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1,374 results on '"Wolosker, Nelson"'

3. DeepVox and SAVE-CT: a contrast- and dose-independent 3D deep learning approach for thoracic aorta segmentation and aneurysm prediction using computed tomography scans

Author

del-Valle, Matheus, de Oliveira, Lariza Laura, Vieira, Henrique Cursino, Lee, Henrique Min Ho, Pinheiro, Lucas Lembrança, Portugal, Maria Fernanda, Miyoshi, Newton Shydeo Brandão, and Wolosker, Nelson

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition, Computer Science - Machine Learning, I.2, I.4
Abstract

Thoracic aortic aneurysm (TAA) is a fatal disease which potentially leads to dissection or rupture through progressive enlargement of the aorta. It is usually asymptomatic and screening recommendation are limited. The gold-standard evaluation is performed by computed tomography angiography (CTA) and radiologists time-consuming assessment. Scans for other indications could help on this screening, however if acquired without contrast enhancement or with low dose protocol, it can make the clinical evaluation difficult, besides increasing the scans quantity for the radiologists. In this study, it was selected 587 unique CT scans including control and TAA patients, acquired with low and standard dose protocols, with or without contrast enhancement. A novel segmentation model, DeepVox, exhibited dice score coefficients of 0.932 and 0.897 for development and test sets, respectively, with faster training speed in comparison to models reported in the literature. The novel TAA classification model, SAVE-CT, presented accuracies of 0.930 and 0.922 for development and test sets, respectively, using only the binary segmentation mask from DeepVox as input, without hand-engineered features. These two models together are a potential approach for TAA screening, as they can handle variable number of slices as input, handling thoracic and thoracoabdominal sequences, in a fully automated contrast- and dose-independent evaluation. This may assist to decrease TAA mortality and prioritize the evaluation queue of patients for radiologists., Comment: 23 pages, 4 figures, 7 tables

Published
2023

4. Are Barriers to Physical Activity Associated With Changing Physical Activity Levels and Sedentary Time in Patients With Peripheral Arterial Disease? A Longitudinal Study.

Author

Santos, Juliane Carolina da Silva, Ritti-Dias, Raphael Mendes, Cucato, Gabriel Grizzo, Wolosker, Nelson, Correia, Marilia de Almeida, and Farah, Breno Quintella

Subjects
HEALTH services accessibility, ECOLOGY, PERIPHERAL vascular diseases, SEDENTARY lifestyles, ACCELEROMETERS, SOCIOECONOMIC factors, DESCRIPTIVE statistics, LONGITUDINAL method, HEALTH behavior, CONFIDENCE intervals, DATA analysis software, PHYSICAL activity, ACTIVITIES of daily living
Abstract

The aims of the current study were to analyze the association between the barriers to and changes in physical activity levels and sedentary behavior, as well as to examine whether these barriers change over time in patients with peripheral artery disease. In this longitudinal study, we assessed 72 patients (68% men; 65.7 ± 9.2 years). Physical activity was measured over a 7-day period using an accelerometer, and data were collected on time spent in sedentary activities, low-light physical activities, and moderate-to-vigorous physical activities. Personal and environmental barriers to physical activity were collected using yes or no questions. Assessments were repeated in the same patients after 27 months (95% confidence interval [26, 28] months). Most barriers remained stable in these patients; however, those who reported lack of money experienced an increase in sedentary behavior (β = 392.9 [159.7] min/week, p =.02) and a decrease in low-light physical activity (β = −372.4 [140.1] min/week, p =.02). These findings suggest that patients with symptomatic peripheral artery disease typically exhibit stable barriers over time, and individuals reporting lack of money demonstrated a decrease in low-light physical activity and an increase in sedentary behavior after 27 months. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Guideline-Based Telemedicine Assessment of Orthopedic Low-Risk Conditions by General Practitioners is Not Inferior to that of Face-to-Face Consultations with Specialists in the Emergency Department: A Randomized Trial.

Author

Foni, Noel Oizerovici, Accorsi, Tarso Augusto Duenhas, Correia, Renata Farias Vidigal, Moreira, Flavio Tocci, Lima, Karine De Amicis, Morbeck, Renata Albaladejo, Souza Jr, Jose Leão de, Pedrotti, Carlos Henrique Sartorato, and Wolosker, Nelson

Abstract

Background: There is a lack of randomized controlled trials focusing on orthopedic telemedicine (TM). The objective of this research was to compare the diagnostic accuracy and pattern of TM consultations of low-risk orthopedic patients performed by general practitioners (GPs) with those of face-to-face evaluations by orthopedists at an emergency department (ED). Methods: This randomized, single-center study was conducted between October 2021 and November 2022 on patients at an ED. Inclusion criteria were age >18 years, low back pain, extremity contusion, ankle sprain, or neck pain. Eligible patients were randomized 1:1 for TM consultations by generalist physicians with subsequent face-to-face orthopedic evaluations (TM–ED group) or face-to-face evaluations by orthopedic physicians (ED group). Primary outcomes were syndromic diagnosis, physical examination, and tests ordered. Secondary analysis included a satisfaction survey. Results: A total of 99 patients were enrolled; mean age was 41 ± 10.1 years, and 62.6% were female. The most common conditions were foot contusion (28.3%), ankle sprain (27.3%), hand contusion (19.2%), low back pain (19.2%), and neck pain (6.1%). Syndromic diagnosis showed no difference between groups (p = 0.231). In the TM–ED group (n = 51), self-examination demonstrated moderate to good agreement with face-to-face evaluations in several areas. Both groups showed similar tests practices. Patient satisfaction was higher in the TM–ED group across multiple measures. Conclusion: TM consultations for low-risk orthopedic patients by GPs are not inferior to face-to-face specialist evaluations at the ED. Virtual assessments are associated with higher patient satisfaction. Clinical Trial Identifier: NCT04981002. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Epidemiology of the use of inferior vena cava filters in Brazil between 2008 and 2019.

Author

Louzada, Andressa Cristina Sposato, Diamante Leiderman, Dafne Braga, Alexandrino da Silva, Marcelo Fiorelli, Cassino Portugal, Maria Fernanda, Carlos de Campos Guerra, João, Teivelis, Marcelo Passos, and Wolosker, Nelson

Abstract

Objectives: The primary objective was to study the totality of inferior vena cava filter placements and their temporal and geographic distribution in the Brazilian Public Health System, which insures more than 160 million Brazilians. The secondary objective was to analyze in-hospital mortality after filter placement and deaths due to pulmonary embolism. Methods: Public and open data on in-hospital mortality due to pulmonary embolism and on rates of inferior vena cava filters placement, its associated diagnosis, and in-hospital mortality in Brazilian public hospitals between January 2008 and December 2019 were extracted from Ministry of Health databases. Results: A total of 9108 inferior vena cava filters were placed, 98.18% of which was therapeutic. We observed a significant increase in the use of these devices over the years, from 508 inferior vena cava filters placed in 2008 to 965 in 2019. In-hospital mortality rate in patients who received inferior vena cava filters was 6.21%, stable over time, and 96.64% of causes of these causes were attributed to venous thromboembolism. The in-hospital mortality rate due to pulmonary embolism, regardless of the placement of vena cava filters, has increased significantly. Conclusion: We observed a low but increasing rate of inferior vena cava filter placements in Brazil between 2008 and 2019, most indications were therapeutic. Our findings were heterogeneous across Brazilian regions and contrasted to those observed in the USA, which is likely due to cultural and socioeconomic factors. [ABSTRACT FROM AUTHOR]

Published
2024
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