Computer-Aided Methodology for Syndromic Strabismus Diagnosis

Strabismus is a pathology that affects approximately 4 % of the population, causing aesthetic problems reversible at any age and irreversible sensory alterations that modify the vision mechanism. The Hirschberg test is one type of examination for detecting this pathology. Computer-aided detection/diagnosis is being used with relative success to aid health professionals. Nevertheless, the routine use of high-tech devices for aiding ophthalmological diagnosis and therapy is not a reality within the subspecialty of strabismus. Thus, this work presents a methodology to aid in diagnosis of syndromic strabismus through digital imaging. Two hundred images belonging to 40 patients previously diagnosed by an specialist were tested. The method was demonstrated to be 88 % accurate in esotropias identification (ET), 100 % for exotropias (XT), 80.33 % for hypertropias (HT), and 83.33 % for hypotropias (HoT). The overall average error was 5.6Δ and 3.83Δ for horizontal and vertical deviations, respectively, against the measures presented by the specialist.     

Über Spätatrophie der Kleinhirnrinde bei chronischem Alkoholismus

Ohne Zusammenfassung     

Mature autologous dendritic cell vaccines in advanced non-small cell lung cancer: a phase I pilot study

Background

Overall therapeutic outcomes of advanced non-small-cell lung cancer (NSCLC) are poor. The dendritic cell (DC) immunotherapy has been developed as a new strategy for the treatment of lung cancer. The purpose of this study was to evaluate the feasibility, safety and immunologic responses in use in mature, antigen-pulsed autologous DC vaccine in NSCLC patients.

Methods

Five HLA-A2 patients with inoperable stage III or IV NSCLC were selected to receive two doses of 5 × 10⁷ DC cells administered subcutaneous and intravenously two times at two week intervals. The immunologic response, safety and tolerability to the vaccine were evaluated by the lymphoproliferation assay and clinical and laboratorial evolution, respectively.

Results

The dose of the vaccine has shown to be safe and well tolerated. The lymphoproliferation assay showed an improvement in the specific immune response after the immunization, with a significant response after the second dose (p = 0.005). This response was not long lasting and a tendency to reduction two weeks after the second dose of the vaccine was observed. Two patients had a survival almost twice greater than the expected average and were the only ones that expressed HER-2 and CEA together.

Conclusion

Despite the small sample size, the results on the immune response, safety and tolerability, combined with the results of other studies, are encouraging to the conduction of a large clinical trial with multiples doses in patients with early lung cancer who underwent surgical treatment.

Trial Registration

Current Controlled Trials: ISRCTN45563569     

Postexercise hypotension induced by low-intensity resistance exercise in hypertensive women receiving captopril

OBJECTIVE: The present study investigated the effect of a single bout of low-intensity resistance exercise on recovery blood pressure in hypertensive women receiving captopril. METHODS: Twelve essential hypertensive women, who were receiving captopril, underwent two experimental sessions: control (C - 40 min of seated rest) and low-intensity resistance exercise (E - six resistance exercises, three sets, 20 repetitions, 40% of one repetition maximum). Clinic blood pressure was measured in the laboratory, before and for 120 min after exercise or rest. Moreover, ambulatory blood pressure was also measured for 21 h after exercise or rest. RESULTS: Clinic blood pressures decreased significantly after exercise (systolic blood pressure =-12+ or -3 mmHg and diastolic blood pressure =-6+ or -2 mmHg, P<0.05), but not after rest. Mean awake blood pressures (systolic: C=132+ or -5 mmHg vs. E=125+ or -4 mmHg and diastolic: C=83+ or -3 mmHg vs. E=78+ or -2 mmHg, P<0.05) were significantly lower in the E than in the C session, while 21-h (systolic blood pressures: C=128+ or -5 mmHg vs. E=123+ or -4 mmHg; and diastolic blood pressures: C=80+ or -3 mmHg vs. E=76+ or -2 mmHg) and asleep (systolic blood pressures: C=120+ or -7 mmHg vs. E=118+ or -5 mmHg; and diastolic blood pressures: C=73+ or -4 mmHg vs. E=71+ or -3 mmHg) blood pressures did not differ between the experimental sessions. Moreover, there was a positive correlation between blood pressure measured in the C session and blood pressure reduction observed in the E session, showing that blood pressure decrease was greater when blood pressure level was higher. CONCLUSION: In hypertensive women receiving captopril, a single bout of low-intensity resistance exercise reduces blood pressure. This reduction persists for 10 h, during the awake period, while patients were engaged in their daily living activities. It was greater in patients with higher ambulatory blood pressure.     

Computational methodology for automatic detection of strabismus in digital images through Hirschberg test

Strabismus is a pathology that affects about 4% of the population, causing aesthetic problems, reversible at any age; however, problems that can also cause irreversible muscular alterations, and alter the vision mechanism. The Hirschberg test is one of the exams used to detect this pathology. The application of high technology resources to help diagnose and treat ophthalmological conditions is, lamentably, not commonly found in the sub-specialty of strabismus. This work presents a methodology for automatic detection of strabismus in digital images through the Hirschberg test. For such, the work was organized into four stages: (1) finding the region of the eyes; (2) determining the precise location of the eyes; (3) locating the limbus and brightness; and (4) identifying strabismus. The methodology has produced results on the range of 100% sensibility, 91.3% specificity and 94% for the correct identification of strabismus, ensuring the efficiency of its geostatistical functions for the extraction of eye texture and for the calculation of the alignment between the eyes on digital images obtained from the Hirschberg test.     

Letter: Penile Kaposi sarcoma: A case of complete resolution with highly active antiretroviral therapy alone

Kaposi sarcoma remains an important cause of morbidity in HIV-infected patients. Regardless of the recent pharmacological progress, treatment of this malignancy is still disappointing. We report the case of a patient with Kaposi sarcoma in an unusual localization, the penis, which completely resolved with highly active antiretroviral therapy alone.     

Breast cancer: 2 case reports

Breast cancer is the most frequently diagnosed life-threatening cancer in women and the leading cause of cancer death among them worldwide. It includes a heterogeneous collection of diseases with various histologically defined subsets, clinical presentations, responses to treatment and outcomes. We describe 2 cases of female patients with ductal breast carcinoma. Dermatologists may have an important role in diagnosing such diseases.