Sensitive Diagnostic Indicator Research Articles

Close relationship with the glandular capsule：a highly sensitive diagnostic indicator of major salivary gland metastatic malignancies in ultrasound.

To investigate the ultrasound (US) characteristics of metastatic malignancies (MM) in the major salivary glands and to assess the diagnostic value of the close relationship with the glandular capsule in identifying MM. From January 2016 and April 2022, 122 patients with major salivary gland malignancies, including 20 patients with MM and 102 patients with primary malignancies (PM) confirmed by histopathological examination, were enrolled in this study. Their clinicopathologic and US data were recorded and analyzed. The diagnostic performance of the close relationship with the glandular capsule for differentiating MM from PM was analyzed. The mean age of MM were older than that of PM (59.50 ± 14.57 vs. 49.96 ± 15.73, p = 0.013). Compared with PM patients, MM were associated with a higher prevalence of local pain symptoms (p = 0.007) and abnormal facial nerve function (p < 0.001). MM were also more frequently characterized by unclear borders, rough margins, irregular shapes, heterogeneous internal echos, absence of cystic areas, presence of calcifications, close relationship with the glandular capsule, and US-reported positive cervical lymph nodes (all p < 0.05). The close relationship with the glandular capsule showed to be a good indicator in distinguishing between MM and PM, with an area under the receiver operating characteristic curve of 0.863, a sensitivity of 100%, a specificity of 72.5%, and an accuracy of 92.2%. Positive and negative predictive were calculated at 41.7% and 100%, respectively. The US finding of a close relationship with the glandular capsule is a highly sensitive diagnostic indicator for MM. Following this finding, US-guided needle biopsy should be recommended to further confirm the diagnosis.

BIAŁKOMOCZ PSÓW I KOTÓW – WYBRANE ZAGADNIENIA Z FIZJOLOGII I PATOFIZJOLOGII NEREK

Protein in the urine of healthy dogs and cats is present in trace amounts. It can occur in larger quantities in the urine of sick animals, as well as during certain physiological conditions. Routinely, proteinuria is assessed using the urine protein to creatinine ratio (UPC), which is a widely recognized prognostic indicator. Under normal conditions, its value is &lt;0.2. Values ranging from 0.2 to 0.4 in cats and from 0.2 to 0.5 in dogs are considered upper limit of normal, whereas UPC values &gt;0.4 in cats and &gt;0.5 in dogs are indicative of proteinuria. When diagnosing the causes of proteinuria in dogs and cats, it is important to consider damage to the glomeruli, renal tubules, interstitial tissue, and progressive loss of nephrons. Protein fractions present in urine, which vary in molecular weight, are sensitive diagnostic indicators of kidney dysfunction. Increased excretion of high molecular weight proteins may indicate damage to the renal glomeruli, while loss of low molecular weight proteins may suggest dysfunction of the renal tubules. If proteinuria persists and/or does not resolve after treating the underlying disease, it is necessary to initiate treatment aimed at reducing proteinuria by &gt;90% in cats and &gt;50% in dogs. The most effective treatment method for reducing proteinuria, while also having nephroprotective and cardioprotective benefits, is the blockade of the renin-angiotensin-aldosterone system (at its different levels). It is also essential to implement a proper diet, particularly by restricting protein and sodium intake.

Dual-Encoded Affinity Microbead Signature Combinatorial Profiling for Acute Myocardial Infarction High-Sensitivity Diagnosis.

The early diagnosis of acute myocardial infarction (AMI) is dependent on the combined feedback of multiple cardiac biomarkers. However, it remains challenging to precisely detect multicardiac biomarkers in complex blood early due to the lack of sensitive and specific diagnostic indicators and the low abundance and small size of associated biomarkers with high specificity (such as microRNAs). To make matters worse, spectral overlap significantly limits the multiplex analysis of cardiac biomarkers by fluorescent probes, leading to bias in the diagnosis of myocardial infarction. Herein, we developed a method for simultaneous detection of miRNAs and protein biomarkers using size- and color-coded microbeads that carry signature for target capture. We also constructed a microfluidic chip with different spacer arrays that segregate these microbeads in different chip regions according to their size to produce signature signals, indicating the level of different biomarkers. The signals on the microbeads were hugely amplified by catalytic hairpin assembly and rolling circle amplification. Notably, this strategy enables the simultaneous and in situ sensitive profiling of six kinds of biomarkers via adding two different fluorescent labels, removing the limitations of spectral overlap. We envision that the strategy has great potential for application in clinical diagnosis for AMI.

