Clinical Test Results Research Articles

Endoscopic Transsphenoidal Surgery: Factors Associated with Tumor Progression in Pituitary Adenomas

This study aimed to measure the incidence of tumor progression among patients that underwent endoscopic transsphenoidal surgery for pituitary adenomas, as well as the performance of the molecular and radiological factors that are commonly associated with progression. Patients of both adult and pediatric populations with pituitary adenomas who were treated for the first time with endoscopic transsphenoidal surgery in a single tertiary care center, between June 2006 and December 2019, were included. Clinical features, laboratory results, imaging findings, and molecular test results were collected. Progression or recurrence was measured in a follow-up MRI. Eighty-eight patients were included. 19.5% presented gonadotroph adenomas and null-cell adenomas, followed by corticotrophs (17.2%) and somatotrophs (13.8%). 20.7% had cellular atypia, 26.2% had p53 expression, and up to 79.5% had Ki-67 under 3%. On postoperative MRI (available for 90.9% of patients), 43.8% had tumor residue. Tumor progression occurred in 32 patients (36.4%). The median progression-free survival time was 5.37 years (95% CI = 3.29–N/A). Cellular atypia, Ki-67 elevation, cavernous sinus invasion, and tumor residue were suggested as significant prognostic factors. Nonetheless, the multivariate time-to-event analysis identified tumor residue as the only factor significantly associated with progression: HR = 4.0, 95% CI = 1.56–10.31. Residual tumor in postoperative imaging aids as a predictor for tumor progression and the invasion of the cavernous sinus, presence of cellular atypia, and a proliferation index (Ki-67) above 3% influence the speed at which the progression appears, therefore not being a predictive factor but rather a modifier of the progression.

Lung Cancer in Non-Smokers: Clinicopathological and Survival Differences from Smokers.

Background Lung cancer in non-smokers is a clinically distinct entity based on unique epidemiology, clinicopathology, genetics, treatment response, and outcome. Data from Indian centres are scarce. The objective of this study was to compare the frequency, clinical characteristics, driver mutations, and survival of non-smoking and smoking lung cancer patients treated at a tertiary cancer centre in North India. Methodology Two years of data on 724 consecutive lung cancer patients were assessed. Clinical, demographics, smoking history, and EGFR and ALK mutation test results were collected. Descriptive and inferential statistics were applied. Survival analysis was performed using the Kaplan-Meier method. Results Non-smokers comprised 40.9% of the study sample. Non-smokers were more likely than smokers to experience disease onset at a younger age (P = 0.004) and metastasis (P < 0.001).The tumor histology showed significant differences (P < 0.001), with non-smokers more likely to be diagnosed with adenocarcinoma (77.4%), while squamous and small cell histologies were commonly found among smokers (37.6% and 13.8%, respectively). The EGFR mutation and ALK rearrangement rates in the cohort were 23.3% and 10.1%, respectively, and were more frequent in non-smoking patients. Overall, 10-year survival was 7%, with a significantly better survival rate of non-smokers than smokers (median survival time of 15.13 vs10.17 months; P = 0.012). Conclusions About four out of 10 patients diagnosed with lung cancer at our centre were non-smokers. They were more often young, diagnosed at an advanced stage, with predominantly adenocarcinoma histology, and had a threefold higher frequency of EGFR mutations than smokers. In our cohort, non-smokers appear to be a targetable group with better survival than smokers.

Internal Brace Ligament Augmentation versus Anatomical Repair with Hamstrings of the ACL – A Clinical Data Comparison Study

