Using Bayesian Optimization and Wavelet Decomposition in GPU for Arterial Blood Pressure Estimation.

Continuous monitoring of arterial blood pressure (ABP) of patients in hospital is currently carried out in an invasive way, which could represent a risk for them. In this paper, a noninvasive methodology to optimize ABP estimators using electrocardiogram and photoplethysmography signals is proposed. For this, the XGBoost machine learning model, optimized with Bayesian techniques, is executed in a Graphics Processing Unit, which drastically reduces execution time. The methodology is evaluated using the MIMIC-III Waveform Database. Systolic and diastolic pressures are estimated with mean absolute error values of 15.85 and 11.59 mmHg, respectively, similar to those of the state of the art. The main advantage of the proposed methodology with respect to others of the current state of the art is that it allows the optimization of the estimator model to be performed automatically and more efficiently at the computational level for the data available. Clinical Relevance- This approach has the advantage of using noninvasive methods to continuously monitor patient's arterial blood pressure, reducing the risk for patients.

Postoperative inverted intercostal hernia incidentally detected by chest computed tomography in a patient with COVID-19.

Inverted intercostal hernias are uncommon, and even more so when comprised of soft tissue instead of lung parenchyma in the postoperative context. This report demonstrates a case in with such a hernia was diagnosed through chest multidetector computerized tomography in a 48-year-old woman who presented to the emergency room with respiratory symptoms and tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). She had positive surgical history for left lower lobectomy with bronchoplastic procedure and mediastinal lymphadenectomy, due to an endobronchial typical carcinoid tumor a few years ago. Therefore, it is important for radiologists to be aware of the imaging characteristics of inverted intercostal hernias, to avoid diagnostic errors.

Nocardiosis in Free-Ranging Cetaceans from the Central-Eastern Atlantic Ocean and Contiguous Mediterranean Sea.

We report the pathologic features of nocardiosis in five free-ranging delphinids from the Canary Islands and Andalusia, namely four striped dolphins (Stenella coerulealba) and one bottlenose dolphin (Tursiops truncatus). All animals had a multiorgan (disseminated) pattern of infection involving suppurative to pyogranulomatous and thromboembolic lesions in two or more organs. Most affected organs were (by decreasing order) lung, pulmonary lymph nodes, liver, kidney, adrenal glands, and central nervous system. Typical intralesional and intravascular branched and filamentous bacteria were highlighted by Grocott's methenamine silver and Gram stains. Bacterial analysis including 16S rRNA gene sequencing identified Nocardia farcinica in two striped dolphins and Nocardia otitidiscaviarum in one striped dolphin and the bottlenose dolphin. All dolphins tested (n = 4) for cetacean morbillivirus were negative; one dolphin had concurrent cutaneous herpesvirosis. These results provide the first record of N. otitidiscaviarum in cetaceans, the first account of N. farcinica in free-ranging dolphins, and confirmation of nocardiosis in central eastern Atlantic Ocean. These results expand the known geographic range of nocardiosis in cetaceans.

Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal.

Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.

Surgically treated mediastinal fat necrosis: an exception to conservative treatment.

Mediastinal fat necrosis is an important differential diagnosis for acute chest pain in previously healthy patients. Imaging examination is essential to establish this diagnosis, as physical examination can be unhelpful and laboratory tests are non-specific. The treatment of choice is conservative, with non-steroidal anti-inflammatory drugs; surgery is reserved for a few selected cases. We present the case of a 37-year-old male patient with mediastinal fat necrosis, refractory to the conservative management and complicated by growing pleural effusion, which was treated surgically.

Nacre morphology and chemical composition in Atlantic winged oyster Pteria colymbus (Röding, 1798).

