Diagnostic Methods Research Articles

Bayesian accuracy estimates for diagnostic tests to detect tuberculosis in captive sun bears (Helarctos malayanus) and Asiatic black bears (Ursus thibetanus) in Cambodia and Vietnam.

Effective control of tuberculosis (TB) depends on early diagnosis of disease, yet available tests are unable to perfectly detect infected individuals. In novel hosts diagnostic testing methods for TB are extrapolated from other species, with unknown accuracy. The primary challenge to evaluating the accuracy of TB tests is the lack of a perfect reference test. Here we use a Bayesian latent class analysis approach to evaluate five tests available for ante-mortem detection of pulmonary TB in captive sun bears and Asiatic black bears in Southeast Asia. Using retrospective results from screening of 344 bears at three rescue centres, we estimate accuracy parameters for thoracic radiography, a serological assay (DPP VetTB), and three microbiological tests (microscopy, PCR (Xpert MTB/RIF, Xpert MTB/RIF Ultra), mycobacterial culture) performed on bronchoalveolar lavage samples. While confirming the high specificities (≥ 0.99) of the three microbiological tests, our model demonstrated their sub-optimal sensitivities (<0.7). Thoracic radiography was the only diagnostic method with sensitivity (0.95, 95% BCI: 0.76, 0.998) and specificity (0.95, 95% BCI: 0.91, 0.98) estimated above 0.9. We recommend caution when interpreting DPP VetTB results, with the increased sensitivity resulting from treatment of weakly visible reactions as positive accompanied by a drop in specificity, and we illustrate how the diagnostic value of weak DPP VetTB reactions is particularly reduced if disease prevalence and/or clinical suspicion is low. Conversely, the reduced utility of negative microbiological tests on bronchoalveolar lavage fluid samples when prevalence and/or clinical suspicion is high is demonstrated. Taken together our results suggest multiple tests should be applied and accompanied by consideration of the testing context, to minimise the consequences of misclassification of disease status of bears at risk of TB in sanctuary settings.

HPB SO16 - The accuracy of various diagnostic methods in differentiating between malignant and benign hilar strictures - a systematic review

Abstract Background It is difficult to distinguish benign and malignant hilar strictures and surgical resection is associated with high rates of morbidity and mortality. Therefore, more accurate diagnostic methods are required. The aim of this systematic review was to investigate the sensitivity and specificity of current diagnostic strategies in differentiating between malignant and benign hilar strictures. Method This systematic review was conducted in line with the PRISMA guidelines. A comprehensive literature search was completed using PUBMED and Medline databases to identify original research studies reporting sensitivity and specificity of various diagnostic methods for hilar strictures. Results A total of 653 papers were identified and after review 20 publications were included in the analysis, comprising 1,824 patients. (18)F-FDG PET/CT appeared in 6 studies with sensitivity range 69.6%-92.3%, followed by cytology identified in 5 studies with sensitivity 32.9%-89% and specificity 89%-100%. Finally, CEA marker was utilized in 3 studies with sensitivity 33%-72% and specificity 84%-90%. Conclusion Due to wide variation in reported accuracy of diagnostic tests in suspected hilar CCA, a prospective observational study is warranted to determine the optimal strategy and understand the current error rate and where improvements may be made.

Abstract PR013: Highly accurate detection of early-stage colorectal cancer using tumor and immune extracellular vesicles biomarkers

