Noninvasive Diagnostic Techniques Research Articles

Thermographic Examination of the Horse

Abstract Thermography is a noninvasive diagnostic imaging technique that detects regions of the body surface with increased (or decreased) temperature by measuring infrared radiation. It reveals physiological and pathophysiological changes primarily related to blood flow and metabolic rate in the examined body regions, as well as altered heat production. These include physical stress, various physical injuries, medical conditions, and environmental factors. In equine medicine, thermography can be used for early detection of tissue temperature changes, allowing intervention at an early stage of a medical deterioration. Thermographic examination can be used to detect tissue abnormalities in all regions of the body. It is particularly useful for the detection of musculoskeletal disorders. Inflammatory processes are present in many diseases and injuries, which can be successfully detected with thermography. Thermography makes it possible to monitor the success of treatment. Often, thermographically visible disease changes are detected before clinical signs or other imaging techniques become visible in the animal. In physical therapy, it helps locate regions of the body in need of treatment and plays an important role in detecting illegal procedures (such as local analgesics) to improve competitive performance in horses. Thermography serves as a complementary diagnostic tool. However, in practice, it has some limitations. The method is not specific and cannot determine the etiology of pathological changes. Therefore, it is usually used together with other diagnostic methods (such as X-ray, ultrasound, computed tomography and magnetic resonance imaging) and can not replace them.

Changes in amyloidosis phenotype over 11 years in a cardiac amyloidosis referral centre cohort in France

BackgroundEarly cardiac amyloidosis (CA) diagnosis enables patients to access effective treatments for better long-term outcomes, yet it remains under-recognised, misdiagnosed and inadequately managed. AimTo reduce diagnostic delays, we aimed to describe the epidemiological and clinical characteristics and changes over an 11-year period. MethodsThis was a retrospective, observational cohort study of all patients referred to the Henri-Mondor Hospital for suspected CA. ResultsOverall, 3194 patients were identified and 3022 were included and analysed. Our patients came from varied ethnic backgrounds, and more than half (55.2%) had confirmed CA. Over 11 years, referrals increased 4.4-fold, mostly from cardiologists. Notably, wild-type transthyretin amyloidosis (ATTRwt) became the predominant diagnosis, with referrals increasing 15-fold from 20 in 2010–2012 to 308 in 2019–2020. The number of amyloid light chain (AL) diagnoses increased, whilst variant transthyretin amyloidosis (ATTRv) numbers remained relatively stable. Concerning disease severity, AL patients presented more frequently with severe cardiac involvement whereas an increasing number of ATTRwt patients presented with National Amyloid Centre stage I (22.0% in 2013–2014 to 45.9% in 2019–2020). Lastly, among patients diagnosed with ATTRv in 2019–2020, 83.9% had ATTR Val122Ile cardiac phenotype. ConclusionsThis study shows that increasing cardiologist awareness and referrals have increased CA diagnoses. With improved awareness and non-invasive diagnostic techniques, more patients with ATTRwt with milder disease and more ATTRv Val122Ile mutations are being referred and diagnosed. Although more AL cases are being recognised, patients are diagnosed with severe cardiac involvement.

Non-invasive detection of Orthohalarachne attenuata (Banks, 1910) and Orthohalarachne diminuata (Doetschman, 1944) (Acari: Halarachnidae) in free-ranging synanthropic South American sea lions Otaria flavescens (Shaw, 1800).

Respiratory mites of the genera Orthohalarachne and Halarachne (Acari: Halarachnidae) are causative agents of nasopharyngeal/nasopulmonary acariasis in pinnipeds and sea otters. Until now, these endoparasitic mites were mainly diagnosed via necropsies and invasive procedures. So far, non-invasive diagnostic techniques have neither been developed nor applied in free-ranging pinnipeds. In the current study, we aimed to evaluate the halarachnid mite infestation status of free-ranging "urban" South American sea lions Otaria flavescens in the city of Valdivia, Chile. Therefore, non-invasive sampling methods were used in the current study, e. g. by observation-based sampling of freshly expectorated nasal mucus in the animal environment. Further, collection devices were developed for target-oriented sampling of sneezed nasal mucus, including sterile petri dishes and stretched clingfilms mounted on telescopic rods. Applying these techniques, 26 individual sputum samples were collected. 11.5% of sputum samples proved positive for halarachnid larvae (in total, n=7), which were morphologically identified as Orthohalarachne attenuata (n=2) or Orthohalarachne diminuata (n=5). In one of the individual sea lion mucus samples, both Orthohalarachne species were detected, thereby confirming a patent co-infestation in vivo. 16S rDNA-based molecular identification of individual Orthohalarachne spp. larvae confirmed morphological findings. For the first time, we here molecularly characterized Orthohalarachne spp. on the basis of three gene regions [18S, 28S and the internal transcribed spacer 1 (ITS1)]. Overall, current data include the successful application of non-invasive techniques to sample halarachnid mites from free-ranging synanthropic pinnipeds and contribute to the current knowledge on respiratory mites infesting South American sea lions by combining morphological and molecular methods to overcome challenges in species identification. This study should further serve as baseline study and calls for more research on occurrence, biology and health implications of orthohalarachnosis in free-living as well as captive pinnipeds.

