Diagnosis Research Articles

EGS SO34 - Idiopathic pancreatitis - a myth or a reality?

Abstract Background Acute pancreatitis is characterized by frequent episodes of inflammation in the pancreas.The most common causes are alcohol abuse and gallstones but approximately 30% of cases are defined as idiopathic because initial evaluation fails to detect the aetiology.This study aims to investigate the aetiology and the reasons for the incorrect labelling of patients with pancreatitis as idiopathic. Method This is a retrospective study and included patients with a diagnosis of idiopathic pancreatitis (IP) between 1 May 2019 and 31 April 2023.Cases were eligible for inclusion if they had been discharged as IP. Data were collected following review of patient notes into Microsoft Excel. Results A total of 129 patients were identified of whom the majority of patients did not find to have gallstones (88%), did not report alcohol use (91%), and did not experience trauma (87%). However, MRCP and EUS were not performed in all patients before they are labelled as idiopathic. Ultrasound was the most commonly performed diagnostic procedure (98%), while MRCP (40%) and EUS (8%) were less frequently utilized. Surprisingly, a quarter of patients underwent a laparoscopic cholecystectomy. Nutritional referrals were lacking in a significant portion of cases and the readmission rates were high (65%). Conclusion The most surprising elements in the data include the high incidence of unperformed diagnostic procedures to exclude the common causes of pancreatitis.Also,the underutilization of nutritional referrals and the high readmission rates suggest potential areas for improvement in the diagnostic workup and management of IP, as well as raising questions about the current clinical practices and their efficacy in this cohort.

Abstract A008: Adaptive immune receptor repertoire characterization highlights the importance of interplay between B and T cells in disease progression

Abstract Understanding the adaptive immune system is integral to disease progression studies, development of diagnostic biomarkers, identification of therapeutic targets, and discerning varied treatment responses. Despite growing interest in profiling B and T cells in cancer research, the interaction between these cells and also the crucial roles of γδ T cells often go overlooked. In this research project, we explored the role of crucial yet frequently ignored γδ T cells in cancer research, using immune repertoire data from bladder cancer patients. We also studied the synergy between B and T cells in the immune repertoires of COVID-19 patients.Roche has developed immunoPETE (immune repertoire Primer Extension Target Enrichment), a DNA- based target enrichment assay to capture adaptive immune repertoire data*. immunoPETE efficiently identifies the heavy chains of B cells, alongside αβ and γδ T cells in one reaction, facilitating normalized clone counts across the adaptive immune system. To explore the significance of γδ T cells, we profiled the immune repertoires of 24 Non-Muscle Invasive Bladder Cancer patients treated with Bacillus Calmette-Guerin (BCG). Additionally, we evaluated the interplay between B and T cells in 117 peripheral blood immune repertoire from healthy and COVID-19 afflicted individuals, ranging from mild to severe cases.Immune repertoire data analysis indicates that underrepresentation of T cell receptor delta locus (TRD) is associated with higher risk of bladder cancer recurrence or progress. Urine pellet DNA was available for a subset of the patients in this study. Comparing immune repertoires from PBMC and urine revealed that urine repertoires represent the tumor repertoire more accurately than PBMC. Analysis of the immune repertoires from the COVID-19 patients linked disease severity with immune repertoire measures across all three cell types, highlighting the importance of multiple lymphocyte classes in disease progression. Using immunoPETE technology, which is capable of capturing the heavy chain of multiple immune cell types simultaneously in a single reaction, we have demonstrated that both B cell and T cell compartments provide distinct and valuable information in cancer and infectious diseases, each responding uniquely to the disease. Additionally, we emphasized the significance of γδ T cells in predicting cancer prognosis. Note: immunoPETE is for Research Use Only. Not for use in diagnostic procedures. Citation Format: Hossein Asgharian, Hamid Mirebrahim, Dilduz Telman, Hahn Zhao, Ulrich Schlecht, Sylvie McNamara, Rajiv Dua, Jan Berka, Patrick Bogard, Dinesh Kumar. Adaptive immune receptor repertoire characterization highlights the importance of interplay between B and T cells in disease progression [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr A008.