Abstract Introduction: Colorectal cancer (CRC) is one of the most common cancers worldwide, and early detection is critical for successful treatment and improved survival rates. However, precancerous and early-stage CRC present significant diagnostic challenges due to the small size of lesions and the very low expression of tumor-specific biomarkers in the bloodstream. Current genomics-based diagnostic methods struggle to detect these lesions, making it imperative to develop more sensitive and specific approaches. Circulating extracellular vesicles (EVs) are emerging as a promising solution for early-stage CRC detection, since EVs are produced by tumor cells as well as the tumor microenviroment and host immune cells. Thus, EVs may offer the means to detect and monitor small early-stage tumors through both direct detection of tumor- associated biomarkers as well through tumor specific host response and tumor microenvironment biomarkers. Methods: To identify novel early-stage CRC specific biomarkers, we performed proteomics analysis on EVs purified from patient plasma using size exclusion chromatography and a proprietary buffer system that enhances EV and corona protein recovery. TrueDiscovery™ Data-independent acquisition (DIA) mass spectrometry (MS) analysis was conducted on 24 pre- cancer/stage 0 and 25 stage 1 CRC patients and 75 normal patient plasma samples. An in-house developed machine learning pipeline was used to identify differentially expressed proteins and model candidate multiplexes to identify those with extremely high diagnostic accuracy (&amp;gt; 0.99). Results: An average of ∼2,500 proteins were identified per sample and included in bioinformatics analysis. Comparative analysis between control patient EVs and either pre- cancerous/Stage 0, or Stage 1 colon cancer EVs using an in-house Machine Learning pipeline identified 336 and 493 differentially expressed proteins for each group (FDR adjusted p-value &amp;lt; 0.001). Of these, the best 17 pre/stage 0 proteins and 53 stage 1 proteins were trained and tested using Support Vector Machine to assess all potential 3-plexes in order to identify those with mean diagnostic accuracy &amp;gt; 99%. This yielded 5 3-plexes in precancer/stage 0 and 34 3-plexes in stage 1 with near perfect diagnostic accuracy. These plexes are currently being assessed in single analyte and multiplex immunoassays with the goal of translating candidate 3-plexes to the clinical. Conclusions: Key biomarkers from CRC patient EVs indicate the potential to detect and diagnose early-stage and low tumor burden cancers using our methods. Interestingly, the most accurate 3-plexes consist of proteins from immune, inflammatory and metabolic processes, suggesting that for the detection of early stage cancer it may be critical to include both tumor and host specific biomarkers. Citation Format: Poorva Mudgal, Cheryl Bandoski, Zachary Opheim, Martin Mehnert, Valesca Anschau, Issa Isaac, Alan Ezrin, Todd Hembrough. Highly accurate detection of early-stage colorectal cancer using tumor and immune extracellular vesicles biomarkers [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 PR013.

Thymidine Phosphorylase Imaging Probe for Differential Diagnosis of Metabolic dysfunction-associated Steatohepatitis.

Metabolic dysfunction-associated steatotic liver disease (MASLD) comprises simple steatosis (SS), which has a low risk of mortality, and metabolic dysfunction-associated steatohepatitis (MASH), which can progress to liver cirrhosis and hepatocellular carcinoma. Because differentiation between MASH and SS is the most important issue in the diagnosis of MASLD, the establishment of noninvasive diagnostic methods is urgently needed. In this study, we evaluated the potential of [123I]IIMU, a thymidine phosphorylase (TYMP) targeted SPECT imaging probe, for differential diagnosis of MASLD in a preclinical animal model. SS and MASH mice were prepared by feeding db/db mice with a standard diet and a methionine/choline-deficient diet, respectively. Control mice were prepared by feeding m/m mice with a standard diet. TYMP expression in the liver was evaluated by RT-PCR, western blotting, and immunohistochemistry. The biodistribution of [125I]IIMU in the three model mice was evaluated at 30min post-injection. SPECT/CT imaging studies of the three model mice were performed 30min after injection of [123I]IIMU. Hepatic TYMP expression level was the highest in the SS mice and the lowest in the MASH mice at both mRNA and protein levels. The immunohistochemistry experiment showed a patchy distribution of TYMP only in the liver of MASH mice. In the biodistribution study, the hepatic accumulation of [125I]IIMU was the highest in the SS mice and the lowest in the MASH mice. The SPECT/CT imaging study showed similar results to the biodistribution experiment. Hepatic TYMP expression level may serve as a promising imaging biomarker for differential diagnosis of SS and MASH. SPECT imaging using [123I]IIMU potentially provides a novel noninvasive diagnostic method to differentiate MASH and SS.

