33 results on '"Diagnostic Advances"'
Search Results
2. The Prognostic Value of Serum Calcium Levels in Elderly Dilated Cardiomyopathy Patients
- Author
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Xinyi Li, Wenfei He, Qiqi Song, Qingshan Ding, Xiaonan Zhang, Zhigang Zeng, Weiping Deng, Gang Deng, Lichang Guan, Wanzi Hong, Yaoxin Liu, Fen Shu, Lishu Xu, Ning Tan, Jinjin Ma, and Lei Jiang
- Subjects
biomarkers ,clinical study ,diagnostic advances ,geriatric cardiomyopathy ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Public aspects of medicine ,RA1-1270 - Abstract
Background: It is unclear whether serum calcium on admission is associated with clinical outcomes in dilated cardiomyopathy (DCM). In this study, we conducted a retrospective study spanning a decade to investigate the prognostic value of baseline calcium in elderly patients with DCM. Methods: A total of 1,089 consecutive elderly patients (age ≥60 years) diagnosed with DCM were retrospectively enrolled from January 2010 to December 2019. Univariate and multivariate analyses were performed to investigate the association of serum calcium with their clinical outcomes. Results: In this study, the average age of the subjects was 68.36 ± 6.31 years. Receiver operating characteristic (ROC) curve analysis showed that serum calcium level had a great sensitivity and specificity for predicting in-hospital death, with an AUC of 0.732. Kaplan–Meier survival analysis showed that patients with a serum calcium >8.62 mg/dL had a better prognosis than those with a serum calcium ≤8.62 mg/dL (log-rank χ2 40.84, p < 0.001). After adjusting for several common risk factors, a serum calcium ≤8.62 mg/dL was related to a higher risk of long-term mortality (HR: 1.449; 95% CI: 1.115~1.882; p = 0.005). Conclusions: Serum calcium level could be served as a simple and affordable tool to evaluate patients’ prognosis in DCM.
- Published
- 2024
- Full Text
- View/download PDF
3. Exploring novel protein-based biomarkers for advancing breast cancer diagnosis: A review.
- Author
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Vellan, Christina Jane, Islam, Tania, De Silva, Sumadee, Mohd Taib, Nur Aishah, Prasanna, Galhena, and Jayapalan, Jaime Jacqueline
- Subjects
- *
CANCER diagnosis , *BIOMARKERS , *INDIVIDUALIZED medicine , *BREAST cancer , *SAMPLING (Process) - Abstract
• Novel protein biomarkers has the potential to revolutionise breast cancer diagnosis. • These biomarkers can enhance diagnostic accuracy and enable the identification of cancer subtypes for tailored treatments as well as minimising overtreatment. • These novel proteomic markers may eventually complement or offer alternatives to existing diagnostic tools for breast cancer. • Integration of these biomarkers into clinical practice, underscores their potential to improve patient outcomes and quality of life significantly. This review provides a contemporary examination of the evolving landscape of breast cancer (BC) diagnosis, focusing on the pivotal role of novel protein-based biomarkers. The overview begins by elucidating the multifaceted nature of BC, exploring its prevalence, subtypes, and clinical complexities. A critical emphasis is placed on the transformative impact of proteomics, dissecting the proteome to unravel the molecular intricacies of BC. Navigating through various sources of samples crucial for biomarker investigations, the review underscores the significance of robust sample processing methods and their validation in ensuring reliable outcomes. The central theme of the review revolves around the identification and evaluation of novel protein-based biomarkers. Cutting-edge discoveries are summarised, shedding light on emerging biomarkers poised for clinical application. Nevertheless, the review candidly addresses the challenges inherent in biomarker discovery, including issues of standardisation, reproducibility, and the complex heterogeneity of BC. The future direction section envisions innovative strategies and technologies to overcome existing challenges. In conclusion, the review summarises the current state of BC biomarker research, offering insights into the intricacies of proteomic investigations. As precision medicine gains momentum, the integration of novel protein-based biomarkers emerges as a promising avenue for enhancing the accuracy and efficacy of BC diagnosis. This review serves as a compass for researchers and clinicians navigating the evolving landscape of BC biomarker discovery, guiding them toward transformative advancements in diagnostic precision and personalised patient care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Advances in the Diagnosis and Treatment of Follicular Thyroid Carcinoma: A Comprehensive Review.
- Author
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Gopalan V, Deshpande SG, Zade AA, Tote D, Rajendran R, Durge S, and Bhargava A
- Abstract
Follicular thyroid carcinoma (FTC) is the second most common type of thyroid cancer, presenting unique diagnostic and therapeutic challenges. This review provides a comprehensive analysis of the recent advancements in the diagnosis and treatment of FTC, emphasizing the significance of these developments in improving patient outcomes. We discuss the evolution of diagnostic techniques, including advancements in imaging modalities, fine needle aspiration biopsy, and molecular diagnostics, which have enhanced the accuracy of FTC detection and differentiation from benign conditions. The review also evaluates current treatment strategies, including surgical interventions, radioactive iodine therapy, and targeted therapies, examining their effectiveness and impact on patient prognosis. Additionally, we address ongoing challenges in FTC management, such as variability in treatment guidelines and disparities in care. Finally, the review explores emerging therapies and future research directions, highlighting innovations that may further optimize FTC management. By synthesizing current knowledge and identifying future research opportunities, this review aims to contribute to refining diagnostic and therapeutic approaches for FTC., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gopalan et al.)
