Diagnostic Issues Research Articles

Enlarging and shrinking focal perivascular spaces.

Perivascular spaces (PVS) are interstitial fluid-filled spaces surrounding blood vessels traversing the deep gray nuclei and white matter of the brain. These are commonly encountered on CT and MR imaging and are generally asymptomatic and of no clinical significance. However, occasional changes in the size of focal PVS, for example, when enlarging, may mimic pathologies including neoplasms and infections, hence potentially confounding radiological interpretation. Given these potential diagnostic issues, we sought to better characterize common clinical and imaging features of focal PVS demonstrating size fluctuations. Upon institutional approval, we retrospectively identified 4 cases demonstrating PVS with size changes at our institution. To supplement our cases, we also performed a literature review, which identified an additional 14 cases. Their clinical and imaging data were analyzed to identify characteristic features. Of the 18 total cases (including the 4 institutional cases), 10 cases increased and 8 decreased in size. These focal PVS ranged from 0.4-4.5cm in size. Whereas a decrease in size did not represent a diagnostic issue, focal increase in size of PVS led to concerning differential diagnoses in at least 30% of the radiology reports. These enlarging PVS were most found in the basal ganglia and temporal lobe, and in patients with previous brain radiation treatment. Focal size change of PVS can occur, especially years after brain radiation treatment. Being cognizant of this benign finding is important to consider in the differential diagnosis to avoid undue patient anxiety or unnecessary medical intervention.

Проблемы диагностики современных тепловозных двигателей

Objective: to consider the issue of diagnostics of modern diesel engines, in particular vibration diagnostics. Consider modern strategies and methods based on vibroacoustic signals that allow you to track and diagnose diesel engine malfunctions, as well as an assessment of the working process in the engine. To determine which means of measuring vibration parameters and methods of processing vibration signals can be considered the most reliable and informative. Propose to make adjustments to the currently used methods of processing vibration signals. Methods: comparison of the effectiveness of vibration measurement tools and mathematical methods of vibration signal processing. Results: the necessity of choosing mathematical methods of vibration signal processing is indicated, both for individual components of a diesel locomotive engine and for evaluating the workflow. Modern mathematical methods, applied to vibration diagnostics, require updating, due to an increase in computing power, as well as due to the development of powerful signal processing methods. To increase the reliability of the comparison results, it is necessary to take into account the large variability of the components and processes of the diesel engine. The need for additional study of modern mathematical methods of vibration signal processing is revealed. Practical importance: the necessity of introducing more modern methods of vibration signal processing is shown, which will optimize the durability of the components’ design using long operating cycles, reduce maintenance costs, track the service life of the internal combustion engine during the operation of the locomotive, improve the monitoring and diagnostics systems of the locomotive engine. The presented methods of assessing the use of certain methods of vibration diagnostics for diesel locomotives can be recommended for practical use.

Advancements In Multi-Modality Medical Image Fusion: A Comprehensive Review

Multimodality medical image fusion involves the amalgamation of multiple images acquired through single or multiple imaging modalities. The purpose of medical image fusion methods is to enhance the quality of medical images by effectively capturing the key features within the fused output. This consequently enhances the practicality of medical images for diagnostic assessment and issue identification. Medical imaging modalities like magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) have been developed and are extensively utilized for clinical diagnoses. These multimodality images harbor vital information crucial for precise and efficient diagnosis of brain ailments. As a result, amalgamating diverse image modalities in the medical domain to create a distinct image brimming with intricate anatomical details and heightened spectral information has become exceedingly valuable in clinical diagnosis. This manuscript offers an exhaustive examination of existing literature on image fusion, elucidating the fundamental concepts and materials essential for a comprehensive grasp of diverse medical fusion techniques.