BN SO19 - Evaluating Wrap Pressure Augmentation Ratio and Physiological Transit Time for Post-Fundoplication Dysphagia

Abstract Background Post-fundoplication dysphagia affects many patients that can often lead to significant weight loss and reduced quality of life, and prompt some to seek surgical reversal. Current diagnostic methods may not fully explain the dysphagia which may necessitate repeat oesophageal physiology testing. This study retrospectively evaluates two novel markers, Wrap Pressure Augmentation Ratio (WPAR) and Physiological Transit Time (PTT), to better understand and manage the post-fundoplication dysphagia. Method The study retrospectively reviewed 54 post-Nissen’s fundoplication patients from January 2020 to May 2024. WPAR was calculated as the ratio of the augmented wrap basal pressure to the median integrated relaxation pressure found during high-resolution manometry following the Chicago Classification guideline [1]. PTT was measured from controlled measurements of antegrade bolus movement [2] during multichannel impedance-pH studies [3]. Patients completed HODQ forms to assess dysphagia [4]. Optimal WPAR and PTT thresholds were determined using Youden’s J index from receiver operating characteristic curves. This study was ethically approved (REC 18/NW/0120, IRAS 333800). Results Out of 54 cases (female=28:26, mean age 50.6), 75.9% reported clinical dysphagia post-fundoplication. Significant correlations were found with WPAR (&amp;lt;1.49, p=0.017) and PTT (&amp;gt;0.83 minutes, p=0.028)(see Table 1). These findings suggest WPAR and PTT as effective markers for post-fundoplication dysphagia. The analysis revealed a moderate correlation between WPAR and PTT (r =-0.45, p&amp;lt;0.05), suggesting that lower WPAR values tend to be associated with longer PTT. SensitivityPositive Predictive Valueχ2p-valueWPAR &amp;lt;1.490.610.895.680.017PTT &amp;gt;0.83 minutes0.780.844.820.028 Table 1 showing predictive DR and PTT values for clinical dysphasia post fundoplication. Conclusion This pilot study identifies PAR and PTT as promising physiological markers for diagnosing post-fundoplication dysphagia. The moderate correlation between PAR and PTT suggests a potential link, indicating that lower pressure augmentation might be associated with slower oesophageal transit times. These markers could enhance management strategies for affected patients. However, the study's small sample size and lack of a control group limit generalizability. Larger, controlled studies are necessary to validate these findings and further explore the relationship between PAR and PTT.

Artificial Intelligence-Driven Wearable Electronics and Smart Nanodevices for Continuous Cancer Monitoring and Enhanced Diagnostic Accuracy

Artificial Intelligence (AI)-driven wearable electronics and smart nanodevices are transforming cancer diagnostics by offering continuous monitoring and enhanced diagnostic accuracy. Traditional cancer diagnostic methods often suffer from delays in detection and limited real-time data, which can hinder timely treatment. In contrast, AI integration in wearable technologies and nanodevices allows for the continuous tracking of physiological biomarkers, enabling earlier detection of cancer and more precise monitoring of disease progression. This review explores the advancements in AI-powered wearable electronics and smart nanodevices for cancer diagnostics, focusing on their applications, benefits, and challenges. AI-driven wearable devices, such as smartwatches and biosensors, are equipped with machine learning algorithms capable of real-time data analysis, facilitating personalized and proactive healthcare solutions. Similarly, smart nanodevices, which leverage nanotechnology combined with AI, offer unprecedented precision in identifying and monitoring cancer cells, allowing for more accurate diagnostic outcomes. Case studies are presented to demonstrate the effectiveness of these technologies in improving diagnostic accuracy and patient outcomes. The review also highlights the challenges these technologies face, including data privacy, ethical concerns, and technical limitations. Additionally, the paper discusses future directions in AI-driven cancer diagnostics, emphasizing the potential for these innovations to revolutionize early cancer detection, improve treatment strategies, and enhance long-term patient outcomes. Ultimately, this review provides a comprehensive understanding of how AI and advanced technologies are reshaping the landscape of cancer diagnostics and monitoring, offering significant implications for clinical practice and research in the medical field.

