scholarly journals Medical and organizational approaches to early diagnosis of skin melanoma

2021 ◽  
Vol 65 (6) ◽  
pp. 557-564
Author(s):  
Evgeniy Yu. Neretin ◽  
Sergey V. Kozlov ◽  
Tatyana G. Zolotareva
Keyword(s):  
Mortality Rate ◽  
Early Diagnosis ◽  
Early Stage ◽  
Close Contact ◽  
Medical Documentation ◽  
Agent Technology ◽  
Skin Melanoma ◽  
Number Of Patients ◽  
Multi Agent ◽  
One Year

Introduction. The most significant problem is the early diagnosis of skin melanoma (SM). In many countries of the world, there is a constant increase in the incidence rate, and the organization of population screening can help solve this problem. Purpose of the study. Evaluation of the use of multi-agent technology in the diagnosis of SM. Material and methods. Study design: at the 1st stage, primary medical documentation was studied - Charts No. 090/y; 027-2/y, statistical reports of the Samara Regional Clinical Oncological Dispensary - Charts No. 7, No. 35, according to the results revealed at stage 2. There was developed and implemented multi-agent technology for SM diagnostics, including various agents of both qualified and specialized levels, these were both individuals and teams of departments who worked in close contact: a public relations agent; artificial intelligence secondary prevention planning agent; agent for training doctors and nurses, patients in the basics of early diagnosis and assessing their level of training; an agent for evaluating performance indicators. Results. After introducing the multi-agent system, the indicator of the share of 1-2 stages of MC in 2010-2019. increased by 48.3% compared to the period 2000-2009 and outpaced the growth in the total number of patients with SM by 6.96%; from 2010 to 2019 the proportion of patients with SM who were actively identified began to increase; one-year mortality rate from 2010 to 2019 decreased in waves (y = 0.0003x5 - 0.0104x4 - 0.2647x3 + 1.4818x2 - 1.8942x + 10.585; R2 = 0.554). Conclusion. The use of multi-agent technology makes it possible to reduce the one-year mortality rate, to achieve a faster growth rate of the newly detected number of patients with an early stage of SM (stage 1-2) compared to the increase in the number of cases, to improve the indicators of early diagnosis, active detection of skin melanoma, which is a positive result.

scholarly journals Effectiveness of multi-agent technology in three-day campaign for early diagnosis of cutaneous melanoma

2021 ◽  
Vol 9 (3) ◽  
pp. 433-446
Author(s):  
E.Yu. Neretin ◽  
◽  
S.Kh. Sadreyeva ◽  
◽  
Keyword(s):  
Early Diagnosis ◽  
Cutaneous Melanoma ◽  
Large Scale ◽  
Early Stage ◽  
Good Prognosis ◽  
Agent Technology ◽  
Correct Treatment ◽  
Scale Population ◽  
Multi Agent ◽  
Epidemiological Situation

BACKGROUND: Melanoma — is a tumor that in most cases affects the skin and is characterized by an extremely aggressive course and a steadily increasing morbidity in the world. However, diagnosed at an early stage, cutaneous melanoma (CM) has a good prognosis with correct treatment. The results of the diagnosis of CM can be improved by joint the efforts of dermatologists and artificial intelligence (AI). AIM: Cutaneous melanoma is a tumor with an unpredictable course. The article discusses ways to solve the problem of early diagnosis using multi-agent technology and an expert system based on AI. MATERIALS AND METHODS: In a large industrial city with more than three million population, a three-day campaign for the early diagnostics of cutaneous melanoma was carried out, which revealed 4 cases of CM (4.35%) at pT1a stage in 96 patients registered in 2019. A total of 800 people were examined. RESULTS: As a result of diagnostics, the following data were obtained: specificity of self-diagnostics of the region was 6.78% by the inhabitants, 78.89% by dermatologists, and 95.24% by expert oncologists. In prospective quality control of diagnostics within 6 months, such parameters as the sensitivity of diagnosing cutaneous melanoma by oncologists and dermatologists were both 100%. As a result of the study, it was found that the multi-agent technology is necessary to improve the results of CM diagnostics, and also for a more complete assessment of the onco-epidemiological situation, and for forecasting of the necessary resources in the region. CONCLUSIONS: The multi-agent technology can improve diagnostic results, but for a more complete assessment of the onco-epidemiological situation, a large-scale population screening in the region is required.