Modern infections: diagnosis and treatment guidelines

An increased spread of infectious disease is a distinctive sign of modern times. The course of infections is accompanied by increase in morbidity, the emergence of new or newly recognized pathogens (HIV, SARS-COVID-19, Lyme disease, Ebola, Lassa and Marburg virus diseases) as well as alterations of immune response to infection. It is of particular importance to highlight resulting issues of diagnostics and treatment of infectious diseases.

FPre-Operative Ultrasound Diagnostics of Mirizzi Syndrome

Background. Mirizzi syndrome (MS) is one of the most severe complications of the gastrointestinal tract and the most complex pathological process in biliary surgery in general. The issue of ultrasound diagnostics (USD) of MS in patients with gallstone disease (GLC) at the preoperative stage for planning the scope of surgical intervention and warning the patient about possible complications is acute. The goal. Determine the sensitivity of preoperative ultrasound in the diagnosis of MS and finding the most significant echo pattern of MS during ultrasound. Materials and Methods. The results of 9126 cholecystectomies performed in the Kharkiv Clinical Hospital on railway transport No. 2 for the period from 1997 to 2023 were analyzed, while MS was suspected in 159 (1.7%) patients by ultrasound. Out of 159 in whom signs of MS were detected by ultrasound, MS was reliably confirmed intraoperatively in 116 (72,9%) patients, and no SM was detected in 43 (27,1%) patients. MS I type was detected in 98 (84.49%) patients, MS II type – 18 (15.51%). Among them there were 87 (75) women, 29 (25) men, the age of the patients ranged from 37 to 80 years (on average – 66.4 years). To analyze the sensitivity of certain echo characteristics during preoperative ultrasound in case of suspicion of SM, the diagnostic sensitivity index (DS) was used. Results. It was established that the most sensitive echocardiogram is the absence of a clear border between the back wall of the gallbladder and the hepaticocholedochus, the frequency is 75.40%. The next sign of sensitivity, which was confirmed intraoperatively, is a shrunken gall bladder, the DS indicator is 54.55%. It was also established that the combination of such echo features as: a shrunken gallbladder and the absence of a clear border between the back wall of the gallbladder and hepatic choledochal, which was detected in 25, in 23 of them, MS was confirmed intraoperatively, the DS rate was 92%. Conclusions. Ultrasound allows with a high (72,9%) degree of probability to establish the presence of SM at the preoperative stage. A reliable ultrasound sign of the presence of SM is the visualization of the common wall between the gallbladder and the hepaticocholedochus – DS 75.40%. With a combination of echo signs: shrunken gallbladder and deformation of the wall of the hepaticocholedochus in the place of attachment of the gallbladder, it is possible to assume MS with a high percentage of reliability (92%) with the help of ultrasound at the preoperative stage. The received information about the high probability of the presence of MS before the operation allows you to correctly plan possible options for the volume and tactics of surgical intervention.

Diagnostic strategy of irritable bowel syndrome: a low- and middle-income country perspective.

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder associated with substantial impairment which considerably burdens healthcare systems worldwide. Research on IBS has largely been conducted in high-income countries posing barriers to the application of diagnostic strategies in low- and middle-income countries (LMICs) due to differences in disease characteristics, healthcare resources, and socioeconomic factors. This review discusses the diagnostic issues associated with LMICs. We present a concise overview of the relevant approaches and propose a diagnostic strategy based on the latest evidence. A positive diagnostic strategy that relies on appropriate symptom-based criteria is crucial within the diagnostic framework. A combination of complete blood count, fecal occult blood test, and complete stool test may reliably identify individuals with suspected IBS who are more likely to have organic diseases, thus justifying the necessity for a colonoscopy. Eventually, we developed a diagnostic algorithm based on a limited setting perspective that summarizes the available evidence and may be applied in LMICs.

