increased prevalence of aggressive histological subtypes, such as micronodular and morpheaform, has been seen, irrespective of the clinical course, in basal cell carcinoma (BCC) following irradiation for tinea capitis. The aim of this study was to assess the histopathological features of BCCs among patients irradiated for tinea capitis and correlate them with the clinical course.

Methods And Results: The medical records and BCC biopsy specimens of individuals who were previously irradiated for tinea capitis were reviewed.

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study.

Background: Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease. Most patients require long-term therapy with systemic steroids, and a steroid-sparing agent is usually also utilized. Dapsone is a chemotherapeutic agent with anti-inflammatory properties that is used as a steroid-sparing agent in PV.

Interstitial pregnancy management and subsequent pregnancy outcome.

We report on management and subsequent fertility outcome of interstitial pregnancy in a retrospective cohort study (Canadian Task Force classification II-3) at a university affiliated teaching hospital. Of 706 women with extrauterine pregnancy, 14 consecutive women with interstitial pregnancy were treated by methotrexate, laparotomy or laparoscopy between 1997 and 2007. The first four women, with significant hemoperitoneum, were treated by laparotomy.

The optimal cutoff serum level of human chorionic gonadotropin for efficacy of methotrexate treatment in women with extrauterine pregnancy.

Objective: To evaluate the efficacy of methotrexate treatment for extrauterine pregnancy and define criteria for prediction of success.

Methods: Of 829 patients with an ectopic pregnancy admitted to E. Wolfson Medical Center, Holon, Israel, from January 1997 through December 2009, 238 had asymptomatic tubal pregnancies and increasing serum β-human chorionic gonadotropin (βhCG) levels.

Postoperative analgesia with tramadol and indomethacin for diagnostic curettage and early termination of pregnancy.

Background: The postoperative analgesic effects of rectal indomethacin and tramadol were compared in patients undergoing elective termination of first trimester pregnancy and diagnostic dilatation and curettage.

Methods: Eighty-one American Society of Anesthesiologists class I and II women undergoing first trimester termination of pregnancy or diagnostic dilation and curettage were randomly allocated to receive rectal suppositories of either tramadol 100 mg (n=41) or indomethacin 100 mg (n=40) 90 min before induction of anesthesia. Pain scores and side effects were evaluated until discharge.

Clinical utility of esophagogastroduodenoscopy in the management of recurrent and intractable vomiting in pregnancy.

Objective: To determine the impact of esophagogastroduodenoscopy (EGD) on the clinical management of pregnancy women with recurrent vomiting and their pregnancy outcome.

Study Design: Retrospective evaluation of 60 pregnant women who underwent diagnostic EGD in the first trimester of pregnancy.

Results: Pregnant women were divided into 2 groups according to the indications for EGD: group 1, intractable vomiting with or without epigastric pain (n = 49) and group 2, vomiting and gastrointestinal bleeding (n = 11).

Sonographic characteristics of the uterine cavity following first-trimester uterine evacuation.

Objective: To characterize the sonographic appearance of the uterine cavity after first-trimester uterine evacuation and to follow the evolution of these findings in an attempt to reduce the number of unnecessary surgical interventions following evacuation.

Methods: We studied retrospectively the sonographic characteristics of the uterine cavity in 599 women, 5-8 days after first-trimester uterine evacuation. The patients were grouped according to the sonographic appearance of the uterine cavity.

Favorable outcome following emergency second trimester cerclage.

Background: To evaluate the outcome of midtrimester emergency cerclage with or without bulging of membranes.

Methods: A retrospective cohort study of 99 women who underwent emergency second trimester cerclage (16-27 gestational weeks). In 75 women the cervix was dilated and effaced but without bulging of membranes (group 1), and in 24 women the dilation and effacement of the cervix were accompanied by bulging of membranes into the vagina in an hourglass formation (group 2).

Intra-uterine fluid collection in postmenopuasal women with cervical stenosis.

Objectives: The aim of the study was to assess the clinical significance of intra-uterine fluid collection in postmenopausal women with cervical stenosis with and without vaginal bleeding.

Methods: A group of 82 consecutive postmenopausal women with cervical stenosis and sonographically confirmed intra-uterine fluid collection underwent D&C with or without hysteroscopy. Diagnostic hysteroscopy was performed in all patients with an endometrial thickness (ET) was greater than 8mm, or with irregular endometrium at any degree of ET.

Transvaginal ultrasound after first-trimester uterine evacuation reduces the incidence of retained products of conception.

