Noninvasive Diagnostic Techniques Research Articles

Evaluation of Glucose-6-Phosphate dehydrogenase in Saliva of Subjects with Normal Appearing Gingiva and Periodontitis using qRT-PCR: A Cross-sectional Study.

To determine the salivary level of glucose-6-phosphate dehydrogenase (G6PD) in subjects with normal appearing gingiva and periodontitis, and to compare the salivary levels of G6PD in all the study groups. Unstimulated saliva (4 mL) was collected from 30 subjects; 15 periodontitis subjects and 15 control subjects. Later, saliva samples were subjected to RNA extraction via TRIzol method. The RNA was converted to complementary DNA, and quantitative real time polymerase chain reaction was set-up. The expression of salivary G6PD in periodontitis subjects showed a significant increase when compared with control subjects, with a p-value of 0.001 (p > 0.05). In conclusion, the overall results show promise in future aspects of G6PD as a potential diagnostic as well as a prognostic marker. However, large-scale, multi-institutional, and large sample sized studies should be conducted to further find out the importance of G6PD in the diagnosis of periodontitis and its prognostic value. The increase of G6PD levels in periodontitis subjects shows the increased oxidative stress, and this can be used for developing new noninvasive diagnostic procedures, developing novel treatment modalities, and also in assessing prognosis of treated cases of periodontitis. How to cite this article: Chavan NV, Srinath S, Yadava ST, et al. Evaluation of Glucose-6-Phosphate dehydrogenase in Saliva of Subjects with Normal Appearing Gingiva and Periodontitis using qRT-PCR: A Cross-sectional Study. J Contemp Dent Pract 2024;25(11):1060-1068.

Optical Based Methods for Water Monitoring in Biological Tissue.

Skin homeostasis is strongly dependent on its hydration levels, making skin water content measurement vital across various fields, including medicine, cosmetology, and sports science. Noninvasive diagnostic techniques are particularly relevant for clinical applications due to their minimal risk of side effects. A range of optical methods have been developed for this purpose, each with unique physical principles, advantages, and limitations. This review provides an in-depth examination of optical techniques such as diffuse reflectance spectroscopy, optoacoustic spectroscopy, optoacoustic tomography, hyperspectral imaging, and Raman spectroscopy. We explore their efficacy in noninvasive monitoring of skin hydration and edema, which is characterized by an increase in interstitial fluid. By comparing the parameters, sensitivity, and clinical applications of these techniques, this review offers a comprehensive understanding of their potential to enhance diagnostic precision and improve patient care.

Non-invasive methods for diagnosing portal hypertension and variceal bleeding due to liver cirrhosis secondary to NAFLD/MASLD: systematic review.

Non-alcoholic fatty liver disease (NAFLD), recently re-termed as metabolic dysfunction-associated steatotic liver disease (MASLD), is a global health concern affecting approximately 25% of adults. Complications such as portal hypertension and variceal bleeding are critical to diagnose but challenging with traditional invasive methods like hepatic venous pressure gradient (HVPG) measurement and esophagogastroduodenoscopy (EGD), which are not always feasible and carry risks. This systematic review aim to evaluate the diagnostic accuracy of non-invasive methods for diagnosing portal hypertension and variceal bleeding in patients with NAFLD/MASLD cirrhosis, comparing these methods to invasive standards. A comprehensive literature search was conducted across PubMed, Cochrane Library, Google Scholar, and ScienceDirect from January 2000 to May 2024. Studies included evaluated non-invasive diagnostic techniques for portal hypertension and variceal bleeding, compared with HVPG and EGD, focusing on adult patients with confirmed NAFLD/MASLD cirrhosis. Data extraction covered study characteristics and diagnostic accuracy metrics. The quality of studies was assessed using the QUADAS-2 tool. Meta-analyses were performed using R and Python. Eleven studies involving 2,707 patients met the inclusion criteria. Liver stiffness measurement (LSM) via transient elastography demonstrated high sensitivity (85%) and specificity (79%) for diagnosing clinically significant portal hypertension (CSPH) at a 20 kPa cutoff. For severe portal hypertension (SPH), LSM had a sensitivity of 81% and specificity of 85% at 25 kPa. Combining LSM with platelet count resulted in a sensitivity of 97% but lower specificity (41%) for CSPH. Spleen stiffness measurement (SSM) also showed good diagnostic performance with a sensitivity of 89% and specificity of 75% for CSPH. Non-invasive tests, particularly LSM and SSM, show promise in diagnosing portal hypertension and variceal bleeding in NAFLD/MASLD cirrhosis. These methods offer high sensitivity, especially in combination, supporting their use in clinical settings to potentially reduce the need for invasive procedures. Future research should aim to standardize protocols and explore additional biomarkers to further enhance diagnostic accuracy. https://www.crd.york.ac.uk/prospero/display_record.php?, identifier CRD42024567024.

