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1.
Sensors (Basel) ; 24(17)2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39275371

RESUMEN

Various data types generated in the semiconductor manufacturing process can be used to increase product yield and reduce manufacturing costs. On the other hand, the data generated during the process are collected from various sensors, resulting in diverse units and an imbalanced dataset with a bias towards the majority class. This study evaluated analysis and preprocessing methods for predicting good and defective products using machine learning to increase yield and reduce costs in semiconductor manufacturing processes. The SECOM dataset is used to achieve this, and preprocessing steps are performed, such as missing value handling, dimensionality reduction, resampling to address class imbalances, and scaling. Finally, six machine learning models were evaluated and compared using the geometric mean (GM) and other metrics to assess the combinations of preprocessing methods on imbalanced data. Unlike previous studies, this research proposes methods to reduce the number of features used in machine learning to shorten the training and prediction times. Furthermore, this study prevents data leakage during preprocessing by separating the training and test datasets before analysis and preprocessing. The results showed that applying oversampling methods, excluding KM SMOTE, achieves a more balanced class classification. The combination of SVM, ADASYN, and MaxAbs scaling showed the best performance with an accuracy and GM of 85.14% and 72.95%, respectively, outperforming all other combinations.

2.
Chest ; 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39276977

RESUMEN

BACKGROUND: Accurate spirometry interpretation is critical in the diagnosis and management of chronic obstructive pulmonary disease (COPD). With increasing efforts for a unified approach by the Global Lung Function Initiative (GLI), this study evaluated the application of race-specific 2012-GLI and race-neutral 2022-GLI reference equations compared to Choi's reference equations, which is derived and widely used in South Korea, for spirometry interpretation in Northeast Asian patients with COPD. RESEARCH QUESTION: What are the effects of applying race-specific 2012-GLI, race-neutral 2022-GLI, and Choi's reference equations on the diagnosis, severity grade, and clinical outcome associations of COPD STUDY DESIGN AND METHODS: Serial spirometry data from the Korea COPD Subgroup Study (KOCOSS) consisting of 3,477 patients were utilized for re-analyses using 2012-GLI, 2022-GLI, and Choi's reference equations. The COPD diagnosis and severity categorization, associations with disease manifestations and health outcomes, and longitudinal trajectories of lung function were determined. RESULTS: Although there was strong concordance in COPD diagnosis comparing 2012-GLI, and 2022-GLI reference equations to Choi's reference equations, a notable portion of patients were reclassified to milder disease severity (17.0% and 23.4% for 2012-GLI and 2022-GLI reference equations, respectively). Relationships between FEV1 percent-predicted values calculated using 2012-GLI, 2022-GLI, and Choi's equations with clinical outcomes including dyspnea severity, exercise capacity, health-related quality of life, and frequency of exacerbations remain consistently significant. Similar annual decline rates of FEV1 and FVC percent-predicted were observed among the reference equations used, except for slower annual decline rate of FEV1 in Choi's equation compared to 2022-GLI race-neutral equation. INTERPRETATION: Application of GLI reference equations for spirometry interpretation in Northeast Asian patients with COPD has potential implications on disease severity grade for clinical management and trial participation, and maintains consistent significant relationships with key disease outcomes.

