Medicine

A 64-year-old man went to the emergency department of Brigham and Women’s Hospital in Boston with a painful festering ulcer spreading on his left, very swollen ankle. It was a gruesome sight; the open sore was about 8 by 5 centimeters (about 3 by 2 inches) and was rimmed by black, ashen, and dark purple tissue. Inside, it oozed with streaks and fringes of yellow pus around pink and red inflamed flesh. It was 2 cm deep (nearly an inch). And it smelled.

The man told doctors it had all started two years prior, when dark, itchy lesions appeared in the area on his ankle—the doctors noted that there were multiple patches of these lesions on both his legs. But about five months before his visit to the emergency department, one of the lesions on his left ankle had progressed to an ulcer. It was circular, red, tender, and deep. He sought treatment and was prescribed antibiotics, which he took. But they didn't help.

With the realm of possibilities large, they started with the man's medical history. The man had immigrated to the US from Korea 20 years ago. He owned and worked at a laundromat, which involved standing for more than eight hours a day. He had a history of eczema on his legs, high cholesterol, high blood pressure, and Type 2 diabetes. For these, he was prescribed a statin for his cholesterol, two blood pressure medications (hydrochlorothiazide and losartan), and metformin for his diabetes. He told doctors he was not good at taking the regimen of medicine.

His diabetes was considered "poorly controlled." A month prior, he had a glycated hemoglobin (A1C or HbA1C) test—which indicates a person's average blood sugar level over the past two or three months. His result was 11 percent, while the normal range is between 4.2 and 5.6 percent.

NOTE: The original title was "Artificial intelligence-assisted detection[...]", so I modified it to be more specific.

Background:

Nasopharyngeal carcinoma is highly curable when diagnosed early. However, the nasopharynx’s obscure anatomical position and the similarity of local imaging manifestations with those of other nasopharyngeal diseases often lead to diagnostic challenges, resulting in delayed or missed diagnoses. Our aim was to develop a deep learning algorithm to enhance an otolaryngologist’s diagnostic capabilities by differentiating between nasopharyngeal carcinoma, benign hyperplasia, and normal nasopharynx during endoscopic examination.

Findings

Endoscopic images used in the internal study (Jan 1, 2017, to Jan 31, 2023) were from 15 521 individuals (9033 [58·2%] men and 6488 [41·8%] women; mean age 47·6 years [IQR 38·4–56·8]). Images from 945 participants (538 [56·9%] men and 407 [43·1%] women; mean age 45·2 years [IQR 35·2– 55·2]) were used in the external validation. STND in the internal dataset discriminated normal nasopharynx images from abnormalities (benign hyperplasia and nasopharyngeal carcinoma) with an area under the curve (AUC) of 0·99 (95% CI 0·99–0·99) and malignant images (ie, nasopharyngeal carcinoma) from non-malignant images (ie, benign hyperplasia and normal nasopharynx) with an AUC of 0·99 (95% CI 0·98–0·99). In the external validation, the system had an AUC for the detection of nasopharyngeal carcinoma of 0·95 (95% CI 0·94–0·96), a sensitivity of 91·6% (95% CI 89·3–93·5), and a specificity of 86·1% (95% CI 84·1–87·9). In the multireader, multicase study, the artificial intelligence (AI)-assisted strategy enhanced otolaryngologists’ diagnostic accuracy by 7·9%, increasing from 83·4% (95% CI 80·1–86·7, without AI assistance) to 91·2% (95% CI 88·6–93·9, with AI assistance; p<0·0001) for primary care otolaryngologists. Reading time per image decreased with the aid of the AI model (mean 5·0 s [SD 2·5] vs 6·7 s [6·0] without the model; p=0·034).

(emphasis mine)

Interpretation

Our deep learning system has shown significant clinical potential for the practical application of nasopharyngeal carcinoma diagnosis through endoscopic images in real-world settings. The system offers substantial benefits for adoption in primary hospitals, aiming to enhance specificity, avoid additional biopsies, and reduce missed diagnoses.

cross-posted from: https://lemmy.world/post/32060710

The U.S. Food and Drug Administration has approved the drug lenacapavir as a twice-yearly injection to prevent HIV.

The drug, called Yeztugo from company Gilead Sciences, was approved Wednesday based on data from clinical trials that showed 99.9% of participants who received it remained HIV negative.

Daniel O'Day, Gilead's chairman and chief executive officer, called the approval a "milestone moment in the decades-long fight against HIV."

"Yeztugo will help us prevent HIV on a scale never seen before. We now have a way to end the HIV epidemic once and for all," O'Day said in a news release.