Atrial Cardiomyopathy: From Diagnosis to Treatment.

With a better understanding of the susceptibility to atrial fibrillation (AF) and the thrombogenicity of the left atrium, the concept of atrial cardiomyopathy (ACM) has emerged. The conventional viewpoint holds that AF-associated hemodynamic disturbances and thrombus formation in the left atrial appendage are the primary causes of cardiogenic embolism events. However, substantial evidence suggests that the relationship between cardiogenic embolism and AF is not so absolute, and that ACM may be an important, underestimated contributor to cardiogenic embolism events. Chronic inflammation, oxidative stress response, lipid accumulation, and fibrosis leading to ACM form the foundation for AF. Furthermore, persistent AF can exacerbate structural and electrical remodeling, as well as mechanical dysfunction of the atria, creating a vicious cycle. To date, the relationship between ACM, AF, and cardiogenic embolism remains unclear. Additionally, many clinicians still lack a comprehensive understanding of the concept of ACM. In this review, we first appraise the definition of ACM and subsequently summarize the noninvasive and feasible diagnostic techniques and criteria for clinical practice. These include imaging modalities such as echocardiography and cardiac magnetic resonance imaging, as well as electrocardiograms, serum biomarkers, and existing practical diagnostic criteria. Finally, we discuss management strategies for ACM, encompassing "upstream therapy" targeting risk factors, identifying and providing appropriate anticoagulation for patients at high risk of stroke/systemic embolism events, and controlling heart rhythm along with potential atrial substrate improvements.

Breath Analysis via Surface Enhanced Raman Spectroscopy.

Breath analysis is increasingly recognized as a powerful noninvasive diagnostic technique, and a plethora of exhaled volatile biomarkers have been associated with various diseases. However, traditional analytical methodologies are not amenable to high-throughput diagnostic applications at the point of need. An optical spectroscopic technique, surface-enhanced Raman spectroscopy (SERS), mostly used in the research setting for liquid sample analysis, has recently been applied to breath-based diagnostics. This promising noninvasive diagnostic tool has been demonstrated for the identification of various diseases, including lung cancer, gastric cancer, and diabetes. The versatility of SERS has enabled the use of different diagnostic strategies and allowed for fast and accurate detection of small analytes in exhaled breath. In this review, we provide an overview of recent advances in SERS-based breath analysis, focusing on sensors for the detection of gases and volatile organic compounds (VOCs) in exhaled breath, and highlight generic strategies for sample preconcentration and methods for spectral analysis. We aim to provide an overview of the state of the art and inspiration for further SERS investigation of expiration.

A Single-Chain Peptide Probe Targeting Pathological Collagen for Precise Staging of Hepatic Fibrosis by MR Imaging.

Hepatic fibrosis, a chronic liver response to injury with potential severe outcomes like cirrhosis and liver cancer, necessitates urgent noninvasive diagnostic techniques to halt disease progression. We herein for the first time developed a single-chain peptide probe targeting pathological collagen for in vivo magnetic resonance imaging (MRI) of hepatic fibrosis. The novel (GhypO)10 probe, distinguished by its unique monomeric conformation achieved through Pro to (2S,4S)-hydroxyproline (hyp) substitution and subsequent disruption of hydrogen bonding, exhibits selectivity for pathological collagen over its intact counterpart in connective tissues. Fluorescence imaging of liver specimens from fibrotic models displayed a discernible relationship between pathological collagen levels and fibrosis stage. Moreover, T1-weighted MR images post Gd-GhypO administration revealed progressive signal enhancement congruent with fibrosis severity, corroborated by a corresponding increase in the contrast-to-noise ratio (ΔCNR). Biodistribution analysis indicates that Gd-GhypO has low Gd retention in the main organs 24 h postinjection, ensuring the probe's safety for molecular imaging. The Gd-GhypO probe therefore emerges as a potent tool for the precise, noninvasive delineation of hepatic fibrosis stages, offering significant implications for the diagnosis and management of liver fibrosis.

