scholarly journals Development and Validation of a Machine Learning Model Predicting Arteriovenous Fistula Failure in a Large Network of Dialysis Clinics

2021 ◽  
Vol 18 (23) ◽  
pp. 12355
Author(s):  
Ricardo Peralta ◽  
Mario Garbelli ◽  
Francesco Bellocchio ◽  
Pedro Ponce ◽  
Stefano Stuard ◽  
...  
Keyword(s):  
Machine Learning ◽  
Arteriovenous Fistula ◽  
Previous History ◽  
Model Performance ◽  
Sensor Data ◽  
Large Network ◽  
Dialysis Patients ◽  
Dialysis Dose ◽  
Initial Cohort ◽  
History Of

Background: Vascular access surveillance of dialysis patients is a challenging task for clinicians. We derived and validated an arteriovenous fistula failure model (AVF-FM) based on machine learning. Methods: The AVF-FM is an XG-Boost algorithm aimed at predicting AVF failure within three months among in-centre dialysis patients. The model was trained in the derivation set (70% of initial cohort) by exploiting the information routinely collected in the Nephrocare European Clinical Database (EuCliD®). Model performance was tested by concordance statistic and calibration charts in the remaining 30% of records. Features importance was computed using the SHAP method. Results: We included 13,369 patients, overall. The Area Under the ROC Curve (AUC-ROC) of AVF-FM was 0.80 (95% CI 0.79–0.81). Model calibration showed excellent representation of observed failure risk. Variables associated with the greatest impact on risk estimates were previous history of AVF complications, followed by access recirculation and other functional parameters including metrics describing temporal pattern of dialysis dose, blood flow, dynamic venous and arterial pressures. Conclusions: The AVF-FM achieved good discrimination and calibration properties by combining routinely collected clinical and sensor data that require no additional effort by healthcare staff. Therefore, it can potentially enable risk-based personalization of AVF surveillance strategies.

Outcomes of radiocephalic arteriovenous fistula in octogenarians

2021 ◽  
pp. 112972982110154
Author(s):  
Raffaella Mauro ◽  
Alessia Pini ◽  
Rodolfo Pini ◽  
Mohammad Abualhin ◽  
Chiara Mascoli ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Previous History ◽  
Venous Catheter ◽  
Dialysis Session ◽  
Old Patients ◽  
Younger Patients ◽  
First Choice ◽  
Clinical Surveillance ◽  
History Of ◽  
The Impact

Background: Current guidelines recommend radiocephalic arteriovenous fistula (RCAVF) as a first choice access for hemodialysis, without specific indication for octogenarians .This study was undertaken to assess the efficacy of RCAVF in octogenarians compared with younger patients. Material and methods: All patients treated by RCAVF from January 2013 to December 2017 were included in a prospective database for a retrospective analysis. Patient demographics, comorbidities, and dialytic treatment data were collected prospectively and compared in patients <80 year-old and ⩾80 years-old. Clinical surveillance was performed during each dialysis session. The main endpoints were primary (PP) and assisted patency (AP). Results: Within the study period, a total of 294 RCAVF were analyzed: 245 (83.3%) RCAVF were performed in <80 year-old and 49 (16.7%) ⩾80 years old. The overall PP and AP at 2-year was 69% ± 2% and 73% ± 3%, respectively. Patients ⩾ 80 years-old had a significantly reduced 2-year PP, AP of RCAVF compared with the younger patients: 50% ± 8% and 62% ± 7% versus 73% ± 3% and 75% ± 3%, p = 0.01 and p = 0.03, respectively. The analysis for possible risk factors for reduction of PP in patients ⩾80 years identified in the central venous catheter(CVC) a predictor of earlier RCAVF failure: HR 3.03(95% CI 1.29–7.13), p = 0.01.Kaplan–Meier curve confirms the reduction of PP in ⩾80 years old patients at 2-year follow-up with previous CVC compared patients without history of CVC: 59% ± 10% versus 24% ± 11%, p = 0.01. A comparison between the two groups was made in order to evaluate the impact of previous history of CVC .In absence of a history of CVC use older patients had a similar 2-year PP compared with younger patients: 59% ± 10% versus 72% ± 4%, p = 0.46. Otherwise, the history of a previous CVC reduced significantly the 2-year PP in ⩾80 years old patients compared the younger: 24% ± 12% versus 75% ± 5%, p = 0.0001. Conclusions: Despite lower overall primary and primary assisted patency, RCAVF are associated with satisfactory results also in octogenarians if performed in absence of history of CVC. Under these circumstances RCAVF can be considered a first choice treatment.

