Data Mining - Concepts and Techniques.

Data Mining Practical Machine Learning Tools and Techniques

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

https://cmapspublic3.ihmc.us/rid=1266358861321_2027852911_13457/Wound%20Healing%20Dressings%20and%20Drug%20Delivery%20Systems.pdf

Wound healing dressings and drug delivery systems: a review.

Background. Glomus tumors are rare and mostly benign lesions of the subcutaneous tissue. Single lesions are preferably located on the acral parts of the body, including the subungual nail apparatus. Observations. We analyzed our files for glomus tumors of the last 10 years and found four tumors, with an equal gender distribution. The patients’ age ranged from 41 to 78 years. The dominant site was subungual on fingers. Advanced and long-standing tumors tend to destroy the overlying nail plate. Another tumor was found on the plantar heel. All patients had a delayed diagnosis between 3⁄4 of a year to three years. Nail plate dermoscopy is a useful tool for diagnosis of early subungual lesions. All tumors were successfully treated surgically with rapid and complete pain relief. Histologically, all four tumors were of the glomangioma subtype with predominant vascular structure. No relapse occurred within a follow-up of up to nine years. Conclusions. Glomus tumors are rare. In case of subungual localization, nail plate dermoscopy is a useful non-invasive diagnostic tool. The treatment of choice is complete tumor removal by surgery. A better knowledge of this tumor will help to reduce the time to final diagnosis and treatment. Key words :  Glomus tumor, nail, plantar tumor, nail dermoscopy, surgery.

Glomus tumor – dermoscopy and surgery

It is well-established that drugs could be leading cause of occurrence of numerous diseases, including pemphigus, being either inducer or triggering factor of the autoimmunity. Despite medications, it should be kept in mind that chronic or acute infections are also capable of being a trigger in various types of cutaneous eruptions, including pemphigus. The rapidly obtained and uncompleted history for accompanied medication leads to general mistakes in the subsequent treatment approach, as the first step in such cases is discontinuation of the drug-inductor. The absence of this information guaranties the fail of the treatment. On the other hand, the lack of performed screening for chronic or acute hepatitis and tuberculosis is not the only mistake, regarding the high dosage of immunosuppressors that have been planned as regiment and the possible fatal effect on the infection’s spread or exacerbation, but also because of the possible triggering ability of chronic or acute infection, which may play also a key role in the generation of antigen- or molecular- mimicry, as a potential source of antibodies reactive with various tissue antigens. It turns out that although the diagnosis of pemphigus in regular cases is usually not a challenge, the treatment occasionally could be, just because of a simple pitfall in anamnesis and screening, as in the presented case. Herein, we present a case of a patient with seborrheic pemphigus, which is strongly demonstrative for these statements, as we want to emphasise the importance of the first and the most powerful clinician’s weapons – the patient’s history and thorough examination.

/pdf/seborrheic-pemphigus-antigen-mimicry-and-the-subsequent-14rwtfkob3.pdf

Seborrheic Pemphigus, Antigen Mimicry and the Subsequent-Wrong Diagnostic and Therapeutic Approach?

BACKGROUND: Skin cancer is an uncommon cause of skull invasion, dural infiltration and brain parenchyma involvement.
CASE REPORT: We report on a series of three elderly patients who presented with squamous cell carcinoma of the scalp with skull bone and cerebral invasion and discuss the diagnostic and therapeutic challenges.
CONCLUSION: A major factor of delayed diagnosis of this potentially life-threatening skin cancer feature is patientsâ€™ neglecting.

/pdf/nonmelanoma-skin-cancer-with-skull-infiltration-and-cranial-7sgiyd576m.pdf

Nonmelanoma Skin Cancer with Skull Infiltration and Cranial Involvement.

Gabapentin-induced generalized cutaneous small-vessel leukocytoclastic vasculitis.

Methemoglobinemia is characterized by an increased level of methemoglobin (MetHb) in the peripheral blood. MetHb levels increase after tumescent anesthesia and need to be monitored. If a patient becomes symptomatic and/or the MetHb levels increase >10%, intravenous injection of an antidote is recommended. Toluidine blue is twice as effective as methylene blue in this respect. A 27-year-old woman with advanced lipedema underwent her third liposuction under tumescent anesthesia. After surgery, her MetHb levels increased and needed injection of toluidine blue. She developed an acute and painful edema after extravasation of some toluidine blue due to a bursting vein. This is the first report in the recent medical literature. Clinical presentation, course, and treatment are described.

Acute edema induced by toluidine blue extravasation-first report.

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