Vol 3, No 2 (2022)

AIMS: to assess radiological and clinical outcomes, in terms of safety and efficacy, of symptomatic vertebral fractures with and without posterior wall and\or both endplates involvement, treated with vesselplasty technique (Vessel-X, Dragon Crown Medical Co., Ltd Shandong, China).

MATERIALS AND METHODS: We retrospectively evaluated 66 Patients who underwent 92 vesselplasty procedures, performed for the treatment of symptomatic vertebral body fractures from March 19 to September 2020. We divided the fractures in two subgroups: 36 vertebral fractures with posterior wall and/or both endplates involvement, which we defined complex, while all the others were defined simple. Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) values has been registered 1 day before the procedure and at 1, 6 and 12 months follow-up. We also evaluated vertebral height restoration by comparing pre-interventional with post-interventional imaging.

RESULTS: 92 vertebrae were treated (58 lumbar, 34 thoracic), with 24 multilevel procedures. We observed a technical success rate of 100%, without major complications; a single case of asymptomatic paravertebral cement leak was reported. Both simple and complex subgroups registered a significative statistical difference in NRS and ODI between preoperative and at 1, 6 and 12 months (p <0.05). A significant statistical difference was demonstrated in vertebral height comparing pre-operative and post-operative data (p <0.05). No significant difference in vertebral height restoration was observed between simple and complex vertebral fractures groups.

CONCLUSIONS: Vesselplasty represents a safe and effective technique for the treatment of both simple and complex painful vertebral fractures, granting a significant reduction of symptoms, excellent cement leakage control and proper vertebral height restoration.

A wide range of extremely effective chemotherapy drugs has a negative effect on the cardiovascular system, leveling oncological treatment success. Early diagnosis of cardiotoxicity is very important, allowing timely application of preventive and therapeutic measures. Left ventricular ejection fraction evaluation using echocardiography is the basic non-invasive instrumental method to assess cardiac function and the main guideline in cardiac dysfunction diagnosis during chemotherapy. However, if dysfunction is subclinical, the ejection fraction can remain normal for a long time, and also has a pronounced inter-operator variability and dependence on volumetric load. Specialists are constantly in search of optimal echocardiographic parameters that allow early-stage cardiac dysfunction diagnosis. Analysis of the global longitudinal deformation of the left atrium seems to be a promising method for these purposes. A large amount of accumulated data suggests that the left atrium is not just a conduit chamber, but a reflection of the filling pressure of the left ventricle, being a sensitive marker of its systolic and diastolic dysfunction. This review presents an analysis of currently available studies on applying the methodology for assessing global longitudinal deformation of the left atrium in cardiac dysfunction diagnosis in the use of cardiotoxic drugs.

BACKGROUND: Due to the gaming industry’s rapid development, a large number of technical tools and technologies with unique characteristics have emerged. One of these technologies, which can be potentially used in medical diagnostics, is streaming (online streaming). By connecting an ultrasound scanner to a video capture system, it is possible to significantly expand the diagnostic device’s functionality.

AIM: To investigate the possibility of applying the gaming industry’s information technology in telemedicine, like tele-ultrasound.

MATERIALS AND METHODS: In this study, an ultrasound video image was captured using a video capture system developed for gamers. The video was obtained during brachycephalic arteries ultrasound in the following modes: greyscale B-mode, color duplex, and pulse Doppler mode. The examination was broadcast to a video streaming service in real time.

RESULTS: An expert sonologist obtained optimal video image parameters and determined the minimum required video streaming settings for an adequate remote evaluation. The following video capture workstation settings are recommended: video, 1280×720; 24 fps; H.264 encoder; bitrate, at least 350 Kbps.

CONCLUSIONS: Using technical and software tools developed for video game streaming to provide tele-ultrasound is possible.

The premature fusion of some of the sternal ossification centers and the obliteration of the manubrio-sternal joint caused a rare deformity called Currarino–Silverman syndrome. Patients present an abnormally short sternum with a forward angulation at the manubrio-sternal junction. Cardiopulmonary diseases and spinal deformities are the most frequent related disorders. It was also described as a component of Turner’s and Noonan’s syndromes.

Herein, we present the case of a 66-year-old woman who presented to our clinic for follow-up computed tomography after surgery and chemotherapy for breast cancer with frequent episodes of dyspnea, wheezing, bronchitis, and mild dyspnea annually, which was more frequent during childhood. Computed tomography showed the absence of metastatic lesions and other accompanying diseases, except for a rare deformity of the anterior chest wall, the so-called, a “superior” pectus carinatum, a chondromanubrial deformity with a dorsal-open angle of 130º, and a sternum body length of 9 cm, which is not depressed in the lower third.

Ethical issues occupy a special place when conducting clinical trials of medicines, where it is impossible to predict in advance and accurately the effectiveness and safety of a new drug on the human body. Currently, during clinical trial examination, attention is paid to patients’ quality of life, and issues of compliance with patients’ rights, as well as compliance with the rules of good clinical practice and current legislation. Thanks to technological development, the number medical studies and devices using, among other things, specialized medical technologies and software is increasing.

Automation, development, improvement, and structuring of the processes involved cause an increase in the use of technical devices that use not only programs but also systems in their work. Artificial intelligence system software have a special place in medical science development.

Artificial intelligence, which was the field of science fiction 50–80 years ago, is now firmly embedded in our everyday life. By introducing artificial intelligence’s capabilities into medical software, using it as part of medical equipment, and developing medical devices with artificial intelligence systems, we get a product that requires careful study and further development, which includes a complex of works on conducting scientific research, and registration and maintenance of such systems and complexes. All work is regulated by legislation in the field of circulation of medical devices and requires a deep systematic and scientific approach, including involving ethics to monitor compliance with the rights and safety of study participants and their medical data.

The Ethics Committee is an independent body that monitors compliance with the rights and requirements of legislation and conducts ethical and scientific examination of research documentation. Ethical issues when planning any research involving a person or his/her data should be discussed and considered in detail. The ethics committees should be contacted not only at the stage of approving research materials, but also when planning the design and developing research documentation and materials for patients, as well as regularly at all stages of the study.