Advanced Diagnostic Procedures Research Articles

Comprehensive Insights into Glomerulonephritis and Interstitial Nephritis: Mechanisms, Diagnosis, and Management

Investigate on kidney poison has been commended by new molecular ways, with an distinction on IMR and genetic susceptibility. The story accentuates custom-made treatment tactics and housings into the complexities of Glomerulonephritis and Interstitial Nephritis therapies in order to augment results for patients suffering from these kidney diseases. From theory to action: a synthesis of insights in glomerulonephritis and interstitial nephritis This abstract assortments thoughts from several sources to offer a complex lookout that both contests and reinforces present thinking. It offers healthcare practitioners a full toolkit for treating glomerulonephritis and interstitial nephritis by combining academic acquaintance with real-world applications.A more accurate system has been unconventional to identify interstitial nephritis and glomerulonephritis. Guided Therapeutic Terrain: Administration Tactics for Glomerulonephritis and Interstitial Nephritis. This demonstration confers many systems to so long as successful patient care, including pharmacological treatment and lifestyle changes. It provides health care physicians with a comprehensive toolset for treating glomerulonephritis and interstitial nephritis by integrating academic knowledge and practical implementations. The paper includes a comprehensive examination of advanced diagnostic procedures as well as current approaches for diagnosing glomerulonephritis and interstitial nephropathy. Through the integration of molecular biomarkers, modern tomography technologies, and modified medicine, the debate aims to give new approaches for quick and accurate diagnosis.

Practices and perspectives on advanced diagnostic and interventional bronchoscopy among pediatric pulmonologists in the United States.

Advanced diagnostic bronchoscopy includes endobronchial ultrasound (EBUS) guided transbronchial lung and lymph node biopsies, CT navigation and robotic bronchoscopy. Interventional bronchoscopy refers to procedures performed for therapeutic purposes such as balloon dilation of the airway, tissue debulking, cryotherapy, removal of foreign bodies and insertion of endobronchial valves [1]. For adult patients, these procedures are standard of care [2, 3]. Despite a lack of formalized training, there are numerous case reports and case series describing the use of advanced diagnostic and interventional bronchoscopy techniques in children. The safety and feasibility of EBUS-TBNA, cryotherapy techniques, endobronchial valves among other techniques have been demonstrated in these publications [1, 4-9]. We sought to better understand the current practices and perspectives on interventional and advanced bronchoscopy among pediatric pulmonologists through surveys sent to pediatric teaching hospitals across the United States. We received 43 responses representing 28 programs from 25 states. The highest bronchoscopy procedure volume occurred in the 0-5 years age group. Among our respondents, 31% self-identified as a pediatric interventional/advanced bronchoscopist. 79% believe that advanced and interventional training is feasible in pediatric pulmonology and 77% believe it should be offered to pediatric pulmonary fellows. This is the first study to characterize current practices and perspectives regarding advanced diagnostic and interventional bronchoscopy procedures among pediatric pulmonologists in the United States. Pediatric interventional pulmonology (IP) is in its infancy and its beginnings echo those of the adult IP where only certain centers were performing these procedures.

Magnetically Driven Biopsy Capsule Robot with Spring Mechanism.

In recent years, capsule endoscopes (CEs) have appeared as an advanced technology for the diagnosis of gastrointestinal diseases. However, only capturing the images limits the advanced diagnostic procedures and so on in CE's applications. Herein, considering other extended functions like tissue sampling, a novel wireless biopsy CE has been presented employing active locomotion. Two permanent magnets (PMs) have been placed into the robots, which control the actuation of the capsule robot (CR) and biopsy mechanism by employing an external electromagnetic actuation (EMA) system. A spring has been attached to the biopsy mechanism to retract the biopsy tool after tissue collection. A camera module has also been attached to the front side of the CR to detect the target point and observe the biopsy process on the lesion. A prototype of CR was fabricated with a diameter of 12 mm and a length of 32 mm. A spring mechanism with a biopsy needle was placed inside the CR and sprang out around 5 mm. An in vitro experiment was conducted, which demonstrated the precise control translation (2 mm/s and 3 mm/s in the x and y directions, respectively) and desired extrusion of the biopsy mechanism (~5 mm) for sampling the tissue. A needle-based biopsy capsule robot (NBBCR) has been designed to perform the desired controlled locomotion and biopsy function by external force. This proposed active locomoted untethered NBBCR can be wirelessly controlled to perform extended function precisely, advancing the intestinal CE technique for clinical applications.

