Modern Diagnostic Techniques Research Articles

Common Peroneal Nerve Entrapment Masked by Acute Lumbar Disc Herniation: Integrated Korean Medicine Treatment with Ultrasound-Guided Pharmacopuncture

The symptoms of common peroneal nerve (CPN) entrapment are similar to the symptoms of lumbar herniated intervertebral disc. We present the successful treatment of CPN entrapment masked by acute lumbar disc herniation. A 49-year-old man presented with low back pain and numbness in his left leg. Following admission, patient history, physical examination, and radiology findings, the patient received integrated Korean medicine (KM) treatment (acupuncture, pharmacopuncture, ultrasound-guided pharmacopuncture, moxibustion and cupping, herbal medicine, and chuna therapy) for lumbar disc herniation. Outcome measures included the numeric rating scale, the European quality of life five dimensions, and the Oswestry disability index. Symptoms persisted, and CPN compression was consequently suspected. On Day 12 of 23, in addition to KM treatment, an ultrasound-guided Shinbaro2 pharmacopuncture (4 mL) was performed on the CPN entrapment site. Significant symptom relief resulted after CPN treatment on Day 12. Improvement was particularly evident in the lower leg and ankle, areas where the pain had previously been misattributed to symptoms of lumbar disc herniation. His low back pain and radiating pain to the back of the left femur started to improve from Day 20 and were mild at discharge. This case highlights the importance of considering peripheral nerve entrapment in patients presenting with symptoms similar to lumbar disc herniation. It also suggests that combining traditional KM with modern diagnostic techniques such as ultrasonography, may be beneficial in the precise location for pharmacopuncture treatment. Further studies are recommended to validate these findings and explore the broader applicability of this approach.

Жизненный цикл изделия: мониторинг процессов механической обработки и фильтрация виброакустических сигналов

Introduction. In modern manufacturing, the product life cycle comprises various stages, from conception to disposal. Among these stages, machining plays a significant role, as it directly influences the durability and functionality of the finished product. With increasing competition and the need to reduce production costs, optimizing machining processes has become a crucial task. Traditionally, conservative technological approaches have been used to ensure processing quality. However, this often leads to decreased productivity and higher costs. Modern monitoring and diagnostic techniques can significantly improve process control, particularly through tool condition monitoring. The subject. This paper discusses the stages of the product life cycle and emphasizes the importance of monitoring machining processes. It explores the potential of using vibroacoustic signals to continuously monitor equipment and product conditions. Special attention is paid to the use of vibroacoustic signals for diagnostics and quality control. Modern approaches to filtering these signals, including the use of the fast Fourier transform and various window functions, are analyzed in order to improve the accuracy of the analysis and identify potential defects. The purpose of this work is to develop an algorithm for an online monitoring system that will monitor the condition of cutting tools based on the creation of a digital shadow using a vibroacoustic complex. The main tasks to be solved are to establish the ranges of applicability of frequency response of acoustic signals and optimal window functions, as well as to establish the relationship between the degree of wear on the cutting tool and the results of vibration diagnostics and surface roughness. The methods and technologies for filtering vibroacoustic signals and their application in real–world production settings are discussed. Special attention is given to the role of digital twins in integrating monitoring and filtering data, allowing for the creation of a virtual model of a product to predict its behavior and optimize processes throughout the life cycle. A comparison of various monitoring methods and technologies is conducted, as well as an analysis of practical examples of digital twin implementation in production processes and its impact on improved control. Results and discussion are presented, identifying current research and practical advancements, while also proposing existing challenges and promising areas for future research in the fields of monitoring, signal filtering, and the use of digital twins in mechanical manufacturing.

Is it possible to regress atherosclerotic lesions with long-term treatment with lipoprotein apheresis?