Analysis of clinical features and prognosis in cardiac amyloidosis patients from Spanish hospitals (2016-2021).

Cardiac amyloidosis (CA) is a prevalent yet underdiagnosed heart condition characterized by the abnormal accumulation of amyloid fibres, frequently resulting in heart failure (HF), particularly in older people. Despite advancements in non-invasive diagnostic techniques and treatments, the epidemiology of CA patients remains inadequately understood. This nationwide retrospective observational study sought to comprehensively investigate CA patients' characteristics, mortality, and readmission patterns. A retrospective observational study encompassed all patients hospitalized with CA between 2016 and 2021 across Spanish hospitals. Standardized incidence rates were calculated using age and sex-adjusted methods, utilizing the Spanish population as the reference. The investigation delved into demographic variables, comorbidities, mortality during the index episode, and 30 and 365-day readmissions for circulatory system diseases. Predictors of readmission were also examined. A total of 5739 index episodes were identified, with CA being the primary cause of admission in 14.1% of cases. The mean age was 81.4 ± 9.9 years, predominantly males (70.3%). The age and sex-standardized hospital attendance rate was 3.90 admissions per 100,000 population (95% CI: 3.82-3.98), higher in males. Common comorbidities included HF (96.4%), atrial fibrillation (46.3%), and renal failure (44.4%). The mortality rate during the index episode was 11.7%, with cardiogenic shock (OR: 9.03; 95% CI: 4.22-19.32) and major psychiatric disorders (OR: 3.36; 95% CI: 1.42-7.94) identified as predictors. Over the follow-up period, 13.1% were readmitted at 30 days and 36.6% at 365. Nephritis (IRR: 2.05; 95% CI: 1.42-2.96) and asthma (IRR: 1.52; 95% CI 1.11-2.07) were associated with increased 30-day readmissions, while renal failure (IRR: 1.43; 95% CI: 1.28-1.59) and chronic pulmonary disease (IRR: 1.40; 95% CI: 1.18-1.67) were linked to higher 365-day readmissions. Predictors of mortality risk in 365-day readmissions included advanced cancer (HR: 1.31; 95% CI: 1.00-1.71), cardiogenic shock in the index episode (HR: 2.72; 95% CI: 1.33-5.57), and a higher number of readmissions during that period (HR: 1.64; 95% CI: 1.56-1.73). This study contributes valuable insights into the significant prevalence of CA, which is often overlooked and underestimated. Afflicting predominantly elderly males with concomitant HF and multiple comorbidities, CA poses a significant clinical challenge. The findings underscore the need for enhanced awareness, early detection, and a multidisciplinary approach to manage this complex cardiac condition.

Effects and Diagnostic Approach of Ultrasound in Veterinary Practice: A Systematic Review

In medicine, ultrasonography is being used more and more for both diagnostic and therapeutic purposes. It is critical that medical professionals and scientists involved in this sector comprehend the biological effects of ultrasound because it has the potential to irreversibly harm biological tissues at high exposure levels. This article examines the fundamental concepts of thermal mechanics and the physical interactions between biological tissues and ultrasound. In order to clarify the biological impacts of ultrasound both in vitro and in vivo, negative health outcomes from animal, cell, and clinical research are examined. Sound waves that are higher than the 20–20,000 Hertz frequency range that humans can typically hear are referred to as ultrasound. Following the sound's reflection off the reflective surface, the ultrasonic transducer produces sound waves (pulse) and receives the sound beam (echo). There is a crystal or piezoelectric substance in the transducer that can transform electrical energy into mechanical energy. Diagnostic ultrasound is a non-invasive diagnostic technique that uses the pulse-echo principle to create images of the inside of the body. Compared to other imaging modalities, such as computed tomography and magnetic resonance, it is affordable, portable, and radiation-free. The capacity of this imaging method to examine a patient's anatomy and physiology in real time makes it unique and offers a significant, quick, and non-invasive evaluation method.

Dermoscopy 101

ABSTRACT Dermoscopy is a noninvasive diagnostic technique that allows dermatology clinicians to evaluate suspicious skin lesions and determine the need for biopsy. Basal cell carcinomas (BCCs) exhibit distinct dermoscopic features that when accurately identified help aid in diagnosis. This article focuses on the most pathognomonic dermoscopic feature of BCC—arborizing vessels.

