We evaluated the clinical applications of artificial intelligence models in diagnosing corneal diseases, highlighting their performance metrics and clinical potential. A systematic search was conducted for several disease categories: keratoconus (KC), Fuch’s endothelial corneal dystrophy (FECD), infectious keratitis (IK), corneal neuropathy, dry eye disease (DED), and conjunctival diseases. Metrics such as sensitivity, specificity, accuracy, and area under the curve (AUC) were extracted. Across the diseases, convolutional neural networks and other deep learning models frequently achieved or exceeded established diagnostic benchmarks (AUC > 0.90; sensitivity/specificity > 0.85–0.90), with a particularly strong performance for KC and FECD when trained on consistent imaging modalities such as anterior segment optical coherence tomography (AS-OCT). Models for IK and conjunctival diseases showed promise but faced challenges in heterogeneous image quality and limited objective training criteria. DED and tear film models benefited from multimodal data yet lacked direct comparisons with expert clinicians. Despite high diagnostic precision, challenges from heterogeneous data, a lack of standardization in disease definitions, imaging acquisition, and model training remain. The broad implementation of artificial intelligence must address these limitations to improve eye care equity.
Acute kidney injury is a frequent complication of liver transplant. Here, we assessed the rate and contributing factors of acute kidney injury and need for renal replacement therapy in patients undergoing liver transplant at a transplant center in Tehran, Iran. We identified all patients who underwent liver transplant at the Imam Khomeini Hospital Complex from March 2018 to March 2019 and who were followed for 3 months after transplant. Acute kidney injury was defined based on the Acute Kidney Injury Network criteria. We collected demographic and pretransplant, intraoperative, and posttransplant data. Univariable and multivariable models were applied to explore independent risk factors for acute kidney injury incidence and need for renal replacement therapy. Our study included 173 deceased donor liver transplant recipients. Rates of incidence of acute kidney injury and need for renal replacement therapy were 68.2% and 14.5%, respectively. The 3-month mortality rate among those with severe and mild or moderate acute kidney injury was 44.0% (14/25) and 9.7% (9/ 93), respectively (P < .001). Multivariable analyses indicated that serum albumin (relative risk of 0.55; 95% confidence interval, 0.34-0.87; P = .021), baseline serum creatinine (relative risk of 2.11; 95% confidence interval, 1.56-2.90; P = .037), and intraoperative mean arterial pressure (relative risk of 0.76; 95% confidence interval, 0.63-0.82; P = .008) were independent factors for predicting posttransplant acute kidney injury. Independent risk factors for requiring renal replacement therapy were pretransplant serum creatinine (relative risk of 1.99; 95% confidence interval, 1.89-4.47; P = .044) and intraoperative vasopressor infusion (relative risk of 1.41; 95% confidence interval, 1.38-2.00; P = .021). We found a high incidence of acute kidney injury among liver transplant recipients in our center. There was a significant association between severity of acute kidney injury and 3-month and in-hospital mortality.
21 December 2020 in Iranian Journal of Allergy, Asthma and Immunology
Asthma is the most common chronic inflammatory respiratory disorder in children. This study was designed to assess the prevalence of asthma in 13-14-year-old adolescents in Karaj, Alborz province in Iran, using the international study of asthma and allergies in childhood (ISAAC) questionnaire. Totally 950 adolescents attending 40 schools located in 4 regions of Karaj city were enrolled in the survey. The Persian version of the ISAAC questionnaire was filled by 13-14-year-old students. Multi-stage clustered random sampling was used to divide the city of Karaj into four educational districts. Ever wheezing was reported in 22% of the individuals; 10.52% claimed to have wheeze in the last 12 months and 22.73% had during or after exercise. The experience of wheezing in the last 12 months was more prevalent among males (11.73% vs. 9.38%; p<0.05). However, having a history of asthma was higher among males (7.55% vs. 3.47%; p<0.05). History of hospitalization (60.8%), family history of asthma (49.4%), and history of food allergy (42.3%) were found to be the most frequent characteristics significantly associated with" ever wheezing" (p<0.05). The prevalence of wheezing in the last 12 months, as a major index of current asthma, was 10% which was close to the national average. However, nocturnal cough and exercise-induced wheezing were higher in Karaj compared to other cities of Iran; which could be related to the high level of air pollution in this industrial area.