Acta Informatica Medica最新文献

Background: Depression is a widespread and incapacitating mental health disorder that impacts millions of people worldwide, playing a substantial role in the overall global health challenges. Depression has a big impact on a person's quality of life, cognitive and social functioning, risk of suicide, risk of heart disease and other illnesses, as well as death from all causes.

Objective: It may be challenging to choose the best tools to screen for severe depression in patients with recurrent depression disorder (PRD) considering the diversity of psychological scales in Vietnam. The aim of this study was to evaluate diagnostic value for detect severe depression of four psychological scales including Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory Scale (BECK), and Zung's Self-Rating Anxiety Scale (SAS) by genders and age groups among PRD in Vietnam.

Methods: This study was conducted at National Institute of Mental Health, Bach Mai Hospital, Vietnam, from 2020 to 2021. There were 109 PRD evaluated with HAM-D, HAM-A, BECK, and SAS by qualified psychiatrists. By analysing Area Under the Curve (AUC) of Receiver Operating Characteristic (ROC) curve, we determined sensitivity, specificity and cut points of four above scales.

Results: Among four scales, the BECK scale had the best diagnostic effect with the most optimal sensitivity and specificity (61.64% and 75%, respectively). We proposed the new cut-off of HAM-D, HAM-A, BECK, and SAS for detecting severe depression among PRD were 20, 34, 30, and 45, respectively. By genders, the cut points for the HAM-D, HAM-A, BECK, and SAS in males were 20, 27, 34, and 44, respectively, while those figure in females were 14, 34, 30, and 46, respectively. By age groups, adults had cut values for four above scales of 20, 34, 27, and 45, respectively, whereas those for the elderly were 16, 17, 35, and 44, respectively.

Conclusion: We highly recommended that BECK is the most optimal method to screen severe depression in PRD in Vietnam. It is essential to utilize varied cut values of HAM-D, HAM-A, BECK, and SAS for different genders and age groups.

Background: In the treatment of valvular heart diseases, transcatheter therapies have changed the rules of the game, especially in the case of aortic stenosis and mitral regurgitation. Since the first in man transcatheter aortic valve intervention (TAVI) performed by Dr. Alain Cribier in 2002 in a non-operable aortic stenosis (AS) patient, TAVI has changed the lives of so many patients for whom medical treatment was, up to then, the only option.

Objective: This article outlines patient selection and pre-procedure evaluation, current perspectives, recent advances, current and future devices, current guidelines informing the use of TAVI, expanding indications for TAVI, ongoing challenges and the future of TAVI.

Methods: The use of these percutaneous techniques has also increased significantly in the past few years with its first application in 2002, transcatheter aortic valve implantation (TAVI) has revolutionized the management of aortic stenosis and has become the standard of care for patients with AS at prohibitively high surgical risks, as well as a preferred treatment for elderly patients with intermediate and high-risk AS.

Results: Since the first pioneering procedure was performed 22 years ago, transcatheter aortic valve implantation (TAVI) has evolved into a routine procedure increasingly performed under conscious sedation via transfemoral access. On a global market worth $2 billion per year, over 300 000 patients have received a transcatheter aortic valve, demonstrating its clinical and market impact. TAVI may be used in lower risk, younger, asymptomatic populations with ongoing studies using an expanding portfolio of devices. Also, for patients deemed unsuitable for cardiac surgery, mitral transcatheter therapies represent the treatment of choice. Percutaneous repair techniques have had the most clinical experience to date.

Conclusion: During this 20-year period, the increased knowledge on pre-procedural planning, the important technological improvements in transcatheter valves, the increased experience and the numerous studies that have been carried out have permitted an expansion of the indications for TAVI, from inoperable patients to high- and intermediate-risk patients. This article outlines patient selection and pre-procedure evaluation, current perspectives, recent advances, current and future devices, current guidelines informing the use of TAVI, expanding indications for TAVI, ongoing challenges and the future of TAVI.