AIM: Investigation into the clinical results of internal brace ligament augmentation technique compared to the simple anatomical repair of the anterior cruciate ligament (ACL). METHODS: From May 2016 to November 2019, 128 patients underwent an operation using the internal brace technique. During the same time, 104 patients were operated on using the simple anatomical ACL repair. The mean age was 22.5-year-old for the first group and 26.8-year- old for the second one. The minimum follow-up was 24 months. All the patients performed an X-ray and magnetic resonance imaging. Two hypotheses were raised to assess the superiority of the internal brace technique versus the anatomical one in the early post-operative phase and the rehabilitation one. RESULTS: The mean operation time was 71 (65–75) min for the internal brace (IB) and 62 (55–65) for the anatomical. We had two post-operative infected knees in the first group (IB) and no infection in the second one. The clinical stability test results were much better in the IB group using the KT 1000. The rehabilitation phase showed a superior IB technique. The return to sport-time of the sportsmen was 6 months for the first group and 7–8 months for the anatomical. All the IB-operated patients found physiotherapy significantly easier than the anatomical ones. CONCLUSIONS: IB-technique performs better clinical outcomes than the anatomical repair. The presence of a foreign body (Ultrabraid) inside the knee may be a risk factor contributing toward the elevated infection rate. The IB technique costs are significantly more expensive compared to the anatomical but the low physiotherapy costs compensate for the final result.

Primary exploration of host-microorganism interaction and enteritis treatment with an embedded membrane microfluidic chip of the human intestinal-vascular microsystem.

Intestinal flora plays a crucial role in the host's intestinal health. Imbalances in the intestinal flora, when accompanied by inflammation, affect the host's intestinal barrier function. Understanding it requires studying how living cells and tissues work in the context of living organs, but it is difficult to form the three-dimensional microstructure intestinal-vascular system by monolayer cell or co-culture cell models, and animal models are costly and slow. The use of microfluidic-based organ chips is a fast, simple, and high-throughput method that not only solves the affinity problem of animal models but the lack of microstructure problem of monolayer cells. In this study, we designed an embedded membrane chip to generate an in vitro gut-on-a-chip model. Human umbilical vein endothelial cells and Caco-2 were cultured in the upper and lower layers of the culture chambers in the microfluidic chip, respectively. The human peripheral blood mononuclear cells were infused into the capillary side at a constant rate using an external pump to simulate the in vitro immune system and the shear stress of blood in vivo. The model exhibited intestine morphology and function after only 5days of culture, which is significantly less than the 21days required for static culture in the Transwell® chamber. Furthermore, it was observed that drug-resistant bacteria triggered barrier function impairment and inflammation, resulting in enteritis, whereas probiotics (Lactobacillus rhamnosus GG) improved only partially. The use of Amikacin for enteritis is effective, whereas other antibiotic therapies do not work, which are consistent with clinical test results. This model may be used to explore intestinal ecology, host and intestinal flora interactions, and medication assessment.

Differentiation of Subjective Cognitive Decline, Mild Cognitive Impairment, and Dementia Using qEEG/ERP-Based Cognitive Testing and Volumetric MRI in an Outpatient Specialty Memory Clinic.

Distinguishing between subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia in a scalable, accessible way is important to promote earlier detection and intervention. We investigated diagnostic categorization using an FDA-cleared quantitative electroencephalographic/event-related potential (qEEG/ERP)-based cognitive testing system (eVox® by Evoke Neuroscience) combined with an automated volumetric magnetic resonance imaging (vMRI) tool (Neuroreader® by Brainreader). Patients who self-presented with memory complaints were assigned to a diagnostic category by dementia specialists based on clinical history, neurologic exam, neuropsychological testing, and laboratory results. In addition, qEEG/ERP (n = 161) and quantitative vMRI (n = 111) data were obtained. A multinomial logistic regression model was used to determine significant predictors of cognitive diagnostic category (SCD, MCI, or dementia) using all available qEEG/ERP features and MRI volumes as the independent variables and controlling for demographic variables. Area under the Receiver Operating Characteristic curve (AUC) was used to evaluate the diagnostic accuracy of the prediction models. The qEEG/ERP measures of Reaction Time, Commission Errors, and P300b Amplitude were significant predictors (AUC = 0.79) of cognitive category. Diagnostic accuracy increased when volumetric MRI measures, specifically left temporal lobe volume, were added to the model (AUC = 0.87). This study demonstrates the potential of a primarily physiological diagnostic model for differentiating SCD, MCI, and dementia using qEEG/ERP-based cognitive testing, especially when combined with volumetric brain MRI. The accessibility of qEEG/ERP and vMRI means that these tools can be used as adjuncts to clinical assessments to help increase the diagnostic certainty of SCD, MCI, and dementia.

