Noninvasive Diagnostic Techniques Research Articles

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.

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.

Combined analysis of a serum mRNA/miRNA marker signature and CA 19-9 for timely and accurate diagnosis of recurrence after resection of pancreatic ductal adenocarcinoma: A prospective multicenter cohort study.

Timely and accurate detection of tumor recurrence in pancreatic ductal adenocarcinoma (PDAC) patients is an urgent and unmet medical need. This study aimed to develop a noninvasive molecular diagnostic procedure for the detection of recurrence after PDAC resection based on quantification of circulating mRNA and miRNA biomarkers in serum samples. In a multicentric study, serum samples from a total of 146 patients were prospectively collected after resection. Samples were classified into a "No Evidence of Disease" and a "Recurrence" group based on clinical follow-up data. A multianalyte biomarker panel was composed of mRNAs and miRNA markers and simultaneously analyzed in serum samples using custom microfluidic qPCR arrays (TaqMan array cards). A diagnostic algorithm was developed combining a 7-gene marker signature with CA19-9 data. The best-performing marker combination achieved 90% diagnostic accuracy in predicting the presence of tumor recurrence (98% sensitivity; 84% specificity), clearly outperforming the singular CA 19-9 analysis. Moreover, time series data obtained by analyzing successively collected samples from 5 patients during extended follow-up suggested that molecular diagnosis has the potential to detect recurrence earlier than routine clinical procedures. TaqMan array card measurements were found to be biologically valid and technically reproducible. The BioPac multianalyte marker panel is capable of sensitive and accurate detection of recurrence in patients resected for PDAC using a simple blood test. This could allow a closer follow-up using shorter time intervals than currently used for imaging, thus potentially prompting an earlier work-up with additional modalities to allow for earlier therapeutic intervention. This study provides a promising approach for improved postoperative monitoring of resected PDAC patients, which is an urgent and unmet clinical need.

Non-Invasive Ultrasound Diagnostic Techniques for Steatotic Liver Disease and Focal Liver Lesions: 2D, Colour Doppler, 3D, Two-Dimensional Shear Wave Elastography (2D-SWE), and Ultrasound-Guided Attenuation Parameter (UGAP).

We conducted a comprehensive literature review to evaluate the efficacy of combining two-dimensional shear wave elastography (2D-SWE) and ultrasound-guided attenuation parameter (UGAP) in assessing the risk of progressive metabolic dysfunction-associated steatohepatitis (MASH). This narrative review explores the applications of liver ultrasound in diagnosing metabolic liver diseases, focusing on recent advancements in diagnostic techniques for steatotic liver disease (SLD). Liver ultrasound can detect a spectrum of SLD manifestations, from metabolic dysfunction-associated liver disease (MASLD) to fibrosis and cirrhosis. It is also possible to identify inflammation, hepatitis, hepatocellular carcinoma (HCC), and various other liver lesions. Innovative ultrasound applications, including elastography and UGAP, can significantly enhance the diagnostic capabilities of ultrasound in accurately interpreting liver diseases. Understanding the pathogenesis of liver diseases requires a thorough analysis of their etiology and progression in order to develop sound diagnostic and therapeutic approaches. Chronic liver diseases (CLD) vary in origin, with MASLD affecting approximately 20-25% of the general population. The insidious progression of CLD from inflammation to fibrosis and cirrhosis underscores the need for effective early detection methods. This review aims to highlight the evolving role of non-invasive ultrasound-based diagnostic tests in the early detection and staging of liver diseases. By synthesizing current evidence, we aim to provide an updated perspective on the utility of advanced ultrasound techniques in redefining the diagnostic landscape for metabolic liver diseases.

Is Contrast-Enhanced Ultrasonography a New, Reliable Tool for Early-Graft-versus-Host Disease Diagnosis?

