Diagnostics

16 pages, 1365 KiB

Open AccessReview

Uterine Perforation as a Complication of the Intrauterine Procedures Causing Omentum Incarceration: A Review

by George Lucian Zorilă, Răzvan Grigoraș Căpitănescu, Roxana Cristina Drăgușin, Anca-Maria Istrate-Ofițeru, Elena Bernad, Mădălina Dobie, Sandor Bernad, Marius Craina, Iuliana Ceaușu, Marius Cristian Marinaş, Maria-Cristina Comănescu, Marian Valentin Zorilă, Ileana Drocaș, Elena Iuliana Anamaria Berbecaru and Dominic Gabriel Iliescu

Diagnostics 2023, 13(2), 331; https://doi.org/10.3390/diagnostics13020331 - 16 Jan 2023

Cited by 2 | Viewed by 4129

Abstract

Objective: Omentum involvement resulting from uterine perforation is a rare complication following intrauterine procedures that might require immediate intervention due to severe ischemic consequences. This review examines the prevalence of this complication, risk factors, the mode and timing of diagnosis, the proper management [...] Read more.

Objective: Omentum involvement resulting from uterine perforation is a rare complication following intrauterine procedures that might require immediate intervention due to severe ischemic consequences. This review examines the prevalence of this complication, risk factors, the mode and timing of diagnosis, the proper management and the outcome. Methods: A systematic literature search was conducted on PubMed, PubMed Central and Scopus using uterine perforation, D&C, abortion and omentum as keywords. The exclusion criteria included the presence of the uterus or placenta’s malignancy and uterine perforation following delivery or caused by an intrauterine device. Results: The review included 11 articles from 133 screened papers. We identified 12 cases that three evaluators further analysed. We also present the case of a 32-year-old woman diagnosed with uterine perforation and omentum involvement. The patient underwent a hysteroscopic procedure with resectioning the protruding omentum into the uterine cavity, followed by intrauterine device insertion. Conclusion: This paper highlights the importance of a comprehensive gynaecological evaluation following a D&C procedure that includes a thorough clinical examination and a detailed ultrasound assessment. Healthcare providers should not overlook the diagnosis of omentum involvement in the presence of a history of intrauterine procedures. Full article

(This article belongs to the Special Issue The Role of Image and Genetic Diagnostics in Maternal-Fetal Medicine and Human Reproduction)

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12 pages, 3358 KiB

Open AccessArticle

3D Reconstruction of Wrist Bones from C-Arm Fluoroscopy Using Planar Markers

by Pragyan Shrestha, Chun Xie, Hidehiko Shishido, Yuichi Yoshii and Itaru Kitahara

Diagnostics 2023, 13(2), 330; https://doi.org/10.3390/diagnostics13020330 - 16 Jan 2023

Cited by 1 | Viewed by 1903

Abstract

In orthopedic surgeries, such as osteotomy and osteosynthesis, an intraoperative 3D reconstruction of the bone would enable surgeons to quickly assess the fracture reduction procedure with preoperative planning. Scanners equipped with such functionality are often more expensive than a conventional C-arm fluoroscopy device. [...] Read more.

In orthopedic surgeries, such as osteotomy and osteosynthesis, an intraoperative 3D reconstruction of the bone would enable surgeons to quickly assess the fracture reduction procedure with preoperative planning. Scanners equipped with such functionality are often more expensive than a conventional C-arm fluoroscopy device. Moreover, a C-arm fluoroscopy device is commonly available in many orthopedic facilities. Based on the widespread use of such equipment, this paper proposes a method to reconstruct the 3D structure of bone with a conventional C-arm fluoroscopy device. We focus on wrist bones as the target of reconstruction in this research as this will facilitate a flexible imaging scheme. Planar markers are attached to the target object and are tracked in the fluoroscopic image for C-arm pose estimation. The initial calibration of the device is conducted using a checkerboard pattern. In general, reconstruction algorithms are sensitive to geometric calibration errors. To assess the practicality of the method for reconstruction, a simulation study demonstrating the effect of checkerboard thickness and spherical marker size on reconstruction quality was conducted. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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8 pages, 1025 KiB

Open AccessCommunication

SARS-CoV-2 Detection via RT-PCR in Matched Saliva and Nasopharyngeal Samples Reveals High Concordance in Different Commercial Assays

by Karoline Almeida Felix de Sousa, Carolina Kymie Vasques Nonaka, Renata Naves de Ávila Mendonça, Verena Neiva Mascarenhas, Thamires Gomes Lopes Weber, Carlos Gustavo Regis Silva, Ana Verena Almeida Mendes, Ricardo Khouri, Bruno Solano Freitas Souza and Clarissa Araújo Gurgel Rocha

Diagnostics 2023, 13(2), 329; https://doi.org/10.3390/diagnostics13020329 - 16 Jan 2023

Cited by 3 | Viewed by 1413

Abstract

Background: Self-collected saliva samples can increase the diagnostic efficiency and benefit healthcare workers, patient care, and infection control. This study evaluated the performance of self-collected saliva samples compared to nasopharyngeal swabs using three commercial kits for the qualitative detection of severe acute respiratory [...] Read more.

Background: Self-collected saliva samples can increase the diagnostic efficiency and benefit healthcare workers, patient care, and infection control. This study evaluated the performance of self-collected saliva samples compared to nasopharyngeal swabs using three commercial kits for the qualitative detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Matched nasopharyngeal and saliva samples were collected from 103 patients with either asymptomatic or symptomatic COVID-19. Both samples were evaluated using three commercial kits (TaqCheck, Allplex, and TaqPath). To evaluate sample stability, viral RNA extraction was performed in the presence or absence of an RNA-stabilizing solution. Storage conditions, including the duration, temperature, and stability after freezing and thawing of the samples, were also evaluated. Results: All the saliva samples showed 100% concordance with the nasopharyngeal swab results using TaqCheck and Allplex kits, and 93% using TaqPath kit. No difference was observed in the samples that used the RNA-stabilizing solution compared to the group without the solution. The Ct values of the freeze–thawed samples after 30 days were higher than those on day 0; however, the results were consistent the fresh samples. Conclusion: The high concordance of SARS-CoV-2 detection via reverse transcription–polymerase chain reaction (RT-PCR) in matched saliva and nasopharyngeal samples using different commercial assays reinforces the concept that self-collected saliva samples are non-invasive, rapid, and reliable for diagnosing SARS-CoV-2 infection. Full article

(This article belongs to the Special Issue SARS-CoV-2 Identification by Diagnostic/Medical Laboratory: Methods, Statistics, Interesting Cases)

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15 pages, 831 KiB

Open AccessArticle

Utilisation of 3D Printing in the Manufacturing of an Anthropomorphic Paediatric Head Phantom for the Optimisation of Scanning Parameters in CT

by Merim Jusufbegović, Adi Pandžić, Mustafa Busuladžić, Lejla M. Čiva, Azra Gazibegović-Busuladžić, Adnan Šehić, Sandra Vegar-Zubović, Rahima Jašić and Adnan Beganović

Diagnostics 2023, 13(2), 328; https://doi.org/10.3390/diagnostics13020328 - 16 Jan 2023

Cited by 1 | Viewed by 2028

Abstract

Computed tomography (CT) is a diagnostic imaging process that uses ionising radiation to obtain information about the interior anatomic structure of the human body. Considering that the medical use of ionising radiation implies exposing patients to radiation that may lead to unwanted stochastic [...] Read more.