Determining Etiologic Diagnoses in Patients with Rapidly Progressive Dementia

AbstractBackgroundOverlap in the presenting clinical features and test results in patients with rapidly progressive dementia (RPD) confounds the etiologic diagnoses of RPD, contributing to diagnostic delays, missed treatment opportunities, and poorer outcomes. There is a need to improve diagnostic accuracy in patients with RPD, with particular emphasis on identifying patients with potentially treatment‐responsive causes of RPD early in the symptomatic course.MethodPatients with RPD were prospectively enrolled and evaluated in inpatient settings and outpatient subspecialty (memory) clinics at Washington University (Saint Louis, MO; 2016–2019) and Mayo Clinic (Jacksonville, FL; 2020–2021). Etiologic diagnoses were independently assigned by two dementia specialists integrating clinical features and the results of widely accessible diagnostic testing and referencing established diagnostic criteria. Diagnostic disagreements were resolved via blinded review by a third specialist. Clinicopathologic correlation was evaluated using neuropathological and genetic data when available.Result160 patients with RPD were assessed, with average age‐at‐symptom onset 60.0±15.9 years; 50% were female. Diagnostic inter‐rater reliability (91% agreement; Cohen’s κ = 0.88, p&lt;0.001) and clinicopathologic correlation were excellent (100% agreement in 24 patients with neuropathologic or genetic data). Autoimmune encephalitis was the leading cause of RPD (39%), followed by Alzheimer disease and related dementias (29%—i.e., frontotemporal dementia, Lewy body dementia, vascular cognitive impairment), Creutzfeldt‐Jakob disease (15%), and other causes (15%—e.g., neurosarcoid, metabolic disruptions, neoplastic disease). The average age of patients with potentially treatable causes (AE and selected “other” causes; 54.4±18.2) was younger than those with neurodegenerative dementing illnesses (67.3±9.5) or CJD (67.4±7.9; p&lt;0.001). Patients with potentially treatable causes were more likely to present with altered level of consciousness and seizures (p&lt;0.05). CSF pleocytosis (&gt;5 WBC/hpf) was more common in AE patients (p&lt;0.05).ConclusionEtiologic diagnoses can be reliably established in RPD patients using available clinical data. Treatment‐responsive causes of RPD are common warranting consideration, particularly in younger patients with altered consciousness, seizures, and CSF pleocytosis.

Snake Venom-specific Phospholipase A2: A Diagnostic Marker for the Management of Snakebite Cases.

Snakebites are a common cause of morbidity and mortality, especially in tropical countries. Snakebites in any community are managed based on the clinical features and intravenous administration of antisnake venom (ASV). The administration of ASV is either deficient or given in excess based on clinical decisions and whole blood clotting test results. The present study is designed to analyze the level of snake venom component in the blood of snakebite in association with the clinical features. Blood samples were collected from the patients admitted to Karnataka Institute of Medical (KIMS) hospital with a history of snakebite considering the inclusion criteria. Serum was collected from the blood of snakebite patients before and after ASV and used to assess the level of venom-specific phospholipase A2 (PLA2) enzyme using the enzyme-linked immunosorbent assay (ELISA) method. Quantitative ELISA results revealed that the snake venom-specific PLA2 in the victim's blood was in the range of 0.3-1.27 mg/mL before the administration of ASV. However, the concentration of PLA2 after 24 hours of ASV administration was decreased in most of the patients. Further, it was observed that envenomation complications were directly proportional to the amount of snake venom-specific PLA2 found in the blood of the snakebite patient. The study concludes that snake venom-specific PLA2 in the blood of snakebite patients could be used as a reliable venom marker, which helps in determination of appropriate ASV dosage in snakebite patients. Kaulgud RS, Hasan T, Vanti GL, Veeresh S, Uppar AP, Kurjogi MM. Snake Venom-specific Phospholipase A2: A Diagnostic Marker for the Management of Snakebite Cases. Indian J Crit Care Med 2022;26(12):1259-1266.

