Objective: This paper presents continued research toward the development of a knowledge-based system for the diagnosis of human toxic exposures. In particular, this research focuses on the challenging task of diagnosing exposures to multiple toxins. Although only 10% of toxic exposures in the United States involve multiple toxins, multiple exposures account for more than half of all toxin-related fatalities. Using simple medical mathematics, we seek to produce a practical decision support system capable of supplying useful information to aid in the diagnosis of complex cases involving multiple unknown substances.
Methods: The system is automatically trained using data mining techniques to extract prior probabilities and likelihood ratios from a database managed by the Florida Poison Information Center (FPIC). When supplied with observed clinical effects, the system produces a ranked list of the most plausible toxic exposures. During testing, the system diagnosed toxins at three levels: identifying the substance, identifying the toxin's major and minor categories, and identifying the toxin's major category alone. To enable comparison between these three levels, accuracy was calculated as the percentage of exposures correctly identified in top 10% of trained diagnoses.
Results: System evaluation utilized a dataset of 8901 multiple exposure cases and 37,617 single exposure cases. Initial system testing using only multiple exposure cases yielded poor results, with diagnosis accuracies ranging from 18.5% to 50.1%. Further investigation revealed that the system's inability to diagnose multiple disorders resulted from insufficient data and that the clinical effects observed in multiple exposures are dominated by a single substance. Including single exposures when training, the system achieved accuracies as high as 83.5% when diagnosing the primary contributors in multiple exposure cases by substance, 86.9% when diagnosing by major and minor categories, and 79.9% when diagnosing by major category alone.
Conclusions: Although the system failed to completely diagnose exposures to multiple toxins, the ability to identify the primary contributor in such cases may prove valuable in aiding medical personnel as they seek to diagnose and treat patients. As time passes and more cases are added to the FPIC database, we believe system accuracy will continue to improve, producing a viable decision support system for clinical toxicology.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.artmed.2013.02.002 | DOI Listing |
Gastroenterology
February 2025
Section of Gastroenterology and Hepatology, Veterans Affairs Northeast Ohio Health Care System, Cleveland, Ohio; Division of Gastroenterology and Hepatology, Case Western Reserve University, Cleveland, Ohio.
Background & Aims: Hepatitis B reactivation (HBVr) can occur due to a variety of immune-modulating exposures, including multiple drug classes and disease states. Antiviral prophylaxis can be effective in mitigating the risk of HBVr. In select cases, clinical monitoring without antiviral prophylaxis is sufficient for managing the risk of HBVr.
View Article and Find Full Text PDFArthroscopy
January 2025
Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China; Orthopaedics Clinical Medical Research Center of Gansu Province, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China; Intelligent Orthopaedic Industry Technology Center of Gansu Province, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China. Electronic address:
Purpose: To review patients with recurrent patellar dislocation surgically treated with robot-assisted medial patellofemoral ligament (MPFL) reconstruction compared with patients who underwent surgery using the traditional freehand technique.
Methods: A retrospective cohort study was performed to identify patients who underwent MPFL reconstruction from January 2020 to December 2023 in our hospital. The inclusion criteria were: patients aged from 15 to 50 years; patellar dislocation occurred two or more times; a Merchant view or computed tomography (CT) scan indicating patellofemoral joint malalignment, external patellar inclination, or lateral patellar dislocation; underwent MPFL reconstruction via robot-assisted or traditional freehand technique; complete medical records and imaging data before and after surgery; a minimum of 1 year of postoperative follow-up.
Int J Surg Case Rep
January 2025
Head and neck Surgery Department, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:
Background: Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are the most prevalent subtypes of melanoma, primarily affecting sun-exposed areas of the face in individuals aged 65 to 80 years. LM accounts for approximately 80 % of in situ melanomas and carries a risk of progression to LMM, which constitutes 4 % to 15 % of global cutaneous melanoma cases. This report discusses the clinical challenges and management strategies for recurrent LM, with an emphasis on accurate diagnosis and surgical intervention.
View Article and Find Full Text PDFPublic Health
January 2025
Division of International Health (Public Health), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Institute for Research Administration, Niigata University, Niigata, Japan. Electronic address:
Objectives: Mumps (infectious parotitis) is an acute respiratory illness caused by the mumps virus in humans. While numerous studies have explored the impact of climate variability on mumps incidence in specific cities or regions, few have analyzed nationwide associations across multiple locations. This study aims to systematically assess the short-term effects of meteorological factors on mumps incidence across Japan over a 15-year period.
View Article and Find Full Text PDFPediatr Cardiol
January 2025
Department of Pediatric Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, 4A Dr J J Nagar, Mogappair, Chennai, 600037, India.
Transcatheter closure (TCC) of certain ventricular septal defect (VSD) subtypes typically requires arteriovenous loop (AVL) formation or retrograde transarterial deployment. Upfront transvenous cannulation from the right ventricle avoids arterial access and loop-related complications. We retrospectively reviewed data of patients who underwent TCC for perimembranous, intraconal, and post-surgical residual VSDs at our institution (January 2019-December 2023).
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!