- Published
- 2024
- Full Text
- View/download PDF
5. The Prognostic Value of Serum Calcium Levels in Elderly Dilated Cardiomyopathy Patients.
- Author
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Li X, He W, Song Q, Ding Q, Zhang X, Zeng Z, Deng W, Deng G, Guan L, Hong W, Liu Y, Shu F, Xu L, Tan N, Ma J, and Jiang L
- Subjects
- Aged, Humans, Middle Aged, Prognosis, Retrospective Studies, Hospital Mortality, Calcium, Cardiomyopathy, Dilated diagnosis
- Abstract
Background: It is unclear whether serum calcium on admission is associated with clinical outcomes in dilated cardiomyopathy (DCM). In this study, we conducted a retrospective study spanning a decade to investigate the prognostic value of baseline calcium in elderly patients with DCM., Methods: A total of 1,089 consecutive elderly patients (age ≥60 years) diagnosed with DCM were retrospectively enrolled from January 2010 to December 2019. Univariate and multivariate analyses were performed to investigate the association of serum calcium with their clinical outcomes., Results: In this study, the average age of the subjects was 68.36 ± 6.31 years. Receiver operating characteristic (ROC) curve analysis showed that serum calcium level had a great sensitivity and specificity for predicting in-hospital death, with an AUC of 0.732. Kaplan-Meier survival analysis showed that patients with a serum calcium >8.62 mg/dL had a better prognosis than those with a serum calcium ≤8.62 mg/dL (log-rank χ
2 40.84, p < 0.001). After adjusting for several common risk factors, a serum calcium ≤8.62 mg/dL was related to a higher risk of long-term mortality (HR: 1.449; 95% CI: 1.115~1.882; p = 0.005)., Conclusions: Serum calcium level could be served as a simple and affordable tool to evaluate patients' prognosis in DCM., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)- Published
- 2024
- Full Text
- View/download PDF
6. An Overview on the Histogenesis and Morphogenesis of Salivary Gland Neoplasms and Evolving Diagnostic Approaches
- Author
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Janaki Iyer, Arvind Hariharan, Uyen Minh Nha Cao, Crystal To Tam Mai, Athena Wang, Parisa Khayambashi, Bich Hong Nguyen, Lydia Safi, and Simon D. Tran
- Subjects
salivary glands ,salivary gland neoplasms ,epithelial tumors ,head and neck cancer ,molecular pathology ,diagnostic advances ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Salivary gland neoplasms (SGN) remain a diagnostic dilemma due to their heterogenic complex behavior. Their diverse histomorphological appearance is attributed to the underlying cellular mechanisms and differentiation into various histopathological subtypes with overlapping fea-tures. Diagnostic tools such as fine needle aspiration biopsy, computerized tomography, magnetic resonance imaging, and positron emission tomography help evaluate the structure and assess the staging of SGN. Advances in molecular pathology have uncovered genetic patterns and oncogenes by immunohistochemistry, fluorescent in situ hybridization, and next–generation sequencing, that may potentially contribute to innovating diagnostic approaches in identifying various SGN. Surgical resection is the principal treatment for most SGN. Other modalities such as radiotherapy, chemotherapy, targeted therapy (agents like tyrosine kinase inhibitors, monoclonal antibodies, and proteasome inhibitors), and potential hormone therapy may be applied, depending on the clinical behaviors, histopathologic grading, tumor stage and location, and the extent of tissue invasion. This review delves into the molecular pathways of salivary gland tumorigenesis, highlighting recent diagnostic protocols that may facilitate the identification and management of SGN.
- Published
- 2021
- Full Text
- View/download PDF
7. Recent advances in the management of allergy associated diseases in children.
- Author
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ZHU, L., ZHU, F., and ZHANG, Z.-K.
- Abstract
The allergy symptoms could arise from variable organ systems and have fluctuating nature in severity as well as symptoms. Moreover, these symptoms could be related to multiple pathological states like common cold, chronic obstipation, diarrhea, etc. On the other hand, food allergy diagnosis that usually spread by IgE-mediated inhalant also poses a great challenge in front of the scientific fraternity. So far, many advances in the field of allergy diagnosis, as well as therapeutics, have been made. These advances include skin prick testing (SPT), serum specific IgE (sIgE) level test, component resolved diagnosis (CRD) test, etc. The present review article would be focused on important pathological states associated with allergy observed commonly in children. Moreover, tjelatest developments about timely management and accurate diagnosis are also discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2018
8. An Overview on the Histogenesis and Morphogenesis of Salivary Gland Neoplasms and Evolving Diagnostic Approaches
- Author
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Arvind Hariharan, Lydia Safi, Uyen Minh Nha Cao, Janaki Iyer, Crystal To Tam Mai, Bich Hong Nguyen, Simon D. Tran, Athena Wang, and Parisa Khayambashi
- Subjects
0301 basic medicine ,Cancer Research ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,salivary glands ,Review ,Targeted therapy ,03 medical and health sciences ,0302 clinical medicine ,molecular pathology ,Biopsy ,otorhinolaryngologic diseases ,Medicine ,Grading (tumors) ,RC254-282 ,medicine.diagnostic_test ,Salivary gland ,business.industry ,Molecular pathology ,diagnostic advances ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Radiation therapy ,salivary gland neoplasms ,030104 developmental biology ,medicine.anatomical_structure ,Fine-needle aspiration ,Oncology ,030220 oncology & carcinogenesis ,Immunohistochemistry ,epithelial tumors ,head and neck cancer ,business - Abstract
Simple Summary Diagnosing salivary gland neoplasms (SGN) remain a challenge, given their underlying biological nature and overlapping features. Evolving techniques in molecular pathology have uncovered genetic mutations resulting in these tumors. This review delves into the molecular etiopatho-genesis of SGN, highlighting advanced diagnostic protocols that may facilitate the identification and therapy of a variety of SGN. Abstract Salivary gland neoplasms (SGN) remain a diagnostic dilemma due to their heterogenic complex behavior. Their diverse histomorphological appearance is attributed to the underlying cellular mechanisms and differentiation into various histopathological subtypes with overlapping fea-tures. Diagnostic tools such as fine needle aspiration biopsy, computerized tomography, magnetic resonance imaging, and positron emission tomography help evaluate the structure and assess the staging of SGN. Advances in molecular pathology have uncovered genetic patterns and oncogenes by immunohistochemistry, fluorescent in situ hybridization, and next–generation sequencing, that may potentially contribute to innovating diagnostic approaches in identifying various SGN. Surgical resection is the principal treatment for most SGN. Other modalities such as radiotherapy, chemotherapy, targeted therapy (agents like tyrosine kinase inhibitors, monoclonal antibodies, and proteasome inhibitors), and potential hormone therapy may be applied, depending on the clinical behaviors, histopathologic grading, tumor stage and location, and the extent of tissue invasion. This review delves into the molecular pathways of salivary gland tumorigenesis, highlighting recent diagnostic protocols that may facilitate the identification and management of SGN.