According to the Centers for Disease Control and Prevention, there were 31,800 estimated new HIV infections in the United States in 2022, the most recent year with available data.

While the drug's approval meets an existing need, the Trump administration's funding decisions have rolled back progress for a vaccine.

Last month, the administration moved to end funding for a broad swath of HIV vaccine research, saying current approaches are enough to counter the virus.

As cannabis use among youth rises in Canada — and THC potency reaches record highs — emergency departments are seeing a surge in cases of a once-rare condition: cannabis hyperemesis syndrome (CHS).

Characterized by relentless vomiting, abdominal pain and temporary relief through compulsive hot showers or baths, CHS is increasingly affecting adolescents and young adults. Yet few people — including many clinicians — know it exists.

Canada ranks among the highest globally for youth cannabis use, with 43 per cent of 16-19-year-olds reporting use in the past year. Usage peaks among those 20–24 years, with nearly half (48 per cent) reporting past-year use.

This rise in regular, heavy use coincides with a 400 per cent increase in THC potency since the 1980s. Strains with THC levels above 25 per cent are now common. As cannabis becomes more potent and accessible, clinicians are seeing more cases of CHS, a condition virtually unheard of before 2004.

CHS unfolds in three phases:

1. Prodromal phase: Nausea and early morning discomfort begin. Users increase cannabis consumption, thinking it will relieve symptoms.

2. Hyperemetic phase: Intense vomiting, dehydration and abdominal pain follow. Hot showers or baths provide temporary relief — a hallmark of CHS.

3. Recovery phase: Symptoms resolve after stopping cannabis entirely.

Diagnosis is often delayed. One reason is because CHS mimics conditions like gastroenteritis or eating disorders, leading to costly CT scans, MRIs and gastric emptying tests. One telltale sign — compulsive hot bathing — is frequently overlooked, despite its strong diagnostic value.

Youth face unique risks. The brain continues to develop until about age 25, and THC exposure during this critical window can impair cognitive functions like memory, learning and emotional regulation. Heavy cannabis use is associated with heightened risks of anxiety, depression, psychosis and self-harm.

I've copied some of the story below

Dr. Donald Craig greeted by surprise guest during award presentation in Saint John

Dr. Donald Craig was an intern at the old General Hospital in Saint John on a snowy night in January 1968 when a doctor asked him for help.

The doctor had to deliver a baby at nearby St. Joseph's Hospital, but a woman at the General was also about to give birth. That child was three months premature and expected to be stillborn.

"Can you handle this?" the doctor asked.

Craig had delivered babies before, but only under the supervision of a doctor or a resident. So he grabbed a book on human labour and began to review it.

Then a nurse came and told him the baby was breech — something the doctor hadn't mentioned. So he went back to his book to look that one up. A few hours later, a nurse came to take him to the delivery room.

"She screams at me, 'Craig, she's ready, she's pushing and she's crying. Let's go.'"

Craig had to break the baby's clavicle on its way out, but he manged to deliver the baby, still expecting it to be stillborn.

And then the baby started to cry.

"My heart took off faster than the baby's heart, and the mother started crying, 'Is that my baby crying?'"

The baby was alive and Craig's thoughts quickly turned to her survival. She weighed two pounds and was three months premature. Her odds of survival weren't great.

He knew the General had just hired a pediatrician who specialized in newborn child care and premature births — and she happened to be in the hospital overnight in case she was needed during the storm.

Craig said that doctor soon appeared, wearing a bathrobe over her pyjamas. She looked at him and asked, "Did you deliver that by yourself? Give me the baby."

He said the doctor "let the mom kiss her baby and said, 'We're just taking the baby down the hall. We're going to be fine.' Then she disappeared."

To this day, Craig says the doctor's skilled care was critical to the survival of the baby, who was in the hospital for a month before being released. Craig checked on her every day and gave updates to her mother, who wasn't allowed to stay in the hospital with her.

"I delivered that baby, but [the doctor] had the skill, and was trained to handle it from there," Craig said.

More than 55 years later, Craig is retired after a decades-long career in family and emergency medicine. He has served as president of the College of Physicians and Surgeons of New Brunswick and the Saint John Medical Society.

He also founded the New Brunswick Medical Education Foundation, which provides scholarships to the province's medical students who agree to set up practice here — a critical part of the efforts to increase the number of doctors in New Brunswick.

In April, the foundation gave Craig the Champions of Care Founder's Award at a gala at the Saint John Trade and Convention Centre. The person who presented him with that award was Krista Barczyk, the premature baby he delivered as an intern decades ago during that January snowstorm.

It was a planned reunion the foundation kept secret from Craig until the moment Barczyk was called to the stage.