Evaluation of simulation-based ultrasound education using a bladder simulator for medical students in Japan: a prospective observational study

PurposeThis study aimed to investigate the usefulness of ultrasound education for medical students using a bladder simulator.MethodsThis prospective observational study included volunteer fifth- and sixth-year medical students. An intravesical urine volume measurement simulator and a pocket-sized hand-held ultrasound device were used. The ultrasound education comprised pre-learning, briefing, simulation, debriefing, and learning summary. The simulation consisted of two tests: bladder simulator cube evaluation and scenario-based clinical application. A self-rated confidence score of 0–10 points along with reasons for the scores was recorded before and after the ultrasound education.ResultsTwelve participants (median age, 23 years; female, 75%) met the inclusion criteria and were examined. Participants’ bladder simulator cube evaluation and scenario-based clinical application test results were good, and the educational difficulty level was appropriate. The mean confidence scores for main unit operation, probe control, image acquisition, image evaluation and clinical application before the ultrasound education were 1.0, 1.8, 1.3, 0.8 and 0.1 points, respectively. The mean confidence scores after the ultrasound education were 5.8, 5.9, 5.4, 5.5 and 5.1, respectively, with significant increases for all items (p < 0.01). The positive impression categories that affected confidence scores after ultrasound education were related to device operation, image acquisition, image evaluation, clinical application and learning.ConclusionUltrasound education using a bladder simulator increases confidence scores by imparting competencies related to device operation, image acquisition, image evaluation and clinical application, and it improves students’ learning impression. This is a useful method for introductory ultrasound education for medical students.

Estimating the Potential of the Electronic Nose System for Monitoring Disturbances in the Functional Obesity of Children in a Hospital: Noninvasive Diagnosis without Biosampling

A portable “diagnostic electronic nose” was used to study the composition of a mixture of volatile compounds emitted by the skin of the forearms in children with obesity and other associated metabolic disorders. Differences and features of the profiles of volatile compounds (primarily organic) of the skin on the left and right forearms in children with obesity and the dependence of the profile on food intake, drugs, concomitant diseases, and body characteristics were evaluated in hospital environment. More than 300 patient profiles were analyzed for 2 years, including the dynamics in profiles during repeated planned hospitalizations. The results suggest that the composition of the gas mixture of compounds emitted by the skin on the forearms can be analyzed and compared without preliminary separation or selection using an array of eight piezoelectric sensors of the “diagnostic electronic nose” device. We measured a correlation between the electronic nose data and the results of standard clinical laboratory tests. The parameters of a sensor array and clinical studies are closely related to each other in the levels of urea, alkaline phosphatase, and glucose. An approach based on scanning a volatile skin profile on the forearm for 3–6 min helps to rank children with obesity into groups associated with the socially significant diseases and conditions: “Normal,” “Obesity with a risk of development of type 2 diabetes mellitus,” and “Type 1 diabetes mellitus.” Using chemometric methods, we optimized the analytical procedure and specified research conditions and control points. The composition of the volatile skin metabolome on the right forearm, scanned on an empty stomach, is the most informative. The accuracy of the difference between the problem groups and the norm is 100%; the accuracy of the rank within pathological groups is 80%. The proportion of false assignments increases in the presence of inflammation in a body of any type. The potentials of the procedure were evaluated in a hospital environment.

Skin, mucosa and nail findings in hospitalized pediatric patients with Coronavirus disease-2019 (COVID-19)

BackgroundCutaneous manifestations of Coronavirus Disease-2019 (COVID-19) disease have not yet been fully described in hospitalized pediatric patients. ObjectivesThis prospective study aims to demonstrate the skin, mucosal, and nail findings of hospitalized children with COVID-19. MethodsThe authors included hospitalized pediatric patients. Two dermatologists examined skin, hair, nails, and mucosa. Patients with drug eruptions were excluded with an anamnesis, clinical and laboratory test results. ResultsOut of 46 enlisted patients, 19 (41,3%) patients displayed skin, mucosal or nail findings. Skin findings were seen on 14 (30.4%) patients. Ten (22%) patients presented skin findings matching described patterns. Half of the patients with patterned rashes had confluent erythematous/maculopapular/morbilliform rashes. Eleven out of 46 (23.9%) patients developed periorbital erythema and edema. Ten (22%) patients had at least one oral mucosal finding. One telogen effluvium, one blue nail, and one flag sign on nails were noticed. Nine (19.5%) patients out of 46 had developed MIS-C. MIS-C patients had mucocutaneous manifestations except one (88.8%). Study limitationsThe authors have detected a higher rate of mucocutaneous manifestations compared to out-patients with mild COVID-19 because the study is based on hospitalized patients only. ConclusionsPediatric COVID-19 patients are more susceptible to developing mucocutaneous manifestations compared to adults. The authors propose COVID-19 should be acknowledged as one of the viral exanthem rashes of childhood. The authors noticed that the most common findings were periorbital erythema and edema. The confluent erythematous/maculopapular/morbilliform rashes appear to be the most common patterns associated with severe COVID-19.