3.
Medicine (Baltimore) ; 103(31): e39121, 2024 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-39093769

RESUMEN

RATIONALE: Depression is a common symptom in post-coronavirus disease 2019 (COVID-19) patients, which can be diagnosed with post-COVID-19 depression or adjustment disorder (AD) of post-COVID-19 syndrome. Recently, there have been reports of treating post-COVID-19 syndrome with herbal interventions. However, there are no studies of AD of post-COVID-19 syndrome treated with an integrative approach. This is a CARE-compliant case report of a patient diagnosed with AD of post-COVID-19 syndrome and improved with integrative personalized medicine care (IPMC). PATIENT CONCERNS: An 84-year-old female patient presented symptoms of depression, insomnia, palpitations, and dyspepsia after COVID-19 diagnosis. DIAGNOSES: The patient was diagnosed with AD due to COVID-19 according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. INTERVENTIONS: The patient was treated with the IPMC approach: conventional Western drugs for symptom improvements with herbal medicine, acupuncture, and moxibustion therapies of traditional Korean medicine to enhance her general conditions. OUTCOMES: Depression, insomnia, palpitations, dyspepsia, and overall quality of life were assessed through various questionnaires before and after treatment. Scores notably decreased across depression scales, and insomnia severity improved significantly. After treatment, gastrointestinal symptoms vanished, and autonomic nervous system balance improved. Quality of life metrics also showed remarkable enhancement. LESSONS: This study is the first case report to demonstrate improvement in AD of post-COVID-19 symptoms using IPMC. It is noteworthy that the patient in this study tapered off their antidepressant medication after the treatment with the IPMC approach. Further studies are needed to establish more qualified evidence to show the effectiveness and safety of IPMC for AD of post-COVID-19 syndrome.


Asunto(s)
COVID-19 , Medicina de Precisión , Humanos , Femenino , COVID-19/complicaciones , COVID-19/terapia , COVID-19/psicología , Anciano de 80 o más Años , Medicina de Precisión/métodos , Trastornos de Adaptación/terapia , Medicina Integrativa/métodos , SARS-CoV-2 , Medicina Tradicional Coreana , Depresión/terapia , Depresión/etiología , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Calidad de Vida
4.
Digit Health ; 10: 20552076241269463, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39119556

RESUMEN

Objective: This study implemented a 12-week walking program using the mobile app WalkON among college students and evaluated its effects. Methods: This study used a quasi-experimental, non-equivalent control group, pre/post design. The WalkON program was conducted from September to December 2022, involving 50 participants in the experimental group and 52 participants in the control group. Results: Significant between-group differences were observed as follows. Sleep quality evaluation score (i.e. higher scores mean poorer sleep quality) decreased more significantly in the experimental group (vs. control group; 1.40 vs. 0.34 points, respectively; p = .027). Anxiety decreased more in the experimental group than in the control group (2.08 vs. 1.75 points, respectively; p = .020). Regarding the mean score of the "health responsibility" domain of health-promoting behaviors, the experimental group saw an increase of 0.25 points compared to 0.15 in the control group (p = .005). The self-efficacy level increased by an average of 0.34 points in the experimental group and 0.03 points in the control group (p = .046). Conclusions: The WalkON program has the potential to positively influence physical activity engagement and health-promoting behaviors in college students. It could be an effective strategy for promoting the physical and mental health of college students lacking engagement in physical activity. This study is significant in that it provides evidence of a mobile app-based program potentially useful to encourage college students to increase their regular physical activity through walking exercises, something especially pertinent in the new norm of contactless environments post-COVID-19.

5.
Lung ; 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38958717

RESUMEN

OBJECTIVES: This study was performed to construct and validate a risk prediction model for non-invasive ventilation (NIV) failure after birth in premature infants with gestational age < 32 weeks. METHODS: The data were derived from the multicenter retrospective study program - Jiangsu Provincial Neonatal Respiratory Failure Collaboration Network from Jan 2019 to Dec 2021. The subjects finally included were preterm infants using NIV after birth with gestational age less than 32 weeks and admission age within 72 h. After screening by inclusion and exclusion criteria, 1436 babies were subsequently recruited in the study, including 1235 infants in the successful NIV group and 201 infants in the failed NIV group. RESULTS: (1) Gestational age, 5 min Apgar, Max FiO2 during NIV, and FiO2 fluctuation value during NIV were selected by univariate and multivariate analysis. (2) The area under the curve of the prediction model was 0.807 (95% CI: 0.767-0.847) in the training set and 0.825 (95% CI: 0.766-0.883) in the test set. The calibration curve showed good agreement between the predicted probability and the actual observed probability (Mean absolute error = 0.008 for the training set; Mean absolute error = 0.012 for the test set). Decision curve analysis showed good clinical validity of the risk model in the training and test cohorts. CONCLUSION: This model performed well on dimensions of discrimination, calibration, and clinical validity. This model can serve as a useful tool for neonatologists to predict whether premature infants will experience NIV failure after birth.