Background: The Medicines and Healthcare Products Regulatory Agency (MHRA) defines data integrity as the maintenance of accuracy, consistency, and completeness of data over time. Recently, "artificial intelligence" has become prevalent across industries, education, culture,and technology, denoting systems that mimic human intelligence and critical thinking using computers and related technologies.

Objective: This article examines the construction of a robust artificial intelligence (AI) system and the incorporation of ALCOA+ principles for data validation, with a specific focus on enhancing data certainty and security.

Methods: This study was carried out through a comprehensive review of various Scopus-indexed literature over the past decade. Results and Discussion: AI has been widely applied in Manufacturing System Optimization, involving organizing production systems, including machines, robots, conveyors, and related operations like maintenance and material handling. Moreover, it's used for Process Monitoring, Diagnostics, and Prognostics in medicine, as well as supervision and regulation in industries. Yet, it's not immune to shortcomings, which could result in system biases and jeopardize data security.

Conclusion: This article explores the creation of a robust AI system, implementing ALCOA+ for data validation in AI-Driven Digital Transformation to improve data certainty and security in industries. It involves systematically recording AI system activities, ensuring database validity, sustaining data recording practices, regularly updating records, ensuring authenticity and completeness, and facilitating data accessibility for review and audits. As AI integration in education advances, there's a crucial need for oversight to maintain data integrity in these systems.

Background: Prostate cancer (PCa) is the second most common cancer and the sixth leading cause of cancer-related mortality in men. In 2000, Abbou performed the first robot-assisted radical prostatectomy, and radical prostatectomy has developed rapidly. Robot-assisted radical prostatectomy (RARP) is a valuable therapeutic option for the management of localized Pca.

Objective: To present the functional outcome of robot-assisted laparoscopic radical prostatectomy using traditional and modified endopelvic fascia preservation methods in a single center in Vietnam.

Methods: We prospectively analyzed a series of 65 patients diagnosed with prostate cancer from 2020 to 2023. All of those were operated by DaVinci Si system robot-assisted laparoscopic prostatectomy. Twenties patients were applied with a modified nerve-sparing technique, intrafascial dissection, and lateral prostatic fascia preservation, leaving the lateral tissue, including the neurovascular bundle, untouched and covered. We used the traditional approach, intrafascial nerve-sparing with open endopelvic fascia and lateral prostatic fascia in 45 cases. Patients were followed up to 12 months to assess the continence and erectile function by using IIEF-5 and EPIC questionnaires.

Results: The study sample included 65 cases; the mean patient age was 64.21 ± 6.68, erection rate after surgery at six months in bilateral NS was 36.58% (15/41) in the traditional group, and 68.42% (13/19) in the modified group (p=0.028). The patient did not recover erectile ability in the group of elderly patients (>65 years old) and unilateral nerve-sparing group. The continence rate six months after surgery was 86.66 % in the conventional group and 85% in the modified group, with no significant difference between the two groups. In the potency group, the IIEF-5 score was 13 ± 4.9, and the EPIC-26 score was 62.20 ± 10.04. Erectile ability in the modified group was better than the traditional group at six months after surgery.

Conclusion: Our results showed better potency recovery in the modified group. These results should be tested in future research with randomized studies.

Background: The lumbar spinal canal consists of 5 interconnected lumbar vertebrae through which the final part of the spinal cord passes and the lumbar and sacral spinal nerves that form the cauda equina. The lumbar canal stenosis can directly affect neurological symptoms and pain in the lumbar region and lower extremities. Due to the frequency of such symptoms, lumbar stenosis has been the subject of research around the world.

Objective: The objective of this study was to measure, analyze and compare the mediosagital and interpeduncular diameters of the lumbar spinal canal in the population of Bosnia and Herzegovina to other populations around the world.

Methods: We conducted a retrospective descriptive study on patients (n=200) who underwent Multi-slice computer tomography (MSCT) performed on a 40-slice CT scanner (Siemens Somatom Definition AS) for lumbar pain between January 1, 2013 and December 31, 2014. Age, gender, midsagittal (MSG) and interpeduncular (IP) diameters of the lumbar spine were recorded for each patient.