Analysis of clinical features of 380 cases of special portal hypertension-Abernethy malformation

Objective: To summarize the clinical features of special portal hypertension-Abernethy malformation reported at home and abroad. Methods: The relevant literature on Abernethy malformation published at home and abroad from January 1989 to August 2021 was collected. Patients'clinical features, imaging and laboratory test results, diagnosis, treatment, and prognosis were analyzed. Results: A total of 380 cases were included from 60 and 202 domestic and foreign literatures. Among them, there were 200 cases of type I, with 86 males and 114 females, and the average age was (17.08±19.42) years, while there were 180 cases of type II, with 106 males and 74 females, and the average was (14.85±19.60) years. The most common reason for the first visit of an Abernethy malformation patient's was gastrointestinal system symptoms such as hematemesis and hematochezia caused by portal hypertension (70.56%). Multiple malformations were present in 45.00% of type Ⅰ and 37.80% of type Ⅱ patients. The most prevalent condition was congenital heart disease (62.22%, and 73.53%). Complications related to Abernethy malformation was occurred in 127 and 105 cases with type I and type II, respectively, with liver lesions in 74.02% (94/127) and 39.05% (42/105) and hepatopulmonary syndrome of 33.07% (42/127) and 39.05% (41/105), respectively. The imaging diagnosis of type I and type II Abernethy malformations were mainly based on abdominal computed tomography (59.00%, and 76.11%). Liver pathology was performed in 27.10% of patients. Blood ammonia increased by 89.06% and 87.50%, and AFP increased by 29.63% and 40.00% in laboratory findings. 9.76% (8/82) and 6.92% (9/130) died, while 84.15% (61/82) and 88.46% (115/130) had improved conditions after medical conservative, or surgical treatment. Conclusion: Abernethy malformation is a rare disease in which congenital portal vein development abnormalities lead to significant portal hypertension and portasystemtic shunt. Patients often seek medical treatment for gastrointestinal bleeding and abdominal pain. Type Ⅰ is more common in women, often associated with multiple malformations, and prone to secondary intrahepatic tumors. Liver transplantation is the main treatment method. Type Ⅱ is more prevalent in males, and shunt vessel occlusion is the first treatment choice. Overall, type Ⅱ has a better therapeutic impact than type Ⅰ.

The Spouses of Stroke Patients Have a Similar Oral Microbiome to Their Partners with an Elevated Risk of Stroke.

Spousal members who share no genetic relatedness show similar oral microbiomes. Whether a shared microbiome increases the risk of cerebrovascular disease is challenging to investigate. The aim of this study was to compare the oral microbiota composition of poststroke patients, their partners, and controls and to compare the risk of stroke between partners of poststroke patients and controls. Forty-seven pairs of spouses and 34 control subjects were recruited for the study. Alcohol use, smoking, metabolic disease history, clinical test results, and oral health were documented. Oral microbiome samples were measured by 16S rRNA gene sequencing. The risk of stroke was measured by risk factor assessment (RFA) and the Framingham Stroke Profile (FSP). Poststroke patients and their partners exhibited higher alpha diversity than controls. Principal-coordinate analysis (PCoA) showed that poststroke patients share a more similar microbiota composition with their partners than controls. The differentially abundant microbial taxa among the 3 groups were identified by linear discriminant analysis effect size (LEfSe) analysis. The risk factor assessment indicated that partners of poststroke patients had a higher risk of stroke than controls. Spearman correlation analysis showed that Prevotellaceae was negatively associated with RFA. Lactobacillales was negatively associated with FSP, while Campilobacterota and [Eubacterium]_nodatum_group were positively associated with FSP. These results suggest that stroke risk may be transmissible between spouses through the oral microbiome, in which several bacteria might be involved in the pathogenesis of stroke.