- Published
- 2021
9. New approaches and emerging technologies in the diagnosis of childhood tuberculosis.
- Author
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Marais, Ben J. and Pai, Madhukar
- Subjects
TUBERCULOSIS in children ,DIAGNOSIS ,HIV-positive persons ,LUNG diseases ,PEDIATRIC respiratory diseases - Abstract
Summary: Childhood tuberculosis (TB) has long been neglected by TB control programmes, as children tend to develop sputum smear-negative disease and rarely contribute to disease transmission. However, children suffer severe TB-related morbidity and mortality in areas with endemic TB and carry a significant proportion of the global disease burden. Apart from improved control of the global TB epidemic, access to accurate diagnosis and effective treatment is essential to reduce the disease burden associated with childhood TB. Access to child friendly anti-TB treatment is improving, but establishing an accurate diagnosis remains a challenge. This review provides an overview of recent advances in the diagnosis of childhood TB, focusing on bacteriological, immunological, radiological and symptom-based approaches. It is possible to establish a fairly accurate diagnosis of either latent infection or active TB in immunocompetent children, even in resource-limited settings, but establishing an accurate diagnosis of TB in HIV-infected (immunocompromised) children remains a major challenge. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
- View/download PDF
10. Accurate diagnosis of prenatal cleft lip/palate by understanding the embryology
- Author
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Mireille Bekker, Bram Smarius, Charlotte Loozen, Wendy Manten, Lou R. Pistorius, and Corstiaan C. Breugem
- Subjects
0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Cleft lip palate ,business.industry ,Cleft lip ,Orofacial clefts ,Congenital malformations ,030105 genetics & heredity ,03 medical and health sciences ,0302 clinical medicine ,Diagnostic Advances ,Cleft palate ,Ultrasound screening ,Embryology ,Embryology face ,Ultrasound ,medicine ,business - Abstract
Cleft lip with or without cleft palate (CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. The face and palate develop in a very characteristic way. For ultrasonographers involved in screening these patients it is crucial to have a thorough understanding of the embryology of the face. This could help them to make a more accurate diagnosis and save time during the ultrasound. Subsequently, the current postnatal classification will be discussed to facilitate the communication with the CP teams.
- Published
- 2017
11. Establishing the presence or absence of chronic kidney disease: Uses and limitations of formulas estimating the glomerular filtration rate
- Author
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Christos Argyropoulos, Helbert Rondon-Berrios, Mark Rohrscheib, Deepak Malhotra, Antonios H. Tzamaloukas, Joseph I. Shapiro, Dominic S. Raj, Zeid J. Khitan, and Ahmed Alaini
- Subjects
Oncology ,medicine.medical_specialty ,Hyperfiltration ,030232 urology & nephrology ,Renal function ,030204 cardiovascular system & hematology ,Biomarkers of chronic kidney disease ,urologic and male genital diseases ,Age and gender ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Chronic kidney disease ,Creatinine excretion ,medicine ,Estimated glomerular filtration rate ,Cystatin C ,Creatinine ,biology ,business.industry ,Renal tissue ,Renal imaging ,medicine.disease ,female genital diseases and pregnancy complications ,3. Good health ,Serum creatinine ,Creatinine clearance ,chemistry ,Diagnostic Advances ,Albuminuria ,biology.protein ,Cystatin ,medicine.symptom ,business ,Kidney disease - Abstract
The development of formulas estimating glomerular filtration rate (eGFR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease (CKD), which is based on eGFR values and albuminuria. This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course. Disagreements between creatinine-based and cystatin-based eGFR values and between eGFR values and measured GFR have been reported in various cohorts. These disagreements are the consequence of variations in the rate of production and in factors, other than GFR, affecting the rate of removal of creatinine and cystatin C. The disagreements create limitations for all eGFR formulas developed so far. The main limitations are low sensitivity in detecting early CKD in several subjects, e.g., those with hyperfiltration, and poor prediction of the course of CKD. Research efforts in CKD are currently directed towards identification of biomarkers that are better indices of GFR than the current biomarkers and, particularly, biomarkers of early renal tissue injury.
- Published
- 2017
12. Non-invasive evaluation of intestinal disorders: The role of elastographic techniques
- Author
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Flavio Caprioli, Mirella Fraquelli, Stefania Orlando, Federica Branchi, and Dario Conte
- Subjects
medicine.medical_specialty ,Disease ,Inflammatory bowel disease ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Predictive Value of Tests ,medicine ,Humans ,Bowel wall ,medicine.diagnostic_test ,business.industry ,Non invasive ,Gastroenterology ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Prognosis ,Appendicitis ,digestive system diseases ,Intestines ,Intestinal Diseases ,Diagnostic Advances ,Elasticity Imaging Techniques ,030211 gastroenterology & hepatology ,Radiology ,Elastography ,Intestinal Disorder ,business ,Stricture - Abstract
Over the recent years the non-invasive techniques for the evaluation of the small bowel have been playing a major role in the management of chronic intestinal diseases, such as inflammatory bowel diseases (IBD). The diagnostic performances of magnetic resonance imaging, computed tomography and ultrasound in the field of small bowel disorders, have been assessed and established for more than two decades. Newer sonographic techniques, such as strain elastography and shear wave elastography, have been put forward for the assessment of disease activity and characterization of IBD-related damage in the setting of Crohn's disease and other gastrointestinal disorders. The data from the preliminary research and clinical studies have shown promising results as regards the ability of elastographic techniques to differentiate inflammatory from fibrotic tissue. The distinction between IBD activity (inflammation) and IBD-related damage (fibrosis) is currently considered crucial for the assessment and management of patients. Moreover, all the elastographic techniques are currently being considered in the setting of other intestinal disorders (e.g., rectal tumors, appendicitis). The aim of this paper is to offer both a comprehensive narrative review of the non-invasive techniques available for the assessment of small-bowel disorders, with particular emphasis on inflammatory bowel diseases, and a summary of the current evidence on the use of elastographic techniques in this setting.
- Published
- 2017
13. Practice guidelines for the pathological diagnosis of primary liver cancer: 2015 update
- Author
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Wen-Ming Cong, Hong Bu, Jie Chen, Hui Dong, Yu-Yao Zhu, Long-Hai Feng, Jun Chen, and Guideline Committee
- Subjects
medicine.medical_specialty ,Pathology ,Consensus ,Hepatocellular carcinoma ,medicine.medical_treatment ,Biopsy ,Liver transplantation ,Practice guidelines ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Diagnosis ,medicine ,Biomarkers, Tumor ,Humans ,Sampling (medicine) ,Medical diagnosis ,Pathological ,Intrahepatic cholangiocarcinoma ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Gastroenterology ,Reproducibility of Results ,General Medicine ,Guideline ,Hepatology ,medicine.disease ,Immunohistochemistry ,Molecular Diagnostic Techniques ,Diagnostic Advances ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,Neoplasm Grading ,business ,Liver cancer - Abstract
In 2010, a panel of Chinese pathologists reported the first expert consensus for the pathological diagnosis of primary liver cancers to address the many contradictions and inconsistencies in the pathological characteristics and diagnostic criteria for PLC. Since then considerable clinicopathological studies have been conducted globally, prompting us to update the practice guidelines for the pathological diagnosis of PLC. In April 18, 2014, a Guideline Committee consisting of 40 specialists from seven Chinese Societies (including Chinese Society of Liver Cancer, Chinese Anti-Cancer Association; Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Pathology, Chinese Anti-Cancer Association; Digestive Disease Group, Chinese Society of Pathology, Chinese Medical Association; Chinese Society of Surgery, Chinese Medical Association; Chinese Society of Clinical Oncology, Chinese Anti-Cancer Association; Pathological Group of Hepatobiliary Tumor and Liver Transplantation, Chinese Society of Pathology, Chinese Medical Association) was created for the formulation of the first guidelines for the standardization of the pathological diagnosis of PLC, mainly focusing on the following topics: gross specimen sampling, concepts and diagnostic criteria of small hepatocellular carcinoma (SHCC), microvascular invasion (MVI), satellite nodules, and immunohistochemical and molecular diagnosis. The present updated guidelines are reflective of current clinicopathological studies, and include a novel 7-point baseline sampling protocol, which stipulate that at least four tissue specimens should be sampled at the junction of the tumor and adjacent liver tissues in a 1:1 ratio at the 12, 3, 6 and 9 o'clock reference positions. For the purposes of molecular pathological examination, at least one specimen should be sampled at the intratumoral zone, but more specimens should be sampled for tumors harboring different textures or colors. Specimens should be sampled at both adjacent and distant peritumoral liver tissues or the tumor margin in order to observe MVI, satellite nodules and dysplastic foci/nodules distributed throughout the background liver tissues. Complete sampling of whole SHCC ≤ 3 cm should be performed to assess its biological behavior, and in clinical practice, therapeutic borders should be also preserved, even in SHCC. The diagnostic criteria of MVI and satellite nodules, immunohistochemical panels, as well as molecular diagnostic principles, such as clonal typing, for recurrent HCC and multinodule HCC were also proposed and recommended. The standardized process of pathological examination is aimed at ensuring the accuracy of pathological PLC diagnoses as well as providing a valuable frame of reference for the clinical assessment of tumor invasive potential, the risk of postoperative recurrence, long-term survival, and the development of individualized treatment regimens. The updated guidelines could ensure the accuracy of pathological diagnoses of PLC, and provide a valuable frame of reference for its clinical assessment.