Results: Results of our study show that the largest MSG diameter is at L1 level for both sexes, with an average length of 19,06mm, and the smallest at L3 level, with an average length of 16,66mm. Our study shows that the MSG diameter is significantly larger in females than males on all levels from L1 to L5. In both sexes, MSG diameter shows the form of an hourglass with narrowing at L3 level. IPD is largest at L5 level for both sexes, with an average length of 31,94mm, and the smallest average length at L1 level, at 24,78mm. IPD diameter is significantly larger in males than females on all levels from L1 to L5. IPD shows a tendency of growth from L1 to L5 in both sexes.

Conclusion: There were significant differences in the dimensions of the lumbar spine canal between female and male patients. We found significant difference in MSG and IP diameters measurements between Bosnian and Herzegovinian population compared to other populations. The dimensions of the lumbar canal provide a baseline of normative data for the evaluation of patients presenting with lower back pain and lumbar canal stenosis in study population.

Background: Psoriasis as an immune-mediated inflammatory skin disease. The basis of the pathogenesis of psoriasis is the dysregulation of immune cell function in genetically predisposed individuals. The characteristic dysfunction of the immune system in patients with psoriasis is manifested as a variation in the cellular phenotypic profile in accordance with the disease status.

Objective: The aim of this study was to evaluate the immunophenotypic profile of lymphocytes obtained by flow cytometry as an auxiliary diagnostic tool in the objectivization of the PASI score.

Methods: The study group included 40 patients with psoriasis, hospitalized and treated at Dermatology Clinic of Clinical center University of Sarajevo and 30 healthy individuals as controls. After venepunction, the blood samples for determining the immune profile were prepared following standard laboratory procedures using conjugated monoclonal antibodies and BD FACSCanto II flow cytometer. T-lymphocytes (CD3, CD4, CD8), B lymphocytes (CD19), Natural killer cells (NK), and activatet T-cells (CD3HLA) were determined for all patients. Based on the PASI score, the severity and area of the disease was assessed for all psoriasis patients by dermatology specialist.

Results: Our data shows no significant difference in any of the lymphocyte subpopulations between psoriasis patients and healthy controls, except CD3HLA. CD3HLA has higher values in patients with psoriasis, p=0.015. Of all the parameters, only NK cells were significantly correlated to the PASI score (rho -0.279; p=0.048). ROC curve analysis revealed a statistically significant difference for the proportion of CD3 lymphocytes (AUC 0.799; p=0.004), CD8 lymphocytes (AUC 0.733; p= 0.023), NK cells (AUC 0.722; p=0.008) and CD3HLA activated T lymphocytes (AUC 0.347; p=0.034).

Conclusion: Profile of major lymphocyte subsets in patients with psoriasis is similar to that of healthy controls. The values of CD3, CD8, NK, CD3HLA were defined as biomarkers capable of distinguishing psoriasis according to the severity of the disease. Immunophenotyping of peripheral blood lymphocytes can play an important role as an auxiliary diagnostic method in differentiating the clinical stages of psoriasis and objectifying the PASI score.

Background: Immediate implant placement (IIP) has become an attractive treatment for many patients. It reduces time and the number of appointments and protects soft and hard tissue, which, in many circumstances, leads to a better esthetic outcome. IIP with provisionalization (IIPP) may contribute to a more promising result due to the guidance of soft tissue and the preservation of the hard tissue. Indications for IIPP are quite strict, and cone beam computed tomography (CBCT) is a must for case selection.

Objective: This case report will demonstrate how IIP with immediate provisionalization can result in a high esthetic outcome and no discomfort for the patient.

Case presentation: A 50-year-old female presented for implant placement following the extraction of a superior central incisor due to a vertical fracture. IIPP has been used.

Conclusion: IIPP can accomplish a stable esthetic result in the case of ideal three-dimensional implant positioning, a well-polished provisional restoration with an S-shaped buccal emergence profile, and by respecting the mesial and distal embrasure spaces for papilla maturity.