The article presents the up-to-date information on the effect of lipoprotein apheresis (LA) on atherosclerotic lesions. Some studies using modern diagnostic imaging techniques (such as intravascular ultrasound or magnetic resonance imaging) have clearly demonstrated plaque regression. Coronary angiography has also seen reversal or at least slow plaque progression. Plaque regression likely leads to a decrease in the incidence of atherosclerotic cardiovascular events (CVEs). However, this has not yet been fully proven. Recent data indicate that reduction in low-density lipoprotein cholesterol and lipoprotein(a) levels is not a major factor in reducing the incidence of atherosclerotic CVEs in patients undergoing extracorporeal treatment. The most significant risk factors in this case are older age and a greater CVE rate observed before the start of LA, as well as smoking. New studies using modern diagnostic imaging methods in patients receiving LA are necessary.

Morel-Lavallee associated lymphedema treated with lymphovenous anastomosis: A case report

Morel-Lavallee Lesions lead to disruption of lymphatic anatomy that require early identification and may necessitate lymphatic reconstruction. We present the case of a 59-year-old male with lower extremity lymphedema resulting after a severe Morel-Lavallee lesion and treated using lymphovenous anastomoses. He was initially managed with multiple aspirations followed by repeat incision and drainage. At 10 months following his injury, he continued to have swelling of his upper thigh and developed a large festoon medially, with lower leg pitting edema. He was diagnosed with lymphedema via lymphoscintigraphy. His superficial lymphatic anatomy was visualized using indocyanine green (ICG) lymphography and showed diffuse dermal backflow across his thigh, with signs of altered lymphatic anatomy distally. We preformed two lymphovenous anastomoses at the level of his mid-thigh to bypass the lymphatic disruption and restore drainage to his lower leg. After rerouting lymphatic flow from the lower extremity, the patient had overall improvement of his symptoms and reduced swelling with continued therapy. At 5 months postoperatively, his volumetric lower extremity measurements showed a decrease by 314 mL and he began walking again in 20-minute intervals. Lymphedema may be an important consideration following severe Morel-Lavallee lesions. Using modern diagnostic and supermicrosurgical techniques, plastic surgeons can help treat this long-term morbidity.

A Review of Probe-Based Enrichment Methods to Inform Plant Virus Diagnostics.

Modern diagnostic techniques based on DNA sequence similarity are currently the gold standard for the detection of existing and emerging pathogens. Whilst individual assays are inexpensive to use, assay development is costly and carries risks of not being sensitive or specific enough to capture an increasingly diverse range of targets. Sequencing can provide the entire nucleic acid content of a sample and may be used to identify all pathogens present in the sample when the depth of coverage is sufficient. Targeted enrichment techniques have been used to increase sequence coverage and improve the sensitivity of detection within virus samples, specifically, to capture sequences for a range of different viruses or increase the number of reads from low-titre virus infections. Vertebrate viruses have been well characterised using in-solution hybridisation capture to target diverse virus families. The use of probes for genotyping and strain identification has been limited in plants, and uncertainty around sensitivity is an impediment to the development of a large-scale virus panel to use within regulatory settings and diagnostic pipelines. This review aims to compare significant studies that have used targeted enrichment of viruses to identify approaches to probe design and potential for use in plant virus detection and characterisation.

AI-Assisted Detection of Biomarkers by Sensors and Biosensors for Early Diagnosis and Monitoring.

