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Purpose of Review: This review aims to provide a comprehensive overview of the diagnosis of brain death/death by neurologic criteria (BD/DNC) by emphasizing the clinical criteria established by the American Academy of Neurology (AAN) in light of their updated guidelines released in 2023. In this review, we will focus on the current implementation of ancillary tests including the catheter cerebral angiogram, nuclear scintigraphy, and transcranial Doppler, which provide support in diagnoses when clinical examination and apnea tests are inconclusive. Finally, we will also provide examples to discuss the implementation of certain imaging studies in the context of diagnosing BD/DNC. Recent Findings: Recent developments in the field of neurology have emphasized the importance of clinical criteria for diagnosing BD/DNC, with the AAN providing clear updated guidelines that include coma, apnea, and the absence of brainstem reflexes. Current ancillary tests, including the catheter cerebral angiogram, nuclear scintigraphy, and transcranial Doppler play a crucial role in confirming BD/DNC when the clinical assessment is limited. The role of commonly used imaging studies including computed tomography and magnetic resonance angiographies of the brain as well as CT/MR perfusion studies will also be discussed in the context of these new guidelines. Summary: BD/DNC represents the permanent cessation of brain functions, including the brainstem. This review article provides the historical context, clinical criteria, and pathophysiology that goes into making this diagnosis. Additionally, it explores the various ancillary tests and selected imaging studies that are currently used to diagnose BD/DNC under the newly updated AAN guidelines. Understanding the evolution of how to effectively use these diagnostic tools is crucial for healthcare professionals who encounter these BD/DNC cases in their practice. [ABSTRACT FROM AUTHOR]

Infertility represents a significant global health challenge impacting millions of couples worldwide. Approximately half of all infertile couples exhibit compromised semen quality, indicative of diminished male fertility. While the diagnosis of male infertility traditionally relies on semen analysis, its limitations in providing a comprehensive assessment of male reproductive health have spurred efforts to identify novel biomarkers. Seminal plasma, a complex fluid containing proteins, lipids, and metabolites, has emerged as a rich source of such indicators. Reproduction depends heavily on seminal plasma, the primary transporter of chemicals from male reproductive glands. It provides a non-invasive sample for urogenital diagnostics and has demonstrated potential in the identification of biomarkers linked to illnesses of the male reproductive system. The abundance of seminal proteins has enabled a deeper understanding of their biological functions, origins, and differential expression in various conditions associated with male infertility, including azoospermia, asthenozoospermia, oligozoospermia, teratozoospermia, among others. The true prevalence of male infertility is understated due to the limitations of the current diagnostic techniques. This review critically evaluates the current landscape of seminal plasma biomarkers and their utility in assessing male infertility. Βy bridging the gap between research and clinical practice, the integrative assessment of seminal plasma biomarkers offers a multimodal approach to comprehensively evaluate male infertility. [ABSTRACT FROM AUTHOR]

This pragmatic review synthesises the current understanding of prodromal dementia with Lewy bodies (pDLB) and prodromal Alzheimer's disease (pAD), including clinical presentations, neuropsychological profiles, neuropsychiatric symptoms, biomarkers, and indications for disease management. The core clinical features of dementia with Lewy bodies (DLB)—parkinsonism, complex visual hallucinations, cognitive fluctuations, and REM sleep behaviour disorder are common prodromal symptoms. Supportive clinical features of pDLB include severe neuroleptic sensitivity, as well as autonomic and neuropsychiatric symptoms. The neuropsychological profile in mild cognitive impairment attributable to Lewy body pathology (MCI-LB) tends to include impairment in visuospatial skills and executive functioning, distinguishing it from MCI due to AD, which typically presents with impairment in memory. pDLB may present with cognitive impairment, psychiatric symptoms, and/or recurrent episodes of delirium, indicating that it is not necessarily synonymous with MCI-LB. Imaging, fluid and other biomarkers may play a crucial role in differentiating pDLB from pAD. The current MCI-LB criteria recognise low dopamine transporter uptake using positron emission tomography or single photon emission computed tomography (SPECT), loss of REM atonia on polysomnography, and sympathetic cardiac denervation using meta-iodobenzylguanidine SPECT as indicative biomarkers with slowing of dominant frequency on EEG among others as supportive biomarkers. This review also highlights the emergence of fluid and skin-based biomarkers. There is little research evidence for the treatment of pDLB, but pharmacological and non-pharmacological treatments for DLB may be discussed with patients. Non-pharmacological interventions such as diet, exercise, and cognitive stimulation may provide benefit, while evaluation and management of contributing factors like medications and sleep disturbances are vital. There is a need to expand research across diverse patient populations to address existing disparities in clinical trial participation. In conclusion, an early and accurate diagnosis of pDLB or pAD presents an opportunity for tailored interventions, improved healthcare outcomes, and enhanced quality of life for patients and care partners. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine–metabolic disorder in women of reproductive age. Diagnosis is based on the evidence-based international guideline 2018 and the Rotterdam Consensus to classify PCOS phenotypes. This study aims to characterize the biodemographic, clinical, metabolic, and reproductive variables and their relationship with PCOS phenotypes in a population from the Ecuadorian Andes. Methodology: A cross-sectional study was conducted with a non-random consecutive sample of 92 women who attended the outpatient gynecology and endocrinology clinic at the Hospital of the Technical University of Loja (UTPL)—Santa Inés, Loja, Ecuador, between January 2022 and July 2023. Descriptive statistics, mean calculations, standard deviation, parametric and nonparametric tests, odds ratios (OR), confidence intervals (CI), and p-values were employed. Results: The average age was 22 ± 3.4 years, with a predominantly mestizo, urban, single, highly educated, and medium–high socioeconomic level population. It was identified that phenotypes A + B are at a higher risk of developing oligomenorrhea and hypertriglyceridemia compared to phenotypes C + D, with statistically significant differences (p < 0.05). Furthermore, in terms of reproductive variables, phenotypes A + B exhibit a significantly higher frequency of elevated anti-Müllerian hormone (AMH) compared to phenotypes C + D, also with statistical significance (p < 0.05). Conclusions: The classical phenotypes A and B of PCOS are the most common in Ecuadorian Andean women and carry a higher risk of insulin resistance, anovulation, metabolic disorders, and elevated triglyceride levels compared to phenotypes C and D. Ethnic diversity and sociocultural habits influence the prevalence and clinical manifestations of these phenotypes. [ABSTRACT FROM AUTHOR]

Background: This study investigated the association between Anti-Müllerian Hormone (AMH) and relevant metabolic parameters and assessed its predictive value in the clinical diagnosis of polycystic ovarian syndrome (PCOS). Methods: A total of 421 women aged 20–37 years were allocated to the PCOS (n = 168) and control (n = 253) groups, and their metabolic and hormonal parameters were compared. Spearman correlation analysis was conducted to investigate associations, binary logistic regression was used to determine PCOS risk factors, and receiver operating characteristic (ROC) curves were generated to evaluate the predictive value of AMH in diagnosing PCOS. Results: The PCOS group demonstrated significantly higher blood lipid, luteinizing hormone (LH), and AMH levels than the control group. Glucose and lipid metabolism and hormonal disorders in the PCOS group were more significant than in the control group among individuals with and without obesity. LH, TSTO, and AMH were identified as independent risk factors for PCOS. AMH along with LH, and antral follicle count demonstrated a high predictive value for diagnosing PCOS. Conclusion: AMH exhibited robust diagnostic use for identifying PCOS and could be considered a marker for screening PCOS to improve PCOS diagnostic accuracy. Attention should be paid to the effect of glucose and lipid metabolism on the hormonal and related parameters of PCOS populations. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are a leading bacterial infection in the emergency department (ED). Diagnosing UTIs in the ED can be challenging due to the heterogeneous presentation; therefore, fast and precise tests are needed. We aimed to evaluate the diagnostic precision of procalcitonin (PCT), soluble urokinase plasminogen activator receptors (suPARs), and C-reactive protein (CRP) in diagnosing UTIs, grading the severity of UTIs, and ruling out bacteremia. Methods: We recruited adults admitted to three Danish EDs with suspected UTIs. PCT, suPAR, and CRP were used in index tests, while blood cultures, expert panel diagnosis, and severity grading were used in the reference tests. Logistic regression and area under the receiver operator characteristic curves (AUROCs) were utilized to evaluate the models and determine the optimal cut-offs. Results: We enrolled 229 patients. PCT diagnosed UTI with an AUROC of 0.612, detected severe disease with an AUROC of 0.712, and ruled out bacteremia with an AUROC of 0.777. SuPAR had AUROCs of 0.480, 0.638, and 0.605, while CRP had AUROCs of 0.599, 0.778, and 0.646. Conclusions: The diagnostic performance of PCT, suPAR, or CRP for UTIs or to rule out severe disease was poor. However, PCT can safely rule out bacteremia in clinically relevant numbers in ED patients suspected of UTI. [ABSTRACT FROM AUTHOR]

