Development of a support vector machine-based image analysis system for assessing the thyroid nodule malignancy risk on ultrasound

An SVM-based image analysis system was developed for assessing the malignancy risk of thyroid nodules. Ultrasound images of 120 cytology confirmed thyroid nodules (78 low-risk and 42 high-risk of malignancy) were manually segmented by a physician using a custom developed software in C++. From each nodule, 40 textural features were automatically calculated and were used with the SVM algorithm in the design of the image analysis system. Highest classification accuracy was 96.7%, misdiagnosing two high-risk and two low-risk thyroid nodules. The proposed system may be of value to physicians as a second opinion tool for avoiding unnecessary invasive procedures.     

Design of a multi-classifier system for discriminating benign from malignant thyroid nodules using routinely H&E-stained cytological images

A multi-classifier diagnostic system was designed for distinguishing between benign and malignant thyroid nodules from routinely taken (FNA, H&E-stained) cytological images. To construct the multi-classifier system, several combination rules and different mixtures of ensemble classifier members, employing morphological and textural nuclear features, were comparatively evaluated. Experimental results illustrated that the classifier combination k-NN/PNN/Bayesian and the majority vote rule enhanced significantly classification accuracy (95.7%) as compared to best single classifier (PNN: 89.6%). The proposed system was designed with purpose to be utilized in daily clinical practice as a second opinion tool to support cytopathologists' decisions, when a definite diagnosis is difficult to be obtained.     

Patellar fractures: contemporary approach to operative treatment, using different types of the tension band principles

Summary Patellar fractures are relatively common accounting to approximately 1% of all skeletal injuries. The subcutaneous anterior location of the patella makes it prone to injury, and fractures may occur as a result of direct or indirect trauma. Traffic accidents and falls are the most common causes. Patellar fractures are a diverse group of injuries, and fracture types vary considerably. The method of treatment is chosen on the basis of patients factors {age, bone quality, activity level and compliance} and fracture type. The surgical goals are anatomic reduction of the articular surface and stable fixation. Contemporary methods of treatment include screws, the tension band and a combination of the two. Frequently these injuries associated with concomitants injuries as fracture of the femur, subtrochanteric fracture, traumatic dislocation of the hip and lesions of the knee ligaments.      

Prevalence of depressive symptoms and its associated factors in older adults: a cross-sectional study in Kathmandu,Nepal

Objective: Globally, depression is one of the most prevalent and burdensome conditions in older adults. However, there are few population-based studies of depression in older adults in developing countries. In this paper, we examine the prevalence of depressive symptoms and explore possible contributory risk factors in older adults living in Nepal.

Methods: A cross-sectional study was conducted in two semi-urban communities in Kathmandu, Nepal. Depression was assessed using the 15-item Geriatric Depression Scale in 303 participants, aged 60 years and over. Multivariate logistic regression was then used to assess associations between potential risk factors and depression.

Results: More than half of the participants (n = 175, 60.6%) had significant depressive symptomatology, with 27.7% having scores suggesting mild depression. Illiteracy (aOR = 2.01, 95% CI: 1.08–3.75), physical immobility (aOR = 5.62, 95% CI: 1.76–17.99), the presence of physical health problems (aOR = 1.97, 95% CI: 1.03–3.77), not having any time spent with family members (aOR = 3.55, 95% CI: 1.29–9.76) and not being considered in family decision-making (aOR = 4.02, 95% CI: 2.01–8.04) were significantly associated with depression in older adults.

Conclusion: The prevalence of depression was significant in older adults. There are clear associations of depression with demographic, social support and physical well-being factors in this population. Strategies that increase awareness in the community along with the health and social care interventions are needed to address the likely drivers of depression in older adults.     

Virtual endoscopy in the diagnosis of an adult double tracheal bronchi case.

We report a case of ipsilateral double tracheal bronchi supplying a tracheal lobe in a 42-year-old man, who presented with a 10-year history of recurrent respiratory infections. Diagnosis was established by chest computed tomography (CCT), virtual endoscopy and bronchoscopy. Both bronchi were surgically resected along with the right upper lobe of the lung and the associated tracheal lobe. To our knowledge, this is the first report of ipsilateral double tracheal bronchi in the adult life to be diagnosed and treated on the basis of modern radiological techniques and especially virtual endoscopy findings.     

Nonunion after primary treatment of tibia fractures with external fixation

The authors retrospectively reviewed 207 fractures of tibial diaphysis, treated primarily with external fixation without bone grafting. Forty-two fractures (20.3%) resulted in nonunion and required reoperation. Parameters analyzed for their significance for nonunion included, soft tissue damage, energy of injury, method of fracture reduction, type of external fixation frame, supplemental interfragmentary screw fixation, dynamization at the fracture site, and postoperative infection. Nonunion rate was found to be significantly higher in type II and III open fractures, high-energy fractures, fractures treated by external fixation using a bilateral frame, and fractures treated with supplemental interfragmentary screw fixation. Multivariate analysis showed that type II and III open fracture, high-energy injury, and supplemental interfragmentary screw fixation were the main risk factors for nonunion.