The steady progress in consumer electronics, together with improvement in microflow techniques, nanotechnology, and data processing, has led to implementation of cost-effective, user-friendly portable devices, which play the role of not only gadgets but also diagnostic tools. Moreover, numerous smart devices monitor patients' health, and some of them are applied in point-of-care (PoC) tests as a reliable source of evaluation of a patient's condition. Current diagnostic practices are still based on laboratory tests, preceded by the collection of biological samples, which are then tested in clinical conditions by trained personnel with specialistic equipment. In practice, collecting passive/active physiological and behavioral data from patients in real time and feeding them to artificial intelligence (AI) models can significantly improve the decision process regarding diagnosis and treatment procedures via the omission of conventional sampling and diagnostic procedures while also excluding the role of pathologists. A combination of conventional and novel methods of digital and traditional biomarker detection with portable, autonomous, and miniaturized devices can revolutionize medical diagnostics in the coming years. This article focuses on a comparison of traditional clinical practices with modern diagnostic techniques based on AI and machine learning (ML). The presented technologies will bypass laboratories and start being commercialized, which should lead to improvement or substitution of current diagnostic tools. Their application in PoC settings or as a consumer technology accessible to every patient appears to be a real possibility. Research in this field is expected to intensify in the coming years. Technological advancements in sensors and biosensors are anticipated to enable the continuous real-time analysis of various omics fields, fostering early disease detection and intervention strategies. The integration of AI with digital health platforms would enable predictive analysis and personalized healthcare, emphasizing the importance of interdisciplinary collaboration in related scientific fields.

Comparison of Extended Skin Cancer Screening Using a Three-Step Advanced Imaging Programme vs. Standard-of-Care Examination in a High-Risk Melanoma Patient Cohort.

Modern diagnostic procedures, such as three-dimensional total body photography (3D-TBP), digital dermoscopy (DD), and reflectance confocal microscopy (RCM), can improve melanoma diagnosis, particularly in high-risk patients. This study assessed the benefits of combining these advanced imaging techniques in a three-step programme in managing high-risk patients. This study included 410 high-risk melanoma patients who underwent a specialised imaging consultation in addition to their regular skin examinations in outpatient care. At each visit, the patients underwent a 3D-TBP, a DD for suspicious findings, and an RCM for unclear DD findings. The histological findings of excisions initiated based on imaging consultation and outpatient care were compared. Imaging consultation detected sixteen confirmed melanomas (eight invasive and eight in situ) in 39 excised pigmented lesions. Outpatient care examination detected seven confirmed melanomas (one invasive and six in situ) in 163 excised melanocytic lesions. The number needed to excise (NNE) in the imaging consultation was significantly lower than that in the outpatient care (2.4 vs. 23.3). The NNE was 2.6 for DD and 2.3 for RCM. DD, 3D-TBP, or RCM detected melanomas that were not detected by the other imaging methods. The three-step imaging programme improves melanoma detection and reduces the number of unnecessary excisions in high-risk patients.

Evaluation of Salivary Biomarkers and Spirometry for Diagnosing COPD in Non-Smokers and Smokers of Polish Origin.

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition with global implications. Accurate and timely diagnosis is critical; however, traditional diagnostic methods (based on spirometry) show limitations, prompting the search for predictive biomarkers and modern diagnostic techniques. This study explored the validation of COPD-related biomarkers (C-reactive protein, procalcitonin, neutrophil elastase, and alpha-1 antitrypsin) in saliva. A diverse cohort, including healthy non-smokers, healthy smokers, and COPD patients of Polish origin, underwent spirometry and marker analysis. The data correlated with clinical factors, revealing noteworthy relations. Firstly, salivary biomarker levels were compared with serum concentrations, demonstrating notable positive or negative correlations, depending on the factor. Further analysis within healthy individuals revealed associations between biomarker levels, spirometry, and clinical characteristics such as age, sex, and BMI. Next, COPD patients exhibited an enhanced concentration of biomarkers compared to healthy groups. Finally, the study introduced a breathing assessment survey, unveiling significant associations between self-perceived breathing and spirometric and tested parameters. Outcomes emphasized the relevance of subjective experiences in COPD research. In conclusion, this research underscored the potential of salivary biomarkers as diagnostic tools for COPD, offering a non-invasive and accessible alternative to traditional methods. The findings paved the way for improved modern diagnostic approaches.

Advancing Renal Amyloidosis Care: The Role of Modern Diagnostic Techniques with the Potential of Enhancing Patient Outcomes.