Abstract A034: Addressing the challenge of pre-analytical variables in circulating protein biomarker analysis for liquid biopsy

Abstract While liquid biopsy using plasma proteins is a promising avenue for early cancer detection, diagnosis, prognosis, and disease monitoring, the clinical translation of plasma proteomics has been limited due to the complexity of the proteome and the impact of pre-analytical variation on its integrity. In recent years, advancements in plasma proteomic technologies, such as Olink, have helped address the challenge of proteome complexity. However, challenges with pre- analytical variables have persisted. During blood collection and whole blood storage, ex vivo blood cell activation and lysis can occur, releasing proteins into the plasma and obscuring relevant in vivo abundances. This is especially true for cancer where many key biomarkers are expressed in white blood cells and platelets. To address these issues, Streck developed Protein Plus BCT, which stabilizes blood cells and minimizes plasma proteome changes following prolonged whole blood storage. To demonstrate its functionality and compatibility with Olink assays, blood was collected from 5 donors into EDTA, ACD-A, and Protein Plus BCT. Plasma was isolated at draw time (< 2 hours) and following 24, 72, and 120 hours of ambient whole blood storage using a double spin protocol (per Instructions for Use). Plasma samples were analyzed using an Olink Explore 384-plex panel. After just 24 hours of whole blood storage, plasma isolated from EDTA or ACD-A had 4.2 and 2.2 times more proteins that are significantly elevated in abundance relative to draw time, respectively, than plasma isolated from Protein Plus BCT. For the key cancer biomarker IL-8, which is associated with worse clinical outcomes and poor response to immunotherapy, Protein Plus BCT maintains draw-time levels such that the mean NPX difference relative to draw time never exceeds -0.18, or a 0.88-fold change for up to 120 hours. Comparatively, samples collected into EDTA and ACD-A show dramatic increases in IL-8 levels with mean NPX differences of 6.34 and 6.62, respectively, corresponding to 80.1- and 98.3-fold increases after 120 hours of whole blood storage. For Galectin-3, an inflammatory biomarker elevated in many cancer types (i.e., lung, breast, and ovarian), the mean NPX difference relative to draw time for samples drawn into EDTA is 1.46 after 24 hours and increases to 2.27 after 120 hours of whole blood storage (a 2.75-fold and 4.8-fold increase, respectively). In samples collected into Protein Plus BCT, the mean NPX difference, relative to draw time, for Galectin-3 never exceeds 0.05 (a 1.04-fold increase) even after 120 hours of whole blood storage. Taken together, these data suggest that Protein Plus BCT extends the storage of whole blood at ambient temperature without compromising the integrity of the sample or the proteomic results, providing researchers and assay developers valuable flexibility in the transport, storage, and processing of their samples. Protein Plus BCT is for Research Use Only. Not for use in diagnostic procedures. Protein Plus BCT should only be used for research or the development of new assays. Citation Format: Rachel M Miller, Jing Li. Addressing the challenge of pre-analytical variables in circulating protein biomarker analysis for liquid biopsy [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr A034.

GPT-4-based AI agents-the new expert system for detection of antimicrobial resistance mechanisms?

The study titled "GPT-4-based AI agents-the new expert system for detection of antimicrobial resistance mechanisms?" is critically important as it explores the integration of advanced artificial intelligence (AI) technologies, like generative pre-trained transformer (GPT)-4, into the field of laboratory medicine, specifically in the diagnostics of antimicrobial resistance (AMR). With the growing challenge of AMR, there is a pressing need for innovative solutions that can enhance diagnostic accuracy and efficiency. This research assesses the capability of AI to support the existing two-step confirmatory process recommended by the European Committee on Antimicrobial Susceptibility Testing for detecting beta-lactamases in Gram-negative bacteria. By potentially speeding up and improving the precision of initial screenings, AI could reduce the time to appropriate treatment interventions. Furthermore, this study is vital for validating the reliability and safety of AI tools in clinical settings, ensuring they meet stringent regulatory standards before they can be broadly implemented. This could herald a significant shift in how laboratory diagnostics are performed, ultimately leading to better patient outcomes.