6.
Artículo en Inglés | MEDLINE | ID: mdl-38951014

RESUMEN

BACKGROUND: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. METHOD: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. RESULT: Recommendations for nine population, intervention, comparator, outcome (PICO) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. CONCLUSIONS: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

7.
Children (Basel) ; 11(6)2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38929201

RESUMEN

OBJECTIVE: This retrospective cohort study was performed to clarify the association between intubation in the delivery room and the mortality after pulmonary hemorrhage in very low birth weight infants (VLBWIs) during hospitalization. METHODS: The study participants were screened from the VLBWIs admitted to the neonatal intensive care unit (NICU) of the Children's Hospital Affiliated to Nanjing Medical University from 31 July 2019 to 31 July 2022. The newborns who ultimately were included were those infants who survived until pulmonary hemorrhage was diagnosed. These subjects were divided into the intubation-at-birth group (n = 29) and the non-intubation-at-birth group (n = 35), retrospectively. RESULTS: Univariate analysis found that the intubation group had a higher mortality and shorter hospital stay than the non-intubation group (p < 0.05) (for mortality: 25/29 (86.21%) in intubation group versus 14/35 (40.00%) in non-intubation group). By multivariate analysis, the result further showed that intubation in the delivery room was related to shorter survival time and higher risk of death (adjusted hazard ratio: 2.341, 95% confidence interval: 1.094-5.009). CONCLUSIONS: Intubation at birth suggested a higher mortality in the VLBWIs when pulmonary hemorrhage occurred in the NICU.

8.
J Korean Soc Radiol ; 85(3): 566-578, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38873383

RESUMEN

Purpose: This study investigated whether the respiratory phase during pleural puncture in CT-guided percutaneous transthoracic needle biopsy (PTNB) affects complications. Materials and Methods: We conducted a retrospective review of 477 lung biopsy CT scans performed during free breathing. The respiratory phases during pleural puncture were determined based on the table position of the targeted nodule using CT scans obtained during free breathing. We compared the rates of complications among the inspiratory, mid-, and expiratory respiratory phases. Logistic regression analysis was performed to control confounding factors associated with pneumothorax. Results: Among the 477 procedures, pleural puncture was performed during the expiratory phase in 227 (47.6%), during the mid-phase in 108 (22.6%), and during the inspiratory phase in 142 (29.8%). The incidence of pneumothorax was significantly lower in the expiratory puncture group (40/227, 17.6%; p = 0.035) and significantly higher in the mid-phase puncture group (31/108, 28.7%; p = 0.048). After controlling for confounding factors, expiratory-phase puncture was found to be an independent protective factor against pneumothorax (odds ratio = 0.571; 95% confidence interval = 0.360-0.906; p = 0.017). Conclusion: Our findings suggest that pleural puncture during the expiratory phase may reduce the risk of pneumothorax during image guided PTNB.