Computed tomography (CT) is a diagnostic imaging process that uses ionising radiation to obtain information about the interior anatomic structure of the human body. Considering that the medical use of ionising radiation implies exposing patients to radiation that may lead to unwanted stochastic effects and that those effects are less probable at lower doses, optimising imaging protocols is of great importance. In this paper, we used an assembled 3D-printed infant head phantom and matched its image quality parameters with those obtained for a commercially available adult head phantom using the imaging protocol dedicated for adult patients. In accordance with the results, an optimised scanning protocol was designed which resulted in dose reductions for paediatric patients while keeping image quality at an adequate level. Full article

(This article belongs to the Special Issue Advancements in Neuroimaging)

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12 pages, 1739 KiB

Open AccessArticle

Outcome Measures of In-Office Endovenous Radiofrequency Treatment of Varicose Vein Feasibility

by Alfonso Pannone, Alessia Di Girolamo, Matteo Orrico and Nicola Mangialardi

Diagnostics 2023, 13(2), 327; https://doi.org/10.3390/diagnostics13020327 - 16 Jan 2023

Cited by 1 | Viewed by 3473

Abstract

RFA is a relatively new treatment, approved by the FDA in 1999 and is a minimally invasive intervention that has become one of the most common alternatives due to its many advantages, including decreased pain, less morbidity, shorter hospital stay and faster return [...] Read more.

RFA is a relatively new treatment, approved by the FDA in 1999 and is a minimally invasive intervention that has become one of the most common alternatives due to its many advantages, including decreased pain, less morbidity, shorter hospital stay and faster return to work. We retrospectively analyzed a total of 503 limbs submitted for surgical interventions for VVs using the RFA, combined or not with surgical phlebectomies and sclerotherapy, in our institution between April 2012 and December 2020. The technical success was 99.8%, as in one case the RFA catheter arrested at the first third of the thigh due to the tortuosity of the vessel. On the first post-operative day, the mean VAS scale was 0.32 ± 0.56 (0–2). Perioperative complications occurred in 77 cases (15.3%): intraoperative pain in 24 cases, in nine cases associated with vagal syndrome, superficial hematoma in 30 cases, EHIT in seven cases, phlebitis in 14 cases and paresthesia in two cases. RFA procedures had been shown to be cost-effective therapeutic options in adult patients requiring treatment due to the incompetence of the GSV. In our study, we highlighted that this technique is feasible as an ambulatory procedure; it improves quality of life and symptoms in the majority of patients with varicose veins, with a rapid return to normal life and work activities. Full article

(This article belongs to the Collection Vascular Diseases Diagnostics)

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19 pages, 2472 KiB

Open AccessReview

Deep Learning in Optical Coherence Tomography Angiography: Current Progress, Challenges, and Future Directions

by Dawei Yang, An Ran Ran, Truong X. Nguyen, Timothy P. H. Lin, Hao Chen, Timothy Y. Y. Lai, Clement C. Tham and Carol Y. Cheung

Diagnostics 2023, 13(2), 326; https://doi.org/10.3390/diagnostics13020326 - 16 Jan 2023

Cited by 9 | Viewed by 3422

Abstract

Optical coherence tomography angiography (OCT-A) provides depth-resolved visualization of the retinal microvasculature without intravenous dye injection. It facilitates investigations of various retinal vascular diseases and glaucoma by assessment of qualitative and quantitative microvascular changes in the different retinal layers and radial peripapillary layer [...] Read more.

Optical coherence tomography angiography (OCT-A) provides depth-resolved visualization of the retinal microvasculature without intravenous dye injection. It facilitates investigations of various retinal vascular diseases and glaucoma by assessment of qualitative and quantitative microvascular changes in the different retinal layers and radial peripapillary layer non-invasively, individually, and efficiently. Deep learning (DL), a subset of artificial intelligence (AI) based on deep neural networks, has been applied in OCT-A image analysis in recent years and achieved good performance for different tasks, such as image quality control, segmentation, and classification. DL technologies have further facilitated the potential implementation of OCT-A in eye clinics in an automated and efficient manner and enhanced its clinical values for detecting and evaluating various vascular retinopathies. Nevertheless, the deployment of this combination in real-world clinics is still in the “proof-of-concept” stage due to several limitations, such as small training sample size, lack of standardized data preprocessing, insufficient testing in external datasets, and absence of standardized results interpretation. In this review, we introduce the existing applications of DL in OCT-A, summarize the potential challenges of the clinical deployment, and discuss future research directions. Full article

(This article belongs to the Special Issue Deep Learning Applications in Ophthalmology)

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12 pages, 1509 KiB

Open AccessArticle

Prognostic Role of CD200 in Acute Lymphoblastic Leukemia Patients

by Mohamed Khalil, Nahla Elsharkawy, Mona Mohsen Elmawardy and Mahmoud Aly Ayoub

Diagnostics 2023, 13(2), 325; https://doi.org/10.3390/diagnostics13020325 - 16 Jan 2023

Cited by 2 | Viewed by 1465

Abstract

Background: Overexpression of CD200 in ALL patients indicates that it may be useful in the characterization of leukemia initiating cells (LIC). We aim at investigating the expression pattern of CD200 on leukemic B cells and the correlation of CD200 expression with various clinical [...] Read more.

Background: Overexpression of CD200 in ALL patients indicates that it may be useful in the characterization of leukemia initiating cells (LIC). We aim at investigating the expression pattern of CD200 on leukemic B cells and the correlation of CD200 expression with various clinical and laboratory findings in 62 newly diagnosed acute lymphoblastic leukemia patients. Methods: All patients were subjected to full history taking, a thorough clinical examination, and laboratory investigations, which included complete blood count (CBC), BM aspiration, immunophenotyping of blast cells, and CD200 expression. Results: There is a higher statistically significant mean value of CD200 expression among the cases (66.15 ± 23.08) than the control group (0.37 ± 0.2) (p value ≤ 0.001). CD200 expression shows a significant correlation with total leucocytic count and hemoglobin level (p = 0.001, 0.03, respectively). Conclusions: This study showed that CD200 expression was expressed in 100% of the patients. Correlations between CD200 expression and different laboratory data of patients revealed that there was an impact of CD200 on different diagnostic findings. After the follow-up of the patients, we found that the use of PRISM function of the software could add value to the detection of minimal residual disease. Full article

(This article belongs to the Special Issue Diagnosis and Management of Pediatric Leukemia)

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14 pages, 1787 KiB

Open AccessArticle

Sex-Specific Cut-Offs of Single Point Insulin Sensitivity Estimator (SPISE) in Predicting Metabolic Syndrome in the Arab Adolescents

by Kaiser Wani, Malak N. K. Khattak, Gamal M. Saadawy, Omar S. Al-Attas, Majed S. Alokail and Nasser M. Al-Daghri

Diagnostics 2023, 13(2), 324; https://doi.org/10.3390/diagnostics13020324 - 16 Jan 2023

Cited by 2 | Viewed by 1515

Abstract

The Single Point Insulin Sensitivity Estimator (SPISE) is a novel surrogate marker for insulin sensitivity and was found comparable to the gold standard clamp test as well as for predicting the Metabolic Syndrome (MetS) in several populations. The present study aimed to assess [...] Read more.