Drug Prediction in Healthcare Using Big Data and Machine Learning

2019 ◽  
pp. 79-92 ◽  
Author(s):  
Mamoon Rashid ◽  
Vishal Goyal ◽  
Shabir Ahmad Parah ◽  
Harjeet Singh
Keyword(s):  
Machine Learning ◽  
Big Data ◽  
Data Analysis ◽  
Side Effects ◽  
Previous History ◽  
Distributed File System ◽  
Optimal Drug ◽  
Hadoop Distributed File System ◽  
History Of ◽  
Medicinal Drugs

The healthcare system is literally losing patients due to improper diagnosis, accidents, and infections in hospitals alone. To address these challenges, the authors are proposing the drug prediction model that will act as informative guide for patients and help them for taking right medicines for the cure of particular disease. In this chapter, the authors are proposing use of Hadoop distributed file system for the storage of medical datasets related to medicinal drugs. MLLib Library of Apache Spark is to be used for initial data analysis for drug suggestions related to symptoms gathered from particular user. The model will analyze the previous history of patients for any side effects of the drug to be recommended. This proposal will consider weather and maps API from Google as well so that the patients can easily locate the nearby stores where the medicines will be available. It is believed that this proposal of research will surely eradicate the issues by prescribing the optimal drug and its availability by giving the location of the retailer of that drug near the customer.

scholarly journals A Giant Coronary Artery Aneurysm with Coronary Arteriovenous Fistula in Asymptomatic Elderly Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Caterina Milici ◽  
Daniella Bovelli ◽  
Valentino Borghetti ◽  
Georgette Khoury ◽  
Marco Bazzucchi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Arteriovenous Fistula ◽  
Chest Trauma ◽  
Coronary Artery Aneurysm ◽  
Previous History ◽  
Artery Aneurysm ◽  
Coronary Arteriovenous Fistula ◽  
Giant Coronary Artery Aneurysm ◽  
History Of ◽  
Coronary Artery Aneurism

Coronary Arteriovenous Fistula (CAF) is a rare defect that occurs in 0.1-0.2% of patients undergoing coronary angiography; Coronary Artery Aneurism (CAA) also occurs in approximately 15–19% of patients with CAF. It is usually congenital, but in rare occasions it occurs after chest trauma, cardiac surgery, or coronary interventions. The case described is that of a 72-year-old woman, without previous history of cardiovascular disease, who presented a huge cardiac mass. A multimodal approach was necessary to diagnose a giant CAA with CAF responsible for compression and displacement of cardiac structures. Due to likely congenitally origin of the lesion and the absence of symptoms correlated to the CAA and to the CAF we decided to avoid invasive interventions and to treat the patient with medical therapy.

405: Previous History of Bladder Cancer is an Independent Prognostic Factor for Upper Tract Transitional Cell Carcinoma

2007 ◽  
Vol 177 (4S) ◽  
pp. 135-135
Author(s):  
Eiji Kikuchi ◽  
Akira Miyajima ◽  
Ken Nakagawa ◽  
Mototsugu Oya ◽  
Takashi Ohigashi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Factor ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Transitional Cell ◽  
Previous History ◽  
Independent Prognostic Factor ◽  
Upper Tract ◽  
History Of

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

Rhabdomyolysis in DOMS

1999 ◽  
Vol 38 (05) ◽  
pp. 164-168 ◽  
Author(s):  
Gloria Ruiz Hernandez ◽  
C. Sanchez Marchori ◽  
J. Munoz Moliner ◽  
C. Martinez Carsi
Keyword(s):  
Bone Scintigraphy ◽  
Previous History ◽  
Biochemical Studies ◽  
History Of ◽  
Increased Activity

SummaryA 26-year-old man with a previous history of external twin bursitis was remitted to our Department for a bone scintigraphy. Before the study, the patient performed an elevated number of intense sprints. Bone scintigraphy showed a bilaterally increased activity in both anterior rectum muscles suggesting rhabdomyolysis. Biochemical studies and MRT confirmed the diagnosis.

Coronary Artery Bypass Grafting in a Patient with Organophosphate Poisoning

2015 ◽  
Vol 18 (4) ◽  
pp. 167 ◽  
Author(s):  
Rajeeva R. Pieris ◽  
Ravindra Fernando
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Previous History ◽  
Organophosphate Poisoning ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Excellent Health ◽  
History Of

A 43-year-old male, with no previous history of mental illness, was diagnosed with coronary heart disease, after which he became acutely depressed and attempted suicide by ingesting an organophosphate pesticide. He was admitted to an intensive care unit and treated with pralidoxime, atropine, and oxygen. His coronary occlusion pattern required early coronary artery bypass grafting (CABG) surgery. His family, apprehensive of a repeat suicidal attempt, requested surgery be performed as soon as possible. He recovered well from the OP poisoning and was mentally fit to express informed consent 2 weeks after admission. Seventeen days after poisoning, he underwent coronary artery bypass grafting and recovered uneventfully. Six years later, he remains in excellent health. We report this case because to the best of our knowledge there is no literature regarding CABG performed soon after organophosphate poisoning.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

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