RESUMO
The skin lightening (SL) industry has a global reach and is projected to continue to grow over the coming decade. While SL treatments may be safely prescribed for treatment of some dermatologic conditions, many over-the-counter SL products contain ingredients that can cause harm to the skin and other organ systems. Given a lack of transparent information to patients and the historical colorist foundation that contextualizes a component of the cosmetic SL industry, dermatologists need to navigate biomedical and ethical concerns when explaining SL products to patients. This commentary briefly outlines the medical ethical issues surrounding this topic and describes avenues by which dermatologists may provide informed patient care that best supports beneficence, justice, autonomy, and nonmaleficence.
RESUMO
Scoliosis is a disease estimated to affect more than 8% of adults in the United States. It is diagnosed with use of radiography by means of manual measurement of the angle between maximally tilted vertebrae on a radiograph (ie, the Cobb angle). However, these measurements are time-consuming, limiting their use in scoliosis surgical planning and postoperative monitoring. In this retrospective study, a pipeline (using the SpineTK architecture) was developed that was trained, validated, and tested on 1310 anterior-posterior images obtained with a low-dose stereoradiographic scanning system and radiographs obtained in patients with suspected scoliosis to automatically measure Cobb angles. The images were obtained at six centers (2005-2020). The algorithm measured Cobb angles on hold-out internal (n = 460) and external (n = 161) test sets with less than 2° error (intraclass correlation coefficient, 0.96) compared with ground truth measurements by two experienced radiologists. Measurements, produced in less than 0.5 second, did not differ significantly (P = .05 cutoff) from ground truth measurements, regardless of the presence or absence of surgical hardware (P = .80), age (P = .58), sex (P = .83), body mass index (P = .63), scoliosis severity (P = .44), or image type (low-dose stereoradiographic image vs radiograph; P = .51) in the patient. These findings suggest that the algorithm is highly robust across different clinical characteristics. Given its automated, rapid, and accurate measurements, this network may be used for monitoring scoliosis progression in patients. Keywords: Cobb Angle, Convolutional Neural Network, Deep Learning Algorithms, Pediatrics, Machine Learning Algorithms, Scoliosis, Spine Supplemental material is available for this article. © RSNA, 2023.
RESUMO
A major pathophysiological cause of cardiovascular disease is vascular plaque calcification. Fluorine 18−Sodium Fluoride (18F-NaF) PET/CT can be used as a sensitive imaging modality for detection of vascular calcification. The aim of this study was to find a non-invasive, cost-efficient, and readily available metric for predicting vascular calcification severity. This retrospective study was performed on 36 participants who underwent 18F-NaF fused PET/CT scans. The mean standard uptake values (SUVs) were calculated from manually sectioned axial sections over the aortic arch and thoracic aorta. Correlation analyses were performed between SUVs and calculated atherogenic indices (AIs). Castelli's Risk Index I (r = 0.63, p < 0.0001), Castelli's Risk Index II (r = 0.64, p < 0.0001), Atherogenic Coefficient (r = 0.63, p < 0.0001), Atherogenic Index of Plasma (r = 0.51, p = 0.00152), and standalone high-density lipoprotein (HDL) cholesterol (r = −0.53, p = 0.000786) were associated with aortic calcification. AIs show strong association with aortic arch and thoracic aorta calcifications. AIs are better predictors of vascular calcification compared to standalone lipid metrics, with the exception of HDL cholesterol. Clinical application of AIs provides a holistic metric beneficial for enhancing screening and treatment protocols.