Pediatric masks of obstructive sleep apnea syndrome

A number of factors contribute to the occurrence of chronic otolaryngological diseases in children at an early age, which often acquire a long, undulating course with exacerbations, relapses and complications. The increasing aggressiveness of environmental factors, the growth of allergization of the population, the formation of strains of microorganisms resistant to the action of medicines, lead to a steady increase in diseases of the nasopharyngeal tonsils and a worsening of their course, especially among children, both in our country and abroad. At the same time, the adenotonsillar problem has long gone beyond ENT pathology and attracts the attention of a wide range of medical resea. The aim of the work: to analyze the literature data on clinical manifestations, laboratory and instrumental diagnostic methods and the prevalence of OSA in children. The analysis of publications using PubMed, EMBASE and Web of Science search engines in the period from January 1970 to March 2024 related to research on epidemiological, pathogenetic, clinical and laboratory aspects of OSA in children and adults was carried out. rchers. Sleep respiratory disorder is a term covering various clinical diagnoses from primary snoring to obstructive sleep apnea. This clinical symptom is registered in at least one in nine children, which makes it one of the most frequently diagnosed sleep disorders and puts it in the category of serious social problems. The most compelling evidence relates to hyperactivity, inattention, and social problems: decreased social competence, increased problematic behavior, and decreased memory scores. Despite the growing body of evidence suggesting cognitive impairment in children with snoring, many results have been contradictory. The availability of pediatric sleep laboratories, even in countries with advanced health systems, is limited, which encourages the search for less complex and more convenient testing methods. Timely detection of the development of the disease allows you to prevent complications and improve the quality of life. The article also describes clinical cases of late diagnosis of obstructive sleep apnea in children.

Ultrasensitive Detection of Blood-Based Alzheimer's Disease Biomarkers: A Comprehensive SERS-Immunoassay Platform Enhanced by Machine Learning.

Accurate and early disease detection is crucial for improving patient care, but traditional diagnostic methods often fail to identify diseases in their early stages, leading to delayed treatment outcomes. Early diagnosis using blood derivatives as a source for biomarkers is particularly important for managing Alzheimer's disease (AD). This study introduces a novel approach for the precise and ultrasensitive detection of multiple core AD biomarkers (Aβ40, Aβ42, p-tau, and t-tau) using surface-enhanced Raman spectroscopy (SERS) combined with machine-learning algorithms. Our method employs an antibody-immobilized aluminum SERS substrate, which offers high precision, sensitivity, and accuracy. The platform achieves an impressive detection limit in the attomolar (aM) range and spans a wide dynamic range from aM to micromolar (μM) concentrations. This ultrasensitive and specific SERS immunoassay platform shows promise for identifying mild cognitive impairment (MCI), a potential precursor to AD, from blood plasma. Machine-learning algorithms applied to the spectral data enhance the differentiation of MCI from AD and healthy controls, yielding excellent sensitivity and specificity. Our integrated SERS-machine-learning approach, with its interpretability, advances AD research and underscores the effectiveness of a cost-efficient, easy-to-prepare Al-SERS substrate for clinical AD detection.