Acute gastrointestinal graft-versus-host disease (GI aGVHD) is a significant and life-threatening complication in patients undergoing allogeneic stem cell transplantation (allo-SCT). Early diagnosis of GI aGVHD is crucial for improving patient outcomes, but it remains a challenge due to the condition's nonspecific symptoms and the reliance on invasive diagnostic methods, such as biopsies and endoscopic procedures. In recent years, interest in non-invasive diagnostic techniques for graft-versus-host disease has increased, with contrast-enhanced ultrasound (CEUS) being one of them. For this reason, we aimed to examine the potential of ultrasound as a non-invasive, safe, and cost-effective alternative for the early detection and monitoring of GI aGVHD in this review. Our narrative review aims to describe the use of multimodal US that includes conventional US (B-mode and Doppler US) and advanced ultrasound techniques such as CEUS and CRTE for the non-invasive diagnosis of GI GVHD. We browsed several databases, including PubMed, Scopus, Web of Science, and Google Scholar. The search spanned 2000 to the present, focusing on articles written in English that reviewed the use of these imaging techniques in the context of GI GVHD. Following our research, we noticed that CEUS offers several advantages, including the real-time visualization of the gastrointestinal wall, assessment of blood flow, and detailed microvascular analysis-all achieved without the use of ionizing radiation. This feature makes CEUS an appealing option for repeated assessments, which are often necessary in monitoring the progression of GI aGVHD. When used in conjunction with conventional gastrointestinal ultrasound (GIUS), CEUS provides a more comprehensive view of the structural and functional changes occurring in the GI tract, potentially enhancing diagnostic accuracy and allowing for earlier intervention. In comparison to traditional diagnostic methods like tissue biopsy or CT scans, CEUS is less invasive, quicker to perform, and better tolerated by patients, especially those in fragile health following allo-SCT. Its non-invasive nature and ability to provide immediate imaging results make it a valuable tool for clinicians, particularly in settings where minimizing patient discomfort and risk is paramount. However, despite these advantages, there are still gaps in the literature regarding CEUS's full diagnostic accuracy for GI aGVHD. Further research, including larger clinical trials and comparative studies, is needed to validate CEUS's role in routine clinical practice and to establish standardized protocols for its use. Nonetheless, CEUS shows considerable potential to transform the diagnostic approach to GI aGVHD by improving early detection, reducing the need for invasive procedures, and ultimately enhancing treatment outcomes for affected patients.

Novel Insights into Non-Invasive Diagnostic Techniques for Cardiac Amyloidosis: A Critical Review

Cardiac amyloidosis (CA) is a cardiac storage disease caused by the progressive extracellular deposition of misfolded proteins in the myocardium. Despite the increasing interest in this pathology, it remains an underdiagnosed condition. Non-invasive diagnostic techniques play a central role in the suspicion and detection of CA, also thanks to the continuous scientific and technological advances in these tools. The 12-lead electrocardiography is an inexpensive and reproducible test with a diagnostic accuracy that, in some cases, exceeds that of imaging techniques, as recent studies have shown. Echocardiography is the first-line imaging modality, although none of its parameters are pathognomonic. According to the 2023 ESC Guidelines, a left ventricular wall thickness ≥ 12 mm is mandatory for the suspicion of CA, making this technique crucial. Cardiac magnetic resonance provides high-resolution images associated with tissue characterization. The use of contrast and non-contrast sequences enhances the diagnostic power of this imaging modality. Nuclear imaging techniques, including bone scintigraphy and positron emission tomography, allow the detection of amyloid deposition in the heart, and their role is also central in assessing the prognosis and response to therapy. The role of computed tomography was recently evaluated by several studies, above in population affected by aortic stenosis undergoing transcatheter aortic valve replacement, with promising results. Finally, machine learning and artificial intelligence-derived algorithms are gaining ground in this scenario and provide the basis for future research. Understanding the new insights into non-invasive diagnostic techniques is critical to better diagnose and manage patients with CA and improve their survival.