LncRNAs in Kawasaki disease and Henoch-Schönlein purpura: mechanisms and clinical applications.

Kawasaki disease (KD) and Henoch-Schönlein purpura (HSP) are the two most predominant types of childhood vasculitis. In childhood vasculitis, factors such as lack of sensitive diagnostic indicators and adverse effects of drug therapy may cause multiorgan system involvement and complications and even death. Many studies suggest that long noncoding RNAs (lncRNAs) are involved in the mechanism of vasculitis development in children and can be used to diagnose or predict prognosis by lncRNAs. In existing drug therapies, lncRNAs are also involved in drug-mediated treatment mechanisms and are expected to improve drug toxicity. The aim of this review is to summarize the link between lncRNAs and the pathogenesis of KD and HSP. In addition, we review the potential applications of lncRNAs in multiple dimensions, such as diagnosis, treatment, and prognosis prediction. This review highlights that targeting lncRNAs may be a novel therapeutic strategy to improve and treat KD and HSP.

Diagnostic markers and potential therapeutic agents for Sjögren's syndrome screened through multiple machine learning and molecular docking.

Primary Sjögren's syndrome (pSS) is a chronic inflammatory autoimmune disease, which mainly damages patients' exocrine glands. Sensitive early diagnostic indicators and effective treatments for pSS are lacking. Using machine learning methods to find diagnostic markers and effective therapeutic ways for pSS is of great significance. In our study, first, 1643 differentially expressed genes (DEGs; 737 were upregulated and 906 were downregulated) were ultimately screened out and analyzed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes based on the datasets from the Gene Expression Omnibus. Then, support vector machine, least absolute shrinkage and selection operator regression, random forest, and weighted correlation network analysis were used to screen out feature genes from DEGs. Subsequently, the intersection of the feature genes was taken to screen 10 genes as hub genes. Meanwhile, the analysis of the diagnostic efficiency of 10 hub genes showed their good diagnostic value for pSS, which was validated through immunohistochemistry on the paraffin sections of the labial gland. Subsequently, a multi-factor regulatory network and correlation analysis of hub genes were performed, and the results showed that ELAVL1 and IGF1R were positively correlated with each other but both negatively correlated with the other seven hub genes. Moreover, several meaningful results were detected through the immune infiltration landscape. Finally, we used molecular docking to screen potential therapeutic compounds of pSS based on the hub genes. We found that the small molecules DB08006, DB08036, and DB15308 had good docking scores with ELAVL1 and IGF1R simultaneously. Our study might provide effective diagnostic biomarkers and new therapeutic ideas for pSS.

The Latest Overview of circRNA in the Progression, Diagnosis, Prognosis, Treatment, and Drug Resistance of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is one of the main causes of tumor-related deaths worldwide. Due to the lack of obvious early symptoms and the lack of sensitive screening indicators in the early stage of HCC, the vast majority of patients are diagnosed with advanced or metastatic HCC, resulting in dissatisfactory treatment result. Therefore, it is urgent to determine effective and sensitive diagnostic and prognostic indicators and to determine new therapeutic targets. Circular RNA (circRNA) is a type of non-coding RNA that has been neglected for a long time. In recent years, it has been proved to play an important role in the development of many human diseases. Increasing evidence shows that change in circRNA expression has an extensive effect on the biological behavior of HCC. In this study, we comprehensively tracked the latest progress of circRNA in the pathogenesis of HCC, and reviewed its role as a biomarker for diagnosis and prognosis prediction in patients with HCC. In addition, we also summarized the potential of circRNA as therapeutic target in HCC and its relationship with HCC drug resistance, providing clues for the clinical development of circRNA-based therapeutic strategies.