The Single Point Insulin Sensitivity Estimator (SPISE) is a novel surrogate marker for insulin sensitivity and was found comparable to the gold standard clamp test as well as for predicting the Metabolic Syndrome (MetS) in several populations. The present study aimed to assess for the first time, the validity of SPISE in predicting MetS among Arab adolescents. In this cross-sectional study, 951 Saudi adolescents aged 10–17 years were randomly recruited from different schools across Riyadh, Saudi Arabia. Anthropometrics were measured and fasting blood samples were collected for the assessment of glucose, lipid profile, adipokines, C-reactive protein and 25 hydroxyvitamin (OH) D. MetS was defined using the National Cholesterol Education Program’s (NCEP) criteria with age-specific thresholds for adolescents. The SPISE as well as insulin resistance (HOMA-IR) indices were calculated. The over-all prevalence of MetS was 8.6% (82 out of 951). SPISE index was significantly lower in MetS than non-MetS participants in both sexes (5.5 ± 2.5 vs. 9.4 ± 3.2, p < 0.001 in boys and 4.4 ± 1.4 vs. 8.6 ± 3.2, p < 0.001 in girls). The SPISE index showed a significant inverse correlation with resistin, leptin, and C-reactive protein, and a significant positive correlation with adiponectin and 25(OH) D. Areas under the curve (AUC) revealed fair and good accuracy for predicting MetS 84.1% and 90.3% in boys and girls, respectively. The sex-specific cut-off proposed was SPISE index ≤6.1 (sensitivity 72.2% and specificity 83.9%) for boys and ≤6.46 (sensitivity 96.3% and specificity 73.4%), for girls. This study suggests that the SPISE index is a simple and promising diagnostic marker of insulin sensitivity and MetS in Arab adolescents. Full article

(This article belongs to the Special Issue New Entities, New Approaches of Endocrine Diseases)

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11 pages, 868 KiB

Open AccessArticle

The Clinical Impact of Metagenomic Next-Generation Sequencing (mNGS) Test in Hospitalized Patients with Suspected Sepsis: A Multicenter Prospective Study

by Yi-Hui Zuo, Yi-Xing Wu, Wei-Ping Hu, Yan Chen, Yu-Ping Li, Zhen-Ju Song, Zhe Luo, Min-Jie Ju, Min-Hua Shi, Shu-Yun Xu, Hua Zhou, Xiang Li, Zhi-Jun Jie, Xue-Dong Liu and Jing Zhang

Diagnostics 2023, 13(2), 323; https://doi.org/10.3390/diagnostics13020323 - 16 Jan 2023

Cited by 5 | Viewed by 2075

Abstract

Background: Metagenomic Next Generation Sequencing (mNGS) has the potential to detect pathogens rapidly. We aimed to assess the diagnostic performance of mNGS in hospitalized patients with suspected sepsis and evaluate its role in guiding antimicrobial therapy. Methods: A multicenter, prospective cohort study was [...] Read more.

Background: Metagenomic Next Generation Sequencing (mNGS) has the potential to detect pathogens rapidly. We aimed to assess the diagnostic performance of mNGS in hospitalized patients with suspected sepsis and evaluate its role in guiding antimicrobial therapy. Methods: A multicenter, prospective cohort study was performed. We enrolled patients with suspected sepsis, collected clinical characteristics and blood samples, and recorded the 30-day survival. Diagnostic efficacy of mNGS test and blood culture was compared, and the clinical impact of mNGS on antibiotic regimen modification was analyzed. Results: A total of 277 patients were enrolled, and 162 were diagnosed with sepsis. The mortality was 44.8% (121/270). The mNGS test exhibited shorter turn-out time (27.0 (26.0, 29.0) vs. 96.0 (72.0, 140.3) hours, p < 0.001) and higher sensitivity (90.5% vs. 36.0%, p < 0.001) compared with blood culture, especially for fungal infections. The mNGS test showed better performance for patients with mild symptoms, prior antibiotic use, and early stage of infection than blood culture, and was capable of guiding antibiotic regimen modification and improving prognosis. Higher reads of pathogens detected by mNGS were related to 30-day mortality (p = 0.002). Conclusions: Blood mNGS testing might be helpful for early etiological diagnosis of patients with suspected sepsis, guiding the antibiotic regimen modification and improving prognosis. Full article

(This article belongs to the Special Issue Diagnosing Pneumonia: Challenges and Advances)

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12 pages, 1762 KiB

Open AccessReview

Could Spinal Epidural Lipomatosis Be the Hallmark of Metabolic Syndrome on the Spine? A Literature Review with Emphasis on Etiology

by Valerio D’Agostino, Miriana Rosaria Petrera, Giuseppe Tedesco, Valerio Pipola, Federico Ponti and Paolo Spinnato

Diagnostics 2023, 13(2), 322; https://doi.org/10.3390/diagnostics13020322 - 16 Jan 2023

Cited by 5 | Viewed by 5501

Abstract

Spinal epidural lipomatosis is defined by an excessive amount of epidural fat in the spinal canal, usually in the lumbosacral tract: a well-known cause of lumbar pain and spinal stenosis with a possible wide range of neurological symptoms. Recent research data reveal that, [...] Read more.

Spinal epidural lipomatosis is defined by an excessive amount of epidural fat in the spinal canal, usually in the lumbosacral tract: a well-known cause of lumbar pain and spinal stenosis with a possible wide range of neurological symptoms. Recent research data reveal that, nowadays, obesity has become the main cause of spinal epidural lipomatosis. Moreover, this condition was recently recognized as a previously unknown manifestation of metabolic syndrome. Radiological studies (CT and MRI) are the only tools that are able to diagnose the disease non-invasively. Indeed, radiologists play a key role in disease recognition, with subsequent possible implications on patients’ systemic health assessments. Despite its clinical importance, the condition is still underreported and neglected. The current literature review summarizes all the main etiologies of spinal epidural lipomatosis, particularly regarding its linkage with metabolic syndrome. An overview of disease characteristics from diagnosis to treatment strategies is also provided. Full article

(This article belongs to the Special Issue Improving Imaging Diagnosis: From Conventional Radiology to Advanced Imaging Techniques)

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17 pages, 884 KiB

Open AccessReview

Barrett’s Esophagus: An Updated Review

by Peter M. Stawinski, Karolina N. Dziadkowiec, Lily A. Kuo, Juan Echavarria and Shreyas Saligram

Diagnostics 2023, 13(2), 321; https://doi.org/10.3390/diagnostics13020321 - 16 Jan 2023

Cited by 4 | Viewed by 4470

Abstract

Barrett’s esophagus (BE) is a change in the distal esophageal mucosal lining, whereby metaplastic columnar epithelium replaces squamous epithelium of the esophagus. This change represents a pre-malignant mucosal transformation which has a known association with the development of esophageal adenocarcinoma. Gastroesophageal reflux disease [...] Read more.

Barrett’s esophagus (BE) is a change in the distal esophageal mucosal lining, whereby metaplastic columnar epithelium replaces squamous epithelium of the esophagus. This change represents a pre-malignant mucosal transformation which has a known association with the development of esophageal adenocarcinoma. Gastroesophageal reflux disease is a risk factor for BE, other risk factors include patients who are Caucasian, age > 50 years, central obesity, tobacco use, history of peptic stricture and erosive gastritis. Screening for BE remains selective based on risk factors, a screening program in the general population is not routinely recommended. Diagnosis of BE is established with a combination of endoscopic recognition, targeted biopsies, and histologic confirmation of columnar metaplasia. We aim to provide a comprehensive review of the epidemiology, pathogenesis, screening and advanced techniques of detecting and eradicating Barrett’s esophagus. Full article

(This article belongs to the Section Optical Diagnostics)

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14 pages, 1795 KiB

Open AccessArticle

The Role of CRP POC Testing in the Fight against Antibiotic Overuse in European Primary Care: Recommendations from a European Expert Panel

by Ivan Gentile, Nicola Schiano Moriello, Rogier Hopstaken, Carl Llor, Hasse Melbye and Oliver Senn

Diagnostics 2023, 13(2), 320; https://doi.org/10.3390/diagnostics13020320 - 15 Jan 2023

Cited by 7 | Viewed by 2854

Abstract

Tackling antibiotic resistance represents one of the major challenges in modern medicine, and limiting antibiotics’ overuse represents the first step in this fight. Most antibiotics are prescribed in primary care settings, and lower respiratory tract infections (LRTIs) are one of the most common [...] Read more.