- Published
- 2016
14. An Overview on the Histogenesis and Morphogenesis of Salivary Gland Neoplasms and Evolving Diagnostic Approaches.
- Author
-
Iyer, Janaki, Hariharan, Arvind, Cao, Uyen Minh Nha, Mai, Crystal To Tam, Wang, Athena, Khayambashi, Parisa, Nguyen, Bich Hong, Safi, Lydia, and Tran, Simon D.
- Subjects
- *
THERAPEUTIC use of monoclonal antibodies , *SALIVARY gland tumors , *MORPHOGENESIS , *THERAPEUTICS , *SEQUENCE analysis , *HORMONES , *IMMUNOHISTOCHEMISTRY , *CANCER chemotherapy , *CANCER invasiveness , *MAGNETIC resonance imaging , *TUMOR classification , *PROTEIN-tyrosine kinase inhibitors , *FLUORESCENCE in situ hybridization , *COMPUTED tomography , *NEEDLE biopsy , *TUMOR grading , *EVALUATION - Abstract
Simple Summary: Diagnosing salivary gland neoplasms (SGN) remain a challenge, given their underlying biological nature and overlapping features. Evolving techniques in molecular pathology have uncovered genetic mutations resulting in these tumors. This review delves into the molecular etiopatho-genesis of SGN, highlighting advanced diagnostic protocols that may facilitate the identification and therapy of a variety of SGN. Salivary gland neoplasms (SGN) remain a diagnostic dilemma due to their heterogenic complex behavior. Their diverse histomorphological appearance is attributed to the underlying cellular mechanisms and differentiation into various histopathological subtypes with overlapping fea-tures. Diagnostic tools such as fine needle aspiration biopsy, computerized tomography, magnetic resonance imaging, and positron emission tomography help evaluate the structure and assess the staging of SGN. Advances in molecular pathology have uncovered genetic patterns and oncogenes by immunohistochemistry, fluorescent in situ hybridization, and next–generation sequencing, that may potentially contribute to innovating diagnostic approaches in identifying various SGN. Surgical resection is the principal treatment for most SGN. Other modalities such as radiotherapy, chemotherapy, targeted therapy (agents like tyrosine kinase inhibitors, monoclonal antibodies, and proteasome inhibitors), and potential hormone therapy may be applied, depending on the clinical behaviors, histopathologic grading, tumor stage and location, and the extent of tissue invasion. This review delves into the molecular pathways of salivary gland tumorigenesis, highlighting recent diagnostic protocols that may facilitate the identification and management of SGN. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
15. New endoscopy advances to refine adenoma detection rate for colorectal cancer screening: None is the winner
- Author
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Marcello Maida, M Manganaro, S. Garufi, G. Scarpulla, and S. Camilleri
- Subjects
medicine.medical_specialty ,Endoscope ,Adenoma ,Colorectal cancer ,Colonoscopy ,Disease ,Chromoendoscopy ,Colorectal cancer screening ,03 medical and health sciences ,0302 clinical medicine ,medicine ,medicine.diagnostic_test ,business.industry ,General surgery ,Gastroenterology ,Cancer ,medicine.disease ,Endoscopy ,Editorial ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Diagnostic advances ,business ,Adenoma detection rate - Abstract
Colorectal cancer (CRC) is the third most common cancer in males and second in females, and globally the fourth cause for cancer death worldwide. Oncological screening of CRC has a major role in the management of the disease and it is mostly performed by colonoscopy. Anyway, effectiveness of endoscopic screening for CRC strictly depends on adequate detection and removal of potentially precancerous lesions, and accuracy of colonoscopy in detection of adenomas is still suboptimal. For this reason, several technological advances have been implemented in order to improve the diagnostic sensitivity of colonoscopy in adenoma detection. Among these: (1) Visual technologies such as chromoendoscopy and narrow band imaging; (2) optical innovation as high definition endoscopy, full-spectrum endoscopy or Third Eye Retroscope; and (3) mechanical advances as Cap assisted colonoscopy, Endocuff, Endoring and G-Eye endoscope. All these technologies advances have been tested over time by clinical studies with mixed results. Which of them is more likely to be successful in the next future?
- Published
- 2017
16. Nuclear medicine imaging in osteonecrosis of hip: Old and current concepts
- Author
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Kanhaiyalal Agrawal, Sujit Kumar Tripathy, Ramesh Kumar Sen, Anish Bhattacharya, and Sampath Santhosh
- Subjects
medicine.medical_specialty ,Avascular necrosis ,Single-photon emission computed tomography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Femoral head ,0302 clinical medicine ,Magnetic resonance imaging ,Nuclear medicine imaging ,Photon emission computed tomography scan ,medicine ,Orthopedics and Sports Medicine ,medicine.diagnostic_test ,business.industry ,Osteonecrosis ,Bone scan ,medicine.disease ,medicine.anatomical_structure ,Positron emission tomography ,Diagnostic Advances ,030220 oncology & carcinogenesis ,Blood supply ,Single photon emission computed tomography/computed tomography ,Radiology ,Early phase ,business - Abstract
Osteonecrosis (ON) is caused by inadequate blood supply leading to bone death, which results in the collapse of the architectural bony structure. Femoral head is the most common site involved in ON. Magnetic resonance imaging (MRI) is a commonly used imaging modality to detect early ON. When MRI is inconclusive, bone scan is helpful in detecting ON during early phase of the disease. As newer nuclear medicine equipment, like single photon emission computed tomography/computed tomography (CT) and positron emission tomography/CT, are emerging in medical science, we review the role of these imaging modalities in ON of femoral head.