A novel circular RNA circ-LRIG3 facilitates the malignant progression of hepatocellular carcinoma by modulating the EZH2/STAT3 signaling

BackgroundCircular RNA (circRNA) is emerging as an important player in human diseases, especially cancer. In our previous study, we identified a series of deregulated circRNAs in hepatocellular carcinoma (HCC) by performing circRNA microarray expression profile. Here, we aimed to explore the role of circ-LRIG3 (hsa_circ_0027345) in HCC.MethodsqRT-PCR and western blot were used to asses gene and protein expression, respectively. CCK-8, EdU and Transwell assays were used to detect cell proliferation, migration and invasion. GSEA software was applied to analyze the pathway related to circ-LRIG3. Co-IP, RIP and ChIP assays were used to identify the positive feedback axis of circ-LRIG3/EZH2/STAT3. Animal study was carried to test the role of circ-LRIG3 in vivo.ResultsCirc-LRIG3 was notably upregulated in HCC and promoted HCC cell proliferation, migration, invasion and reduced apoptosis. Circ-LRIG3 formed a ternary complex with EZH2 and STAT3, facilitating EZH2-induced STAT3 methylation and subsequent phosphorylation, resulting in the activation of STAT3 signaling. In turn, activated STAT3 could directly bind to circ-LRIG3 promoter to increase circ-LRIG3 transcription activity, thus forming a positive feedback loop. The animal models showed that exogenous expression of circ-LRIG3 enhanced tumorigenicity and metastasis in vivo, whereas these effects were blocked after treatment with C188–9, a specific STAT3 small-molecule inhibitor. Clinically, high circ-LRIG3 was closely linked with aggressive clinicopathological features and was identified as an independent risk prognostic factor of overall survival. Importantly, plasma circ-LRIG3 was found to be a highly sensitive and specific non-invasive diagnostic indicator for HCC.ConclusionsOur study reveals the carcinogenic role of circ-LRIG3 in HCC, which may provide a new therapeutic target for HCC patients.

High creatine kinase-muscle brain levels greatly exceeding total creatine kinase levels in a 2-month-old infant

The measurement of creatine kinase muscle brain (CK-MB) by the method of immunoinhibition has various drawbacks, which are posing as a hindrance in its role as a sensitive diagnostic indicator. A 2-month-old infant presented with symptoms of difficulty in breathing and cough. A chest X-ray done showed an incidental finding of a cardiac anomaly, and ultrasonography cranium showed a well-defined cystic lesion seen in the frontal horn of the bilateral lateral ventricle and signs of a resolving hemorrhage. The CK-MB level (761U/L) was greatly exceeding the CK levels (427U/L). This raise in CK-MB may be due to the presence of CK-BB or macro-CK in the plasma. Electrophoresis of the CK enzyme is, therefore, the best way to resolve the shortcomings of immunoinhibition. Macro-CK and CK-BB should hence also be kept in mind when the physician makes a diagnosis on the basis of such a laboratory report.

A framework to determine sensitive inorganic monitoring indicators for tracing groundwater contamination by produced formation water from shale gas development in the Fuling Gasfield, SW China

Potential environmental impacts on shallow groundwater from shale gas development facilitated by horizontal drilling and hydraulic fracturing is a widely debated “hot topic”. In terms of potential aqueous phase contamination (including flowback fluids and produced water), there is a large gap in knowledge of the indicators for routine monitoring and contamination tracing, which should be considered critical and should be prioritized for analysis. Since formation water from shale formations is the main source of flowback fluids and produced water, and there are significant differences in some specific inorganic geochemical and isotopic compositions between shallow groundwater and formation water, this study has provided a framework to determine sensitive monitoring and diagnostic indicators for tracing potential groundwater contamination from produced water using end-member analysis. The results from a case study of the Fuling Gasfield, Sichuan Basin, SW China as the first and largest commercial shale gas development site in China, shows that produced authentic formation water with similar Br/Cl and Na/Cl ratio with seawater and low δ2H and δ18O values compared to the evaporated seawater might originate from evaporated seawater modified by water-rock interactions and be mixed with fresh meteoric water. The inorganic geochemical and isotopic indicators, such as Ba, Li, Na, Cl, Br, 87Sr/86Sr (as εSrsw) and δ11B are sensitive to the detection of contamination of fresh shallow groundwater by produced formation water, even in very small fractions (0.05%). Meanwhile, we present a groundwater contamination case related to shale gas development in the Fuling Gasfield. The robust conservative geochemical (Cl and Br) and isotopic (δ11B and εSrsw) mass balances show that 0.2–0.9% of formation water entered the shallow groundwater causing contamination. The case has also confirmed the effectiveness of those indicators. Findings from this study may help to improve groundwater monitoring and environmental regulations in countries with shale gas exploration and development.