Analyzing Foramen Ovale Morphometrically in Adult Dry Skulls of Nigerian-Based Population

Introduction: The foramen ovale is one of the major foramina on the greater wing of the sphenoid that is used for advanced surgical therapeutic and diagnostic procedures pertaining to the middle cranial fossa. The study was aimed at determining the length and width of foramen ovale in a Nigerian population. Materials and Methods: Seven dehydrated adult skulls, all the same gender, were acquired from the anatomy departments of Achievers University in Owo and Delta State University in Abraka, Nigeria. The length and the width of the foramen ovale were measured using digital sliding calipers. The paired sample t-test was used for the analysis. Results: The mean length of the foramen ovale was 0.611±0.21cm on the right side, and 0.42±0.12cm on the left side. The mean width was 0.5±0.15cm on the right side, and 0.43±0.12cm on the left side. Conclusion: Understanding the dimensions of the foramen ovale vary is crucial for neurosurgery during invasive surgical procedures like percutaneous trigeminal rhizotomy, as well as for biopsying Meckel cave lesions and cavernous sinus tumors.

Gut microbiota in relationship to diabetes mellitus and its late complications with a focus on diabetic foot syndrome: A review.

Diabetes mellitus is a chronic disease affecting glucose metabolism. The pathophysiological reactions underpinning the disease can lead to the development of late diabetes complications. The gut microbiota plays important roles in weight regulation and the maintenance of a healthy digestive system. Obesity, diabetes mellitus, diabetic retinopathy, diabetic nephropathy and diabetic neuropathy are all associated with a microbial imbalance in the gut. Modern technical equipment and advanced diagnostic procedures, including xmolecular methods, are commonly used to detect both quantitative and qualitative changes in the gut microbiota. This review summarises collective knowledge on the role of the gut microbiota in both types of diabetes mellitus and their late complications, with a particular focus on diabetic foot syndrome.

Ergonomics of bronchoscopy: good advice or a pain in the neck?

Interventional pulmonologists require a unique set of skills including precise motor abilities and physical endurance, but surprisingly the application of ergonomic principles in the field of bronchoscopy remains limited. This is particularly intriguing when considering the significant impact that poor ergonomics can have on diagnostic aptitude, income potential and overall health. It is therefore imperative to provide comprehensive education to physicians regarding the significance of ergonomics in their work, especially considering the introduction of advanced diagnostic and therapeutic procedures. By implementing simple yet effective measures (e.g. maintaining neutral positions of the wrist, neck and shoulder; adjusting the height of tables and monitors; incorporating scheduled breaks; and engaging in regular exercises), the risk of injuries can be substantially reduced. Moreover, objective tools are readily available to assess ergonomic postures and estimate the likelihood of work-related musculoskeletal injuries. This review aims to evaluate the current literature on the impact of procedure-related musculoskeletal pain on practising pulmonologists and identify modifiable factors for future research.

Diagnostic coelioscopy in a budgerigar (Melopsittacus undulatus) for evaluation of internal organs

There is limited data on minimally invasive coelioscopy in smaller exotic birds like budgerigar. This study was taken primarily to collect baseline data of internal organs of budgerigar during a diagnostic coelioscopic procedure. A 2.7 mm 180 mm rigid endoscope (Karl Storz) was used for the procedure where in lung, liver, heart, kidney, gonad and intestines were visualized and evaluated. Special emphasis is placed on assessing feasibility and safety of applying advanced diagnostic procedures in small birds.