10.
Sci Rep ; 14(1): 10462, 2024 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-38714885

RESUMEN

Respiratory infections are common causes of acute exacerbation of chronic obstructive lung disease (AECOPD). We explored whether the pathogens causing AECOPD and clinical features changed from before to after the coronavirus disease 2019 (COVID-19) outbreak. We reviewed the medical records of patients hospitalized with AECOPD at four university hospitals between January 2017 and December 2018 and between January 2021 and December. We evaluated 1180 patients with AECOPD for whom medication histories were available. After the outbreak, the number of patients hospitalized with AECOPD was almost 44% lower compared with before the outbreak. Patients hospitalized with AECOPD after the outbreak were younger (75 vs. 77 years, p = 0.003) and more often stayed at home (96.6% vs. 88.6%, p < 0.001) than patients of AECOPD before the outbreak. Hospital stay was longer after the outbreak than before the outbreak (10 vs. 8 days. p < 0.001). After the COVID-19 outbreak, the identification rates of S. pneumoniae (15.3 vs. 6.2%, p < 0.001) and Hemophilus influenzae (6.4 vs. 2.4%, p = 0.002) decreased, whereas the identification rates of P. aeruginosa (9.4 vs. 13.7%, p = 0.023), Klebsiella pneumoniae (5.3 vs. 9.8%, p = 0.004), and methicillin-resistant Staphylococcus aureus (1.0 vs. 2.8%, p = 0.023) increased. After the outbreak, the identification rate of influenza A decreased (10.4 vs. 1.0%, p = 0.023). After the outbreak, the number of patients hospitalized with AECOPD was lower and the identification rates of community-transmitted pathogens tended to decrease, whereas the rates of pathogens capable of chronic colonization tended to increase. During the period of large-scale viral outbreaks that require quarantine, patients with AECOPD might be given more consideration for treatment against strains that can colonize chronic respiratory disease rather than community acquired pathogens.


Asunto(s)
COVID-19 , Hospitalización , Enfermedad Pulmonar Obstructiva Crónica , Humanos , COVID-19/epidemiología , COVID-19/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Anciano , Masculino , Femenino , Anciano de 80 o más Años , SARS-CoV-2/aislamiento & purificación , Persona de Mediana Edad , Pandemias , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Progresión de la Enfermedad , Estudios Retrospectivos , Streptococcus pneumoniae/aislamiento & purificación , Streptococcus pneumoniae/patogenicidad , Haemophilus influenzae/aislamiento & purificación
11.
Mov Disord Clin Pract ; 11(6): 704-707, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38696328

RESUMEN

BACKGROUND: The vermiform appendix is considered a potential reservoir for the abnormal α-synuclein aggregate in Parkinson's disease (PD). Previous epidemiologic evidence on the association between appendectomy and PD risk remains inconclusive, especially outside the Western world. OBJECTIVES: To investigate the association between appendectomy and PD risk in Korea. METHODS: Among 703,831 eligible adult subjects in the National Health Insurance Service sample cohort, we identified 16,122 patients who underwent appendectomy. The rest formed the control group. PD risk was assessed using time-dependent Cox regression analyses. RESULTS: The appendectomy group did not have altered risk of PD compared with the control group in either unadjusted [hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.97-1.80, P = 0.08] or adjusted model (HR 1.42, CI 0.88-2.30, P = 0.15). No further statistical difference appeared when stratified by sex. CONCLUSIONS: Appendectomy is not associated with altered risk of PD in the Korean population.


Asunto(s)
Apendicectomía , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/epidemiología , Masculino , Apendicectomía/efectos adversos , Femenino , República de Corea/epidemiología , Persona de Mediana Edad , Anciano , Adulto , Factores de Riesgo , Estudios de Cohortes , Modelos de Riesgos Proporcionales
12.
J Clin Neurol ; 20(4): 394-401, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38627228

RESUMEN

BACKGROUND AND PURPOSE: The onset of Huntington's disease (HD) usually occurs before the age of 50 years, and the median survival time from onset is 15 years. We investigated survival in patients with late-onset HD (LoHD) (age at onset ≥60 years) and the associations of the number of mutant CAG repeats and age at onset (AAO) with survival in patients with HD. METHODS: Patients with genetically confirmed HD at six referral centers in South Korea between 2000 and 2020 were analyzed retrospectively. Baseline demographic, clinical, and genetic characteristics and the survival status as at December 2020 were collected. RESULTS: Eighty-seven patients were included, comprising 26 with LoHD (AAO=68.77±5.91 years, mean±standard deviation; 40.54±1.53 mutant CAG repeats) and 61 with common-onset HD (CoHD) (AAO=44.12±8.61 years, 44.72±4.27 mutant CAG repeats). The ages at death were 77.78±7.46 and 53.72±10.86 years in patients with LoHD and CoHD, respectively (p<0.001). The estimated survival time was 15.21±2.49 years for all HD patients, and 10.74±1.95 and 16.15±2.82 years in patients with LoHD and CoHD, respectively. More mutant CAG repeats and higher AAO were associated with shorter survival (hazard ratio [HR]=1.05, 95% confidence interval [CI]=1.01-1.09, p=0.019; and HR=1.17, 95% CI=1.03-1.31, p=0.013; respectively) for all HD patients. The LoHD group showed no significant factors associated with survival after disease onset, whereas the number of mutant CAG repeats had a significant effect (HR=1.12, 95% CI=1.01-1.23, p=0.034) in the CoHD group. CONCLUSIONS: Survival after disease onset was shorter in patients with LoHD than in those with CoHD. More mutant CAG repeats and higher AAO were associated with shorter survival in patients with HD.

