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Deep Learning for Discrimination of Early Spinal Tuberculosis from Acute Osteoporotic Vertebral Fracture on CT.

Infect Drug Resist

January 2025

Department of Orthopedics, First Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China.

Background: Early differentiation between spinal tuberculosis (STB) and acute osteoporotic vertebral compression fracture (OVCF) is crucial for determining the appropriate clinical management and treatment pathway, thereby significantly impacting patient outcomes.

Objective: To evaluate the efficacy of deep learning (DL) models using reconstructed sagittal CT images in the differentiation of early STB from acute OVCF, with the aim of enhancing diagnostic precision, reducing reliance on MRI and biopsies, and minimizing the risks of misdiagnosis.

Methods: Data were collected from 373 patients, with 302 patients recruited from a university-affiliated hospital serving as the training and internal validation sets, and an additional 71 patients from another university-affiliated hospital serving as the external validation set.

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We present a case of a 73-year-old woman with a medical history significant for hyperlipidemia, on pravastatin, who developed Takotsubo cardiomyopathy following a diagnosis of osteoporosis. She presented to the Emergency Department with acute transient left arm pain that resolved spontaneously. Investigations revealed elevated troponin levels, non-specific electrocardiographic changes, no significant coronary artery disease on angiography, and left ventricular systolic dysfunction, findings consistent with Takotsubo cardiomyopathy.

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High anion gap metabolic acidosis (HAGMA) is a common biochemical abnormality in hospitalized patients, often linked to conditions such as lactic acidosis, renal failure, or drug toxicity. A rare etiology, 5-oxoprolinuria, resulting from acetaminophen use, malnutrition, and sepsis, is increasingly recognized in critically ill patients. We report a 29-year-old male with a history of intellectual disability and normal baseline kidney function who was admitted with acute necrotizing pancreatitis and developed severe metabolic acidosis and acute kidney injury (AKI).

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