Renal amyloidosis is a set of complex disorders characterized by the deposition of amyloid proteins in the kidneys, which causes gradual organ damage and potential kidney failure. Recent developments in diagnostic methods, particularly mass spectrometry and proteome profiling, have greatly improved the accuracy of amyloid typing, which is critical for disease management. These technologies provide extensive insights into the specific proteins involved, allowing for more targeted treatment approaches and better patient results. Despite these advances, problems remain, owing to the heterogeneous composition of amyloid proteins and the varying efficacy of treatments based on amyloid type. Access to sophisticated diagnostics and therapy varies greatly, highlighting the global difference in renal amyloidosis management. Future research is needed to investigate next-generation sequencing and gene-editing technologies, like clustered regularly interspaced short palindromic repeats (CRISPR), which promise more profound insights into the genetic basis of amyloidosis.

Comorbid Condition Induced by Lichenoid Tuberculosis of the Skin and Lichen Planus. Significance of a Multidisciplinary Approach to Timely Diagnosis and Treatment

In Ukraine, all cases tuberculosis (TB) of the skin are classified as «extrapulmonary TB», which complicates the accurate determination of disease prevalence. Clinical cases of skin TB require a multi­disciplinary approach for diagnosis, particularly for differential diagnosis from chronic dermatoses with similar morphological skin lesions and for treatment. Objective — to conduct a differential diagnosis and determine the presence of comorbid pathology in a patient exhibiting clinical manifestations typical of both lichenoid tuberculosis of the skin and lichen planus. This involves utilising a suite of modern diagnostic procedures, including pathohistological analysis and Doppler laser flowmetry. Materials and methods. We observed a patient, B., born in 2005, who presented with skin lesions characteristic of both lichenoid TB of the skin and lichen planus. According to the patient's history, the duration of the disease was 4 years. Using laser Doppler flowmetry with a Vingmed SD-100 flowmeter (Medata, Sweden), we measured microcirculation and its standard deviation, coefficient of variation and maximum amplitude of slow, fast and pulse oscillations in the affected areas and visually unchanged skin (3—4 cm from the rash elements). Pathohistological examinations were also conducted in the areas of efflorescence. Results and discussion. Considering the clinical examination data, results of comprehensive laboratory and pathohistological research, and indicators of laser Doppler flowmetry in the areas of skin lesions, a comorbid condition caused by lichenoid TB of the skin and lichen planus was diagnosed. The patient was referred to a phthisiologist at his place of residence for comprehensive specific treatment with antitubercu­lar drugs. The patient was also recommended to undergo dermatological monitoring to assess the effectiveness of the pathogenetic therapy prescribed for lichen planus. Conclusions. The variety of clinical forms of skin TB and a number of chronic dermatoses, particularly lichen planus, as well as the similarity in the clinical picture of morphological elements of the skin rash in these diseases, necessitate a multidisciplinary approach and the execution of a complex of clinical, specialised laboratory, pathohistological and modern diagnostic instrumental studies. These enable timely differential diagnosis of skin lesions, including comorbid conditions, and the prescription of rational comprehensive therapy. The use of laser Doppler flowmetry to determine the state of dermal blood circulation in the affected skin areas is an important additional diagnostic test in the differential diagnosis of some chronic dermatoses or in determining a comorbid state.

A Review on High Performance Liquid Chromatography (HPLC)

High-performance liquid chromatography (HPLC) is an important qualitative and quantitative technique, generally used for the estimation of pharmaceutical and biological samples. It is the most versatile, safest, dependable, and fastest chromatographic technique for the quality control of drug components. This article was prepared with a review different aspects of HPLC, such as principle types, instrumentation, and application. High- Performance Liquid Chromatography has played a significant role in clinical laboratories for the separation and quantitation of biomarkers in different body fluids. The development of HPLC involves four basic steps; scouting, optimization, robustness testing, and validation. The technique is used to analyze drugs and medicines for their purity and to maintain the highest standards for pharmaceutical products with the end goal of helping patients with medical issues. Method of validation is the process used to confirm that the analytical procedure employed for a specific test is suitable for its intended use. Validation High-Performance Liquid Chromatography method as per ICH guidelines covers all the performance characteristics of validation, like Accuracy, precision, specificity, linearity, range, limit of detection, limit of quantification, robustness, system suitability the testing. The limitation of High-Performance Liquid Chromatography methods of development, public health importance, and validation is the automated process becomes complicated, has low separation power, and is expensive but High-Performance Liquid Chromatography is the modern diagnostic technique is used in all sectors