Advanced Arthritis of the Carpus: Preoperative Planning Practices of 337 Hand Surgeons.

Background Surgical procedure selection for carpal arthritis depends on which articular surfaces are affected, but there is no consensus on how to preoperatively evaluate cartilage surfaces. Despite advances in cross-sectional imaging, the utility of advanced imaging for preoperative decision-making has not been well established. Objectives Our objective was to assess if there is an added value to presurgical advanced imaging or diagnostic procedures in planning for carpal arthrodesis or carpectomy and to determine what imaging or diagnostic procedures influence surgical treatment options. Methods A seven-question survey was sent to 2,400 hand surgeons. Questions assessed which articular surfaces surgeons consider important for decision-making, which imaging modalities surgeons employ, and how often surgeons utilize diagnostic arthroscopy before performing carpectomy or arthrodesis procedures. Results A total of 337 (14%) surveys were analyzed. The capitolunate articulation (alone or in combination) was most frequently reported to impact surgical decision-making (48.1%). Most surgeons (86.6%) reported that standard plain radiographs are usually sufficient. Few surgeons reported always obtaining magnetic resonance imaging (MRI) or computed tomography (CT), with 44.2% of surgeons believing that MRI is never useful and 38.4% believing that CT is never useful. Most surgeons (68.2%) reported that they never perform wrist arthroscopy as part of their decision-making process. Conclusions This study provides information on the decision-making process in the surgical management of carpal arthritis. Given advances in cross-sectional imaging, further studies are needed to determine the utility of MRI and CT for the planning of surgical procedures in the treatment of arthritis of the carpus. Level of Evidence Level 4.

Declining clinical skills in medical education: A perspective on its causes and potential solutions

The medical education is undergoing decline in clinical training during the last 40 years. The Medical Interview of the patient and Physical Examination to arrive at a provisional diagnosis are replaced mostly by advanced diagnostic tests and procedures, after enquiry of the symptoms. This is leading to wrong diagnoses, delayed diagnoses, increase in cost, unfavorable outcome and many a time litigation and compensation against the doctor and hospital. The article outlines cause of decline in clinical skill and points to possible solution.

Life and Death Sometimes Coincide, and Pastoral Response is Crucial to the Brokenhearted.

Perinatal loss may remain unexplained, despite current technology, modern preventive care measures, and advanced diagnostic procedures. Culturally sensitive and competent discussions should be prioritized in medicine, but religious and spiritual feelings are often marginalized. Here we highlight our reflections on the importance of the spiritual and theological responses to parents grieving stillbirth. Chaplains are critical for the wellbeing of both families and physicians.

Clinical variables for predicting type-1 and type-2 non-ST segment elevation myocardial infarction in those presenting with ischemic symptoms.

IntroductionThe accuracy of detecting myocardial infarction (MI) has greatly improved with the advent of more sensitive assays, and this has led to etiologic subtyping. Distinguishing between type 1 and type 2 non-ST-segment elevation myocardial infarction (NSTEMI) early in the clinical course allows for the most appropriate advanced diagnostic procedures and most efficacious treatments. The purpose of this study was to investigate the predictive effect of demographic and clinical variables on predicting NSTEMI subtypes in patients presenting with ischemic symptoms.Material and methodsWe performed a single institution retrospective cohort study of patients who presented to the emergency department (ED) with ischemic signs and symptoms consistent with non-ST-segment myocardial infarction, for whom results of coronary angiography were available. We analyzed demographic, laboratory, echocardiography and angiography data to determine predictors of NSTEMI sub-types.ResultsFive hundred and forty-six patients were enrolled; 426 patients were found on coronary angiography to have type 1 acute MI (T1AMI), whereas 120 patients had type 2 acute MI (T2AMI). Age (OR per year = 1.03 (1.00, 1.05), p = 0.03), prior MI (OR = 3.50 (1.68, 7.22), p = 0.001), L/H > 2.0 (OR = 1.55 (1.12, 2.13), p = 0.007), percentage change in troponin I > 25% (OR = 2.54 (1.38, 4.69), p = 0.003), and regional wall motion abnormalities (RWMA) (OR = 3.53 (1.46, 8.54), p = 0.004) were independent predictors of T1AMI, whereas sex, race, body mass index, hypertension, end-stage renal disease (ESRD), heart failure, family history (FH) of coronary artery disease (CAD), HbA1c, and left ventricular ejection fraction (LVEF) were not.ConclusionsKey clinical variables such as age, prior MI, L/H ratio, percentage change in troponin I, and presence of RWMA on echocardiogram may be utilized as significant predictors of T1AMI in patients presenting with ischemic symptoms to the ED.

