Standard Diagnostic Methods Research Articles

MOLECULAR CHARACTERIZATION SOME BACTERIAL PATHOGENS CAUSING BOVINE MASTITIS WITH SPECIAL REFERENCE TO Mycoplasma bovis

In dairy industry, bovine mastitis is the most prevalent disease, which reduces milk production and causes economic losses. This study was conducted to estimate the prevalence of Mycoplasma bovis and some bacteria causing mastitis in dairy farms and partial sequencing of 16SrRNA target genes and Quinolones Resistance Determining Regions (QRDRs) (gyrA and parC) in M. bovis isolates. 370 milk samples were obtained from farms located in villages in Fayoum governorate, Egypt. The examined milk samples (8,91%) were positive for the California mastitis test (CMT). Multiplex RT-PCR was used for the recognition of microorganisms causing mastitis (Staphylococcus (S.) aureus, Streptococcus species (spp.), Escherichia (E.) coli, and Mycoplasma (M.) bovis) from mastitic milk. The results revealed that E. coli was the most predominant (84.8%) followed by S. aureus (81.8%) while M. bovis was the lowest one (51.5%). Mixed infection with two or more mastitic bacterial agents was also identified. All 33 examined mastitic milk samples were diagnosed with mixed infection with E. coli, S. aureus, Streptococcus spp. and M. bovis (36.36%), E. coli and S. aureus (21.21%), and rephrase E. coli, M. bovis, and Streptococcus spp. (6.06%). The sequence analysis of M. bovis 16SrRNA genes illustrated a high similarity of examined isolates to strains previously deposited in the GenBank recovered from the same locality. The gyrA amino acids showed no substitution but showed 100% similarity with M. bovis isolates worldwide. However, the amino acid sequence of parC, showed substitution at positions 2 (Gln to Arg) (CAG >>CGT), 75 (Ile to Ser) (ATT>>AGC), and 79 (Asn to Asp) (AAC>>GAT). Sequence results can lead to the creation of appropriate treatment and control measures for M. bovis, while multiplex RT-PCR, can be exploited as a standard diagnostic method for major mastitis pathogens.

Ion Mobility Spectrometry for the Metabolomic Study of Inflammatory Bowel Disease Using the Volatile Organic Compounds Profile in Human Serum and Urine

Inflammatory bowel disease (IBD) is an immune-mediated disease characterized by chronic mucosal inflammation of the digestive tract. The IBD diagnosis is currently based on the results of imaging, clinical, and histopathological tests. The gold standard diagnostic method is endoscopy, an invasive imaging technique that requires patient sedation and prior bowel preparation and is expensive. In the present work, monitoring the volatile compound fingerprint of serum and urine by headspace gas chromatography-ion mobility spectrometry (HS-GC-IMS) is presented as a rapid and reliable diagnostic complementary test for patients with IBD. The analytical method was optimized and applied for the analysis of serum (118) and urine (123) samples from patients with IBD (in remission and active phase of the disease) and healthy volunteers without IBD. Orthogonal partial least square discriminant analysis was performed using all the integrated markers present in the topographic maps of each sample type, allowing the differentiation between healthy IBD volunteers and IBD patients and between IBD status (remission or active). The individual study of markers allowed the identification and quantification of twelve and six compounds in urine and serum samples, respectively. This information was further used to perform a one-way analysis of variance to compare the different categories.

Evaluation of the diagnostic accuracy of a point-of-care device to measure concentrations of nonesterified fatty acids in serum and whole blood