Clinical analysis of multiple primary gastrointestinal malignant tumors: A 10-year case review of a single-center.

Multiple primary malignant tumors (MPMTs) was first described by Billroth as early as 1889, with the first report published by Warren and Gates in 1932. Since then, numerous cases have been reported. A literature review of 1104269 patients with cancer revealed that the incidence of MPMTs ranged from 0.73 to 11.7%. In recent years, however, there has been a significant upward trend in the incidence of this phenomenon, which may be associated with many different factors, including the advancement of modern diagnostic procedures facilitating the examination and diagnosis of more MPMTs, increased exposure to chemotherapy and radiotherapy that exacerbate the risk of new malignant tumors in patients with cancer, and prolonged survival of patients with cancer allowing sufficient time for the development of new primary cancers. To analyze the incidence, clinical features, treatment factors, prevalence, and prognosis of patients with MPMTs in the gastrointestinal tract treated in a single center. Additionally, we analyzed the different tumor combinations, time interval between the occurrence of tumors, and staging. This retrospective cohort study analyzed 8059 patients with pathologically confirmed gastrointestinal malignant tumors treated at the Gansu Province Hospital in Lanzhou, Gansu, China between June 2011 and June 2020. Of these, 85 patients had MPMTs. The clinical features, treatment factors, prevalence, and prognosis of this latter cohort were analyzed. The incidence of MPMTs in patients with gastrointestinal malignant tumors was 1.05% (85/8059), including 83 double primary malignant tumors and two triple primary malignant tumors of which 57 (67.06%) were synchronous MPMTs (SMPMTs) and 28 (32.94%) were metachronous MPMTs (MMPMTs). The most frequent associations were found between the rectum colon cancers within the SMPMT category and the gastric-colon cancers within the MMPMT category. For the MMPMTs, the median interval was 53 months. The overall 1-, 3- and 5-year survival rates from diagnosis of the first primary cancer were 91.36%, 65.41%, and 45.97%, respectively; those from diagnosis of the second primary cancer were 67.90%, 29.90%, and 17.37%, respectively. MPMTs in the gastrointestinal tract have a high incidence and poor prognosis. Thus, it is necessary to perform both gastroscopy and colonoscopy in patients with gastrointestinal tumors. Multidisciplinary comprehensive diagnosis and treatment may improve the diagnosis rate and treatment efficiency of MPMTs.

Recent advances in orthognathic surgery and modern diagnostic techniques

New technological tools are increasingly being applied in orthognathic surgery. Advanced techniques of imaging, diagnosis and treatment planning development, as well as simulation, guidance and evaluation of the treatment outcome are gradually taking the place of conventional techniques, enabling three-dimensional (3D) digital planning and personalized treatment of craniofacial deformities. Conventional and advanced three-dimensional techniques, such as three-dimensional ultrasound imaging (3D U/S), three-dimensional magnetic resonance imaging (3T-MRI), three-dimensional computed tomography (CT) and cone beam computed tomography (CBCT) imaging, as well as combinations of these techniques, are classified as modern technological tools, while robotic surgery and four-dimensional video stereophotogrammetry have already begun to find clinical application. In conclusion, advances in diagnostic and planning techniques in orthognathic surgery present many preoperative, intraoperative and postoperative advantages, significantly reducing the chances of complications and providing safety, accuracy and a high level of medical care. The aim of this literature review is to collect, present and evaluate new data and contemporary diagnostic methods in the field of orthognathic surgery.