Destiny for Rendezvous: Is Cholecysto/Choledocholithiasis Better Treated with Dual- or Single-Step Procedures?

Biliary lithiasis is common worldwide, affecting almost 20% of the general population, though few experience symptoms. The frequency of choledocholithiasis in patients with symptomatic cholelithiasis is estimated to be 10-33%, depending on patients' age. Unlike gallbladder lithiasis, the medical and surgical treatment of common bile duct stones is uncertain, having changed over the last few years. The prior gold standard treatment for cholelithiasis and choledocholithiasis was open cholecystectomy with bile duct clearance, choledochotomy, and/or surgical sphincterotomy. In the last 10-15years, new treatment approaches to the complex pathology of choledocholithiasis have emerged with the advent of endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic surgery, and advanced diagnostic procedures. Although ERCP followed by laparoscopic cholecystectomy is the preferred mode of management, a single-step strategy (laparo-endoscopic rendezvous) has gained acceptance due to lesser morbidity and a lower risk of iatrogenic damage. Given the above, a tailored approach relying on careful evaluation of the disease is necessary in order to minimize complication risks and overall costs. Yet, the debate remains open, with no consensus on the superiority of laparo-endoscopic rendezvous to more conventional approaches.

Prevalence of post-stroke upper extremity paresis in developing countries and significance of m-Health for rehabilitation after stroke - A review

This review focuses on the need of mobile health (or m-Health) based devices for remote diagnosis of patients suffering from upper limb or upper extremity (UE) paresis due to stroke in developing or low and middle-income (LMI) countries. More than 70% of stroke survivors suffer from UE paresis. UE paresis limits the ability of an individual to perform activities of daily living (ADL), as well as social and recreational activities and hence needs sufficient care. Therefore, this paper considers advanced diagnostic procedures of post stroke upper limb paresis. To begin with, a detailed survey of death due to stroke, post-stroke disability and scarcity of rehabilitation centers in context of developing countries are presented briefly. It has been found that in developing countries, especially in the rural areas, patients suffering from disabilities due to stroke do not receive appropriate on-time treatment due to developmental and financial barriers. Conventional rehabilitation management systems fail to cater required rehabilitation services thereby arousing the need for evolution of wearable m-Health devices for uninterrupted monitoring of patients with UE paresis. Some lacunae in existing rehabilitation management systems and proposal for alleviating these gaps are presented in this paper. Continuous monitoring of affected body part can lead to timely diagnosis and faster recovery. Therefore, this paper attempts to establish the need for m-Health based device for UE monitoring to facilitate a better rehabilitation process for the stroke survivors.

