Diagnostic Test Results Research Articles

Clinical findings and prognostic factors for immediate survival in 33 dogs undergoing surgery for biliary peritonitis.

To report demographics, clinical signs, physical examination, diagnostic test results, surgical findings, and prognostic factors for in-hospital postoperative mortality following biliary peritonitis surgery in dogs. Retrospective, multi-institutional cohort study. Thirty-three client-owned dogs. The medical records of dogs that underwent surgery for biliary peritonitis between 2015 and 2021 were reviewed. Dogs were included if they had a definitive diagnosis of biliary peritonitis and a surgery report. Information on demographics, clinical signs and duration, physical examination findings, laboratory and diagnostic imaging results, surgery, perioperative medical treatment, and complications for each patient was obtained. Statistical analyses were performed to identify risk factors that affected survival. Cholecystectomy was the procedure most frequently performed (31/33, 94%). The overall mortality rate was 36% (12/33). Survival was affected negatively by hyperbilirubinemia (p = .049), administration of vasopressors (p = .002), renal dysfunction (p = .008), and number of postoperative complications (p = .005). A mortality rate of 50% was observed in dogs with a total bilirubin level greater than 60.5 μmol/L. There was no difference in mortality rate between septic and nonseptic biliary effusions. New prognostic factors associated with in-hospital postoperative mortality in dogs treated surgically for biliary peritonitis were identified, while others that had been reported previously were confirmed. A preoperative bilirubin threshold value associated with a 50% mortality was identified. Additional information that could help to predict survival in dogs with biliary peritonitis has been provided. However, further research is warranted.

Allergic contact dermatitis to chlorhexidine in children

Background: Hypersensitivity to chlorhexidine is rare in children. The usefulness of different diagnostic tests for allergic contact dermatitis (ACD) is unknown. Objective: We aim to describe a case series of children with hypersensitivity to chlorhexidine and to compare the results of different diagnostic tests. Patients: Nine children with hypersensitivity to chlorhexidine were included. Only six of these children and their parents consented to a comprehensive allergy assessment, which included the prick test, intradermal test, patch test, and repeated open application test (ROAT). Results: Seven children (78%) presented symptoms of chlorhexidine hypersensitivity within the first 5 years of life; two of them before the age of 1 year. In four children, the dermatitis lesions were suggestive of wound superinfection. All six children who participated in the comprehensive diagnostic evaluation had negative results on the prick test. The immediate-reading intradermal test was positive in one case and uncertain in two cases. The patch test was positive in five cases, and the ROAT was positive in all six cases when using 2% chlorhexidine alcohol solution. Conclusion: ACD to chlorhexidine in children appears to be rare and can be difficult to detect. Clinicians should consider this diagnosis when wounds worsen with chlorhexidine. Although the patch test is the most standardized method for detecting ACD, the ROAT with 2% chlorhexidine alcohol solution was the most sensitive test in our patients.

A phenomap of TTR amyloidosis to aid diagnostic screening.

Cardiac amyloidosis due to transthyretin (ATTR) remains an underdiagnosed cause of cardiomyopathy. As awareness of the disease grows and referrals for ATTR increase, clinicians are likely to encounter more atypical forms of the condition in clinical practice. Therefore, physicians and treating cardiologists should be aware of the full phenotypic spectrum of ATTR. The phenotypic manifestation of ATTR varies depending on the stage of the disease, the presence and type of TTR mutation and the patient's comorbidities. ATTR findings can be grouped into four major categories: clinical profile and cardiac phenotype, extra-cardiac findings, electrocardiogram and imaging findings, which cumulatively form the full phenomap of ATTR. Results from any diagnostic test for ATTR should be interpreted in light of the pre-test probability for the disease. Findings that suggest negative markers for ATTR can point towards other forms of amyloidosis (such as AL amyloidosis) or alternate causes of left ventricular hypertrophy, including hypertrophic cardiomyopathy or Fabry disease. The rising number of referrals for ATTR cardiomyopathy presents a challenge in daily clinical practice. To prevent an increase in false-positive diagnostic test results, an ATTR phenomap can serve as a valuable tool for guiding diagnostic assessments, interpreting test outcomes and prioritizing appropriate referrals for ATTR screening.