13.
Acta Radiol ; 65(6): 654-662, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38623647

RESUMEN

BACKGROUND: Post-contrast T1-Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions (SPACE) is the preferred 3D T1 spin-echo sequence for evaluating brain metastases, regardless of the prolonged scan time. PURPOSE: To evaluate the application of accelerated post-contrast T1-SPACE with iterative denoising (ID) for intracranial enhancing lesions in oncologic patients. MATERIAL AND METHODS: For evaluation of intracranial lesions, 108 patients underwent standard and accelerated T1-SPACE during the same imaging session. Two neuroradiologists evaluated the overall image quality, artifacts, degree of enhancement, mean contrast-to-noise ratiolesion/parenchyma, and number of enhancing lesions for standard and accelerated T1-SPACE without ID. RESULTS: Although there was a significant difference in the overall image quality and mean contrast-to-noise ratiolesion/parenchyma between standard and accelerated T1-SPACE without ID and accelerated SPACE with and without ID, there was no significant difference between standard and accelerated T1-SPACE with ID. Accelerated T1-SPACE showed more artifacts than standard T1-SPACE; however, accelerated T1-SPACE with ID showed significantly fewer artifacts than accelerated T1-SPACE without ID. Accelerated T1-SPACE without ID showed a significantly lower number of enhancing lesions than standard- and accelerated T1-SPACE with ID; however, there was no significant difference between standard and accelerated T1-SPACE with ID, regardless of lesion size. CONCLUSION: Although accelerated T1-SPACE markedly decreased the scan time, it showed lower overall image quality and lesion detectability than the standard T1-SPACE. Application of ID to accelerated T1-SPACE resulted in comparable overall image quality and detection of enhancing lesions in brain parenchyma as standard T1-SPACE. Accelerated T1-SPACE with ID may be a promising replacement for standard T1-SPACE.


Asunto(s)
Artefactos , Neoplasias Encefálicas , Medios de Contraste , Estudios de Factibilidad , Imagenología Tridimensional , Imagen por Resonancia Magnética , Humanos , Neoplasias Encefálicas/diagnóstico por imagen , Femenino , Estudios Retrospectivos , Masculino , Persona de Mediana Edad , Anciano , Imagen por Resonancia Magnética/métodos , Imagenología Tridimensional/métodos , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Relación Señal-Ruido , Anciano de 80 o más Años , Aumento de la Imagen/métodos
14.
Neurol Res ; 46(6): 561-567, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38563313