Clinical Relevance of Ultrasonographic and Electrophysiological Findings of the Median Nerve in Unilateral Carpal Tunnel Syndrome Patients.

Few studies have compared the unaffected and affected sides in the same carpal tunnel syndrome (CTS) patients using ultrasonography and electrophysiological tests. We focused on unilateral idiopathic CTS patients to investigate whether clinical test results differ between the unaffected and affected sides. The bilateral wrist joints of 61 unilateral idiopathic CTS patients were evaluated. The median nerve cross-sectional area of ultrasound image, and latencies of the compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) were measured. The values obtained were compared between the affected and unaffected sides. The diagnostic accuracies of each parameter were assessed, and cut-off values were defined. Significant differences were observed in all parameters between the affected and unaffected sides (p &lt; 0.01). Area under the curve (AUC) values were 0.74, 0.88, and 0.73 for the cross-sectional area, CMAP distal latency, and SNAP distal latency, respectively. Cut-off values were 11.9 mm2, 5.1 ms, and 3.1 ms for the cross-sectional area, CMAP distal latency, and SNAP distal latency, respectively. The most reliable parameter that reflected clinical symptoms was the distal latency of CMAP. Cut-off values for each parameter are considered to be an index for the onset of the clinical symptoms of CTS.

Triglyceride glucose index and Atherogenic index ofplasma for predicting colorectal neoplasms in patients without cardiovascular diseases.

Colorectal neoplasms (CRN) include colorectal cancer (CRC) and colorectal adenoma (CRA). The relationship between CRN and triglyceride-glucose (TyG) index or between CRN and atherogenic index of plasma (AIP) is unclear. This study aims to investigate the roles of TyG index and AIP in predicting CRN in people without cardiovascular disease (CVD). 2409 patients without CVD underwent colonoscopy were enrolled. Clinical information and relevant laboratory test results of these patients were collected and recorded. According to endoscopic and pathological results, all participants were divided into a neoplasms group and a non-neoplasms group. The TyG index was calculated as ln (TGs×FPG/2), while AIP was calculated as log (TGs/HDL-C). We used uni- and multivariate logistic regression and restricted cubic spline (RCS) to analyze the association between the TyG inedx, AIP and CRN, develop predictive models and construct the nomograms. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive value for CRN. Participants in the neoplasms group were more likely to be older, have higher TyG index, higher AIP and higher rates of fecal occult blood test positivity, and were more likely to be male, smokers and those with the family history of CRC (P < 0.05). The higher TyG index was related to the higher risk of CRN [OR (95% CI): 1.23 (1.08 - 1.41), P = 0.003]. The higher AIP was related to the higher risk of CRN [OR (95% CI): 1.55 (1.16 - 2.06), P = 0.003]. These two indicators are better for predicting CRN in women than men. The combined use of the TyG index and other independent risk factors (age, sex, smoking status, family history and FOBT) to distinguish CRN was effective, with a sensitivity of 61.0%, a specificity of 65.1% and an AUC of 0.669 (95%CI, 0.639 - 0.698). Likewise, the combined use of the AIP and other independent risk factors to distinguish CRN was also effective, the model had an overall 56.3% sensitivity and 68.7% specificity with an AUC of 0.667 (95%CI, 0.638 - 0.697). This study showed that the TyG index and the AIP might be biomarkers that could be used to predict the risk of CRN in patients without CVD.