Sono-Elastography: An Ultrasound Quantitative Non-Invasive Measurement to Guide Bacterial Pneumonia Diagnosis in Children.

Lung ultrasound (LUS) is, at present, a standard technique for the diagnosis of acute lower respiratory tract infections (ALRTI) and other lung pathologies. Its protocolised use has replaced chest radiography and has led to a drastic reduction in radiation exposure in children. Despite its undeniable usefulness, there are situations in which certain quantitative measurements could provide additional data to differentiate the etiology of some pulmonary processes and thus adapt the treatment. Our research group hypothesises that several lung processes such pneumonia may lead to altered lung tissue stiffness, which could be quantified with new diagnostic tests such as lung sono-elastography (SE). An exhaustive review of the literature has been carried out, concluding that the role of SE for the study of pulmonary processes is currently scarce and poorly studied, particularly in pediatrics. The aim of this review is to provide an overview of the technical aspects of SE and to explore its potential usefulness as a non-invasive diagnostic technique for ALRTI in children by implementing an institutional image acquisition protocol.

Advances in application of novel magnetic resonance imaging technologies in liver disease diagnosis.

Liver disease is a major health concern globally, with high morbidity and mor-tality rates. Precise diagnosis and assessment are vital for guiding treatment approaches, predicting outcomes, and improving patient prognosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic technique that has been widely used for detecting liver disease. Recent advancements in MRI technology, such as diffusion weighted imaging, intravoxel incoherent motion, magnetic resonance elastography, chemical exchange saturation transfer, magnetic resonance spectroscopy, hyperpolarized MR, contrast-enhanced MRI, and ra-diomics, have significantly improved the accuracy and effectiveness of liver disease diagnosis. This review aims to discuss the progress in new MRI technologies for liver diagnosis. By summarizing current research findings, we aim to provide a comprehensive reference for researchers and clinicians to optimize the use of MRI in liver disease diagnosis and improve patient prognosis.

The significant value of educated nurse in ECG Holter monitoring interpretation

Abstract Funding Acknowledgements Type of funding sources: None. Introduction ECG Holter monitoring is a non-invasive diagnostic procedure that continuously records electrocardiography during 24 hours daily routine. The primary role of the nurse is to secure that the electrodes are placed correctly, and to advise the patient. Purpose The aim of our study is to emphasize the great importance of nurses by involving them into the interpretation of ECG Holter monitoring. Materials and Methods Senior nurses in our hospital, R. Macedonia were educated, by cardiologists, in electrocardiography interpretation. The nurses proactively ensured the technical quality of the monitoring and the data processing. We analyzed the time from the setting up the 24 hours ECG Holter monitoring to the time when the results were issued to the patient in the period from January 2020 to December 2022. All data used for the study were taken from the Hospital Information System. Our Hospital Information System records the date and exact time (hours and minutes) of the opening and closing of the report. Only the referred cardiologist is authorized to close the report. Results Three thousand twenty-three 24 hours ECG Holter monitoring reports were processed. The average time of closing the report was 1680 minutes or 28 hours. If we exclude in average the first 22 hours of wearing the device, then we can conclude that the time from when the device is disconnected from the patient to the completion of the report, including the physician examination is in average 6 hours. Conclusion ECG educated nurses can be actively involved in the interpretation of ECG Holter monitoring which reduces the time for obtaining the results to less than 24 hours and enables rapid diagnosis and treatment by a cardiologist/electrophysiologist.

Ultrasonographic Characteristics in the Fingers and Other Superficial Glomus Tumours.

