International journal of clinical research & trials最新文献

{"title":"Artificial Intelligence in Colorectal Polyp Detection and Characterization.","authors":"Alexander Le,&nbsp;Moro O Salifu,&nbsp;Isabel M McFarlane","doi":"10.15344/2456-8007/2021/157","DOIUrl":"https://doi.org/10.15344/2456-8007/2021/157","url":null,"abstract":"<p><strong>Background: </strong>Over the past 20 years, the advancement of artificial intelligence (AI) and deep learning (DL) has allowed for fast sorting and analysis of large sets of data. In the field of gastroenterology, colorectal screening procedures produces an abundance of data through video and imaging. With AI and DL, this information can be used to create systems where automatic polyp detection and characterization is possible. Convoluted Neural Networks (CNNs) have proven to be an effective way to increase polyp detection and ultimately adenoma detection rates. Different methods of polyp characterization of being hyperplastic vs. adenomatous or non-neoplastic vs. neoplastic has also been investigated showing promising results.</p><p><strong>Findings: </strong>The rate of missed polyps on colonoscopy can be as high as 25%. At the beginning of the 2000s, hand-crafted machine learning (ML) algorithms were created and trained retrospectively on colonoscopy images and videos, achieving high sensitivity, specificity, and accuracy of over 90% in many of the studies. Over time, the advancement of DL and CNNs has allowed algorithms to be trained on non-medical images and applied retrospectively to colonoscopy videos and images with similar results. Within the past few years, these algorithms have been applied in real-time colonoscopies and has shown mixed results, one showing no difference while others showing increased polyp detection.Various methods of polyp characterization have also been investigated. Through AI, DL, and CNNs polyps can be identified has hyperplastic/adenomatous or non-neoplastic/neoplastic with high sensitivity, specificity, and accuracy. One of the research areas in polyp characterization is how to capture the polyp image. This paper looks at different modalities of characterizing polyps such as magnifying narrow band imaging (NBI), endocytoscopy, laser-induced florescent spectroscopy, auto-florescent endoscopy, and white-light endoscopy.</p><p><strong>Conclusions: </strong>Overall, much progress has been made in automatic detection and characterization of polyps in real time. Barring ethical or mass adoption setbacks, it is inevitable that AI will be involved in the field of GI, especially in colorectal polyp detection and identification.</p>","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10524292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Challenges and Opportunities for Healthcare Reform: A Book Review","authors":"Victoria L. Henglein, Samy I McFarlane","doi":"10.15344/2456-8007/2020/155","DOIUrl":"https://doi.org/10.15344/2456-8007/2020/155","url":null,"abstract":"","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44441474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report: Rare Presentation of Intracranial Hemorrhage post Guillain Barré Syndrome","authors":"Sarah El Halabi, Jaafar Al Shami, Ghadir Hijazi, Zakaria Alameddine, M. Ghandour, A. Saad","doi":"10.38179/ijcr.v1i1.23","DOIUrl":"https://doi.org/10.38179/ijcr.v1i1.23","url":null,"abstract":"\u0000Background: Guillain Barre Syndrome (GBS) is an autoimmune disease where antibodies attack the myelin sheath of peripheral nerves. The hallmark of the disease includes symmetrical quadriparesis, respiratory distress, and failure with subsequent need for mechanical ventilation. Most cases occur after a viral or bacterial infection. Other causes, such as intracranial hemorrhage, also exist, and several case studies report an association between these two pathologies.\u0000\u0000\u0000Case Report: In this report, we present the case of an elderly male patient with intracranial (IC) bleeding post-GBS. The patient was admitted to the hospital for dyspnea and diagnosed with pneumonia. When he started complaining of progressive bilateral ascending paralysis of his lower extremities, we performed a lumbar puncture, and he was diagnosed with GBS. We started him on intravenous immune globulins (IVIGs) immediately, but his weakness progressed to include his respiratory muscles, and he required mechanical ventilatory support with Intensive Care Unit (ICU) admission. We extubated him after two weeks, but he needed to be reintubated 24 hours later for a severely decreased level of consciousness. An urgent computed tomography scan of the brain showed IC bleeding. The patient developed a septic shock due to his pneumonia, which was refractory to antibiotics and vasopressors. He passed away a few weeks after that.