Natural Language Processing for the Identification of Incidental Lung Nodules in Computed Tomography Reports: A Quality Control Tool.

PURPOSE: To evaluate the diagnostic performance of a natural language processing (NLP) model in detecting incidental lung nodules (ILNs) in unstructured chest computed tomography (CT) reports. METHODS: All unstructured consecutive reports of chest CT scans performed at a tertiary hospital between 2020 and 2021 were retrospectively reviewed (n = 21,542) to train the NLP tool. Internal validation was performed using reference readings by two radiologists of both CT scans and reports, using a different external cohort of 300 chest CT scans. Second, external validation was performed in a cohort of all random unstructured chest CT reports from 57 different hospitals conducted in May 2022. A review by the same thoracic radiologists was used as the gold standard. The sensitivity, specificity, and accuracy were calculated. RESULTS: Of 21,542 CT reports, 484 mentioned at least one ILN (mean age, 71 ± 17.6 [standard deviation] years; women, 52%) and were included in the training set. In the internal validation (n = 300), the NLP tool detected ILN with a sensitivity of 100.0% (95% CI, 97.6 to 100.0), a specificity of 95.9% (95% CI, 91.3 to 98.5), and an accuracy of 98.0% (95% CI, 95.7 to 99.3). In the external validation (n = 977), the NLP tool yielded a sensitivity of 98.4% (95% CI, 94.5 to 99.8), a specificity of 98.6% (95% CI, 97.5 to 99.3), and an accuracy of 98.6% (95% CI, 97.6 to 99.2). Twelve months after the initial reports, 8 (8.60%) patients had a final diagnosis of lung cancer, among which 2 (2.15%) would have been lost to follow-up without the NLP tool. CONCLUSION: NLP can be used to identify ILNs in unstructured reports with high accuracy, allowing a timely recall of patients and a potential diagnosis of early-stage lung cancer that might have been lost to follow-up.

Perfil epidemiológico da hipospádia na Região Bragantina do estado de São Paulo, Brasil / Epidemiological profile of hypospadias in the Bragantina region of the state of São Paulo, Brazi

Modelo de estudo: Estudo de prevalência. Objetivo do estudo: Avaliar o perfil epidemiológico dos casos de hipospádia atendidos no Hospital São Francisco na Providência de Deus da Universidade São Francisco (HUSF), Bra-gança Paulista/SP nos últimos 10 anos (2007-2017), relacionando os tipos de hipospádia com as malformações asso-ciadas e idade à primeira cirurgia corretiva. Metodologia: Foi realizado um levantamento de casos de hipospádia atendidos entre 2007 e 2017 no HUSF, com pacientes oriundos das cidades da Região Bragantina do estado de São Paulo. Os tipos de hipospádia foram relacionados com as malformações associadas. Foram pesquisados nos prontuários: tipo de hipospádia, idade à primeira cirurgia, laudo de exame ultrassonográfico, etnia, local de nascimento e malformação associada. Os dados foram analisados estatisticamente utilizando os testes Qui-quadrado, teste F e de Kruskal-Wallis. Resultados: Em 1401 atendimentos pediátricos no período avaliado, foram encontrados 45 casos de hipospádia com prevalência igual a 0,7/1000 nascidos vivos. Do total de casos, 29 foram classificados como do tipo distal, seis casos de hipospádia média e 10 casos do tipo proximal [F-test (2,8)=5,552; P=0,003; χ2=9,3117; P=0,009]. Nos casos de hipospádia distal, foram detectadas 16 malformações associadas e, nos tipos média e proximal, foram observadas sete malformações associadas em cada uma (KW=3,322, P=0,19). O maior número de casos foi abordado cirurgica-mente no intervalo entre os três e quatro anos de idade. Conclusão: A hipospádia distal foi a mais prevalente, com idade à primeira cirurgia em desacordo com o intervalo proposto para a correção da hipospádia. (AU)

Study model: a Prevalence study. Objective: Evaluating the epidemiological profile of hypospadias cases assisted in the Hospital São Francisco na Providência de Deus of the Universidade São Francisco (HUSF), Bragança Paulista, Brazil, in the last 10 years (2007-2017), relating the types of hypospadias with associated malformations and age at the first corrective surgery. Methodology: A survey of hypospadias cases assisted between 2007 and 2017 in HUSF was carried out with patients from the Bragantina region of the state of São Paulo. The types of hypospadias were related to the associated malformations. The following data were collected from the medical records: type of hypospadias, age at first surgery, ultrasound imaging, ethnicity, place of birth, associated malformation. Data were statistically analyzed using Chi-squared, F-test and Kruskal-Wallis tests. Results: In 1401 pediatric assistances, it was found 45 cases of hypo-spadias with a prevalence of 0.7/1000 births. From the total, 29 cases were classified as distal, six cases of medium, and 10 cases as proximal types [F-test (2.8)=5.552, P=0.003, χ2=9.3117, P=0.009]. Cases of distal hypospadias had 16 associated malformations, and for medial and proximal types there were seven associated malformations in each one (KW=3.322, P=0.19). The largest number of cases was surgically corrected between three and four years of age. Conclusion: Distal hypospadias were the most prevalent in the Bragantina region in the last 10 years. It was also ob-served that the age at first surgery is in disagreement with the range proposed for the corrective approach of hypospadia (AU)

Enzymatic de-glycosylation of rutin improves its antioxidant and antiproliferative activities.

Bioavailability and biological properties of flavonoid glycosides can be improved after the enzymatic hydrolysis of specific glycosyl groups. In this study, we evaluate the antioxidant and antiproliferative potential of rutin after enzymatic hydrolysis performed by α-l-rhamnosidases (hesperidinase from Penicillium sp. and naringinase from Penicillium decumbens) previously heated at 70°C for 30 min to inactivate the undesirable ß-d-glucosidase activity. The highest in vitro antioxidant activity determined by DPPH radical scavenging was achieved with rutin hydrolyzed by hesperidinase. Rutin was predominantly bioconverted into quercetin-3-glucoside. There was no statistical difference between xanthine oxidase inhibition by rutin before and after hydrolysis. However, in vitro inhibitory activity against ten human tumor cell lines showed that hydrolyzed rutin exerted a more potent antiproliferative effect than quercetin and rutin on various cancer cell lines, specially glioma, and ovarian and breast adenocarcinomas. These results indicate that quercetin-3-glucoside could be a promising functional derivative obtained by rutin hydrolysis.