Use of autofluorescent stomatoscopy in the diagnostic algorithm for oral mucosal and vermilion border lesions in adolescents

Relevance. There is currently significant interest in studying the prevalence of diseases affecting the oral mucosa and lip vermilion border in adolescents. A promising approach in this field is the use of modern non-invasive optical technologies, which not only offer additional insights into the patient's oral health status but also enhance their compliance.Materials and methods. A total of 71 adolescents (9th to 11th grade students) aged 15 to 17 years (mean age — 16.2 ± 0.8 years) were examined. The oral mucosa and lip vermilion border were assessed for abnormalities under natural light and through endogenous fluorescence using autofluorescent stomatoscopy. Various optical filters were applied, and clinical images were compared with autofluorescent images. A visual analog scale was used to assess the clarity of the diagnostic test results for the participant. Recommendations were provided, and treatment was prescribed according to the established diagnoses.Results. Oral mucosal lesions and lesions of the lip vermilion border were observed in 45% of cases, all of benign origin, without visible changes to the naked eye or pain. The most frequently diagnosed lesions were morsicatio buccarum and chapped lips. Distinct autofluorescent characteristics of the identified lesions were observed and documented. Participant-reported feedback was positive in 100% of cases during autofluorescent stomatoscopy. The mean score for the clarity of diagnostic results, assessed using the visual analog scale, was 9.3±0.12, indicating a high level of diagnostic visibility.Conclusion. Implementing a qualified clinical approach focused on preventing oral diseases in adolescent patients is recommended with the use of autofluorescent stomatoscopy. This technique not only offers real-time insights into the patient’s oral health status but also actively engages young patients, increasing their motivation to maintain good oral health.

Clinical and genetic profiles of patients with hereditary and wild type transthyretin amyloidosis: the transthyretin cardiac amyloidosis registry in the state of Sao Paulo, Brazil REACT-SP

Abstract Introduction Transthyretin amyloidosis (ATTR) is a multisystem disease caused by the deposition of fibrillar protein in organs and tissues. ATTR genotypes and phenotypes are highly heterogeneous. Purpose We designed the Transthyretin Cardiac Amyloidosis Registry in the state of São Paulo (REACT-SP), aiming to describe the demographic, genetic, clinical, and diagnostic test results and treatment of patients with ATTR. Methods We present data on physical signs and symptoms, cardiac and neurological assessments, and genetics in patients enrolled in the Transthyretin Cardiac Amyloidosis Registry in the state of São Paulo, Brazil. Results Six hundred-forty-four patients were enrolled, 505 with the variant form (ATTRv) and 139 with wild-type (ATTRwt). Sixteen different mutations were detected, the most common being Val50Met (48.3%) and V142Ile (40.8%). Overall, more than half of the patients presented cardiological involvement, and the difference in this proportion between the ATTRv and ATTRwt groups was significant (43.9 vs. 89.9%; p<0.001). The neurological phenotype also differed between ATTRv and ATTRwt (56.8 vs. 31.7%; p<0.001). The mixed phenotype was found in 25.6% of the population, without a significant difference between the forms of amyloidosis. A group of patients remained asymptomatic (10.4%), with a lower proportion of asymptomatic ATTRwt patients. The median time between the onset of symptoms and diagnosis was 1,853 (IQR 1277–2997) days, which was longer in ATTRv patients than in ATTRwt patients (p<0.001). Sinus rhythm was reported in 74.2%, atrial fibrillation in 17.0%, low voltage in 28.6%, repolarization abnormalities in 39.8%, and pseudo infarction in 27.4%. Echocardiography showed median Left Ventricular Ejection Fraction (LVEF) was 60%, Interventricular Septum (IVS) 14 mm, Posterior Wall Thickness (PWT) 13 mm, Left Atrium (LA) 41 mm, Left Ventricular Diastolic Diameter (LVDD) 45 mm, Left Ventricular Systolic Diameter (LVSD) 30 mm, basal Right Ventricular Diastolic Diameter (RVDD) 35 mm and Left Ventricle (LV) longitudinal strain 9.1%. There was some degree of LV diastolic dysfunction in 38.4%, apical sparing in 31.3%, and thrombus or masses in 1.0%. Late Gadolinium Enhancement (LGE) was absent in 29% and was subendocardial in 35.5%, transmural in 13.7%, mesocardial in 13.7%, and epicardial in 8.2%. Conclusions This study details the clinical and genetic spectrum of patients with ATTR in São Paulo, Brazil. This preliminary analysis highlights the considerable phenotypic heterogeneity of neurological and cardiac manifestations in patients with variant and wild-type ATTR.