Detection of Filariid Infections in Mexican Primate Populations Through qPCR.

Filariae are parasitic nematodes of high veterinary and medical importance, responsible for some acute tropical diseases. They are transmitted through the bite of hematophagous vectors such as biting midges and blackflies. Filariae are among the most prevalent vector-borne parasitoses in Neotropical primates in which severe infections can cause inflammatory reactions and tissue damage. Given the location inside the host (peritoneal cavity, bloodstream, and lymphatics), the detection of filariid nematodes is challenging and is mostly postmortem; hence the scarcity of studies on the prevalence of filariae in wild primate populations. Here, we report the prevalence of filariid infections in free-ranging populations of Geoffroy's spider (Ateles geoffroyi) and black howler (Alouatta pigra) monkeys across southern Mexico, using a combination of noninvasive sampling and molecular diagnostic techniques. Fecal samples were screened for filariid DNA by qPCR protocols. A total of 88 samples were examined with an overall prevalence of 26%. Filariae were slightly more common in spider monkeys compared to howler monkeys. This study constitutes the first report of the prevalence of infection of filariid nematodes in populations of wild spider monkey across southern Mexico, and the first reporting of filariae in black howler monkeys, as part of a new era of primate parasitology and the diagnostics of parasite infections in light of the everyday more affordable molecular tools.

Update in the diagnosis and treatment of actinic keratosis

Actinic keratosis (AK) is among the most common conditions in dermatology in an increasingly aging population. However, the presence of severe field cancerization with large treatment fields showing multiple lesions with distinct features often poses atherapeutic challenge. The most accurate possible characterization of the treatment field, risk assessment concerning the occurrence of cutaneous squamous cell carcinoma, and knowledge of the efficacy and local side effects of the available interventions are of paramount importance for effective management and preventive efforts. This article summarizes current developments in the diagnosis and treatment of AK and discusses their application in everyday clinical practice. In particular, the focus is on the increasing value of non-invasive diagnostic techniques like "line-field" confocal optical coherence tomography, and the recently approved topical agents tirbanibulin 1% ointment and 5‑fluorouracil 4% cream, as well as current developments of photodynamic therapy and prevention.

Vascular Pathogenesis in Acute and Long COVID: Current Insights and Therapeutic Outlook.

Long coronavirus disease 2019 (COVID-19)-a postacute consequence of severe acute respiratory syndrome coronavirus 2 infection-manifests with a broad spectrum of relapsing and remitting or persistent symptoms as well as varied levels of organ damage, which may be asymptomatic or present as acute events such as heart attacks or strokes and recurrent infections, hinting at complex underlying pathogenic mechanisms. Central to these symptoms is vascular dysfunction rooted in thrombotic endothelialitis. We review the scientific evidence that widespread endothelial dysfunction (ED) leads to chronic symptomatology. We briefly examine the molecular pathways contributing to endothelial pathology and provide a detailed analysis of how these cellular processes underpin the clinical picture. Noninvasive diagnostic techniques, such as flow-mediated dilation and peripheral arterial tonometry, are evaluated for their utility in identifying ED. We then explore mechanistic, cellular-targeted therapeutic interventions for their potential in treating ED. Overall, we emphasize the critical role of cellular health in managing Long COVID and highlight the need for early intervention to prevent long-term vascular and cellular dysfunction.

Photoplethysmography-Based Angiography of Skin Tumors in Arbitrary Areas of Human Body.

Noninvasive, rapid, and robust diagnostic techniques for clinical screening of tumors located in arbitrary areas of the human body are in demand. To address this challenge, we analyzed the feasibility of photoplethysmography-based angiography for assessing vascular structures within malignant and benign tumors. The proposed hardware and software were approved in a clinical study involving 30 patients with tumors located in the legs, torso, arms, and head. High-contrast and detailed vessel maps within both benign and malignant tumors were obtained. We demonstrated that capillary maps are consistent and can be interpreted using well-established dermoscopic criteria for vascular morphology. Vessel mapping provides valuable details, which may not be available in dermoscopic images and can aid in determining whether a tumor is benign or malignant. We believe that the proposed approach may become a valuable tool in the preliminary cancer diagnosis and is suitable for large-scale screening.