Glomus tumours are painful superficial tumours, and ultrasonography is an extremely useful and noninvasive diagnostic technique for superficial organs. In this study, we retrospectively examined glomus tumours using ultrasonography. Among 18 patients histopathologically diagnosed with glomus tumours via ultrasonography, we observed five different development sites: subungual areas or those surrounding the nail bed (12), other areas on the finger surface (3), abdominal wall (1), upper arm (1), and forearm (1). The ultrasonographic images revealed significant differences in tumour size, indicating that tumours on other body surfaces tended to be smaller than those on patients' fingers (p < 0.01). The depth/width ratios of tumours on the other body surfaces were significantly higher than those on the fingers (p < 0.05). The tumours showed a regular shape (72.2%) and clear border (100%). Furthermore, most tumours were low-echo tumours with a diameter of up to 15 mm, clear margins, and no lateral shadows. Abundant blood flow and vessels in and out of the tumours were also observed. In conclusion, our study describes the ultrasonographic characteristics of glomus tumours and reveals that they cannot be ruled out when diagnosing small painful subcutaneous tumours.

The Role of Autophagy and Apoptosis in Affected Skin and Lungs in Patients with Systemic Sclerosis.

Systemic sclerosis (SSc) is a complex autoimmune inflammatory disorder with multiple organ involvement. Skin changes present the hallmark of SSc and coincide with poor prognosis. Interstitial lung diseases (ILD) are the most widely reported complications in SSc patients and the primary cause of death. It has been proposed that the processes of autophagy and apoptosis could play a significant role in the pathogenesis and clinical course of different autoimmune diseases, and accordingly in SSc. In this manuscript, we review the current knowledge of autophagy and apoptosis processes in the skin and lungs of patients with SSc. Profiling of markers involved in these processes in skin cells can be useful to recognize the stage of fibrosis and can be used in the clinical stratification of patients. Furthermore, the knowledge of the molecular mechanisms underlying these processes enables the repurposing of already known drugs and the development of new biological therapeutics that aim to reverse fibrosis by promoting apoptosis and regulate autophagy in personalized treatment approach. In SSc-ILD patients, the molecular signature of the lung tissues of each patient could be a distinctive criterion in order to establish the correct lung pattern, which directly impacts the course and prognosis of the disease. In this case, resolving the role of tissue-specific markers, which could be detected in the circulation using sensitive molecular methods, would be an important step toward development of non-invasive diagnostic procedures that enable early and precise diagnosis and preventing the high mortality of this rare disease.

Refining the Diagnostic Technique to Determine Prevalence of Demodex Mites in Eyelash Hair Follicles Within Standard Ophthalmic Practice: A Single-Center Outpatient Clinical Study.

A high density of Demodex infestation in human eyelids and eyelash follicles has been implicated in a variety of ocular surface conditions. However, Demodex infestation often goes undiagnosed and untreated, due to an overlap in signs and symptoms with other sources of ocular surface inflammation. We sought to refine the diagnostic technique for outpatient assessment for Demodex infestation and determine prevalence of Demodex mites in the hair follicles of eyelashes from patients in a standard ophthalmic practice. Patients recruited from a single outpatient ophthalmology clinic were examined for the presence of Demodex mites following standard ophthalmic consultation. During anterior segment biomicroscopic examination, investigators searched for cylindrical dandruff and collarettes around the base of patient eyelashes. These were removed, and individual eyelashes manipulated with tweezers to reveal Demodex mites. Presence of Demodex, cylindrical dandruff and collarettes, time taken to identify the first Demodex mite, mean number of Demodex mites per hair shaft, and patient-reported symptoms of blepharitis were recorded and analyzed to determine potential correlations. A total of 173 patients were recruited, of whom 106 were included in Demodex prevalence analyses. Demodex infestation was identified in 100/106 (94%) patients, with a mean time of 2 minutes and 20 seconds taken to find the first Demodex mite and a mean number of 3 mites identified per hair shaft. Presence of Demodex significantly correlated with the presence of cylindrical dandruff (98/106 [92%] patients; p < 0.001), but not with the presence of collarettes (62/106 [58%] patients; p = 0.230) or symptoms of blepharitis (15/106 [14%] patients; p = 0.591). These results highlight the pervasiveness of Demodex infestation, predicted by the presence of cylindrical dandruff, in the eyelashes of patients in a standard ophthalmic practice. They support the use of a non-invasive diagnostic technique to allow fast, simple identification of Demodex by ophthalmologists and optometrists in outpatient clinical practice.