Guía de práctica clínica para la toma de muestra de sangre venosa en pacientes adultos en México

More than 70 % of medical decisions are based on the results of diagnostic tests from the clinical laboratory. To establish and standardize procedures and technical resources that allow for the generalization of optimal samples obtained by phlebotomy, a multidisciplinary group of experts gathered and developed Guía de práctica clínica para la toma de muestra de sangre venosa en pacientes adultos en México (Clinical Practice Guide for Venous Blood Sampling in Adult Patients in Mexico). This guide includes recommendations on requesting the exam, preparing the area, the patient's preanalytical conditions, required supplies, sample identification, use of the tourniquet, selection and disinfection of the puncture site, extraction and collection of the blood sample, recommendations for phlebotomy in patients with difficult venous access,among other procedures.

Treatment of equine keratomycosis, part 1: selection of appropriate therapy based on clinical presentation and diagnostic testing improves clinical outcomes.

To determine clinical outcome, treatment costs, and hospitalization duration in horses treated for keratomycosis and identify ophthalmic examination and diagnostic results associated with these outcomes. This was a retrospective study of 126 equine keratomycosis cases between 2004 and 2020 with fungal infection confirmed on cytology, culture, and/or histopathology and a minimum of 1-month follow-up. Details of the ophthalmic examination, diagnostic test results, and treatment and cost outcomes were recorded. Outcomes of interest were analyzed by treatment type. The relationship of patient and diagnostic test variables to the outcomes of interest was determined via logistic and linear regression models. Globe retention and positive visual outcome occurred in 82.5% and 78.9% of medically and 88.4% and 85.5% of surgically treated cases, respectively. While not statistically significant, there were more positive clinical outcomes with surgery; in recent years, the globe and vision were preserved in 94.7% of cases following penetrating keratoplasty. The choice to pursue surgery was related to lesion depth. Medical treatment was associated with statistically shorter hospitalization times and lower total and hospitalization invoices compared to all surgical treatments. Diagnosis of stromal abscess was associated with higher total invoice and longer hospitalization times compared to ulcerative keratomycosis, although clinical outcomes were similar. Overall positive clinical outcomes were achieved despite the severity of the disease in many cases, highlighting the need for appropriate treatment selection based on clinical presentation. Expanding knowledge of clinical decision-making, treatment options, and associated clinical and financial outcomes may further improve outcomes for equine keratomycosis patients.

The Usefulness of Lordosis Load Test and Urinary Biochemistry in the Diagnosis of Orthostatic Proteinuria.