CD20&lt;sup&gt;+&lt;/sup&gt;B LYMPHOCYTES, A HIGHLY INFORMATIVE BIOMARKER FOR EARLY DIAGNOSIS OF CHRONIC ENDOMETRITIS

Plasma cells are often considered to be among important criteria in histological diagnosis of chronic endometritis (CE). Low plasma cell numbers in endometrial stroma, uneven distribution and similarity to the cells of cytogenic endometrial stroma represent difficulties with their identification by routine histological methods of study, and their absence prevents distinct diagnosis of CE. The paper presents data on comparative ROC-analysis of two immunohistochemical parameters of chronic endometritis: CD20+B lymphocytes and CD138+ plasma cells (PC). The study group included 937 women with CE, who were examined for infertility and failed IVF attempts. The control group consisted of 103 women without signs of CE who were studied for male infertility factor.The sensitivity of CD20+B cell assays for the diagnosis of CE was 98% (Se = 0.98), thus being 1.44 times higher compared to the sensitivity of CD138+PC, that was, respectively, 68% (Se = 0.68). The specificity of both indicators for the diagnosis of the absence of CE was high, i.e., 98% (Sp = 0.98), and 99% (Sp = 0.99), respectively. The threshold quantitative values for the two endometrial parameters (cutoff point) for the CE diagnosis were also determined when using CD138+PC-1 cell/5mm2 and CD20+B lymphocytes-5cell/5mm2. Analysis of linear regression showed a highly significant (p = 0.00053) relationship of CD138+ PC from CD20+B lymphocytes: With increased numbers of CD20+B lymphocytes, there is a trend for higher CD138+PC numbers which confirms their direct pathogenetic relationship. The topographic and quantitative features of CD20 B lymphocytes in the endometrium determined during immunohistochemical examination allow us to recommend this approach as a highly sensitive and significant early diagnostic indicator of chronic endometritis.

Assessment of the Use of PCR as an Early Diagnostic Indicator of Bovine Tuberculosis in Dairy Farms

Background: Zoonotic tuberculosis has been mainly associated with the consumption of bovine dairy products and its control has been prioritized by the Food and Agriculture Organisation. Objective: As such, the aim of this study is to assess whether the polymerase chain reaction (PCR) can be used as an early diagnostic indicator of Mycobacterium bovis infection in bovine dairy farms. Methods: Milk samples (n=78) were collected from all the animals older than 8 years of age, in all (n=4) bovine dairy farms located in a specific agricultural region of Greece, with high prevalence in bovine tuberculosis. Detection of DNA belonging to slow growing members of the genus Mycobacterium was conducted in pooled samples using two PCR assays targeting 16S-rRNA and 65-kDa heat shock protein (hsp65). Randomly selected PCR products were submitted to sequence analysis for confirmation of the specificity of the amplification process. DNA isolation and PCR testing were conducted in compliance with ISO17025 accreditation requirements. Results: The overall percentage of positivity was 47.7%, and ranged among farms from 0% to 76.9%. PCRpositive animals were detected in both farms that were at the time of investigation positive with the tuberculin skin test (TST), whereas the only farm with a negative TST record tested also negatively with PCR. Interestingly, one farm that was negative with TST since 2012 but had a long prior record of high level TST-positivity, tested positively with PCR. Conclusion: In conclusion it can be stated that PCR can be used for the detection of mycobacteria in pooled samples of milk collected from the older animals of a dairy farm, as an early and sensitive diagnostic indicator. This can support TST monitoring for the control of bovine tuberculosis, and improve detection of farms, in which routine monitoring should be intensified. The specific approach offers significant practical benefits that compensate for the additional cost of PCR.

Circulating miR-625 as an Emerging Biomarker for Liver Cirrhosis.