Rapid and non-invasive diagnostic techniques for embryonic developmental potential: a metabolomic analysis based on Raman spectroscopy to identify the pregnancy outcomes of IVF-ET.

The non-invasive and rapid assessment of the developmental potential of embryos is of great clinical importance in assisted reproductive technology (ART). In this retrospective study, we analyzed the metabolomics of 107 samples provided by volunteers and utilized Raman spectroscopy to detect the substance composition in the discarded culture medium of 53 embryos resulting in successful pregnancies and 54 embryos that did not result in pregnancy after implantation. The culture medium from D3 cleavage-stage embryos was collected after transplantation and a total of 535 (107 × 5) original Raman spectra were obtained. By combining several machine learning methods, we predicted the developmental potential of embryos, and the principal component analysis-convolutional neural network (PCA-CNN) model achieved an accuracy rate of 71.5%. Furthermore, the chemometric algorithm was used to analyze seven amino acid metabolites in the culture medium, and the data showed significant differences in tyrosine, tryptophan, and serine between the pregnancy and non-pregnancy groups. The results suggest that Raman spectroscopy, as a non-invasive and rapid molecular fingerprint detection technology, shows potential for clinical application in assisted reproduction.

Fibrosis avanzada asociada a esteatohepatitis no alcohólica (NASH) en España: resultados de un estudio Delphi

ObjectiveTo describe in detail the epidemiology, diagnosis, clinical management, treatment options, impact on quality of life and unmet needs of patients with advanced liver fibrosis (F3-F4) associated with non-alcoholic steatohepatitis (NASH) in Spain. MethodologyDelphi study of two rounds of consultation rounds with 41 expert hepatologists from 16 autonomous communities to collect their experience in clinical practice. ResultsThe estimated prevalence of adult patients diagnosed with F3-F4 fibrosis associated with NASH in Spain is 0.019% (95% confidence interval [CI]: 0.019-0.020%). Approximately 7,588 adults with this condition are currently diagnosed and managed in the Digestive System Services of Spanish hospitals, and around 1,881 new patients are diagnosed each year. Management is multidisciplinary and includes the specialties of Digestive System, Endocrinology and Internal Medicine, considering the frequently associated metabolic comorbidities (obesity, type 2 diabetes mellitus or dysmetabolic iron overload). Despite a clear impact on quality of life, this it is not routinely evaluated in clinical practice. The most widely used non-invasive diagnostic techniques are transitional elastography and liver fibrosis index 4 (FIB-4). The absence of effective and safe treatments appears as the main unmet need for the management of these patients. ConclusionsThis study provides a representation of the current situation of patients diagnosed with F3-F4 fibrosis associated with NASH in Spain, increasing the evidence available and contributing to informed decision-making by professionals and the health system.

Invasive and Non-Invasive Diagnostic Pathways in the Diagnosis of Cardiac Amyloidosis.

The appropriate diagnosis and subtyping of cardiac amyloidosis (CA) is frequently missed or delayed due to its vague presentation, clinical overlapping, and diagnostic pitfalls. Recent developments in both invasive and non-invasive diagnostic techniques have significantly changed the diagnostic approach of CA. With the present review, we aim to summarize the current diagnostic approach of CA and to underline the indications of tissue biopsy, either surrogate site or myocardial. The most important factor for timely diagnosis is increased clinical suspicion, especially in certain clinical scenarios. Appropriate imaging with echocardiography or cardiac magnetic resonance (CMR) can provide significant evidence for the diagnosis of CA. Importantly, all patients should undergo monoclonal proteins assessment, with these results significantly determining the steps to follow. A negative monoclonal protein assessment will lead to a non-invasive algorithm which, in combination with positive cardiac scintigraphy, can establish the diagnosis of ATTR-CA. The latter is the only clinical scenario in which the diagnosis can be established without the need of biopsy. However, if the imaging results are negative but the clinical suspicion remains high, a myocardial biopsy should be performed. In the case of the presence of monoclonal protein, an invasive algorithm follows, first by surrogate site sampling and then by myocardial biopsy if the results are inconclusive or prompt diagnosis is needed. The role of endomyocardial biopsy, even though limited by current advances in other techniques, is highly valuable in selected patients and is the only method to reliably establish a diagnosis in challenging cases.

