Artificial Intelligence has potential for Prevention and early diagnosis of Cervical cancer, claims research

A recent groundbreaking study published
in the journal eClinicalMedicine highlighted the potential of using artificial
intelligence (AI) in the early diagnosis and prevention of cervical cancer.

Cervical cancer is the primary
cause of increased morbidity and mortality worldwide. Effective screening of
precancerous lesions helps in preventing cervical cancer. Cervical cytology
screening and colposcopy are vital tools to prevent cervical intraepithelial
neoplasia (CIN) and cervical cancer. Recently, AI has been used for various
medical image analysis tasks to identify various diseases. Previous literature
has shown the magnificent diagnostic accuracy of AI in detecting CIN and
cervical cancer. However, a meta-analysis of all the studies has not been
performed. Hence, researchers conducted a systematic review and meta-analysis
to examine the pooled accuracy, sensitivity, and specificity of AI-assisted
cervical cytology screening and colposcopy for cervical intraepithelial
neoplasia and cervical cancer screening.

Also Read: Self-Test for HPV Becomes Important Component of Cervical Cancer Screening: Study Suggests

Various databases such as PubMed,
Embase, and Cochrane Library were used to collect data between January 1, 1986,
and August 31, 2024. Various studies that investigated the sensitivity and
specificity of AI-assisted cervical cytology screening and colposcopy for
histologically verified cervical intraepithelial neoplasia and cervical cancer
and a minimum of five cases were included. The performance of AI and
experienced colonoscopists were used to evaluate various metrics along with the
area under the receiver operating characteristic curve (AUROC), sensitivity,
specificity, accuracy, positive predictive value (PPV), and negative predictive
value (NPV), analyzed through random effect models. Subgroup analyses were done
to compare diagnostic performance across developed and developing countries.

Findings:

  • About 77 studies that met the inclusion criteria
    were included.
  • The pooled diagnostic performance metrics for
    AI-assisted cervical cytology using Papanicolaou (Pap) smears were as follows:

accuracy

94% (95% CI 92–96);

sensitivity,

95% (95% CI 91–98);

specificity,

94% (95% CI 89–97);

positive predictive value (PPV),

88% (95% CI 78–96);

negative predictive value (NPV),

95% (95% CI 89–99)

  • For AI-assisted cervical cytology using the
    ThinPrep cytologic test (TCT), the pooled metrics were:

accuracy,

90% (95% CI 85–94);

sensitivity,

97% (95% CI 95–99);

specificity,

94% (95% CI 85–98);

PPV,

84% (95% CI 64–98);

NPV,

96% (95% CI 94–98).

Also Read: HPV vaccination switch to 1-dose gender-neutral approach may help eliminate cervical cancer, finds study

Thus, the study concluded that AI
can be used as a potential source for early diagnosis and prevention of cervical
cancer. AI demonstrates enhanced diagnostic accuracy and can be used as a reliable
tool for diagnostic precision. The study underscores the importance of using AI
as a cost-effective tool for cervical cancer screening, minimizing observer
variability, and improving outcomes.

Further reading: Liu, Lei et al. Performance
of artificial intelligence for diagnosing cervical intraepithelial neoplasia
and cervical cancer: a systematic review and meta-analysis. eClinicalMedicine,
Volume 80, 102992. Doi: 10.1016/j.eclinm.2024.102992.

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Calcium intake below certain threshold associated with higher risk of eczema: Study

Calcium intake below a certain threshold is associated with a higher risk of eczema suggests a study published in the Scientific Reports.

Eczema is a common chronic skin condition. Previous studies indicated that dietary factors, such as calcium intake, might influence the onset and progression of eczema in the population of gravidas and infants. However, there were no studies on the correlation between dietary calcium and the adult population. In this study, we aim to investigate the correlation between dietary calcium intake and the prevalence of eczema in adults. The characteristics of adults (≥ 18 years) were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 database. Dietary calcium intake was assessed using the 24-hour dietary recall method. The prevalence of eczema was determined through an allergy questionnaire. Logistic regression modelling was applied to analyze the correlation between dietary calcium intake and eczema prevalence. Restricted cubic spline (RCS) was used to investigate the nonlinear relationship between calcium intake and eczema. A two-stage linear regression model was used to calculate calcium intake’s critical effect on eczema’s prevalence by smoothed curve fitting. Subgroup analyses were performed to explore the effect of different demographic characteristics on the relationship between dietary calcium intake and eczema. Results In this cross-sectional study, we collected 4086 adult samples. There were 1930 males (46.9%) and 2156 females (53.1%), at the average age of 46.7 years, and 266 participants (7.6%) were diagnosed with eczema. Logistic regression results showed there was a significant difference between the third quartile group and eczema compared to the 1st quartile group of dietary calcium (OR: 1.913, 95% CI: 1.024–3.576, P = 0.043). The RCS showed an inverted U-shaped correlation between dietary calcium intake and eczema prevalence (non-linear P-value < 0.05). An increase in calcium intake was associated with an increase in eczema prevalence when the logarithmic value of dietary calcium intake was below 7.089 (OR: 1.790, 95% CI: 1.006–3.183, P = 0.048). These data indicated there was an inverted U-shaped correlation between dietary calcium intake and the prevalence of eczema, which suggested moderate reduction of calcium intake might be beneficial in the incidence of eczema. Further prospective studies are needed to explore causal relationships and optimal calcium intake levels to prevent eczema.