The objective of this study was to compare measurements of nonesterified fatty acids (NEFA) between the gold standard diagnostic laboratory method and a handheld NEFA meter (Qucare Pro meter, DFI Co. Ltd.). Three experiments were conducted to study the usability of the meter. In experiment 1 we compared results of the meter obtained from measurements in serum and whole blood with results of the gold standard method. Based on the results of experiment 1 we compared the results measured by the meter in whole blood with results obtained from the gold standard method on a larger scale, as we wanted to omit the step of centrifugation with the cow-side test. In experiment 3 we determined the influence of ambient temperature on measurements. Overall, blood samples of 231 cows were collected between 14 and 20 d in milk. The Spearman correlation coefficients (ρ) were calculated and Bland-Altman plots were created to compare the accuracy of the NEFA meter with the gold standard. In addition, in experiment 2 receiver operating characteristic (ROC) curve analyses were performed, to define thresholds for the NEFA meter to detect cows with a NEFA concentration above 0.3, 0.4, and 0.7 mEq/L. In experiment 1, there was a high correlation between NEFA concentrations in whole blood and serum determined by the NEFA meter and the gold standard (ρ = 0.90 for measurement in whole blood; ρ = 0.93 for measurement in serum). In experiment 2, the measurement in whole blood with the NEFA meter was compared with the gold standard. Despite a lower correlation (ρ = 0.79) the ROC curve analyses revealed a high specificity and a moderate sensitivity for lower cut-points (i.e., 0.3 and 0.4 mEq/L). The NEFA meter underestimated especially high concentration of >0.7 mEq/L. Considering thresholds of 0.3, 0.4, and 0.7 mEq/L measured by the gold standard test, sensitivity and specificity were 59.1% and 96.7%, 79.0% and 95.4%, and 86.4% and 95.6%, respectively, when using 0.3, 0.3, and 0.4 mEq/L as thresholds for the NEFA meter. Accuracy was 74.1%, 88.3%, and 93.8% for the 3 thresholds tested. Experiment 3 showed that measurements should be conducted at approximately 21°C (ρ = 0.73) as correlations were poor at 6.2°C and 15.1°C (ρ = 0.18 and 0.22, respectively).

Nitrite-negative results in urinary tract infection by Enterobacterales: does the nitrite dipstick test have low sensitivity?

Urinary tract infection (UTI) is one of the most common bacterial infections among humans. Urine culture is the gold standard diagnostic method for UTI; however, the dipstick test for nitrite is a widely used method signalling the presence of urinary nitrate-reducing bacteria. Unlike the gold standard, the dipstick test is easy to perform, while it is also less time-consuming and less expensive, and produces a result in a few minutes. This study investigates the sensitivity of the dipstick test for nitrite compared with the Griess test in urine samples from UTI caused by Enterobacterales species. We used the Griess test, which is the gold standard in nitrite measurement, to determine the sensitivity of the nitrite dipstick test. Semiquantitative urine culture was performed using standard procedures, and Enterobacterales identification was performed by manual conventional biochemical tests. In the first sample selection, 3 % (8/267) of urine samples suspected of UTI, analysed from March to April 2016, were nitrite-negative by dipstick test but positive for Enterobacterales in the urine culture. In the second sample selection, 5 % (2/44) of urine samples from October to December 2022 were also nitrite-negative but showed urine Enterobacterales isolation. All nitrite-negative dipstick results were consistent with the Griess test. Escherichia coli was the most prevalent bacterium, followed by Klebsiella pneumoniae, independent of sample selection. The dipstick test is a safe alternative for investigating nitrite in urine samples. We believe that the cause of nitrite-negative results is a lack of dietary nitrate, dilution of urine and exogenous interference (e.g. ascorbic acid). These findings support the idea that standard urine culture is necessary to rule out UTI.

Features of the development and formation of the epidemic situation by comorbid socially significant infectious diseases in the region under extreme conditions of the COVID-19 pandemic

The article presents an overview of current trends in the epidemiology of socially significant infectious diseases (SSID) under the influence of the COVID-19 pandemic, especially comorbid ones, taking into account the data of epidemiological monitoring of their spread in the region. A detailed description of the dynamics of the detection of SSID in the period 2017-2021 is given. The options of intensification of anti-epidemic measures, including re-organization of specialized medical care in SSID, are proposed.The purpose of the study. To establish the features of the development and formation of the epidemic situation in the SSID and their development in the extreme conditions of the COVID-19 pandemic. Materials and methods. The data on the spread of SSID in the preand period of the development of the COVID-19 pandemic in the region, as well as our own studies of the features of the development of comorbid SSID in 1762 newly diagnosed and patients with recurrent tuberculosis (TB) were analyzed. The results of standard diagnostic methods, including molecular genetic ones, were used to verify the diagnosis to determine the resistance of pathogens to antibacterial drugs. The results of the study, the epidemic situation in the region for SSID, primarily TB, in the extreme conditions of the COVID-19 pandemic, although it remained tense, but their prevalence continued to decrease. The article presents an analysis of the features of the course of SSID and describes a clinical case of the course and treatment of comorbid generalized HIV-associated TB. Conclusions. In the case of the COVID-19 pandemic, as a variant of extreme conditions, there were no trends in the deterioration of the epidemic situation in the region for the priority of the SSID TB. There is an increase in the number of people infected with HIV infection and changes in the structure of morbidity. Taking into account the ongoing reorganization of the healthcare system and the peculiarities of the functioning of its services providing specialized assistance to the population (tuberculosis, infectious, AIDS service), in the conditions of possible predicted other epidemics/pandemics, it is necessary to reorganize these services as well.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for differential identification of adult Schistosoma worms