Maternal-fetal medicine fellows’ perception and comfort with obstetrical ultrasound and prenatal diagnosis

Ultrasound training is a vital component of maternal-fetal medicine fellowships in the United States. Of the 18 months of core clinical training, the American Board of Obstetrics and Gynecology currently requires a minimum of 3 months to be dedicated to ultrasound to be eligible for board certification. However, the experience and degree of hands-on training differ among the fellowship programs and have not been reassessed for nearly a decade. To assess regional heterogeneity in the ultrasound training experience during maternal-fetal medicine fellowship in the United States. A survey was distributed to postgraduate year (PGY)-6 maternal-fetal medicine fellows registered to attend an annual ultrasound training course before the conference (n=114). For programs with >1 fellow attending (n=39), only 1 of them completed the survey to represent the program. The questions included demographics of the program, ultrasound training structure, the fellows' self-perception of ultrasound capabilities, research, mentorship, and technical aspects of sonography. Seventy two postgraduate year 6 fellows with a wide geographic distribution as follows completed the survey (96% response rate): 10 (14%) from the West, 16 (22%) from the Midwest, 17 (24%) from the South, and 29 (40%) from the Northeast. Respondents undergoing training in the South were less likely to report feeling comfortable performing nuchal translucency and detailed anatomic surveys than those from other regions (nuchal translucency: P=.046; anatomy: P=.011). Most of the respondents reported feeling comfortable performing growth (78%) and umbilical artery Doppler (58%) and feeling uncomfortable with three-dimensional ultrasound, neurosonography, and fetal echocardiography. Respondents in the Northeast were more likely to report feeling comfortable performing chorionic villus sampling (P=.001). There was no difference among fellowship programs in the presence or absence of ultrasound curriculum, bedside teaching, ultrasound-focused research mentorship, or months of ultrasound training. Despite the standardization of ultrasound training structure across the United States, there remains regional heterogeneity in fellow self-reported comfort with specific ultrasound techniques and chorionic villus sampling at a midpoint in their fellowship training. The maternal-fetal medicine attending involvement at the bedside did not affect the fellow self-reported comfort with ultrasound surveys. This study highlights the need for further optimization of maternal-fetal medicine fellowship ultrasound training, especially in advanced sonography and diagnostic procedures.

A Study on Pressure Ulcer: Influencing Factors and Diagnostic Techniques.

Pressure ulcer (PU) is one of the most common occurrences in bedridden subjects. Despite the standard of care, there is a huge challenge in monitoring immobile subjects in all the bodily pressure points. This increases the chance of onset of PU which in turn increases the expenditure for treating and managing the PU. Hence, we made a study on the biological and physiological factors that are responsible for the formation of PU and also on various techniques used for diagnosis. Thus, we have summarised the efficacy of various advanced diagnostic procedures with their limitations. Though there are advanced imaging techniques, risk assessment tools based on the visual inspection are widely followed in hospitals. Based on our observation, we here have identified three major areas; one being the development of mathematical modeling, the second is towards the development of non-invasive devices and finally to automate cot facility. We have also provided possible suggestions as to solutions that could be useful to researchers and for society. Thus, this review covers the present difficulty faced by bedridden subjects and respective care-takers along with the knowledge gap and a few suggestions as to future scope.

A 3D-printed innovative pedal fixator for connecting different pedal-operated tools to improve work ergonomics during advanced diagnostic and therapeutic endoscopic procedures.

A 3D-printed innovative pedal fixator for connecting different pedal-operated tools to improve work ergonomics during advanced diagnostic and therapeutic endoscopic procedures.

Single-Use and Reusable Flexible Bronchoscopes in Pulmonary and Critical Care Medicine.

Flexible bronchoscopy plays a critical role in both diagnostic and therapeutic management of a variety of pulmonary disorders in the bronchoscopy suite and the intensive care unit. In the set-ting of the ongoing viral pandemic, single-use flexible bronchoscopes (SUFB) have garnered attention as various professional pulmonary societies have released guidelines regarding uses for SUFB given the concern for risk of viral transmission when using reusable flexible bronchoscopes (RFB). In addition to offering sterility, SUFBs are portable, easily accessible, and may be more cost-effective than RFB when considering the potential costs of treating bronchoscopy-related infections. Furthermore, since SUFBs are one time use, they do not require reprocessing after use, and therefore may translate to reduced cleaning and storage costs. Despite these advantages, RFBs are still routinely used to perform advanced diagnostic and therapeutic bronchoscopic procedures given the need for optimal maneuverability, handling, angle of deflection, image quality, and larger channel size for passing of ancillary instruments. Here, we review the published evidence on the applications of single-use and reusable bronchoscopes in bronchoscopy suites and intensive care units. Specifically, we will discuss the advantages and disadvantages of these devices as pertinent to fundamental, advanced, and therapeutic bronchoscopic interventions.