RESUMEN

OBJECTIVE: This retrospective study was conducted to investigate the application value of metagenomics next generation sequencing (mNGS) technology in the diagnosis and treatment of neonatal infectious meningitis. METHODS: From 1 January 2020 to 31 December 2022, 73 newborns suspected of infectious meningitis were hospitalized. After screening by inclusion and exclusion criteria, 69 newborns were subsequently included in the study, containing 27 cases with positive mNGS result and 42 cases with negative mNGS result. Furthermore, according to the diagnosis of meningitis, mNGS positive group and mNGS negative group were further divided into infectious meningitis with mNGS (+) group (n = 27) and infectious meningitis with mNGS (-) group (n = 26), respectively. RESULTS: (1) Compared with cerebrospinal fluid (CSF) culture, mNGS has better diagnostic value [positive predictive value (PPV) = 100.00% (27/27), negative predictive value (NPV) = 38.10% (16/42), agreement rate = 62.32% (43/69), area under the curve (AUC) = 0.750, 95% confidence interval (CI): 0.636-0.864]. (2) There were significant differences in the onset age, age at first CSF test, CSF leukocyte count, CSF glucose, positive rate of CSF culture, blood leukocyte count, procalcitonin (PCT), C-reaction protein (CRP), age at first mNGS test and adjusting anti-infective medication in the comparison between infectious meningitis with mNGS (+) group and infectious meningitis with mNGS (-) group (p < 0.05). (3) mNGS could help improve the cure rate [crude odds ratio (OR) = 3.393, 95%CI: 1.072-10.737; adjusted OR = 15.580, 95%CI: 2.114-114.798]. CONCLUSION: Compared with classic meningitis detection methods, mNGS has better PPV, NPV, agreement rate, and AUC. mNGS could help improve the cure rate.


Asunto(s)
Secuenciación de Nucleótidos de Alto Rendimiento , Metagenómica , Humanos , Estudios Retrospectivos , Recién Nacido , Masculino , Femenino , Metagenómica/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Estudios de Casos y Controles , Meningitis Bacterianas/diagnóstico , Meningitis Bacterianas/líquido cefalorraquídeo , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/terapia
15.
Acute Crit Care ; 39(1): 1-23, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38476061

RESUMEN

BACKGROUND: Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. METHODS: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. RESULTS: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. CONCLUSIONS: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

16.
Abdom Radiol (NY) ; 49(6): 1861-1869, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38512517

RESUMEN

PURPOSE: To evaluated the impact of a deep learning (DL)-based image reconstruction on multi-arterial-phase magnetic resonance imaging (MA-MRI) for small hypervascular hepatic masses in patients who underwent gadoxetic acid-enhanced liver MRI. METHODS: We retrospectively enrolled 55 adult patients (aged ≥ 18 years) with small hepatic hypervascular mass (≤ 3 cm) between December 2022 and February 2023. All patients underwent MA-MRI, subsequently reconstructed with a DL-based application. Qualitative assessment with Linkert scale including motion artifact (MA), liver edge (LE), hepatic vessel clarity (HVC) and image quality (IQ) was performed. Quantitative image analysis including signal to noise ratio (SNR), contrast to noise ratio (CNR) and noise was performed. RESULTS: On both arterial phases (APs), all qualitative parameters were significantly improved after DL-based image reconstruction. (LE on 1st AP, 1.22 vs 1.61; LE on 2nd AP, 1.21 vs 1.65; HVC on 1st AP, 1.24 vs 1.39; HVC on 2nd AP, 1.24 vs 1.44; IQ on 1st AP, 1.17 vs 1.45; IQ on 2nd AP, 1.17 vs 1.47, all p values < 0.05). The SNR, CNR and noise were significantly improved after DL-based image reconstruction. (SNR on AP1, 279.08 vs 176.14; SNR on AP2, 334.34 vs 199.24; CNR on AP1, 106.09 vs 64.14; CNR on AP2, 129.66 vs 73.73; noise on AP1, 1.51 vs 2.33; noise on AP2, 1.45 vs 2.28, all p values < 0.05). CONCLUSIONS: Gadoxetic acid-enhanced MA-MRI with DL-based image reconstruction improved the qualitative and quantitative parameters. Despite the short acquisition time, high-quality MA-MRI is now achievable.