The relationship between salivary cytokines and oral cancer and their diagnostic capability for oral cancer: a systematic review and network meta-analysis

BackgroundOral cancer (OC) is a common malignancy in clinical practice. Saliva testing is a convenient and noninvasive early diagnostic technique for OC. Several salivary cytokines have been identified as potential biomarkers for OC, including IL-8, IL-6, TNF-α, IL-1β, and IL-10. Nonetheless, the optimal cytokine for OC diagnosis remains inconclusive and highly contentious.MethodsPubMed, Embase, Web of Science, and Cochrane Library databases were comprehensively retrieved to collect all case–control studies on OC. A meta-analysis was performed to compare the levels of salivary IL-8, IL-6, IL-10, TNF-α, and IL-1β in OC patients and healthy controls. Network meta-analysis (NMA) was carried out to probe into the accuracy of these salivary cytokines in diagnosing OC.ResultsThis analysis included 40 studies, encompassing 1280 individuals with OC and 1254 healthy controls. Significantly higher levels of salivary IL-8, IL-6, TNF-α, IL-1β, and IL-10 were observed in patients with OC in comparison to healthy controls. The results of NMA showed that TNF-α had the highest diagnostic accuracy for OC, with a sensitivity of 79% and a specificity of 92%, followed by IL-6 (sensitivity: 75%, specificity: 86%) and IL-8 (sensitivity: 80%, specificity: 80%).ConclusionThis study suggests that IL-8, IL-6, IL-10, TNF-α, and IL-1β may be potential diagnostic biomarkers for OC. Among them, TNF-α, IL-6, and IL-8 are highly accurate in the diagnosis of OC. Nevertheless, further studies that eliminate other confounding factors are warranted, and more standardized procedures and large-scale studies are needed to support the clinical use of saliva testing.

Full-Wave Simulation of a Helmholtz Radiofrequency Coil for Magnetic Resonance Applications

Magnetic resonance imaging (MRI) is a non-invasive diagnostic technique able to provide information about the anatomical, structural, and functional properties of different organs. A magnetic resonance (MR) scanner employs radiofrequency (RF) coils to generate a magnetic field to excite the nuclei in the sample (transmit coil) and pick up the signals emitted by the nuclei (receive coil). To avoid trial-and-error approaches and optimize the RF coil performance for a given application, accurate design and simulation processes must be performed. We describe the full-wave simulation of a Helmholtz coil for high-field MRI performed with the finite-difference time-domain (FDTD) method, investigating magnetic field pattern differences between loaded and unloaded conditions. Moreover, the self-inductance of the single loops constituting the Helmholtz coil was estimated, as well as the frequency splitting between loops due to inductive coupling and the sample-induced resistance. The result accuracy was verified with data acquired with a Helmholtz prototype for small phantom experiments with a 3T MR clinical scanner. Finally, the magnetic field variations and coil detuning after the insertion of the RF shield were evaluated.

Epidemiological Changes in Transthyretin Cardiac Amyloidosis: Evidence from In Vivo Data and Autoptic Series.