Introduction Renal disease is commonly suspected in patients with proteinuria. Renal biopsy might be considered based on the patient's clinical history and the results of diagnostic tests. However, as orthostatic proteinuria is benign and requires no treatment, it is important to obtain a diagnosis without renal biopsy whenever possible. Therefore, up to now, for the diagnosis of orthostatic proteinuria, in addition to resting urinalysis evaluation (disappearance of proteinuria), we have performed the lordosis load test and urine biochemistry of the samples showing peak proteinuria in a lordosis load test. Method We retrospectively enrolled all patients who visited the pediatric department and underwent the lordosis load test at Kanazawa Medical Center between 2011 and 2020. In the present study, samples with the highest concentrations of protein after the lordosis load test were subjected to general urinary biochemistry and urinary sediment analysis. Patients were followed up with the lordosis load test for several years. Results Enrolled in the study were 68 patients with OP. The mean age at the time of diagnosis was 11.5 years (range, six to 16 years). General urinary tests, urinary sediment, and urinary biochemistry including N-acetyl-beta-D-glucosaminidase (NAG), alpha1-microglobulin(α1MG), and beta 2-microglobulin (β2MG) were normal in all patients with orthostatic proteinuria except one case who was a premature baby. Conclusion If proteinuria disappears after two hours of rest, and urinary biochemistry of the samples showing peak proteinuria in the lordosis load test is normal, orthostatic proteinuria can be diagnosed more accurately.

Screening for Sexually Transmitted Infections in Adolescents with Genitourinary Complaints: Is There a Still Role for Endocervical Gram Stains?

Study objective: Adolescent females are disproportionately affected by Sexually Transmitted Infections (STIs). Endocervical Gram stain smears taken during gynecological examination are inexpensive, relatively easy procedures to perform and interpret. The purpose of this study was to evaluate the performance characteristics of Gram smears in the diagnosis of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and Trichomonas vaginalis (TV) in a female adolescent population presenting to the Emergency Department (ED) with genitourinary complaints. Methods: This study was a retrospective, cohort analysis of consecutive females (ages 13 – 19) seen at three academic medical centers over a two-year study period. All patients underwent a pelvic exam with diagnostic testing for STIs. Positive criteria for a Gram stain included greater than ten white blood cells per high-power field, gram-negative intracellular/extracellular diplococci (suggesting GC), or direct visualization of TV organisms. Polymerase Chain Reaction (PCR) assays were used as the gold standard definition for CT/GC infection. Direct microscopic visualization of organisms on a separate wet mount prep was considered the gold standard for TV infection. Demographic information, clinical findings of cervicitis, and the results of diagnostic testing were obtained from ED records using standardized abstraction forms. Results: During the study period, 1303 adolescent females were evaluated for genitourinary complaints. A total of 181 adolescents (12.9%) had at least one documented STI. Overall, 298 patients (22.9%) had positive gram stains. The sensitivity, specificity, and positive likelihood ratio for Gram stain in the diagnosis of STI were 28.7% (95% CI, 22.2 to 35.9), 78.1% (95% CI, 75.5 to 80.5), and 1.31 (95% CI 1.0 to 1.7), respectively. The sensitivity of Gram stain to Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis were 35.9% (95% CI 26.8 to 45.8), 34.5% (95% CI 18.0 to 54.3), and 5.7% (95% CI 1.3 to 15.7), respectively. The consistency of the data recording was excellent, with a median kappa statistic of 0.89. Conclusions: The positive likelihood ratio of inflammation on endocervical Gram stain is too low to recommend its use to direct empiric treatment of adolescents at risk for sexually transmitted infections. Diagnostic uncertainty or treatment failures should prompt specific laboratory testing.

Enabling laboratory readiness and preparedness for the evaluation of suspected viral hemorrhagic fevers: development of a laboratory toolkit.

Viral hemorrhagic fevers (VHFs), such as Ebola virus disease, Marburg virus disease, and Lassa fever, are associated with significant morbidity and mortality and the potential for person-to-person transmission. While most individuals in whom VHF is suspected will ultimately be diagnosed with a non-VHF illness, such patients may present to any United States healthcare facility (HCF) for initial evaluation; therefore, all HCFs must be prepared to evaluate and initiate care for suspect VHF patients, especially if they are acutely ill. Included within this evaluation is the ability to perform basic routine laboratory testing before VHF-specific diagnostic test results are available, as well as rapid malaria testing to assess for a common, dangerous "VHF mimic." To improve laboratory preparedness and readiness in the initial care of suspect VHF patients who may present to acute care hospitals. Plan-Do-Study-Act quality improvement model. Frontline healthcare facilities and their clinical laboratories. We describe the development of a laboratory testing toolkit for a suspect VHF patient that can assist frontline HCFs in providing basic laboratory testing required for the care of these patients. The toolkit provides guidance on infection prevention and control, waste management, occupational health, laboratory test collection, processing, and resulting, in the context of suspect VHF patient evaluation. The toolkit is designed to be readily adapted by any frontline HCF in the US. With the guidance provided, facilities will be able to support safer initial evaluation of VHF suspects and ensure high-quality patient care.