THE METHOD OF DOUBLE CONTRAST IN THE INTRAOPERATIVE DIAGNOSIS OF REGMATOGENIC RETINAL DETACHMENT

Usually, the recurrence rate of regmatogenic retinal detachment (ROS) after surgery ranges from 3% to 30%. In cases where the disease recurs after successful surgery, in 60% of cases the main factor is the progression of proliferative vitreoretinopathy (PVR), which makes it one of the most severe complications that can occur in the postoperative period. In addition, after removal or absorption of a tampon agent (in particular, endotamponade with silicone oil), recurrent retinal detachment may occur due to the inability to detect retinal rupture during surgery.Objective: this study is aimed at evaluating the effectiveness of diagnostic methods used during operations for regmatogenic retinal detachment. After completing the standard stages of central vitrectomy, the group of patients was divided into two equal groups: the first group included patients who received the double contrast method, and the second group (control) – patients who underwent the traditional surgical method.Results and discussion: in patients of the control group, there was a significant increase in the number of relapses of ROS. In addition, it was found that an increase in the number of retinal tears correlated with a greater likelihood of macular involvement; Statistical evaluation has shown that the absence of AST and tight adhesion of the posterior hyaloid membrane to the retina and small retinal tears increase the risk of recurrence of ROS due to the progression of PVR.

ENDOCARDITE BACTERIANA E PROFILAXIA ANTIBIÓTICA NA ODONTOLOGIA: MANEJO E PREVENÇÃO EM PACIENTES DE RISCO

This study addresses bacterial endocarditis, a severe inflammatory condition of the endocardium caused by the colonization of pathogenic bacteria or fungi. The objective was to analyze and synthesize evidence regarding risk factors, pathogenic mechanisms, diagnostic methods, prevention strategies, and therapeutic approaches for this disease, with an emphasis on the relationship between oral infections and bacterial endocarditis. A literature review was conducted, selecting articles from the PubMed, Medline, and Google Scholar databases published between 2011 and 2024, using specific keywords: "Bacterial Endocarditis," "Oral Infections," "Antibiotic Prophylaxis," "Dental Biofilm," and applying rigorous inclusion and exclusion criteria to ensure the relevance and quality of the studies. The literature unanimously indicates that antibiotic prophylaxis is the best way to prevent the development of bacterial endocarditis (BE), particularly in patients with risk factors, such as those with congenital heart diseases or valve prostheses. Administering antibiotics before procedures that may cause bacteremia is essential to reduce the risk of infection. Effective prevention involves not only antibiotic prophylaxis but also continuous education for patients and healthcare professionals about the importance of maintaining oral health to prevent systemic complications. The adoption of preventive measures can significantly reduce the incidence of BE, especially in individuals with preexisting heart conditions. In this sense, dentistry plays a vital role, as dental procedures can cause temporary bacteremia, and collaboration between healthcare professionals and dentists is crucial to ensure the protection of these patients.

The role of computed tomography in differential diagnosis of "intracardiac mass" in the mitral valve region (a series of case reports)

The differential diagnosis of "intracardiac mass" in the region of the mitral annulus, detected by echocardiography, can be challenging. A multimodal approach is usually required to clear up. Sometimes the nature of detected mass may be due to subvalvular mitral annular calcification. The presented series of case reports emphasizes the importance and clinical significance of computed tomography in identifying and characterization subvalvular mitral annular calcification with ambiguous results of other diagnostic methods, in particular echocardiography.

Validation of Vetscan Imagyst®, a diagnostic test utilizing an artificial intelligence deep learning algorithm, for detecting strongyles and Parascaris spp. in equine fecal samples