Statistical-based modeling strategy for entrance skin dose estimation in patient undergoing body interventional radiology.

Interventional radiology (IR) provides significant advancements in diagnostic and therapeutic procedures, yet concerns persist regarding radiological risks such as erythema, burns, and epilation. Direct dose measurements observed difficulties regarding the perturbation of the detector probe in X-ray images during fluoroscopy-guided procedures, high-cost expenses, and non-compliant patients. This study aims to develop a statistical-based model for estimating entrance skin dose (ESD) in body IR procedures using patient radiation-dose recording data. Models are categorized into vascular and non-vascular procedures. This study demonstrates that the simplified models are sufficient in estimating patient ESDs for both IR groups, with a 95% confidence interval. This user-friendly method enables radiologists to calculate doses without complex parameters such as the backscatter factor and mass-energy absorption coefficient, as required in conventional calculation methods. It not only does this support to radiologists in effectively refining treatment protocols, but also enables patients to monitor their received doses immediately after treatment ends.

Assessment of air dose distribution in the vertical plane for better occupational exposure management.

The International Commission on Radiological Protection recommended a significant reduction of the equivalent dose limit for the eye lens. Reportedly, medical staff in charge of diagnostic imaging procedures may exceed the new dose limits for the eye lens. The use of dosimeters dedicated to the eye lens remains low, and dosimeters for the neck region were often used to assess eye lens doses. However, measurements by neck badges may overestimate or underestimate the recommended eye lens doses because the height of the neck differs from that of the eye. This study aimed to evaluate the air dose distribution in the vertical plane to understand the difference between neck and eye doses. H*(10) in the height of the eye position was 52.8% lower than that in the height of the neck position in the under-table position. Thus, the equivalent eye lens dose evaluated using a neck badge dosimeter may be overestimated.

Sepsis management of the acute care surgery patient: What you need to know

ABSTRACT Increasingly, acute care surgeons have taken over the management of general surgery consult patients in the hospital, many of whom present with sepsis and/or in septic shock. In this article, we will discuss the intricacies of sepsis management for acute care surgery. The underlying tenants of sepsis management will be outlined with specific attention to the nuances associated with surgical patients. Ultimately, when a surgical problem is identified, this management will culminate with the need for specific source control — the unique aspect when a surgical as opposed to a medical disease process is the cause of sepsis. However, surgeons must also be competent in the other components of sepsis management including antimicrobial therapy and hemodynamic support. This article is designed for the surgeon or for any provider caring for patients with a potential acute care surgical problem, recognizing that different practice settings will vary with regard to resource availability for laboratory tests, invasive monitoring, diagnostics, and surgeon availability.

Reducing healthcare costs by timely diagnosis and management in functional motor disorders.

Functional motor disorders (FMDs) are prevalent and highly disabling conditions among young adults, leading to reduced independence. Despite advancements in diagnosis and treatment, the economic burden of FMDs remains largely unknown. This study evaluates the impact of accurate FMDs diagnosis on direct healthcare costs within the Italian National Health System by comparing healthcare utilization and costs before and after diagnosis. This before-after study included 40 patients with a definite diagnosis of FMDs. Retrospective data on healthcare utilization, including diagnostic tests, specialist visits, hospitalizations, Emergency Room (ER) visits, and rehabilitation services, were collected from diaries and documents two years before and after diagnosis. Healthcare direct costs decreased by 67%, from an average of €4,467 [95% CI 3,604-5,329] to €1,461 [95% CI 945-1,976] after diagnosis. Hospitalization costs fell from €2,618 [95% CI 1,899-3,336] to €492 [95% CI 162-821], and ER costs dropped from €403 [95% CI 177-628] to €43 [95% CI 6-78]. Diagnostic procedure costs decreased significantly, from €403 [95% CI 177-628] to €43 [95% CI 6-78]. Specialist visit costs remained unchanged. Rehabilitation costs increased from €371 [95% CI 194-547] to €635 [95% CI 318-915], but this rise was not statistically significant. Accurate diagnosis of FMDs significantly reduces healthcare costs by minimizing unnecessary tests, hospitalizations, and ER visits while emphasizing rehabilitation. This highlights the economic and clinical benefits of improved diagnostic accuracy and specific multidisciplinary intervention. Investing in cost-effective diagnostic tools is crucial for earlier diagnosis and reducing delays.