- Published
- 2017
17. Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis
- Author
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Massimiliano Motton, Gino Puntel, Simone Perandini, Laura Spezia, Giuseppe Sala, M. Signorini, Federico Zamboni, Gian Alberto Soardi, Stefania Montemezzi, Arianna Rossi, Raffaele Augelli, and Chiara Dallaserra
- Subjects
Solitary pulmonary nodule ,medicine.medical_specialty ,Bayesian prediction ,Computer-aided diagnosis ,Lung neoplasms ,Multidetector computed tomography ,business.industry ,Bayesian probability ,medicine.disease ,030218 nuclear medicine & medical imaging ,Bayesian Prediction ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Diagnostic Advances ,medicine ,Radiology ,business - Abstract
The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions. Raters' predictions were evaluated by means of receiver operating characteristic (ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions (P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs (15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses (mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization.
- Published
- 2016
18. Potential of hybrid adaptive filtering in inflammatory lesion detection from capsule endoscopy images
- Author
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Vasileios Charisis and Leontios J. Hadjileontiadis
- Subjects
Crohn’s disease ,medicine.medical_specialty ,Pathology ,Support Vector Machine ,Normal Distribution ,02 engineering and technology ,Capsule Endoscopy ,Sensitivity and Specificity ,law.invention ,Pattern Recognition, Automated ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Capsule endoscopy ,law ,Image Interpretation, Computer-Assisted ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Curvelet ,Image Processing, Computer-Assisted ,Humans ,Diagnosis, Computer-Assisted ,Inflammatory lesion ,Ulcer ,Inflammation ,Crohn's disease ,business.industry ,Gastroenterology ,Reproducibility of Results ,General Medicine ,Genetic algorithms ,medicine.disease ,Adaptive filter ,Diagnostic Advances ,030211 gastroenterology & hepatology ,020201 artificial intelligence & image processing ,Radiology ,business ,Algorithms ,Software - Abstract
A new feature extraction technique for the detection of lesions created from mucosal inflammations in Crohn’s disease, based on wireless capsule endoscopy (WCE) images processing is presented here. More specifically, a novel filtering process, namely Hybrid Adaptive Filtering (HAF), was developed for efficient extraction of lesion-related structural/textural characteristics from WCE images, by employing Genetic Algorithms to the Curvelet-based representation of images. Additionally, Differential Lacunarity (DLac) analysis was applied for feature extraction from the HAF-filtered images. The resulted scheme, namely HAF-DLac, incorporates support vector machines for robust lesion recognition performance. For the training and testing of HAF-DLac, an 800-image database was used, acquired from 13 patients who undertook WCE examinations, where the abnormal cases were grouped into mild and severe, according to the severity of the depicted lesion, for a more extensive evaluation of the performance. Experimental results, along with comparison with other related efforts, have shown that the HAF-DLac approach evidently outperforms them in the field of WCE image analysis for automated lesion detection, providing higher classification results, up to 93.8% (accuracy), 95.2% (sensitivity), 92.4% (specificity) and 92.6% (precision). The promising performance of HAF-DLac paves the way for a complete computer-aided diagnosis system that could support physicians’ clinical practice.
- Published
- 2016
19. Cardiovascular magnetic resonance: Diagnostic utility and specific considerations in the pediatric population
- Author
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Vassilios S. Vassiliou, Gerald F. Greil, Claire E. Raphael, Peter Drivas, Frances M. Mitchell, and Sanjay K Prasad
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Cardiology ,Magnetic resonance imaging ,Disease ,030204 cardiovascular system & hematology ,Pediatrics ,030218 nuclear medicine & medical imaging ,Imaging ,Clinical Practice ,03 medical and health sciences ,Patient population ,0302 clinical medicine ,Diagnostic Advances ,Pediatrics, Perinatology and Child Health ,Diagnosis ,medicine ,Medical physics ,Cardiovascular magnetic resonance ,business ,Pediatric population - Abstract
Cardiovascular magnetic resonance is a non-invasive imaging modality which is emerging as important tool for the investigation and management of pediatric cardiovascular disease. In this review we describe the key technical and practical differences between scanning children and adults, and highlight some important considerations that must be taken into account for this patient population. Using case examples commonly seen in clinical practice, we discuss the important clinical applications of cardiovascular magnetic resonance, and briefly highlight key future developments in this field.
- Published
- 2016
20. Role of computed tomography angiography in detection and staging of small bowel carcinoid tumors
- Author
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Karen M. Horton, Siva P. Raman, Elliot K. Fishman, and David Bonekamp
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Carcinoid tumors ,Small bowel adenocarcinoma ,Neuroendocrine tumors ,Malignancy ,medicine.disease ,Primary tumor ,digestive system diseases ,medicine.anatomical_structure ,Diagnostic Advances ,Maximum intensity projection ,medicine ,Radiology ,Mesentery ,business ,Computed tomography angiography - Abstract
Small-bowel carcinoid tumors are the most common form (42%) of gastrointestinal carcinoids, which by themselves comprise 70% of neuroendocrine tumors. Although primary small bowel neoplasms are overall rare (3%-6% of all gastrointestinal neoplasms), carcinoids still represent the second most common (20%-30%) primary small-bowel malignancy after small bowel adenocarcinoma. Their imaging evaluation is often challenging. State-of-the-art high-resolution multiphasic computed tomography together with advanced postprocessing methods provides an excellent tool for their depiction. The manifold interactive parameter choices however require knowledge of when to use which technique. Here, we discuss the imaging appearance and evaluation of duodenal, jejunal and ileal carcinoid tumors, including the imaging features of the primary tumor, locoregional mesenteric nodal metastases, and distant metastatic disease. A protocol for optimal lesion detection is presented, including the use of computed tomography enterography, volume acquisition, computed tomography angiography and three-dimensional mapping. Imaging findings are illustrated with a series of challenging cases which illustrate the spectrum of possible disease in the small bowel and mesentery, the range of possible appearances in the bowel itself on multiphase data and extraluminal findings such as the desmoplastic reaction in mesentery and hypervascular liver metastases. Typical imaging pitfalls and pearls are illustrated.
