A deep learning model for the classification of atrial fibrillation in critically ill patients.

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the intensive care unit and is associated with increased morbidity and mortality. New-onset atrial fibrillation (NOAF) is often initially paroxysmal and fleeting, making it difficult to diagnose, and therefore difficult to understand the true burden of disease. Automated algorithms to detect AF in the ICU have been advocated as a means to better quantify its true burden.

Quantifying deep neural network uncertainty for atrial fibrillation detection with limited labels.

Atrial fibrillation (AF) is the most common arrhythmia found in the intensive care unit (ICU), and is associated with many adverse outcomes. Effective handling of AF and similar arrhythmias is a vital part of modern critical care, but obtaining knowledge about both disease burden and effective interventions often requires costly clinical trials. A wealth of continuous, high frequency physiological data such as the waveforms derived from electrocardiogram telemetry are promising sources for enriching clinical research.

The critical care data exchange format: a proposed flexible data standard for combining clinical and high-frequency physiologic data in critical care.

To develop a standardized format for exchanging clinical and physiologic data generated in the intensive care unit. Our goal was to develop a format that would accommodate the data collection pipelines of various sites but would not require dataset-specific schemas or ad-hoc tools for decoding and analysis.A number of centers had independently developed solutions for storing clinical and physiologic data using Hierarchical Data Format-Version 5 (HDF5), a well-supported standard already in use in multiple other fields.

Generalizable deep temporal models for predicting episodes of sudden hypotension in critically ill patients: a personalized approach.

The vast quantities of data generated and collected in the Intensive Care Unit (ICU) have given rise to large retrospective datasets that are frequently used for observational studies. The temporal nature and fine granularity of much of the data collected in the ICU enable the pursuit of predictive modeling. In particular, forecasting acute hypotensive episodes (AHE) in intensive care patients has been of interest to researchers in critical care medicine.

Toxoplasmosis chorioretinitis mimicking acute retinal necrosis associated with local corticosteroid.

Background: The cases discussed highlight the atypical presentation and diagnostic dilemmas of toxoplasmosis with fulminant retinal necrosis and the potentially devastating visual outcomes of toxoplasma chorioretinitis following local corticosteroid exposure.

Case Presentation: We report a series of three patients who presented with toxoplasmosis mimicking severe acute retinal necrosis. Patients were between 59 and 77 years old and had been exposed to local corticosteroids preceding our evaluation.

Predictive Modeling using Intensive Care Unit Data: Considerations for Data Pre-processing and Analysis.

The vast quantities of data generated and collected in the Intensive Care Unit (ICU) have given rise to large retrospective datasets that are frequently used for observational studies. The temporal nature and fine granularity of much of the data collected in the ICU enable the pursuit of predictive modeling, an increasingly common topic in ICU literature. Since patient conditions can rapidly change in the ICU, predicting the onset of events that are indicative of deteriorating patient state has potential clinical utility.

Prediction of Patient-specific Acute Hypotensive Episodes in ICU Using Deep Models.

Forecasting acute hypotensive episodes (AHE) in intensive care patients has been of recent interest to researchers in the healthcare domain. Advance warning of an impending AHE may give care providers additional information to help mitigate the negative clinical impact of a serious event such as an AHE or prompt a search for an evolving disease process. However, the currently accepted definition of AHE is restrictive does not account for inter-patient variability.

Formulation of a Peribulbar Block for Prolonged Postoperative Pain Management in Vitreoretinal Surgery: A Randomized Clinical Trial.

Purpose: To evaluate postoperative pain level using a supplemental peribulbar injection at the conclusion of retinal surgery.

Design: Prospective, parallel-assigned, single-masked, randomized clinical trial.

Participants: Fifty-eight patients undergoing scleral buckle, vitrectomy, or combined surgery.

Vogt-Koyanagi-Harada-like syndrome after CTLA-4 inhibition with ipilimumab for metastatic melanoma.

Cytotoxic T-lymphocyte-associated antigen is a naturally occurring inhibitor of T-cell costimulation. Monoclonal antibody inhibition of cytotoxic T-lymphocyte-associated antigen with ipilimumab blocks this negative regulator of costimulation, promoting T-cell activation and survival, and leads to melanoma regression. Findings of the Vogt-Koyanagi-Harada (VKH) syndrome, an uveomeningitic syndrome that features neurological, auditory, ophthalmologic, and cutaneous involvement because of autoimmune targeting of melanocytic antigen, have rarely been described in association with melanoma immunotherapy.

Toxoplasma chorioretinitis diagnosed by histopathology in a patient with AIDS.

Purpose: To demonstrate the diagnostic difficulties in cases of retinal necrosis in immunocompromised patients including the potential for false-negative anterior segment sampling and also to emphasize the utility of diagnostic vitrectomy with histopathologic examination.

Methods: This patient's chart was thoroughly reviewed to present salient features that are relevant to any ophthalmologist attempting to diagnose and treat chorioretinitis. A 38-year-old man with HIV/AIDS who presented with bilateral retinal necrosis.

Cystic benign melanosis of the conjunctiva.

Purpose: To report the clinical and histologic features of cystic benign melanosis.

Methods: This case series reports on the clinical and histopathologic features of 3 patients with enlarging, cystic, brown, pigmented, conjunctival lesions.

Results: Slit-lamp examination showed cystic melanotic lesions of bulbar conjunctiva.

Use of near-infrared spectroscopy as a physiologic monitor for intra-abdominal hypertension.

Background: Intra-abdominal hypertension (IAH) is increasingly recognized as an important parameter in critically ill (ICU) patients. IAH affects perfusion to all abdominal components including the abdominal wall (AW). Near infrared spectroscopy (NIRS) measures changes in three chromophores including oxygenated hemoglobin (HbO2), deoxygenated hemoglobin (Hb), and cytochrome aa3 (Cyt), providing information concerning dysoxia.

Distance stereoacuity in prism-induced convergence stress.

Purpose: In an initial study of prism-induced exodeviation, degraded stereoacuity was not associated with decreased binocular visual acuity, suggesting that accommodative convergence was not recruited. Distance stereoacuity degraded earlier when measured with the Frisby-Davis Distance (FD2) than when measured with the Distance Randot (DR). We now describe a follow-up study in which we reversed the prism order and also addressed potential biases of testing order and different measurable levels of stereoacuity to clarify the relationship between exodeviation, distance stereoacuity, and binocular visual acuity.

Stereoacuity and binocular visual acuity in prism-induced exodeviation.

Background: Intermittent exotropia may be controlled by accommodative or motor convergence. Previous studies have reported that reduced binocular visual acuity in intermittent exotropia is due to the accommodation required to control the deviation. To test this hypothesis, we simulated convergence stress by inducing exodeviations in normal volunteers to investigate whether the transition from nonfused to fused is associated with a gradual or immediate transition in stereoacuity and binocular visual acuity.

Bull's-eye maculopathy in an infant with Leigh disease.

Purpose: To report a bull's-eye maculopathy-like fundus abnormality in an infant with Leigh disease.

Design: Observational case report.

Methods: We reviewed the medical, ophthalmic, and genetic records of an eight-month-old boy who presented with hypotonia and bilaterally decreased vision.