Early clinical diagnosis, effective intraoperative guidance, and an accurate prognosis can lead to timely and effective medical treatment. The current conventional clinical methods have several limitations. Therefore, there is a need to develop faster and more reliable clinical detection, treatment, and monitoring methods to enhance their clinical applications. Raman spectroscopy is noninvasive and provides highly specific information about the molecular structure and biochemical composition of analytes in a rapid and accurate manner. It has a wide range of applications in biomedicine, materials, and clinical settings. This review primarily focuses on the application of Raman spectroscopy in clinical medicine. The advantages and limitations of Raman spectroscopy over traditional clinical methods are discussed. In addition, the advantages of combining Raman spectroscopy with machine learning, nanoparticles, and probes are demonstrated, thereby extending its applicability to different clinical phases. Examples of the clinical applications of Raman spectroscopy over the last 3 years are also integrated. Finally, various prospective approaches based on Raman spectroscopy in clinical studies are surveyed, and current challenges are discussed. [ABSTRACT FROM AUTHOR]

Onychomycosis is an under-recognized healthcare burden. Despite the risk of misdiagnosis, confirmatory laboratory testing is under-utilized. Histopathologic examination with polymerase chain reaction (PCR) is currently the most effective diagnostic method; it offers direct detection and identification of a fungal invasion. In this retrospective cohort study, we assessed confirmatory testing results, with matching clinical diagnoses, in 96,293 nail specimens submitted during a 9-month period from 2022 to 2023. Toenail specimens were examined using fungal culture, histopathology and/or PCR. Clinical diagnoses were identified using the International Classification of Diseases 10th Revision codes. For clinically diagnosed onychomycosis patients, the overall positivity rate was 59.4%; a similar positivity rate (59.5%) was found in patients with clinically diagnosed non-fungal nail dystrophy. Performing a histopathologic examination with PCR was more likely to provide pathogen identification results than using fungal culture. Male patients had a higher rate of onychomycosis overall; however, female patients had more non-dermatophyte mold onychomycosis caused by Aspergillus. Clinically diagnosed onychomycosis patients with a co-diagnosis of tinea pedis were more likely to test positive for onychomycosis by PCR (odds ratio [OR]: 4.2; 95% confidence interval [CI]: 2.7–6.4), histopathology (OR: 2.5; 95% CI: 2.0–3.1) and fungal culture (OR: 3.2; 95% CI: 1.5–6.6). Our results support the use of confirmatory laboratory testing when there is a clinical diagnosis of onychomycosis. [ABSTRACT FROM AUTHOR]

Optical microscopy is a ubiquitous tool in the physical and life sciences and in histopathology, where visible light microscopy is used to analyse clinical tissue sections at the micron scale to help diagnose diseases. In recent years, microscope technologies have dramatically evolved, but these have generally come with increased cost and complexity. To widen access to advanced microscopy capabilities, we have developed a cost-effective modular platform for optical microscopy (www.openscopes. com). Many of these instruments can be based around a new low-cost and flexible microscope stand, 'open-Frame', for which the core components are open source. openFrame can support implementations of a wide range of microscope modalities for diverse applications, including research, pathology and training. Unlike many commercial microscopes that are often designed for specific applications and cannot be easily upgraded or adapted for different imaging modalities, openFramebased instruments can be relatively easily maintained, upgraded or adapted to another modality without requiring manufacturer support. To this end, openFramebased instruments are envisaged to operate with opensource software, enabling researchers to assemble and modify their microscopes with minimal challenges presented by proprietary (closed) hardware or software. Here, we describe the implementation of a low-cost, research-grade modular optical microscope applicable to research and pathology. [ABSTRACT FROM AUTHOR]

Introduction: ectopic pregnancy is currently a world of health problem. The increase in its incidence is attributed to the difficulties in the diagnosis that are often presented and to the morbidity and mortality that derive from it. It is one of the first causes of death in the first quarter of pregnancy. Objective: assess ectopic pregnancy as a clinical dilemma for diagnosis. Methods: a narrative bibliographic review was carried out that included various texts, articles, printed and digital materials related to ectopic pregnancy. The databases and directories Scielo, Lilacs, Latindex, Medline and Scopus were consulted, through the keywords in Spanish and Bollean operators to expand the results: "Hemorrhages" and "Ectopic pregnancy". 22 original and review articles were selected, in the national and international context, published between 2000 and 2020. Development: in every nosological illness a good interrogation and a physical examination favor the diagnosis, however difficult it may be. Following the steps of the clinical method helps to obtain an appropriate and timely diagnosis. It is transcendental that the doctor knows the pathophysiology and the clinical elements in ectopic pregnancy, which can go to look in an exquisite interrogation and a detailed physical examination. Conclusions: the diversity of possible clinical presentations has led to "the great simulator of gynecology", so it constitutes a clinical dilemma its diagnosis in the different levels of health care. [ABSTRACT FROM AUTHOR]

Introduction: Segmental resection of the intestine and its temporary or permanent bypass is a frequent procedure in surgical practice, which involves the construction of a stoma. The disease that leads to surgery, the clinical conditions of the patient and the technical aspects in the construction of the ostomy are key points in the postoperative evolution. Methods: A review of the literature was performed, identifying the complications associated with the construction of stomas, with the aim of offering treatment and decision-making tools to the medical personnel involved in the care of these patients. Results: Emergency surgery, immunosuppression, obesity, and the technique used to open the orifice in the abdominal wall favor the appearance of early complications that require medical management or surgical reintervention. Conclusions. Every patient with a stoma must be carefully evaluated by the surgeon and the enterostomal therapist in the first 72 hours after surgery. [ABSTRACT FROM AUTHOR]

We report a case of drug‐induced lung injury treated with prior atezolizumab and subsequent sotorasib. The patient was a 62‐year‐old woman with lung adenocarcinoma harbouring a KRAS G12C mutation that was resistant to chemotherapy, including immune checkpoint inhibitors. Cough and dyspnea appeared on day 80 after sotorasib was administered as second‐line therapy, and chest computed tomography revealed ground glass opacities in all lung lobes. Bronchoalveolar lavage fluid showed an increased total cell count with lymphocyte predominance. The patient was considered to have lung injury caused by prior atezolizumab or sotorasib administration. Withdrawal of sotorasib did not improve symptoms and shadows in both lungs. We administered moderate‐dose prednisolone and the lung disorder quickly resolved. Prednisolone tapering was completed in 2 months, followed by several months without relapse. Definitive identification of the responsible drug for the drug‐induced lung injury proved challenging in the setting of exposure to multiple potential inciting agents. There is a need for high levels of clinical suspicion for timely evaluation and management.We report a case of drug‐induced lung injury treated with prior atezolizumab and subsequent sotorasib. Definitive identification of the responsible drug for the drug‐induced lung injury proved challenging in the setting of exposure to multiple potential inciting agents. There is a need for high levels of clinical suspicion for timely evaluation and management. [ABSTRACT FROM AUTHOR]

Background and objective: To research the prevalence of hepatic abscesses at our facility. To examine the Age and Sex distribution. to examine the clinical characteristics based on variations in symptoms and symptomatology. To determine the disease's microbiology. To shed light on the role that radiological imaging plays in making a diagnosis and organising treatment appropriately. to classify the disease's mode of therapy. Method: On 100 patients who were enrolled in the trial throughout the time, a study was conducted at Department of General Surgery, Deccan College of Medical Sciences, Hyderabad, Telangana, India from to December 2022 to October 2023. Ultrasonography was used to confirm the clinical diagnosis of hepatic abscess in these patients. Result: Men are more common than women. 6:1 ratio; 5 th decade is peak incidence. Eighty four percent of cases had alcohol as the cause. The most prevalent clinical features are abdominal pain (96%) and soreness (72%), with the typical mode of presentation being observed in 81% of patients. Sixty five percent of cases had a right lobe abscess. Aspiration is the most often used therapeutic method (45%). Conclusion: According to an ultrasound, the abscess in the current study had completely disappeared after three to four months; in our series, individuals with lower socioeconomic status account for roughly 70% of all abscesses examined. [ABSTRACT FROM AUTHOR]