- Published
- 2015
21. Nonalcoholic fatty liver disease: Diagnostic biomarkers
- Author
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Fatemeh Hadizadeh, Elham Faghihimani, and Peyman Adibi
- Subjects
medicine.medical_specialty ,Cirrhosis ,business.industry ,Liver fibrosis ,Adipokine ,Inflammation ,Disease ,medicine.disease ,Obesity ,Gastroenterology ,Pathophysiology ,03 medical and health sciences ,0302 clinical medicine ,Diagnostic Advances ,030220 oncology & carcinogenesis ,Internal medicine ,Nonalcoholic fatty liver disease ,medicine ,030211 gastroenterology & hepatology ,medicine.symptom ,Metabolic syndrome ,business ,Non-alcoholic steatohepatitis - Abstract
Nonalcoholic fatty liver disease is a common medical condition worldwide and its prevalence has increased notably in the past few years due to the increases in prevalence of obesity and metabolic syndrome. However, diagnosis of this disease is still a matter of debate because of disease variations and pathophysiologic alterations. Specific single markers have gained considerable attention recently, among them markers related to hepatic pathophysiology, inflammation, adipocytokines and so forth. But, it seems that no single marker is sufficient for diagnosis and staging of the disease, and applying a panel including different types of tests may be more useful.
- Published
- 2017
22. Clinical applications of advanced magnetic resonance imaging techniques for arthritis evaluation
- Author
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Marta Gómez Cabrera, Alexie D Riofrio, Antonio Luna, and Teodoro Martín Noguerol
- Subjects
medicine.medical_specialty ,Arthritis ,Dynamic contrast enhanced ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Magnetic resonance imaging ,0302 clinical medicine ,medicine ,Orthopedics and Sports Medicine ,030203 arthritis & rheumatology ,Musculoskeletal system ,medicine.diagnostic_test ,business.industry ,DIXON ,Diffusion weighted imaging ,equipment and supplies ,medicine.disease ,Cartilage ,Diagnostic Advances ,Joint ,Radiology ,business ,human activities ,Diffusion MRI - Abstract
Magnetic resonance imaging (MRI) has allowed a comprehensive evaluation of articular disease, increasing the detection of early cartilage involvement, bone erosions, and edema in soft tissue and bone marrow compared to other imaging techniques. In the era of functional imaging, new advanced MRI sequences are being successfully applied for articular evaluation in cases of inflammatory, infectious, and degenerative arthropathies. Diffusion weighted imaging, new fat suppression techniques such as DIXON, dynamic contrast enhanced-MRI, and specific T2 mapping cartilage sequences allow a better understanding of the physiopathological processes that underlie these different arthropathies. They provide valuable quantitative information that aids in their differentiation and can be used as potential biomarkers of articular disease course and treatment response.
- Published
- 2017
23. Liver elastography, comments on EFSUMB elastography guidelines 2013
- Author
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Mireen Friedrich-Rust, Chiara De Molo, Xin-Wu Cui, Dagmar Schreiber-Dietrich, Andre Ignee, and Christoph F. Dietrich
- Subjects
Liver Cirrhosis ,Strain elastography ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Liver Neoplasms ,Gastroenterology ,General Medicine ,Prognosis ,Severity of Illness Index ,Liver ,Diagnostic Advances ,Predictive Value of Tests ,Practice Guidelines as Topic ,medicine ,Ultrasound elastography ,Elasticity Imaging Techniques ,Humans ,Medical physics ,Elastography ,Radiology ,business - Abstract
Recently the European Federation of Societies for Ultrasound in Medicine and Biology Guidelines and Recommendations have been published assessing the clinical use of ultrasound elastography. The document is intended to form a reference and to guide clinical users in a practical way. They give practical advice for the use and interpretation. Liver disease forms the largest section, reflecting published experience to date including evidence from meta-analyses with shear wave and strain elastography. In this review comments and illustrations on the guidelines are given.
- Published
- 2013
24. Transcranial Doppler ultrasonography: From methodology to major clinical applications
- Author
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Eduardo Bossone, Giuseppe Santoro, Raffaele Calabrò, Antonello D'Andrea, Lucia Riegler, Marianna Conte, Raffaella Scarafile, Massimo Cavallaro, Rosangela Cocchia, Maria Giovanna Russo, Enrica Pezzullo, Andreina Carbone, Francesco Natale, Pio Caso, D'Andrea, A, Conte, M, Cavallaro, M, Scarafile, R, Riegler, L, Cocchia, R, Pezzullo, E, Carbone, A, Natale, F, Santoro, G, Caso, P, Russo, Mg, Bossone, E, and Calabro, R
- Subjects
medicine.medical_specialty ,Traumatic brain injury ,business.industry ,Neurointensive care ,030204 cardiovascular system & hematology ,medicine.disease ,Transcranial Doppler ,03 medical and health sciences ,0302 clinical medicine ,Paradoxical embolism ,Cerebral blood flow ,Diagnostic Advances ,medicine.artery ,Internal medicine ,Anesthesia ,Middle cerebral artery ,cardiovascular system ,medicine ,Patent foramen ovale ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,030217 neurology & neurosurgery - Abstract
Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler (TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency (≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called “paradoxical embolism”, most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called “microembolic signal grading score”. In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage (caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.
- Published
- 2016
25. Intra-cardiac distribution of late gadolinium enhancement in cardiac sarcoidosis and dilated cardiomyopathy
- Author
-
Hideki Katoh, Masao Saotome, Hideharu Hayashi, Hiroshi Satoh, Takeji Saitoh, Tsuyoshi Urushida, Makoto Sano, and Kenichiro Suwa
- Subjects
medicine.medical_specialty ,Sarcoidosis ,Dilated cardiomyopathy ,030204 cardiovascular system & hematology ,Late gadolinium enhancement ,Sudden cardiac death ,03 medical and health sciences ,Basal (phylogenetics) ,Magnetic resonance imaging ,0302 clinical medicine ,Internal medicine ,Diagnosis ,medicine ,Distribution (pharmacology) ,Clinical significance ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Diagnostic Advances ,Heart failure ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Cardiac involvement of sarcoid lesions is diagnosed by myocardial biopsy which is frequently false-negative, and patients with cardiac sarcoidosis (CS) who have impaired left ventricular (LV) systolic function are sometimes diagnosed with dilated cardiomyopathy (DCM). Late gadolinium enhancement (LE) in magnetic resonance imaging is now a critical finding in diagnosing CS, and the novel Japanese guideline considers myocardial LE to be a major criterion of CS. This article describes the value of LE in patients with CS who have impaired LV systolic function, particularly the diagnostic and clinical significance of LE distribution in comparison with DCM. LE existed at all LV segments and myocardial layers in patients with CS, whereas it was localized predominantly in the midwall of basal to mid septum in those with DCM. Transmural (nodular), circumferential, and subepicardial and subendocardial LE distribution were highly specific in patients with CS, whereas the prevalence of striated midwall LE were high both in patients with CS and with DCM. Since sarcoidosis patients with LE have higher incidences of heart failure symptoms, ventricular tachyarrhythmia and sudden cardiac death, the analyses of extent and distribution of LE are crucial in early diagnosis and therapeutic approach for patients with CS.
