COVID-19 morbidity in patients after orthotopic heart transplantation - single center clinical observation.

INTRODUCTION: The study is a prospective clinical observation of patients after orthotopic heart transplantation in a large academic medical center in relation to COVID-19 morbidity. The study population was comprised of 552 patients. All patients were consulted and advised by telephone as regards the prophylaxis of SARS-CoV-2 infection. Hospital and outpatient follow-ups were limited to the minimum. Preventive modification of immunosuppression was not recommended in relation to the pandemic. Three patients with multiple comorbidities (a woman aged 60, a man aged 59, and another man aged 83; 2.25 years, 5.5 years, and 7.5 years after heart transplantation, respectively) and one patient with concomitant arterial hypertension (a woman aged 48, 5.5 years after heart transplantation) presented with a symptomatic COVID-19 infection. Three of the patients were on tacrolimus immunosuppression, and both female patients were additionally on therapy with mycophenolate mofetil, which was discontinued following the diagnosis of infection. One male patient received combined therapy of cyclosporine A and mycophenolate mofetil. The 60-year-old woman presented with gastrointestinal manifestations of the COVID-19 infection which were of moderate severity. The recovery was achieved. The 59-year-old man presented with myocardial infarction, exacerbated renal insufficiency that required hemodialysis and cardiorespiratory failure complicated by bacterial sepsis. As a result, the patient died. The 83-year-old male patient reporting fever, myalgia, fatigue, cough and dyspnea was admitted to hospital and deceased due to septic shock two days after admission. The 48-year old woman who presented with mild symptoms of the upper respiratory tract infection recovered after two weeks. Symptomatic treatment was used in all the patients. Another male patient (aged 45 years, 8 years after orthotopic heart transplant with no significant comorbidities) was an asymptomatic carrier of SARS-CoV-2 and remained under hospital care. CONCLUSIONS: Of 552 patients after orthotopic heart transplantation, two SARS-CoV-2-related deaths were reported.

Influence of the measurement method of features in ultrasound images of the thyroid in the diagnosis of Hashimoto's disease.

INTRODUCTION: This paper shows the influence of a measurement method of features in the diagnosis of Hashimoto's disease. Sensitivity of the algorithm to changes in the parameters of the ROI, namely shift, resizing and rotation, has been presented. The obtained results were also compared to the methods known from the literature in which decision trees or average gray level thresholding are used. MATERIAL: In the study, 288 images obtained from patients with Hashimoto's disease and 236 images from healthy subjects have been analyzed. For each person, an ultrasound examination of the left and right thyroid lobe in transverse and longitudinal sections has been performed. METHOD: With the use of the developed algorithm, a discriminant analysis has been conducted for the following five options: linear, diaglinear, quadratic, diagquadratic and mahalanobis. The left and right thyroid lobes have been analyzed both together and separately in transverse and longitudinal sections. In addition, the algorithm enabled to analyze specificity and sensitivity as well as the impact of sensitivity of ROI shift, repositioning and rotation on the measured features. RESULTS AND SUMMARY: The analysis has shown that the highest accuracy was obtained for the longitudinal section (LD) with the method of linear, yielding sensitivity = 76%, specificity = 95% and accuracy ACC = 84%. The conducted sensitivity assessment confirms that changes in the position and size of the ROI have little effect on sensitivity and specificity. The analysis of all cases, that is, images of the left and right thyroid lobes in transverse and longitudinal sections, has shown specificity ranging from 60% to 95% and sensitivity from 62% to 89%. Additionally, it was shown that the value of ACC for the method using decision trees as a classifier is equal to 84% for the analyzed data. Thresholding of average brightness of the ROI gave ACC equal to 76%.

Assessment of significance of features acquired from thyroid ultrasonograms in Hashimoto's disease.

INTRODUCTION: This paper concerns the analysis of the features obtained from thyroid ultrasound images in left and right transverse and longitudinal sections. In the image analysis, the thyroid lobe is treated as a texture for healthy subjects and patients with Hashimoto's disease. The applied methods of analysis and image processing were profiled to obtain 10 features of the image. Then, their significance in the classification was shown. MATERIAL: In this study, the examined group consisted of 29 healthy subjects aged 18 to 60 and 65 patients with Hashimoto's disease. For each subject, four ultrasound images were taken. They were all in transverse and longitudinal sections of the right and left lobe of the thyroid, which gave 376 images in total. METHOD: 10 different features obtained from each ultrasound image were suggested. The analyzed thyroid lobe was marked automatically or manually with a rectangular element. RESULTS: The analysis of 10 features and the creation for each one of them their own decision tree configuration resulted in distinguishing 3 most significant features. The results of the quality of classification show accuracy above 94% for a non-trimmed decision tree.

Balanoposthitis with epithelial dysplasia treated by photodynamic therapy.

BACKGROUND: Balanoposthitis is the inflammation of the glans and foreskin of the penis. Balanoposthitis is a risk factor of penis cancer. Photodynamic therapy using topical aminolaevulinic acid could be an alternative therapeutic approach in cases resistant to conventional treatment. OBJECTIVE: We present the case of 50-year-old male with balanoposthitis associated with epithelial dysplasia treated by topical aminolaevulinic acid photodynamic therapy. METHODS: On admission, 2hours after topical application of aminolaevulinic acid we performed the photodynamic diagnosis estimating pathological fluorescence of the lesions. Then 4 hours after topical application of aminolaevulinic acid we followed irradiation using light in the wavelength 630nm and giving a dose 120J/cm(2). RESULTS: After 5 procedures of photodynamic therapy we noticed complete recovery. CONCLUSION: Photodynamic therapy appears to be an alternative, non-invasive, well tolerated method of treatment of eithelial dysplasia of the penis.