This study sought to analyze whether an accurate diagnosis of the type and subtype of hepatic Glycogen Storage Diseases (GSDs) could be performed based on general clinical and biochemical aspects via comparing the proposed diagnostic hypotheses with the molecular results. Twelve physicians with experience in hepatic GSDs reviewed 45 real cases comprising a standardized summary of clinical and laboratory data. There was no relation between the hit rate and the time since graduation, the time of experience in GSD, and the number of patients treated during their careers. The average assertiveness was 47%, with GSD Ia and Ib being the best-identified types, while no expert correctly identified GSD IXc. Underage investigation for later manifestations, incomplete clinical description, and complementary analysis, the overvaluation of a specific clinical finding ("false positive") or the discarding of the diagnosis in the absence of it ("false negative"), as well as the lack of knowledge of the rarest GSD types, may have impacted the accuracy of the assessment. This study emphasized that characteristics considered as determinants in identifying the specific types or subtypes of GSD are not exclusive, thus becoming factors that may have induced the evaluators to misdiagnose. [ABSTRACT FROM AUTHOR]

Introduction: One of the millennium challenges worldwide is to fight the advance of the human immunodeficiency virus/aids. Objective: To characterize the sick population with clinical onset of AIDS according to sociodemographic and epidemiologic variables. Methods: An observational and descriptive study was carried out, from 2017 to 2021, of 87 people diagnosed with clinical onset of AIDS in Santiago de Cuba province. In the statistical analysis, measures of central tendency and dispersion were used, as well as the distribution of absolute and relative frequencies; also, confidence intervals of 95% were computed for the proportions of selected variables. Results: The average age in the series was 42 years (79.3%), likewise, there was a prevalence of the male sex (91.9%), single as marital status (91.9%), working bond (72.4%), mixed race (52.8%) and black skin color (39.3%), and the urban origin (73.5%). The anal coitus was the main way of infection (84.0%), while the majority of the affected individuals of both sexes (65.2% in males and 66.7% in females) did not use condoms and homosexuality predominated among men (55.0%). Conclusions: The clinical onset of AIDS prevailed in young and single men, with working bond, among whom risky sexual behaviors were very significant. [ABSTRACT FROM AUTHOR]

Introduction: In the continuous training process of medical students, it is necessary to incorporate current issues; likewise, it is important to know the problems to seek solutions with the science support. Objective: To diagnose the training process of medical students as for the detection of incapacitating sequelae post-COVID-19. Methods: An observational, descriptive and cross-sectional study, with qualitative approach, of 20 students from 5th year of Medicine career, belonging to the University of Medical Sciences in Camagüey was carried out during their stay for the Public Health subject, from July to December, 2022. For such a purpose it was designed and applied an evaluative instrument with dimensions and indicators. Results: It was found that 50.0% of these students were in the age range of 21-26 years, while 65.0% were female. The cognitive dimension was evaluated as bad because 3 indicators, of the 4 that made it up, received that qualification; the same happened with the instrumental dimension. On the other hand, the attitudinal dimension and its 2 indicators were qualified as good. Conclusions: Inadequacies existed in the training process of medical students, which block their professional performance. On the base of the diagnosis, the interest in searching for information related to the detection of post-COVID-19 incapacitating sequelae is confirmed as strength. [ABSTRACT FROM AUTHOR]

In the interest of preventing the Coronavirus Disease 2019 (COVID-19) pandemic from spreading, it is crucial to promptly identify and confine afflicted patients. Serological antibody testing is a significant diagnostic technique that is increasingly employed in clinics, however its clinical use is still being investigated. The present study was carried out to scrutinize how well Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibody testing using in-house developed rapid antibody assay worked against the chemiluminescence (CLIA) assay. Either IgG positive (IgG + IgM-) or IgM positive (IgM + IgG-); both IgG and IgM positive (IgM + IgG+); and negatives (IgM- IgG-) have been evaluated. A total of 300 samples with diverse age and sexual identity data were included. The combined sensitivities for IgG + IgM+, IgM + IgG-, IgG + IgM- and IgG-IgM- were evaluated. More accurate diagnostic results may be obtained using molecular diagnostic tools. The Antibody Rapid Diagnostic kit's (in-house developed) performance was satisfactory for determining the presence of Covid-19 infection with IgG and IgM positivity. The IgG and IgM positivity helped evaluate the immune response in the individual for the COVID-19 infection. These results lend support to the additional utilisation of serological antibody tests in the COVID-19 diagnosis. Key points: • We performed an archival research analysis to check Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibody testing. • We determined the presence of Covid-19 infection with IgG/IgM positivity. [ABSTRACT FROM AUTHOR]

Background Syphilis diagnosis relies on immunologic markers and clinical protocols. However, syphilitic lesions can be confused with other genital ulcer diseases. Methods Using a PlexPCR VHS assay, we analyzed lesion DNA samples from 87 individuals who were clinically diagnosed with early syphilis infection and had at least 1 positive serologic test result. DNA was detected by the PlexPCR VHS multiplex assay and β-globin genes. Results Among the participants, 99% (86/87) had a positive rapid treponemal test result. DNA was successfully detected in 91% (79/87) of the lesion samples. PlexPCR VHS identified 5 herpes simplex virus (HSV)/ Treponema pallidum coinfections (2 HSV-1 and 3 HSV-2), only T pallidum DNA in 62% (49/79), and only HSV-2 in 12.7% (10/79). While 19% (15/79) were negative for all pathogens, none were varicella zoster virus positive. The PlexPCR VHS had 68.4% agreement with the clinical diagnosis. Conclusions Since the PlexPCR VHS detects multiple organisms simultaneously, it can help to confirm actual syphilis and identify other pathogen coinfections or the pathogen causing the ulcer. [ABSTRACT FROM AUTHOR]

Conventional techniques for microbial detection are time-consuming, expensive, and unsuitable. The use of nanoparticles is a valuable technique for the detection of bacterial as well as viral DNA. Gold nanoparticles (gold NPs) have been used as a promising detector for rapid and low-cost identification of microbes with high sensitivity. In this study, gold nanoparticles-probes were used to identify Pseudomonas aeruginosa and Acinetobacter baumannii genomic DNA. Thiol-functionalized probes were attached to gold NPs. Hybridization of the probe with the amplified product of Oprl and glta genes resulted in accumulation of gold nanoparticles in a cross-linked manner, caused a color change of the reaction mixture, which indicated the presence of Pseudomonas aeruginosa and Acinetobacter baumannii in the sample. To study the sensitivity, the polymerase chain reaction product with different bacteria was used, and results were compared. The gold nanoparticle-based colorimetric assay can be used as a direct and rapid method with high sensitivity for specific identification of these pathogens in clinical and food samples. [ABSTRACT FROM AUTHOR]

[Display omitted] • The current review describes bacterial classification using SERS for the identification of pathogens for clinical application diagnosis. • This review provides a brief overview of the mechanism and evolution of the SERS diagnostic principle for pathogenic bacteria. • Discussed the several novel SERS-compatible technologies in clinical applications and computational challenges of pre-processing spectra. • Its highlights the limitations and perspectives of the SERS technique. • It summarizes the potential applications for direct bacterial diagnosis in clinical samples such as blood, urine and sputum. The rapid and reliable detection of pathogenic bacteria at an early stage is a highly significant research field for public health. However, most traditional approaches for pathogen identification are time-consuming and labour-intensive, which may cause physicians making inappropriate treatment decisions based on an incomplete diagnosis of patients with unknown infections, leading to increased morbidity and mortality. Therefore, novel methods are constantly required to face the emerging challenges of bacterial detection and identification. In particular, Raman spectroscopy (RS) is becoming an attractive method for rapid and accurate detection of bacterial pathogens in recent years, among which the newly developed surface-enhanced Raman spectroscopy (SERS) shows the most promising potential. Recent advances in pathogen detection and diagnosis of bacterial infections were discussed with focuses on the development of the SERS approaches and its applications in complex clinical settings. The current review describes bacterial classification using surface enhanced Raman spectroscopy (SERS) for developing a rapid and more accurate method for the identification of bacterial pathogens in clinical diagnosis. The initial part of this review gives a brief overview of the mechanism of SERS technology and development of the SERS approach to detect bacterial pathogens in complex samples. The development of the label-based and label-free SERS strategies and several novel SERS-compatible technologies in clinical applications, as well as the analytical procedures and examples of chemometric methods for SERS, are introduced. The computational challenges of pre-processing spectra and the highlights of the limitations and perspectives of the SERS technique are also discussed. Taken together, this systematic review provides an overall summary of the SERS technique and its application potential for direct bacterial diagnosis in clinical samples such as blood, urine and sputum, etc. [ABSTRACT FROM AUTHOR]