Extracardial pathology as an additional risk factor in the correction of congenital heart defects in children

Introduction. Concomitant diseases as a risk factor for surgery remain an urgent problem in pediatric cardiac surgery. The article presents the role of comorbidity in pediatric cardiac surgery. A comparative analysis of the indicators of cardiac surgical treatment of patients with and without extracardiac pathology was carried out. Aim: to determine the significance of extracardiac causes as an additional risk factor in the correction of congenital heart lesions in children. 
 Materials and methods. Prospective analysis of five hundred patients who had undergone cardiac surgery in the departments of cardiac surgery and interventional cardiology. Patients were divided into a main group of patients with concomitant pathology 
 (n = 350) and a control group (n = 150) without concomitant pathology. A complex of modern therapeutic and diagnostic procedures and a multidisciplinary approach were used. 
 Results. A high incidence of complications was shown in the main group (70%). Hospital mortality was higher in patients with concomitant pathology and amounted to 17.4%, compared to 3.3% in the group without concomitant pathology. The average duration in the ICU for patients with concomitant pathology was 18 ± 2 bed days, for patients without concomitant pathology — 4 ± 2 bed days. 
 Conclusion. The presence of concomitant pathology has been shown to influence significantly on the development of complications and be a prognostic risk factor that must be included in modern prediction models.

Update on AMD imaging ‐ Initial diagnosis, follow‐up

AMD is a clinical entity in which diagnostic and therapeutic recommendations are the subject of constant change and up‐date. During this course a basic knowledge on AMD diagnosis will be presented along with the employment of modern diagnostic techniques such as OCT‐angiography. Disease characteristics obtained from OCT, OCTA and fluorescein angiography imaging will be depicted in the context of modern recommendations for its treatment, especially anti‐VEGF treatment schedules. Management algorithms will be outlined along with most frequent therapeutic dilemmas occurring in that clinical entity.

Recent advances and challenges in plant viral diagnostics.

Accurate and timely diagnosis of plant viral infections plays a key role in effective disease control and maintaining agricultural productivity. Recent advances in the diagnosis of plant viruses have significantly expanded our ability to detect and monitor viral pathogens in agricultural crops. This review discusses the latest advances in diagnostic technologies, including both traditional methods and the latest innovations. Conventional methods such as enzyme-linked immunosorbent assay and DNA amplification-based assays remain widely used due to their reliability and accuracy. However, diagnostics such as next-generation sequencing and CRISPR-based detection offer faster, more sensitive and specific virus detection. The review highlights the main advantages and limitations of detection systems used in plant viral diagnostics including conventional methods, biosensor technologies and advanced sequence-based techniques. In addition, it also discusses the effectiveness of commercially available diagnostic tools and challenges facing modern diagnostic techniques as well as future directions for improving informed disease management strategies. Understanding the main features of available diagnostic methodologies would enable stakeholders to choose optimal management strategies against viral threats and ensure global food security.

An update on diagnosis and treatment of hepatoblastoma.

Hepatoblastoma (HB) remains the most common paediatric liver tumour and survival in children with hepatoblastoma has improved considerably since the advent of sequential surgical regimens of chemotherapy based on platinum-based chemotherapeutic agents in the 1980s. With the advent of modern diagnostic imaging and pathology techniques, new preoperative chemotherapy regimens and the maturation of surgical techniques, new diagnostic and treatment options for patients with hepatoblastoma have emerged and international collaborations are investigating the latest diagnostic approaches, chemotherapy drug combinations and surgical strategies. Diagnosis of hepatoblastoma relies on imaging studies (such as ultrasound, computed tomography, and magnetic resonance imaging), alpha-fetoprotein (AFP) levels, and histological confirmation through biopsy. The standard treatment approach involves a multimodal strategy with neoadjuvant chemotherapy followed by surgical resection. In cases where complete resection is not feasible or tumors exhibit invasive characteristics, liver transplantation is considered. The management of metastatic and recurrent hepatoblastoma poses significant challenges, and ongoing research focuses on developing targeted therapies and exploring the potential of immunotherapy. Further studies are necessary to gain a better understanding of the etiology of hepatoblastoma, develop prevention strategies, and personalize treatment approaches. We aim to review the current status of diagnosis and treatment of hepatoblastoma.