Study on exhaled volatile organic compounds identifying cognitive fatigue induced by N-back task in healthy young adults.

Cognitive fatigue in specific occupations may present a risk to personal safety. The study aimed to explore the characteristic volatile organic compounds (VOCs) in exhaled breath in response to cognitive fatigue, to provide a scientific basis for the non-invasive exhaled breath diagnostic techniques for cognitive fatigue assessing. Thirty healthy young adults were recruited and assigned to complete two 1.5-hour cognitive fatigue-inducing trials of the N-back task and one control trial of low emotion film watching of the same duration time. The Chalder Fatigue Scale was employed to assess the cognitive fatigue of the subjects before and after the induction and film watching. Exhaled VOCs were collected and detected using a Bio-VOC sampler and Thermal Desorption Gas Chromatography-Mass Spectroscopy method. The differences in exhaled VOCs between the pre- and post-induction and film watching was evaluated using either the paired t-test or the Wilcoxon signed-rank test. It was found that the scale scores of the task group (n = 50) significantly increased after the induction, whereas no such findings were observed in the control group (n = 10), indicating that the cognitive fatigue state of the task group was effectively induced through the performance of the N-back task. A total of 15 VOCs were identified in the exhaled breath samples of the task group. And only the level of isoprene changed significantly from 339.77 ± 162.21 μg/m³ to 604.18 ± 230.75 μg/m³ with the induction of cognitive fatigue. In contrast, the change of isoprene in the control group was not statistically significant. The study demonstrated that after inducing cognitive fatigue by N-back task in healthy young subjects, isoprene levels in exhaled breath increased significantly. It suggests that isoprene could be considered a characteristic volatile organic compound in exhaled breath associated with cognitive fatigue.

Methods for tissue perfusion assessment after Dellon decompression of tarsal tunnels in diabetic neuropathy: key to effective management-a narrative review.

Diabetic neuropathy significantly elevates the risk of foot ulceration and lower-limb amputation, underscoring the need for precise assessment of tissue perfusion to optimize management. This narrative review explores the intricate relationship between sympathetic nerves and tissue perfusion in diabetic neuropathy, highlighting the important role of autonomic neuropathy in blood flow dynamics and subsequent compromises in tissue perfusion. The consequences extend to the development of diabetic peripheral neuropathy and related foot complications. By analyzing both non-invasive diagnostic methods and surgical interventions, such as tarsal tunnel decompression, the paper seeks to highlight their effectiveness in improving tissue perfusion, preventing ulcers, and reducing the risk of amputations in patients with diabetic peripheral neuropathy. We reviewed current literature on both non-invasive diagnostic tools and surgical techniques for assessing and improving tissue perfusion in diabetic neuropathy. Methods discussed include transcutaneous oxygen pressure (TcPO2), Doppler ultrasound, Tissue-Muscle Perfusion Scintigraphy with 99mTc-MIBI, and the SPY Laser Angiographic System. Emphasizing the critical importance of surgical interventions, such as tarsal tunnel decompression and neurolysis of the posterior tibial nerve, the article underscores their efficacy in enhancing tissue perfusion and preventing ulcers and amputations. Additionally, it addresses the significance of precise blood flow measurement and timely intervention in the management of diabetic neuropathy and foot ulcers. The non-invasive techniques for assessing tissue perfusion and blood flow in diabetic neuropathy such as TcPO2, Doppler ultrasound and Tissue-Muscle Perfusion Scintigraphy with 99mTc-MIBI are explained. Also, this review introduces the SPY Laser Angiographic System, which employs near-infrared fluorescence imaging to assess blood flow and perfusion in tissues. This advanced tool generates real-time microvascular blood flow images and proves instrumental in diagnosing and monitoring diabetic foot ulcers. In conclusion, surgical interventions, both vascular and peripheral nerve are pivotal for optimizing patient care. Early identification of foot ulcers and peripheral arterial disease is imperative, and an understanding of blood flow dynamics, combined with effective surgical techniques, constitutes key elements in managing diabetic neuropathy, healing and preventing ulcers, and limb salvage.

Vision transformer-equipped Convolutional Neural Networks for automated Alzheimer's disease diagnosis using 3D MRI scans.

