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Explainability of a CNN for breast density assessment
No full textDeep neural network explainability is a critical issue in Artificial Intelligence (AI). This work aims to develop a method to explain a deep residual Convolutional Neural Network able to automatically classify mammograms into
breast density classes. Breast density, a risk factor for breast cancer, is defined as the amount of fibroglandular tissue compared to fat tissue visible on a mammogram. We studied the explainability of the classifier to understand the reasons behind its predictions, in fact with a deep multi-layer structure, it acts like a blackbox. As there is no well-established method, we explored different possible analyses and visualization techniques. The main obtained results were the achievement of a performance improvement in terms of accuracy and a contribution to assess trust in the model. This is fundamental for a potential application in clinical practice
Photoluminescent radiation-induced color centers in lithium fluoride for detection of pulsed 10 keV XFEL beam
No full textImages of the Spring-8 Angstrom Compact free electron LAser (SACLA) 10 keV pulsed (10 fs) beam were recorded in a lithium fluoride (LiF) crystal by exploiting visible photoluminescence of radiation-induced color centers (CCs). Photoluminescent beam images stored in LiF, irradiated at several energies from 0.04 to 0.8 J, were acquired by a fluorescence optical microscope and processed with an algorithm developed in Matlab, allowing to reconstruct the transversal beam fluence distribution
Scientific laboratory recovered in former normal school in Parma, birth of a European project: “A European Museum of Education: Preserving and Sharing Educational and Cultural Heritage”
No full textHigh school students helped the recovery of a nineteenth-century scientific laboratory in Parma. It belonged to a former normal school and it consists of a collection of tools compiled through the years since 1861. These scientific devices can still be used to teach physics and science. This “discovery” led to the creation of new educational activities, and forced to a reflection on the protection of our scientific heritage. By collaborating with Spanish and Portuguese colleagues, the work will grow in the Erasmus+ project “A European Museum of Education:
Preserving and Sharing Educational and Cultural Heritage
Marantic Endocarditis Associated with COVID-19: A Rare Case Report of a Potentially Deadly Disease
Get PDFCoronavirus disease 2019 (COVID-19) has overwhelmed healthcare globally with millions of cases and over 2 million deaths worldwide. The hypercoagulable state associated with COVID-19 is a well-recognized complication that carries a poor prognosis. Marantic endocarditis, or
non-bacterial thrombotic endocarditis (NBTE), is caused by a sterile vegetation on the cardiac valves resulting from the deposition of fibrin and platelet aggregates. It is highly associated with the hypercoagulable and acquired inflammatory states. Herein, we report a unique and rare case of COVID-19 presenting with NBTE
Unilateral Proptosis due to Orbital Metastasis of Paratesticular Leiomyosarcoma
Get PDFParatesticular leiomyosarcomas are uncommon malignant tumours that originate from smooth muscle and show aggressive tumour behaviour due to a high incidence of local recurrence and distant metastasis. Orbital metastasis is also rare and associated with a poor
prognosis. Clinical suspicion plays an essential role in the diagnosis of orbital leiomyosarcoma because of its uncommon presentation. Comprehensive neuroimaging and histopathological work-up are warranted for definitive diagnosis and management. To date, surgical
resection remains the best curative treatment. However, leiomyosarcomas are usually friable and unencapsulated, which makes surgery challenging. Also, whether adjunctive chemotherapy will alter the long-term prognosis remains to be determined. Herein, we report the case of a middle-aged man who presented with proptosis and decreased vision, who was subsequently diagnosed with metastatic orbital
leiomyosarcoma from a primary paratesticular tumour. We performed orbital enucleation with negative margins. The patient is currently under systemic pazopanib chemotherapy
Reversible Neurological Adverse Reaction to Apixaban
Get PDFPrescriptions for the novel oral anticoagulant factor Xa inhibitors (rivaroxaban, apixaban, edoxaban) have equalled or exceeded those for vitamin K antagonists in many clinical settings requiring chronic anticoagulation, and those of injectable heparins for deep vein thrombosis prophylaxis. The authors report the case of an 80-year-old woman followed by her cardiologist for permanent atrial fibrillation who was prescribed apixaban. Within a few days the patient developed neurological symptoms of imbalance and non-vertiginous dizziness, headache, confusion/disorientation and asthenia. Her symptoms began to resolve after the drug was stopped, with return to baseline function within 72 h. The plasma concentration of apixaban was 4 times higher than the laboratory upper limit of normal. Symptoms did not recur when the patient was switched to rivaroxaban therapy