Analysis of Circulating Plasma MicroRNA Profile in Low-Grade and High-Grade Glioma – A Cross-Sectional Study

Background Glioma is the second most common type of brain tumor, accounting for 24% of all brain tumor cases. The current diagnostic procedure is through an invasive tissue sampling to obtain histopathological analysis, however, not all patients are able to undergo a high-risk procedure. Circulating microRNAs (miRNAs) are considered as promising biomarkers for glioma due to their sensitivity, specificity, and non-invasive properties. There is currently no defined miRNA profile that contributes to determining the grade of glioma. This study aims to find the answer for “Is there any significant miRNA that able to distinguish different grades of glioma?”. Methods This study was conducted to compare the expression of miRNAs between low-grade glioma (LGG) and high-grade glioma (HGG). Eighteen blood plasma samples from glioma patients and 6 healthy controls were analyzed for 798 human miRNA profiles using NanoString nCounter Human v3 miRNA Expression Assay. The differential expressions of miRNAs were then analyzed to identify the differences in miRNA expression between LGG and HGG. Results Analyses showed significant expressions in 12 miRNAs between LGG and HGG, where all of them were downregulated. Out of these significant miRNAs, miR-518b, miR-1271-3p, and miR-598-3p showed the highest potential for distinguishing HGG from LGG, with area under curve (AUC) values of 0.912, 0.889, and 0.991, respectively. Conclusion miR-518b, miR-1271-3p, and miR-598-3p demonstrate significant potentials in distinguishing LGG and HGG.

Dexmedotomidina

Procedural sedation is often required in paediatrics to execute diagnostic procedures. There are many sedative drugs that may be used, but all of them carry not negligible side effect risks and may not be easy to manage. The use of dexmedetomidine has increased in the last few years because of its sedation efficacy in painless procedures. Paediatricians should know the use of dexmedetomidine because of its sensational safety profile even in neonates, its administration route versatility, its neuroprotective properties and its in-home palliative care role in children with otherwise untreatable sleep disorders. This article summarizes the main characteristics of dexmedetomidine, its use, strengths and weaknesses.

Methodological notes on physical parameters of low-level laser irradiation. Part 2. Light dosage at laser therapeutic sessions

Purpose. The general goal of this methodological article, consisting of two parts, is to provide a unifying theoretical approach to the still debated problem on determining the depth of laser light penetration into biotissues and the dosage of laser therapeutic effect from the standpoint of modern medical physics. The purpose of the second part of the article is to demonstrate that calculation of the absorbed dosage at laser therapy sessions is similar to the calculation of classical doses in radiobiology and radiation therapy.Materials and methods. The authors reviewed current state of terms and definitions related to the calculation of doses in ionizing and non-ionizing radiation. The Monte Carlo method was used to simulate the soft tissue volume in which 95 % of radiation energy is absorbed. A classical absorbed dose measured in Grays was estimated. Numerical simulation of absorbed doses for various typical laser therapy procedures was performed.Results. It has been shown that the effective irradiated volume of tissues, despite of small variations in soft tissue density between patients, allows to calculate the absorbed radiation dose in Grays, similar to radiobiological doses. Comparative findings on a single local absorbed dose for various percutaneous therapeutic procedures do not contradict the known clinical data, and even more, make the relationship of different doses for different therapeutic purposes more clear. As it has been found, typical doses range from 0.7 Gy for intravascular blood irradiation to 106 Gy for destructive photodynamic therapy and UV therapy procedures in dermatology.Conclusion. The proposed methodological approach proposes a new look at both the problem of the depth of laser light penetration into biotissues and the problem of laser light doses during therapeutic and diagnostic procedures from a unified medical and physical standpoint.

