• Title/Summary/Keyword: Clinical features

Search Result 2,900, Processing Time 0.024 seconds

Machine Learning Prediction for the Recurrence After Electrical Cardioversion of Patients With Persistent Atrial Fibrillation

  • Soonil Kwon;Eunjung Lee;Hojin Ju;Hyo-Jeong Ahn;So-Ryoung Lee;Eue-Keun Choi;Jangwon Suh;Seil Oh;Wonjong Rhee
    • Korean Circulation Journal
    • /
    • v.53 no.10
    • /
    • pp.677-689
    • /
    • 2023
  • Background and Objectives: There is limited evidence regarding machine-learning prediction for the recurrence of atrial fibrillation (AF) after electrical cardioversion (ECV). This study aimed to predict the recurrence of AF after ECV using machine learning of clinical features and electrocardiograms (ECGs) in persistent AF patients. Methods: We analyzed patients who underwent successful ECV for persistent AF. Machine learning was designed to predict patients with 1-month recurrence. Individual 12-lead ECGs were collected before and after ECV. Various clinical features were collected and trained the extreme gradient boost (XGBoost)-based model. Ten-fold cross-validation was used to evaluate the performance of the model. The performance was compared to the C-statistics of the selected clinical features. Results: Among 718 patients (mean age 63.5±9.3 years, men 78.8%), AF recurred in 435 (60.6%) patients after 1 month. With the XGBoost-based model, the areas under the receiver operating characteristic curves (AUROCs) were 0.57, 0.60, and 0.63 if the model was trained by clinical features, ECGs, and both (the final model), respectively. For the final model, the sensitivity, specificity, and F1-score were 84.7%, 28.2%, and 0.73, respectively. Although the AF duration showed the best predictive performance (AUROC, 0.58) among the clinical features, it was significantly lower than that of the final machine-learning model (p<0.001). Additional training of extended monitoring data of 15-minute single-lead ECG and photoplethysmography in available patients (n=261) did not significantly improve the model's performance. Conclusions: Machine learning showed modest performance in predicting AF recurrence after ECV in persistent AF patients, warranting further validation studies.

Correlation Between Mammograghic Findings and Clinical/Pathologic Features in Women with Small Invasive Breast Carcinomas

  • Li, Jun-Nan;Xu, Jing;Wang, Ju;Qing, Chun;Zhao, Yu-Mei;Liu, Pei-Fang
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.24
    • /
    • pp.10643-10646
    • /
    • 2015
  • Background: To study the relationship between mammographic findings and clinical/pathologic features in women with 1-15mm sized invasive breast cancer. Materials and Methods: We investigated a consecutive series of 134 cases diagnosed in Tianjin Medical University Cancer Institute and Hospital in 2007. Mammographic findings were classified into five groups as follows :1) stellate mass without calcification; 2) non-stellate mass without calcification; 3) intermediate suspicious calcification with or without associated mass; 4) higher probability malignant calcification with or without associated mass; 5) focal asymmetry/distortion without associated calcification. Associations between mammographic and clinical/pathological features (menopause status/family history/histologic grade/lymph node status and ER/PR/HER2 status) was analyzed through logistic regression and chi square tests. Results: Compared to the stellate mass without calcification group, higher probability malignant calcification patients were associated significantly with a positive lymph node status, always presenting in patients who were non-menopausal and with a family history of carcinoma. Conclusions: Higher probability malignant calcifications with or without associated tumor masses are associated with clinical/pathologic features of poor prognosis.

Clinical and Histopathological Analysis of 66 Cases with Cardiac Myxoma

  • Zheng, Jian-Jie;Geng, Xi-Gang;Wang, Hai-Chen;Yan, Yang;Wang, Hong-Yan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.3
    • /
    • pp.1743-1746
    • /
    • 2013
  • Background and Purpose: Cardiac myxoma is a major primary heart tumor which often causes unexpected symptoms or sudden death. This present study was designed to investigate its clinical pathological features and biological behavior. Methods: A retrospective analysis of the clinical pathologic and immunohistochemical features of 66 cases with cardiac myxoma was conducted. Results: In 66 patients with cardiac myxoma, 61 cases had involvement of the left atrium, one case in both the right ventricular and left atria. The female: male ratio was 2.7:1. Patients had symptoms of blood flow obstruction and systemic alterations with performance of arterial embolization. Tumors were spherical, lobulated or irregular in shape, and soft and brittle. Immunohistochemical markers of vimentin and CD34 in tumor cells were positive. Conclusion: Cardiac myxoma always exists in the left atrium and is more common in women, with diverse clinical manifestations and pathomorphism. Although proliferative activity and the recurrence rate are low, in addition to thorough surgical resection, strengthened review is important for young patients.