\u0000\u0000\u0000Conclusion: Our case represents a unique type of association between IC hemorrhages and GBS, where the bleeding occurred several days after, as opposed to before GBS. It also reinforces the correlation between GBS and Intracranial bleeding and stresses the importance of having a high index of suspicion when facing either pathology since both have similar symptoms that may overlap or mask each other.\u0000","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72524523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19: What We Know So Far","authors":"N. Emmanuel, V. Zibara, J. Saad, R. Iskandar, Rawad Abi Assaad, E. Ammanouil, Yara Bilen, G. Chidiac, N. Ahmar","doi":"10.38179/ijcr.v1i1.19","DOIUrl":"https://doi.org/10.38179/ijcr.v1i1.19","url":null,"abstract":"\u0000Objective: Since the emergence of the COVID-19 pandemic at the end of 2019, the number of affected cases has not stopped rising. Similarly, the number of scientific publications and pre-prints has been increasing exponentially, with an effort to understand this disease more and find a proper solution. The purpose of this article is to review the current understanding of the novel coronavirus.\u0000\u0000\u0000Background: The latest COVID-19 pandemic caused by the SARS-CoV-2 has spread globally ever since it emerged in Wuhan's city in China. This rapidly spreading disease has changed our lives in unimaginable ways, spreading fear and uncertainty due to the lack of knowledge and the flooding with new information, which lacks the scientific method and cannot be critically appraised. The purpose of this article is to gather some of the best knowledge that has been published so far in a unified narrative review, making it easy for the scientific community to review the most accurate and recent understandings about COVID-19.\u0000\u0000\u0000Methods: We screened relevant articles using a specified number of keywords and specific databases, including PubMed and Embase. We selected peer-reviewed English published material related to the topic, except for a few pre-prints that we deemed necessary to include. We also screened the reference lists of these articles to find relevant publications with the same criteria.\u0000\u0000\u0000Discussion: This narrative overview comprises several subsections that discuss the epidemiology, virology, pathogenesis, clinical manifestations, diagnostic methods, and management of the disease. We also presented a section on the implications of the disease in pregnancy. We wrapped up the review with a special division regarding the response to COVID-19,  which has been diverse in different countries.\u0000\u0000\u0000Conclusion: COVID-19 has been a serious global health threat with a high transmission and case fatality rate, particularly in vulnerable populations. Epidemiologic models have so far guided the response, but they need to be interpreted carefully, with an understanding of their limitations. The disease's response has varied among different countries; with no current vaccine or standard treatment, the world stands in fear, maximizing preventive strategies to reduce the damages caused by this virus. This manuscript presents a summary of everything that is so far known about COVID-19 to make it easier for the medical community to overview the disease that has changed the world.