Daily Dose of Aspirin Linked With Anemia in Older People

Taking a 100-mg dose of aspirin each day was associated with a 20% higher risk of anemia compared with a placebo, according to a secondary analysis of results from the ASPREE (Aspirin in Reducing Events in the Elderly) randomized clinical trial that included 19 114 people aged 65 years or older. The incidence of anemia was about 51 events per 1000 person-years in the aspirin group and 43 events in the placebo group. Participants who received daily aspirin also tended to have a larger decrease in ferritin levels—a measure of overall iron stores—and in hemoglobin concentration over 3 and 5 years, respectively.

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Luglio 2023

Toward Automated Detection of Silent Cerebral Infarcts in Children and Young Adults With Sickle Cell Anemia

Stroke, Ahead of Print. BACKGROUND:Silent cerebral infarcts (SCI) in sickle cell anemia (SCA) are associated with future strokes and cognitive impairment, warranting early diagnosis and treatment. Detection of SCI, however, is limited by their small size, especially when neuroradiologists are unavailable. We hypothesized that deep learning may permit automated SCI detection in children and young adults with SCA as a tool to identify the presence and extent of SCI in clinical and research settings.METHODS:We utilized UNet—a deep learning model—for fully automated SCI segmentation. We trained and optimized UNet using brain magnetic resonance imaging from the SIT trial (Silent Infarct Transfusion). Neuroradiologists provided the ground truth for SCI diagnosis, while a vascular neurologist manually delineated SCI on fluid-attenuated inversion recovery and provided the ground truth for SCI segmentation. UNet was optimized for the highest spatial overlap between automatic and manual delineation (dice similarity coefficient). The optimized UNet was externally validated using an independent single-center prospective cohort of SCA participants. Model performance was evaluated through sensitivity and accuracy (%correct cases) for SCI diagnosis, dice similarity coefficient, intraclass correlation coefficient (metric of volumetric agreement), and Spearman correlation.RESULTS:The SIT trial (n=926; 31% with SCI; median age, 6.8 years) and external validation (n=80; 50% with SCI; age, 11.5 years) cohorts had small median lesion volumes of 0.40 and 0.25 mL, respectively. Compared with the neuroradiology diagnosis, UNet predicted SCI presence with 100% sensitivity and 74% accuracy. In magnetic resonance imaging with SCI, UNet reached a moderate spatial agreement (dice similarity coefficient, 0.48) and high volumetric agreement (intraclass correlation coefficient, 0.76; ρ=0.72;P

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Giugno 2023