scholarly journals Problems of the Diagnosis and Treatment of Acute Mesenteric Ischemia: a SingleCenter Experience

2018 ◽  
Vol 3 (4) ◽  
Keyword(s):  
Blood Flow ◽  
Mortality Rate ◽  
Early Diagnosis ◽  
High Mortality ◽  
Mesenteric Ischemia ◽  
Intestinal Resection ◽  
Acute Mesenteric Ischemia ◽  
Mesenteric Arteries ◽  
Diagnosis And Treatment ◽  
Number Of Patients

Objective: To improve the diagnosis and treatment of acute mesenteric ischemia by using available methods of early diagnosis and modern methods of treatment. Summary Background Data: The number of patients with disorders of the mesenteric circulation is increasing all over the world. In comparison with the occlusion of the coronary, cerebral arteries and peripheral veins, acute obstruction of the mesenteric arteries and veins is diagnosed much later, which causes a high mortality rate from 53 to 100%. Methods: In this study the experience of treatment of 162 patients with acute mesenteric ischemia was analyzed. All patients underwent treatment in Institute of Urgent and Recovery Surgery (IURS NAMS, Donetsk, Ukraine) from 2002 to 2017. Results: From 162 patients: 112 patients were with acute occlusive and 50 patients with acute nonocclusive mesenteric ischemia. The intravital diagnosis was not confirmed in 26 patients (16 %). 119 of patients died, the level of mortality was 73, 5%. 104 patients were operated, 32 patients were discharged (30,8 %), 72 patients died, a mortality rate was 69,2 %. Operations with restore of blood flow were performed in 14 patients, 5 patients died, 9 patients left the hospital. Conservative therapy was performed in 22 patients, in 11 patients with good results (50 %). Conclusions: The early diagnosis of this pathology is crucial and it can reduce the high mortality rate of patients with AMI. Treatment of OAMI should be carried out in a community of general, vascular and endovascular surgeons. Restoration of blood flow through mesenteric vessels with the help of endovascular technology and implementation of thrombembolectomy during open surgical intervention in a number of cases allows to avoid intestinal resection.

"TRUE" INCIDENCE OF SKIN MELANOMA, BASED ON A MASSIVE 3-DAY EARLY DIAGNOSIS CAMPAIGN IN A BIG INDUSTRIAL CITY

2021 ◽  
pp. 71-83
Author(s):  
E.Yu. Neretin ◽  
S.Kh. Sadreeva
Keyword(s):  
Early Diagnosis ◽  
Incidence Rate ◽  
Large Scale ◽  
Multi Agent System ◽  
Skin Melanoma ◽  
True Incidence ◽  
Industrial City ◽  
Non Invasive ◽  
Official Rate ◽  
Multi Agent