\u0000","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80623446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report: Fatal Case of Disseminated Tuberculosis in a 24-year-old Male Patient with Crohn’s Disease","authors":"","doi":"10.38179/ijcr.v1i1.2","DOIUrl":"https://doi.org/10.38179/ijcr.v1i1.2","url":null,"abstract":"","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89201835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report: Case of Megacolon due to Bowel Intussusception in an Elderly Patient","authors":"","doi":"10.38179/ijcr.v1i1.3","DOIUrl":"https://doi.org/10.38179/ijcr.v1i1.3","url":null,"abstract":"","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75578807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Malignancy Among Urban Black Rheumatoid Arthritis Patients.","authors":"Isabel M McFarlane,&nbsp;Manjeet S Bhamra,&nbsp;Abhimnayu Amarnani,&nbsp;Su Yien Zhaz,&nbsp;Srinivas Kolla,&nbsp;Milena Rodriguez Alvarez,&nbsp;George Mo,&nbsp;Maya Srinivasan,&nbsp;Gil Hevroni,&nbsp;Talia Meisel,&nbsp;Abida Hasan,&nbsp;Marie S Baguidy,&nbsp;Michael Hadaddin,&nbsp;Adielle Melamed,&nbsp;Kristaq Koci,&nbsp;Nicholas Taklalsingh,&nbsp;Joshy Pathiparampil,&nbsp;Latoya Freeman,&nbsp;Ian Kaplan,&nbsp;Naureen Kabani,&nbsp;David J Ozeri,&nbsp;Elsie Watler,&nbsp;Mosab Frefer,&nbsp;Vytas Vaitkus,&nbsp;Keron Matthew,&nbsp;Fray Arroyo-Mercado,&nbsp;Helen Lyo,&nbsp;Aleksander Feoktistov,&nbsp;Randolph Sanchez,&nbsp;Faisal Soliman,&nbsp;Felix Reyes Valdez,&nbsp;Veena Dronamraju,&nbsp;Michael Trevisonno,&nbsp;Christon Grant,&nbsp;Guerrier Clerger,&nbsp;Kunfeng Sun,&nbsp;Khabbab Amin,&nbsp;Makeda Dawkins,&nbsp;Jason Green,&nbsp;Samir Fahmy,&nbsp;Apoorva Jayarangaiah,&nbsp;Stephen Anthony Waite,&nbsp;Aaliya Burza","doi":"10.15344/2456-8007/2020/145","DOIUrl":"https://doi.org/10.15344/2456-8007/2020/145","url":null,"abstract":"Background Rheumatoid arthritis (RA) patients have an increased risk of malignancy with postulated risk factors that include chronic inflammation, smoking and the use of immunosuppressants have been postulated as drivers of higher malignancies rates. Our study aimed to describe the prevalence and type of malignancies encountered in an urban, predominantly Black RA patient population. Methods Cross sectional analysis of 1142 patients with RA diagnosis by ICD-codes of which 501 cases met the inclusion criteria for the study. Blacks accounted for 88.4% of the study population. Fifty-six patients had cancer recorded in their medical records and these cases were further reviewed for tumor type, timing of diagnosis and patient clinical characteristics. Results The cancer prevalence was 11.2% (56/501) in our Black RA population being studied. Mean age at cancer diagnosis was 59.9 ± 5.2 for the patients who developed cancer before RA diagnosis and 58.25 ± 16.02 for those who developed malignancy after RA diagnosis. There were 18 breast cancers, 4 colon and 4 cervical cancers; for lung, multiple myeloma, thyroid, squamous cell carcinoma and pancreas there were 3 cases each; for endometrial, Non-Hodgkin's lymphoma, meningioma and prostate, 2 cases each and 1 each for urinary bladder, esophageal adenocarcinoma, lymphoma, glioblastoma, liver, Hodgkin's lymphoma, sarcoma, ovary and renal cell carcinoma. No differences were found in years of RA duration, joint erosion, joint space narrowing or SENS score except for significantly higher ESR among the cancer group and RF seropositivity in the non-cancer group.Therapeutic modalities were not significantly different between the cancer and no cancer groups. Conclusion Breast cancer was the most prevalent malignancy among our Black RA population. Further studies are needed to identify the contributing factors to the malignancy risk of breast cancer in our Black RA population and whether it is gender-related since RA is more prevalence in women.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10517469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sepsis Intervention Protocol (SIP) on Adherence to Three-hour and Six-hour Bundles and Mortality Outcomes in the Emergency Department.","authors":"Osagie Igiebor,&nbsp;Mohamed Nakeshbandi,&nbsp;Ninfa Mehta,&nbsp;Randi Ozaki,&nbsp;Michael Lucchesi,&nbsp;Maryanne Daley,&nbsp;Moro O Salifu,&nbsp;Samy I McFarlane","doi":"10.15344/2456-8007/2020/149","DOIUrl":"https://doi.org/10.15344/2456-8007/2020/149","url":null,"abstract":"<p><p>Sepsis is a commonly encountered diagnosis affecting nearly 1.7 million adults in the USA annually. According to Center for Disease Control (CDC), over 270,000 Americans die of sepsis each year and 1 in 3 hospital mortalities is attributed to sepsis. The Surviving Sepsis Campaign (SSC) Guidelines for management of severe sepsis and septic shock published in 2004 provide key elements in the treatment of sepsis that are organized into two bundles of care, the \"resuscitation\" and \"management\" bundles, including interventions to be accomplished within specified timeframes. In this quality improvement study, we implemented a sepsis intervention protocol (SIP) intended to increase adherence to 3-hour and 6-hour bundles, and to examine the impact on mortality of patients presenting with severe sepsis and septic shock in our emergency department. We analyzed data from our emergency department as reported to the New York State Department of Health (NYSDOH) from 2017Q2 to 2018Q2 (April 2017 -June 2018), the period prior to implementation of SIP, compared to data from 2018Q3 to 2019Q2 (July 2018 to June 2019) after implementation of SIP. The implementation of SIP resulted in increased3-hour and 6-hour bundle adherence and showed a clinically significant reduction of the mean pre-intervention hospital percent mortality of 40.3% to a mean post-intervention hospital percent mortality of 28.7%. A t-test analysis of the pre and post intervention mean hospital percent mortality revealed a reduction in mortality outcomes that was also statistically significant (p <0.05). Our study demonstrates that a well-designed and implemented SIP can increase bundle adherence and is highly effective in reducing mortality among high-risk population.</p>","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10549849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of <i>Stevia Rebaudiana</i> on Glucose Homeostasis, Blood Pressure and Inflammation: A Critical Review of Past and Current Research Evidence.","authors":"Justina Ray,&nbsp;Shweta Kumar,&nbsp;Daniel Laor,&nbsp;Naila Shereen,&nbsp;Felix Nwamaghinna,&nbsp;Alastair Thomson,&nbsp;Jessica Perez Perez,&nbsp;Lina Soni,&nbsp;Samy I McFarlane","doi":"10.15344/2456-8007/2020/142","DOIUrl":"https://doi.org/10.15344/2456-8007/2020/142","url":null,"abstract":"<p><p>The prevalence of obesity and its related comorbidities continues to rise in the United States and worldwide. Insulin resistance, increased inflammation and oxidative stress are the major pathogenic mechanisms involved in obesity-associated co-morbid conditions. Major efforts to curb the rising tide of obesity, including lifestyle modifications, anti-obesity medications and surgical interventions have shown minimal success. Therefore, introducing new methods to combat obesity, diabetes and associated disorders are desperately needed. <i>Stevia rebaudiana</i>, a natural, non-caloric sweetener has generated significant interest in the scientific community due to its effects on glucose homeostasis, blood pressure and inflammation, all known consequences of obesity. In this review, we assess the effects of Stevia on these parameters in humans as well as in animal models, highlighting its potential role as an effective intervention for the major cardiovascular risk factors associated with obesity.</p>","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10536594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Echocardiography in Evaluation of Athletic Heart: A Scoping Study.","authors":"Yitzhak Rosen,&nbsp;Hymie H Chera,&nbsp;Mohammed Abdulrazzaq,&nbsp;Mohammed Al-Sadawi,&nbsp;Boaz D Rosen,&nbsp;Joao Lima,&nbsp;Richard Grodman,&nbsp;Jason Lazar,&nbsp;Samy I McFarlane","doi":"10.15344/2456-8007/2020/153","DOIUrl":"https://doi.org/10.15344/2456-8007/2020/153","url":null,"abstract":"<p><p>Echocardiography can be a useful tool to evaluate athlete's heart in various sports. In this scoping review, we discuss some of the structural and functional changes of the right ventricle across different echocardiographic modes and techniques among individuals engaging in extreme athletic activity. We highlight the role of imaging in the evaluation of athlete's heart and describe similarities and differences between echocardiographic and cardiac MRI features related to acute and chronic athletic activity. We will also review novel echocardiographic parameters including speckle tracking and strain/strain rate imaging. Overall, we aim to present common echocardiographic parameters in elite sports population in order to facilitate better interpretation of their interpretations that may not necessarily be a distinct digression from these common features.</p>","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10537379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}