Krvarenje iz tumora dojke kao hitno stanje u medicini

Introduction: Breast cancer is the most common form of malignancy in women. It affects about one million women worldwide every year and the incidence continues to rise. As a result of the introduction of screening procedures into everyday practice, advanced diagnostic procedures, and modern surgical and oncological treatment, breast cancer is nowadays a well-controlled disease, often completely curable. However, in clinical practice, we do still encounter locally advanced forms of breast cancer with bleeding as a frequent complication of ulcerated tumours. This is a life-threatening emergency that in most cases must be corrected with palliative surgical procedures. The objective: To present the complication of haemorrhage in breast cancer patients to emergency medicine specialists and other doctors, to help them recognise and treat such patients appropriately. Methodology: The PubMed database and Google Scholar were searched for relevant articles based on specific keywords. Conclusion: Recognising haemorrhage as a complication of breast cancer and providing adequate and timely surgical treatment significantly improves the rate of survival and quality of life even in patients with terminal cancer.

DeepFMD: Computational Analysis for Malaria Detection in Blood-Smear Images Using Deep-Learning Features

Malaria is one of the most infectious diseases in the world, particularly in developing continents such as Africa and Asia. Due to the high number of cases and lack of sufficient diagnostic facilities and experienced medical personnel, there is a need for advanced diagnostic procedures to complement existing methods. For this reason, this study proposes the use of machine-learning models to detect the malaria parasite in blood-smear images. Six different features—VGG16, VGG19, ResNet50, ResNet101, DenseNet121, and DenseNet201 models—were extracted. Then Decision Tree, Support Vector Machine, Naïve Bayes, and K-Nearest Neighbour classifiers were trained using these six features. Extensive performance analysis is presented in terms of precision, recall, f-1score, accuracy, and computational time. The results showed that automating the process can effectively detect the malaria parasite in blood samples with an accuracy of over 94% with less complexity than the previous approaches found in the literature.

Application of Wavelet Filtering to Vibrational Signals from the Mining Screen for Spring Condition Monitoring

The main task of mineral processing plants is to further process the raw material extracted in the mining faces into a concentrate with the highest possible concentration of the final product. In practice, it is a complex process in which several stages can be distinguished. After the ore has been transported to the surface by the skip shaft, one of the first steps is sieving the ore, which is typically performed using vibrating mining screens. In a typical Ore Enrichment Plant, the screening process is carried out by several such machines. This is a typical bottleneck in the technological chain. For this reason, the main challenge for users is to achieve the highest reliability and efficiency of these technical facilities. The solution is to focus on predictive maintenance strategies based on the development of monitoring and advanced diagnostic procedures capable of estimating the time of safe operation. This work was developed as part of an advanced diagnostic system ensuring comprehensive technical conditioning and early fault detection of components such as the engine, transmission, bearings, springs, and screen. This article focuses on vibration data. The problem of damage detection in the presence of periodically impulsive components resulting from falling feed material on the screen and its further screening process has been considered. These disturbances are of a non-Gaussian noise nature, the elimination of which is essential to extract the fault-related signal of interest. One solution may be to properly smooth and filter the raw signal. In this article, a wavelet filtering technique is applied. First, the wavelet filtering procedure is described. In the next step, the performance of a wavelet filter is investigated depending on its parameters. Then, the results of wavelet filtering are compared with such methods as low-pass filtering and smoothing using a moving average. Finally, the impact of wavelet filtering on the calculation of screen trajectories is investigated.