Cardiac amyloidosis is an infiltrative disease that causes progressive myocardial impairment secondary to amyloid fibril deposition in the extracellular space of the myocardium. Many amyloid precursors, including transthyretin protein, are known to determine cardiac damage by aggregating and precipitating in cardiac tissue. Transthyretin cardiac amyloidosis may be either caused by rare genetic mutations of the transthyretin gene in the hereditary variant, or may arise as a consequence of age-related mechanisms in the acquired form. Although it has been labeled as a rare disease, in recent years, transthyretin cardiac amyloidosis has stood out as an emerging cause of aortic stenosis, unexplained left ventricular hypertrophy and heart failure with preserved ejection fraction, particularly in the elderly. Indeed, the integration of data deriving from both in vivo imaging techniques (whose advancement in the last years has allowed to achieve an easier and more accessible non-invasive diagnosis) and forensic studies (showing a prevalence of amyloid deposition in cardiac tissue of elderly patients up to 29%) suggests that cardiac amyloidosis is a more common disease than traditionally considered. Thanks to all the improvements in non-invasive diagnostic techniques, along with the development of efficacious therapies offering improvements in survival rates, transthyretin cardiac amyloidosis has been transformed from an incurable and infrequent condition to a relatively more diffuse and treatable disease, which physicians should take into consideration in the differential diagnostic processes in daily clinical practice.

Modern methods of diagnosis and treatment of vasculogenic erectile dysfunction

A review of modern methods of diagnosis and treatment of vasculogenic erectile dysfunction is presented. Data regarding the diagnostic value of noninvasive and invasive diagnostic techniques are displayed: stamp test, Snap-Gauge test, use of the RigiScan and Androscan-MIT systems, intracavernous injections of vasoactive drugs, Doppler ultrasound of penile vessels, penile angiography, and magnetic resonance arteriography. The advantages and disadvantages of each of these tests are shown. The main directions of conservative and surgical treatment of vasculogenic erectile dysfunction are presented. Notably, early detection of erectile dysfunction with the prescription of appropriate treatment can improve the quality of life of patients and prevent life-threatening complications of cardiovascular conditions.

Clinical Updates in Coronary Artery Disease: A Comprehensive Review.

Despite significant goals achieved in diagnosis and treatment in recent decades, coronary artery disease (CAD) remains a high mortality entity and continues to pose substantial challenges to healthcare systems globally. After the latest guidelines, novel data have emerged and have not been yet considered for routine practice. The scope of this review is to go beyond the guidelines, providing insights into the most recent clinical updates in CAD, focusing on non-invasive diagnostic techniques, risk stratification, medical management and interventional therapies in the acute and stable scenarios. Highlighting and synthesizing the latest developments in these areas, this review aims to contribute to the understanding and management of CAD helping healthcare providers worldwide.

Basosquamous carcinoma: Comprehensive epidemiological, clinical, dermoscopic, and confocal features from a single center institution.

Basosquamous carcinoma (BSC) is a rare and aggressive nonmelanoma skin cancer (NMSC) that exhibits features of both BCC and squamous cell carcinoma (SCC). The gold standard for diagnosis is histopathological examination. BSC is often challenging to diagnose and manage due to its mixed histological features and potential for aggressive behavior AIM: To identify specific features aiding clinicians in differentiating BSCs using non-invasive diagnostic techniques. We conducted a retrospective descriptive, monocentric study of the epidemiological clinical, dermoscopic, and reflectance confocal microscopy (RCM) features of histopathologically proven BSCs diagnosed between 2010 and 2023. A total of 192 cases were selected. The study population consisted of 17 men (60.9%). Total 95.8% of patients at the time of diagnosis were≥50 years. BSC occurred in the head and neck area in 124 cases (63.1%) of which 65 (33.9%) were in the H-zone. For 47.4% of patients, BSC presented as a macule with undefined clinical margins (43.3%). Dermoscopic images were available for 98 cases: the most common parameter was the presence of whitish structureless areas (59 [60.2%]), keratin masses (58 [59.2%]), superficial scales, and ulceration or blood crusts (49 [50%] both). Vessels pattern analysis revealed hairpin vessels (exclusively) and linear irregular vessels as the most frequent (55 [56.1%] both). RCM examination was performed in 21 cases which revealed specific SCC features such as solar elastosis (19 [90.5%]), atypical honeycomb pattern (17 [89%]), proliferation of atypical keratinocytes (16 [80%]) combined with BCC' ones as bright tumor islands (12 [57.8%]), and cleft-like dark spaces (11 [53.4%]). Our study reflects the largest cohort of BSCs from a single institution. We described an incidence rate of 4.7%, higher than reported in the Literature, with the involvement of patients≥50years in almost 96% of cases and an overall male predominance. At clinical examination, BSC was described as a hyperkeratotic macule with undefined clinical margins with one or more dermoscopic SCC' features, whereas the presence of typical BCC aspects was observed in less than 10% of cases, differently from what was previously reported. At RCM analysis, BSCs presented with an atypical honeycomb pattern with proliferation of atypical keratinocytes, hyperkeratosis, and in nearly 55% of patients, bright tumor islands with cleft-like dark spaces. The distinctive dermoscopic patterns, along with the RCM features aid in the differentiation of BSCs from other NMSCs.