"I didn't hear half of her speech because I was so shocked," Craig said. "Then I got a copy of her speech and I printed it off to put up on my wall."

Diabetes Canada says it's received a surge in reports from people who've seen ads for or bought products that use the charity's logos without authorization.

Since January, Diabetes Canada says it's had over 300 calls to its 1-800 line and emails from people reporting misleading advertisements for diabetes products that have the charity's logo.

Diabetes Canada isn't the only organization being affected. Products ranging from purported medications and supplements to devices that claim to be blood glucose monitors are also carrying the logos of Obesity Canada and Health Canada. Some of the groups say they want the ads taken down and social media companies are doing that, but new ads keep appearing.

So, you’ve got a receding hairline in 2025. You could visit a dermatologist, sure, or you could try a new crop of websites that will deliver your choice of drugs on demand after a video call with a telehealth physician. There’s Rogaine and products from popular companies like Hims, or if you have an appetite for the experimental, you might find yourself at Anagen.

Anagen works a lot like Hims—some of its physicians have even worked there, according to their LinkedIn profiles and the Hims website—but take a closer look at the drugs on offer and you’ll start to notice the difference. Its Growth Maxi formula, which sells for $49.99 per month, contains Finasteride and Minoxidil; two drugs that are in Hims’ hair regrowth products. But it also contains Liothyronine, a thyroid medication also known as T3 that the Mayo Clinic warns may temporarily cause hair loss if taken orally. Keep reading and you’ll see Latanoprost, a glaucoma drug. Who came up with this stuff anyway?

The group behind the Anagen storefront and products it sells is HairDAO, a “decentralized autonomous organization” founded in 2023 by New York-based cryptocurrency investors Andrew Verbinnen and Andrew Bakst. HairDAO aims to harness the efforts of legions of online biohackers already trying to cure their hair loss with off-label drugs. Verbinnen and Bakst’s major innovation is to inject cash into this scenario: DAO participants are incentivized with crypto tokens they earn by contributing to research, or uploading blood work to an app.

cross-posted from: https://programming.dev/post/30549287

Question Is a multicomponent vaccine against seasonal influenza and SARS-CoV-2 (mRNA-1083) immunogenic and well-tolerated in adults 50 years and older?

Findings In this phase 3 study, mRNA-1083 elicited noninferior immune responses against standard care immunization: licensed standard-dose or high-dose seasonal influenza vaccine (A/H1N1, A/H3N2, B/Victoria, B/Yamagata) coadministered with licensed SARS-CoV-2 (Omicron XBB.1.5) vaccine. The multicomponent vaccine mRNA-1083 had an acceptable tolerability and safety profile.

Meaning mRNA-1083 was demonstrated to be at least as immunogenic as recommended standard care vaccines against both seasonal influenza and COVID-19 and well-tolerated in adults 50 years and older.

New bismuth-based organic-inorganic hybrid materials show exceptional sensitivity and long-term stability as X-ray detectors, significantly more sensitive than commercial X-ray detectors. In addition, these materials can be produced without solvents by ball milling, a mechanochemical synthesis process that is environmentally friendly and scalable. More sensitive detectors would allow for a reduction in the radiation exposure during X-ray examinations.

Research publication on https://pubmed.ncbi.nlm.nih.gov/40207598/ Open access to the research on https://advanced.onlinelibrary.wiley.com/doi/10.1002/adma.202418626

For all of you histology and clinical laboratory nerds, there is now a pathology community on mander.xyz. This will be the third pathology community on Lemmy, with the other two currently being unmaintained. Drop by for some pretty purple/pink stuff.

The last type of chemotherapy that David Easton tried in his five-year fight against prostate cancer left him living a life that was really no life at all.

The retired Ontario autoworker slept 20 hours a day. His little time awake was spent hunched on or over the toilet at his home in Ayton, a small community about two hours northwest of Toronto.

He and his wife, Ann Easton, decided in February of 2024 that he would stop chemotherapy, even though he had exhausted all other treatments and very much wanted to live.

Then, about a year later, Mr. Easton was presented with a new option: a radioactive drug delivered by IV that would target his cancer and spare his healthy cells, unlike chemotherapy. “The nurse said that chemo was like being hit with a sledgehammer,” Ms. Easton said, “and this stuff is like being tickled with a feather.”

The only catch was that the 73-year-old would have to limit time with his wife and grandchildren for a few days after the drug was injected into his bloodstream because he would be radioactive.

The radiopharmaceutical that Mr. Easton received at London Health Sciences Centre on March 20 is called Pluvicto, and it is part of a new class of treatments that proponents predict will soon be a fourth pillar of cancer care, alongside surgery, chemotherapy and traditional radiation.