Reference:

Wu, Q., Guo, Z., Zhang, N. et al. Correlation between dietary calcium intake and eczema in American adult population. Sci Rep 14, 31270 (2024). https://doi.org/10.1038/s41598-024-82723-x

Keywords:

Calcium, intake, below, certain, threshold, associated, higher risk, eczema, study, Scientific Reports, Wu, Q., Guo, Z., Zhang, N, Eczema, Dietary calcium intake, American adult, NHANES, Cross-sectional study

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Co-sensitization to tree nuts observed in children with peanut sensitization and eczema: Study

A recent study conducted at Charité—Universitätsmedizin Berlin highlighted a significant link between peanut sensitization and co-sensitization to tree nuts in infants and toddlers with eczema. The study suggest that peanut-sensitized infants, particularly those under 2 years old, are at high risk for sensitization to tree nuts such as hazelnuts, walnuts, and cashews. The findings were published in the recent issue of Clinical and Translational Allergy journal.

The study evaluated 101 peanut-sensitized infants and toddlers, with a median age of 16 months, all of whom expressed specific IgE (sIgE) levels of at least 0.1 kU/l to peanuts. Among these participants, 98% had eczema which increased the risk of sensitization and the subsequent development of food allergies.

An overwhelming 96% of the participants demonstrated sIgE sensitization to at least one tree nut. Hazelnut was the most common allergen (94%), followed by walnut (87%) and cashew (84%). 80% of the children showed sIgE to all 3 tree nuts, while 27% were sensitized to the 2S albumins of all three nuts. The children sensitized to these albumins expressed higher sIgE levels than the children who were not sensitized.

5% of the infants had a 90% chance of reacting to hazelnut based on probability curves, while nearly 14% had the same likelihood for cashew. Overall, 16% had a high probability of reacting to either hazelnut or cashew. The study highlighted the elevated risks associated with peanut sensitization in infants, particularly for the ones already with eczema. These findings align with previous research by indicating that peanut allergy often increases the risk of tree nut allergies.

As a retrospective analysis, it lacked clinical confirmation of tree nut allergies through oral food challenges, which would have provided direct evidence of allergic reactions. The data spanned from 2007 to 2020, before the widespread adoption of guidelines recommending the early introduction of allergens to prevent food allergies.

Overall, the research highlights the importance of evaluating sIgE levels for tree nuts in peanut-sensitized infants, particularly those with eczema. Early detection and testing, such as oral food challenges, could help determine the clinical significance of sensitization and guide dietary recommendations to manage or prevent severe allergic reactions.

Source:

Meixner, L., Heller, S., Bluhme, F., Trendelenburg, V., Beyer, K., & Kalb, B. (2024). Infants and toddlers with sensitization to peanut are often co‐sensitized to tree nuts. In Clinical and Translational Allergy (Vol. 14, Issue 11). Wiley. https://doi.org/10.1002/clt2.70008

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Machine Learning Model Outperforms Pulmonologists in Detecting Lung Cancer, suggests research

Researchers have discovered that a machine learning (ML) model, using dynamic ensemble selection (DES), outperforms experienced pulmonologists in cancer lung diagnosis. Lung cancer is the cause of cancer deaths in the world, mainly due to late detection. Improving survival rates is dependent on the early detection approach. A recent study was conducted by Ricco N. and colleagues which was published in the journal of Scientific Reports .

This was a retrospective analysis of data from 38,944 patients suspected to have LC within the Region of Southern Denmark from 2009 to 2018. The study included 9,940 patients with complete data, with 2,505 (25%) diagnosed with LC. The DES model involved smoking history and key blood biomarkers such as lactate dehydrogenase, total calcium, sodium levels, leukocyte and neutrophil counts, and C-reactive protein. It was compared against the performance of five pulmonologists in terms of sensitivity, specificity, and others.

Key Findings:

Model Performance:

  • The DES model resulted in an area under the receiver operating characteristic (ROC) curve of 0.77±0.01.

