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Automated annotation and classification of BI-RADS assessment fro radiology reports

Castro SM, Tseylin E, Medvedeva O, Mitchell K, Visweswaran S, Bekhuis T, Jacobson RS. Automated annotation and classification of BI-RADS assessment fro radiology reports. Journal of Biomedical Informatics 2017; 69:177-187.The Breast Imaging Reporting and Data System (BI-RADS) was developed to reduce variation in the descriptions of findings. Manual analysis of breast radiology report data is challenging but is necessary for clinical and healthcare quality assurance activities.The objective of this study is to develop a natural language processing (NLP) system for automated BI-RADS categories extraction from breast radiology reports. We evaluated an existing rule-based NLP algorithm, and then we developed and evaluated our own method using a supervised machine learning approach. We divided the BI-RADS category extraction task into two specific tasks: (1) annotation of all BI-RADS category values within a report, (2) classification of the laterality of each BI-RADS category value. We used one algorithm for task 1 and evaluated three algorithms for task 2. Across all evaluations and model training, we used a total of 2159 radiology reports from 18 hospitals, from 2003 to 2015.

The Breast Ultrasound Lexicon: Breast Imaging Reporting and Data System (BI-RADS)

Sedgwick E. The Breast Ultrasound Lexicon: Breast Imaging Reporting and Data System (BI-RADS). Semin Roentgenol 2011; 46(4):245-251 A radiologist’s ability to perceive an abnormality on an image is not unlike an art critic’s ability to perceive the significance of color choice when evaluating a painting. Perception is a learned skill, refined over time, and difficult to quantify. Some have better perception than others. Radiology residents are given the example of “Aunt Minnie,” a term coined by the late Dr Edward B. Neuhauser, the former chief of Radiology at Boston Children’s Hospital. An “Aunt Minnie” refers to a radiology finding pathognomonic for a disease. A radiologist should be able to perceive a finding because he or she has seen it many times before, like one recognizes his or her Aunt Minnie.

Interobserver Concordance in the BI-RADS Classification of Breast Ultrasound Exams

Calas MJG, Almeida RMVR, Gutfilen B, Pereira WCA. Interobserver concordance in the BI-RADS classification of breast ultrasound exams. Clinics. 2012;67(2):185-189. doi:10.6061/clinics/2012(02)16. Breast ultrasound is an important complement to the clinical/mammographic investigation of breast lesions. This operator-dependent method entails real-time image detection and analysis and requires extensive training and experience in identifying and differentiating between benign and malignant lesions.

The never-ending success story of BI-RADS

Kinkel K. The never-ending success story of BI-RADS. Diagn Interv Imaging. 2017 Mar;98(3):177-178. doi: 10.1016/j.diii.2017.02.003. PubMed PMID: 28262125. Any physician who wants to become familiar with the Breast Imaging Reporting and Data system (BI-RADS) will discover more than 1600 papers on Pub Med. What makes another paper about BI-RADS interesting? Hasn’t everything already been written about the subject? The paper published in this issue of Diagnostic & Interventional Imaging by Spak et al. summarizes the most recent changes in the fifth and latest edition of the BI-RADS. It represents a quick help in daily practice to keep the radiologist updated on the appropriate use of words and what to include in a clearly written breast imaging report.The effort to adapt a common language took also place among different breast imaging modalities. Spak et al. mention that the latest BI-RADS edition includes an extended description of lesion localization in the mammography section to make comparison with the MRI localization easier [1]. This edition also took great care to simplify mass description across different imaging modalities and avoid confusion as the language had been simplified and made more consistent between mammography, ultrasound and MRI. The purpose was to reduce differences in wording similar messages among imaging modalities. This can potentially help the radiologist in comparing imaging modalities to discriminate benign from malignant lesions or to correlate findings from one imaging modality to another. The Table 1 in Spak et al. paper is an ideal tool in any breast imaging reading room as it gives a quick overview of major changes between the 4th and the 5th edition.