Tackling antibiotic resistance represents one of the major challenges in modern medicine, and limiting antibiotics’ overuse represents the first step in this fight. Most antibiotics are prescribed in primary care settings, and lower respiratory tract infections (LRTIs) are one of the most common indications for their prescription. An expert panel conducted an extensive report on C-reactive protein point-of-care (CRP POC) testing in the evaluation of LRTIs and its usefulness to limit antibiotic prescriptions. The expert panel stated that CRP POC testing is a potentially useful tool to limit antibiotic prescriptions for LRTI in a community setting. CRP POC must be used in conjunction with other strategies such as improved communication skills and the use of other molecular POC testing. Potential barriers to the adoption of CRP POC testing are financial and logistical issues. Moreover, the efficacy in limiting antibiotic prescriptions could be hampered by the fact that, in some countries, patients may gain access to antibiotics even without a prescription. Through the realization of a better reimbursement structure, the inclusion in standardized procedures in local guidelines, and better patient education, CRP point-of-care testing can represent a cornerstone in the fight against antimicrobial resistance. Full article

(This article belongs to the Section Point-of-Care Diagnostics and Devices)

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10 pages, 2867 KiB

Open AccessArticle

Clinical Significance of Maximum Intensity Projection Method for Diagnostic Imaging of Thoracic Outlet Syndrome

by Takeshi Ogawa, Shinzo Onishi, Naotaka Mamizuka, Yuichi Yoshii, Kazuhiro Ikeda, Takeo Mammoto and Masashi Yamazaki

Diagnostics 2023, 13(2), 319; https://doi.org/10.3390/diagnostics13020319 - 15 Jan 2023

Cited by 1 | Viewed by 1914

Abstract

The aim of this study was to use the magnetic resonance imaging maximum-intensity projection (MRI-MIP) method for diagnostic imaging of thoracic outlet syndrome (TOS) and to investigate the stricture ratios of the subclavian artery (SCA), subclavian vein (SCV), and brachial plexus bundle (BP). [...] Read more.

The aim of this study was to use the magnetic resonance imaging maximum-intensity projection (MRI-MIP) method for diagnostic imaging of thoracic outlet syndrome (TOS) and to investigate the stricture ratios of the subclavian artery (SCA), subclavian vein (SCV), and brachial plexus bundle (BP). A total of 113 patients with clinically suspected TOS were evaluated. MRI was performed in a position similar to the Wright test. The stricture was classified into four grades. Then, the stricture ratios of the SCA, SCV, and BP in the sagittal view were calculated by dividing the minimum diameter by the maximum diameter of each structure. Patients were divided into two groups: surgical (n = 22) and conservative (n = 91). Statistical analysis was performed using the Mann–Whitney U test. The stricture level and ratio in the SCV were significantly higher in the surgical group, while the stricture level and the ratio of SCA to BP did not show significant differences between the two groups. The MRI-MIP method may be helpful for both subsidiary and severe diagnoses of TOS. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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15 pages, 3785 KiB

Open AccessArticle

Standardized Uptake Values on SPECT/CT: A Promising Alternative Tool for Treatment Evaluation and Prognosis of Metastatic Neuroendocrine Tumours

by Mirela Gherghe, Alexandra Maria Lazar, Laurentiu Simion, Ionela-Nicoleta Irimescu, Maria-Carla Sterea, Mario-Demian Mutuleanu and Rodica Maricela Anghel

Diagnostics 2023, 13(2), 318; https://doi.org/10.3390/diagnostics13020318 - 15 Jan 2023

Cited by 1 | Viewed by 2294

Abstract

(1) Background: The aim of our study was to assess the feasibility of ^99mTcEDDA/HYNIC-TOC SPECT/CT quantitative analysis in evaluating treatment response and disease progression in patients with NETs. (2) Methods: This prospective monocentric study evaluated 35 SPECT/CT examinations performed on 14 patients [...] Read more.

(1) Background: The aim of our study was to assess the feasibility of ^99mTcEDDA/HYNIC-TOC SPECT/CT quantitative analysis in evaluating treatment response and disease progression in patients with NETs. (2) Methods: This prospective monocentric study evaluated 35 SPECT/CT examinations performed on 14 patients with neuroendocrine tumours who underwent a baseline and at least one follow-up ^99mTcEDDA/HYNIC-TOC scan as part of their clinical management. The examination protocol included a whole-body scan acquired 2 h after the radiotracer’s administration, with the SPECT/CT performed 4 h post-injection. Images were analyzed by two experienced physicians and patients were classified into response categories based on their changes in SUV values. (3) Results: We evaluated 14 baseline studies and 21 follow-up scans, accounting for 123 lesions. A statistically positive correlation has been found between the SUV_max and SUV_peak values in tumoral lesions (p < 0.05). No correlation has been found between the SUV values and the ki67 proliferation index. Finally, 64.29% patients were classified as SD at the end of the study, with only 14.29% of patients exhibiting PD and 21.43% patients with PR. (4) Conclusions: The quantitative analysis of ^99mTcEDDA/HYNIC-TOC SPECT/CT data in patients with neuroendocrine tumours could represent an alternative to ⁶⁸Ga-DOTA-peptides PET/CT for the monitoring and prognosis of NETs. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

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10 pages, 1724 KiB

Open AccessArticle

Kinetics of the Cell Cycle Arrest Biomarkers (TIMP2 and IGFBP7) for the Diagnosis of Acute Kidney Injury in Critically Ill COVID-19 Patients

by Massimiliano Greco, Silvia De Rosa, Fabian Boehm, Sofia Spano, Romina Aceto, Antonio Voza, Francesco Reggiani, Marta Calatroni, Gianluca Castellani, Elena Costantini, Gianluca Villa and Maurizio Cecconi

Diagnostics 2023, 13(2), 317; https://doi.org/10.3390/diagnostics13020317 - 15 Jan 2023

Cited by 1 | Viewed by 1869

Abstract

Background: Acute kidney injury (AKI) is highly prevalent in critical COVID-19 patients. The diagnosis and staging of AKI are based on serum creatinine (sCr) and urinary output criteria, with limitations in the functional markers. New cell-cycle arrest biomarkers [TIMP2]*[IGFBP7] have been proposed for [...] Read more.