  • Sensitivity: 76.2%±2.04%, 6.5% better than the average pulmonologist.

  • Specificity: 63.8%±2.3%.

  • Positive predictive value (PPV): 41.6%±1.2%.

  • F1-score: 53.8%±1.0%.

Comparison with Pulmonologists:

  • DEs model outperformed all the five pulmonologists, while sensitivity was exceptionally high, particularly for early-stage detection.

Significant Biomarkers:

  • Smoking status, LDH, serum calcium levels, low sodium levels, leucocytes, neutrophil count and CRP values were the strongest predictors of LC.

The DES ML model clearly outperformed pulmonologists in detecting lung cancer with higher sensitivity and identification of critical biomarkers for risk stratification. These findings show the ability of ML in changing the current landscape of early detection strategies for improving outcomes for patients at risk of LC. ML-driven models integrated into health care could provide decision-making support to clinicians and may decrease the rate of late-stage cancer diagnosis.

Reference:

Flyckt, R.N.H., Sjodsholm, L., Henriksen, M.H.B. et al. Pulmonologists-level lung cancer detection based on standard blood test results and smoking status using an explainable machine learning approach. Sci Rep 14, 30630 (2024). https://doi.org/10.1038/s41598-024-82093-4

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Intestinal flora closely associated with diabetes after kidney transplantation suggests study

Intestinal flora closely associated with diabetes after kidney transplantation suggests a study published in the BMC Nephrology.

Post-transplant diabetes mellitus (PTDM) is a common complication following renal transplantation, and its incidence has been gradually increasing in recent years, posing a significant public health challenge. Managing PTDM is complex, as studies suggest that it involves changes in the microbial flora across multiple organs.

Kidney transplantation is the optimal treatment for end-stage nephropathy. It involves transplanting a healthy kidney into a patient whose kidneys have failed, significantly enhancing the recipient’s quality of life. Thanks to advancements in surgical technology, medical care, the introduction of Calcineurin Inhibitors (CNIs), and improved immunosuppressive protocols, the survival rates for kidney grafts have significantly increased over recent decades. However, cardiovascular diseases remain a leading cause of morbidity and mortality among kidney transplant recipients. A major contributor to these adverse outcomes is post-transplant diabetes mellitus (PTDM). Research indicates that PTDM increases the risk of myocardial infarction by 60%, and it is also linked to higher incidences of cerebrovascular accidents and arterial diseases in the aorta or lower limbs following kidney transplantation.

The human microbiota comprises a diverse array of microorganisms, including bacteria, archaea, fungi, viruses, and protozoa. These organisms inhabit various parts of the human body such as the skin, respiratory, digestive, and genitourinary tracts. They play a crucial role in health by aiding digestion, regulating the immune system, protecting against pathogens, and synthesizing essential vitamins like vitamin B12, vitamin K, and riboflavin. The intestine, the most heavily colonized part, hosts a bacterial load similar in magnitude to the number of the body’s cells, about 3.9 × 10^13.

Recent research highlights the critical role of gut flora metabolism in the development of diabetes among post-renal transplant patients. This paper reviews the alterations in gut flora observed in PTDM patients and explores how gut flora influences PTDM.

In conclusion, there is a significant relationship between intestinal flora and post-transplant diabetes mellitus, with interactions that may contribute to the disease’s development. Dysbiosis of the gut flora is implicated in this process, potentially due to the symptomatic response triggered by abnormal levels of short-chain fatty acids (SCFAs) and enteric-derived uremic toxins.

Reference:

Chen, Lb., Chen, Q., Chao, S. et al. Influence of gut flora on diabetes management after kidney transplantation. BMC Nephrol 25, 468 (2024). https://doi.org/10.1186/s12882-024-03899-y

Keywords:

Intestinal, flora, closely, associated, diabetes, after, kidney, transplantation, study, BMC Nephrology, Chen, Lb., Chen, Q., Chao, S, Post-transplant diabetes mellitus, Gut microbiota, Kidney transplantation, Outcome, Diagnosis

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Drug Safety Alert: Indian Pharmacopoeia Commission Flags ADR Linked To Beta blockers

New Delhi: The Indian Pharmacopoeia Commission (IPC), through its recently issued drug safety alert for the month of December, has revealed that cardiovascular drug beta-blockers (metoprolol, propranolol, and atenolol) may lead to adverse drug reactions (ADRs) named hypokalaemia.

In connection with the above, the Indian Pharmacopoeia Commission (IPC) has cautioned healthcare professionals to diligently monitor the potential occurrence of adverse drug reactions (ADRs) when administering beta-blockers such as metoprolol, propranolol, and atenolol.

