Current Trends In Diagnosis Research Articles

Cytomegalovirus infection in gastroenterology

To highlight the relevance of gastrointestinal manifestations of cytomegalovirus infection (CMVI), to highlight the main risk factors for the development of this pathology, current trends in diagnosis and treatment. CMVI is one of the most common opportunistic diseases, characterized by a variety of manifestations from asymptomatic to severe generalized forms affecting internal organs and body systems. The prevalence of CMVI worldwide ranges from 20 to 95%. Particular attention is paid to timely diagnosis, treatment and prevention of CMVI. The "gold standard" in the diagnosis of digestive diseases associated with CMVI is immunohistochemical examination and detection of cytomegalovirus (CMV) DNA in tissues using the polymerase chain reaction (PCR). Of undoubted interest in the diagnosis of CMV is the detection of CMV DNA in stool using digital PCR. Compared to quantitative PCR, digital PCR has higher accuracy and sensitivity. As first-line therapy, the drugs of choice are ganciclovir and valganciclovir. Maribavir has been successfully used to treat patients with CMV infection refractory to one or more previous therapies. One of the promising directions in the treatment of cytomegalovirus colitis in patients with ulcerative colitis is fecal microbiota transplantation. Timely identification of risk factors for the development of CMV infection, the introduction of innovative methods and approaches in diagnosis, and the use of effective methods for treating diseases of the digestive system associated with CMV infection can improve the prognosis of the underlying disease and reduce the risk of developing urgent conditions in gastroenterology.

Current Trends in Diagnosis and Treatment Approach of Diabetic Retinopathy during Pregnancy: A Narrative Review.

Diabetes mellitus during pregnancy and gestational diabetes are major concerns worldwide. These conditions may lead to the development of severe diabetic retinopathy during pregnancy or worsen pre-existing cases. Gestational diabetes also increases the risk of diabetes for both the mother and the fetus in the future. Understanding the prevalence, evaluating risk factors contributing to pathogenesis, and identifying treatment challenges related to diabetic retinopathy in expectant mothers are all of utmost importance. Pregnancy-related physiological changes, including those in metabolism, blood flow, immunity, and hormones, can contribute to the development or worsening of diabetic retinopathy. If left untreated, this condition may eventually result in irreversible vision loss. Treatment options such as laser therapy, intravitreal anti-vascular endothelial growth factor drugs, and intravitreal steroids pose challenges in managing these patients without endangering the developing baby and mother. This narrative review describes the management of diabetic retinopathy during pregnancy, highlights its risk factors, pathophysiology, and diagnostic methods, and offers recommendations based on findings from previous literature.

SAT664 Obesity And Overweight Diagnosis, Physician Prescription And Patient Filling Of Anti-Obesity Medications In US

Abstract Disclosure: K. Ezendu: Employee; Self; Eli Lilly & Company. C.K. Choong: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. M. Brown: Employee; Self; Eli Lilly & Company. R. Malik: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. E.R. Hankosky: Employee; Self; Eli Lilly & Company. Stock Owner; Self; Eli Lilly & Company. Background: The prevalence of obesity and overweight is high and growing in the US adult population. Current trends in diagnosis and treatment with anti-obesity medications (AOMs) of obesity or overweight are unknown. Objectives: To describe obesity and overweight diagnosis rates, AOM prescribing rates, and AOM fill rates in AOM-eligible adults from 2016 to 2021. Methods: Separate cohorts of AOM-eligible adults (18-80 years) were constructed from Optum’s de-identified Market Clarity Data for each year from 2016 to 2021. AOM-eligible individuals were defined as adults with obesity (≥1 body mass index (BMI) value ≥30 kg/m2) or adults with overweight (≥1 BMI 27 - <30 kg/m2) and ≥1 obesity-related complication (ORC) including type 2 diabetes, hypertension, obstructive sleep apnea, dyslipidemia, and cardiovascular diseases. Obesity or overweight diagnosis rates in each cohort (2016-2021) were determined as the percentage of adults with obesity or overweight (as determined by BMI in the electronic health record (EHR)), respectively, who had a corresponding ICD-10 diagnosis in claims or EHR. The prescribing or fill rate of AOMs (i.e., phentermine-topiramate, lorcaserin, orlistat, naltrexone-bupropion, liraglutide, and semaglutide) was determined as the percentage of AOM-eligible members with a written prescription of an AOM in the EHR or at least one filled AOM prescription based on pharmacy claims in each year, respectively. Results: There were between 1,606,593 to 2,277,415 AOM-eligible adults constituting each cohort. The cohorts had similar distributions for age, gender, race, BMI, and insurance type. The obesity diagnosis rate increased from 39.4% in 2016 to 57.2% in 2021, with the diagnosis rate in claims only at 33.5% in 2016 and 47.3% in 2021. The overweight diagnosis rate rose from 18.1% in 2016 to 31.2% in 2021, with the claims-based rate at 15.4% in 2016 and 29.2% in 2021. The prescribing rate for AOMs was low, ranging from 0.4% to 0.5% across all years. Similarly, the fill rates for AOMs rose from 0.4% in 2016 to 0.6% in 2021. From 2016 to 2021, the prescribing and fill rates for incretin AOMs (i.e., liraglutide and semaglutide) doubled (from 0.1% to 0.2%) and quadrupled (from 0.1% to 0.4%), respectively. Conclusions: Despite some increases in recent years, obesity and overweight diagnosis rates remain low, suggesting a significant clinical care gap. Even in the most recent year, less than 3 of 5 people with obesity received an official diagnosis and less than half received a claims-based diagnosis. The overall obesity and overweight diagnoses were higher than reported in claims, signaling a gap in reimbursement. AOM prescribing and filling remained consistently low, with less than 7 in 1000 AOM-eligible adults receiving or filling AOM prescriptions. The clinical care gap for overweight and obesity is substantial, needing effective measures to reduce barriers for obesity care. Presentation: Saturday, June 17, 2023