- Published
- 2016
26. CD4-positive diffuse large B-cell lymphoma: A variant with aggressive clinical potential
- Author
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John L. Frater, Friederike Kreisel, Anjum Hassan, TuDung T. Nguyen, and Mohammad Hussaini
- Subjects
Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,CD4+ ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,hemic and lymphatic diseases ,medicine ,T-cell lymphoma ,CD20 ,Chemotherapy ,biology ,business.industry ,Germinal center ,Diffuse large B-cell lymphoma ,medicine.disease ,BCL6 ,Lymphoma ,Diagnostic Advances ,030220 oncology & carcinogenesis ,biology.protein ,CD5 ,Lineage infidelity ,business ,030215 immunology - Abstract
CD4 expression is rare in diffuse large B-cell lymphoma (DLBCL), with 4 previously reported cases. Its significance is uncertain. We report five patients with CD4(+) DLBCL and one CD4(+) primary mediastinal large B-cell lymphoma. Cases were identified by searching the electronic database of the department; each was reviewed. Average age was 56 years. Neoplastic cells expressed CD20 (5/6 tested cases). BCL2/BCL6 expression were seen in 3/3 tested cases, suggesting a germinal center origin. Additionally, expression of T-cell antigens CD2 and CD5 was noted in 2/2 and CD7 in 1/1 tested case. CD3 was negative in all. Lymph nodes were commonly involved (67%). Patients received chemotherapy +/- radiation (6/6) and bone marrow transplant (2/6). Average survival was 44.2 mo. CD4 expression in DLBCL raises questions of lineage commitment. CD4(+) DLBCL is rare; care should be exercised not to diagnose these as T-cell lymphomas. A subset behaves aggressively.
- Published
- 2016
27. Remote electrocardiograph monitoring using a novel adhesive strip sensor: A pilot study
- Author
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Paul A. Friedman, Christopher G. Scott, Kevin E. Bennet, Lyle J. Olson, Charles J. Bruce, Virend K. Somers, Dorothy J. Ladewig, and Scott Burrichter
- Subjects
030213 general clinical medicine ,medicine.medical_specialty ,Monitoring ,RR interval ,030204 cardiovascular system & hematology ,Poor quality ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Cohen's kappa ,Internal medicine ,medicine ,cardiovascular diseases ,PR interval ,Electrocardiograph ,Novel ,Sensor ,business.industry ,Remote ,Atrial fibrillation ,medicine.disease ,Diagnostic Advances ,Ambulatory ,Cardiology ,Ecg monitor ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business - Abstract
The increase in health care costs is not sustainable and has heightened the need for innovative low cost effective strategies for delivering patient care. Remote monitoring holds great promise for preventing or shortening duration of hospitalization even while improving quality of care. We therefore conducted a proof of concept study to examine the quality of electrocardiograph (ECG) recordings obtained remotely and to test its potential utility in detecting harmful rhythms such as atrial fibrillation. We tested a novel adhesive strip ECG monitor and assessed the ECG quality in ambulatory individuals. 2630 ECG strips were analyzed and classified as: Sinus, atrial fibrillation (AF), indeterminate, or other. Four readers independently rated ECG quality: 0: Noise; 1: QRS complexes seen, but P-wave indeterminate; 2: QRS complexes seen, P-waves seen but poor quality; and 3: Clean QRS complexes and P-waves. The combined average rating was: Noise 12%; R-R, no P-wave 10%; R-R, no PR interval 18%; and R-R with PR interval 60% (if Sinus). If minimum diagnostic quality was a score of 1, 88% of strips were diagnostic. There was moderate to high agreement regarding quality (weighted Kappa statistic values; 0.58 to 0.76) and high level of agreement regarding ECG diagnosis (ICC = 0.93). A highly variable RR interval (HRV ≥ 7) predicted AF (AUC = 0.87). The monitor acquires and transmits diagnostic high quality ECG data and permits characterization of AF.
- Published
- 2016
28. Accurate diagnosis of myalgic encephalomyelitis and chronic fatigue syndrome based upon objective test methods for characteristic symptoms
- Author
-
Frank N.M. Twisk
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Pediatrics ,business.industry ,Encephalomyelitis ,Muscle weakness ,Chronic fatigue ,medicine.disease ,Malaise ,Cognitive test ,Diagnostic Advances ,medicine ,Chronic fatigue syndrome ,Objective test ,medicine.symptom ,Headaches ,Psychiatry ,business - Abstract
Although myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are considered to be synonymous, the definitional criteria for ME and CFS define two distinct, partially overlapping, clinical entities. ME, whether defined by the original criteria or by the recently proposed criteria, is not equivalent to CFS, let alone a severe variant of incapacitating chronic fatigue. Distinctive features of ME are: muscle weakness and easy muscle fatigability, cognitive impairment, circulatory deficits, a marked variability of the symptoms in presence and severity, but above all, post-exertional "malaise": a (delayed) prolonged aggravation of symptoms after a minor exertion. In contrast, CFS is primarily defined by (unexplained) chronic fatigue, which should be accompanied by four out of a list of 8 symptoms, e.g., headaches. Due to the subjective nature of several symptoms of ME and CFS, researchers and clinicians have questioned the physiological origin of these symptoms and qualified ME and CFS as functional somatic syndromes. However, various characteristic symptoms, e.g., post-exertional "malaise" and muscle weakness, can be assessed objectively using well-accepted methods, e.g., cardiopulmonary exercise tests and cognitive tests. The objective measures acquired by these methods should be used to accurately diagnose patients, to evaluate the severity and impact of the illness objectively and to assess the positive and negative effects of proposed therapies impartially.
- Published
- 2015
29. Cardiac magnetic resonance in clinical cardiology
- Author
-
Andreas Kumar and Rodrigo Bagur
- Subjects
Very high resolution ,Clinical cardiology ,medicine.medical_specialty ,Pathology ,Diagnostic methods ,Heart disease ,business.industry ,Large array ,Tissue characterization ,medicine.disease ,In plane ,Diagnostic Advances ,medicine ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Cardiac magnetic resonance - Abstract
Over the last decades, cardiac magnetic resonance (CMR) has transformed from a research tool to a widely used diagnostic method in clinical cardiology. This method can now make useful, unique contributions to the work-up of patients with ischemic and non-ischemic heart disease. Advantages of CMR, compared to other imaging methods, include very high resolution imaging with a spatial resolution up to 0.5 mm × 0.5 mm in plane, a large array of different imaging sequences to provide in vivo tissue characterization, and radiation-free imaging. The present manuscript highlights the relevance of CMR in the current clinical practice and new perspectives in cardiology.