The microstructure and nanostructure of nacre in Pteria colymbus were studied with high-resolution field emission scanning electron microscopy (FESEM). The tablets were found to be flat and polyhedral with four to eight sides, and lengths ranging from 0.6 to 3.0 µm. They consisted of nanocrystals 41 nm wide, growing in the same direction. X-ray diffraction showed the crystals to be mineral phase aragonite, which was confirmed by Raman spectroscopy. Fourier transform infrared spectroscopy identified a band at 1,786.95 cm-1 attributed to carboxylate (carbonyl) groups of the proteins present in the organic matrix as well as bands characteristic of calcium carbonate. X-ray fluorescence showed the nacre to contain 98% calcium carbonate, as well as minor elements (Si, Na, S and Sr) and trace elements (Mg, P, Cu, Al, Fe, Cl, K and Zn).

Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal / Consenso de terminologia em radiologia torácica em português do Brasil e de Portugal

ABSTRACT Effective communication among members of medical teams is an important factor for early and appropriate diagnosis. The terminology used in radiology reports appears in this context as an important link between radiologists and other members of the medical team. Therefore, heterogeneity in the use of terms in reports is an important but little discussed issue. This article is the result of an extensive review of nomenclature in thoracic radiology, including for the first time terms used in X-rays, CT, and MRI, conducted by radiologists from Brazil and Portugal. The objective of this review of medical terminology was to create a standardized language for medical professionals and multidisciplinary teams.

RESUMO A comunicação eficiente entre a equipe médica é um fator importante no diagnóstico e tratamento precoce e adequado dos pacientes. A terminologia utilizada em relatórios de exames radiológicos aparece nesse contexto como um elo importante entre radiologistas e os demais integrantes da equipe médica. Portanto, a heterogeneidade no uso de termos em relatórios é importante mas ainda pouco discutida. Este artigo é resultado de uma extensa revisão da nomenclatura radiológica em radiologia torácica, englobando pela primeira vez termos utilizados em vários métodos (radiografia, TC e RM), desenvolvida por radiologistas brasileiros e portugueses. O objetivo desta revisão da terminologia médica foi criar uma linguagem padronizada para os profissionais médicos e as equipes multidisciplinares.

Histopathological Differential Diagnosis of Meningoencephalitis in Cetaceans: Morbillivirus, Herpesvirus, Toxoplasma gondii, Brucella sp., and Nasitrema sp.

Infectious and inflammatory processes are among the most common causes of central nervous system involvement in stranded cetaceans. Meningitis and encephalitis are among the leading known natural causes of death in stranded cetaceans and may be caused by a wide range of pathogens. This study describes histopathological findings in post-mortem brain tissue specimens from stranded cetaceans associated with five relevant infectious agents: viruses [Cetacean Morbillivirus (CeMV) and Herpesvirus (HV); n = 29], bacteria (Brucella sp.; n = 7), protozoa (Toxoplasma gondii; n = 6), and helminths (Nasitrema sp.; n = 1). Aetiological diagnosis was established by molecular methods. Histopathologic evaluations of brain samples were performed in all the cases, and additional histochemical and/or immunohistochemical stains were carried out accordingly. Compared with those produced by other types of pathogens in our study, the characteristic features of viral meningoencephalitis (CeMV and HV) included the most severe and frequent presence of malacia, intranuclear, and/or intracytoplasmic inclusion bodies, neuronal necrosis and associated neuronophagia, syncytia and hemorrhages, predominantly in the cerebrum. The characteristic features of Brucella sp. meningoencephalitis included the most severe and frequent presence of meningitis, perivascular cuffing, cerebellitis, myelitis, polyradiculoneuritis, choroiditis, ventriculitis, vasculitis, and fibrinoid necrosis of vessels. The characteristic features of T. gondii meningoencephalitis included lymphocytic and granulomatous encephalitis, tissue cysts, microgliosis, and oedema. In the case of Nasitrema sp. infection, lesions are all that we describe since just one animal was available. The results of this study are expected to contribute, to a large extent, to a better understanding of brain-pathogen-associated lesions in cetaceans.

Retrospective Study of Fishery Interactions in Stranded Cetaceans, Canary Islands.