Benefits of early transplantation in patients with chronic renal failure undergoing coronary revascularization

Objective: This study aimed to evaluate the effectiveness of post-revascularization surgery in reducing future cardiac events among kidney transplant candidates. Additionally, the role of non-invasive diagnostic techniques and the use of coronary angiography in determining the prognosis of patients scheduled for kidney transplantation were examined. Material and Methods: A retrospective analysis was conducted on 202 renal transplant recipients who underwent their first coronary revascularization procedure after initiating renal replacement therapy between January 2021 and December 2021. Demographic data collected included patient age, sex, race, duration of prior end-stage renal disease, and primary renal diagnosis. Results: The study population consisted of 120 men and 82 women, with a mean age of 56.9 years. Diabetes mellitus (DM) and hypertension (HT) were present in 58.4% and 89.6% of the patients, respectively. Coronary angiography was performed in 30% of patients considered at risk. The median graft rejection time was 145 days according to Kaplan-Meier analysis. Discussion: Coronary artery disease (CAD) has a significant negative impact on the pre-, intra-, and post-transplant survival of patients with chronic kidney disease. Myocardial revascularization is recommended in selected patients with unstable cardiac symptoms or chronic kidney disease, providing long-term survival benefits. Collaborative decision-making between cardiologists and nephrologists is crucial to provide optimal care for this high-risk patient population. Lifestyle modifications, risk factor control, and careful patient selection for myocardial revascularization are key in managing coronary artery disease in chronic kidney disease patients. Conclusion: Managing coronary artery disease in chronic kidney disease patients, especially those who are candidates for kidney transplantation, requires a comprehensive approach. Optimal treatment strategies should consider the intricate relationship between cardiovascular and renal factors. Collaborative care involving cardiologists, nephrologists, and transplant specialists, as well as a focus on both myocardial revascularization and medical therapy, can lead to improved outcomes. Further research is needed to refine treatment guidelines and strategies for this high-risk patient population.

Clinical trends of children with primary cardiac tumors: 15-year experience from a single center.

e22008 Background: Clinical presentation of pediatric primary cardiac tumors is exceptionally rare throughout the world. The purpose of our study is to evaluate clinical intervention by following up on children with primary cardiac tumors. Methods: Our study retrospectively enrolled 97 children diagnosed with primary cardiac tumors from Jan 2005 to Dec 2020 in a single center, Children’s Hospital of Nanjing Medical University by confirming with clinicoradiological and non-invasive diagnostic procedures. Primary outcome was to measure clinical trends and interventions while secondary was to analyze survival of 26 (26.80%) operative and 71 (73.19%) non-operative patients. Surgical intervention patients were followed for 6 Mo in the first postoperative year, then every year. Meanwhile, non-serious, asymptomatic, and no hemodynamic changes patients were treated non-operatively and followed up every year regularly. Results: In primary outcome, median age of children was 4.72±4.10 years (1d~16y), and median follow-up was 5.60±4.97 years (1m~15y). Most enrolled children were younger than 1 year old at the time of diagnosis. Primary cardiac tumors patients consisting of 60 rhabdomyoma (61.85%), 11 myxomas (11.34%), 7 fibromas (7.21%), 3 lymphangiomas (3.09%), 2 lipomas (2.06%), 9 unclassified tumors (9.27%) and 5 malignant tumors (5.15%) were retrospectively analyzed. Major 75 patients (77.31%) were diagnosed during various treatments of clinical symptoms, whereas 18 (18.55%) were diagnosed with routine investigation and 14 (14.43%) were diagnosed by prenatal fetal echocardiography. Herein, 26 children with critical symptoms and serious hemodynamic alteration had undergone surgical intervention in our hospital. Among them, 6 (23.07%) patients had postoperative complications; 2 (7.7%) patients were unable to survive due to post-operative arrhythmia and low cardiac output syndrome; While 2 (7.7%) patients with myxomas had a reoccurrence, and 2 (7.7%) patients had been diagnosed with another rhabdomyoma after intervention, others recovered well. Meanwhile, 71 children had non-surgical management, where 8 (11.26%) were lost to follow-up; 3 (4.22%) patients with malignant tumors were unable to survive after discharge due to unknown causes, and other patients had no serious symptoms or growth of tumors during follow-up. In secondary outcome, survival between operative and non-operative patients had no significant difference ( P &gt; 0.05). Conclusions: Clinical intervention of pediatric primary cardiac tumors may be performed one-on-one by accounting presentations, symptoms, and emergence even though majority of primary cardiac tumors in children are benign in nature, and postoperative reoccurrence is feasible, particularly for rhabdomyoma. Meanwhile, the primary goal of surgical intervention is to reinstate normal hemodynamics, and preserve significant structures and cardiac tissues.

