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Perkins Mcintosh posted an update 6 months, 1 week ago
Facial nerve dysfunction is common in patients with Bell’s palsy, trauma, tumour, or iatrogenic injuries. Imaging assessment is the most convenient method for patients and their treating physician. With developments in artificial intelligence (AI), manual work will be replaced. In this study, a database of facial images of patients with oral and maxillofacial diseases was set up to develop a facial nerve functional assessment system based on AI. This database was then used to evaluate the accuracy of a state-of-the-art algorithm for facial landmark detection named ‘HRNet’. Utilizing this database and with appropriate human intervention, HRNet was used in facial annotation. The accuracy of annotations was evaluated through the normalized mean error. A total of 912 images were collected from 300 people; 546 of these images had abnormal features including defects, swelling, scars, or facial paralysis. The accuracy for the abnormal group was lower than that for the normal group before and after training, but improvements in accuracy were identified in both groups post-training. In conclusion, this new database demonstrates the ability of HRNet to localize facial landmarks in patients with oral and maxillofacial diseases. More images for training should be added to this database to diversify it in the future.
Elevation of high-sensitivity troponin-T (hs-TnT) is linked to cardiovascular morbidity and mortality. However, its prognostic value for survival and cardiovascular events and its relation to clinical characteristics and cardiac function parameters in clinically asymptomatic adults with congenital heart disease (ACHD) needs further exploration.
A systematic literature search was performed in PubMed and Cochrane from 2010 to May 2020 for hs-TnT as a prognostic marker in ACHD. Three independent reviewers evaluated the articles according to the Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. Overall, eight studies with a total of 2162 ACHD patients (18-63 years) were included.
Hs-TnT level was elevated in 8-26% of asymptomatic ACHD. The follow-up for all-cause mortality and cardiovascular events ranged from 3.0 to 5.6 years and in 8-38% of the participants cardiac endpoints were reached. Throughout the included studies, elevated hs-TnT was found to be an independent predictor for survival and heart failure in stable ACHD. Serial hs-TnT measurement was found to be beneficial over single measurement. Hs-TnT levels were correlated with male sex, higher age, and higher New York Heart Association class and associated with several cardiac dysfunction parameters.
More scientific research investigating the prognostic value of hs-TnT in stable ACHD is needed and the clinical relevance to guide aftercare has still to be determined.
More scientific research investigating the prognostic value of hs-TnT in stable ACHD is needed and the clinical relevance to guide aftercare has still to be determined.Pat Jasan emerged as a largescale popular social movement in the Kachin region of northern Myanmar in 2014, with the objective of eradicating illicit drug production and consumption from the region. It has since been heavily criticized for its methods and opposition to harm reduction initiatives. The purpose of this paper is to understand better the cultural and psychological response to worsening drug issues that underpin the rise of Pat Jasan as a mass social movement. The paper contextualises two ways in which Pat Jasan frames the local drugs crisis first, the sense of existential threat posed by drug related social harms; and second, the belief that ‘all’ Kachin households are negatively impacted by these harms. We outline the underpinning ideological beliefs upon which these frames rest. We discuss how even though non-Christian beliefs and practices have largely disappeared, they remain layered within the deep culture of attitudes towards drug use and how best to deal with the community-level harms that are believed to be created by such behaviours. Critically, the paper also draws attention to the largely unrecognized involvement of women as mobilizing forces of the Pat Jasan movement and how the movement leveraged popular feeling at a critical moment in the region’s political history.Cardiac hemangiomas are exceedingly rare and can lead to cardiac tamponade. Cardiac tamponade is a true medical emergency that can cause cardiovascular collapse and death if not managed appropriately. There are many causes of cardiac tamponade such as trauma, autoimmune causes, and malignancy. Cardiac tumors are difficult to diagnose and may be present on advanced imaging including cardiac MRI. For patients with cardiac tumors causing tamponade, emergent pericardiocentesis and cardiovascular surgery consultation are necessary in management. We present a unique case of cardiac tamponade caused by a cardiac hemangioma.Compartment syndrome (CS) is a condition associated with intra-compartment pressures exceeding the perfusion pressure of the tissue. This condition can occur in any body compartment surrounded by fascia, however CS of some regions like the thenar and hypothenar is extremely rare. KU-0063794 Acute CS is often caused by major trauma and idiopathic acute CS is sparsely reported in literature. We present a case report of a 39-year-old male, with a medical history of rheumatoid arthritis (RA) for which he uses adalimumab and low-dose prednisone, with idiopathic acute CS of thenar and hypothenar compartments. Unexplained tremendous pain, paresthesia and swelling of his hand were the only symptoms observed. Due to direct recognition of the condition there was no delay in time to treatment. Treatment involved a fasciotomy of the thenar and hypothenar compartments as well as a release of the carpal tunnel. This direct surgical approach resulted in retaining excellent function and appearance of the hand. We hypothesized several causes for the etiology of the condition (e.g. rhabdomyolysis, rheumatologic disease-related condition, other systemic diseases, trauma, infection), but all could be rejected based on laboratory or clinical findings. Remarkable is that the patient experienced a comparable episode in his other hand two years earlier. Although the acute CS is of unknown origin in the presented case, the development of acute CS in both hands over time suggests a predisposing factor in idiopathic acute CS that is far from being elucidated.
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