Assessment of malaria transmission in Kenya using multilevel logistic regression

Background: Kenya has a lower malaria incidence in comparison to other African malaria-endemic nations. Malaria is a significant public health concern in the country. The malaria indicator survey (MIS) data were analyzed using the logistic regression model. Nonetheless, independent data may be the cause of most MIS's hierarchical structure. This approach does not consider any association between data points within a cluster, as it assumes that the individual malaria statuses are independent of their causes. The approach may lead to biased analysis conclusions. The primary goal of this research is to determine the impact of sample enumeration areas (SEAs) and SEA features on individual malaria rapid diagnostic test (RDT) results. We are interested in identifying key factors influencing household members' malaria RDT findings or Kenya's malaria prevalence and assessing variation. Methods: Our study utilized the robust 2020 Kenya National Malaria Indicator Surveys (KMIS) dataset, which is representative of the entire nation. This dataset, comprising 301 clusters (134 urban and 167 rural areas), was instrumental in applying several multilevel models, including random sample and sample Enumeration Area (SEA) effects. We also considered the weights used in the s survey design, which is used to adjust uneven probabilities of choice within clusters, further enhancing the reliability and relevance of our findings. The methods used in this study involved a rigorous analysis of the KMIS dataset, including applying multilevel models and considering survey design weights to ensure the robustness and strength of our results. ResultsThis study's findings are significant and crucial in understanding the prevalence of malaria in Kenya. The findings reveal that factors such as region, place of residence, mosquito bed net use, water source location, wealth index, age, household size, and altitude are significantly associated with malaria's prevalence.After accounting for these variables, systematic changes across SEAs accounted for approximately 47.1% of the remaining variability in malaria occurrence in the study locations. In contrast, the remaining 52.9% was projected to be unmeasured differences between individuals or family units. These findings provide a detailed explanation of the various processes that influence malaria prevalence in Kenya. Conclusions: The study's multilevel logistic regression model, which includes random effects, identified two SEA-level and eight individual/household risk factors for malaria infection. Thus, increasing the availability of insecticide-treated bed nets is one crucial element that public health policymakers should consider. Furthermore, health planners can organize spatially targeted initiatives to prevent malaria transmission with the help of spatial clustering data.

How Corporate Governance Practices Influence the CSR in the Non-financial Sector of Pakistan An Empirical Study of Pakistan Stock Exchange

In the course of this research the variables such as Women Directors, Board Size, Board Independences, Ownership structure and Audit committee are taken into consideration and how these factors influence Corporate Social Responsibility (CSR) disclosures. The analysis is based on data taken from the Pakistan Stock Exchange (PSX) for the period 2010-17. The analysis technique such as Fixed Effect Regression model is used which is based on Hausman diagnostic test results. Where the result reflects a positive significant effect of AUDIT, BIND and WDIR on CSR disclosure, however the relationship between BS and OWN on CSR disclosure has not been established. Control Variables such as Profitability (PRFT), Firm Size (FS) and Leverage (LEV) are investigated in this study. Using fixed effect model correlation matrix, regression analysis and descriptive statistics are examined. Considering the non-financial sectors of Pakistan, the study determines that AUDIT, BIND and WDIR plays pivotal role while promoting CSR related activities. Furthermore, the insights gained from the present study explored the importance of Corporate Governance (CG) strategies to promote CSR, the outcome of the study can be a helping hand for the policy makers and corporate decision makers while devising effective governance strategies. The control variables such as FS, PRFT and LEV provide depth of understanding regarding the factors influencing CSR disclosure. In a broad sense, the current research enhances the scholarly discourse on CSR disclosure. The findings of the study give a roadmap for future research studies to fill the identified gaps and further improve CSR disclosure practices in non-financial sector of Pakistan.