Gamified Learning in Dermatology and Dermoscopy Education: A Paradigm Shift.

Teaching methods in medical education have been changing. More recent teaching modalities go beyond the traditional delivery of knowledge, promoting learning motivation and improving teaching and learning outcomes. For example, "gamification" and "serious games" are methodologies that use the principles of games to facilitate learning processes and the acquisition of skills and knowledge, thereby improving the attitude towards learning when compared to traditional teaching methods. Since dermatology is a visual field, images are a key component of different teaching strategies. Likewise, dermoscopy, a non-invasive diagnostic technique that allows the visualization of structures within the epidermis and upper dermis, also uses images and pattern recognition strategies. Although a series of Apps using game-based strategy have been created to teach and facilitate dermoscopy learning, studies are required to demonstrate their effectiveness. In this review, we summarize the current literature. This review summarizes the current evidence of game-based learning strategies in medical education, including dermatology and dermoscopy.

Diagnosis of Chronic Kidney Disease in the Elderly – A Challenge for the Practitioner

"The recent increase in life expectancy is the main argument for a better understanding of the pathophysiological mechanisms underlying aging. These, once known, can provide possible links to therapies to prevent aging or slow down the process. Normal aging is associated with a progressive decrease in the glomerular filtration rate. Accurate estimation of GFR in the elderly is under the suspicion of multiple errors mainly due to sarcopenia and decreased protein intake. Differentiation between chronic kidney disease and the physiological decline of GFR might be a challenge in clinical practice and this has consequences on the evolution and treatment of the numerous comorbidities of the elderly. The current trend to use non-invasive diagnostic techniques explains the need to identify a serological marker to help differentiate between decreased GFR secondary to kidney aging or the development of chronic kidney disease."

Weighted Average Ensemble Deep Learning Model for Stratification of Brain Tumor in MRI Images.

Brain tumor diagnosis at an early stage can improve the chances of successful treatment and better patient outcomes. In the biomedical industry, non-invasive diagnostic procedures, such as magnetic resonance imaging (MRI), can be used to diagnose brain tumors. Deep learning, a type of artificial intelligence, can analyze MRI images in a matter of seconds, reducing the time it takes for diagnosis and potentially improving patient outcomes. Furthermore, an ensemble model can help increase the accuracy of classification by combining the strengths of multiple models and compensating for their individual weaknesses. Therefore, in this research, a weighted average ensemble deep learning model is proposed for the classification of brain tumors. For the weighted ensemble classification model, three different feature spaces are taken from the transfer learning VGG19 model, Convolution Neural Network (CNN) model without augmentation, and CNN model with augmentation. These three feature spaces are ensembled with the best combination of weights, i.e., weight1, weight2, and weight3 by using grid search. The dataset used for simulation is taken from The Cancer Genome Atlas (TCGA), having a lower-grade glioma collection with 3929 MRI images of 110 patients. The ensemble model helps reduce overfitting by combining multiple models that have learned different aspects of the data. The proposed ensemble model outperforms the three individual models for detecting brain tumors in terms of accuracy, precision, and F1-score. Therefore, the proposed model can act as a second opinion tool for radiologists to diagnose the tumor from MRI images of the brain.

Inside Front Cover: Theranostic applications of multifunctional carbon nanomaterials (View 2/2023)

Carbon nanomaterials are potent multifunctional materials with diverse biomedical applications in theranostic techniques. They can be considered as safe and efficient tools for non-invasive diagnostic techniques such as magnetic resonance imaging (MRI). Various functionalized CNMs exhibit a great capacity to improve cell targeting of anticancer drugs. These therapeutic carbon-based materials bring new hope for advancing the diagnosis sector for a wide range of diseases such as brain disorders, cardiovascular diseases, and cancer in the near future.