Pancreatic adenocarcinoma — current trends in diagnosis and treatment

Pancreatic adenocarcinoma — current trends in diagnosis and treatment

Survey of equine veterinarians regarding primary equine back pain in the United States.

Back pain is a common complaint, clinical finding and performance limiting factor in sport horses. This study sought to gather current veterinary trends in the diagnosis, treatment and management of primary equine back pain in the United States. A 22 question survey was distributed electronically to equine practitioners through AAEP and ACVSMR listservs and through closed social media groups. The survey was open from April 20, 2022 to July 5, 2022. Responses were analyzed using Microsoft excel pivot tables. Ninety-seven survey responses were obtained and analyzed. Respondents reported the clinical signs most frequently relayed to them by the owner/rider/trainer of horses diagnosed with primary back pain were behavioral issues and poor performance. Most common diagnostic tests reported were radiography of the spinous processes, thoraco-lumbar vertebral bodies, and transcutaneous ultrasound of the thoraco-lumbar region. Most common pathologies reported were impinging dorsal spinous processes, degenerative sacro-iliac joint disease, and osteoarthritis in lumbar or thoracic articular process joints. In regards to impinging spinous process ("kissing spine") treatments, 72.2% of respondents recommended surgery only after non-surgical treatments failed, and 14.6% of respondents never recommended surgery. The majority (82%) of respondents reported some level of improvement in clinical signs of primary back pain with rehabilitation alone. To date, there has been no consensus or discussion about common abnormalities, diagnostic tests, treatments or management options for primary equine back pain in the United States. Results of this survey are a starting point showing current trends in diagnosis, treatment and management of primary equine back pain among equine practitioners in the United States showing 82% of practitioners using rehabilitation as a component of treatment.

Current Trends in Diagnosis, Treatment and Prognosis of Canine Insulinoma.

Simple SummaryDogs can develop a tumour of the pancreas that produces too much insulin, which is called an ‘insulinoma’. These tumours cause signs such as collapse at exercise and very low blood sugar. Insulinomas are difficult to cure because they spread to other tissues very commonly. The diagnosis of an insulinoma requires the demonstration of the simultaneous occurrence of low blood glucose levels and either normal or elevated blood insulin levels. The diagnostic imaging of insulinomas in dogs is preferably conducted by taking computed tomography scans. In general, the surgical treatment of insulinomas is the preferred therapy because it results in the best survival times, but many dogs also require medical treatment at some point. The prognosis of dogs with insulinomas is guarded, because clinical symptoms relating to low blood sugar almost always return due to tumour regrowth or spread. This review paper aims to provide a summary and update the current recommendations in the veterinary literature for the diagnosis, treatment and clinical outcome of insulinomas in dogs. The contents of this review are comprehensive and relevant to veterinarians that work at all levels and will inform and advance our understanding of insulinomas in dogs.The most common pancreatic tumour in dogs is the insulinoma. Canine insulinomas are considered to be malignant in more than 95% of the cases because they almost always tend to metastasise. The diagnosis of an insulinoma requires the demonstration of the simultaneous occurrence of hypoglycaemia and blood insulin levels that are within or above the high end of the reference interval. The staging of canine insulinomas is preferably conducted by contrast-enhanced computed tomography. In general, surgical treatment is the most effective because of it results in long survival times, but many dogs also require medical treatment at some point. The prognosis of canine insulinomas is guarded as clinical hypoglycaemia almost always returns due to metastasis or tumour regrowth. This review aims to provide a summary and update the current recommendations in the veterinary literature for the diagnosis, treatment and prognostication of canine insulinomas.