Current Concepts of the Management of Painful Traumatic Peripheral Nerve Neuromas

Painful neuromas are a complex clinical condition that results in notable disability and functional impairment after injury to a peripheral nerve. When regenerating axons lack a distal target, they form a stump neuroma. Up to 60% of neuromas are painful because of mechanical sensitivity and crosstalk between nerve fibers. Clinical evaluation includes a thorough history and physical examination followed by directed diagnostic imaging and procedures to assess pain generators and their effect on quality of life. Nonsurgical management options may include pharmacological interventions, desensitization strategies, injections, and therapies to reduce pain perception and improve function. Surgical interventions, such as nerve reconstruction by direct repair or grafting, redirection to alternative targets, and containment of regenerating axons by relocation into innervated tissues or in grafts, are considered when conservative measures fail. A comprehensive and individualized treatment plan is crucial for optimizing patient outcomes with painful neuromas. The plan should consider the underlying pathology, pain generators, and psychosocial factors contributing to the patient's pain.

21-Hydroxylase Deficiency Detected in Neonatal Screening: High Probability of False Negativity in Late Onset Form.

Despite the high sensitivity of neonatal screening in detecting the classical form of congenital adrenal hyperplasia due to 21-hydroxylase deficiency, one of the unclear issues is identifying asymptomatic children with late onset forms. The aim of this nationwide study was to analyse the association between genotype and screened level of 17-hydroxyprogesterone in patients with the late onset form of 21-hydroxylase deficiency and to quantify false negativity. In the Czech Republic, 1,866,129 neonates were screened (2006-2022). Among this cohort, 159 patients were confirmed to suffer from 21-hydroxylase deficiency, employing the 17-hydroxyprogesterone birthweight/gestational age-adjusted cut-off limits, and followed by the genetic confirmation. The screening prevalence was 1:11,737. Another 57 patients who were false negative in neonatal screening were added to this cohort based on later diagnosis by clinical suspicion. To our knowledge, such a huge nationwide cohort of false negative patients has not been documented before. Overall, 57 patients escaped from neonatal screening in the monitored period. All false negative patients had milder forms. Only one patient had simple virilising form and 56 patients had the late onset form. The probability of false negativity in the late onset form was 76.7%. The difference in 17-hydroxyprogesterone screening values was statistically significant (p<0.001) between severe forms (median 478.8 nmol/L) and milder (36.2 nmol/L) forms. Interestingly, the higher proportion of females with milder forms was statistically significant compared with the general population. A negative neonatal screening result does not exclude milder forms of 21-hydroxylase deficiency during the differential diagnostic procedure of children with precocious pseudopuberty.

Inter-Laboratory Comparison of qPCR Assays for Piscirickettsia salmonis in Atlantic Salmon (Salmo salar L.) in 11 Chilean Laboratories.

Real-time PCR (qPCR) testing is an essential component of early detection surveillance systems for Piscirickettsia salmonis infection in Atlantic salmon farms in Chile. Currently, all 11 laboratories in the authorised diagnostic laboratory network use assays based on published protocols. Compared with other P. salmonis qPCR assays, these assays have the advantage of targeting two different genes, that is, the 16S ribosomal gene and the internal transcribed spacer (ITS), potentially allowing for higher diagnostic accuracy. However, variation and lack of harmonisation of qPCR testing systems (e.g., primers/probe, RNA/DNA as target, extraction methods, etc.) may contribute to among-laboratory variation in qPCR results and an increased frequency of false-negative and false-positive results. The purpose of the ring trial reported herein was to compare qPCR results from 11 laboratories in Chile routinely testing Atlantic salmon for P. salmonis as part of a national control program. The panel of 14 samples included duplicates of three concentrations of P. salmonis in a homogenised head kidney, LF89 and EM90 bacteria and two negative controls (blank and a suspension of Flavobacterium psychrophilum). The sample order was randomised across labs, samples were tested blinded and analysed without knowledge of the source lab. Of the laboratories, 8 (72.7%) had at least one incorrect result out of 14 tested samples. Low-concentration samples (Ct of about 30) were more often incorrectly classified by reverse transcription-qPCR (RT-qPCR) (3/6 labs) than by qPCR (0/5). Six (54.5%) labs had at least one false-positive result indicating that cross-contamination was likely during sample processing. Affected laboratories are advised to conduct internal investigations to confirm the causes of false-positive results and recommendations for design and implementation of future ring trials are discussed.