Introduction: Leprosy also widely known by the name Hansen's disease is a chronic disease caused by Mycobacterium leprae affecting mankind with various clinico-pathological forms. It remained a major public health issue due to associated case load, morbidity and stigma attached to it. India declared elimination of leprosy in the year 2005. However, it is surprising to see that in some parts of the country, the prevalence is still significant. The objective of the study is to describe the spectrum of histopathological profile of leprosy and compare its correlation with clinical diagnosis in this post elimination era. Methods: A 24-months prospective study was conducted with clinically diagnosed leprosy cases in a tertiary care hospital in eastern India. Lesions were graded and the histopathological slides along with its bacteriological index (BI) on slit skin smears where possible was reviewed and analyzed. Agreement of histopathological finding with clinical finding was established. Results: A total of 220 cases were included in the study. On histopathology, borderline category was the most frequently reported with borderline tuberculoid the most common subtype. Most common clinical feature was hypopigmented plaque, followed by erythematous skin lesions, nodules, macules etc. Bacteriological index was studied in 192 slit skin smears. Moderate agreement between clinical and histopathological diagnosis with kappa measure of inter-rater agreement as 0.457 was noted. Conclusion: Clinico-histopathological correlation is pivotal in the accurate diagnosis of leprosy to prevent, treat, and control the resurgence of the disease in the post-elimination era. [ABSTRACT FROM AUTHOR]

Introduction: Lesions in the oral mucosa constitute a heterogeneous group of disorders which prognosis and treatment depend on the early diagnosis. Objective: To characterize patients with lesions in the oral mucosa according to clinical, epidemiological, histological and pathological variables. Methods: A descriptive, longitudinal and prospective study of 23 patients with lesions in the oral mucosa was carried out. They belonged to the family doctor offices from Vista Alegre neighborhood and were assisted in the Stomatology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba from September, 2021 to June, 2022. Results: In the series there was a prevalence of the female sex, the 60 years and over age group, subprosthesis stomatitis as more frequent lesion (39.1%) and chronic traumatisms as risk factors (65.2%); also, in patients referred to the secondary care level there was coincidence between the clinical, histological and pathological diagnoses (76.9%). Conclusions: The final diagnosis will depend on the clinical, epidemiological, histological and pathological valuation of these lesions and on the preparation of the specialists on the topic. [ABSTRACT FROM AUTHOR]

Introduction: Appendicitis is the most common abdominal emergency. While the clinical diagnosis may be straight forward in patients who present with classic signs and symptoms, atypical presentations may result in diagnostic confusion and delay in treatment. Abdominal pain is the primary presenting complaint of patients with acute appendicitis. Nausea, vomiting, and anorexia occur in varying degrees. Abdominal examination reveals localised tenderness and muscular rigidity after localisation of the pain to the right iliac fossa. Laboratory data upon presentation usually reveal an elevated leukocytosis. Measurement of C-reactive protein is most likely to be elevated. The advances in imaginology trend to diminish the false positive or negative diagnosis. In experienced hands, ultrasound may have a sensitivity of 90% and specificity higher than 90%. Despite all medical advances, the diagnosis of acute appendicitis continues to be a medical challenge. Materials and Methods: The present study was a cross-sectional study. This Study was conducted from June 2021 to May 2022 at Department of General Surgery, Jorhat Medical College and Hospital. Result: In our study, the peak incidence of Acute appendicitis is found in the age group of 15-20 years and 21-30 years. Male to female ratio is 1:1.9. Pain in the right iliac region (98%) is seen followed by Anorexia (74%) then Vomiting(72%) are the most common symptoms. Tenderness in the Right iliac region (98%) is seen followed by elevated temperatur (64%) and Rebound Tenderness in the right iliac fossa (58%) are the commonest sign. Some special signs like Pointing signs (74%), Dunphy's signs(64%) are most commonly found. The mean WBC (mm) (mean±s.d.) of patients was 11628.0000± 3789.7305. The mean CRP (mean±s.d.) of patients was 25.5444± 39.5294. (62.0%) patients had Aperstaltic blind end tube, non compressible, outer diameter > 6mm . The mean Alvarado's Score (mean±s.d.) of patients was 6.4400± 1.2316. Conclusion: We found that, the initial step of diagnosis of acute appendicitis is mainly clinical. On application of Alvarado score, the diagnostic sensitivity is increased. The addition of White blood cells count, C - reactive protein and Abdominal ultrasonography increased the diagnostic accuracy further [ABSTRACT FROM AUTHOR]

Background: Diagnoses are crucial assets of clinical work and provide the foundation for treatment and follow up. They should be informative and customized to the patient's problem. Common prefixes, morphemes, and suffixes may aid the implementation of expressions that generate diagnoses. Results: Apt choices of symbols plays a major role in science. In this study, the variables e, o, and p are assigned to names of an etiological agent, a disorder, and a pathogenetic mechanism, respectively. The suffix -itis designates infections, allergies, inflammation, and/or immune reactions. Diagnoses (d) are generated by the formula d:= e&o&p where '&' means concatenation and ':= ' means assignment. Thus, with e:= 'Staphylococcus aureus ', o:= 'endocard', and p:= 'itis', d:= e&o&p generates the diagnosis d = 'Staphylococcus aureus endocarditis'. Diagnoses formed this way comply with common clinical diagnoses. Certain extensions generate complete, systematic medical diagnoses that are applicable to all medical specialties. For example, common medical prefixes, morphemes, and suffixes give rise to o = 'hypothyroidism', o = 'tachycardia', and o = 'hypophagocytosis'. The formula scales well with the developments in clinical medicine, systems biology, molecular biology, and microbiology. The diagnosis generating formula d:= e&o&p requires meticulous analysis of the components of diagnoses plus the introduction of appropriate variables and terms. Terms partition on established clinical categories and adhere to established clinical nomenclature. The syntax generates universal medical diagnoses. Conclusions: The present study concerns a universal diagnosis syntax (UDS) that generates diagnoses using the formula d:= e&o&p with several extensions described in the study. The formula is easy to learn and covers diagnoses in all medical specialties. The present work succeeded in creating diagnoses from the formula. The fundamental insight is that no matter how complicated a diagnosis is it can be generated by a systematic process, which adds terms one by one. UDS may have implications for medical education and classifications. The formula lays a foundation for structured clinical decision-making. Formulas are hallmarks of hard science. So, d:= e&o&p anticipates a scientific medical revolution. [ABSTRACT FROM AUTHOR]

Background: Non-syndromic inherited retinal dystrophies (IRDs) such as retinitis pigmentosa or Leber congenital amaurosis generally manifest between early childhood and late adolescence, imposing profound long-term impacts as a result of vision impairment or blindness. IRDs are highly heterogeneous, with often overlapping symptoms among different IRDs, and achieving a definite diagnosis is challenging. This narrative review provides a clinical overview of the non-syndromic generalized photoreceptor dystrophies, particularly retinitis pigmentosa and Leber congenital amaurosis. The clinical investigations and genetic testing needed to establish a diagnosis are outlined, and current management approaches are discussed, focusing on the importance of the involvement of an interdisciplinary team from diagnosis and initial care to long-term follow-up and support. Results: The effective management of IRDs requires a multidisciplinary, and ideally interdisciplinary, team of experts knowledgeable about IRDs, with experienced professionals from fields as diverse as ophthalmology, neuropsychiatry, psychology, neurology, genetics, orthoptics, developmental therapy, typhlology, occupational therapy, otolaryngology, and orientation and mobility specialties. Accurate clinical diagnosis encompasses a range of objective and subjective assessments as a prerequisite for the genetic testing essential in establishing an accurate diagnosis necessary for the effective management of IRDs, particularly in the era of gene therapies. Improvements in genome sequencing techniques, such as next-generation sequencing, have greatly facilitated the complex process of determining IRD-causing gene variants and establishing a molecular diagnosis. Genetic counseling is essential to help the individual and their family understand the condition, the potential risk for offspring, and the implications of a diagnosis on visual prognosis and treatment options. Psychological support for patients and caregivers is important at all stages of diagnosis, care, and rehabilitation and is an essential part of the multidisciplinary approach to managing IRDs. Effective communication throughout is essential, and the patient and caregivers' needs and expectations must be acknowledged and discussed. Conclusion: As IRDs can present at an early age, clinicians need to be aware of the clinical signs suggesting visual impairment and follow up with multidisciplinary support for timely diagnoses to facilitate appropriate therapeutic or rehabilitation intervention to minimize vision loss. [ABSTRACT FROM AUTHOR]