A Case of Rhabdoid Meningioma

  • Han, Jung-Ho;Seol, Ho-Jun;Kim, Dong-Gyu;Jung, Hee-Won
    • Journal of Korean Neurosurgical Society
    • /
    • v.39 no.2
    • /
    • pp.144-147
    • /
    • 2006
  • Rhabdoid meningioma is an uncommon meningioma variant, which was initially described in 1998 by Perry et al. It is classified as a variant corresponding to grade III in the recent World Health Organization[WHO] classification of tumors of the nervous system, because of its unique histopathological features and its highly aggressive clinical course. To date there were still a lot of arguments about their developmental patterns and the treatment strategy especially for rhabdoid meningiomas lacking other histological features of malignancy. Although the exact causes of rhabdoid transformation of a benign meningioma are unknown, malignant transformation long duration after surgical resection under an underlying predilection for malignancy is suggested in our case. And we suggest that any histological rhabdoid features in recurrent meningiomas or even in primary cases seem to indicate the malignant clinical course and the need for aggressive treatments, because transformation from a benign or atypical one to a malignant one seems to occur at last.

Haplorchis taichui as a Possible Etiologic Agent of Irritable Bowel Syndrome-Like Symptoms

  • Watthanakulpanich, Dorn;Waikagul, Jitra;Maipanich, Wanna;Nuamtanong, Supaporn;Sanguankiat, Surapol;Pubampen, Somchit;Praevanit, Rangson;Mongkhonmu, Srisuchat;Nawa, Yukifumi
    • Parasites, Hosts and Diseases
    • /
    • v.48 no.3
    • /
    • pp.225-229
    • /
    • 2010
  • The aim of this study is to clarify the clinical features of Hap/orchis taichui infection in humans in Nan Province, Thailand, and to correlate the clinical features with irritable bowel syndrome (IBS)-like symptoms. In this study area, only H. taichui, but neither other minute intestinal flukes nor small liver flukes were endemic. The degree of infection was determined by fecal egg counts and also by collecting adult worms after deworming. The signs and symptoms of individual patients together with their hematological and biochemical laboratory data were gathered to evaluate the relationship between the clinical features and the severity of infection. Special emphasis was made to elucidate the possible similarities of the clinical features of H. taichui infection and IBS-like symptoms. The results showed useful clinical information and the significant (> 50%) proportion of haplorchiasis patients complained of abdominal pain, lassitude, and flatulence, which were the important diagnostic symptoms of IBS. This study has reported a possible link between H. taichui and IBS, and H. taichui might probably play a role in the etiology of these IBS-like symptoms.

Clinical investigation on acute pyelonephritis without pyuria: a retrospective observational study

  • Song, Hyung Keun;Shin, Dong Hyuk;Na, Ji Ung;Han, Sang Kuk;Choi, Pil Cho;Lee, Jang Hee
    • Journal of Yeungnam Medical Science
    • /
    • v.39 no.1
    • /
    • pp.39-45
    • /
    • 2022
  • Background: The current guidelines for the diagnosis of acute pyelonephritis (APN) recommend that APN be diagnosed based on the clinical features and the presence of pyuria. However, we observed that some of the patients who are diagnosed with APN do not have characteristic clinical features or pyuria at the initial examination. We performed this study to investigate the characteristics of APN without pyuria. Methods: A retrospective, cross-sectional study was conducted on 391 patients diagnosed with APN based on clinical and radiologic findings, between 2015 and 2019. The clinical features, laboratory results, and computed tomography (CT) findings were compared between patients with normal white blood cell (WBC) counts and those with abnormal WBC counts (WBC of 0-5/high power field [HPF] vs. >5/HPF) in urine. Results: More than 50% of patients with APN had no typical urinary tract symptoms and one-third of them had no costovertebral angle (CVA) tenderness. Eighty-eight patients (22.5%) had normal WBC counts (0-5/HPF) on urine microscopy. There was a negative correlation between pyuria (WBC of >5/HPF) and previous antibiotic use (odds ratio, 0.249; 95% confidence interval, 0.140-0.441; p<0.001), and the probability of pyuria was reduced by 75.1% in patients who took antibiotics before visiting the emergency room. Conclusion: The diagnosis of APN should not be overlooked even if there are no typical clinical features, or urine microscopic examination is normal. If a patient has already taken antibiotics at the time of diagnosis, imaging studies such as CT should be performed more actively, regardless of the urinalysis results.