BackgroundCurrent methods for obtaining fecal egg counts in horses are often inaccurate and variable depending on the analyst’s skill and experience. Automated digital scanning of fecal sample slides integrated with analysis by an artificial intelligence (AI) algorithm is a viable, emerging alternative that can mitigate operator variation compared to conventional methods in companion animal fecal parasite diagnostics. Vetscan Imagyst is a novel fecal parasite detection system that uploads the scanned image to the cloud where proprietary software analyzes captured images for diagnostic recognition by a deep learning, object detection AI algorithm. The study describes the use and validation of Vetscan Imagyst in equine parasitology.MethodsThe primary objective of the study was to evaluate the performance of the Vetscan Imagyst system in terms of diagnostic sensitivity and specificity in testing equine fecal samples (n = 108) for ova from two parasites that commonly infect horses, strongyles and Parascaris spp., compared to reference assays performed by expert parasitologists using a Mini-FLOTAC technique. Two different fecal flotation solutions were used to prepare the sample slides, NaNO3 and Sheather’s sugar solution.ResultsDiagnostic sensitivity of the Vetscan Imagyst algorithm for strongyles versus the manual reference test was 99.2% for samples prepared with NaNO3 solution and 100.0% for samples prepared with Sheather’s sugar solution. Sensitivity for Parascaris spp. was 88.9% and 99.9%, respectively, for samples prepared with NaNO3 and Sheather’s sugar solutions. Diagnostic specificity for strongyles was 91.4% and 99.9%, respectively, for samples prepared with NaNO3 and Sheather’s sugar solutions. Specificity for Parascaris spp. was 93.6% and 99.9%, respectively, for samples prepared with NaNO3 and Sheather’s sugar solutions. Lin’s concordance correlation coefficients for VETSCAN IMAGYST eggs per gram counts versus those determined by the expert parasitologist were 0.924–0.978 for strongyles and 0.944–0.955 for Parascaris spp., depending on the flotation solution.ConclusionsSensitivity and specificity results for detecting strongyles and Parascaris spp. in equine fecal samples showed that Vetscan Imagyst can consistently provide diagnostic accuracy equivalent to manual evaluations by skilled parasitologists. As an automated method driven by a deep learning AI algorithm, VETSCAN IMAGYST has the potential to avoid variations in analyst characteristics, thus providing more consistent results in a timely manner, in either clinical or laboratory settings.Graphical

Oxford Nanopore Technology-Based Identification of an Acanthamoeba castellanii Endosymbiosis in Microbial Keratitis.

(1) Background: Microbial keratitis is a serious eye infection that carries a significant risk of vision loss. Acanthamoeba spp. are known to cause keratitis and their bacterial endosymbionts can increase virulence and/or treatment resistance and thus significantly worsen the course of the disease. (2) Methods and Results: In a suspected case of Acanthamoeba keratitis, in addition to Acanthamoeba spp., an endosymbiont of acanthamoebae belonging to the taxonomic order of Holosporales was detected by chance in a bacterial 16S rDNA-based pan-PCR and subsequently classified as Candidatus Paracaedibacter symbiosus through an analysis of an enlarged 16S rDNA region. We used Oxford Nanopore Technology to evaluate the usefulness of whole-genome sequencing (WGS) as a one-step diagnostics method. Here, Acanthamoeba castellanii and the endosymbiont Candidatus Paracaedibacter symbiosus could be directly detected at the species level. No other microbes were identified in the specimen. (3) Conclusions: We recommend the introduction of WGS as a diagnostic approach for keratitis to replace the need for multiple species-specific qPCRs in future routine diagnostics and to enable an all-encompassing characterisation of the polymicrobial community in one step.

A New Method of Intelligent Fault Diagnosis of Ship Dual-Fuel Engine Based on Instantaneous Rotational Speed

Ship engine misfire faults not only pose a serious threat to the safe operation of ships but may also cause major safety accidents or even lead to ship paralysis, which brings huge economic losses. Most traditional fault diagnosis methods rely on manual experience, with limited feature extraction capability, low diagnostic accuracy, and poor adaptability, which make it difficult to meet the demand for high-precision diagnosis. To this end, a fusion intelligent diagnostic model—ResNet–BiLSTM—is proposed based on a residual neural network (ResNet) and a bidirectional long short-term memory network (BiLSTM). Firstly, a multi-scale decomposition of the instantaneous rotational speed signal of a ship’s engine is carried out by using the continuous wavelet transform (CWT), and features containing misfire fault information are extracted. Subsequently, the extracted features are fed into the ResNet–BiLSTM model for learning. Finally, the intelligent diagnosis of ship dual-fuel engine misfire faults is realized by the classifier. The model combines the advantages of ResNet18 in image feature extraction and the capability of BiLSTM in temporal information processing, which can efficiently capture the time-frequency features and dynamic changes in the fault signal. Through comparison experiments with fusion models AlexNet–BiLSTM, VGG–BiLSTM, and the existing AlexNet–LSTM and VGG–LSTM models, the results show that the ResNet–BiLSTM model outperforms the other models in terms of diagnostic accuracy, robustness, and generalization ability. This model provides an effective new method for intelligent diagnosis of ship dual-fuel engine misfire faults to solve the traditional diagnostic methods’ limitations.