Полевые исследования: проблема, задачи, возможности. Часть 1

For more than a century, the state of psychology has been characterized as a crisis (crisis of methodology). The present state of the social objects, which serve as the research subjects for us, is characterized by increasing dynamism and variability. The current state, as reflected in its typical objects and conditions of conducting scientific research and practice work by ordinary researchers, often remains out of the attention span of methodologists and historians of science. Changes of the conditions created for conducting scientific research and research and practice work in modern institutions require reinterpreting the methods and methodology of the discipline and of the third-level disciplinary methodology. These are conventionally called by us “methods and methodology of field research”. The raised issue is masked and smoothed out by the dominance in Russian psychology of researches based on models of academic groups (schoolchildren, students, seminar listeners, etc.), i.e., by scientific research and research and practice works conducted under relatively simple conditions. However, the range of research and practical tasks is much wider; a pronounced shift to studies of mainly academic groups is a shift to “accessibility and comfort” zone and it leads to the erosion of the discipline. Purpose: historical and theoretical analysis of methodological, methodical and organizational aspects of conducting the research in a modern institution. Methods: analysis of scientific literature, psychodiagnostics, reflection on the experience of scientific research and practical work in modern institutions. It is summarized that: 1) the state of the discipline methodology, understanding of its method, subject and technology of conducting relevant scientific research, and explanation of the results obtained are interrelated; 2) with the availability of administrative resources methodological and methodical problems persist and are reproduced even under strictly specified diagnostic conditions; 3) diagnostic issues in the space-time dimension of modern institutions change the unresolved tasks of “methods and methodology of field research” into the status of “raised to the second power problems, “raised to the third power problems”; 4) one of the least developed issues of psychodiagnostics is the issue of the “situation”, which requires its constructive solution.

Detection of Mycoplasma hyopneumoniae viability using a PCR-based assay

Mycoplasma hyopneumoniae detection in clinical specimens is accomplished by PCR targeting bacterial DNA. However, the high stability of DNA and the lack of relationship between bacterial viability and DNA detection by PCR can lead to diagnostic interpretation issues. Bacterial messenger RNA is rapidly degraded after cell death, and consequently, assays targeting mRNA detection can be used for the exclusive detection of viable bacterial cells. Therefore, this study aimed at developing a PCR-based assay for the detection of M. hyopneumoniae mRNA and at validating its applicability to differentiate viable from inert bacteria. Development of the RNA-based PCR encompassed studies to determine its analytical sensitivity, specificity, and repeatability, as well as its diagnostic accuracy. Comparisons between DNA and mRNA detection for the same target gene were performed to evaluate the ability of the RNA-based PCR to detect exclusively viable M. hyopneumoniae after bacterial inactivation using various methods. The RNA-based PCR was also compared to the DNA-based PCR as a tool to monitor the growth of M. hyopneumoniae in vitro. Under the conditions of this study, the developed RNA-based PCR assay detected only viable or very recently inactivated M. hyopneumoniae, while the DNA-based PCR consistently detected cells irrespective of their viability status. Changes in growth activity over time were only observable via RNA-based PCR. This viability PCR assay could be directly applied to evaluate the clearance of M. hyopneumoniae or to determine the viability of the bacterium at late stages of eradication programs.

Sticky platelet syndrome—diagnostic issues and controversies

Sticky platelet syndrome—diagnostic issues and controversies

Future advances of artificial biosensor technology in biomedical applications

Recent advancements in synthetic biology have facilitated the concept of a cell-based and cell-free biosensing platform, which enables the identification of molecular signals encompassing metal/chemical to disease biomarkers. The artificial sensing incorporates the concept of both whole-cell and cell-free biosensing strategies, which include highly regulated natural and synthetic components to exhibit genetically encoded molecular sensing properties. These sensors utilize protein expression to release signalling molecules as the result of received input to facilitate the detection of analytes. Intending to use modified living cells or artificial cells in biosensing, the proposed study highlights the importance of cell-based and cell-free sensors in biomedical and diagnostics. The article's first section will explain the biosensing types including cell-free, cell-based, vesicle-based, and paper-based sensing where sensing relies on cell, cellular components, and cell-free systems which mostly involve transcriptional or translational machinery. It highlights the advantages, disadvantages, and challenges of advancing approaches. The second section of the article elaborates on the principle of sensing and the strategies involved. Though very few studies have been reported on this topic, therefore, the current article focuses on the artificial sensors that have been designed for medical and diagnostic purposes. The review also marks the current and future advancements in the field including artificial intelligence, nanotechnology, stem cells, and omics. Sensing recently has a big impact on disease diagnosis as well as drug development and targeted therapies. While newly developed biology-based diagnostics technologies still have high costs, require highly trained personnel, suffer stability issues and reduce sensor performance. Therefore, this review brings readers’ attention to advances and challenges in the following field and promotes the resolution of medical and diagnostics issues in the future.