Objective: To assess the incidence of retained products of conception (RPOC) in relation to transvaginal ultrasound performed after first-trimester uterine evacuation.

Methods: This was a prospective randomized study involving 809 women undergoing first-trimester uterine evacuation. The study group included 404 women in whom transvaginal sonography was performed at the end of the surgical procedure and the control group contained 405 women who did not undergo ultrasound examination.

Demonstration of cranial sutures and fontanelles at 15 to 16 weeks of gestation: a comparison between two-dimensional and three-dimensional ultrasonography.

Objective: The purpose of this study was to evaluate the feasibility of obtaining good quality three-dimensional ultrasound pictures of the cranial sutures and fontanelles and to compare between two-dimensional and three-dimensional ultrasound in identifying the normal appearance of cranial sutures and fontanelles by the transvaginal approach at 15 to 16 weeks of gestation.

Methods: Fifty fetuses were prospectively evaluated by two-dimensional and three-dimensional transvaginal sonography between 15 and 16 weeks of gestation. The sagittal, coronal, lambdoidal, and metopic sutures, as well as anterior and posterior fontanelles, were inspected.

Whole-abdomen, single-dose consolidation radiotherapy in patients with pathologically confirmed complete remission of advanced ovarian epithelial carcinoma: a long-term survival analysis.

The value of consolidation therapy in advanced epithelial ovarian carcinoma patients is controversial. The aim of the present study was to assess the long-term survival of patients with a pathologically confirmed complete remission who had consolidation by single-dose, whole-abdominopelvic radiotherapy. Of 96 histologically confirmed stage II-IV epithelial ovarian carcinoma patients who underwent cytoreductive surgery followed by high-dose, platin-based chemotherapy, 57 were in complete clinical remission at the end of therapy and 50 underwent a second-look laparotomy.

Role of sonography in the diagnosis of retained products of conception.

Objective: To present our experience with clinical and sonographic diagnosis of retained products of conception and to evaluate its correlation with histopathologic findings.

Methods: This was a retrospective study on 156 patients admitted for retained products of conception. Women were referred because of 1 or more of the following: abdominal pain, bleeding, and fever.

Reproductive performance following midtrimester termination of pregnancy.

The aim of the study was to determine the impact of midtrimester abortion with extra-amniotic PGE(2) on future fertility and reproduction. Two hundred and fifteen women were enrolled. The mean induction-to-abortion interval was 21.

Extra-amniotic prostaglandin E2 for midtrimester termination of pregnancy in live fetuses vs. fetal demise.

This study compared the course of midtrimester termination of pregnancies with fetal demise and those with a viable fetuses by extra-amniotic prostaglandin (PG) E(2). A total of 275 women who underwent second trimester abortion with extra-amniotic PGE2(2) were divided into two groups: 95 patients (35%) with fetal demise and 180 women (65%) with a live fetuses. Extra-amniotic PGE2(2) was administered in doses of 200 micro g every 2 h up to 20 doses.

Midtrimester abortion in patients with a previous uterine scar.

Objective: To investigate whether extraamniotic prostaglandin E2 (PGE2) for midtrimester pregnancy interruption in women with a scarred uterus has any adverse effects compared to those without an uterine scar.

Study Design: Two hundred and sixty-two women who underwent second trimester (16-27 gestational weeks) termination of pregnancy were enrolled in this study. Thirty-one women with a uterine scar were compared with 231 patients without a scarred uterus.

Clinical significance of the floating fetal head in nulliparous women in labor.

Objective: To examine the course of labor in nulliparous women in active labor with a floating fetal head.

Study Design: A prospective, cohort study of nulliparous women presenting in active labor at term with a floating fetal head (station > or = -3, n = 108) or engaged fetal head (n = 241). All patients were examined by a senior physician.

The minilaparoscope as a tool for localization and preparation for cannula insertion in patients with multiple previous abdominal incisions or umbilical hernia.

Study Objective: To access a method that attempts to reduce the risk of bowel and blood vessel trauma in entry-risk patients during laparoscopy.

Design: Three-year observational study (Canadian Task Force classification II-2).

Setting: Tertiary university hospital.

Laparoscopic surgery for extrauterine pregnancy in hemodynamically unstable patients.

Study Objective: To assess the feasibility and safety of laparoscopic surgery in treatment of ectopic pregnancy in hemodynamically unstable women.

Design: Three-year observational study (Canadian Task Force classification II-2).

Setting: Tertiary university hospital.