Skin melanoma (SM) is a malignant tumor that is quite rarely diagnosed in Russia. However, both absolute and relative numbers (incidence) of patients with this diagnosis are growing. The trend persists for many years, but the official incidence rate does not reflect the true picture, so it is likely to be lower than the true one. The aim of the study was to calculate the assumed incidence of skin melanoma based on the data from a large-scale early diagnosis campaign. Materials and Methods. In 2019, 800 patients were examined during a 3-day campaign in the Samara region. A non-invasive diagnostic method (digital dermatoscopy), a multi-agent technology based on artificial intelligence and a proprietary technology (patent No. 2018620399, No. 2018613016) were used during the campaign. Four skin melanomas were identified at an early, pre-invasive stage. Results. Two different methods (depending on the percentage of population coverage and the campaign duration), made it possible to calculate a true indicator of the skin melanoma incidence. Conclusion. It was possible to adjust the "true" incidence rate of skin melanoma. In 2019, it ranged from 9.65 to 15.31 per 100 000 people, which is significantly higher than the official rate registered that year (8.11 per 100 000 population). Keywords: skin melanoma, true incidence, large-scale campaign, multi-agent system, skin melanoma modeling. Меланома кожи (МК) является злокачественной опухолью, которая встречается в РФ довольно редко, причем растет как абсолютное количество пациентов с данным диагнозом, так и относительное (заболеваемость). Данная тенденция стабильно сохраняется на протяжении многих лет, однако официальный показатель заболеваемости не отражает реальной картины и вполне вероятно, что он несколько ниже «истинного». Целью исследования был расчет предполагаемой заболеваемости меланомой кожи на основании данных, полученных в результате масштабной кампании по ранней диагностике. Материалы и методы. В Самарской области в 2019 г. была проведена 3-дневная кампания, которая позволила обследовать 800 обратившихся пациентов с помощью неинвазивного метода диагностики (цифровой дерматоскопии) и мультиагентной технологии, основанной на искусственном интеллекте и авторской методике (патент на изобретение № 2018620399, № 2018613016). Всего было выявлено 4 меланомы кожи на ранней, доинвазивной, стадии. Результаты. В ходе расчета по 2 различным методикам (в зависимости от процента охвата населения и продолжительности акции) был получен «истинный» показатель заболеваемости МК. Выводы. «Истинный» показатель заболеваемости МК был скорректирован и составил от 9,65 до 15,31 на 100 тыс. населения, что значительно больше официального, зарегистрированного в отчетном 2019 г. (8,11 на 100 тыс. населения). Ключевые слова: меланома кожи, «истинная» заболеваемость, масштабная кампания, мультиагентная система, моделирование заболеваемости меланомы кожи.

scholarly journals Prevalence of oral mucosal lesions in a tertiary care centre: one-year prospective study

2020 ◽  
Vol 6 (9) ◽  
pp. 1704
Author(s):  
Smruti Milan Tripathy ◽  
Poonji Gupta ◽  
Akshay Jain ◽  
Probal Chatterji
Keyword(s):  
Oral Cavity ◽  
Early Stage ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Research Centre ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Number Of Patients ◽  
Malignant Lesions ◽  
One Year

<p class="abstract"><strong>Background:</strong> Lesions of the oral cavity are very common among the general population and account for a significant number of patients in the outpatient department of otorhinolaryngology. The lesions of oral cavity can cause varied symptoms like pain, dysphagia, and difficulty in speaking. The lesions can range from simple benign conditions to life threatening malignancies.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in the department of otorhinolaryngology, Teerthanker Mahaveer Medical College and Research Centre from January 2019 till December 2019. All the 256 patients who presented to the outpatient department with lesions in the oral cavity during the given time period were included in the study after getting informed and written consent.  </p><p class="abstract"><strong>Results:</strong> Aphthous ulcers were the most common lesion (18.7%) found in this study. Buccal mucosa (50%) and anterior 2/3<sup>rd</sup> of tongue (34.3%) were the most common sites involved. Total of 204/256 (79.6%) patient had some form of addiction which included both smoked and smokeless form of tobacco as the most common type of addiction. Among the tobacco smokers, 24/80 (30%) had pre malignant and malignant lesions while among tobacco chewers 37/76 (48.6%) had pre malignant and malignant lesions.</p><p class="abstract"><strong>Conclusions:</strong> Lesions of the oral cavity are common among Indian population due to high prevalence of tobacco addiction. A thorough history taking and examination can detect premalignant and malignant lesions at an early stage, so that timely treatment can reduce the mortality rates in such patients.</p>

scholarly journals Excisional biopsy of a dysplastic nevus in a district polyclinic is a path to early detection of skin melanoma