Tau protein plays a crucial role in diagnosing neurodegenerative diseases. However, performing an assay to detect tau protein on a nanoscale is a great challenge for early diagnosis of diseases. Enzyme-linked immunosorbent assay (ELISA), western-blotting, and molecular-based methods, e.g., PCR and real-time PCR, are the most widely used methods for detecting tau protein. These methods are subject to certain limitations: the need for advanced equipment, low sensitivity, and specificity, to name a few. With the above said, it is necessary to discover advanced and novel methods for monitoring tau protein. Counted among remarkable approaches adopted by researchers, biosensors can largely eliminate the difficulties and limitations associated with conventional methods. The main objective of the present study is to review the latest biosensors developed to detect the tau protein. Furthermore, the problems and limitations of conventional diagnosis methods were discussed in detail. [ABSTRACT FROM AUTHOR]

To analyze the knowledge of Brazilian pediatricians about cow's milk protein allergy (CMPA) using a validated questionnaire. Quantitative study with a cross-sectional design in which an online questionnaire on CMPA knowledge was applied. The sample calculation indicated 1024 participants. The online form was divided into two blocks, the first comprising questions on the identification of pediatricians, and the second comprising the validated questionnaire, built from the Brazilian Consensus on Food Allergy (2018). The general evaluation of the questionnaire showed a percentage of agreement of 91% and a Content Validity Index of 0.95. The results of the applied questionnaires were presented in absolute and relative frequencies, mean, median, standard deviation, and percentiles. The level of significance was set at 5% (p <0.05). The validated questionnaire was answered by 1316 Brazilian doctors, of whom 1017 (77.3%) were females, and their mean age was 45.50 ± 13.20 years. The mean total number of correct answers was 80.66 ± 10.42%. Pediatricians mostly answered questions about the concept and treatment of CMPA. The question with the lowest rate of correct answers was related to clinical and laboratory investigation. Most physicians who answered the questionnaire demonstrated they understood the concept and the main CMPA therapeutic recommendations. [ABSTRACT FROM AUTHOR]

Nonobstructive azoospermia (NOA) is one of the most important causes of male infertility, accounting for 10–15% of infertile men worldwide. Among these, more than 70% of cases are idiopathic NOA (iNOA), whose pathogenesis and molecular basis remain unknown. This work profiles 3696 human testicular single‐cell transcriptomes from 17 iNOA patients, which are classified into four classes with different arrest periods and variable cell proportions based on the gene expression patterns and pathological features. Genes related to the cell cycle, energy production, and gamete generation show obvious abnormalities in iNOA germ cells. This work identifies several candidate causal genes for iNOA, including CD164, LELP1, and TEX38, which are significantly downregulated in iNOA germ cells. Notably, CD164 knockdown promotes apoptosis in spermatogonia. Cellular communications between spermatogonial stem cells and Sertoli cells are disturbed in iNOA patients. Moreover, BOD1L2, C1orf194, and KRTCAP2 are found to indicate testicular spermatogenic capacity in a variety of testicular diseases, such as Y‐chromosome microdeletions and Klinefelter syndrome. In general, this study analyzes the pathogenesis of iNOA from the perspective of germ cell development, transcription factor (TF) regulatory networks, as well as germ cell and somatic cell interactions, which provides new ideas for clinical diagnosis. [ABSTRACT FROM AUTHOR]

Background: Dengue, Chikungunya, and Zika are co-endemic in Honduras and are often misdiagnosed due to similar clinical and epidemiological behavior. Most arboviral infections reported in primary care are based on clinical diagnoses without laboratory confirmation. Therefore, the accuracy of physicians' diagnoses and the factors that affect them needs to be evaluated. Methods: A cross-sectional study with convenience sampling at primary healthcare centers was conducted from June to September 2016 and 2017. Clinical data and dried blood spots on Whatman 903 filter paper from 415 arboviral cases and 248 non-arboviral febrile cases were collected. Viral RNA was extracted from a 6-mm DBS paper disc and confirmed by RT-qPCR and sequencing. Results: Only 30.84% of diagnostic accuracy was observed in physicians in primary care when comparing arboviral clinical diagnosis with RT-qPCR detection. Moreover, in Dengue and Zika clinical cases, only 8.23% and 27.08% were RT-qPCR confirmed, respectively. No Chikungunya cases were confirmed. In 2017, 20.96% of febrile cases were RT-qPCR confirmed arboviral infections. The symptoms of 45.5% of arboviral cases can fit more than one case definition for arboviruses. The "symptom compliance" and "patient with suspected close contact" were the criteria most utilized by physicians for arboviral diagnosis. The pattern of the epidemiological curves of the arboviral clinical cases didn't match the one of the RT-qPCR confirmed cases. Conclusions: Low diagnostic accuracy for overall and individual arboviral infections was observed in physicians. Unspecific symptomatology, overlapping case definitions, and reported close contact to an arboviral patient might contribute to misdiagnosis. Without laboratory confirmation, surveillance data may not reflect the real behavior of these diseases and could impact health interventions. [ABSTRACT FROM AUTHOR]

The implementation of next-generation sequencing (NGS) in clinical oncology has enabled the analysis of multiple cancer-associated genes for diagnostics and treatment purposes. The detection of pathogenic and likely pathogenic mutations is crucial to manage the disease. Obtaining the mutational profile may be challenging in samples with low yields of DNA—reflected by the type of biological material, such as formalin-fixed paraffin-embedded tissue (FFPE), needle biopsies, and circulating free/tumor DNA, as well as a sparse tumor content. Moreover, standardized strict procedures for the extraction of DNA in a clinical setting might contribute to lower amounts of DNA per µL. The detection of variants in low-yield DNA samples remains a challenge in clinical diagnostics, where molecular analyses such as NGS are needed. Here, we performed vacuum centrifugation on DNA extracted from five FFPE tissue blocks, with concentrations below 0.2 ng/µL. Through NGS analysis, we found that low-yield DNA samples could be concentrated to sufficient levels, without compromising the mutational profile. [ABSTRACT FROM AUTHOR]

Dyspnea is one of the most common symptoms of many respiratory diseases, including COVID-19. Clinical assessment of dyspnea relies mainly on self-reporting, which contains subjective biases and is problematic for frequent inquiries. This study aims to determine if a respiratory score in COVID-19 patients can be assessed using a wearable sensor and if this score can be deduced from a learning model based on physiologically induced dyspnea in healthy subjects. Noninvasive wearable respiratory sensors were employed to retrieve continuous respiratory characteristics with user comfort and convenience. Overnight respiratory waveforms were collected on 12 COVID-19 patients, and a benchmark on 13 healthy subjects with exertion-induced dyspnea was also performed for blind comparison. The learning model was built from the self-reported respiratory features of 32 healthy subjects under exertion and airway blockage. A high similarity between respiratory features in COVID-19 patients and physiologically induced dyspnea in healthy subjects was observed. Learning from our previous dyspnea model of healthy subjects, we deduced that COVID-19 patients have consistently highly correlated respiratory scores in comparison with normal breathing of healthy subjects. We also performed a continuous assessment of the patient's respiratory scores for 12–16 h. This study offers a useful system for the symptomatic evaluation of patients with active or chronic respiratory disorders, especially the patient population that refuses to cooperate or cannot communicate due to deterioration or loss of cognitive functions. The proposed system can help identify dyspneic exacerbation, leading to early intervention and possible outcome improvement. Our approach can be potentially applied to other pulmonary disorders, such as asthma, emphysema, and other types of pneumonia. [ABSTRACT FROM AUTHOR]