Performance of post-mortem diagnostic tests for tuberculosis in wild ungulates at low and high prevalence assessed using Bayesian latent class models.

Animal tuberculosis (TB) is often maintained by multi-host communities, including livestock and wildlife. Quantitative studies of such communities require estimating the true prevalence of TB, correcting the apparent prevalence by the diagnostic sensitivity (Se) and specificity (Sp) of the test. The goal of this study was to lay the foundations for estimating the true prevalence of TB in wild ungulate populations (wild boar and two cervids: red deer and fallow deer). We used Bayesian latent class models to assess the Se and Sp of gross pathology, IS6110 real-time PCR in tissues, bacteriological culture, and P22 indirect ELISA. We analyzed 308 harvested wild ungulates (211 wild boar and 97 cervids: 92 red deer and 5 fallow deer). The Se of bacteriological culture (80.4%, CI95 61.0-96.3%) and gross pathology (87.9%, CI95 69.5-99.9%) was reasonably good in wild boar. These tests showed lower Se in cervids: 60.2% (CI95 38.3-82.3%) for bacteriological culture and 81.5% (CI95 63.6-96.2%) for gross pathology. The Se of the real-time PCR was low (50.7% in wild boar and 53.0% in cervids). These tests showed Sp between 95.2 and 99.1% in both taxa. The P22 ELISA performed reasonably well in wild boar (Se = 71.9%, CI95 59.2-83.4%; Sp = 98.8%, CI95 96.9-99.9%) but lacked Sp in cervids (Se = 77.1%, CI95 62.9-89.7%; Sp = 74.5%, CI95 65.7-83.3%). The real-time PCR in wild boar and cervids and bacteriological culture in cervids tended to show higher Se in low-prevalence populations, possibly due to a higher proportion of early-stage TB lesions. In cervids, the parallel interpretation of gross pathology and bacteriological culture significantly improved the diagnostic performance (Se = 93.1%, CI95 84.7-98.9%; Sp = 92.9%, CI95 86.0-98.3%). Our results allow the estimation of true prevalence from the results of a single diagnostic test applied to harvested wild boar, red deer, and fallow deer, paving the way for more precise quantitative ecological studies of the multi-host TB maintenance community.

HEPATITIS C VIRUS AND LEUKEMIA PATIENTS: PREVALENCE AND RISK FACTORS ASSOCIATED WITH INFECTION AMONG LEUKEMIA PATIENTS WHO ACHIEVE LONG-TERM REMISSION AFTER CHEMOTHERAPY

Aim and objective: Leukemia patients are at elevated risk of hepatitis C virus infections, with anti-HCV prevalence ranging from 4.3% to 70% post-chemotherapy remission. Long-term leukemia survivors' natural histories are unclear. We measured anti-HCV antibodies to investigate the frequency of HCV infections and the associated odds factors of contracting HCV among leukemia patients who achieved long-term remissions after chemotherapy. Methods: This study is a cross-sectional study, comprising leukemia patients at the oncology center at Kuwait Hospital in Sana'a, Yemen. It included people with leukemia of different ages and genders. Data was collected through a standard questionnaire prepared for this study, which includes clinical symptoms, risk factors, demographic data, and the results of diagnostic tests. Antibody tests for the hepatitis C virus (HCV) were done by ELISA. Results: The majority of patients with HCV are male, with a mean age of 12.8 years. The prevalence is 5.5%, with males having a higher prevalence. Most patients receive blood transfusions more than twice, with major blood banks, Al-Kuwait hospitals, and private hospitals being the primary sources. AML and ALL are the two most common leukemias. Male patients have a higher risk, and those over 15 years old have a higher risk. Conclusions: This study is the first in Yemen to investigate the prevalence of HCV infections in patients with leukemia. According to our research, leukemia patients had a greater prevalence of HCV than the general population's national prevalence. However, health care workers (HCWs) and patients receiving maintenance hemodialysis (HD) patients have prevalence's of HCV that are comparable. Peer Review History: Received 14 May 2024; Reviewed 13 July 2024; Accepted 22 August; Available online 15 September 2024 Academic Editor: Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, toyinpharm@gmail.com Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com