Background: Acute kidney injury (AKI) is highly prevalent in critical COVID-19 patients. The diagnosis and staging of AKI are based on serum creatinine (sCr) and urinary output criteria, with limitations in the functional markers. New cell-cycle arrest biomarkers [TIMP2]*[IGFBP7] have been proposed for early detection of AKI, but their role in critically ill COVID-19 patients is poorly understood. Methods: We conducted an observational study to assess the performance of [TIMP2]*[IGFBP7] for the detection of AKI in critical COVID-19 patients admitted to our intensive care unit (ICU). We sampled urinary [TIMP2]*[IGFBP7] levels at ICU admission, 12 h, 24 h, and 48 h, and compared the results to the development of AKI, as well as baseline and laboratory data. Results: Forty-one patients were enrolled. The median age was 66 years [57–72] and most were males (85%). Thirteen patients (31.7%) developed no/mild stage AKI, 19 patients (46.3%) moderate AKI, and nine patients (22.0%) severe AKI. The ICU mortality was 29.3%. sCr levels in the Emergency Department or at ICU admission were not significantly different according to AKI stage. [TIMP-2]*[IGFBP-7] urinary levels were elevated in severe AKI at 12 h after ICU admission, but not at ICU admission or 24 h or 48 h after ICU admission. Conclusion: Urinary biomarkers [TIMP-2]*[IGFBP-7] were generally increased in this population with a high prevalence of AKI, and were higher in patients with severe AKI measured at 12 h from ICU admission. Further studies are needed to evaluate the best timing of these biomarkers in this population. Full article

(This article belongs to the Special Issue Predictive and Prognostic Markers in Critically Ill Patients)

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11 pages, 845 KiB

Open AccessArticle

Polycystic Ovary Syndrome, Subclinical Hypothyroidism, the Cut-Off Value of Thyroid Stimulating Hormone; Is There a Link? Findings of a Population-Based Study

by Ehsan Rojhani, Maryam Rahmati, Faegheh Firouzi, Marzieh Saei Ghare Naz, Fereidoun Azizi and Fahimeh Ramezani Tehrani

Diagnostics 2023, 13(2), 316; https://doi.org/10.3390/diagnostics13020316 - 15 Jan 2023

Cited by 3 | Viewed by 2555

Abstract

Despite solid evidence regarding the association of over-hypothyroidism with polycystic ovary syndrome (PCOS), the relationship between PCOS and subclinical hypothyroidism (SCH) is still a topic of debate. In the present population-based study, we aimed to assess if there is a difference between PCOS [...] Read more.

Despite solid evidence regarding the association of over-hypothyroidism with polycystic ovary syndrome (PCOS), the relationship between PCOS and subclinical hypothyroidism (SCH) is still a topic of debate. In the present population-based study, we aimed to assess if there is a difference between PCOS and the control group regarding the upper reference limit of thyroid stimulating hormone (TSH). We also aimed to identify the prevalence of SCH in women with PCOS compared to controls. This study was conducted on data collected in the Iranian PCOS prevalence study and the Khuzestan PCOS prevalence study. Participants that met our eligibility criteria were categorized into two groups: PCOS (n = 207) and control (n = 644). Quantile and logistic regression models were used to explore the effect of PCOS status on TSH cut-off values and SCH, respectively. The 95 percentiles of TSH were not significantly different in the PCOS group compared to control ones (6.12 and 6.56 microU/mL, respectively). There was no statistically significant association between PCOS status and SCH (OR adjusted: 1.40; 95%CI: 0.79, 2.50; p = 0.2). The prevalence of SCH and the upper reference limit of TSH were not significantly different in PCOS and controls. Investigation of SCH in women with PCOS might be questionable. Full article

(This article belongs to the Special Issue Diagnosis of Polycystic Ovary Syndrome (PCOS): State-of-the-Art and Open Questions)

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15 pages, 19642 KiB

Open AccessReview

The Neoplastic Side of the Abdominal Wall: A Comprehensive Pictorial Essay of Benign and Malignant Neoplasms

by Giorgia Porrello, Roberto Cannella, Eduardo Alvarez-Hornia Pérez, Giuseppe Brancatelli and Federica Vernuccio

Diagnostics 2023, 13(2), 315; https://doi.org/10.3390/diagnostics13020315 - 15 Jan 2023

Cited by 1 | Viewed by 2497

Abstract

Abdominal wall neoplasms are usually benign and, in the majority of these cases, no further work-up or treatment is indicated. The percentage of malignant abdominal neoplasms, however, is not negligible. Radiologists play a pivotal role in identifying imaging features that should favor malignancy, [...] Read more.

Abdominal wall neoplasms are usually benign and, in the majority of these cases, no further work-up or treatment is indicated. The percentage of malignant abdominal neoplasms, however, is not negligible. Radiologists play a pivotal role in identifying imaging features that should favor malignancy, including larger lesion size, edema, neurovascular involvement, and peripheral or inhomogeneous dynamic enhancement, thus indicating to the clinician the need for further work-up. Histopathology is the reference standard for the characterization of abdominal wall neoplasms. In patients undergoing surgery, radiological assessment is needed to guide the surgeon by providing a comprehensive anatomic guide of the tumor extension. We present a pictorial review of benign and malignant abdominal wall neoplasms that can be encountered on radiological examinations, with a main focus on CT and MRI features that help in narrowing the differential diagnosis. Full article

(This article belongs to the Special Issue Improving Imaging Diagnosis: From Conventional Radiology to Advanced Imaging Techniques)

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8 pages, 2581 KiB

Open AccessArticle

Evaluation of the Effect of Duration on Retinal Nerve Fiber Layer Thickness and Choroidal Thickness in Exfoliation Syndrome and Exfoliative Glaucoma

by Müslüm Toptan and Ali Simsek

Diagnostics 2023, 13(2), 314; https://doi.org/10.3390/diagnostics13020314 - 14 Jan 2023

Viewed by 1070

Abstract

Aims: To compare retinal nerve fiber layer (RNFL) thickness and choroidal thickness in patients with exfoliation syndrome (XFS) and exfoliative glaucoma (XFG) for 1–5 years or 6–10 years compared to healthy volunteers. Methods and Material: Seventy-eight eyes of 78 patients with XFG, 78 [...] Read more.

Aims: To compare retinal nerve fiber layer (RNFL) thickness and choroidal thickness in patients with exfoliation syndrome (XFS) and exfoliative glaucoma (XFG) for 1–5 years or 6–10 years compared to healthy volunteers. Methods and Material: Seventy-eight eyes of 78 patients with XFG, 78 eyes of 78 patients with XFS, and 83 eyes of 83 healthy individuals were included in this prospective study. SD-OCT data for choroid thickness and RNFL were recorded. Results: RNFL thickness was statistically significantly lower in eyes with XFG and XFS than in the control group (p < 0.001). Macular choroidal thickness decreased significantly in the XFG group compared to the XFS and control groups (p < 0.001). No significant difference was observed between the XFS and control groups (p > 0.05). In terms of choroidal and RNFL thicknesses by years in XFG and XFS patients, values were lower in the patients diagnosed 6–10 years previously than in those diagnosed 1–5 years previously. However, the difference was not statistically significant (p > 0.05). Conclusions: Thinning of both choroidal and RNLF thickness in XFG and XFS patients may mean that PEX material is an important risk factor for the progression of XFS to XFG. In addition, thinner choroid and RNLF thickness in the 6–10 years groups show the effect of PEX material and the importance of time. Full article

(This article belongs to the Section Optical Diagnostics)

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12 pages, 921 KiB

Open AccessArticle

Derived Neutrophil-Lymphocyte Ratio and C-Reactive Protein as Prognostic Factors for Early-Stage Non-Small Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy

by Baiqiang Dong, Xuan Zhu, Runzhe Chen, Qing Wu, Jia’nan Jin, Lin Wang, Yujin Xu and Ming Chen

Diagnostics 2023, 13(2), 313; https://doi.org/10.3390/diagnostics13020313 - 14 Jan 2023

Cited by 3 | Viewed by 1478

Abstract

Objectives: To explore the relationship between peripheral blood inflammation parameters and overall survival (OS) and progression-free survival (PFS) of early-stage non-small cell lung cancer patients who underwent stereotactic body radiotherapy (SBRT). Patients and methods: In this study, eligible patients treated with [...] Read more.