Estimating cetacean interactions with fishery activities is challenging. Bycatch and chronic entanglements are responsible for thousands of cetacean deaths per year globally. This study represents the first systematic approach to the postmortem investigation of fishery interactions in stranded cetaceans in the Canary Islands. We retrospectively studied 586 cases necropsied between January 2000 and December 2018. Of the cases with a known cause of death, 7.4% (32/453) were due to fishery interactions, and the Atlantic spotted dolphin (Stenella frontalis) was the most affected species [46.9% (15/32)]. Three types of fishery interactions were recognized by gross findings: bycatch [65.6% (21/32)], chronic entanglements [18.8% (6/32)], and fishermen aggression [15.6% (5/32)]. Among the bycaught cases, we differentiated the dolphins that died because of ingestion of longline hooks [23.8% (5/21)] from those that died because of fishing net entrapments [76.2% (16/21)], including dolphins that presumably died at depth due to peracute underwater entrapment (PUE) [37.5% (6/16)], dolphins that were hauled out alive and suffered additional trauma during handling [43.8% (7/16)], and those that were released alive but became stranded and died because of fishery interactions [18.7% (3/16)]. Gross and histologic findings of animals in each group were presented and compared. The histological approach confirmed gross lesions and excluded other possible causes of death. Cetaceans in good-fair body condition and shallow diving species were significantly more affected by fishery interactions, in agreement with the literature. Low rates of fishery interactions have been described, compared with other regions. However, within the last few years, sightings of entangled live whales, especially the minke whale (Balaenoptera acutorostrata) and Bryde's whale (B. edeni), have increased. This study contributes to further improvement of the evaluation of different types of fishery interactions and may facilitate the enforcement of future conservation policies to preserve cetacean populations in the Canary Islands.

Factors associated with subcentimeter pulmonary nodule outcomes followed with computed tomography imaging in oncology patients.

INTRODUCTION: Technological advancements in computed tomography (CT) have enabled the frequent detection of small pulmonary nodules (PNs), especially in patients with an oncologic history. It is important the malignant versus benign etiology of PNs be determined. The aim of the present study was to evaluate the behavior and clinical/radiological characteristics of subcentimeter PNs detected by CT in oncologic patients. METHODS: An observational, longitudinal, retrospective and single-center study was conducted with a sample of 100 patients with a diagnosis of a primary malignant solid tumor outside of the lungs who developed indeterminate subcentimeter PNs (n = 251) detected on consecutive thoracic CT scans from 2015 to 2017. Follow-up CTs for each patients were examined in each of three periods (0-3 months, 3-6 months, and 6 months to 1 year). RESULTS: In our study sample, 28 patients (28 %) showed one or more signs suspicious of pulmonary metastasis, including ≥50 % PN growth, nodule growth followed by size reduction in patients undergoing chemotherapy, and the appearance of multiple nodules. The majority (56 %) of the PNs were detected during the 3-6-month follow-up CT scan. PNs with irregular, lobuled, or spiculated margins exhibited faster growth than PNs with regular, smooth margins. Malignancy of PNs was found to be significantly associated with being male, a primary colorectal cancer diagnosis, and advanced stage disease. CONCLUSION: Our findings reinforce the necessity of an individualized CT follow-up strategy for patients with an oncologic history, as well as the importance of early nodule screening, with the inter-scan interval being dependent on the primary neoplasm.

Measles-Associated Pneumonia / Neumonia asociada al sarampión

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COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan?

The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary angiography that can objectively identify filling defects in pulmonary arterial branches.

COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan?

The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary angiography that can objectively identify filling defects in pulmonary arterial branches.

COVID-19 and acute pulmonary embolism: what should be considered to indicate a computed tomography pulmonary angiography scan?

Abstract The full spectrum of COVID-19 is still emerging, although several studies have highlighted that patients infected with the novel coronavirus can potentially develop a hypercoagulable state. However, several aspects related to the incidence and pathophysiology of the association between COVID-19 and pulmonary embolism are not well established. Here, we present a case of a patient with COVID-19 who developed acute pulmonary embolism. Clinical and laboratory data and findings of non-enhanced CT indicate possibility of acute pulmonary embolism, and support the decision to proceed with computed tomography pulmonary angiography that can objectively identify filling defects in pulmonary arterial branches.