- Published
- 2015
30. Various diffusion magnetic resonance imaging techniques for pancreatic cancer
- Author
-
Xiao-Ming Zhang, Meng-Yue Tang, Xiao Hua Huang, and Tian-wu Chen
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Magnetic resonance spectroscopic imaging ,Magnetic resonance imaging ,Pulse sequence ,medicine.disease ,Diagnostic Advances ,Pancreatic cancer ,medicine ,Radiology ,Diffusion (business) ,business ,Diffusion Kurtosis Imaging ,Diffusion MRI ,Biomedical engineering ,Tractography - Abstract
Pancreatic cancer is one of the most common malignant tumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods are conducive to detecting small lesions. Compared to the other techniques, magnetic resonance imaging (MRI) has irreplaceable advantages and can provide valuable information unattainable with other noninvasive or minimally invasive imaging techniques. Advances in MR hardware and pulse sequence design have particularly improved the quality and robustness of MRI of the pancreas. Diffusion MR imaging serves as one of the common functional MRI techniques and is the only technique that can be used to reflect the diffusion movement of water molecules in vivo. It is generally known that diffusion properties depend on the characterization of intrinsic features of tissue microdynamics and microstructure. With the improvement of the diffusion models, diffusion MR imaging techniques are increasingly varied, from the simplest and most commonly used technique to the more complex. In this review, the various diffusion MRI techniques for pancreatic cancer are discussed, including conventional diffusion weighted imaging (DWI), multi-b DWI based on intra-voxel incoherent motion theory, diffusion tensor imaging and diffusion kurtosis imaging. The principles, main parameters, advantages and limitations of these techniques, as well as future directions for pancreatic diffusion imaging are also discussed.
- Published
- 2015
31. Multidetector computed tomography of temporomandibular joint: A road less travelled
- Author
-
Ajoy Roychaudhary, Ashu Seith Bhalla, Ongkila Bhutia, and Shivani Pahwa
- Subjects
musculoskeletal diseases ,Orthodontics ,Osteochondroma ,business.industry ,Dentistry ,General Medicine ,medicine.disease ,Surgical planning ,Condyle ,Sagittal plane ,Temporomandibular joint ,Hemifacial microsomia ,stomatognathic diseases ,medicine.anatomical_structure ,stomatognathic system ,Diagnostic Advances ,Coronal plane ,Multidetector computed tomography ,medicine ,business - Abstract
This article reviews the imaging anatomy of temporomandibular joint (TMJ), describes the technique of multi-detector computed tomography (MDCT) of the TMJ, and describes in detail various osseous pathologic afflictions affecting the joint. Traumatic injuries affecting the mandibular condyle are most common, followed by joint ankylosis as a sequel to arthritis. The congenital anomalies are less frequent, hemifacial microsomia being the most commonly encountered anomaly involving the TMJ. Neoplastic afflictions of TMJ are distinctly uncommon, osteochondroma being one of the most common lesions. MDCT enables comprehensive evaluation of osseous afflictions of TMJ, and is a valuable tool for surgical planning. Sagittal, coronal and 3D reformatted images well depict osseous TMJ lesions, and their relationship to adjacent structures.
- Published
- 2015
32. New endoscopy advances to refine adenoma detection rate for colorectal cancer screening: None is the winner.
- Author
-
Maida M, Camilleri S, Manganaro M, Garufi S, and Scarpulla G
- Abstract
Colorectal cancer (CRC) is the third most common cancer in males and second in females, and globally the fourth cause for cancer death worldwide. Oncological screening of CRC has a major role in the management of the disease and it is mostly performed by colonoscopy. Anyway, effectiveness of endoscopic screening for CRC strictly depends on adequate detection and removal of potentially precancerous lesions, and accuracy of colonoscopy in detection of adenomas is still suboptimal. For this reason, several technological advances have been implemented in order to improve the diagnostic sensitivity of colonoscopy in adenoma detection. Among these: (1) Visual technologies such as chromoendoscopy and narrow band imaging; (2) optical innovation as high definition endoscopy, full-spectrum endoscopy or Third Eye Retroscope; and (3) mechanical advances as Cap assisted colonoscopy, Endocuff, Endoring and G-Eye endoscope. All these technologies advances have been tested over time by clinical studies with mixed results. Which of them is more likely to be successful in the next future?, Competing Interests: Conflict-of-interest statement: All authors declare no conflict of interest related to this publication.
- Published
- 2017
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33. Contrast enhanced ultrasound with quantitative perfusion analysis for objective characterization of pancreatic ductal adenocarcinoma: A feasibility study
- Author
-
Stefano Canestrini, Stefano Crosara, Roberto Pozzi Mucelli, Mirko D'Onofrio, and Riccardo De Robertis
- Subjects
medicine.medical_specialty ,Quantitative imaging ,Pancreatic ductal adenocarcinoma ,business.industry ,Contrast enhanced ultrasound ,Perfusion analysis ,Quantitative perfusion ,medicine.anatomical_structure ,Diagnostic Advances ,Parenchyma ,medicine ,Time to peak ,Ductal adenocarcinoma ,Radiology ,Pancreas ,business ,Pancreatic adenocarcinoma ,Contrast-enhanced ultrasound - Abstract
The aim of this study was to determine whether contrast enhanced ultrasound (CEUS) quantitative perfusion analysis allows an objective characterization of ductal adenocarcinoma (ADK) of the pancreas. Patients with pancreatic ADK underwent CEUS. All examinations were performed on an Acuson S2000 system (Siemens, Erlangen, Germany) after the iv administration of 2.4 mL contrast agent (SonoVue(®), Bracco, Milan, Italy). All lesions were pathologically proved. An operator manually drew different regions of interest within the tumor and the adjacent parenchyma to allow the quantitative perfusion analysis. The mean values of peak of enhancement, time to peak and ascending curve were calculated and compared using the Student's t test. The quantitative perfusion analysis was possible in all lesions. The mean values of the peak of enhancement, time to peak and ascending curve were 17.19%, 7.97 s and 159.52% s within the tumor and 33.57%, 8.89 s and 355.29% s within the adjacent parenchyma. The peak of enhancement and the ascending curve values were significantly different within the tumor and the adjacent parenchyma. Thus, CEUS allows the quantitative perfusion analysis of pancreatic ductal adenocarcinoma.
- Published
- 2014
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