Advances of Genome Editing with CRISPR/Cas9 in Neurodegeneration: The Right Path towards Therapy.

The rate of neurodegenerative disorders (NDDs) is rising rapidly as the world's population ages. Conditions such as Alzheimer's disease (AD), Parkinson's disease (PD), and dementia are becoming more prevalent and are now the fourth leading cause of death, following heart disease, cancer, and stroke. Although modern diagnostic techniques for detecting NDDs are varied, scientists are continuously seeking new and improved methods to enable early and precise detection. In addition to that, the present treatment options are limited to symptomatic therapy, which is effective in reducing the progression of neurodegeneration but lacks the ability to target the root cause-progressive loss of neuronal functioning. As a result, medical researchers continue to explore new treatments for these conditions. Here, we present a comprehensive summary of the key features of NDDs and an overview of the underlying mechanisms of neuroimmune dysfunction. Additionally, we dive into the cutting-edge treatment options that gene therapy provides in the quest to treat these disorders.

Gut microbiota in relationship to diabetes mellitus and its late complications with a focus on diabetic foot syndrome: A review.

Diabetes mellitus is a chronic disease affecting glucose metabolism. The pathophysiological reactions underpinning the disease can lead to the development of late diabetes complications. The gut microbiota plays important roles in weight regulation and the maintenance of a healthy digestive system. Obesity, diabetes mellitus, diabetic retinopathy, diabetic nephropathy and diabetic neuropathy are all associated with a microbial imbalance in the gut. Modern technical equipment and advanced diagnostic procedures, including xmolecular methods, are commonly used to detect both quantitative and qualitative changes in the gut microbiota. This review summarises collective knowledge on the role of the gut microbiota in both types of diabetes mellitus and their late complications, with a particular focus on diabetic foot syndrome.

Incidence and outcomes of fever of unknown origin after kidney transplant in the modern era.

While presumably less common with modern molecular diagnostic and imaging techniques, fever of unknown origin (FUO) remains a challenge in kidney transplant recipients (KTRs). Additionally, the impact of FUO on patient and graft survival is poorly described. A cohort of adult KTRs between January 1, 1995 and December 31, 2018 was followed at the University of Wisconsin Hospital. Patients transplanted from January 1, 1995 to December 31, 2005 were included in the "early era"; patients transplanted from January 1, 2006 to December 31, 2018 were included in the "modern era". The primary objective was to describe the epidemiology and etiology of FUO diagnoses over time. Secondary outcomes included rejection, graft and patient survival. There were 5590 kidney transplants at our center during the study window. FUO was identified in 323 patients with an overall incidence rate of .8/100 person-years. Considering only the first 3years after transplant, the incidence of FUO was significantly lower in the modern era than in the early era, with an Incidence Rate Ratio (IRR) per 100 person-years of .48; 95% CI: .35-.63; p<.001. A total of 102 (31.9%) of 323 patients had an etiology determined within 90days after FUO diagnosis: 100 were infectious, and two were malignancies. In the modern era, FUO remained significantly associated with rejection (HR=44.1; 95% CI: 16.6-102; p<.001) but not graft failure (HR=1.21; 95% CI: .68-2.18; p=.52) total graft loss (HR=1.17; 95% CI: .85-1.62; p=.34), or death (HR=1.17; 95% CI: .79-1.76; p=.43. FUO is less common in KTRs during the modern era. Our study suggests infection remains the most common etiology. FUO remains associated with significant increases in risk of rejection, warranting further inquiry into the management of immunosuppressive medications in SOT recipients in the setting of FUO.