Neonatal point-of-care lung ultrasound: what should be known and done out of the NICU?

LU is still a useful tool in level I/II neonatal units, both for diagnostic and functional issues. • Neonatal lung ultrasound has been recently introduced in the usual care in many Neonatal Intensive Care Units. • It also has many advantages in level I/II neonatal units, both for neonatologist or even pediatricians that treat neonates in those sites.

Autism and the HCA: autistic history and autistic diagnosis

This series of articles will explore the neurodivergent condition of autism from a range of different perspectives. This second article will explore the history of, and diagnostic issues relating to, autism.

Modern doctors' view on the problem of diagnostics and treatment of asthenic syndrome in different regions of the Russian Federation

Introduction: The problem of asthenic disorders is determined by their high prevalence, the lack of diagnostic criteria and recommendations for therapy, and the absence of unified principles of coding in ICD-10. The aim of the study was to evaluate the current practice of neurologists and physicians of the Russian Federation (RF) in the diagnosis and pharmacotherapy of asthenic syndrome (AS). Materials and Methods: An anonymous author-developed questionnaire survey of physicians on the issues of diagnostics and treatment of asthenia was conducted on the Google forms platform. Results: Total 238 specialists from 23 regions of the RF, 62.5% of neurologists and 37.5% of physicians, took part in the survey. Women suffer from AS more often than men. AS is most frequently verified at the age of 40-60 (65.5%) and under 40 (39.6%). Doctors use the codes G90.8 – other disorders of the autonomic nervous system – and I67.8 – other specified cerebral vascular lesions. The main causes of AS are affective disorders in 67.2% of patients and infectious diseases in 70% of patients. Almost 67% of doctors use anxiety and depression assessment scale, and only 13% of respondents use MFI-20 scale. The choice of therapy depended on the psychopathologic syndrome in 73.9% of cases. Most doctors favored nootropic drugs, metabolic action drugs, and B vitamins. Conclusion: The current medical practice of diagnosing and treating AS was studied and informative data were obtained with regard to understanding the clinical-typological structure and nosological affiliation of AS. The results demonstrate the expediency of developing a unified algorithm for the management of patients with various manifestations of AS.

Hypersensitivity Pneumonitis: Challenges of a Complex Disease.

Hypersensitivity pneumonitis (HP) is a complex interstitial lung disease caused by chronic inhalation of a wide variety of antigens in susceptible and sensitized individuals, commonly associated with an occupational exposure. An impressive number of inciting antigens causing hypersensitivity pneumonitis have been found to cover a wide range of occupations. As working practices have changed over time, especially in industrialized countries, new names for occupational HP have emerged. This review emphasizes the main diagnostic issues arising from the high variability of clinical presentation and the broad spectrum of causal antigens. Furthermore, it provides an overview of current methods to unveil possible causes of hypersensitivity pneumonitis, highlights HP's current diagnostic and treatment challenges and the remaining areas of uncertainty, and presents prevention strategies.