Translational Echocardiography: The Dog as a Clinical Research Model of Cardiac Dysfunction

Heart disease is a major contributor to mortality and disability on a global scale. Hence, there is a need for research to improve non-invasive diagnostic techniques. Diseases in dogs with characteristics very similar to those of human pathologies hold promise as a source of data for evaluating and developing echocardiographic techniques and devices. Methods: We conducted a structured literature search from June 2022 to January 2023 to evaluate the relevance of dogs as a translational model for echocardiographic clinical research. We searched various academic databases, including PubMed Central (PMC), Core, DIGITAL.CSIC, DOAB, DOAJ, EBSCO host, Elsevier B.V, Redib, Scopus, and Web of Science, available through the Academic Information System of the Autonomous University of Baja California. Results: Out of the 243 articles initially screened, we identified 119 relevant articles that met our inclusion criteria for further analysis. This review is an introduction to the canine model by analyzing the cardiovascular anatomical similarities between the two species, the pathophysiological overlaps in some diseases, the parallels in echocardiographic techniques in dogs compared to humans, and the suitability of dogs with a naturally occurring cardiac disease as a model for translational clinical research compared to other animal species. Conclusions: This review emphasizes the importance of canine patients as an ideal cardiac disease symmetrical clinical model since they share common heart diseases with humans. Furthermore, dogs have a shorter lifespan, leading to the relatively rapid evolution of these diseases, which makes studying these pathologies and developing echocardiographic techniques more feasible. The results strongly indicate the need for interdisciplinary collaboration and translational medical research to create innovative echocardiographic technologies and improve the connection between veterinary and human cardiac imaging research.

A Clinico-Epidemiological Study of Hyperkeratotic Palmoplantar Lesions and Its Correlation With Dermoscopy and Histopathology in a Tertiary Care Center.

Introduction Hyperkeratotic lesions on the palms and soles are one of the most frequent clinical presentations encountered in dermatological practice, with a myriad of underlying etiologies that closely resemble one another and are clinically indistinguishable. Histopathological examination is the tool used by dermatologists to arrive at a final diagnosis, butit is invasive and not feasible under all circumstances. Dermoscopy is a new age, increasingly popular, noninvasive diagnostic technique of great value that is used to diagnose underlying etiology by acting as a bridge between clinical and histopathological pictures. This study aimed to evaluate the various etiologies underlying palmoplantar hyperkeratosis and the role of dermoscopy in the diagnosis of each disease along with its ability to delineate a close differential diagnosis and ensure appropriate treatment. Materials and methods This was a hospital-based observational cross-sectional studyconducted from July 1to December 31, 2022. Consenting patients with hyperkeratotic palmoplantar lesions on clinical examinationattending the dermatology outpatient department at our tertiary care hospital were included after institutional ethical clearance was obtained. Patients with HIV, hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) infection, or a history of hyperkeratotic lesions since birth, i.e., inherited palmoplantar keratodermas, were excluded from the study. A total of 60 patients aged between 18 and 60 years who met the above criteria were included. A complete history was taken; a thoroughexaminationwas performed. Routine investigationsand tissue histology were done. Potassium hydroxide (KOH) mount and patch testing were done as and when required. Dermoscopywith DermLite DL4was performed in all cases on lesional areas, and the findings were noted. Results Palmoplantar psoriasis has been found to be the most common cause of hyperkeratosis in our study with 24 (40%) out of 60 cases, followed bychronic hand-foot eczema found in 19 (31%) cases. Dermoscopic findings that help in differentiating various etiologies arevascular findings and scaling types. Vascular findings, mainlyregularly arranged dots and globules, were more prominent in palmoplantar psoriasis. Yellow white scaling was frequently observed in hyperkeratotic hand eczema.Most of the cases corresponded with their provisional diagnoses on histopathology, butfour out of 19 histopathologically confirmed cases ofeczema showed clinical resemblance to palmoplantar psoriasis, along with dermoscopic features of psoriasis. Two out of four cases of histopathologically confirmed palmoplantar LP were clinically considered palmoplantar psoriasis and hyperkeratotic hand-foot eczema. Conclusion Although hyperkeratoses of palms and soles are a common clinical entity, the similarity between the clinical features of the underlying conditions causes a diagnostic dilemma for treating dermatologists. Dermoscopy is a noninvasive, quick, reproducible, supportive investigation in the diagnosis of these conditions that certainly aids in reaching closer to a differential diagnosis and for better delineation, but it does not avert the need for a skin biopsy. Further confirmation with histopathological examination is advisable, especially in these conditions as they show close morphological similarity. A combination of all these investigations and clinical examinations gives better diagnoses and appropriate treatment.