Nasal trauma due to continuous positive airway pressure in neonates. Arch Dis Child …

Fischer C, Bertelle V, Hohlfeld J, Forcada-Guex M, Stadelmann-Diaw C, Tolsa JF. Nasal trauma due to continuous positive airway pressure in neonates. Arch Dis Child Fetal Neonatal Ed. 2010 Nov;95(6):F447-51. doi: 10.1136/adc.2009.179416. Epub 2010 Jun 28. PubMed PMID: 20584802. To evaluate the incidence and severity of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) in neonates.Nasal trauma is a frequent complication of nCPAP, especially in preterm neonates, but long-term cosmetic sequelae are very rare. This study provides a description of nasal trauma and proposes a simple staging system. This could serve as a basis to develop strategies of prevention and treatment of this iatrogenic event.

Nasal injury in preterm infants receiving non-invasive respiratory support: a systematic review

Imbulana DI, Manley BJ, Dawson JA, Davis PG, Owen LS. Nasal injury in preterm infants receiving non-invasive respiratory support: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2018 Jan;103(1):F29-F35. doi: 10.1136/archdischild-2017-313418. Epub 2017 Sep 28. Review. PubMed PMID:28970314. OBJECTIVE Binasal prongs are the most commonly used interface for the delivery of nasal positive airway […]

The kangaroo method is safe for premature infants under 30 weeks of gestation during ventilatory …

The kangaroo method is safe for premature infants under 30 weeks of gestation during ventilatory support van Zanten, Henriëtte A. et al. Journal of Neonatal Nursing, Volume 13, Issue 5, 186 - 190. A case control study into the safety of the kangaroo method in a group of ventilated prematurely born children less than 30 weeks of pregnancy was conducted. Four parameters, heart rate, oxygen saturation, respiratory rate and arterial blood pressure, were compared with one another 1 h before, 1 h after the start and 1 h after finishing kangaroo care. This nursing intervention is safe for this group of premature born infants. They are protected against the risk of decline in physiological stability during and after kangaroo care when the temperature of the infant is controlled and when necessary, extra warmth is provided.

Nursing Care Guidelines for prevention of nasal breakdown in neonates receiving nasal CPAP

McCoskey L. Nursing Care Guidelines for prevention of nasal breakdown in neonates receiving nasal CPAP. Adv Neonatal Care. 2008 Apr;8(2):116-24. doi:10.1097/01.ANC.0000317260.99072.ae. Review. PubMed PMID: 18418209. Use of nasal continuous positive airway pressure (CPAP) is increasing as a means of respiratory support for respiratory distress syndrome in many premature neonates across the United States. Nasal CPAP is less invasive and may be as effective as mechanical ventilation in premature infants, and has been shown to cause less lung damage in premature neonates. Because of the increased use of nasal CPAP in neonates, especially younger and more fragile neonates, the presence of nare and nasal septum breakdown may be seen as a complication. Currently, all nasal CPAP systems use a hat and prong or mask type of delivery system. This appears to be effective for many neonates, but for some, it is difficult to appropriately fit the hat and prongs. The result of an inappropriately fitted device can be mild to severe nare and nasal septum damage. This article will discuss the need for nasal CPAP and the mechanics of nasal CPAP, but more importantly, serve to guide caregivers in the appropriate physical assessment and care of a neonate on nasal CPAP with the goal of preventing skin breakdown and nasal damage.

Non-invasive versus invasive respiratory support in preterm infants at birth …

Schmölzer GM, Kumar M, Pichler G, Aziz K, O'Reilly M, Cheung PY. Non-invasive versus invasive respiratory support in preterm infants at birth: systematic review and meta-analysis. BMJ. 2013 Oct 17;347:f5980. doi: 10.1136/bmj.f5980. Review. Erratum in: BMJ. 2014;348:g58. PubMed PMID: 24136633; PubMed Central PMCID: PMC3805496. To assess the role of nasal continuous positive airway pressure (CPAP) initiated at birth for prevention of death and bronchopulmonary dysplasia in very preterm infants.One additional infant could survive to 36 weeks without bronchopulmonary dysplasia for every 25 babies treated with nasal CPAP in the delivery room rather than being intubated.

Hemorragia Postparto. Donde estamos y hacia donde vamos?