Clinical Features of Knee Pain of Female after Menopausal and Survey Method for Moxibustion Treatment (폐경기 이후 여성의 슬통 양상과 뜸시술에 관한 설문)

  • Kang, Mi Suk
    • Journal of Acupuncture Research
    • /
    • v.30 no.5
    • /
    • pp.169-174
    • /
    • 2013
  • Objectives : This study was accomplished to find out clinical features of knee pain of female after menopausal and their recognition of moxibustion treatment. Methods : Before and after 8 times moxibustion treatment(mostly 2 times a weak), survey was done. Moxibustion treatment was done on painful location, 3 times per each point. Results & Conclusions : Other symptom with Knee pain was Click 30.8 %, stiffness 25.6 %, press pain 16.7 %, swelling 14.1 %, fever 5.1 %, none 7.7 %. VAS of moxibustion treatment is significantly increased after treatment. Expectation of moxibustion treatmen is not. "Bad smell" is the first cause of evasion of moxibustion therapy. It should have been considered to reduce bad smell in development of moxibustion.

Comorbid Anxiety in Bipolar Disorder (양극성장애에서의 공존 불안)

  • Kyungwon Kim;Eunsoo Moon
    • Anxiety and mood
    • /
    • v.20 no.1
    • /
    • pp.1-7
    • /
    • 2024
  • This review article summarizes the main research findings on the presence of anxiety disorders in individuals with bipolar disorder. It examines the prevalence of comorbid anxiety disorders in bipolar disorder, which is generally high. Moreover, it explores the variations in comorbid anxiety across different subtypes of bipolar disorder. The article also investigates the clinical features, treatment, and prognosis associated with comorbid anxiety in bipolar disorder. It reveals that bipolar patients with comorbid anxiety exhibit complex clinical features, worse treatment outcomes, and a poorer prognosis. Given the significant impact of comorbid anxiety on clinical features, treatment outcomes, and prognosis, it is crucial to address this issue when treating individuals with bipolar disorder. Therefore, further research on the treatment of co-occurring anxiety in bipolar disorder patients is warranted.

Is This Symptom Even a Food Allergy?: Clinical Types of Food Protein-induced Enterocolitis Syndrome

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.17 no.2
    • /
    • pp.74-79
    • /
    • 2014
  • Food protein-induced enterocolitis syndrome (FPIES) is an under-recognized non-IgE-mediated gastrointestinal food allergy. The diagnosis of FPIES is based on clinical history, sequential symptoms and the timing, after excluding other possible causes. It is definitively diagnosed by an oral food challenge test. Unfortunately, the diagnosis of FPIES is frequently delayed because of non-specific symptoms and insufficient definitive diagnostic biomarkers. FPIES is not well recognized by clinicians; the affected infants are often mismanaged as having viral gastroenteritis, food poisoning, sepsis, or a surgical disease. Familiarity with the clinical features of FPIES and awareness of the indexes of suspicion for FPIES are important to diagnose FPIES. Understanding the recently defined clinical terms and types of FPIES is mandatory to suspect and correctly diagnose FPIES. The aim of this review is to provide a case-driven presentation as a guide of how to recognize the clinical features of FPIES to improve diagnosis and management of patients with FPIES.

Small-Fiber Neuropathy (세섬유 신경병증)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
    • /
    • v.5 no.1
    • /
    • pp.1-10
    • /
    • 2003
  • Small-fiber neuropathy (SFN) is a common clinical problems. The disorder is a generalized peripheral polyneuropathy that selectively involves small-diameter myelinated and unmyelinated nerve fibers. It is often idiopathic and typically presents with painful feet in patients over the age of 60. And autoimmune mechanisms are often suspected, but rarely identified. The clinical features consisted of painful dysesthesias and postganglionic sympathetic dysfunction, as well as reduced pinprick and temperature sensation. Although affected patients complain of neuropathic pain, this condition is often difficult to diagnose because of the few objective physical signs and normal nerve conduction studies. Diagnosis of SFN is made on the basis of the clinical features, normal nerve conduction studies, and abnormal specialized tests of small fiber function. These specialized studies include assessment of epidermal nerve fiber density as well as sudomotor, quantitative sensory, and cardiovagal testing. Unless an underlying disease is identified, treatment is usually directed toward alleviation of neuropathic pain.

  • PDF