Evaluation of Advanced Diagnostic Methods for Typhoid Fever in the Malwa Region, Punjab

Aim: The aim of study was to assess the effectiveness of conventional and advanced diagnostic techniques to overcome on false positive result of typhoid cases due to cross reactivity of different antibody present in human body. Method: Sampling was conducted in selected hospitals at both primary and secondary levels in the Malwa region. Blood and stool samples were collected from patients suspected for typhoid fever, and tests were performed at Bector Diagnostics Lab. The laboratory parameter like IgG and IgM Typhi Dot done form the blood and direct Stool culture at selective media recommended by CLSI guideline. A total of 450 patients were included in the study, out of which 150 patients taken as healthy controls and 300 were the patients showing symptoms of typhoid and had a fever for four days. Result: The results for “sensitivity and specificity” of all 3 diagnostic tests were as follows: 47.61% and 40.14% for Widal testing in hospitals, 100% and 96.90% for TyphiDot, and 79.16% and 99% for Stool culture. The Widal test showed interoperator variability and was insensitive. Overall, the IgM antibody-detection device TyphiDot showed the most encouraging and dependable results. Conclusion: This study demonstrated the importance of TyphiDot in the apparent treatment of typhoid fever. Its diagnosis is necessary for effective treatment or preventative measures. More diagnoses are required to ensure accuracy in typhoid fever cases.

Transferable lessons for care provided to children with intellectual and developmental disabilities based on an analysis of facilitators and barriers to SARS-CoV-2 testing.

The purpose of this article is to report on the lessons learned from parents and caregivers of school-age children with intellectual and developmental disabilities (IDD) in Missouri and Maryland regarding the facilitators and barriers to SARS-COV-2 testing. Parents participated in interview sessions that employed fuzzy cognitive mapping (FCM), a reliable knowledge-based method that facilitates democratic discourse to understand how stakeholders make decisions. A total of 94 parents from Missouri (58) and Maryland (36) participated in the FCM sessions. Eight primary barriers and eight primary facilitating factors were identified that influence a successful SARS-COV-2 test. Analyzing the connections between these factors provided valuable information about not only which ideas were most central to the goal of a successful test, but also which factors could be modified to improve the likelihood of success. Results indicate that the physical environment and child preparedness play a central role in successful SARS-COV-2 testing for children with IDD; however, these factors within the context of other invasive procedures should be studied further. It is likely that the findings from this study are transferable to other diagnostic procedures such as influenza, respiratory syncytial virus (RSV), and methicillin-resistant Staphylococcus aureas (MRSA), which require similar testing techniques using a nasopharyngeal swab.

Cervical cancer screening: efficacy of PAX1 and JAM3 methylation assay in the triage of atypical squamous cell of undetermined significance (ASC-US)

BackgroundAtypical squamous cells of undetermined significance (ASC-US) often present diagnostic challenges with cytology-based results, leading to potential underdiagnosis or overdiagnosis. An effective triage method is essential for managing these cases to reduce unnecessary referrals and treatment.MethodsA total of 322 women diagnosed with ASC-US were tested for HPV-DNA and the PAX1 and JAM3 methylation (PAX1m/JAM3m) test in the study.ResultsMethylation levels of PAX1 and JAM3 were significantly elevated in cervical lesions classified as CIN2 or more severe lesions (CIN2+). The methylation assay demonstrated a sensitivity of 83.8% and a specificity of 95.8%, outperforming HPV-DNA testing in differentiating high-grade cervical lesions among women with ASC-US. Moreover, PAX1m/JAM3m testing significantly reduced the colposcopy referral rate for further diagnostic procedures in high-risk HPV-positive women by 79.5%.ConclusionsPAX1m/JAM3m testing shows promise as a reliable supplemental method to HPV-DNA testing for the triage of women with cytologic ASC-US. In addition, the molecular triage based on the CISCER assay or single PAX1 or JAM3 methylation, had better effects in the women with non-HPV16/18 group. This approach could potentially minimize overtreatment and unnecessary referrals in clinical practice, enhancing patient management and resource utilization.