Alzheimer's disease (AD) is a neurodegenerative ailment that is becoming increasingly common, making it a major worldwide health concern. Effective care depends on an early and correct diagnosis, but traditional diagnostic techniques are frequently constrained by subjectivity and expensive costs. This study proposes a novel Vision Transformer-equipped Convolutional Neural Networks (VECNN) that uses three-dimensional magnetic resonance imaging to improve diagnosis accuracy. Utilizing the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, which comprised 2,248 3D MRI images and diverse patient demographics, the proposed model achieved an accuracy of 92.14%, a precision of 86.84%, a sensitivity of 93.27%, and a specificity of 89.95% in distinguishing between AD, healthy controls (HC), and moderate cognitive impairment (MCI). The findings suggest that VECNN can be a valuable tool in clinical settings, providing a non-invasive, cost-effective, and objective diagnostic technique. This research opens the door for future advancements in early diagnosis and personalized therapy for Alzheimer's Disease.

Reflectance Confocal Microscopy Can Help in Detecting Clinically Silent Mammary Paget's Disease.

Early detection and comprehensive diagnostic approaches for breast cancer are essential for improving prognosis. When it comes to changes in the skin of the breast or the nipple-areola complex (NAC), particularly if they are unilateral, it is essential to be vigilant, as these changes could be an early sign of underlying malignancy or other pathologies. Primary breast malignancies, such as mammary Paget's disease (MPD), can manifest as erythema, scaling, or ulceration of the NAC, while secondary cutaneous metastases from other breast carcinomas may present as nodules, erythematous plaques, or inflammatory reactions. Non-malignant inflammatory conditions, including eczema or mastitis, can also mimic these changes; histologic evaluation is the gold-standard diagnostic tool. The usefulness of conventional diagnostic techniques breast lesions has been confirmed, but in recent years, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have emerged as additional tools to diagnose cases characterized by cutaneous changes; they may, therefore, result in new perspectives on the non-invasive diagnosis of MPD. RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time, offering a promising approach to the non-invasive diagnosis of MPD, particularly when a lesion is not clinically evident and may mimic other benign or inflammatory conditions. We describe an atypical clinical presentation of mammary Paget's disease diagnosed early by reflectance confocal microscopy evaluation and confirmed histologically.

Differences between echocardiography and cardiac nuclear magnetic resonance parameters in children with bicuspid aortic valve-related aortopathy.

The bicuspid aortic valve (BAV) is the most common congenital heart defect. Patients with BAV frequently develop aortopathy, which depends on the dysfunction and morphotype of the BAV. The aim of our study was to compare the echocardiography and cardiac magnetic resonance (CMR) findings in BAV patients, and to define the risks of BAV dysfunction and aortopathy. The retrospective study included 50 patients (68% male) with BAV, with an average age of 13.6 ± 3.9 years, who underwent a transthoracic echocardiographic examination and CMR at our institute from 2012 to 2020. The BAV types were evaluated significantly differently by echocardiography and CMR (p = 0.013). 54% of patients had BAV insufficiency on echo and 70% on echo CMR. It was more prevalent in males, older patients, and patients with a higher body surface area. By comparing the degree of insufficiency measured by echo (1+, IQR 0-1), and CMR (0, IQR 0-1), a significant difference was observed (p = 0.04), while a moderate positive correlation was proved (rr = 0.4; p = 0.004). Stenosis was registered in 44% of patients by echo, while 58% had stenosis on CMR. The peak pressure gradient measured by echo was significantly higher than the velocity on CMR (41, IQR 22.7-52.5 mmHg vs. 23, IQR 15.5-35.0 mmHg; p = 0.002). Aortopathy was registered in 76% of patients on echo and 78% on CMR; 38% of patients had severe aortic dilatation on echo and 54% on CMR (p = 0.003). Patients with BAV stenosis on echo had more frequent dilatation of the tubular ascending aorta (15/24 pts; p = 0.02). All patients with BAV insufficiency on CMR had aortopathy (p = 0.04) and had enlargement of the sinus of Valsalva and sinotubular junction. In patients with associated coarctation, the development of aortopathy occurred less frequently than those without coarctation (7/39 vs. 32/39; p = 0.003). The Bland-Altman method, a specific type of scatterplot that is used to visualize the results of comparing two measures, demonstrated the existence of agreement between the two methods, and a level of agreement between the methods of 95% was demonstrated. Our study indicated significant differences in the measured BAV morphotype and dysfunction when comparing the two diagnostic methods. On the other hand, moderate to strong correlations were found in the evaluated parameters, which indicates the importance of performing noninvasive diagnostic procedures in the follow-up of these patients.