El embarazo puede implicar riesgos importantes para la mujer. Las complicaciones propias de la gestación pueden derivar en graves secuelas o incluso la muerte de la madre y/o del feto trayendo consecuencias catastróficas para su entorno familiar y la sociedad en general. Cada día mueren en el mundo un promedio 800 mujeres por causas prevenibles relacionadas con el embarazo y el parto. De estas muertes el 99% ocurren en países en vías de desarrollo y la mayoría de ellas en zonas rurales. Hoy en día es claro que la atención oportuna y adecuada antes, durante y después del parto puede salvar la vida de muchas gestantes y recién nacidos. Es por esto que reducir la mortalidad infantil y mejorar la salud materna constituyen dos importantes indicadores de desarrollo de una región, definidos en el Objetivo sobre Salud y Desarrollo dentro de los Objetivos de Desarrollo Sostenible adoptados por la comunidad internacional en el año 2015. La meta establecida en los Objetivos del Milenio de lograr la disminución de la MM en un 75% a nivel mundial no fue alcanzada a pesar de una reducción del 44% de la mortalidad frente al indicador reportado en 1990. La región de Latinoamérica y el Caribe contribuye de manera importante con la mortalidad materna con una razón de 85 por cada 100.000 nacidos vivos y aunque estas estadísticas son cada vez más confiables, el sistema de registro de muchos de los países en latinoamérica continúa siendo deficiente. La hemorragia postparto constituye una verdadera emergencia obstétrica y su incidencia varía entre el 5 al 15% de nacimientos a nivel mundial. Además de causar muertes la mayoría de ellas prevenibles, produce un número importante de casos de morbilidad materna extrema (MME) o “casi muerte” representados por la necesidad de histerectomías, transfusión de hemoderivados, coagulopatía, choque hipovolémico y anemias severas que pueden terminar en daño permanente de órgano blanco. Debido a toda una serie de falencias en la atención y el cuidado materno en países en vías de desarrollo, el riesgo absoluto de muerte por HPP es mucho mayor que en países desarrollados (1 en 1000 vs. 1 en 100.000 respectivamente).

Prevention and management of postpartum haemorrhage

Mavrides E, Allard S, Chandraharan E, Collins P, Green L, Hunt BJ, Riris S, Thomson AJ on behalf of the Royal College of Obstetrici ans and Gyna ecologists. Prevention and management of postpartum haemorrhage. BJOG 2016;124:e106–e149. PPH is the most common form of major obstetric haemorrhage. The traditional definition of primary PPH is the loss of 500 ml or more of blood from the genital tract within 24 hours of the birth of a baby. PPH can be minor (500–1000 ml) or major (more than 1000 ml). Major could be divided to moderate (1000–2000 ml) or severe (more than 2000 ml). The recommendations in this guideline apply to women experiencing primary PPH of 500 ml or more. Women with pre-existing bleeding disorders and women taking therapeutic anticoagulants are at increased risk of PPH; this guideline does not include specific recommendations for the management of such situations or for managing haemorrhage in women who refuse blood transfusion. Guidance on these topics is available from other sources.

Practice Bulletin No. 183: Postpartum Hemorrhage

ommittee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017 Oct;130(4):e168-e186. doi: 10.1097/AOG.0000000000002351. PubMed PMID: 28937571. Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). In the United States, the rate of postpartum hemorrhage increased 26% between 1994 and 2006 primarily because of increased rates of atony (3). In contrast, maternal mortality from postpartum obstetric hemorrhage has decreased since the late 1980s and accounted for slightly more than 10% of maternal mortalities (approximately 1.7 deaths per 100,000 live births) in 2009 (2, 4). This observed decrease in mortality is associated with increasing rates of transfusion and peripartum hysterectomy (2-4).The purpose of this Practice Bulletin is to discuss the risk factors for postpartum hemorrhage as well as its evaluation, prevention, and management. In addition, this document will encourage obstetrician-gynecologists and other obstetric care providers to play key roles in implementing standardized bundles of care (eg, policies, guidelines, and algorithms) for the management of postpartum hemorrhage.