Editor’s Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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12 pages, 275 KiB  
Article
Novel Biomarkers in Evaluating Cardiac Function in Patients on Hemodialysis—A Pilot Prospective Observational Cohort Study
by Lazar Chisavu, Viviana Mihaela Ivan, Adelina Mihaescu, Flavia Chisavu, Oana Schiller, Luciana Marc, Flaviu Bob and Adalbert Schiller
Diagnostics 2024, 14(6), 664; https://doi.org/10.3390/diagnostics14060664 - 21 Mar 2024
Viewed by 708
Abstract
Chronic kidney disease patients treated by hemodialysis present a high cardiovascular morbidity and mortality. There is an imperative need for novel biomarkers for identifying these patients and to offer possible therapeutically interventions. We performed a prospective observational cohort study on 77 patients in [...] Read more.
Chronic kidney disease patients treated by hemodialysis present a high cardiovascular morbidity and mortality. There is an imperative need for novel biomarkers for identifying these patients and to offer possible therapeutically interventions. We performed a prospective observational cohort study on 77 patients in the period of October 2021–October 2023. We measured serum plasma levels of interleukin 1-beta, galectin 3, human suppression of tumorigenicity factor 2, bone morphogenetic protein 2 and fibroblastic growth factor 23 at the inclusion site. We evaluated the correlations of these biomarkers with cardiac function and structure evaluated by echocardiography. The mean age was 61.02 (±11.81) years, with 45 (56.2%) males and with a dialysis vintage of 4.95 (2.4–7.8) years. Median ejection fraction was 51 (43–54%), and more than two-thirds of the patients presented valvular calcifications. Overall mortality was 22%. Interleukin 1-beta was correlated positively with ejection fraction and global longitudinal strain and negatively with left atrium diameter and left ventricle telesystolic diameter. Galectin 3 values were negatively correlated with aortic valve fibrosis and mitral valve calcifications, and human suppression tumorigenicity factor 2 was negatively correlated with mitral valve calcifications. Some of these novel biomarkers could be used to better assess cardiovascular disease in patients on maintenance hemodialysis. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Kidney Disease)
15 pages, 1783 KiB  
Review
The Role of Cardiovascular Magnetic Resonance Imaging in the Assessment of Mitral Regurgitation
by Ioannis Botis, Maria-Anna Bazmpani, Stylianos Daios, Antonios Ziakas, Vasileios Kamperidis and Theodoros D. Karamitsos
Diagnostics 2024, 14(6), 644; https://doi.org/10.3390/diagnostics14060644 - 19 Mar 2024
Viewed by 1031
Abstract
Mitral regurgitation (MR), a primary cause of valvular disease in adults, affects millions and is growing due to an ageing population. Cardiovascular magnetic resonance (CMR) has emerged as an essential tool, offering insights into valvular and myocardial pathology when compared to the primary [...] Read more.
Mitral regurgitation (MR), a primary cause of valvular disease in adults, affects millions and is growing due to an ageing population. Cardiovascular magnetic resonance (CMR) has emerged as an essential tool, offering insights into valvular and myocardial pathology when compared to the primary imaging modality, echocardiography. This review highlights CMR’s superiority in high-resolution volumetric assessment and tissue characterization, including also advanced techniques like late gadolinium enhancement imaging, parametric mapping, feature tracking and 4D flow analysis. These techniques provide a deeper understanding of MR’s pathophysiology and its effect on cardiac chambers, enabling CMR to surpass echocardiography in predicting hard clinical outcomes and left ventricular (LV) remodelling post mitral valve surgery. Despite its advantages, CMR’s application faces limitations like cost, lack of standardization, and susceptibility to arrhythmia artifacts. Nonetheless, as technological advancements continue and new evidence emerges, CMR’s role in MR assessment is set to expand, offering a more nuanced and personalized approach to cardiac care. This review emphasizes the need for further research and standardized protocols to maximize CMR’s potential in MR management. Full article
(This article belongs to the Special Issue Advances in Cardiovascular and Pulmonary Imaging)
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14 pages, 4154 KiB  
Review
Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review
by Federica Magon, Yaroslava Longhitano, Gabriele Savioli, Andrea Piccioni, Manfredi Tesauro, Fabio Del Duca, Gabriele Napoletano, Gianpietro Volonnino, Aniello Maiese, Raffaele La Russa, Marco Di Paolo and Christian Zanza
Diagnostics 2024, 14(4), 434; https://doi.org/10.3390/diagnostics14040434 - 16 Feb 2024
Cited by 1 | Viewed by 3291
Abstract
Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be reversible (such as pericardial effusion or [...] Read more.