Abstract 4118342: Acoustic Analysis For The Detection Of Leaflet Thrombosis After Transcatheter Aortic Valve Replacement

Introduction: Following trans-catheter aortic valve replacement (TAVR), patients may develop aortic valve leaflet thrombosis, a condition associated with an increased risk of embolic events. Currently, the diagnosis of post-TAVR leaflet thrombosis is based on echocardiography surveillance or cardiac tomography (CCT) scan, both require specialized team and equipment, and may also expose the patients to radiation and contrast. Acoustic analysis is a non-invasive reproducible method, which incorporates the recording of cardiac sounds and analyzing them via machine learning algorithms. Here, we investigated the diagnostic abilities of acoustic analysis in the detection of post-TAVR leaflet thrombosis. Methods: Using an electronic stethoscope, heart sounds were prospectively recorded at 2 time points: 24-hours and 6-months post-TAVR. CCT scan was performed 6-months following TAVR to detect leaflet thrombosis. Acoustic sounds were analyzed, using a Gaussian support vector machine (SVM) algorithm, to identify features associated with leaflet thrombosis. Results: Of 19 consecutive patients, 3 were found to have high-grade leaflet thrombosis based on CCT results. The SVM algorithm effectively classified heart sounds into "normal" and "thrombotic", with a sensitivity of 100% and specificity of 97.2%. Following anticoagulation therapy, all 3 patients showed no signs of leaflet thrombosis on follow-up CCT scans and were also classified as "normal" by the algorithm. Notably, at the time of leaflet thrombosis, Doppler echocardiographies showed normal pressure gradients across the affected valves. Conclusions: These initial results suggest that acoustic analysis, combined with machine learning algorithms, may identify post-TAVR leaflet thrombosis, providing a non-invasive, cost-effective, and radiation-free alternative to traditional diagnostic methods.

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.

Emerging technologies for the management of diabetic foot ulceration: a review.

Diabetic foot ulcers (DFUs) and infections are common complications that frequently result in reduced quality of life and even morbidity for patients with diabetes. This paper highlights significant findings in DFU treatments and emerging advanced technologies for monitoring ulceration in patients with diabetes. The management of DFUs requires a multidisciplinary approach that involves patient education. It is well-established that poor glycemic control significantly contributes to diabetic foot ulcer complications, presenting global challenges in quality of life, economics, and resource allocation, affecting approximately half a billion people and potentially leading to lower limb amputation or mortality. Therefore, effective DFU management necessitates a multidisciplinary approach that includes patient education. However, current clinical guidelines for DFU treatment are not performing effectively, resulting in unnecessary increases in financial and emotional burden on patients. Researchers have experimented with advanced technologies and methods, including traditional approaches, to address complications related to DFU healing. This paper also presents the evolution of patents in the field of DFU medication and advanced diagnostic methods, showcasing relevant innovations that may benefit a wide range of researchers.