Creating a story on the pages of a book about diffuse B-large cell lymphoma

Within the framework of VI All-Union Congress of Hematologists of Russia and III Congress of Transfusiologists of Russia, the symposium concerning diffuse large B cell lymphoma (DLBCL) was held on April 21. Leading Russian experts discussed current trends in diagnosis, the causes of the failures and successes of the treatment of this heterogeneous disease, the changes that are expected in the very near future. During the symposium, the detailed data concerning the new option for DLBCL therapy polatuzumab vedotin (immunoconjugate) were also presented. The symposium was supported by Roche.

A Rare Cause of Hemoperitoneum

A Rare Cause of Hemoperitoneum

Current trends in diagnosis and treatment strategies of COVID-19 infection.

Coronaviruses are terrifically precise and adapted towards specialized respiratory epithelial cells, observed in organ culture and human volunteers both. This virus is found to possess an unpredictable anti-viral T-cell response which in turn results in T-cell activation and finally apoptosis, leading to cytokine storm and collapse of the whole immune system. The present review provides comprehensive information regarding SARS-CoV-2 infection, mutant strains, and the impact of SARS-COV-2 on vital organs, the pathophysiology of the disease, diagnostic tests available, and possible treatments. It also includes all the vaccines developed so far throughout the world to control this pandemic. Until now, 18 vaccines have been approved by the WHO and further 22 vaccines are in the third trial. This study also provides up-to-date information regarding the drugs repurposed in clinical trials and the recent status of allopathic drugs along with its result. Although vaccines are available, specific treatment is not available for the disease. Furthermore, the effect of vaccines on new variants is a new area of research at this time. Therefore, a preventive attitude is the best approach to fight against this virus.

Renal Complications Related to Checkpoint Inhibitors: Diagnostic and Therapeutic Strategies.

Immune checkpoint inhibitors (ICI) targeting CTLA-4 and the PD-1/PD-L1 axis have unprecedentedly improved global prognosis in several types of cancers. However, they are associated with the occurrence of immune-related adverse events. Despite their low incidence, renal complications can interfere with the oncologic strategy. The breaking of peripheral tolerance and the emergence of auto- or drug-reactive T-cells are the main pathophysiological hypotheses to explain renal complications after ICI exposure. ICIs can induce a large spectrum of renal symptoms with variable severity (from isolated electrolyte disorders to dialysis-dependent acute kidney injury (AKI)) and presentation (acute tubule-interstitial nephritis in >90% of cases and a minority of glomerular diseases). In this review, the current trends in diagnosis and treatment strategies are summarized. The diagnosis of ICI-related renal complications requires special steps to avoid confounding factors, identify known risk factors (lower baseline estimated glomerular filtration rate, proton pump inhibitor use, and combination ICI therapy), and prove ICI causality, even after long-term exposure (weeks to months). A kidney biopsy should be performed as soon as possible. The treatment strategies rely on ICI discontinuation as well as co-medications, corticosteroids for 2 months, and tailored immunosuppressive drugs when renal response is not achieved.

Diagnosis and endovascular management of pulmonary arteriovenous malformations.

Pulmonary arteriovenous malformations (PAVM) are abnormal communication of a branch of the pulmonary artery and pulmonary vein circumventing the intervening pulmonary capillaries. This results in a right-to-left (R-L) shunt and its related manifestations, which include hampered gas exchange leading to hypoxaemia, dyspnoea, paradoxical emboli leading to stroke, cerebral abscess, myocardial infarction and pulmonary haemorrhage due to rupture of the PAVM. Endovascular transcatheter embolization of the feeding vessels with coils or occlusion devices is the current standard care of treatment and preferred treatment modality. The articles aim to provide insights into the current trends in diagnosis, the current recommendations, approach and management options for patients with PAVM.