Sensitive and specific diagnostic indicators are essential for liver cirrhosis. This study aims to analyze two plasma microRNAs (miR-625 and miR-920) as possible biomarkers for liver cirrhosis. miR-625 and miR-920 expressions were analyzed in the plasma of 40 patients with liver cirrhosis and 41 healthy controls. Plasma levels of miR-625 and miR-920 were assessed by qRT-PCR. Analysis of the results was performed by the Mann-Whitney U-test. Spearman's test was used to show correlations between the miR-625 and clinical parameters. Receiver operating characteristic (ROC) analysis was performed to assess sensitivity and specificity. miR-625 is downregulated in patients with liver cirrhosis. Expression of miR-625 correlated with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. ROC curve analysis revealed that miR-625 had a sensitivity of 82.4% and specificity of 88.9% (area under the curve (AUC): 0.902) which indicated a high diagnostic power for cirrhosis. This study demonstrates for the first time that, miR-625 may be considered as a potential noninvasive biomarker for diagnosis of liver cirrhosis in patients, irrespective of etiology.

Intracellular free magnesium concentration in healthy horses.

Equine metabolic syndrome (EMS) is a worldwide disease in horses that parallels human diabetes mellitus type 2. In both diseases, patients show an altered peripheral insulin sensitivity as a key feature. In humans, multiple studies have demonstrated the beneficial effect of magnesium supplementation on insulin sensitivity. However, serum magnesium levels vary and are therefore not a reliable indicator of the patients' magnesium status. Determining the intracellular free magnesium concentration appears to be a more sensitive diagnostic indicator. In this study, the free intracellular magnesium concentration was measured using mag-fura 2 spectrophotometry in blood lymphocytes in 12 healthy, non-obese horses at 9a.m., 12a.m. and 4p.m. to establish reference ranges according to a protocol designed for human blood lymphocytes. Additionally, the serum magnesium concentration was measured. In all horses, the total serum magnesium concentration was within the reference range. The mean free magnesium concentration in blood lymphocytes of all horses was 0.291±0.067mmol/L with no significant difference between the time points. The reference range for the free intracellular magnesium concentration in equine lymphocytes was set at 0.16-0.42mmol/L. The established values are slightly lower than those in healthy humans. The designed protocol for the measurement of the intracellular free magnesium concentration might be an excellent research tool to assess the cellular magnesium status and to reliably diagnose an altered magnesium homeostasis in EMS. Further studies shall elucidate possible alterations in cellular magnesium status in horses with EMS.

Metabolite changes in risk of type 2 diabetes mellitus in cohort studies: A systematic review and meta-analysis

AimsFasting plasma glucose, oral glucose tolerance test, and glycated hemoglobin are diagnostic markers for type 2 diabetes mellitus (T2DM). However, it is necessary to detect physiological changes in T2DM rapidly and stratify diabetic stage using other biomarkers. We performed a systematic review and meta-analysis to contribute to the development of objective and sensitive diagnostic indicators by integrating metabolite biomarkers derived from large-scale cohort studies. MethodsWe searched for metabolomics studies of T2DM cohort in PubMed, Scopus, and Web of Science for studies published within the last 10 years from January 2008 to February 2017. The concentrations of metabolites and odds ratios (ORs) were integrated and risk ratio (RR) values were estimated to distinguish subjects with T2DM and normal participants. ResultsFourteen cohort studies were investigated in this meta-analysis. There were 4592 patients in the case group and 11,492 participants in the control group. We noted a 1.89-, 1.63-, and 1.87-fold higher risk of T2DM associated with leucine (RR 1.89 [95% CI 1.57–2.29]), alanine (RR 1.63 [95% CI 1.48–1.79]), and oleic acid (RR 1.87 [95% CI 1.62–2.17]), respectively. Lysophosphatidylcholine C18:0 (RR 0.80 [95% CI 0.72–0.90]) and creatinine (RR 0.63 [95% CI 0.53–0.74]) were associated with 20% and 37% decreased T2DM risks, respectively. ConclusionsMost amino acids in patients were positively related to diabetes, while creatinine and some lysophosphatidylcholines showed a negative relationship. This suggests that diabetic risk prediction using metabolites that sensitively reflect changes in the body will improve individual diagnosis and personalize medicine.