Background: Rhizopus delemar is an invasive fungal pathogen that can cause fatal mucormycosis in immunodeficient individuals. Encephalitis caused by R. delemar is rare and difficult to diagnose early. Clinical detection methods for R. delemar include blood fungal culture, direct microscopic examination, and histopathological examination, but the detection is often inadequate for clinical diagnosis and can easily lead to missed diagnosis with delayed treatment. Case presentation: We report a case of a 47-year-old male with brainstem hemorrhage caused by encephalitis due to R. delemar. The patient had a history of hypertension, type 2 diabetes, and irregular medication. No pathogens were detected in cerebrospinal fluid (CSF) and nasopharyngeal secretion cultures. R. delemar was identified by metagenomic next-generation sequencing (mNGS) in CSF, and in combination with the patient's clinical characteristics, encephalitis caused by R. delemar was diagnosed. Antibiotic treatment using amphotericin B liposome in combination with posaconazole was given immediately. However, due to progressive aggravation of the patient's symptoms, he later died due to brainstem hemorrhage after giving up treatment. Conclusions: mNGS technique is a potential approach for the early diagnosis of infections, which can help clinicians provide appropriate antibiotic treatments, thus reducing the mortality and disability rate of patients. [ABSTRACT FROM AUTHOR]

Background: With advances in massive parallel sequencing (MPS) technology, whole-genome sequencing (WGS) has gradually evolved into the first-tier diagnostic test for genetic disorders. However, deployment practice and pipeline testing for clinical WGS are lacking. Methods: In this study, we introduced a whole WGS pipeline for genetic disorders, which included the entire process from obtaining a sample to clinical reporting. All samples that underwent WGS were constructed using polymerase chain reaction (PCR)-free library preparation protocols and sequenced on the MGISEQ-2000 platform. Bioinformatics pipelines were developed for the simultaneous detection of various types of variants, including single nucleotide variants (SNVs), insertions and deletions (indels), copy number variants (CNVs) and balanced rearrangements, mitochondrial (MT) variants, and other complex variants such as repeat expansion, pseudogenes and absence of heterozygosity (AOH). A semiautomatic pipeline was developed for the interpretation of potential SNVs and CNVs. Forty-five samples (including 14 positive commercially available samples, 23 laboratory-held positive cell lines and 8 clinical cases) with known variants were used to validate the whole pipeline. Results: In this study, a whole WGS pipeline for genetic disorders was developed and optimized. Forty-five samples with known variants (6 with SNVs and Indels, 3 with MT variants, 5 with aneuploidies, 1 with triploidy, 23 with CNVs, 5 with balanced rearrangements, 2 with repeat expansions, 1 with AOHs, and 1 with exon 7–8 deletion of SMN1 gene) validated the effectiveness of our pipeline. Conclusions: This study has been piloted in test development, optimization, and validation of the WGS pipeline for genetic disorders. A set of best practices were recommended using our pipeline, along with a dataset of positive samples for benchmarking. [ABSTRACT FROM AUTHOR]

The prevalence of dementia is currently increasing worldwide. This syndrome produces a deterioration in cognitive function that cannot be reverted. However, an early diagnosis can be crucial for slowing its progress. The Clock Drawing Test (CDT) is a widely used paper-and-pencil test for cognitive assessment in which an individual has to manually draw a clock on a paper. There are a lot of scoring systems for this test and most of them depend on the subjective assessment of the expert. This study proposes a computer-aided diagnosis (CAD) system based on artificial intelligence (AI) methods to analyze the CDT and obtain an automatic diagnosis of cognitive impairment (CI). This system employs a preprocessing pipeline in which the clock is detected, centered and binarized to decrease the computational burden. Then, the resulting image is fed into a Convolutional Neural Network (CNN) to identify the informative patterns within the CDT drawings that are relevant for the assessment of the patient's cognitive status. Performance is evaluated in a real context where patients with CI and controls have been classified by clinical experts in a balanced sample size of 3 2 8 2 drawings. The proposed method provides an accuracy of 7 5. 6 5 % in the binary case-control classification task, with an AUC of 0. 8 3. These results are indeed relevant considering the use of the classic version of the CDT. The large size of the sample suggests that the method proposed has a high reliability to be used in clinical contexts and demonstrates the suitability of CAD systems in the CDT assessment process. Explainable artificial intelligence (XAI) methods are applied to identify the most relevant regions during classification. Finding these patterns is extremely helpful to understand the brain damage caused by CI. A validation method using resubstitution with upper bound correction in a machine learning approach is also discussed. [ABSTRACT FROM AUTHOR]

Background: Stereotactic body radio therapy (SBRT) has emerged as a standard treatment option for nonsurgical candidates with early-stage non-small cell lung cancer (NSCLC). Pathological proof is sometimes difficult to obtain in patients with solitary pulmonary nodules (SPNs). We aimed to compare the clinical outcomes of stereotactic body radiotherapy via helical tomotherapy (HT-SBRT) for early-stage lung cancer patients with or without a pathological diagnosis. Methods: Between June 2011 and December 2016, we treated 119 lung cancer patients with HT-SBRT, including 55 with a clinical diagnosis and 64 with a pathological diagnosis. Survival outcomes, including local control (LC), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS), were compared between two cohorts with and without a pathological diagnosis. Results: The median follow-up for the whole group was 69 months. Patients with a clinical diagnosis were significantly older (p = 0.002). No significant differences were observed between the clinical and pathological diagnosis cohorts in terms of the long-term outcome, with 5-year LC, PFS, CSS, and OS of 87% versus 83% (p = 0.58), 48% versus 45% (p = 0.82), 87% versus 84% (p = 0.65), and 60% versus 63% (p = 0.79), respectively. Recurrence patterns and toxicity were also similar. Conclusions: Empiric SBRT appears to be a safe and effective treatment option in a multidisciplinary setting when patients with SPNs highly suggestive of malignancy are unable/refuse to obtain a definitive pathological diagnosis. [ABSTRACT FROM AUTHOR]

Back pain is one of the most common triggers of performance failure in athletic and riding horses. Diagnosis of equine back pain has been very challenging for equine practitioners, particularly in chronic cases. Therefore, the identification of blood biomarkers would facilitate the clinical differentiation of chronic back pain. This study aimed to investigate serum biomarkers of glial cell activation, axonal damage, and inflammation for the diagnosis of equine chronic back pain. Serum samples from forty horses comprising chronic back pain (CBP), back pain concurrent with lameness (BPL), lameness (LN), and healthy control (HC) (n=10 per group) were screened for ionized calcium-binding adaptor molecule 1 (Iba-1), glial fibrillary acidic protein (GFAP), phosphorylated neurofilament-H (pNF-H) by ELISA, and proinflammatory cytokines (IL-1β, IL-6, and TNF-α) by multiplex assay. Serum concentrations of GFAP (3.81±1.72 ng/mL) and pNF-H (0.76±0.18 ng/mL) were significantly (p<0.05) higher in horses with CBP when compared with other groups. Iba-1 was not significantly higher in CBP horses. There was no significant difference between the pro-inflammatory cytokines among the groups. The levels of IL-1β, IL-6, and TNF-α were also increased in the CBP than the HC control horses but lower in relation to BPL and LN horses. In addition, serum Iba-1, GFAP, and pNF-H showed a high discriminatory capacity for horses with CBP with high sensitivity (50-100%) and specificity (70-100%). This study provides evidence that serum levels of the GFAP and pNF-H may be useful in the clinical differentiation of horses with chronic back pain. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population. Methods: We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, amount of thromboembolic cerebral venous sinus(ATCVS), and other relevant indicators. Results: The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher lymphocyte ratio (LR), blood urea nitrogen (BUN), and intracranial pressure (ICP) compared to the non-headache group, whereas mean corpuscular volume (MCV) and levels of protein (cerebrospinal fluid, CSF) and lactic dehydrogenase (LDH) in CSF were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CI-(CSF) were the risk factors for the occurrence of headache in CVT patients. Conclusion: Age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CI- (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT. [ABSTRACT FROM AUTHOR]