Objectives: To explore the relationship between peripheral blood inflammation parameters and overall survival (OS) and progression-free survival (PFS) of early-stage non-small cell lung cancer patients who underwent stereotactic body radiotherapy (SBRT). Patients and methods: In this study, eligible patients treated with SBRT from 2013 to 2018, and both serum complete blood count and blood biochemical results were available prior to (within 60 days) radiotherapy were included. Results: A review of hospital registries identified 148 patients, and the 5-year OS and PFS of the entire cohort were 69.8% and 65.6%, respectively, with the median follow-up time was 52.8 months. Multivariable analysis showed that derived neutrophil-lymphocyte ratio (dNLR) ≥1.4 and C-reactive protein (CRP) ≥2.9 were statistically and independently associated with worse OS (HR = 4.62, 95% CI 1.89–11.27, p = 0.001; HR = 2.92, 95% CI 1.49–5.70, p = 0.002, respectively). The 5-year OS for patients with dNLR below and equal to or above the 1.4 were 85.3% and 62.9% (p = 0.002), respectively, and 76.7% for the low CRP group versus 58.5% for the high CRP group (p = 0.030). Higher serum level of post-treatment CRP also independent parameters for inferior PFS (HR = 4.83, 95% CI 1.28–18.25, p = 0.020). Conclusions: Our results demonstrate that dNLR and CRP are associated with the outcomes of early-stage NSCLC patients treated with SBRT, which may assist in selecting optimal nursing care and therapeutic scheme for every individual. Full article

(This article belongs to the Section Clinical Laboratory Medicine)

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21 pages, 2261 KiB

Open AccessArticle

A Novel Lightweight CNN Architecture for the Diagnosis of Brain Tumors Using MR Images

by Kamireddy Rasool Reddy and Ravindra Dhuli

Diagnostics 2023, 13(2), 312; https://doi.org/10.3390/diagnostics13020312 - 14 Jan 2023

Cited by 7 | Viewed by 1723

Abstract

Over the last few years, brain tumor-related clinical cases have increased substantially, particularly in adults, due to environmental and genetic factors. If they are unidentified in the early stages, there is a risk of severe medical complications, including death. So, early diagnosis of [...] Read more.

Over the last few years, brain tumor-related clinical cases have increased substantially, particularly in adults, due to environmental and genetic factors. If they are unidentified in the early stages, there is a risk of severe medical complications, including death. So, early diagnosis of brain tumors plays a vital role in treatment planning and improving a patient’s condition. There are different forms, properties, and treatments of brain tumors. Among them, manual identification and classification of brain tumors are complex, time-demanding, and sensitive to error. Based on these observations, we developed an automated methodology for detecting and classifying brain tumors using the magnetic resonance (MR) imaging modality. The proposed work includes three phases: pre-processing, classification, and segmentation. In the pre-processing, we started with the skull-stripping process through morphological and thresholding operations to eliminate non-brain matters such as skin, muscle, fat, and eyeballs. Then we employed image data augmentation to improve the model accuracy by minimizing the overfitting. Later in the classification phase, we developed a novel lightweight convolutional neural network (lightweight CNN) model to extract features from skull-free augmented brain MR images and then classify them as normal and abnormal. Finally, we obtained infected tumor regions from the brain MR images in the segmentation phase using a fast-linking modified spiking cortical model (FL-MSCM). Based on this sequence of operations, our framework achieved 99.58% classification accuracy and 95.7% of dice similarity coefficient (DSC). The experimental results illustrate the efficiency of the proposed framework and its appreciable performance compared to the existing techniques. Full article

(This article belongs to the Special Issue Brain Tumor Imaging)

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10 pages, 2302 KiB

Open AccessArticle

Application of Teeth in Toxicological Analysis of Decomposed Cadavers Using a Carbamazepine-Administered Rat Model

by Hiroaki Ichioka, Urara Saito, Kaori Shintani-Ishida, Takahira Shirahase, Nozomi Idota, Narisato Kanamura and Hiroshi Ikegaya

Diagnostics 2023, 13(2), 311; https://doi.org/10.3390/diagnostics13020311 - 14 Jan 2023

Viewed by 1291

Abstract

In a regular autopsy, blood and organs are used to quantify drug and toxicant concentrations; however, specimens such as blood cannot be collected from highly decomposed corpses, making the quantification of drug and toxicants impossible. This study aimed to estimate the blood carbamazepine [...] Read more.

In a regular autopsy, blood and organs are used to quantify drug and toxicant concentrations; however, specimens such as blood cannot be collected from highly decomposed corpses, making the quantification of drug and toxicants impossible. This study aimed to estimate the blood carbamazepine (CBZ) concentration from teeth, a part of the human body that is best preserved after death. We sampled teeth and blood of rats administered CBZ. The correlation between the tooth and serum CBZ concentrations was analyzed. Rats were euthanized after CBZ administration and kept at 22 °C for 0 to 15 days before sampling the teeth and measuring the CBZ concentration. Undecalcified, fresh, frozen sections of rat teeth were prepared, and CBZ localization was evaluated. CBZ concentrations in both teeth and cardiac blood peaked at 60 min after administration and increased in a dose-dependent manner. CBZ concentration in teeth did not substantially change after death, with high CBZ distribution being observed in the pulp cavity. The tooth and serum CBZ concentrations were highly correlated, suggesting that the measurement of toxicant concentration in sampled teeth would allow for the estimation of blood toxicant concentration in highly decomposed corpses. Full article

(This article belongs to the Special Issue Diagnostic Methods in Forensic Pathology)

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17 pages, 1860 KiB

Open AccessReview

Multidisciplinary Forensic Approach in “Complex” Bodies: Systematic Review and Procedural Proposal

by Gennaro Baldino, Cristina Mondello, Daniela Sapienza, Chiara Stassi, Alessio Asmundo, Patrizia Gualniera, Stefano Vanin and Elvira Ventura Spagnolo

Diagnostics 2023, 13(2), 310; https://doi.org/10.3390/diagnostics13020310 - 14 Jan 2023

Cited by 7 | Viewed by 2146

Abstract

The recovery of severely altered cadavers (i.e., extensively decomposed, mummified, charred or dismembered) can be a challenge for forensic pathologists due to the difficulties in identification, PMI estimation and manner and cause of death determination. In such cases, integrating routine approaches (autopsy, histology, [...] Read more.

The recovery of severely altered cadavers (i.e., extensively decomposed, mummified, charred or dismembered) can be a challenge for forensic pathologists due to the difficulties in identification, PMI estimation and manner and cause of death determination. In such cases, integrating routine approaches (autopsy, histology, toxicology) to more specific forensic branches can be fundamental to improving the investigative process. In this paper a systematic review using PubMed, Scopus and Web of Science databases has been performed. The aim was to evaluate the forensic approaches implemented in the management of severely altered bodies due to decomposition, mummification, skeletonization, charring or dismemberment (to which we refer to as “complex”), and the role of each approach in the solution of a case. Then, the literature revision results were used to propose a schematic flowchart summarizing the post mortem activities that can be performed in forensic practice, adaptable in relation to each case. Full article

(This article belongs to the Special Issue Diagnostic Methods in Forensic Pathology)

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10 pages, 2652 KiB

Open AccessArticle

Estimation of the Differential Pathlength Factor for Human Skin Using Monte Carlo Simulations

by Murad Althobaiti

Diagnostics 2023, 13(2), 309; https://doi.org/10.3390/diagnostics13020309 - 13 Jan 2023

Cited by 1 | Viewed by 1490

Abstract

Near-infrared technology is an emerging non-invasive technique utilized for various medical applications. Recently, there have been many attempts to utilize NIR technology for the continues monitoring of blood glucose levels through the skin. Different approaches and designs have been proposed for non-invasive blood [...] Read more.

