A common gynecological disease in the world is breast cancer that early diagnosis of this disease can be very effective in its treatment. The use of image processing methods and pattern recognition techniques in automatic breast detection from mammographic images decreases human errors and increments the rapidity of diagnosis. In this paper, mammographic images are analyzed using image processing techniques and a pipeline structure for the diagnosis of the cancerous masses. In the first stage, the quality of mammogram images and the contrast of abnormal areas in the image are improved by using image contrast improvement and a noise decline. A method based on color space is then used for image segmentation that is followed by mathematical morphology. Then, for feature image extraction, a combined gray-level cooccurrence matrix (GLCM) and discrete wavelet transform (DWT) method is used. At last, a new optimized version of convolutional neural network (CNN) and a new improved metaheuristic, called Advanced Thermal Exchange Optimizer, are used for the classification of the features. A comparison of the simulations of the proposed technique with three different techniques from the literature applied on the MIAS mammogram database is performed to show its superiority. Results show that the accuracy of diagnosing cancer cases for the proposed method and applied on the MIAS database is 93.79%, and sensitivity and specificity are obtained 96.89% and 67.7%, respectively.
Objective: To investigate whether sequential regimen such as traditional anti-reabsorption medications followed by zoledronic acid could reduce the side effects after initiation of zoledronic acid in postmenopausal osteoporosis patients. Methods: A total of 156 postmenopausal osteoporosis patients who presented at our osteoporosis outpatient clinic were enrolled in this study. They were randomly divided into four groups: the control group, alendronate group, calcitonin group, and raloxifene group. All participants were treated with Caltrate 600 mg per day and calcitriol 0.25 ug per day as a baseline treatment, followed by administrating 5 mg/100 mL of zoledronic acid intravenously for one single time three months afterwards. During the abovementioned course of three months, the alendronate group received 70 mg of alendronate sodium orally once a week, the calcitonin group received nasal spray form of salmon calcitonin 10iu daily, the raloxifene group received 60mg of raloxifene orally daily, and the control group received nothing but only the baseline treatment. We tested parameters such as β-cross, blood calcium level, renal function both pre and post zoledronic acid treatment. We also documented those side effects that typically occurred within one week of treatment initiation, which included the proportion, severity, onset time, and duration of the fever, demand for pain medication, severity of bone and joint pain, flu-like symptoms, arrhythmia, blood calcium level, and kidney function impairment. We also evaluated how willing the patients were to receive a second dose of zoledronic acid. Then we did comparative analysis between control group and sequential group. Results: The side effects such as fever, bone and joint pain, flu-like symptoms after zoledronic acid treatment in alendronate group and calcitonin group were all significantly lower than that in control group, while raloxifene group showed no significant difference compared to that in the control group. The proportions of patients who needed NSAIDs in the alendronate group and the calcitonin group were significantly lower than that in control group. However, the raloxifene group showed no significant difference in the NSAIDs demand from that of the control group. The percentages of patients who consented to a second dose of zoledronate therapy in the alendronate, calcitonin and raloxifene groups were significantly higher than that in the control group. Conclusions: Sequential treatment with alendronate sodium or calcitonin can significantly reduce the side effects such as fever, bone/joint pain, flu-like symptoms caused by first-time zoledronic acid therapy. Raloxifene sequential treatment does not seem to have decreased or increased the side effects of zoledronic acid treatment. Also, sequential treatment can improve the patient compliance with a second dose of zoledronic acid.
Objective: To explore the clinical efficacy of Zoledronic Acid Injection in the treatment of postmenopausal osteoporosis with different bone turnover rates. Methods: A total of 63 patients diagnosed with postmenopausal osteoporosis were included in this study. Each patient was administrated 5 mg/100mL Zoledronic Acid (Aclasta) intravenously once and then given a one-year prescription of 600 mg/d oral Caltrate. The bone turnover parameters (PINP, β-cross, N-MID) were measured prior to the injection of Zoledronic Acid while the bone mineral density (BMD) and the pain scores of each patient were tested before treatment and after the one-year medication. On this basis, the patients were divided into several groups according to their bone turnover rates for intergroup comparison of treatment outcomes. Results: BMD results and pain scores of all participants were significantly improved at different levels after treatment. However, these improvements had no significant differences between the patients with high and low bone turnover rates. Conclusion: Zoledronic Acid Injection can relieve bone pain, enhance the quality of life and increase the BMD in patients with postmenopausal osteoporosis, regardless of the bone turnover status.
Osteoporosis is commonly seen in aged people, but not much attention is paid to it. Patient compliance is challenged by many factors, including long-time treatment and high rates of fatality and disability caused by fragility fractures. With age-related changes, the treatment will last for a lifetime. A clinical case of postmenopausal patient who had received incontinuous treatment of alendronate for 20 years was studied in this article. As the level of compliance varied in different treatment phases, the curative outcome of this patient was altered. This study also presented a literature review to discuss the current situation, treatment and compliance of osteoporosis in China and the corresponding influences on bone mineral density (BMD) and prognosis. Hopefully, this study can increase physicians' awareness of osteoporosis in clinical treatment and its pharmacotherapy and treatment course.
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