NRF2 gene expression and DNA fragmentation markers as possible predictors of chronic smoking induced spermatozoa dysfunction in infertility with normal seminogram

Introduction: Male factor is responsible for about half of infertility problems. However, the reasons for the decrease in male fertility are still broadly unclear. The mechanisms of how smoking may impact male fertility have not been established. However, with its influence on different semen parameters, it is regarded as a risk factor for infertility.Aim: To investigate the effect of chronic smoking on spermatozoa NRF2 expression and DNA fragmentation in infertile men with apparently normal seminogram and to determine if NRF2 expression and DNA fragmentation markers could be possible predictors of the impact of chronic cigarette smoking on male fertility.Methods: Semen samples were collected from 170 subjects; 65 nonsmokers (40 fertile and 25 infertile) and 105 smokers (25 fertile and 80 infertile). NRF2 gene expression, 8-OHdG and DNA fragmentation were assayed.Results: There were significant increases in 8-OHdG and %DNA fragmentation with a significant decrease in NRF2 gene expression in infertile smokers. ROC curve analysis of spermatozoa NRF2 gene expression showed 95% sensitivity 93.3% specificity at cutoff value ≤0. 931 (p 19.33 pg/ml predicting the detrimental effect of smoking on spermatozoa DNA.Conclusion: Chronic cigarette smoking may be a hidden causative mechanism of delayed fertility. Spermatozoa NRF2 gene expression and seminal 8-OHdG levels may serve as sensitive diagnostic indicators predicting smoking induced infertility. So, the presence of normal seminal parameters could not be an exclusion of potential effect of chronic smoking on male fertility.

A study of disseminated intravascular coagulation in acute leukemia reveals markedly elevated D-dimer levels are a sensitive indicator of acute promyelocytic leukemia.

While the presence of disseminated intravascular coagulation (DIC) has been implicated in worse clinical outcome in acute leukemia, the relationship between different subtypes of acute leukemia and the clinicopathologic features of DIC has not been systematically well studied. In this study, we retrospectively reviewed 149 cases of newly diagnosed acute leukemia and assessed the utility of evaluating red blood cell morphologic features, and coagulation parameters in determining the presence of DIC as well as differentiating subtypes of acute leukemia. Review of our cohort demonstrates a novel finding, that elevated D-dimer concentrations ≥19 000 ng/mL fibrinogen equivalent units (FEU) are a sensitive diagnostic indicator of acute promyelocytic leukemia (APL) with moderate specificity, sensitivity 96%, specificity 92% in acute leukemia subtyping. Similar to other studies, APL showed an increased incidence of DIC (P < 0.01) compared to other subtypes of acute leukemia. Surprisingly, the presence of schistocytes on the peripheral blood smear was not a statistically significant indicator of DIC, sensitivity of 36% and specificity of 89%. Finally, the presence of DIC was not a significant indicator of poorer prognosis amongst all patients with AML. Overall we identify elevated D-dimer concentrations ≥19 000 ng/mL FEU are a sensitive indicator of acute promyelocytic leukemia (APL), with a sensitivity of 96% and specificity of 92% in the subtyping of acute leukemias, and that the presence of schistocytes in peripheral blood smears is not a diagnostically sensitive screening test for DIC with a sensitivity of 36%.

Network Biomarkers Constructed from Gene Expression and Protein-Protein Interaction Data for Accurate Prediction of Leukemia.

Leukemia is a leading cause of cancer deaths in the developed countries. Great efforts have been undertaken in search of diagnostic biomarkers of leukemia. However, leukemia is highly complex and heterogeneous, involving interaction among multiple molecular components. Individual molecules are not necessarily sensitive diagnostic indicators. Network biomarkers are considered to outperform individual molecules in disease characterization. We applied an integrative approach that identifies active network modules as putative biomarkers for leukemia diagnosis. We first reconstructed the leukemia-specific PPI network using protein-protein interactions from the Protein Interaction Network Analysis (PINA) and protein annotations from GeneGo. The network was further integrated with gene expression profiles to identify active modules with leukemia relevance. Finally, the candidate network-based biomarker was evaluated for the diagnosing performance. A network of 97 genes and 400 interactions was identified for accurate diagnosis of leukemia. Functional enrichment analysis revealed that the network biomarkers were enriched in pathways in cancer. The network biomarkers could discriminate leukemia samples from the normal controls more effectively than the known biomarkers. The network biomarkers provide a useful tool to diagnose leukemia and also aids in further understanding the molecular basis of leukemia.