Эндометриоз. Обзор клинического протокола под разным углом зрения (дискуссия)

Endometriosis is a common disease characterized by the tissue similar in morphology and function to the endometrium outside the uterine cavity. The review presents a historical background, an overview of the theories concerning the endometriosis pathogenesis, a description of the clinical picture, diagnostic issues and a discussion concerning the clinical recommendations of the Ministry of Health of the Russian Federation on the patient management with endometriosis, which are currently in force. To date, the etiology and pathogenesis of this disease have not been fully clarified, and the development of this pathology is still debated. Endometriosis has significant adverse health outcomes and negatively affects the life quality of patients. Endometriosis-associated infertility contributes to a decrease in fertility, having an adverse impact on the country's economy. The disease clinical debut may be a menstrual disorder, abnormal uterine bleeding, infertility, the development of chronic pelvic pain syndrome, manifested by dyspareunia, dyschezia, dysmenorrhea. The progress of medicine in this area is associated with an individual patient management, where an improvement a woman's life quality, therapy and overcoming infertility, reducing the frequency of relapses and minimizing surgical interventions are highlighted Properly selected individual therapy leads to a decrease in the incidence of endometriosis clinical manifestation, which has a beneficial effect on personal, social, demographic and economic indicators. KEYWORDS: endometriosis, endometrium, endometrial pathogenesis, endometrial disease, endometriosis treatment, clinical recommendations, endometriosis-associated infertility. FOR CITATION: Dobrokhotova Yu.E., Markova E.A., Khlynova S.A., Narimanova M.R. Endometriosis. Сlinical protocol review from different angles (discussion). Russian Journal of Woman and Child Health. 2024;7(2):89–97 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-1.

Respiratory Syncytial Virus-related Lower Respiratory Tract Infections in Neonatal and Post-neonatal Babies: A Series of Four Cases

Respiratory Syncytial Virus (RSV) is a highly contagious seasonal virus that is the leading cause of acute Lower Respiratory Tract Infections (LRTI) in the paediatric age group and is one of the leading causes of death in children under five in developing countries. There is evidence that severe RSV infection and hospitalisation in early life increase the risk of recurrent wheezing, childhood asthma, and allergic sensitisation. Even though RSV being a major global health concern, very few papers concentrate on the neonatal period in India. The present case series presents four cases (three females and one male baby) highlighting the impact of RSV in neonatal and post-neonatal infants in India. The cases highlight the diversity of presentation; one infant required prolonged High-flow Nasal Cannula (HFNC) support, while two needed just symptomatic care. The importance of Polymerase Chain Reaction (PCR) in resource-constrained situations is highlighted as diagnostic issues are examined. Treatment focuses on supportive care; oxygen and respiratory support are provided in more severe cases. The present study emphasises the need for early detection and preventative measures, such as using novel treatments like nirsevimab. The present case series advocates for focused therapies and additional research in the Indian paediatric environment, adding insightful perspectives to the expanding body of knowledge on RSV.

A simple and rapid colorimetric detection of Staphylococcus aureus relied on the distance-dependent optical properties of silver nanoparticles.

The quick and accurate diagnosis of pathogens has appeared as a pressing issue in clinical diagnostics, environmental monitoring, and food safety. The available assays are suffering from limited capacities in simple, fast, low-cost, and on-site detection to increase prevention and proper treatment. Herein, we address these challenges by developing a simple, speedy, affordable, and ultrasensitive nanoplasmonic biosensor for colorimetric detection of cDNA from staphylococcal RNA relying on the distance-dependent optical features of silver nanostructures for the measurement of color variations and spectral shifts owing to the plasmon coupling generated by the cross-linking accumulation of AgNPs. The method described utilizes silver nanoparticles (AgNPs) immobilized with two different single-stranded oligonucleotides (ssDNA1 and ssDNA2) that specifically recognize the target DNA. Sandwich hybridization of target DNA with ssDNA1 and ssDNA2 induced color variations and spectral shifts of AgNPs, whereas test samples without the target DNA remained yellow as the initial color of colloidal silver. The designed nanoplasmonic biosensor demonstrated high specificity with the detection limit (LOD) of ∼1.8 amol target DNA (∼106 molecules per test) in the broad linear dynamic range from 0.01 to 100 nM, and LOD down to a few cells was attained for amplified bacterial nucleic acids and a linear range from 102 CFU mL-1 to 107 CFU mL-1. The sensing approach showed great potential for the timely diagnosis of pathogens in low-density samples, and it has considerable merits over traditional culture approaches and qPCR techniques.