This came after a preliminary analysis of adverse drug reactions (ADRs) from the Pharmacovigilance Programme of India (PvPI) database.

Beta blockers are a class of medications that are predominantly used to manage abnormal heart rhythms (arrhythmia) and to protect the heart from a second heart attack after a first heart attack (secondary prevention). They are also widely used to treat high blood pressure, although they are no longer the first choice for initial treatment for most people.

Beta blockers are competitive antagonists that block the receptor sites for the endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) on adrenergic beta receptors of the sympathetic nervous system, which mediates the fight-or-flight response.

Metoprolol is a beta-blocker used in the treatment of hypertension and angina and used to reduce mortality due to myocardial infarction. Metoprolol is indicated for the treatment of essential hypertension in adults, functional heart disorders, migraine prophylaxis, cardiac arrhythmias, prevention of cardiac death and reinfarction after the acute phase of myocardial infarction, stable symptomatic CHF, and angina pectoris.

Propranolol is a non-selective beta-adrenergic antagonist used to treat hypertension, angina, atrial fibrillation, myocardial infarction, migraine, essential tremor, hypertrophic subaortic stenosis, and pheochromocytoma.

Propranolol is indicated for the treatment of cardiac arrhythmias, tachycardia, hypertrophic obstructive cardiac myopathy, pheochromocytoma, thrombosis, management of angina, essential and renal hypertension, and prophylaxis of migraine.

Atenolol is a synthetic beta-1 selective blocker used in the management of hypertension and chronic angina and to reduce mortality in known or suspected myocardial infarction in hemodynamically stable patients. Atenolol is indicated for the treatment of hypertension, angina pectoris, and cardiac arrhythmias.

Following the preliminary analysis of adverse drug reactions (ADRs) from the PvPI database, it is reported that beta-blockers such as metoprolol, propranolol, and atenolol can lead to hypokalaemia.

Hypokalaemia, or low potassium, is a condition where there are lower than normal levels of potassium in the blood. Potassium is important for the proper functioning of muscles and nerve cells, especially in the heart.

Also Read:Expert Panel Reaffirms Beta-blockers as First-Line Therapy for Hypertension in India

Now, as per the issued drug safety alert, the following suspected drug is associated with the ADR, as given below:

S. No.

Suspected Drugs

Indications

Adverse Drug Reaction

1

Beta-blockers (Metoprolol, Propranolol, Atenolol)

Metoprolol: For the treatment of essential hypertension in adults, functional heart disorders, migraine prophylaxis, cardiac arrhythmias, prevention of cardiac death and reinfarction after the acute phase of myocardial infarction, stable symptomatic CHF and angina pectoris.

Propranolol: For the treatment of cardiac arrhythmias, tachycardia, hypertrophic obstructive cardiac myopathy, pheochromocytoma, thrombosis, management of angina, essential and renal hypertension, and prophylaxis of migraine.

Atenolol: For the treatment of hypertension, angina pectoris, and cardiac arrhythmias.

Hypokalaemia

In light of the above, the Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, has advised healthcare professionals, patients, and consumers to closely monitor the possibility of the above ADRs associated with the use of the above-suspected drugs.

Further, the safety alert added, “If such reaction is encountered, please report to the NCC-PvPI, IPC, by filling out the Suspected Adverse Drug Reactions Reporting Form/Medicines Side Effect Reporting Form for Consumer (http://www.ipc.gov.in), through Android Mobile App “ADR PvPI App” and PvPIHelpline No. 1800-180-3024 (toll-free).

Also Read:Drug Safety Alert: IPC Flags Adverse Reactions to Amphotericin B and Carbimazole

To view the official notice, click the link below:

https://medicaldialogues.in/pdf_upload/drugsafetyalertdecember2024-267735.pdf

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Flu and RSV are sustaining California’s sniffly season, COVID yet to surge this winter

The season of sniffles and coughs has come again. But while influenza and RSV activity is “moderate and increasing” around California, COVID activity is unusually low for the holiday season.

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Early-life gut microbes may protect against diabetes, research in mice suggests

The microbiome shapes the development of insulin-producing cells in infancy, leading to long-term changes in metabolism and diabetes risk, new research in mice has found.

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Some doctors increasingly using artificial intelligence to take notes during appointments

It was easy to miss Dr. Robert Gray’s quick movements, tapping the screen of his smartphone at the beginning and end of patient visits on a recent day.

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Tonsil cancer: What is it and how to prevent it

Tonsil cancer is a type of head and neck cancer. Head and neck cancers include cancers of the tongue; the back of the tongue, which you can’t see when you look in the mirror; the tonsils; or the throat, which includes several body parts, such as the larynx or voice box. We also see other rare cancers, including salivary gland cancers and cancers in the sinuses and nose.

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