Abstract 11197: Gender Differences and Temporal Trends in Clinical Characteristics and Use of Myocardial Scintigraphy in Evaluation of Stable CAD

Introduction: Data on temporal and gender differences in referral patterns and clinical characteristics of patients referred for myocardial scintigraphy for suspected coronary artery disease (CAD), is lacking. Furthermore, the differential impact of COVID-19 pandemic on gender differences in referrals and clinical risk profile of referred patients is not known. Methods: This is a cross-sectional observational single center study of patients evaluated across 3 yearly time intervals in 2000, 2010 and 2020. We evaluated 2,615 patients (68% women) with mean age 65.9 years, who were referred for stress/rest myocardial scintigraphy. Trends in clinical characteristics and test results were compared in women and men across these intervals. Results: Men were more likely to be referred for testing than women, however there was a consistent increase in proportion of women referred over time, including the time of COVID pandemic in 2020. Men were more likely to present with typical symptoms, compared to women. Among women, there is a significant increase in prevalence of active smoking and a decrease in age at presentation and hypertension, over time (p&lt;0.05). Among men, there was a significant decrease in history of previous MI, with no change in other risk factors over time. Across time intervals, in both men and women, there was a significant increase in EF (Ejection Fraction) and decrease in presence of ischemic myocardium at risk, identified by semi-quantitative scores including summed rest score (SRS), summed stress score (SSS) at rest (p&lt;0.05). Conclusions: There are gender differences in proportion of men and women who are referred for stress testing, for evaluation of stable CAD. There was a substantial change in risk of inducible myocardial ischemia among male and female patients with known or suspected CAD. Our findings are relevant to understand the implications of gender differences on risk assessment and diagnostic accuracy in known or suspected CAD, over time.

Growth stimulation expressed gene 2 (ST2): Clinical research and application in the cardiovascular related diseases.

As an interleukin (IL)-1 receptor family member, scientists found that when circulating soluble growth stimulation expressed gene 2 (sST2) is low, its ligand, IL-33, will bind to ST2L to exert protective effects on various types of cells. On the other hand, competitive binding of IL-33 occurs when sST2 concentrations are increased, followed by a reduction in the amount available for cell protection. Based on this mechanism, the usage of sST2 is to identify the population of high-risk patients with cardiovascular disease. In recent years, the role of serum sST2 in the occurrence, diagnosis, prognosis, and treatment of cardiovascular diseases has been gradually accepted by doctors. This manuscript systemically reviews the biological functions and applications of sST2 in disease diagnosis and treatment, especially for cardiovascular diseases. In clinical testing, since IL-33 can negatively impact sST2 measurement accuracy, the properties of current assay kits have been summarized and discussed to provide a clear view of the clinical chemistry results. Although sST2 is a promising biomarker, there are few quantitative approaches available for clinical testing. In this context, a mass spectrometry (MS)-based approach might be an option, as this is a powerful analytical tool to distinguish structurally related molecules in the matrix and decrease false-positive results in clinical testing. Moreover, approaches developed based on MS would be an ideal way to further study sST2 standardization.

Specific refraction-index increments of oxygenated hemoglobin from thalassemia-minor patients are not significantly different than those from healthy individuals.

The mass and concentration of hemoglobin per erythrocyte are important hematological parameters. Measuring these parameters from intact erythrocytes requires the value of specific refraction-index increment (RII) of oxygenated hemoglobin, which diverges in the literature. Refractive indices of hemoglobin solutions are measured directly by digital holographic microscopy on a microfluidic channel filled with hemoglobin solutions prepared by hemolysis of fresh human erythrocytes and refractive-index standards sequentially. Hemoglobin extracted from thalassemic patients shows 3-4% higher RII than that from healthy volunteers, but the difference is not significant in comparison to inter-subject variations within each group. The quantified RIIs are applied to quantify mean corpuscular hemoglobin mass of blood from 37 human subjects, and results are in accord with standard clinical test results.

A complete blood count-based multivariate model for predicting the recovery of patients with moderate COVID-19: a retrospective study

Many resource-limited countries need an efficient and convenient method to assess disease progression in patients with coronavirus disease 2019 (COVID-19). This study developed and validated a complete blood count-based multivariate model for predicting the recovery of patients with moderate COVID-19. We collected the clinical data and laboratory test results of 86 patients with moderate COVID-19. These data were categorized into two subgroups depending on the laboratory test time. Univariate logistic regression and covariance diagnosis were used to screen for independent factors, and multifactorial logistic regression was used for model building. Data from 38 patients at another hospital were collected for external verification of the model. Basophils (OR 6.372; 95% CI 3.284–12.363), mean corpuscular volume (OR 1.244; 95% CI 1.088–1.422), red blood cell distribution width (OR 2.585; 95% CI 1.261–5.297), and platelet distribution width (OR 1.559; 95% CI 1.154–2.108) could be combined to predict recovery of patients with moderate COVID-19. The ROC curve showed that the model has good discrimination. The calibration curve showed that the model was well-fitted. The DCA showed that the model is clinically useful. Small increases in the above parameters within the normal range suggest an improvement in patients with moderate COVID-19.