Point-of-Care Ultrasound (POCUS) is a rapid and valuable diagnostic tool available in emergency and intensive care units. In the context of cardiac arrest, POCUS application can help assess cardiac activity, identify causes of arrest that could be reversible (such as pericardial effusion or pneumothorax), guide interventions like central line placement or pericardiocentesis, and provide real-time feedback on the effectiveness of resuscitation efforts, among other critical applications. Its use, in addition to cardiovascular life support maneuvers, is advocated by all resuscitation guidelines. The purpose of this narrative review is to summarize the key applications of POCUS in cardiac arrest, highlighting, among others, its prognostic, diagnostic, and forensic potential. We conducted an extensive literature review utilizing PubMed by employing key search terms regarding ultrasound and its use in cardiac arrest. Apart from its numerous advantages, its limitations and challenges such as the potential for interruption of chest compressions during image acquisition and operator proficiency should be considered as well and are discussed herein. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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19 pages, 3620 KiB  
Review
The Role of Ultrasonography in the Process of Weaning from Mechanical Ventilation in Critically Ill Patients
by Lou’i Al-Husinat, Basil Jouryyeh, Ahlam Rawashdeh, Chiara Robba, Pedro Leme Silva, Patricia Rieken Macedo Rocco and Denise Battaglini
Diagnostics 2024, 14(4), 398; https://doi.org/10.3390/diagnostics14040398 - 12 Feb 2024
Cited by 1 | Viewed by 3282
Abstract
Weaning patients from mechanical ventilation (MV) is a complex process that may result in either success or failure. The use of ultrasound at the bedside to assess organs may help to identify the underlying mechanisms that could lead to weaning failure and enable [...] Read more.
Weaning patients from mechanical ventilation (MV) is a complex process that may result in either success or failure. The use of ultrasound at the bedside to assess organs may help to identify the underlying mechanisms that could lead to weaning failure and enable proactive measures to minimize extubation failure. Moreover, ultrasound could be used to accurately identify pulmonary diseases, which may be responsive to respiratory physiotherapy, as well as monitor the effectiveness of physiotherapists’ interventions. This article provides a comprehensive review of the role of ultrasonography during the weaning process in critically ill patients. Full article
(This article belongs to the Special Issue Critical Care Imaging—2nd Edition)
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15 pages, 690 KiB  
Article
The Role of New Morphological Parameters Provided by the BC 6800 Plus Analyzer in the Early Diagnosis of Sepsis
by Sara Sacchetti, Matteo Vidali, Teresa Esposito, Stefano Zorzi, Alessia Burgener, Lorenzo Ciccarello, Gianmaria Cammarota, Valentina Zanotti, Luca Giacomini, Mattia Bellan, Mario Pirisi, Ramon Simon Lopez, Umberto Dianzani, Rosanna Vaschetto and Roberta Rolla
Diagnostics 2024, 14(3), 340; https://doi.org/10.3390/diagnostics14030340 - 4 Feb 2024
Viewed by 981
Abstract
Background: Late diagnosis of sepsis is associated with adverse consequences and high mortality rate. The aim of this study was to evaluate the diagnostic value of hematologic research parameters, that reflect the cell morphology of blood cells, available on the BC 6800 plus [...] Read more.
Background: Late diagnosis of sepsis is associated with adverse consequences and high mortality rate. The aim of this study was to evaluate the diagnostic value of hematologic research parameters, that reflect the cell morphology of blood cells, available on the BC 6800 plus automated analyzer (Mindray) for the early detection of sepsis. Materials and Methods: A complete blood count (CBC) was performed by Mindray BC 6800 Plus Analyzer in 327 patients (223 with a confirmed diagnosis of sepsis following sepsis-3 criteria, 104 without sepsis), admitted at the Intensive Care Unit of the Novara’s Hospital (Italy) and in 56 patients with localized infection. Results: In univariate logistic regression, age, Hb, RDW, MO#, NMR, NeuX, NeuY, NeuZ, LymX, MonX, MonY, MonZ were associated with sepsis (p < 0.005). In multivariate analysis, only RDW, NeuX, NeuY, NeuZ, MonX and MonZ were found to be independent predictors of sepsis (p < 0.005). Morphological research parameters are confirmed to be predictors of sepsis even when analyzing the group with localized infection. Conclusions: In addition to already established biomarkers and basic CBC parameters, new morphological cell parameters can be a valuable aid in the early diagnosis of sepsis at no additional cost. Full article
(This article belongs to the Special Issue A Useful Diagnostic Method: Blood Test)
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12 pages, 570 KiB  
Review
Mycological Methods for Routine Air Sampling and Interpretation of Results in Operating Theaters
by Rok Tomazin and Tadeja Matos
Diagnostics 2024, 14(3), 288; https://doi.org/10.3390/diagnostics14030288 - 29 Jan 2024
Cited by 1 | Viewed by 1205
Abstract
Many infectious diseases are transmitted via the air and are, therefore, particularly difficult to combat. These infections include various invasive mycoses caused by molds. The usual route of infection is the inhalation of conidia. In hospitals, infection can also occur through the deposition [...] Read more.