Syphilis in pregnancy: The impact of “the Great Imitator”

Syphilis remains a common congenital infection over the globe. There has been a tremendous rise in the number of congenital syphilis cases worldwide in the last 20 years. It affects large numbers of pregnant mothers in high burden regions causing a significantly high perinatal mortality and morbidity, which can be easily prevented by early antenatal screening and treatment.Diagnosis of maternal syphilis in pregnancy mainly based on clinical symptoms, serological tests and direct identification of treponemes in clinical samples. However, the diagnosis can be challenging due to the relapsing-remitting nature of the disease. The early stage of the infection is usually symptomatic which is commonly followed by an asymptomatic latent phase but infectious and as a result serological tests will be positive. The risk of transplacental transmission is high during the second and third trimester.Obstetric complications of syphilis include spontaneous miscarriage, non-immune hydrops, stillbirth, preterm labour, low birth weight, increased neonatal mortality and congenital syphilis among neonates.Penicillin is the drug of choice for treatment and should be commenced immediately. Babies born to mothers with syphilis should also be treated with penicillin. Early detection and prompt intervention are the key to the prevention and successful control of congenital syphilis. The aim of this review is to highlight the impact of syphilis infection on pregnancy and discuss the current trends in diagnosis and management of maternal and congenital syphilis.

369 Poster - Change in trend in various clinico-pathological factors and treatment profile of breast cancer patients in developing countries: A tertiary cancer center experience

Background: Breast cancer management has undergone a seismic revolution in last decade with immense benefit to patients; it is encouraging to see how we have remained abreast of new developments in breast cancer management over that time. However sheer impact of this upon current trends in diagnosis and management of disease, are largely unknown. We aimed to assess & evaluate change in spectrum in socio-demographic profile and management of breast cancer over a decade within a specialist tertiary of a medical college hospital.

Epidemiological Study of Thoracolumbar Pott’s Spine at a Tertiary Care Hospital in North India

Abstract The vertebral column is involved in less than 1% of all the cases of tuberculosis. It can associated with major neurological deficits due to compression of adjacent neural structures with significant deformity of spinal column. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications. In order to extract current trends in diagnosis and medical or surgical treatment of spinal TB we performed a review with patients admitted to our hospital between 2016 and 2017. Although the development of more accurate imaging modalities such as magnetic resonance imaging and advanced surgical techniques have made the early diagnosis and management of spinal TB much easier, these are still very challenging topics. In this review we aim to discuss the diagnosis and management of spinal TB based on studies with acceptable design, clearly explained results and justifiable conclusions.

Canine pseudopregnancy: an evaluation of prevalence and current treatment protocols in the UK

BackgroundThere is a dearth of literature on pseudopregnancy in the bitch, with only a few treatment-based studies published since the 1990s. Pseudopregnancy may be under-recognised in bitches and may account for a proportion of behavioural cases seen in veterinary practices including aggression. Little is known about commonly used treatments for overtly pseudopregnant bitches and it is possible that current regimes may not be prescribed for a sufficient duration to control any clinical signs including, physical and behavioural changes. To investigate current trends in diagnosis and treatment of canine pseudopregnancy, a postal survey was sent to 2000 randomly selected veterinary surgeons in UK veterinary practices. The questionnaire queried how often vets recognise cases of pseudopregnancy in spayed and entire bitches, which physical or behavioural signs are commonly recognised for diagnosis, and which management or treatment protocols are used.ResultsThe response rate was 19.8% (397/2000). Ninety-six percent of veterinary surgeons reported seeing pseudopregnant bitches showing behavioural changes without any physical changes within the last 12 months. Of those behavioural changes, collecting and mothering objects was the most frequently reported behavioural sign (96%). Ninety-seven percent of vets had seen aggression in pseudopregnant bitches. Nevertheless, only 52% of vets routinely asked owners about behavioural changes during consultations. Forty-nine percent of respondents reported seeing pseudopregnancy in spayed bitches. The most commonly reported physical sign was enlarged mammary glands and/or milk production (89%). Treatment options varied (surgical, medical or none) and depended on duration and severity of physical and behavioural signs, owners’ preference, cost, concurrent disease, drug availability and previous history.ConclusionsThis is the largest epidemiological study of canine pseudopregnancy in the UK. The prevalence and severity of clinical signs in dogs with pseudopregnancy are variable and possibly under-estimated. Dogs with overt pseudopregnancy experience diverse physical and behavioural changes and information on standard treatment protocols are lacking. Although, progress on our understanding of diagnosis and treatment of pseudopregnancy in spayed and entire bitches has been made, further studies are warranted.

