Anti-NMDA receptor encephalitis is an acute form of brain inflammation that is potentially lethal but has a high probability for recovery with treatment. Although the clinical picture of anti-NMDAR encephalitis is usually recognizable due to its relatively well-known symptoms, the disorder can sometimes present itself in an unpredictable and atypical way. In this case report, we wish to present the influence of different delay times prior to the establishment of diagnosis. Thus, our first patient was diagnosed with anti-NMDAR encephalitis 4 years after the initial symptoms, the second one after 8 years, and the third one after 13 months. The outcomes of the three presented patients indicate the importance of being aware of many clinical presentations of this disorder, as its early diagnosis greatly affects the outcome and may reduce permanent damage, especially in cognitive functions.
Tracheomegaly (TM) is a rare appearance that is radiologically defined as an excessive enlargement of the tracheal diameter. We present a comprehensive analysis of tracheal diameter measurements and TM incidence in patients admitted and treated due to COVID-19 pneumonitis and its association with possible respiratory complications. In this retrospective study, we included 1015 patients divided into three groups: 383 patients treated using mechanical ventilation (MV), 132 patients treated using high-flow ventilation (HFV), and 500 randomly selected patients using nasal catheter (NC) oxygenation. The tracheal lumen diameter was measured continuously using a chest X-ray, and the cuff/trachea (C/T) diameter ratio was calculated. We detected TM in 71 patients (18.54%). Regression analysis showed statistical significance in MV patients for the trachea diameter at the level of the cuff, maximal trachea diameter and C/T diameter ratio, and days on MV. Respiratory complications showed a significant association with the C/T diameter ratio. The C/T diameter ratio was shown to be a reliable potential predictor of the occurrence of respiratory complications. The results of the study highlight the importance of the early detection and prevention of TM in COVID-19 patients on MV using a chest X-ray and measurement of the C/T diameter ratio.
to evaluate the relationship between epilepsy, antiepileptic drugs (AEDs) and quality of life (QoL) in patients with epilepsy (PE), and its association with depressive symptoms and sexual dysfunction (SD). QoL was assessed by use of the Quality of Life in Epilepsy-31 Inventory (QOLIE-31), SD by the Arizona Sexual Experiences Scale (ASEX), and depressive symptoms by the Hamilton Rating Scale for Depression (HAM-D17). The study included 108 PE (women 63% and men 37% men), mean age 39.54±15.91 years. Focal type epilepsy was diagnosed in 14.8%, generalized type in 35.2%, and both types were present in 40.7% of study patients. Drug-resistant epilepsy (DRE) was present in 44/108 and vagus nerve stimulation (VNS) was implanted in 27/44 patients. The mean response on QOLIE-31 was 62.88±17.21 with no significant differences according to gender, type of epilepsy, and age. A statistically significantly lower QoL was found in the 'Overall QoL' domain (35-55 vs. <35 age group). Patients taking both types of AEDs had a significantly lower QoL compared to those on newer types of AEDs. Higher QoL was associated with less pronounced depressive symptoms (p=0.000). Significant correlations were found between lower QoL and SD (p=0.001). In 27 patients with DRE having undergone VNS, a favorable effect of VNS implantation on the QoL and mood was observed as compared with 18 patients without VNS (p=0.041).
Since its first use in medical purpose in the 1960s, the concept of artificial intelligence has been especially appealing to health care, particularly radiology. With the development of ever more powerful computers from the 1990s to the present, various forms of artificial intelligence have found their way into different medical specialties-most notably radiology, dermatology, ophthalmology, and pathology. Due to the growing presence of such systems, it is paramount for the specialists handling them to get acquainted with them in order to provide the best service for their patients. It is therefore the aim of this article to explain the most basic principles of artificial intelligence, accentuating the most prominent concepts used in radiology today, such as deep learning and neural networks. It will also mention some of the artificial intelligence systems approved for clinical use in the US, such as IDx-DR, used to discover more than mild diabetic retinopathy in patients over 22 years of age; and Arterys, used for cardiac segmentation and discovering liver and lung nodules. Same as in many other fields, there is a constant need for improvement-in construction, testing, and application of these new technologies. Many ethical questions are asked, considering privacy and liability of artificial intelligence systems in clinical use. One of the greatest concerns for radiologists is the possibility of being replaced by these systems. This scenario seems to be far-fetched, at least for the time being. Radiologists should use that time to get to know the "enemy". If they accomplish this, they might discover that they had had an ally all along.
Many years scientist try to explore the connection between air pollution and its influence on human health and after numerous conducted researches they came up with the clear evidence that air pollution has a significant impact on overall health and especially on stroke. In the Global Burden of Disease Study, it has emerged as a significant contributor to the global stroke burden, especially in low-and middle-income countries. Furthermore, these and some other researches have suggested a closer link between air pollution and ischemic stroke, due to huge diversity of the results of numerous other studies, for drawing definitive conclusions, further research is still needed. Due to the complexity of stroke with its types and subtypes, the results of their reaction to air pollution differ. Some studies have shown the link between cardioembolic stroke and AP, others with SAH but not with intracerebral haemorrhage. There was a suggestion that nitrogen dioxide exposure might be associated with stroke caused by small vessel disease, while other studies are not reporting any association of AP and the risk of ischemic stroke. In some studies, AP was more affecting young adults and in some, it was more pronounced in women. Some studies reported a more clear link between AP and recent stroke in patients with other risk factors like diabetes and previous stroke. Studies have varied by the concentration and types of pollutants studied, which vary geographically, as well as by duration to AP exposure being short-or long-term, and in some studies being present only during warm seasons.Regulations have improved air quality in many countries in Europe and the United States, resulting in greater life expectancy, which highlights the continued importance of further efforts in that direction. Sažetak: Zagađenje Zraka: novootkriveni faktor riZika u raZvoju moždanog udaraVeć nekoliko godina znanstvenici pokušavaju istražiti povezanost zagađenja zraka i njegovog utjecaja na zdravlje ljudi, a nakon brojnih provedenih istraživanja došli su do jasnih dokaza da zagađenje zraka ima značajan utjecaj na cjelokupno zdravlje, s posebnim naglaskom na ravoj moždanog udara. U "Global Bourden of Disease" (szo)pokazalo se da zagađeni zrak značajno doprinosi globalnom opterećenju od moždanog udara, posebno u zemljama s niskim i srednjim dohotkom. Nadalje, ova i neka druga istraživanja sugeriraju blisku povezanost zagađenja zraka i ishemijskim moždanim udarom, dok zbog raznolikosti rezultata brojnih drugih studija, za donošenje konačnih zaključaka, potrebna su još daljnja istraživanja. Zbog složenosti moždanog udara s njegovim tipovima i podvrstama, rezultati njihove reakcije na onečišćenje zraka razlikuju se. Neke studije pokazuju vezu između kardioemboličkog moždanog udara i zagađenog zraka, druge sa subarahnoidalnim krvarenjem, ali ne i intracerebralnog krvarenjem. Bilo je nagovještaja i da je izlaganje dušičnom dioksidu povezano s moždanim udarom uzrokovanim bolešću malih žila, dok druge studije ne opisuju tu povezanost sa rizikom od ishemijskog m...
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