Asunto(s)
Medios de Contraste , Aprendizaje Profundo , Gadolinio DTPA , Neoplasias Hepáticas , Imagen por Resonancia Magnética , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Femenino , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Anciano , Adulto , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Hígado/diagnóstico por imagen , Relación Señal-Ruido
17.
J Korean Soc Radiol ; 85(1): 197-203, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38362399

RESUMEN

Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

18.
Acute Crit Care ; 39(1): 91-99, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38303581

RESUMEN

BACKGROUND: Mechanical power (MP) has been reported to be associated with clinical outcomes. Because the original MP equation is derived from paralyzed patients under volume-controlled ventilation, its application in practice could be limited in patients receiving pressure-controlled ventilation (PCV). Recently, a simplified equation for patients under PCV was developed. We investigated the association between MP and intensive care unit (ICU) mortality. METHODS: We conducted a retrospective analysis of Korean data from the Fourth International Study of Mechanical Ventilation. We extracted data of patients under PCV on day 1 and calculated MP using the following simplified equation: MPPCV = 0.098 ∙ respiratory rate ∙ tidal volume ∙ (ΔPinsp + positive end-expiratory pressure), where ΔPinsp is the change in airway pressure during inspiration. Patients were divided into survivors and non-survivors and then compared. Multivariable logistic regression was performed to determine association between MPPCV and ICU mortality. The interaction of MPPCV and use of neuromuscular blocking agent (NMBA) was also analyzed. RESULTS: A total of 125 patients was eligible for final analysis, of whom 38 died in the ICU. MPPCV was higher in non-survivors (17.6 vs. 26.3 J/min, P<0.001). In logistic regression analysis, only MPPCV was significantly associated with ICU mortality (odds ratio, 1.090; 95% confidence interval, 1.029-1.155; P=0.003). There was no significant effect of the interaction between MPPCV and use of NMBA on ICU mortality (P=0.579). CONCLUSIONS: MPPCV is associated with ICU mortality in patients mechanically ventilated with PCV mode, regardless of NMBA use.

19.
J Neurol Sci ; 458: 122891, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38310734

RESUMEN

BACKGROUND: Although epilepsy is an uncommon comorbidity of Parkinson's disease (PD), the exact incidence of PD among the patients with epilepsy is not clarified yet. OBJECTIVES: We aimed to estimate the incidence of PD in patients with epilepsy and explore the association between epilepsy and PD. METHODS: Epilepsy patients enrolled in the National Health Insurance Service Health Screening Cohort (NHIS-HealS) (2002-2013) between 2003 and 2007 were set up as the experimental group. The major outcome was the occurrence of PD. Non-epilepsy patients were obtained through Propensity Score Matching of 'greedy nearest neighbor' algorithm in 1:1 ratio. The Cox Proportional Hazards model was used to calculate PD incidence and hazard ratio (HR). RESULTS: A total of 10,510 patients were finally included in the study, which contained 5255 patients in epilepsy and non-epilepsy groups, respectively. During the follow-up period, 85 patients with Parkinson's disease among 5255 patients with epilepsy and 57 patients with Parkinson's disease among 5255 patients without epilepsy occurred. The 10,000 Person-Year (PY), representing the number of PD patients per 10,000 per year, was 21.38 in the epilepsy group and 11.18 in the non-epilepsy group. When all variables were adjusted, it was found that the epilepsy group had a 2.19 times significantly higher risk of developing Parkinson's disease than the control group (The adjusted HR: 2.19 (95% CI, 1.55-3.12)). CONCLUSION: This study indicates an increased risk of PD in patients with epilepsy. However, further research is needed to prove an exact causal relationship between these two brain disorders.


Asunto(s)
Epilepsia , Enfermedad de Parkinson , Humanos , Estudios de Cohortes , Incidencia , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/epidemiología , Comorbilidad , Epilepsia/epidemiología , Epilepsia/complicaciones , Factores de Riesgo
20.
Acute and Critical Care ; 39(1): 1-23, 20240201.
Artículo en Inglés | BIGG - guías GRADE | ID: biblio-1562554

RESUMEN

Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. Methods Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. Results Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusions We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.


Asunto(s)
Humanos , Respiración Artificial/normas , Desconexión del Ventilador , Enfermedad Crítica
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