Tendências atuais no diagnóstico e terapêutica da hidrocefalia de pressão normal

A hidrocefalia de pressão normal, também chamada de síndrome de Adams e Hakim, é uma patologia relativamente infreqüente, mas que adquire relevância nos dias atuais, uma vez que consiste em importante causa reversível de demência. A tríade clínica clássica inclui distúrbios da marcha, demência e incontinência urinária. A cirurgia de derivação ventricular ainda é o procedimento de escolha na maioria dos casos, apesar de não estar isenta de complicações, as quais levam à necessidade de revisão do sistema em até 20% dos casos. Apesar do conhecimento que emergiu nos últimos 40 anos, os resultados pós-cirúrgicos de implantação de shunts em pacientes diagnosticados com hidrocefalia de pressão normal, não melhoraram signifi cativamente na última década. Por essa razão, fatores preditivos de bom prognóstico com o tratamento de derivação, como ausência de atrofi a cerebral e sintomatologia recente (menor que um ano) devem ser identifi cados no pré-operatório, para que ocorra a seleção criteriosa dos pacientes que serão submetidos à cirurgia. Ao contrário da cirurgia de derivação ventricular, o uso da ventriculostomia endoscópica ainda é controverso. Procura-se indicá-la para pacientes nos quais haja suspeita de estenose interventricular funcional e naqueles em que o teste de infusão ventricular demonstre aumento da resistência ao fluxo liquórico.

Current trends in diagnosis and control of piglet diarrhoea of bacterial and viral aetiology-: Alternative approaches for avoidingantibiotic use-A review

Current trends in diagnosis and control of piglet diarrhoea of bacterial and viral aetiology-: Alternative approaches for avoidingantibiotic use-A review

Heads Up! concussion: current trends in diagnosis and management

Heads Up! concussion: current trends in diagnosis and management

Re-Examining the Need for Tissue Diagnosis in Pediatric Diffuse Intrinsic Pontine Gliomas: A Review.

Diffuse intrinsic pontine glioma (DIPG) is a malignant brain tumor of childhood that carries an extremely poor prognosis. There are ~200-300 new cases diagnosed each year, [1, 2] and little progress has been made in changing the prognosis and outcome of the tumor since it was first documented in the literature in 1926 [3]. The median overall survival is 8-11 months [4], with an overall survival rate of 30% at 1 year, and less than 10% at 2 years [4]. This review will provide background information on DIPGs, a historical look at the trends in caring for DIPG, and current trends in diagnosis and treatment. By changing the way we care for these terminal tumors, we can work towards having a better understanding of the underlying molecular biology, and attempt to develop better chemotherapeutic tools to combat the disease.

Tuberculous Lymphadenitis and Parotitis.

Tuberculous lymphadenitis is the most common extrapulmonary manifestation of disseminated tuberculosis (TB). It is considered to be the local manifestation of the systemic disease that has disseminated to local lymph nodes, but a high index of suspicion is needed for the diagnosis, because there are several infectious and noninfectious diseases that can mimic the same clinical picture. In recent years, different diagnostic methods have been introduced, including fine-needle aspiration cytology, which has emerged as a simple outpatient diagnostic procedure that replaced the complete excisional node biopsy, and a number of molecular methods which have greatly improved diagnostic accuracy. This chapter covers the most actual knowledge in terms of epidemiology, clinical manifestations, pathogenesis, and treatment and emphasizes current trends in diagnosis of tuberculous lymphadenitis. TB parotid gland involvement is extremely rare, even in countries in which TB is endemic. Because of the clinical similarity, parotid malignancy and other forms of parotid inflammatory disease always take priority over the rarely encountered TB parotitis when it comes to differential diagnosis. As a result, clinicians often fail to make a timely diagnosis of TB parotitis when facing a patient with a slowly growing parotid lump. This chapter highlights the most important features of this uncommon disease.