Diffuse Calcinosis from Total Thyroidectomy and Secondary Hypocalcaemia
Get PDFHypoparathyroidism is a rare endocrine disorder and its main cause is cervical surgery such as thyroidectomy. The incidence of hypoparathyroidism after total thyroidectomy varies, and is reported to be between 0.3 and 6.3%. In terms of brain imaging, hypoparathyroidism can cause calcification mainly of the basal ganglia, with other areas rarely affected. Concerning extracerebral calcification, few studies have investigated the prevalence of visceral calcifications. We describe a case of a woman with secondary hypocalcaemia who presented with a transient ischaemic attack (TIA) and the investigation revealed an extensive calcinosis of the brain and the vascular structures responsible for the event
A Rare Case of Exocrine Pancreatic Insufficiency
Get PDFLipomatous pseudohypertrophy (LPH) of the pancreas is an uncommon affection of exocrine pancreatic insufficiency. It is defined as substitution of the pancreatic exocrine gland by a large fat component. We report the case of a young patient with malabsorption syndrome (chronic diarrhoea and steatorrhoea), abnormal laboratory results and normal fibroscopy. Computed tomography revealed characteristic diffuse pancreatic abnormalities
Monocular Diplopia in Idiopathic Intracranial Hypertension: A Case Report and Literature Review
Get PDFBackground: Diplopia is the double vision of a single object, and can be binocular or monocular. Binocular diplopia is caused by the misalignment of the visual axes, with images falling on the fovea of the fixating eye and on the extra-foveal retina of the non-fixating eye, as a consequence of both neurological (i.e., oculomotor nerve palsies, ocular myopathies, neuromuscular junction disorders) and ophthalmic disorders (i.e., decompensation of a pre-existing strabismus). In contrast, monocular diplopia is generally explained by intraocular pathology (i.e., refractive errors, ocular media abnormalities, dry eyes), causing the image of a single object to fall, at the same time, on the fovea and on
the extra-foveal retina of the same eye.
Methods: We report the case of a 22-year-old woman presenting with acute-onset monocular diplopia.
Results: The diagnosis of idiopathic intracranial hypertension (IIH) was based on the presence of papilloedema and elevated cerebrospinal fluid (CSF) pressure. Monocular diplopia resolved after CSF subtraction.
Conclusions: We describe a case of monocular diplopia as a presenting symptom of IIH, and discuss diagnostic issues of this possibly underestimated symptom in neurology clinical practice. Careful ophthalmic and neuro-ophthalmic examination can identify clinical features of diplopia, and drive diagnosis and treatment
A Life-Threatening Presentation of Primary Small Cell Colorectal Non-Hodgkin Lymphoma as Cardiac Tamponade and Its Challenging Management
Get PDFColorectal non-Hodgkin lymphoma (NHL) is quite aggressive and rare, only constituting less than 1% of all cases of colorectal cancer. The pericardium is an extremely rare first site of metastasis. Cardiac tamponade can be a life-threatening initial presentation. We report a 55-year-old female who presented with severe shortness of breath, intermittent abdominal pain and altered bowel habits. She had low blood pressure with congested neck veins. Her echocardiogram showed pericardial and cardiac infiltration with tumour mass; a large pericardial effusion with signs of cardiac tamponade. There was no safe window for percutaneous drainage, and the patient was not physically fit for surgical drainage. A multidisciplinary approach was used to diagnose and manage the case involving a cardiologist, gastroenterologist, pathologist, radiologist and oncologist. CT scans of the whole body showed a large rectosigmoid mass infiltrating the uterus and adnexa. Flexible sigmoidoscopy showed a large bleeding mass at the rectosigmoid junction. The biopsy confirmed small cell NHL. Three cycles of chemotherapy were urgently commenced over a period of 5 weeks (1 cycle of CVP; 2 cycles of CHOP). The patient showed significant symptomatic improvement. A 5-week follow-up echocardiogram showed significant shrinkage of the pericardial tumour and only a small rim of pericardial effusion. The effusion did not recollect in her follow-up echocardiograms. A year later, she was referred to the palliative care team due to the further spreading of her lymphoma. In conclusion, colorectal small cell NHL may initially present as cardiac tamponade. Urgent initiation of chemotherapy can be a treatment option whenever a drainage procedure is unsaf