Background: Homocysteine (Hcy) has been found to be closely related to the occurrence of diabetes mellitus (DM) and is considered as one of the risk factors of DM. However, Hcy alone is not enough as a factor to predict DM, and our study analyzed and determined the relationship between the main metabolites involved in the Hcy metabolic pathway and DM. Methods: A total of 48 clinical samples were collected, including 18 health control samples and 30 DM samples. All standards and samples were detected by LC-QTOF-MS. Multivariate statistical analysis and k-means cluster analysis were performed to screen and confirm the metabolites significantly correlated with DM. Results: A total of 13 metabolites of the Hcy metabolic pathway were detected in the samples. The content of Hcy, cysteine, taurine, pyridoxamine, methionine, and choline were significantly increased in the DM group (p < 0.05). Hcy, choline, cystathionine, methionine, and taurine contributed significantly to the probabilistic principal component analysis (PPCA) model. The odds ratios (OR) of Hcy, cysteine, taurine, methionine, and choline were all greater than one. K-means cluster analysis showed that the Hcy, taurine, methionine, and choline were significantly correlated with the distribution of glucose values (divided into four levels: 10.5–11.7 mmol/L, 7.7–9.7 mmol/L, 6.0–6.9 mmol/L, and 5.0–5.9 mmol/L, respectively). Conclusion: Hcy, taurine, methionine, and choline can be used as risk factors for diabetes diagnosis and are expected to be used for the assessment of diabetes severity. [ABSTRACT FROM AUTHOR]

Background: Due to the high transmissibility of SARS-CoV-2, accurate diagnosis is essential for effective infection control, but the gold standard, real-time reverse transcriptase-polymerase chain reaction (RT-PCR), is costly, slow, and test capacity has at times been insufficient. We compared the accuracy of clinician diagnosis of COVID-19 against RT-PCR in a general adult population. Methods: COVID-19 diagnosis data by 30th September 2021 for participants in an ongoing population-based cohort study of adults in Western Sweden were retrieved from registers, based on positive RT-PCR and clinician diagnosis using recommended ICD-10 codes. We calculated accuracy measures of clinician diagnosis using RT-PCR as reference for all subjects and stratified by age, gender, BMI, and comorbidity collected pre-COVID-19. Results: Of 42,621 subjects, 3,936 (9.2%) and 5705 (13.4%) had had COVID-19 identified by RT-PCR and clinician diagnosis, respectively. Sensitivity and specificity of clinician diagnosis against RT-PCR were 78% (95%CI 77–80%) and 93% (95%CI 93–93%), respectively. Positive predictive value (PPV) was 54% (95%CI 53–55%), while negative predictive value (NPV) was 98% (95%CI 98–98%) and Youden's index 71% (95%CI 70–72%). These estimates were similar between men and women, across age groups, BMI categories, and between patients with and without asthma. However, while specificity, NPV, and Youden's index were similar between patients with and without chronic obstructive pulmonary disease (COPD), sensitivity was slightly higher in patients with (84% [95%CI 74–90%]) than those without (78% [95%CI 77–79%]) COPD. Conclusions: The accuracy of clinician diagnosis for COVID-19 is adequate, regardless of gender, age, BMI, and asthma, and thus can be used for screening purposes to supplement RT-PCR. [ABSTRACT FROM AUTHOR]

Aim: The study aims to compare the use of clinical probing and Cone Beam Computed Tomography (CBCT) in the diagnosis of furcation involvement (FI) in patients with periodontitis. Methods and materials: Twenty-two patients, aged 30 to 65 years with periodontitis were included in the study. The patients who visited from April 2021 to May 2022 were assessed based on selection criteria. A total of 135 teeth were checked for furcation involvement. Buccal, mesiopalatal, and distopalatal sites of maxillary molars and buccal and lingual sites of mandibular molars were examined clinically using a Nabers probe and radiographically by CBCT. Results: There was a significant difference between clinical and radiographic evaluations with the percentage of grade (III) cases detected with radiographic evaluation being significantly higher than that of clinical evaluation. The maxillary 1st molar 21 (60%) and maxillary 2nd molar had no furcation involvement on clinical evaluation. In Radiographic evaluation Grade I FI was more in maxillary first molars least in mandibular 2nd molar. Furcation involvement was detected clinically more on the buccal side, maxillary 1st molar and least detected at maxillary 2nd molar at MP and DP sides (0.00%) Radiographically the FI was detected more on the buccal side, maxillary 1st molar 14 (40.00%) and least detected at maxillary 1st molar at DP and MP side of maxillary 2nd molar (4.00%). Conclusion: CBCT was more reliable in the detection of grade III FI compared to clinical probing. It can be a useful tool in detecting maxillary furcations. This makes CBCT reliable in the diagnosis of furcation involvement compared to conventional methods. Dental implant planning made easy with CBCT scans as it is evaluated for its efficiency. [ABSTRACT FROM AUTHOR]

Background: Aspergillosis is a defiance in avian medicine, however between of Aspergillus species, 3 are the most frequently observed (A. flavus, A. fumigatus and A. niger). Psittaciformes present medical conditions related to the 3 species, however A. fumigatus is the most observed. The defiance of the diagnosis is related to fungus characteristics (they are saprophytic in healthy birds), the clinical signs and lesions, which are common to various respiratory diseases, and the difficulty to access specific diagnostic methods. Thus, we report a case of aspergillosis in a cockatiel, whose clinical diagnosis was confirmed by fungal culture of cloacal swab, and treatment with a fungistatic drug. Case: A female cockatiel, 2-month-old, not dewormed, presented diarrhea, sneezing and difficulty to gain weight, although eating well (extruded feed and supplementation with fruits and vegetables). At a clinical examination revealed body score (BCS) of 3 (scale 1 at 5), cloacal temperature (CT) of 40 °C, dilated nostrils and edema in the left eye region associated to evident hyperemia. Due to it has lived with another animal, was inferred that was hypovitaminosis A, by food dispute and/or dominance, or endoparasitosis, being prescribed vitamin A supplementation and deworming with ivermectin. The bird returned 15 days later, showing maintenance of weight loss, BCS 2, ruffled feathers and areas suggestive of apteriolysis in both forelimbs, respiratory difficulty and pulmonary and cranial air sacs rales, in addition presented wound in the pygostyle region and ventus, occasioned by attempted attack of a dog, and aggravated by self-mutilation. Due the worsening of the clinical condition, an oral cavity and cloacal swabs were collected to bacteriological and fungal culture. As treatment was prescribed: a natural tranquilizer, seeking to control the self-mutilation; doxycycline oral suspension, to treat a probable bacterial respiratory infection; and oral itraconazole suspension, manipulated and with a dose calculated by allometric scaling, being placed an elizabethan collar in order to prevent biting the pygostyle and ventus. With a positive result of the cloacal swab fungal culture for A. fumigatus, the doxycycline was discontinued. After the first 30 days of treatment with itraconazole, the patient returns to alert, weighing 95 g, BCS 3, with absence of respiratory signs and with signs of recent molting process. New swabs (oral and cloacal) were collected for repetition of bacterial and fungal cultures, being maintained the treatment with itraconazole. The results of both bacterial and fungal cultures were negative. At the end of the treatment with itraconazole, the patient returns demonstrating weight gain, EEC 3, CT of 42°C, uniform feather coverage and absence of any respiratory sign, being released by the clinician. Discussion: A preponderant factor in the treatment of various respiratory diseases in birds is the diagnosis, since many of diseases present the same clinical signs. Thus, the use of fungal culture was essential to determine the origin of the signs. Still, even with an accurate diagnosis, the clinician often comes up against the difficulty of treatment, especially in cases of mycotic infections. The knowledge about the best drug, considering the pharmacology, as well as the availability of concentrations and dosages marketed, in addition to the long period of treatment, can difficult or make impossible the case resolution. In fact, this is confirmed by the literature, where the most of aspergillosis diagnosis are post mortem, resulting from the delay in seeking veterinary care or in the administration of ineffective drugs. Thus, with this report, we sought to present a diagnostic tool, sometimes neglected, and a compilation with the main drugs and their effectiveness in the treatment of aspergillosis in Psittaciformes. [ABSTRACT FROM AUTHOR]

Complex genetic disease mechanisms, such as structural or non-coding variants, currently pose a substantial difficulty in frontline diagnostic tests. They thus may account for most unsolved rare disease patients regardless of the clinical phenotype. However, the clinical diagnosis can narrow the genetic focus to just a couple of genes for patients with well-established syndromes defined by prominent physical and/or unique biochemical phenotypes, allowing deeper analyses to consider complex genetic origin. Then, clinical-diagnosis-driven genome sequencing strategies may expedite the development of testing and analytical methods to account for complex disease mechanisms as well as to advance functional assays for the confirmation of complex variants, clinical management, and the development of new therapies. [ABSTRACT FROM AUTHOR]