Hybrid CFD PINN FSI Simulation in Coronary Artery Trees

This paper presents a novel hybrid approach that integrates computational fluid dynamics (CFD), physics-informed neural networks (PINN), and fluid–structure interaction (FSI) methods to simulate fluid flow in stenotic coronary artery trees and predict fractional flow reserve (FFR) in areas of stenosis. The primary objective is to utilize a 1D PINN model to accurately predict outlet flow conditions, effectively addressing the challenges of measuring or estimating these conditions within complex arterial networks. Validation against traditional CFD methods demonstrates strong accuracy while embedding physics-based training to ensure compliance with fundamental fluid dynamics principles. The findings indicate that the hybrid CFD PINN FSI method generates realistic outflow boundary conditions crucial for diagnosing stenosis, requiring minimal input data. By seamlessly integrating initial conditions established by the 1D PINN into FSI simulations, this approach enables precise assessments of blood flow dynamics and FFR values in stenotic regions. This innovative application of 1D PINN not only distinguishes this methodology from conventional data-driven models that rely heavily on extensive datasets but also highlights its potential to enhance our understanding of hemodynamics in pathological states. Ultimately, this research paves the way for significant advancements in non-invasive diagnostic techniques in cardiology, improving clinical decision making and patient outcomes.

Endometriosis: Future Biological Perspectives for Diagnosis and Treatment.

Endometriosis is an oestrogen-dependent inflammatory disease affecting menstruating women, with varying levels of severity. Oestrogen dysregulation is responsible for chronic inflammation, angiogenesis, endometrial lesion development, progression, and infertility during menarche in afflicted women. The inflammatory mediators associated with this chronic painful disease have been established, with research also indicating the relationship between dysbiosis and disease manifestation. Endometriosis is also present with several painful comorbidities, including endometrial cancer, cardiovascular disease, and autoimmunity. The lack of specific and sensitive non-invasive diagnostic procedures, coupled with poor response to current therapeutic approaches, means that treatment needs remain unmet. Surgical procedures are performed to remove endometriosis ectopic lesions, for which the recurrence rate of disease is up to 50%, with certain patients exhibiting no alleviation of symptoms. This review aims to outline the aetiology of endometriosis, detailing novel diagnostic approaches and potential therapeutic approaches, namely advanced therapeutic medical products (ATMPs), including stem cell therapy and clustered regularly interspaced short palindromic repeats (CRISPR) gene editing. This timely review also provides novel insights into the important recent modalities which may be applied for the diagnosis and therapeutic response of endometriosis, including biomarkers, microfluidic platforms, and organoid systems. Undoubtedly, reliable, reproducible, sensitive, and specific models of endometriosis in humans are urgently needed to investigate and detail the aetiology of this debilitating disease.

Clinical application of oral contrast-enhanced ultrasound in evaluating the preoperative T staging of gastric cancer.

Oral contrast-enhanced ultrasound (OCEUS) is widely used in the noninvasive diagnosis and screening of gastric cancer (GC) in China. To investigate the clinical application of OCEUS in evaluating the preoperative T staging of gastric cancer. OCEUS was performed before the operation, and standard ultrasound images were retained. The depth of infiltration of GC (T-stage) was evaluated according to the American Joint Committee on Cancer 8th edition of the tumor-node-metastasis staging criteria. Finally, with postoperative pathological staging as the gold standard reference, the sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic value of OCEUS T staging were evaluated. OCEUS achieved diagnostic accuracy rates of 76.6% (T1a), 69.6% (T1b), 62.7% (T2), 60.8% (T3), 88.0% (T4a), and 88.7% (T4b), with an average of 75.5%. Ultrasonic T staging sensitivity exceeded 62%, aside from T1b at 40.3%, while specificity was over 91%, except for T3 with 83.5%. The Youden index was above 60%, with T1b and T2 being exceptions. OCEUS T staging corresponded closely with pathology in T4b (kappa > 0.75) and moderately in T1a, T1b, T2, T3, and T4a (kappa 0.40-0.75), registering a concordance rate exceeding 84%. OCEUS was effective, reliable, and accurate in diagnosing the preoperative T staging of GC. As a noninvasive diagnostic technique, OCEUS merits clinical popularization.

Regression of hepatic fibrosis after pharmacological therapy for nonalcoholic steatohepatitis.