Many infectious diseases are transmitted via the air and are, therefore, particularly difficult to combat. These infections include various invasive mycoses caused by molds. The usual route of infection is the inhalation of conidia. In hospitals, infection can also occur through the deposition of conidia in otherwise sterile anatomical sites during surgical and other invasive procedures. Therefore, knowledge of airborne mold concentrations can lead to measures to protect patients from fungal infections. The literature on this topic contains insufficient and sometimes ambiguous information. This is evidenced by the fact that there are no international recommendations or guidelines defining the methodology of air sampling and the interpretation of the results obtained. Surgical departments, intensive care units and medical mycology laboratories are, therefore, left to their own devices, leading to significant differences in the implementation of mycological surveillance in hospitals. The aim of this mini-review is to provide an overview of the current methods of air sampling and interpretation of results used in medical mycology laboratories. Full article
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13 pages, 1901 KiB  
Review
Artificial Intelligence in Coronary Artery Calcium Scoring Detection and Quantification
by Khaled Abdelrahman, Arthur Shiyovich, Daniel M. Huck, Adam N. Berman, Brittany Weber, Sumit Gupta, Rhanderson Cardoso and Ron Blankstein
Diagnostics 2024, 14(2), 125; https://doi.org/10.3390/diagnostics14020125 - 5 Jan 2024
Cited by 1 | Viewed by 1779
Abstract
Coronary artery calcium (CAC) is a marker of coronary atherosclerosis, and the presence and severity of CAC have been shown to be powerful predictors of future cardiovascular events. Due to its value in risk discrimination and reclassification beyond traditional risk factors, CAC has [...] Read more.
Coronary artery calcium (CAC) is a marker of coronary atherosclerosis, and the presence and severity of CAC have been shown to be powerful predictors of future cardiovascular events. Due to its value in risk discrimination and reclassification beyond traditional risk factors, CAC has been supported by recent guidelines, particularly for the purposes of informing shared decision-making regarding the use of preventive therapies. In addition to dedicated ECG-gated CAC scans, the presence and severity of CAC can also be accurately estimated on non-contrast chest computed tomography scans performed for other clinical indications. However, the presence of such “incidental” CAC is rarely reported. Advances in artificial intelligence have now enabled automatic CAC scoring for both cardiac and non-cardiac CT scans. Various AI approaches, from rule-based models to machine learning algorithms and deep learning, have been applied to automate CAC scoring. Convolutional neural networks, a deep learning technique, have had the most successful approach, with high agreement with manual scoring demonstrated in multiple studies. Such automated CAC measurements may enable wider and more accurate detection of CAC from non-gated CT studies, thus improving the efficiency of healthcare systems to identify and treat previously undiagnosed coronary artery disease. Full article
(This article belongs to the Special Issue Artificial Intelligence in Cardiology Diagnosis )
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0 pages, 2739 KiB  
Article
Temporal Trend of the SARS-CoV-2 Omicron Variant and RSV in the Nasal Cavity and Accuracy of the Newly Developed Antigen-Detecting Rapid Diagnostic Test
by Daisuke Tamura, Yuji Morisawa, Takashi Mato, Shin Nunomiya, Masaki Yoshihiro, Yuta Maehara, Shizuka Ito, Yasushi Ochiai, Hirokazu Yamagishi, Toshihiro Tajima, Takanori Yamagata and Hitoshi Osaka
Diagnostics 2024, 14(1), 119; https://doi.org/10.3390/diagnostics14010119 - 4 Jan 2024
Viewed by 942
Abstract
The aim of this work is to analyze the viral titers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) at the anterior nasal site (ANS) and nasopharyngeal site (NS), evaluate their virological dynamics, and validate the usefulness of [...] Read more.
The aim of this work is to analyze the viral titers of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) at the anterior nasal site (ANS) and nasopharyngeal site (NS), evaluate their virological dynamics, and validate the usefulness of a newly developed two-antigen-detecting rapid antigen diagnostic test (Ag-RDT) that simultaneously detects SARS-CoV-2 and RSV using clinical specimens. This study included 195 asymptomatic to severely ill patients. Overall, 668 specimens were collected simultaneously from the ANS and NS. The cycle threshold (Ct) values calculated from real-time polymerase chain reaction were used to analyze temporal changes in viral load and evaluate the sensitivity and specificity of the Ag-RDT. The mean Ct values for SARS-CoV-2-positive, ANS, and NS specimens were 28.8, 28.9, and 28.7, respectively. The mean Ct values for RSV-positive, ANS, and NS specimens were 28.7, 28.8, and 28.6, respectively. SARS-CoV-2 and RSV showed the same trend in viral load, although the viral load of NS was higher than that of ANS. The sensitivity and specificity of the newly developed Ag-RDT were excellent in specimens collected up to 10 days after the onset of SARS-CoV-2 infection and up to 6 days after the onset of RSV infection. Full article
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
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