Radiomics in immuno-oncology.

With the ongoing advances in imaging techniques, increasing volumes of anatomical and functional data are being generated as part of the routine clinical workflow. This surge of available imaging data coincides with increasing research in quantitative imaging, particularly in the domain of imaging features. An important and novel approach is radiomics, where high-dimensional image properties are extracted from routine medical images. The fundamental principle of radiomics is the hypothesis that biomedical images contain predictive information, not discernible to the human eye, that can be mined through quantitative image analysis. In this review, a general outline of radiomics and artificial intelligence (AI) will be provided, along with prominent use cases in immunotherapy (e.g. response and adverse event prediction) and targeted therapy (i.e. radiogenomics). While the increased use and development of radiomics and AI in immuno-oncology is highly promising, the technology is still in its early stages, and different challenges still need to be overcome. Nevertheless, novel AI algorithms are being constructed with an ever-increasing scope of applications.

Pregnancy outcomes in Benghazi, Libya, before and during the armed conflict in 2011.

Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes. This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011. Data were collected on all women admitted to the delivery ward during February to May 2011 (the months of the most active fighting in the city) (n = 7096), and October to December 2010 (the months immediately before the war) (n = 5935). Compared with the preceding months there was a significant rise during the conflict in the rate of deliveries involving preterm (3.6% versus 2.5%) and low-birth-weight (10.1% versus 8.5%) infants and caesarean sections (26.9% versus 25.3%). Psychosocial stress may have been a factor (among others) in an increase in negative pregnancy outcomes, and obstetric hospitals should be aware of these issues in times of war.

Cervical cancer in north-eastern Libya: 2000-2008.

Libya is a country with a low population, listed under the EMRO. Using registers and patient records from a major primary oncology clinic, data was gathered from Libyan cervical cancer patients and various parameters were studied across 9 years. Out of 4,090 female cancer cases during the study period, 1.8% were cervical cancer (n = 74). The average age of presentation was 53 years, with most of the cases (60%, n = 44) being premenopausal. Approximately 65% (n = 48) of cervical cancer patients are diagnosed at later stages (i.e. stages III and IV). The majority of these cases are squamous cell carcinoma (83.8%, n = 62), while 16.2% (n = 12) were found to be adenocarcinoma. Patients with squamous cell carcinoma presented at later stages more often than those with adenocarcinoma. Human papilloma virus was strongly implicated in cervical cancer, with 94% (n = 63) of those who were tested being positive for HPV-16 (82.5%, n = 52) and HPV-18 (12.7%, n = 8). Diagnosis was most frequently made through biopsy (97.3%, n = 72) as opposed to Pap smears (2.7%, n = 2). Most Libyan patients were put through chemotherapy (75%, n = 55) and triple therapy (surgery with combined chemotherapy and radiotherapy) was the most common (38%, n = 28) modality of treatment. Comparisons were made between Libya and other nations, either in the developed world or neighbouring countries. The major problem of cervical cancer in Libya is delayed presentation and hence, all the recommendations focus on increased awareness for the populace, implementation of a national cancer control plan and a national screening programme.

Pregnancy outcomes in Benghazi, Libya, before and during the armed conflict in 2011

Stressful life events experienced by pregnant women may lead to adverse obstetric outcomes.This study in Benghazi compared the rates of preterm, low-birth-weight and caesarean-section births at Al-Jamhouria hospital in the months before and during the armed conflict in Libya in 2011.Data were collected on all women admitted to the delivery ward during February to May 2011 [the months of the most active fighting in the city][n - 7096], and October to December 2010 (the months immediately before the war][n = 5935]. Compared with the preceding months there was a significant rise during the conflict in the rate of deliveries involving preterm [3.6% versus 2.5%]and low-birth-weight [10, 1% versus 8.5%]infants and caesarean sections [26.9% versus 25.3%]. Psychosocial stress may have been a factor [among others]in an increase in negative pregnancy outcomes, and obstetric hospitals should be aware of these issues in times of war

قد تؤدي أحداث الحياة الضاغطة التي تعاني منها الحوامل إلى حصائل توليدية ضائرة. وتقدم هذه الدراسة التي أجريت في بنغازي مقارنة لمعدلات الولادة قبل الأوان، والوزن المنخفض أثناء الولادة، والولادات القيصرية في مستشفى الجماهيرية قبل وخلال الشهور التي سبقت النزاع المسلح في ليبيا عام 2011 . وقد جمع الباحثون البيانات عن جميع الحوامل اللاتي أدخلن إلى جناح الولادة خلال الأشهر من شباط/فبراير إلى أيار/مايو 2011 ، وهي الشهور التي اندلع فيها القتال الأكثر ضراوة في المدينة، وعددهن 7096 حاملا، واللاتي أدخلن خلال الأشهر من تشرين الأول/أكتوبر إلى كانون الأول/ديسمبر 2010 ، وهي الأشهر التي سبقت القتال مباشرة، وعددهن 5935 حاملا. وبالمقارنة مع الأشهر السابقة اتضح وجود ارتفاع يعتد به إحصائيا في معدلات الولادة قبل الأوان [3.6 % مقابل 2.5 %]، ونقص الوزن عند الولادة [10.1 % مقابل 8.5 %]، والعمليات القيصرية [26.9 % مقابل 25.3 %]. إن الكرب النفسي قد يكون واحد من العوامل المتعددة التي تزيد من الحصائل السلبية للحمل، وينبغي أن تتنبه مستشفيات التوليد لهذه القضايا في أوقات الحروب

Les femmes enceintes qui vivent des événements stressants peuvent être plus à risque d'une issue obstétricale défavorable.L'étude menée à Benghazi a comparé les taux de prématurité, de faible poids de naissance et de césarienne à l'hôpital Al-Jamhouria dans les mois précédant et pendant le conflit armé en Libye en 2011.Les données recueillies auprès de toutes les femmes admises en salle d'accouchement entre février et mai 2011 [au plus fort des combats dans la ville][n = 7096], et entre octobre et décembre 2010 [les mois précédant la guerre][n = 5935]. Par rapport aux mois précédents, une augmentation importante du taux d'accouchements impliquant une prématurité [3, 6 % contre 2, 5 %]et un faible poids de naissance [10, 1 % contre 8, 5 %]ainsi que des césariennes [26, 9 % contre 25, 3 %]a été observée pendant le conflit.Le stress psychosocial peut avoir été un facteur [entre autres]dans l'augmentation des issues négatives de la grossesse, et les établissements obstétricaux devraient être informés de ces problèmes en temps de guerre

A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.

We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.