Validity of lung ultrasound with bedside lung ultrasonography in emergency protocol in diagnosing pneumonia

Background: Pneumonia is an acute inflammation of the lung parenchyma caused by microorganisms. In 2020, pneumonia was included in the top 10 diseases requiring hospitalization in Indonesia with a mortality rate of 23% for patients treated in the intensive care unit. The diagnosis of pneumonia is based on anamnesis, physical examination, and supporting examinations. However, in practice, diagnostic procedures in patients with immobilization or patients with unstable hemodynamics are difficult to perform. Lung ultrasound (LUS) with bedside lung ultrasonography in emergency (BLUE) protocol is a simple and portable supporting examination that is known to be able to diagnose pneumonia more easily, accurately, and quickly. Therefore, a study related to the validity of LUS in diagnosing pneumonia needs to be conducted. Methods: This study is a diagnostic test. The study was conducted over a period of 6 months (August 2023 to February 2024) at Prof. Dr. I.G.N.G. Ngoerah hospital. In this study, the validity was assessed consisting of sensitivity, specificity, and accuracy of LUS in diagnosing pneumonia. Data were analyzed using STATA MP 17. Results: The total subjects in this study were 70 people. The sensitivity of LUS in diagnosing pneumonia was 86.8% (CI95%=74.7-94.5%) and the specificity was 70.6% (CI95%=44-89.7%), with an accuracy of 82.8%. The positive test predictive value was 90.2% (CI95%=78.6-96.7%) and the negative test predictive value was 63.2% (CI95%=38.4-83.7%). Thus, in subjects with LUS suggestive of pneumonia, pneumonia management can be done immediately. However, in subjects with LUS results not showing pneumonia, further supporting examinations are needed to confirm the diagnosis of pneumonia. Sensitivity, specificity, and accuracy varies based on age, body mass index, immunocompromised status, and degree of pneumonia Conclusions: LUS with BLUE protocol is a valid supporting examination in diagnosing pneumonia (rule in disease).

Comparative treatment of homeless persons with an infectious disease in the US emergency department setting: a retrospective approach

BackgroundResearch has long documented the increased emergency department usage by persons who are homeless compared with their housed counterparts, as well as an increased prevalence of infectious diseases. However, there...

STABILOMETRY AS A METHOD FOR DIAGNOSIS AND TRAINING OF THE HUMAN POSTURAL BALANCE

Introduction. Posture is intrinsically linked to balance and the maintenance of an upright body position. Achieving stable posture and upright movement relies on the body’s complex neuromuscular regulation system. In clinical practice, stabilometry is employed to assess balance function and postural control. This study aims to synthesize data on the effectiveness of stabilometry as a diagnostic tool for evaluating postural balance and as a training method to enhance it. Materials and Methods. An analysis of 45 sources from databases including Academia.edu, PubMed, ResearchGate, and Google Scholar over the past decade was conducted using Keywords: posture, stabilometry, and postural balance. Results. Stabilometry is a contemporary technique for tracking the projection of the body’s center of mass on the support plane, as well as its fluctuations while standing or performing diagnostic tests and medical procedures. This review examines the application of stabilometry both for diagnosing balance and as a supplementary training method to improve postural balance in athletes and individuals with musculoskeletal disorders. Stabilometry results have highlighted correlations between stomatognathic system dysfunctions and musculoskeletal issues and demonstrated the positive impact of occlusal adjustments on body balance. As such, stabilometry can serve as an effective diagnostic tool for assessing posture in a dental clinic, useful for both diagnostic assessments and evaluating preventive or treatment outcomes. Conclusions. Training that combines myogymnastic exercises with stabilometric platform exercises significantly improved balance and functional efficiency in patients, as shown through stabilometric analysis. A key area of ongoing research is the interplay between posture and other bodily systems, particularly the stomatognathic system, which may be pivotal in treating temporomandibular joint dysfunction.