The context of the Coronavirus pandemic has fundamentally changed the way we approach medical services. Beyond setting up new technological possibilities, it has propelled telemedicine to become a reality, bringing undeniable practical benefits. The questions that arise are both justified and worrying: can digitalization replace a direct interpersonal relationship that involves a physical examination, while preserving the quality of the medical act and the degree of patient satisfaction? Isn't there a risk that the digitization of the medical record will cancel out the deep human character of classical medicine that has evolved since the time of Hippocrates? Should the implementation of telemedicine be "the state-of-art" of modern medicine, in accordance with the co-evolution of digital technology? It is hard to believe that once used in this period, telemedicine will be abandoned. However, telemedicine must be analyzed not only in the short term but also in the long term, in order to be able to evaluate both its usefulness and possible deficiencies. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is one of the most common malignancies that is usually detected late in the clinic. The currently available diagnostic tools for CRC are either invasive or insensitive to early lesions due to the dearth of reliable biomarkers. In this study, we discovered that the extracellular vesicles (EVs) in the faeces of CRC patients can act as a potent biomarker for the non‐invasive diagnosis and prognosis of CRC. This finding is based on the identification of two transmembrane proteins—CD147 and A33—on faeces‐derived EVs (fEVs) that are intrinsically associated with CRC. The detection results show that the levels of CD147 and A33 on fEVs were upregulated in the CRC patients (n = 48), dramatically distinguishing them from the healthy donors (n = 16). The CD147/A33‐enriched EVs offer a clinical sensitivity of 89%, much higher than that (40%) of carcinoembryonic antigen (CEA), a clinically‐established serum biomarker for CRC diagnosis. In addition, the analysis of longitudinal faeces samples (n = 29) demonstrated that the CD147/A33‐enriched fEVs can be utilized to track the prognosis of CRC. Due to the high compliance of faeces‐based detection, the CD147/A33‐enriched fEVs could serve as new‐generation CRC biomarkers for large‐scale, non‐invasive CRC screening as well as real‐time monitoring of patient outcomes during clinical interventions. [ABSTRACT FROM AUTHOR]

In this paper an automatic lab-on-PCB system with pre-stored reagents is described. The releasing method of the reagents is biocompatible, easy to perform, and free of debris. In addition, the fabrication process is scalable to mass production. The PCB-chip consists of a PMMA microfluidic circuit, and a commercial Printed Circuit Board (PCB) with integrated sensors and actuators. The quantity of pre-stored reagent moved toward the microfluidic circuit is programmable. The PCB-chip requires a reader for controlling the whole process. The experimental results show the correct functioning of the device storing the reagent, releasing the correct amount of liquids and mixing the liquids. The detection by absorbance provide a linearity of $R^{2} = 0.9907$ with an error of 4,9%. A lab-on-PCB with pre-stored reagents, automatic microfluidic handling, and integrated sensors and actuators for biomedical applications is described. The PCB-chip could be modified in order to perform different biochemical analysis. The characteristics of the proposed lab-on-PCB system make it very attractive from the market point of view, mainly thank to its portability due to the capability of pre-storing reagents, together with its low cost and its scalability to mass production. [2022-0123] [ABSTRACT FROM AUTHOR]

Background: Acute abdomen is the most commonly attended surgical emergency. It can be caused by intra-abdominal, extra-abdominal and metabolic causes. A few imaging modalities are at disposal of primary care physicians like plain x-ray and ultrasonography. Materials and Methods: This study has been done to compare the efficacy of clinical diagnosis, plain radiography and sonography in diagnosis of non-traumatic acute abdomen. Every patient under study admitted in the Department of General Surgery underwent thorough clinical evaluation, biochemical investigations, X-rays and sonography. Findings of clinical evaluation, X-Rays and sonography were compared to the final diagnosis found intraoperatively. Results: Clinical diagnosis was made in 47 (94%) out of 50 patients. X-rays were able to diagnose in 20 patients (40%) whereas sonography diagnosed 26 patients (52%). Conclusion: The present study showed that clinical evaluation, x-rays or Ultrasound alone are not sufficient to diagnose cause of non-traumatic acute abdomen in all cases. Clinical evaluation combined with x-rays and ultrasound increases the number and accuracy of pre-operative diagnosis in non-traumatic acute abdomen. [ABSTRACT FROM AUTHOR]

Simple Summary: The primary purpose of this review is to provide an in-depth analysis of existing Artificial Intelligence (AI) algorithms used in the field of prostate cancer (PC) for diagnosis and treatment. This review aims to show the research community that AI-enabled technologies have the potential for widespread growth and penetration of PC diagnostics and therapeutics to simplify and accelerate existing healthcare processes. As medical science and technology progress towards the era of "big data", a multi-dimensional dataset pertaining to medical diagnosis and treatment is becoming accessible for mathematical modelling. However, these datasets are frequently inconsistent, noisy, and often characterized by a significant degree of redundancy. Thus, extensive data processing is widely advised to clean the dataset before feeding it into the mathematical model. In this context, Artificial intelligence (AI) techniques, including machine learning (ML) and deep learning (DL) algorithms based on artificial neural networks (ANNs) and their types, are being used to produce a precise and cross-sectional illustration of clinical data. For prostate cancer patients, datasets derived from the prostate-specific antigen (PSA), MRI-guided biopsies, genetic biomarkers, and the Gleason grading are primarily used for diagnosis, risk stratification, and patient monitoring. However, recording diagnoses and further stratifying risks based on such diagnostic data frequently involves much subjectivity. Thus, implementing an AI algorithm on a PC's diagnostic data can reduce the subjectivity of the process and assist in decision making. In addition, AI is used to cut down the processing time and help with early detection, which provides a superior outcome in critical cases of prostate cancer. Furthermore, this also facilitates offering the service at a lower cost by reducing the amount of human labor. Herein, the prime objective of this review is to provide a deep analysis encompassing the existing AI algorithms that are being deployed in the field of prostate cancer (PC) for diagnosis and treatment. Based on the available literature, AI-powered technology has the potential for extensive growth and penetration in PC diagnosis and treatment to ease and expedite the existing medical process. [ABSTRACT FROM AUTHOR]

Ultrasound flow imaging has long been used for cardiovascular diagnostics. Color Doppler imaging (CDI) is the predominant ultrasound flow imaging mode, but its diagnostic value is hampered by aliasing artifacts that limit the range of detectable blood velocities. Here, we present the first demonstration of how edge artificial intelligence (AI) can enable real-time CDI with aliasing resistance. Specifically, graphical processing unit acceleration and AI-ready edge computing hardware have been leveraged to realize the first end-to-end CDI processing pipeline that involves AI-based aliasing correction. Performance results show that, using our edge AI engine, aliasing-resistant CDI frames with threefold velocity detection range can be generated at a real-time frame rate of 25 frames per second (for raw datasets with 192 channels, 12-bit data resolution, and 25-MHz sampling rate). Overall, edge AI can critically improve the real-time visualization quality of ultrasound flow imaging and, in turn, potentially transform its bedside application value. [ABSTRACT FROM AUTHOR]

The blood, body fluid and other samples of patients collected by clinical laboratory can be detected to find disease markers through different methods, so as to provide clinicians with an important basis for disease prevention, diagnosis, curative effect and prognosis. LC-MS/MS is an analytical instrument with high sensitivity, high specificity, high resolution and high efficiency. In recent years, with the improvement of instrument sensitivity, LC-MS/MS showed great superiority, practicability and development potential in analytical and clinical practices, thus many diseases can be diagnosed accurately, quickly and sensitively in the early stage. For example, LC-MS/MS was used for neonatal screening, and it could screen more than 30 disease markers including various amino acids and carnitine simultaneously. Comparing with immunoassay, LC-MS/MS applied to endocrine hormones can simultaneously determine a variety of analytes and provide structural information of analytes. It has the advantages of high throughput and high specificity. Due to the expensive instruments and the cost of training, only a few clinical laboratories have the ability to develop and verify LC-MS/MS method. Based on the inherent limitations of the instrument, such as matrix effect and ion suppression effect, the efficiency of the method was decreased, resulting in challenges in the process of method development. In addition, the technical levels of different clinical laboratories are uneven, so it is necessary to establish corresponding reference measurement methods and reference ranges for clinical analysis. The standardization of quantitative results is significant for laboratory to build the traceability system. The research progress of the application of LC-MS/MS in clinical practices was introduced, and the advantages and disadvantages of the application of LC-MS/MS in neonatal screening, vitamin D detection, endocrine hormone detection, therapeutic drug concentration monitoring and protein quantitative analysis were discussed in the review. Finally the possible challenges and the recent advancement that clinical laboratories may confront in the application of LC-MS/MS were discussed. [ABSTRACT FROM AUTHOR]