Congenital cytomegalovirus diagnosis: healthcare claims data of linked pregnant people-infant pairs, United States, 2018—2023

Objective To describe maternal demographics and compare clinical characteristics of infants with congenital cytomegalovirus (cCMV) identified through diagnostic codes and laboratory data in the United States during 2018–2023. Methods We used a CDC-licensed subset of HealthVerity data, which contained linked pregnant people-infant claims data from publicly and privately insured individuals during 2018–2023 (2023 Quarter 3 HealthVerity Maternal Outcomes Masterset data). We identified infants with cCMV using diagnostic codes or positive laboratory test results within 45 days of birth. Results Among 744 (4.6 per 10,000 live births) infants with cCMV during 2018–2023, 599 (81%) were identified by a diagnostic code only. Among 732 linked pregnant people, 91 (12%) had a diagnosis of CMV infection during pregnancy, with a similar distribution by age group and insurance type, but a lower proportion were Black as compared to those without CMV infection during pregnancy (14% vs. 29%, respectively). Overall, 452 (61%) infants had ≥1 cCMV-related clinical sign at birth and 185 (25%) had valganciclovir prescriptions. Eighty-eight (68%) infants identified by a positive laboratory test only had no cCMV-related signs and none had valganciclovir prescriptions. Conclusions Using healthcare claims data, we found a minimal overlap of cCMV identified by diagnostic codes and laboratory test results. A minority of linked pregnant people with infants with cCMV had a CMV diagnosis during pregnancy. cCMV surveillance will help better understand the validity of ICD codes to identify infants with cCMV, describe the spectrum of disease, and monitor the use of antivirals.

Secondary School – Higher Education Institution Continuity on the Example of Teaching Computer Science and Information Technology

The problem of continuity at different levels of education is not new for pedagogy, teaching individual disciplines, including computer science and information technology. It is impossible not to take into account that information technologies are an independent discipline, a means through which the transformation of school and university education has been taking place in recent decades. The content of informatics at school and university should to a certain extent correspond to the level of science development and the requirements of society. The variety of digital tools and the ubiquitous availability of information create huge opportunities for their creative use within their discipline, related natural science subjects, and in various other spheres of human activity. Based on a comparative analysis, the article draws conclusions about the problems faced by both domestic and foreign specialists in the field of education. The article analyzes the strengths and weaknesses, opportunities and problems of the school and university education systems in Russia and abroad, and considers their relationship. It is substantiated that the lack of consistency and discreteness in the process of teaching computer science and information technology at school lead to a discrepancy between the training of school graduates and the requirements for the basic knowledge of first-year university students. The article presents the results of the analysis of basic curricula at school (in the field of computer science) and curricula in the preparation of future computer science teachers at the university (using the Transbaikal State University as an example). The authors analyze the results of diagnostic testing, which was conducted with first-year students of the Transbaikal State University in September 2023/2024, in order to monitor their existing knowledge and skills in the field of computer science. The article suggests ways to solve the problem of secondary school – higher education institution continuity in the field of computer science. The results of the study can be used in the preparation of future computer science teachers in higher educational institutions. Keywords: continuity of education, lifelong education, computer science and educational technologies, information competence, computer literacy