DiGAN Breakthrough: Advancing diabetic data analysis with innovative GAN-based imbalance correction techniques

In the rapidly evolving field of medical diagnostics, the challenge of imbalanced datasets, particularly in diabetes classification, calls for innovative solutions. The study introduces DiGAN, a groundbreaking approach that leverages the power of Generative Adversarial Networks (GAN) to revolutionize diabetes data analysis. Marking a significant departure from traditional methods, DiGAN applies GANs, typically seen in image processing, to the realm of diabetes data. This novel application is complemented by integrating the unsupervised Laplacian Score for sophisticated feature selection. The pioneering approach not only surpasses the limitations of existing techniques but also sets a new benchmark in classification accuracy with a 90% weighted F1-score, achieving a remarkable improvement of over 20% compared to conventional methods. Additionally, DiGAN demonstrates superior performance over popular SMOTE-based methods in handling extremely imbalanced datasets. This research, focusing on the integrated use of Laplacian Score, GAN, and Random Forest, stands at the forefront of diabetic classification, offering a uniquely effective and innovative solution to the long-standing data imbalance issue in medical diagnostics.

Emergency Bilateral Internal Iliac Artery Ligation in Antepartum Haemorrhage with Complete Placenta Previa and Placenta Accreta at Previous Caesarean Scar Site: A Case Report

Implantation and placentation at the normal site are critical for a successful pregnancy. Many complications associated with pregnancy, which manifest late in pregnancy, such as preeclampsia and preterm labour, have been reported to have origins early during pregnancy with abnormalities in implantation and placental development. Placental abnormalities result from impaired embedding of the placenta in the endometrium, encompassing a wide range of placental pathologies associated with high maternal morbidity and mortality. Pregnancy-related complications such as Postpartum Haemorrhage (PPH) and hysterectomy have been closely linked to the Placenta Accreta Spectrum (PAS). PAS refers to the aberrant and invasive implantation of the placenta into the myometrium. Invasiveness in placenta accreta is marginal, followed by placenta increta (partial), placenta percreta (total), and placenta previa (covering the cervix). Here, the authors present a unique case report of an antenatal woman with antepartum haemorrhage, placenta previa, and placenta accreta at the previous Lower Segment Caesarean Section (LSCS) scar site, with massive PPH at 35 weeks, who benefited from an emergency LSCS with bilateral uterine and internal iliac artery ligation procedure, resulting in a life-saving outcome. The most common risk factors for PAS include prior caesarean section and curettage. The adhered placenta can lead to pelvic bleeding and necessitate an emergency hysterectomy. Therefore, it poses unique diagnostic and treatment issues, with the majority of cases requiring preterm termination of pregnancy.

Диагностическое устройство одноэлементных изоляторов воздушной линии электропередачи по температуре

Insulator, electrical device designed for electrical isolation and mechanical fastening of electrical installations or their separate parts, which are under different electrical potentials. As an element of the power system, it plays an important role in ensuring its reliable operation. At present the issue of diagnostics and monitoring of insulators is still topical. The article provides statistical data of failures on overhead lines and lists methods and devices for detecting insulation damage. The research problem is the lack of a reliable and cost-effective device for early detection of insulator failure under voltage. The solution is the previously proposed method of diagnosing single-element insulators by temperature. The author proposed a scheme of the diagnostic device, described its principle of operation in normal and emergency modes. The diagnostic device made according to the proposed scheme is simple, works under voltage and without the intervention of operating personnel.