Near-infrared technology is an emerging non-invasive technique utilized for various medical applications. Recently, there have been many attempts to utilize NIR technology for the continues monitoring of blood glucose levels through the skin. Different approaches and designs have been proposed for non-invasive blood glucose measurements. Light photons penetrating the skin can undergo multiple scattering events, and the actual optical pathlength becomes larger than the source-to-detector separation (optode spacing) in the reflection-mode configuration. Thus, the differential pathlength factor (DPF) must be incorporated into the modified Beer–Lambert law. The accurate estimation of the DPF values will lead to an accurate quantification of the physiological variations within the tissue. In this work, the aim was to systematically estimate the DPF for human skin for a range of source-to-detector separations and wavelengths. The Monte Carlo (MC) method was utilized to mimic the different layers of human skin with different optical properties and blood and water volume fractions. This work could help improve the accuracy of the near-infrared technique in the measurement of physiological variations within skin tissue. Full article

(This article belongs to the Section Optical Diagnostics)

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19 pages, 6316 KiB

Open AccessArticle

Advanced Time-Frequency Methods for ECG Waves Recognition

by Ala’a Zyout, Hiam Alquran, Wan Azani Mustafa and Ali Mohammad Alqudah

Diagnostics 2023, 13(2), 308; https://doi.org/10.3390/diagnostics13020308 - 13 Jan 2023

Cited by 4 | Viewed by 2547

Abstract

ECG wave recognition is one of the new topics where only one of the ECG beat waves (P-QRS-T) was used to detect heart diseases. Normal, tachycardia, and bradycardia heart rhythm are hard to detect using either time-domain or frequency-domain features solely, and a [...] Read more.

ECG wave recognition is one of the new topics where only one of the ECG beat waves (P-QRS-T) was used to detect heart diseases. Normal, tachycardia, and bradycardia heart rhythm are hard to detect using either time-domain or frequency-domain features solely, and a time-frequency analysis is required to extract representative features. This paper studies the performance of two different spectrum representations, iris-spectrogram and scalogram, for different ECG beat waves in terms of recognition of normal, tachycardia, and bradycardia classes. These two different spectra are then sent to two different deep convolutional neural networks (CNN), i.e., Resnet101 and ShuffleNet, for deep feature extraction and classification. The results show that the best accuracy for detection of beats rhythm was using ResNet101 and scalogram of T-wave with an accuracy of 98.3%, while accuracy was 94.4% for detection using iris-spectrogram using also ResNet101 and QRS-Wave. Finally, based on these results we note that using deep features from time-frequency representation using one wave of ECG beat we can accurately detect basic rhythms such as normal, tachycardia, and bradycardia. Full article

(This article belongs to the Special Issue Medical Data Processing and Analysis)

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13 pages, 1034 KiB

Open AccessReview

Radiomics in Cardiac Computed Tomography

by Isabelle Ayx, Matthias F. Froelich, Stefan Baumann, Theano Papavassiliu and Stefan O. Schoenberg

Diagnostics 2023, 13(2), 307; https://doi.org/10.3390/diagnostics13020307 - 13 Jan 2023

Cited by 5 | Viewed by 1781

Abstract

In recent years, there has been an increasing recognition of coronary computed tomographic angiography (CCTA) and gated non-contrast cardiac CT in the workup of coronary artery disease in patients with low and intermediate pretest probability, through the readjustment guidelines by medical societies. However, [...] Read more.

In recent years, there has been an increasing recognition of coronary computed tomographic angiography (CCTA) and gated non-contrast cardiac CT in the workup of coronary artery disease in patients with low and intermediate pretest probability, through the readjustment guidelines by medical societies. However, in routine clinical practice, these CT data sets are usually evaluated dominantly regarding relevant coronary artery stenosis and calcification. The implementation of radiomics analysis, which provides visually elusive quantitative information from digital images, has the potential to open a new era for cardiac CT that goes far beyond mere stenosis or calcification grade estimation. This review offers an overview of the results obtained from radiomics analyses in cardiac CT, including the evaluation of coronary plaques, pericoronary adipose tissue, and the myocardium itself. It also highlights the advantages and disadvantages of use in routine clinical practice. Full article

(This article belongs to the Special Issue Coronary Artery Disease Assessment and Pre-procedural Planning Using Cardiac Computed Tomography)

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15 pages, 1340 KiB

Open AccessArticle

Fetal Ultrasound and Magnetic Resonance Imaging Abnormalities in Congenital Cytomegalovirus Infection Associated with and without Fetal Growth Restriction

by Kenji Tanimura, Akiko Uchida, Mizuki Uenaka, Hitomi Imafuku, Shinya Tairaku, Hiromi Hashimura, Yoshiko Ueno, Takumi Kido and Kazumichi Fujioka

Diagnostics 2023, 13(2), 306; https://doi.org/10.3390/diagnostics13020306 - 13 Jan 2023

Viewed by 2036

Abstract

Congenital cytomegalovirus infection (cCMV) can cause fetal growth restriction (FGR) and severe sequelae in affected infants. Clinicians generally suspect cCMV based on multiple ultrasound (US) findings associated with cCMV. However, no studies have assessed the diagnostic accuracy of fetal US for cCMV-associated abnormalities [...] Read more.

Congenital cytomegalovirus infection (cCMV) can cause fetal growth restriction (FGR) and severe sequelae in affected infants. Clinicians generally suspect cCMV based on multiple ultrasound (US) findings associated with cCMV. However, no studies have assessed the diagnostic accuracy of fetal US for cCMV-associated abnormalities in FGR. Eight FGR and 10 non-FGR fetuses prenatally diagnosed with cCMV were examined by undergoing periodic detailed US examinations, as well as postnatal physical and imaging examinations. The diagnostic accuracy of prenatal US for cCMV-associated abnormalities was compared between FGR and non-FGR fetuses with cCMV. The diagnostic sensitivity rates of fetal US for cCMV-related abnormalities in FGR vs. non-FGR fetuses were as follows: ventriculomegaly, 66.7% vs. 88.9%; intracranial calcification, 20.0% vs. 20.0%; cysts and pseudocysts in the brain, 0% vs. 0%; ascites, 100.0% vs. 100.0%; hepatomegaly, 40.0% vs. 100.0%; splenomegaly, 0% vs. 0%. The diagnostic sensitivity of fetal US for hepatomegaly and ventriculomegaly in FGR fetuses with cCMV was lower than that in non-FGR fetuses with cCMV. The prevalence of severe long-term sequelae (e.g., bilateral hearing impairment, epilepsy, cerebral palsy, and severe developmental delay) in the CMV-infected fetuses with FGR was higher, albeit non-significantly. Clinicians should keep in mind the possibility of overlooking the symptoms of cCMV in assessing fetuses with FGR. Full article

(This article belongs to the Special Issue Fetal Growth Restriction (FGR): Diagnosis and Management)

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10 pages, 265 KiB

Open AccessArticle

Impact of ACE and Endoplasmic Reticulum Aminopeptidases Polymorphisms on COVID-19 Outcome

by Amany A. Ghazy, Abdulrahman H. Almaeen, Ibrahim A. Taher, Abdullah N. Alrasheedi and Amel Elsheredy

Diagnostics 2023, 13(2), 305; https://doi.org/10.3390/diagnostics13020305 - 13 Jan 2023

Viewed by 1333

Abstract

Background: COVID-19 outcomes display multiple unexpected varieties, ranging from unnoticed symptomless infection to death, without any previous alarm or known aggravating factors. Aim: To appraise the impact of ACErs4291(A/T) and ERAP1rs26618(T/C) human polymorphisms on the outcome of COVID-19. Subjects and methods: In total, [...] Read more.

