A survey on deep learning in medical image analysis

Prospective Cohort Study

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

SUMMARY The availability of an increasing number of antiretroviral agents and the rapid evolution of new information has introduced extraordinary complexity into the treatment of HIV-infected persons. In 1996, the Department of Health and Human Services and the Henry J. Kaiser Family Foundation convened the Panel on Clinical Practices for the Treatment of HIV to develop guidelines for the clinical management of HIV-infected adults and adolescents. This report recommends that care should be supervised by an expert, and makes recommendations for laboratory monitoring including plasma HIV RNA, CD4 cell counts and HIV drug resistance testing. The report also provides guidelines for antiretroviral therapy, including when to start treatment, what drugs to initiate, when to change therapy, and therapeutic options when changing therapy. Special considerations are provided for adolescents and pregnant women. As with treatment of other chronic conditions, therapeutic decisions require a mutual understanding between the patient and the health care provider regarding the benefits and risks of treatment. Antiretroviral regimens are complex, have major side effects, pose difficulty with adherence, and carry serious potential consequences from the development of viral resistance due to non-adherence to the drug regimen or suboptimal levels of antiretroviral agents. Patient education and involvement in therapeutic

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Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents

Background Only 15 to 20 percent of patients with chronic hepatitis C have a sustained virologic response to interferon therapy. We compared the efficacy and safety of recombinant interferon alfa-2b alone with those of a combination of interferon alfa-2b and ribavirin for the initial treatment of patients with chronic hepatitis C. Methods We randomly assigned 912 patients with chronic hepatitis C to receive standard-dose interferon alfa-2b alone or in combination with ribavirin (1000 or 1200 mg orally per day, depending on body weight) for 24 or 48 weeks. Efficacy was assessed by measurements of serum hepatitis C virus (HCV) RNA and serum aminotransferases and by liver biopsy. Results The rate of sustained virologic response (defined as an undetectable serum HCV RNA level 24 weeks after treatment was completed) was higher among patients who received combination therapy for either 24 weeks (70 of 228 patients, 31 percent) or 48 weeks (87 of 228 patients, 38 percent) than among patients who received interfe...

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Interferon Alfa-2b Alone or in Combination with Ribavirin as Initial Treatment for Chronic Hepatitis C

497 spontaneous clearance or chronic evolution of hcv in hiv/hcv co-infected patients – influence of the il28b genotype

Forty HIV-1-sero-positive and 15 HIV-1 antibody negative homosexual or bisexual men were examined by means of magnetic resonance imaging (MRI) and 20 neuropsychological tests. Subcortical, mainly frontal cerebral pathological aberrations were detected in 75 per cent of the patients on examination with ultra low field MRI computer assisted classification. No such changes were found among controls. The extent of the subcortical aberrations detected correlated with severity of immune deficiency, stage of infection (CDC classification), duration of infection, and reported neuropsychological symptoms. Neuropsychological testing showed impairment in memory function, concentration capacity, and fine motor control in the patients but not in the controls.

[A magnetic tomography study: 3 out of 4 HIV-I infected men suffer subcortical pathologic changes].

Background: People living with HIV (PLHIV) have an increased risk of hematologic malignancies (HMs). We aimed to characterize HMs among PLHIV at Karolinska University Hospital, Stockholm, Sw...

Incidence, treatment and outcome of HIV-associated hematologic malignancies in people living with HIV in Sweden

Background: The design of an optimal highly active antiretroviral therapy (HAART) customised on patient's background and viral genotyping, is still a challenge. EuResist has been the first data-driven system to be implemented as a free web-service for customised HAART optimisation, and was proven to be superior to all existing genotypic interpretation systems (GIS) since it takes into account not only genotype but multiple other variables. Data and methods: The EuResist database stores and updates periodically demographic, clinical, and genomic information of HIV+ patients from several countries in Western Europe. The EuResist system is trained on treatment change episodes (TCE) drawn from the EuResist data base, composed of a new drug regimen with a baseline HIV-1 RNA load and a CD4+ count, a baseline viral pol genotype, demographic and previous treatment information. Each TCE is associated to an HIV-1 RNA measurement after 8 weeks, which is used for the definition of virological success (below 500 copies/ml or >2 Log10 reduction from baseline HIV-1 RNA). The system is a combination of three independent machine learning models (based on logistic regression, random forests, and Bayesian networks). The 2010 update has been trained on >5,000 TCE, composed of 20 FDA/EMEA approved nucleoside/tide, non-nucleoside, and protease inhibitors, including the recently approved compounds (RAC) tipranavir, etravirine and darunavir. Results: The EuResist combined system performance in predicting the correct virological success of a TCE after 8-weeks (validation set, n=561) exhibited an area under the receiver operating characteristic (AUROC) of 0.8 (whereas Stanford HIVdb GIS assessed to 0.73, p=0.002). The inclusion of therapy history, clinical, and demographic covariates was shown to increase significantly prediction performance. In the subset of regimens containing RAC (n=151), the EuResist AUROC was 0.7 and Stanford HIVdb AUROC was 0.63, not allowing to assess a significant difference owing to the small sample size. See Figure ​1. Conclusions: Based on patient’s information and virus genotype, the EuResist web-service ranks the most effective HAART regimens by the probability to achieve an undetectable HIV-1 RNA load after 8 weeks. Thus, it might be useful in clinical practice. The 2010 update includes also RAC and achieved fair performance, which is expected to increase with expanding training data. Supplement: Abstracts of the Tenth International Congress on Drug Therapy in HIV Infection http://www.biomedcentral.com/content/pdf/1758-2652-13-S4-info.pdf Conference: Tenth International Congress on Drug Therapy in HIV Infection 7-11 November 2010 Glasgow, UK (Published: 8 November 2010) doi:10.1186/1758-2652-13-S4-O6 Cite this article as: Pironti et al.: O116. The EuResist expert model for customised HAART optimisation: 2010 update and extension to newest compounds. Journal of the International AIDS Society 2010 13(Suppl 4):O6. Full text: PubMed Central: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3112868/

https://link.springer.com/content/pdf/10.1186/1758-2652-13-S4-O6.pdf

Anders Sönnerborg

Papers

497 spontaneous clearance or chronic evolution of hcv in hiv/hcv co-infected patients – influence of the il28b genotype

[A magnetic tomography study: 3 out of 4 HIV-I infected men suffer subcortical pathologic changes].

Incidence, treatment and outcome of HIV-associated hematologic malignancies in people living with HIV in Sweden

The EuResist expert model for customised HAART optimisation: 2010 update and extension to newest compounds

The EuResist Approach for Predicting Response to Anti HIV-1 Therapy