Background: Statistical data play a crucial role in research, planning and decision making in the health system, especially in the formulation and implementation of health policies. Health policy, adequate health legislation and sustainable financing of the health system remain serious challenges for countries in transition and especially for the Republic of Kosovo.

Objective: To analyze the challenges of collection, accuracy and accurate reporting and the impact of the accuracy of these health statistics on the creation of appropriate public health policies in Kosovo.

Methods: This research is mainly based on a combination of qualitative, quantitative, deductive, analytical and comparative methods conducted by health workers at all three levels of the health organization and IT experts who were actively involved in some of the important components of our research.

Results: It is interesting to note that respondents gave typical scores for the security and confidentiality of medical data and statistics during the cycle of their collection and processing, with one score being 3 and the other 5, and 50% of respondents gave a score of 5 for the successful fulfilment of the mission and tasks established by the Law on the rational use of medical data and statistics to support public health policy.

Conclusion: The research and findings provide sufficient evidence that Kosovar health data and statistics system suffers from serious deficiencies ranging from the legal framework, organizational structure, functional organization, segregation of duties and responsibilities, to a pronounced lack of human resources, professional profiles in the health statistics service and the necessary technology to perform the basic tasks in a timely and high quality manner.

Background: The most common complications after performing the triple Descemet's stripping automated endothelial keratoplasty (DSAEK), which combines the cataract phacoemulsification, intraocular lens implantation and DSAEK procedure, are detachment or decentration of the donor lamella and postoperative interface haze. One reason for this is the retained viscoelastic used during surgery.

Objective: This study aimed to describe triple DSAEK procedure without the usage of viscoelastic and to discuss its potential benefits on surgical outcomes.

Methods: The surgical procedures and outcomes of patients with Fuchs' dystrophy and lens opacification who underwent the triple DSAEK were retrospectively reviewed. The surgical procedure was described, and postoperative complications were studied.

Results: The study included 10 eyes of 10 patients. Capsulorhexis and IOL implantation performed in locally potentiated anesthesia compared to general anesthesia did not significantly differ (P > 0,05). The mean preoperative best-corrected visual acuity was 0.75 LogMar. The mean postoperative best-corrected visual acuity was 0.2 LogMar. The central graft thickness before surgery was 129.6 μm and 6 months after surgery was 114.2 μm. Successful attachment of the donor lamellae was observed in all 10 patients. None of the patients had postoperative interface haze or any other possible viscoelastic caused complication.

Conclusion: Although viscoelastic can facilitate certain aspects of the triple DSAEK procedure, we conclude that this procedure can be performed completely without its use. If performed by a trained surgeon, the procedure can be feasible without the complications of donor lamella detachment, decentration, or interface haze.

Background: The use of social media platforms has become increasingly popular in various professional fields, including dentistry. Among these platforms, Instagram has gained significant attention due to its visual nature and widespread popularity. The potential of Instagram as a tool for dental education, patient engagement, and professional networking has been the subject of several studies.

Objective: This paper aims to investigate the use of Instagram among dental patients and examine its implications for the dental industry..

Methods: This cross-sectional study was conducted in Saudi Arabia between September and December 2023 and involved 478 anonymous dental patients who responded to survey invitations. The questionnaire addressed demographics, Instagram usage, and factors influencing the selection of a dentist. Data analysis employed IBM SPSS Statistics, presented as descriptive statistics and bivariate analysis.

Results: Of the respondents, 66.6% preferred Instagram to follow dentists. Demographically, younger age correlated with increased Instagram use. Over half used Instagram 2-3 times daily, with evenings being the preferred time. Notably, 48.3% visited a dentist's Instagram account. Recommendations, qualifications, and online reviews were crucial factors in choosing a dentist, while before-and-after photos, engagement, and content quality mattered on Instagram.

Conclusion: Instagram serves as a valuable tool in oral healthcare, fostering patient engagement, education, and community building. Dental practitioners should leverage Instagram judiciously, emphasizing its supplementary role to professional consultations rather than a substitute for personalized dental advice.