Effects of Music Therapy on Patients with Cancer Receiving Outpatient Treatment

Patients with cancer often experience anxiety when waiting for diagnostic test results, before receiving treatment, or when informed of a recurrence. Therefore, appropriate interventions are required at each of these stages. This study determines the effects of music therapy with preferred music on anxiety, blood pressure, pulse, and the satisfaction of patients with cancer when receiving outpatient intravenous therapy in a long-term care facility. This quasi-experimental non-equivalent control-group and non-synchronized study was conducted in the outpatient injection room of a long-term care facility in South Korea. This study included 57 patients (divided into experimental and control groups) with female reproductive system/breast or digestive system cancer who received short-term intravenous vitamin C on an outpatient basis. The participants chose from a music selection table for each genre, which was based on the prior research, under the supervision of a professor experienced in music therapy. The participants selected 20 songs to listen to for 1 h while receiving intravenous therapy. The participants were surveyed for state anxiety and satisfaction to confirm the effects of music therapy, and their systolic and diastolic blood pressure and pulse were measured. The state anxiety (U=282, p=.046) and satisfaction (U=262, p=.016) scores of the experimental and control groups revealed significant differences. There were no significant differences in systolic blood pressure (U=311, p=.13), diastolic blood pressure (t=1.88, p=.065), and pulse (t=-0.5, p=.61) between the experimental and control groups. Music therapy is an effective intervention for reducing anxiety and improving satisfaction in patients with cancer when receiving short-term outpatient treatment. However, to generalize these results, a larger sample size of participants is needed with similar types of cancer.

Peningkatan Kemampuan Penggunaan Tata Bahasa Baku Pada Remaja Tingkat SMP/MTs Di Gampong Keude Lueng Putu Pidie Jaya

Introducing language to the public, especially teenagers, certainly requires a long process. This is done for the sake of creating the nation's children who understand their language, namely Indonesian. This Community service activity aims to encourage teenagers to understand standard Indonesian grammar and also to improve teenagers' ability to use standard Indonesian. There are three stages used in this community service method, namely the first stage is observation, the second stage is the core activity, namely providing training, and the third stage is the final activity, namely entering the activity evaluation stage. The level of use of varieties of Indonesian by teenagers in the school environment is still relatively low, the level of use of standard Indonesian by teenagers in the family environment is also still low, while the results of diagnostic tests on standard Indonesian grammar skills of teenagers in Keude Lueng Putu gampong are also still low. However, even though teenagers' abilities are still relatively low, this activity can show that teenagers have high enthusiasm for participating in activities and increased competence in answering Indonesian grammar questions that were previously not understood and misused. Therefore, training on standard grammar really needs to be given to teenagers in Gampong Keude Lueng Putu.

Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management.

Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system. Diagnosing TTS requires a comprehensive approach, starting with clinical suspicion and progressing to both non-invasive and invasive multimodal tests guided by a specific diagnostic algorithm. Management of TTS should be personalized, considering potential complications, the presence or absence of coronary artery disease (CAD), diagnostic test results, and the patient's clinical course. The current data primarily derive from case series, retrospective analyses, prospective registries, and expert opinions. In recent years, there has been growing recognition of gender differences in the pathophysiology, presentation, and outcomes of TTS. This review provides an updated overview of gender disparities, highlighting the importance of tailored diagnostic and management strategies.

Urticaria multiforme in Asian children.

Urticaria multiforme is an uncommon presentation of acute urticaria. It most commonly affects children and most often occurs secondary to an underlying viral infection. We performed a retrospective review of a cohort of Asian children with urticaria multiforme and reviewed the literature on the condition. We retrospectively reviewed the clinical notes of children and adolescents less than 16 years of age, diagnosed with urticaria multiforme at our tertiary paediatric hospital between January 2017 and December 2022. Data collected and analysed included age, gender, initial diagnosis, antecedent symptoms, recent immunisations and medications, results of diagnostic tests, treatment and outcome. A total of 20 children were identified, with median age of diagnosis of 1.9 years, with most patients (79%) 7 years of age or younger. Viral infections were the commonest triggers. The most common referring diagnoses were erythema multiforme and Stevens-Johnson syndrome. Common antecedent or concomitant symptoms were fever and upper respiratory symptoms. Blood investigations were generally unremarkable except for mildly increased white cell counts and other markers of infection. Outcomes were good in all patients, with resolution of symptoms within 6 weeks without sequelae. Urticaria multiforme is an uncommon presentation of acute urticaria. Despite its striking appearance, it is generally a benign, self-limiting condition. Extensive investigations are usually not required and management is largely supportive.