2021 ◽  
pp. 66-72
Author(s):  
N. G. Artemeva ◽  
O. A. Romanova
Keyword(s):  
Mortality Rate ◽  
Early Diagnosis ◽  
Cutaneous Melanoma ◽  
Early Stage ◽  
Excisional Biopsy ◽  
Early Stage Disease ◽  
Dysplastic Nevus ◽  
Pigmented Lesions ◽  
Grade 3 ◽  
Surgery Department

Introduction. Russia has a high mortality rate of cutaneous melanoma – 2.5 per 100,000 population whereas the incidence rate is 7.7 per 100,000 population, i.e. one in every three patients dies. In the foreign countries (the USA, Australia), melanoma mortality rate is 10-15%. Such high rates are explained by the fact that patients with early-stage disease do not seek medical advice, as in early stages a tumour does not cause inconvenience to a patient and looks like an ordinary mole.The purpose of the study was to confirm the advisability of removing a progressive dysplastic nevus (grade 3 lentiginous melanocytic dysplasia) with a view to prevent and make early diagnosis of cutaneous melanoma.Materials and methods. The authors removed 180 pigmented lesions that were clinically diagnosed as a progressive dysplastic nevus in the Surgery Department of Central Polyclinic of Literary Fund from 2009 to March 2020. The patients were referred to the Surgery Department by physicians, dermatologists and other specialists of the polyclinic. Following an oncologist consultation, excisional biopsy of a nevus was performed under local anesthesia.Results. Histological examination revealed 29 (16%) dysplastic nevi with grade 3 LMD and 18 (10%) early-stage melanomas.Conclusions. If excisional biopsy of a dysplastic nevus becomes routine in Ambulatory Surgery practice, it will increase the early diagnosis of melanoma and significantly reduce mortality rates of this disease. For excisional biopsy, the authors recommend to excise at a distance of 0.5 to 1.0 cm from the lesion boundaries, since it is not possible to clinically distinguish a progressive dysplastic nevus from early melanoma.

Successful Treatment of Congenital Shoulder Luxation in a Dog by Closed Pinning

1994 ◽  
Vol 07 (04) ◽  
pp. 170-172 ◽  
Author(s):  
R. A. Read
Keyword(s):  
Early Diagnosis ◽  
Successful Treatment ◽  
Humeral Head ◽  
One Year

Congenital shoulder luxation in the dog is commonly associated with deformity of the humeral head and glenoid, making reduction and stabilization difficult. Early diagnosis of congenital luxation of the shoulder in a Papillon made it possible to successfully reduce and stabilize the luxation using a closed pinning technique. One year later the joint was functionally and radiographically normal.

A CLINICAL CASE OF PRIMARY HYPERPARATHYROIDISM OF THE OSTEO-VISCERAL FORM

2020 ◽  
pp. 155-161
Author(s):  
Poselyugina O.B. ◽  
Kulish A.S. ◽  
Vasiliev D.F.
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Case ◽  
Early Stage ◽  
Diagnostic Errors ◽  
Epidemiological Studies ◽  
Medical Documentation ◽  
Screening Methods ◽  
Internal Organs ◽  
Blood Calcium ◽  
Slow Development