Detection of Viral Respiratory Factors via Multiplex PCR in Newborn &amp; Pediatric Patients and Their Distribution According to Seasons

Objective: Respiratory viruses are a global public health problem, and viruses cause up to 80% of respiratory infections. This study aimed to elucidate the viral respiratory tract factors and the frequency of coinfections in the newborn and pediatric age groups determined by the molecular respiratory tract panel (MRTP) kit. Materials &amp; Method: The results of the respiratory tract panel test with the molecular multiplex method were applied to 1486 newborn and pediatric patients between 01.10.2020 and 30.04.2022 to determine the viral respiratory tract factors were analyzed retrospectively. The Multiplex RT – PCR test confirmed results were recorded from the hospital database under the supervision of a microbiologist, negative and positive controls were evaluated, and test was validated. Results: Clinical virology laboratory test results were scanned and at least one respiratory tract virus was detected in nasopharyngeal swabs of 499 (33.6%) patients. A total of 634 viruses were detected in 499 NS-positive samples. The most commonly detected viral pathogens were parainfluenza – 3 (36.9%, n=184), respiratory syncytial virus (22.8%, n=114), human rhinovirus (19.2%, n=96), SARS-CoV-2 (12.6%, n=63), and human bocavirus (10.8%, n=54) respectively. Conclusion: In this research, we tried to elaborate the accuracy of molecular multiplex method and the respiratory tract panel test to determine the respiratory factors in newborn and pediatric age group patients. The logic behind this lies beneath the fact that diagnosing with a kit that can detect both single and multiple factors causing coinfection can be performed simultaneously.

Relationships between the Clinical Test Results and Neurophysiological Findings in Patients with Thoracic Outlet Syndrome.

A thoracic outlet syndrome (TOS) is the type of brachial plexus disorder most difficult to objectively assess using a clinical examination and differential diagnosis. Its symptoms can be frequently misdiagnosed, especially among others with cervical disc-root conflicts, plexopathies, and peripheral neuropathies. In this study, we aim to identify the correlations between positive Doppler ultrasonography results indicating pathological changes in the subclavian flow velocity, clinical tests, and chosen clinical neurophysiology recordings as proposed alternative or supplementary diagnostic tools for evaluating TOS patients. Sixty TOS patients with positive Doppler ultrasonography and Roos test results and sixty healthy people as a control group were bilaterally examined, and the results were compared. Pain intensity was assessed using a visual analogue scale (VAS). Sensory perceptions within C4–C8 dermatomes were assessed with Von Frey filament (FvF) tests. The activity of motor units in the proximal and distal muscles of the upper extremities was evaluated using surface electromyography (sEMG) during maximal contractions before and after a provocative raised hands test (RHT). An electroneurography (ENG) was used to evaluate the transmission of nerve impulses peripherally. Motor evoked potential (MEP) recordings, induced by the over-vertebral magnetic stimulation of the C5–C7 neuromeres, were used to examine motor transmissions from the cervical motor centres to the upper extremities muscles. The results revealed a relationship between positive Doppler test scores and pathological changes in the subclavian flow velocity through the results of the following diagnostic tools: a VAS score of 1.9 was detected on average, superficial sensory perception abnormalities were found in the innervation areas of the ulnar nerves detected by FvF tests, a decrease in the amplitudes of sEMG recordings was seen in distal rather than proximal muscles (especially following the RHT), a decrease in the motor and sensory peripheral transmissions of nerve impulses in the median, ulnar and cutaneous anterobrachial median nerves was seen, as well as MEP amplitudes recorded from the abductor pollicis brevis muscle. The provocative RHT combined with sEMG and MEP recordings can be considered accurate and objective clinical neurophysiology tools that could supplement the commonly used clinical tests. Such an approach may result in a more precise neurogenic TOS diagnostic algorithm.