The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls.

BackgroundIndividuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes “mental pain.” Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. The present study investigated whether mental pain is elevated in BPD compared to Depressive Disorders (DD) without BPD.MethodsThe Orbach and Mikulincer Mental Pain Scale (OMMP) was administered to BPD (N = 57), DD (N = 22), and healthy controls (N = 31). The OMMP assesses total mental pain, comprised of nine subtypes: irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, self-estrangement, confusion, social distancing, and emptiness. Co-occurring psychiatric diagnoses, depression severity, and other potentially confounding clinical and demographic variables were also assessed.ResultsThe total Mental Pain score did not differentiate BPD from DD. Moreover, most of the subscales of the OMMP were not significantly different in BPD compared to DD. However, the elevation of mental pain subscale “narcissistic wounds,” characterized by feeling rejected and having low self-worth, was a specific predictor of BPD status and the severity of BPD symptoms.ConclusionOn OMMP total score, mental pain was similarly elevated in BPD and DD. However, the narcissistic wounds sub-type of mental pain was a sensitive and specific diagnostic indicator of BPD and, therefore, may be an important aspect of BPD in need of increased focus in assessment and theoretical models.

Long-Lasting Immune Protection and Other Epidemiological Findings after Chikungunya Emergence in a Cambodian Rural Community, April 2012.

The East/Central/South African genotype of Chikungunya virus with the E1-A226V mutation emerged in 2011 in Cambodia and spread in 2012. An outbreak of 190 cases was documented in Trapeang Roka, a rural village. We surveyed 425 village residents within 3–4 weeks after the outbreak, and determined the sensitivity and specificity of case definitions and factors associated with infection by CHIKV. Self-reported clinical presentation consisted mostly of fever, rash and arthralgia. The presence of all three clinical signs or symptoms was identified as the most sensitive (67%) and specific (84%) self-reported diagnostic clinical indicator compared to biological confirmation by MAC-ELISA or RT-PCR used as a reference. Having an indoor occupation was associated with lower odds of infection compared with people who remained at home (adjOR 0.32, 95%CI 0.12–0.82). In contrast with findings from outbreaks in other settings, persons aged above 40 years were less at risk of CHIKV infection, likely reflecting immune protection acquired when Chikungunya circulated in Cambodia before the Khmer Rouge regime in 1975. In view of the very particular history of Cambodia, our epidemiological data from Trapeang Roka are the first to support the persistence of CHIKV antibodies over a period of 40 years.

The diagnostic role of signal peptide–C1r/C1s, Uegf, and Bmp1–epidermal growth factor domain-containing protein 1 in non–ST-elevation acute coronary syndrome

ObjectiveChest pain and/or electrocardiogram changes in non–ST elevation or suspicious chest pain and cardiac marker elevations are defined as non–ST-elevation acute coronary syndrome (NSTE-ACS). Serial electrocardiogram and marker follow-up are needed to make a diagnosis of NSTE-ACS and to eliminate noncoronary chest pain (NCCP). Signal peptide–C1r/C1s, Uegf, and Bmp1–epidermal growth factor domain-containing protein 1 (SCUBE1) is stored within the α granules of inactive platelets and secreted at a high rate during thrombosis. We believe that SCUBE1 may be a sensitive early diagnostic indicator in distinguishing coronary-induced chest pain from noncoronary-induced chest pain. Materials and methodsThe study included 190 patients with an initial diagnosis of acute coronary syndrome in the emergency department. Based on a definitive diagnosis, these patients were classified into 3 groups: ST-elevation myocardial infarction (STEMI), NSTE-ACS, and NCCP. ResultsPlasma SCUBE1 levels were significantly higher in the STEMI group when compared with those of the other groups (P < .05). They were also significantly higher in the NSTE-ACS group when compared with those of the NCCP group (P < .01). Troponin I, creatinine kinase, and creatinine kinase MB levels were significantly different in the NSTE-ACS group when compared with those of the NCCP group (P < .05). ConclusionHigh rates of SCUBE1 were found both in the STEMI and NSTE-ACS patients. Furthermore, in the study group, SCUBE1 was an adequate marker for distinguishing NSTE-ACS from NCCP.