Publications by authors named "Antoinette R Esce"

2 Publications

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Predicting nodal metastases in papillary thyroid carcinoma using artificial intelligence.

Am J Surg 2021 May 13. Epub 2021 May 13.

Department of Pathology, MSC08 4640, University of New Mexico, Albuquerque, NM, 87131, USA.

Background: The presence of nodal metastases is important in the treatment of papillary thyroid carcinoma (PTC). We present our experience using a convolutional neural network (CNN) to predict the presence of nodal metastases in a series of PTC patients using visual histopathology from the primary tumor alone.

Methods: 174 cases of PTC were evaluated for the presence or absence of lymph metastases. The artificial intelligence (AI) algorithm was trained and tested on its ability to discern between the two groups.

Results: The best performing AI algorithm demonstrated a sensitivity and specificity of 94% and 100%, respectively, when identifying nodal metastases.

Conclusion: A CNN can be used to accurately predict the likelihood of nodal metastases in PTC using visual data from the primary tumor alone.
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May 2021

Evaluation of Antibiotic Prophylaxis for Acute Nonoperative Orbital Fractures.

Ophthalmic Plast Reconstr Surg 2021 Sep-Oct 01;37(5):462-464

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of New Mexico, Albuquerque, New Mexico, U.S.A.

Purpose: The use of antibiotic prophylaxis for the prevention of infection in nonoperative orbital fractures is controversial, with limited high-quality evidence and inconsistent recommendations in the current scientific literature. Our primary study objective was to identify the prophylactic antibiotic prescribing pattern at our institution for nonoperative orbital fractures and to determine the effect of antibiotic prophylaxis.

Methods: We retrospectively reviewed 16 years of data from a single institution on patients with acute traumatic fractures of the orbital floor or medial orbital wall. Prophylactic administration of antibiotics and complication rates were evaluated, and complication rates and patient characteristics analyzed.

Results: Of 154 patients with nonoperative orbital fractures, 17 patients (group 1) received IV or oral antibiotics and 137 patients (group 2) did not. No patient in either group had documented infectious orbital complications following their orbital injury. Patients receiving antibiotics were more likely to have a concurrent periorbital laceration (58.8% ± 11.9% vs. 28.5% ± 3.9%; P = 0.01).

Conclusion: We present the largest cohort yet reported of patients managed without antibiotic prophylaxis for nonoperative orbital fractures, with no infectious complications identified. Currently there is no evidence of utility to prophylactic antibiotics in the setting of nonoperative traumatic orbital fractures. Rather than prescribing antibiotics, we recommend clinicians educate patients on return precautions and offer close follow up for the rare, but potentially severe infectious complications of orbital trauma.
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October 2021