Archives of Medical Science最新文献

Introduction: Atherosclerosis is a leading cause of cardiovascular events, requiring accurate risk stratification. Traditional methods rely on subjective imaging and clinical scores, limiting precision.

Material and methods: We developed a deep learning (DL) model combining U-Net for lesion segmentation, ResNet for classification, and an attention mechanism to enhance detection of high-risk plaques. Multimodal data - including ultrasound, CTA, and clinical variables - underwent standard preprocessing. The dataset was split (8 : 1 : 1) and evaluated using 5-fold cross-validation.

Results: The U-Net achieved a Dice coefficient of 0.88. The ResNet, integrated with clinical features, reached 92% classification accuracy and an AUC of 0.97. The attention mechanism improved vulnerable plaque detection by 10%. Grad-CAM visualizations showed 85% agreement with expert annotations. Processing time was reduced by 70% compared to traditional assessment methods. Multicenter validation confirmed strong generalizability.

Conclusions: This study constructed a multimodal DL model that significantly enhances the clinical value of atherosclerosis risk stratification. The prediction accuracy increased to 92% with an AUC of 0.97, and the average processing time per case was reduced from 6.3 ±1.4 min to 1.9 ±0.4 min (a reduction of approximately 70%). The model demonstrated higher precision in both lesion segmentation and high-risk plaque identification, providing clinicians with a rapid and reliable decision-support tool that is expected to further optimize individualized intervention strategies and improve patient prognosis.

In patients with hypertension, intestinal dysbiosis and increased intestine permeability are commonly observed. Modifications of intestinal microbiota with certain probiotics, prebiotics, and synbiotics, as well as gut microbiota transfer, have been associated with a reduction in blood pressure. Therefore, these interventions, especially probiotics, can be employed as adjuncts to hypertension therapy. Bacteria constituting dysbiotic intestinal microbiota produce compounds with hypertensinogenic activity (trimethylamine - TMA, pathogen-associated molecular patterns - PAMPs). In addition, in a state of dysbiosis, a decrease in the production of compounds with antihypertensive activity (short-chain fatty acids - SCFAs) is observed. A diet high in salt significantly alters the intestinal microbiota, and such dysbiosis has been implicated in the pathogenesis of salt-sensitive hypertension. This narrative review article discusses the importance of the gut microbiota, its dysbiosis in patients with hypertension, and potential therapeutic options.

Introduction: We aimed to estimate the incidence of depression among women of childbearing age between 1990 and 2019 in terms of age, sex, country, and Socio-Demographic Index (SDI).

Material and methods: This study analyzed trends in age-standardized incidence rates (ASIR) and disability-adjusted life years (DALYs) using data from the Global Burden of Disease Study. We calculated the estimated annual percentage change (EAPC) and its corresponding 95% confidence interval (CI).

Results: From 1990 to 2019, the ASIR (per 100,000) and age-standardized DALY rate (per 100,000) of depression in women of childbearing age showed a decreasing trend, with EAPC values of -0.53 and -0.44, respectively. Singapore's ASIR and Cuba's age-standardized DALY rate had the lowest EAPC (-2.24 and -2.11). Among the 21 geographical regions, the ASIR and DALY in Central Latin America had the highest EAPC (EAPC of 0.74 and 0.66, respectively), while East Asia had the lowest EAPC (-1.79 and -1.45, respectively). When looking at the changes in ASIR and age-standardized DALY rates from a national perspective, Mexico, Spain, and Germany had the largest increases in ASIR and age-standardized DALY rates. The EAPCs of depression ASIR in women of childbearing age were 1.55, 1.46, and 1.17, respectively, and the EAPCs of depression age-standardized DALY rates in women of childbearing age were 1.40, 1.29, and 1.01, respectively.

Conclusions: From 1990 to 2019, there was a consistent downward trend in the burden of depression in women of childbearing age globally. However, certain countries and regions such as Central Latin America (including Mexico) experienced an upward trend in ASIR and age-standardized DALY rates.