Background: COVID-19 outcomes display multiple unexpected varieties, ranging from unnoticed symptomless infection to death, without any previous alarm or known aggravating factors. Aim: To appraise the impact of ACErs4291(A/T) and ERAP1rs26618(T/C) human polymorphisms on the outcome of COVID-19. Subjects and methods: In total, 240 individuals were enrolled in the study (80 with severe manifestations, 80 with mild manifestations, and 80 healthy persons). ACErs4291(A/T) and ERAP1rs26618(T/C) genotyping was performed using RT-PCR. Results: The frequency of the ACErs4291AA genotype was higher among the severe COVID-19 group than others (p < 0.001). The ERAP1rs26618TT genotype frequency was higher among the severe COVID-19 group in comparison with the mild group (p < 0.001) and non-infected controls (p = 0.0006). The frequency of the ACErs4291A allele was higher among severe COVID-19 than mild and non-infected groups (64.4% vs. 37.5%, and 34.4%, respectively), and the ERAP1rs26618T allele was also higher in the severe group (67.5% vs. 39.4%, and 49.4%). There was a statistically significant association between severe COVID-19 and ACErs4291A or ERAP1rs26618T alleles. The coexistence of ACErs4291A and ERAP1rs26618T alleles in the same individual increase the severity of the COVID-19 risk by seven times [OR (95%CI) (LL–UL) = 7.058 (3.752–13.277), p < 0.001). A logistic regression analysis revealed that age, male gender, non-vaccination, ACErs4291A, and ERAP1rs26618T alleles are independent risk factors for severe COVID-19. Conclusions: Persons carrying ACErs4291A and/or ERAP1rs26618T alleles are at higher risk of developing severe COVID-19. Full article

(This article belongs to the Section Pathology and Molecular Diagnostics)

15 pages, 1256 KiB

Open AccessReview

Role of Iron Deficiency in Heart Failure—Clinical and Treatment Approach: An Overview

by Cristina Elena Singer, Corina Maria Vasile, Mihaela Popescu, Alin Iulian Silviu Popescu, Iulia Cristina Marginean, George Alexandru Iacob, Mihai Daniel Popescu and Cristina Maria Marginean

Diagnostics 2023, 13(2), 304; https://doi.org/10.3390/diagnostics13020304 - 13 Jan 2023

Cited by 9 | Viewed by 4427

Abstract

Background: The association of chronic heart failure (CHF) and iron deficiency (ID) with or without anemia is frequently encountered in current medical practice and has a negative prognostic impact, worsening patients’ exercise capacity and increasing hospitalization costs. Moreover, anemia is common in patients [...] Read more.

Background: The association of chronic heart failure (CHF) and iron deficiency (ID) with or without anemia is frequently encountered in current medical practice and has a negative prognostic impact, worsening patients’ exercise capacity and increasing hospitalization costs. Moreover, anemia is common in patients with chronic kidney disease (CKD) and CHF, an association known as cardio-renal anemia syndrome (CRAS) possessing a significantly increased risk of death. Aim: This review aims to provide an illustrative survey on the impact of ID in CHF patients—based on physiopathological traits, clinical features, and the correlation between functional and absolute ID with CHF—and the benefit of iron supplementation in CHF. Method: We selected the most recent publications with important scientific content covering the association of CHF and ID with or without anemia. Discussions: An intricate physiopathological interplay is described in these patients—decrease in erythropoietin levels, activation of the renin-angiotensin-aldosterone system, systemic inflammation, and increases in hepcidin levels. These mechanisms amplify anemia, CHF, and CKD severity and worsen patients’ outcomes. Conclusions: Anemia is frequently encountered in CHF and represents a negative prognostic factor. Data from randomized controlled trials have underlined the administration of intravenous iron therapy (ferric carboxymaltose) as the only viable treatment option, with beneficial effects on quality of life and exercise capacity in patients with ID and systolic heart failure. Full article

(This article belongs to the Special Issue Advances in the Pathology of Lung, Brain, and Heart Diseases)

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19 pages, 711 KiB

Open AccessReview

IgA Nephropathy: Current Understanding and Perspectives on Pathogenesis and Targeted Treatment

by Yating Du, Tingzhu Cheng, Chenxuan Liu, Tingting Zhu, Chuan Guo, Shen Li, Xiangrong Rao and Jinpu Li

Diagnostics 2023, 13(2), 303; https://doi.org/10.3390/diagnostics13020303 - 13 Jan 2023

Cited by 12 | Viewed by 5798

Abstract

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide, with varied clinical and histopathological features between individuals, particularly across races. As an autoimmune disease, IgAN arises from consequences of increased circulating levels of galactose-deficient IgA1 and mesangial deposition of IgA-containing immune [...] Read more.

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide, with varied clinical and histopathological features between individuals, particularly across races. As an autoimmune disease, IgAN arises from consequences of increased circulating levels of galactose-deficient IgA1 and mesangial deposition of IgA-containing immune complexes, which are recognized as key events in the widely accepted “multi-hit” pathogenesis of IgAN. The emerging evidence further provides insights into the role of genes, environment, mucosal immunity and complement system. These developments are paralleled by the increasing availability of diagnostic tools, potential biomarkers and therapeutic agents. In this review, we summarize current evidence and outline novel findings in the prognosis, clinical trials and translational research from the updated perspectives of IgAN pathogenesis. Full article

(This article belongs to the Special Issue Diagnosis and Management of Primary Glomerular Disease)

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20 pages, 4035 KiB

Open AccessReview

Immunotherapy Assessment: A New Paradigm for Radiologists

by Vincenza Granata, Roberta Fusco, Sergio Venanzio Setola, Igino Simonetti, Carmine Picone, Ester Simeone, Lucia Festino, Vito Vanella, Maria Grazia Vitale, Agnese Montanino, Alessandro Morabito, Francesco Izzo, Paolo Antonio Ascierto and Antonella Petrillo

Diagnostics 2023, 13(2), 302; https://doi.org/10.3390/diagnostics13020302 - 13 Jan 2023

Cited by 1 | Viewed by 2414

Abstract

Immunotherapy denotes an exemplar change in an oncological setting. Despite the effective application of these treatments across a broad range of tumors, only a minority of patients have beneficial effects. The efficacy of immunotherapy is affected by several factors, including human immunity, which [...] Read more.

Immunotherapy denotes an exemplar change in an oncological setting. Despite the effective application of these treatments across a broad range of tumors, only a minority of patients have beneficial effects. The efficacy of immunotherapy is affected by several factors, including human immunity, which is strongly correlated to genetic features, such as intra-tumor heterogeneity. Classic imaging assessment, based on computed tomography (CT) or magnetic resonance imaging (MRI), which is useful for conventional treatments, has a limited role in immunotherapy. The reason is due to different patterns of response and/or progression during this kind of treatment which differs from those seen during other treatments, such as the possibility to assess the wide spectrum of immunotherapy-correlated toxic effects (ir-AEs) as soon as possible. In addition, considering the unusual response patterns, the limits of conventional response criteria and the necessity of using related immune-response criteria are clear. Radiomics analysis is a recent field of great interest in a radiological setting and recently it has grown the idea that we could identify patients who will be fit for this treatment or who will develop ir-AEs. Full article

(This article belongs to the Special Issue Imaging Diagnosis in Abdomen)

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