Future of invasive and non-invasive hemodynamic assessment for coronary artery disease management.

Coronary artery disease represents a global health challenge. Accurate diagnosis and evaluation of hemodynamic parameters are crucial for optimizing patient management and outcomes. Nowadays a wide range of both non-invasive and invasive methods are available to assess the hemodynamic impact of both epicardial coronary stenosis and vasomotor disorders. In fact, over the years, important developments have reshaped the nature of both invasive and non-invasive diagnostic techniques, and the future holds promises for further innovation and integration. Non-invasive techniques have progressively evolved and currently a broad spectrum of methods are available, from cardiac magnetic resonance imaging with pharmacological stress and coronary computed tomography (CT) to the newer application of FFR-CT and perfusion CT. Invasive methods, on the contrary, have developed to a full-physiology approach, able not only to identify functionally significant lesions but also to evaluate microcirculation and vasospastic disease. The aim of this review is to summarize the current state-of-the-art of invasive and non-invasive hemodynamic assessment for CAD management.

Seasonal assessment of mastitis in crossbred goats: A thermographic approach

Sub-clinical mastitis exhibits a higher prevalence in dairy goats than clinical mastitis, necessitating the adoption of non-invasive diagnostic techniques such as infrared thermography (IRT) to detect this economically significant production disease in the dairy sector. Accordingly, this study aims to employ IR imaging of the udder and teat quarters of lactating crossbred goats (Alpine × Beetal and Sanen × Beetal) across various seasons, utilising IRT, to discern cases of sub-clinical (SCM) and clinical mastitis (CM). Over a year, 100–110 lactating crossbred dairy goats underwent consistent IRT screenings, followed by a comprehensive evaluation of udder health status using the California mastitis test and somatic cell count (SCC). The receiver operating characteristic (ROC) analysis was conducted to establish the cut-off values for different thermographic parameters in this study. The results revealed that the SCC increased significantly (p < 0.01) in healthy, SCM, and CM milk samples across the seasons. The analysis of ROC revealed a comparatively higher sensitivity, specificity, and accuracy for udder thermograms during SCM than CM and vice versa for teat thermograms. IRT analysis reflected a difference (p < 0.01) in the udder and teat thermograms among quarters of healthy, SCM, and CM in summer, winter, autumn, and rainy seasons. A significant increase (p < 0.01) in udder thermograms was observed for quarters affected with SCM and CM relative to healthy, with an increase of 1.89 and 2.94 °C in winter, 0.85 and 1.63 °C in summer, 0.73 and 1.41 °C in rainy, and 1.33 and 2.38 °C in autumn, respectively. Similarly, for teat thermograms it was 1.79 and 2.81 °C in winter, 0.76 and 1.41 °C in summer, 0.70 and 1.37 °C in rainy, and 1.09 and 1.93 °C in autumn, respectively. Therefore, regardless of the seasons examined in this study, IRT proves to be an effective and supportive tool for early mastitis detection in lactating crossbred dairy goats.