The global incidence of nonalcoholic fatty liver disease (NAFLD) is escalating considerably. NAFLD covers a range of liver conditions from simple steatosis to the more severe form known as nonalcoholic steatohepatitis, which involves chronic liver inflammation and the transformation of hepatic stellate cells into myofibroblasts that generate excess extracellular matrix, leading to fibrosis. Hepatocyte ballooning is a key catalyst for fibrosis progression, potentially advancing to cirrhosis and its decompensated state. Fibrosis is a critical prognostic factor for outcomes in patients with NAFLD; therefore, those with substantial fibrosis require timely intervention. Although liver biopsy is the most reliable method for fibrosis detection, it is associated with certain risks and limitations, particularly in routine screening. Consequently, various noninvasive diagnostic techniques have been introduced. This review examines the increasing prevalence of NAFLD, evaluates the noninvasive diagnostic techniques for fibrosis, and assesses their efficacy in staging the disease. In addition, it critically appraises current and emerging antifibrotic therapies, focusing on their mechanisms, efficacy, and potential in reversing fibrosis. This review underscores the urgent need for effective therapeutic strategies, given the dire consequences of advanced fibrosis.

Clinical and Dermoscopic Evaluation of Patients With Topical Steroid Damaged Faces (TSDF).

Background Topical steroid-dependent or damaged face (TSDF) is a common condition where the widespread availability of over-the-counter topical corticosteroid (TCS)-containing products leads to their misuse and addiction. Prolonged use of these steroids on the face can result in significant side effects. Early diagnosis and cessation of steroid use are important. Dermoscopy can serve as an easy-to-use and non-invasive tool for the early diagnosis and for assessing the exact extent of damage caused by steroid misuse. Aims and objectives To observe the various clinical and demographic features of patients with TSDF, the dermoscopic features of these patients, and to find their association with the potency and duration of application of TCS. Material and methods In this observational, cross-sectional study of 250 patients (aged 12-60 years, both genders) presenting with facial dermatosis and clinical signs of TSDF, having a history of at least one month of TCS use, were enrolled using consecutive sampling. Demographic data, clinical features, and dermoscopic findings were recorded. Dermoscopic results were compared with clinical examination, TCS potency, and duration of application. Results The majority (208; 83.2%) of the patients were females, and most of them belonged to the age group of 26-35 years (87; 34.8%). Hyperpigmentation (101; 40.4%) was the most prevalent indication for TCS use in the study. The most common clinical findings included erythema, hypertrichosis, and telangiectasia. Dermoscopic findings such as linear, serpentine, polygonal, and Y-shaped vessels, along with breaking of the pseudo reticular network, red diffuse areas, Demodex tails, and comedones were significantly associated with the duration of TCS use. Linear vessels, Demodex tails, and comedones also correlated significantly with TCS potency, while most other findings did not. Conclusion Dermoscopy is a novel, non-invasive diagnostic technique for the early identification of TCS abuse. In TSDF, it confirms the diagnosis and predicts disease severity earlier than examination by the naked eye alone.

Assessment of median nerve with magnetic resonance neurography in cases with carpal tunnel syndrome and controls.

Background: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disorder that is diagnosed using clinical signs and symptoms and confirmed via nerve conduction studies (NCSs). While NCS is a semi-invasive procedure, magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that detects macroscopic nerve abnormalities and evaluates a patient's surgical or medication treatment options. This study assessed magnetic resonance neurography (MRN)'s diagnostic and grading value by comparing it to electrodiagnostic studies in patients with CTS and healthy individuals. Methods: This was a cross-sectional study on 27 wrists with CTS and 27 healthy wrists. After history taking and physical examination, we employed an NCS to confirm and determine the severity of CTS, then MRN and diffusion tensor imaging (DTI) were used to calculate apparent diffusion coefficient (ADC), fractional anisotropy (FA), and cross-sectional area (CSA). Results: 18 patients with CTS (27 median nerves) and 15 healthy controls (27 median nerves) were evaluated. The mean FA in the CTS group was significantly lower (0.38 ± 0.05 vs. 0.45 ± 0.06, P < 0.001). The mean CSA and ADC were higher in patients with CTS but not statistically significant. FA's diagnostic cut-off was 0.42, with a sensitivity of 70.4% and a specificity of 63%. Conclusion: MRN with DTI can be an effective and non-invasive diagnostic technique for the detection of CTS. The FA measure demonstrated adequate sensitivity and specificity for differentiating patients with CTS from healthy individuals.