Introduction. Primary hyperparathyroidism is an endocrine disease resulting from a primary pathology of the parathyroid gland, characterized by increased secretion of parathyroid hormone and increased blood calcium levels. Among the endocrine diseases, primary hyperparathyroidism is the third most common after diabetes mellitus and thyroid disease. In Russia, according to epidemiological studies, primary hyperparathyroidism is found in 1% of the population, women suffer 2-3 times more often than men do, and the average age of diagnosis is 54-59 years. In the absence of a timely diagnosis, primary hyperparathyroidism causes systemic damage to internal organs: renal impairment, nephrolithiasis, esophageal affection, cardiovascular and nervous system involvement, and it leads to a violation of bone tissue integrity. The aim is to demonstrate a clinical case of a patient with primary hyperparathyroidism and to analyze the stages of diagnosis of the disease and treatment. Material and methods. The review of medical literature on the problem of diagnostics and treatment of primary hyperparathyroidism was performed, as well as an analysis of the patient’s medical documentation with this pathology. Results and discussion. A variant of complicated course of primary hyperparathyroidism of bone and visceral form is considered. About 15 years passed from the moment of appearance of the first symptoms of the disease to the development of complications of renal and bone system. Despite the slow development of the disease and availability of screening methods, hyperparathyroidism was detected at the stage of complications. This article provides a detailed analysis of the primary hyperparathyroidism history, as well as analyzes the possibilities of diagnosis, treatment and prevention of this pathology. The efficacy of the therapy has been assessed, and ways of correction have been outlined. The analysis of the reasons that made it difficult to diagnose this pathology at an early stage, before the development of serious complications of internal organs, has been carried out. Conclusions: It can be assumed that the presented clinical case will increase the awareness of physicians, especially therapists, about the primary manifestations of this pathology and the peculiarities of its detection and routing the patient, which will allow avoiding many diagnostic errors.

ANALYSIS OF THE MAIN INDICATORS CHARACTERIZING MEDICAL CARE FOR CHILDREN WITH CANCER IN SAINT-PETERSBURG AND IN THE LENINGRAD REGION IN 2013-2017

2019 ◽  
Vol 65 (1) ◽  
pp. 77-82
Author(s):  
Maksim Rykov ◽  
Ivan Turabov ◽  
Yuriy Punanov ◽  
Svetlana Safonova
Keyword(s):  
Mortality Rate ◽  
Medical Care ◽  
Statistical Data ◽  
Leningrad Region ◽  
Children With Cancer ◽  
Health Committee ◽  
The Government ◽  
Delivery Of Medical Care ◽  
One Year ◽  
The One

Background: St. Petersburg is a city of federal importance with a large number of primary patients, identified annually. Objective: analysis of the main indicators characterizing medical care for children with cancer in St. Petersburg and the Leningrad region. Methods: The operative reports for 2013-2017 of the Health Committee of the Government of St. Petersburg and the Health Committee of the Leningrad Region were analyzed. Results. In 2013-2017 in the Russian Federation, 18 090 primary patients were identified, 927 (5.1%) of them in the analyzed subjects: in St. Petersburg - 697 (75,2%), in the Leningrad Region - 230 (24,8%). For 5 years, the number of primary patients increased in St. Petersburg - by 36%, in the Leningrad Region - by 2,5%. The incidence increased in St. Petersburg by 18,1% (from 14,9 in 2013 to 17,6 in 2017 per 100 000 of children aged 0-17). The incidence in the Leningrad Region fell by 4.9% (from 14.4 in 2013 to 13.7 in 2017). Mortality in 2016-2017 in St. Petersburg increased by 50% (from 2 to 3), in the Leningrad Region - by 12,5% (from 2,4 to 2,7). The one-year mortality rate in St. Petersburg increased by 3,9% (from 2,5 to 6,4%). In the Leningrad Region, the one-year mortality rate decreased from 6,5% in 2016 to 0 in 2017. The number of pediatric oncological beds did not change in St. Petersburg (0,9 per 10,000 children aged 0-17 years) and the Leningrad Region (0). In St. Petersburg patients were not identified actively in 2016-2017; in the Leningrad Region their percentage decreased from 8,7 to 0. The number of oncologists increased in St. Petersburg from 0,09 to 0.12 (+33,3%), in the Leningrad Region - from 0 to 0,03. Conclusion: Morbidity in St. Petersburg and the Leningrad region is significantly different, which indicates obvious defects in statistical data. Patients were not identified during routine preventive examinations which indicate a low oncologic alertness of district pediatric physicians. Delivery of medical care for children with cancer and the statistical data accumulation procedures should be improved.

Sign in / Sign up

Export Citation Format

Share Document