Technology & Inventions : Emergency Medicine News

Technology & Inventions : Emergency Medicine News

AI Detection of TB

An abstract presented at the recent European Congress of Clinical Microbiology & Infectious Diseases in Copenhagen found that computer-assisted detection could improve the diagnosis of tuberculosis in parts of the world where trained radiologists are unavailable. (https://bit.ly/3oQciR5.) Users just have to send a photo of a chest x-ray developed on film to a central location for analysis. The researchers compared AI’s ability to spot TB in chest x-rays with that of two radiologists with at least 10 years of experience. AI correctly identified 75 percent of all PCR-confirmed cases in 498 chest x-rays (sensitivity 75%) and 85.7 percent of non-TB cases (specificity 85.7%) compared with an experienced radiologist’s assessment at 75% sensitivity and 82% specificity. Less experienced radiologists’ assessments were 62.5% sensitive and 91.7% specific. (Medscape. April 20, 2023; https://bit.ly/43m1o4z.)The World Health Organization told Medscape that it had recommended AI for interpreting digital chest x-rays since 2021, especially where no experienced radiologists are available, such as in low-resource countries that have high rates of TB.

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AI, detection, TB, tuberculosis, radiologists, x-ray, PCR, World Health Organization, WHO, limb-salvaging technique, LimFlow System, transcatheter, TADV, ischemia, revascularization, amputation, CLTI, AstraZeneca, heart failure, dapagliflozin, PCWP, HFpEF, SGLT2

Limb-Salvaging Technique

Research using the LimFlow system to test a technique called transcatheter arterialization of deep veins (TADV) showed that three-quarters of patients with chronic limb-threatening ischemia (CLTI) and no revascularization options were able to avoid amputation. (N Engl J Med. 2023;388[13]:1171; https://bit.ly/3WOvVWi; one author disclosed being a consultant to LimFlow.) The minimally-invasive LimFlow System is designed to bypass blocked arteries in the legs of CLTI patients and deliver oxygenated blood back into the foot via the veins, according to a news release from the company. (LimFlow. April 3, 2023; https://bit.ly/3IXtLOt.) Researchers enrolled 105 patients with CTLI with no revascularization options. “Using the LimFlow system, the investigators connected arterial flow in the leg to the downstream deep-venous segments instead of to an arterial target,” a Medscape article reported. “This reverses the blood flow in the veins and perfuses the distal limb through the venous rather than the arterial system.” (Medscape. March 31, 2023; https://bit.ly/43qHpRT.) Sixty-six percent of the study patients survived without amputation and limb salvage was achieved in 76 percent at six months. Find more information about the LimFlow System for TADV at www.limflow.com.

Treatment for HFpEF

An AstraZeneca-funded study of its SGLT2 inhibitor dapagliflozin (Farxiga) produced reductions in left-heart filling pressures for patients with heart failure with preserved ejection fraction (HFpEF). (Medscape. March 23, 2023; https://bit.ly/3MutyTI.) Twenty-four weeks of treatment produced an average 6.1-mm Hg drop in pulmonary capillary wedge pressure (PCWP) from baseline in patients with HFpEF with severe elevations in PCWP during exercise compared with patients receiving placebo. Similar results were found in patients at rest; dapagliflozin yielded an average reduction in PCWP of 3.5 mm Hg compared with controls. Researchers used high-fidelity micromanometer catheters to record PCWP in 37 patients with HFpEF who had a left ventricular ejection fraction of at least 50%, a New York Heart Association functional class of 2 or 3, and a PCWP during exercise of at least 25 mm Hg. Those treated with dapagliflozin also showed a significant reduction from their baseline plasma volume compared with patients receiving placebo. Find complete prescribing information for Farxiga at https://bit.ly/3NaFI5N.

MS. TALBOT is an editorial assistant for Emergency Medicine News.

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