Portal venous gas in a domestic shorthair cat with large cell lymphoma

AbstractPortal venous gas is defined as air within the portal venous system, whereas pneumobilia is defined as gas within the biliary tract. This report describes an 11.5‐year‐old female spayed domestic shorthair being managed for large cell lymphoma. While being hospitalised, the patient was noted to have evidence of portal venous gas on diagnostic imaging. The case study highlights common underlying causes of portal venous gas and pneumobilia in addition to diagnostic options and findings for evaluation. The most common cause of portal venous gas is bowel necrosis. Ultrasound and computed tomography scan are the most sensitive diagnostic methods in differentiation. Being familiar with the radiographic signs of and potential underlying causes of portal venous gas and pneumobilia may allow for more prompt investigations of potentially life‐threatening underlying causes. If recent surgical manipulation to the hepatobiliary/hepatoenteric system is not present and there is no history of trauma, then further diagnostic workup should be performed to evaluate for an underlying cause. Treatment of portal venous gas and pneumobilia is based on treating the suspected underlying cause.

Pancreatic cancer – challenge for modern medicine

Introduction. Pancreatic cancer is one of the most dangerous carcinomas of the digestive tract, with a very poor prognosis for patients. Annually, more than three and a half thousand people in Poland are diagnosed with this tumor. Aim. The aim of the work was to assess and compile existing knowledge about pancreatic adenocarcinoma. Materials and methods. Data for the paper was gathered with the usage of Google Scholar. Moreover, articles from sources like PubMed or National Institutes of Health were used. Materials were published between 2015 and 2024. Results. Tumor morbidity is still increasing, the biggest group of patients are people who are more than 55 years old. Many modifiable and nonmodifiable factors play a role in the pathogenesis of pancreatic cancer. Lifestyle, stimulants, BMI or physical activity can be included into the first group. Nonmodifiable factors are sex, age, race, genetic predisposition or blood group. Typical symptoms of this tumor are loss of the body weight, fatigue, nausea, jaundice and abdominal pain. Clinicians use the following diagnostic methods: CT, MRI, ERCP, MRCP or USG. Only the radical chirurgical treatment gives a hope for total recovery, additionally chemotherapy can be admitted. Chemotherapy schemes are FOLFIRINOX or monotherapy with gemcitabine. Conclusions. Pancreatic cancer is still a challenge for clinicians, as its treatment is limited by poor effectiveness of possible ways of treatment. The majority of tumors are diagnosed at the advanced stage, when full patient recovery is not possible. New ways of treatment such as immunotherapy, monoclonal antibodies or gene therapy are a ray of hope. Keywords: pancreatic cancer, treatment of pancreatic cancer, epidemiology, diagnostic methods.

Effect on MDA-MB231 human breast cancer cell line treated with bilberry (Vaccinium myrtillus) using Annexin V and AgNOR staining

Background/Aim: Cancer has become a prevalent disease, emerging as one of the major chronic health issues today. Currently, common treatments against cancer include chemotherapy, radiotherapy, surgery, and the use of chemically synthesized drugs. However, despite significant advancements in diagnostic methods and treatments, drug resistance and metastasis remain primary hurdles to successful cancer therapy. Consequently, attention has been shifted towards exploring alternative treatments and therapies against cancer. This study sought to examine the time and dose-dependent effects of blueberry (Vaccinium myrtillus L) on MDA-MB-231 cell lines. Methods: The study used the MDA-MB231 breast cancer cell line. We established three groups: control, 40 µl/ml bilberry, and 80 µl/ml bilberry, which were incubated at 37°C and 5% CO2 for 24 and 48 h, respectively. After incubation, we examined the viability, apoptosis, and cell cycle of MDA-MB-231 cells with the Muse Cell Analyzer and assessed the status of nucleolar organizer region (NOR) proteins via silver nitrate (AgNOR) staining. Results: Bilberry extracts were found to enhance apoptosis and exhibit a cytotoxic effect, thereby reducing cell proliferation in MDA-MB-231 cells after 24 and 48 h of culture. There was notably increased apoptosis at concentrations of 40 µl and 80 µl. Moreover, after 48 h of incubation, a significant difference emerged between the control and 40 µg/ml bilberry samples, notably in the average AgNOR count and the total AgNOR area/total nuclear area ratio. Conclusion: Our study suggests that blueberries may be a potential therapeutic candidate for cancer treatment, thereby potentially enriching cancer research.