BackgroundSchistosomiasis is a major neglected tropical disease that affects up to 250 million individuals worldwide. The diagnosis of human schistosomiasis is mainly based on the microscopic detection of the parasite’s eggs in the feces (i.e., for Schistosoma mansoni or Schistosoma japonicum) or urine (i.e., for Schistosoma haematobium) samples. However, these techniques have limited sensitivity, and microscopic expertise is waning outside endemic areas. Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) has become the gold standard diagnostic method for the identification of bacteria and fungi in many microbiological laboratories. Preliminary studies have recently shown promising results for parasite identification using this method. The aims of this study were to develop and validate a species-specific database for adult Schistosoma identification, and to evaluate the effects of different storage solutions (ethanol and RNAlater) on spectra profiles.MethodsAdult worms (males and females) of S. mansoni and S. japonicum were obtained from experimentally infected mice. Species identification was carried out morphologically and by cytochrome oxidase 1 gene sequencing. Reference protein spectra for the creation of an in-house MALDI-TOF MS database were generated, and the database evaluated using new samples. We employed unsupervised (principal component analysis) and supervised (support vector machine, k-nearest neighbor, Random Forest, and partial least squares discriminant analysis) machine learning algorithms for the identification and differentiation of the Schistosoma species.ResultsAll the spectra were correctly identified by internal validation. For external validation, 58 new Schistosoma samples were analyzed, of which 100% (58/58) were correctly identified to genus level (log score values ≥ 1.7) and 81% (47/58) were reliably identified to species level (log score values ≥ 2). The spectra profiles showed some differences depending on the storage solution used. All the machine learning algorithms classified the samples correctly.ConclusionsMALDI-TOF MS can reliably distinguish adult S. mansoni from S. japonicum.Graphical

Endoscopic research methods for morphofunctional changes in the small intestine

Purpose: to analyze the results of diagnosis and treatment of tumors of the small intestine, which served as a source of small bowel bleeding. Materials and methods: 35 patients were analyzed: men - 19 (59.4%), women - 16 (41.6%) aged 19 to 85 years, with tumors and tumor-like lesions of the jejunum and ileum. The main indication for examination of the small intestine in these patients was the search for a source of bleeding that was not identified by standard diagnostic methods (esophagogastroduodenoscopy and colonoscopy). After analyzing the clinical picture in 5 examined patients with identified tumors of the small intestine, 3 (15.5%) clinical symptoms were manifested by obvious intestinal bleeding characterized by melena or hematochezia, and in 2 (10.5%) patients the course was latent. Conclusion: After analyzing the results of the diagnosis of small intestine tumors complicated by bleeding in young and middle-aged patients, the survey data demonstrate the importance of enteroscopy techniques in patients with iron deficiency anemia and chronic recurrent bleeding

Diagnostic Value of Epithelial Cell Adhesion Molecule Flow Cytometry for Diagnosis of Metastatic Carcinoma in Serous Effusions

Introduction: Malignant serous effusions are common in metastatic carcinomas. Although cytomorphology is recognized as the gold standard diagnostic method, it exhibits moderate sensitivity. This study aimed to assess the diagnostic value of immunophenotyping with a single epithelial marker, known as the epithelial cell adhesion molecule (EpCAM, CD326), in discriminating malignant metastatic carcinomas of serous fluids. Methods: This prospective study was conducted on suspicious or confirmed cases of malignant tumors from September 16, 2019, to June 21, 2020. Serous fluid samples were assessed via cytomorphology using the Wright-Papanicolaou method and the anti-EpCAM mouse monoclonal antibody (clone VU-1D9) flow cytometry. The EpCAM(+)/CD45(−) immunophenotype was defined as the metastatic involvement of carcinoma in the serous cavity. Results: A total of 118 samples (90 females and 28 males; mean age, 54.04 ± 16.14 years), collected from peritoneal and pleural fluids, were examined in this study. Five samples (4.24%) were positive in both EpCAM flow cytometry and cytology, while 102 samples (86.44%) were negative for both EpCAM flow cytometry and cytology, yielding an overall agreement of 92%, 84%, and 90.7% for the peritoneal, pleural, and total samples, respectively. Based on the Bayesian latent class model, the EpCAM flow cytometry showed sensitivity and specificity of 58.5% (95% CI: 0.3, 99.7) and 96.2% (95% CI: 47.8, 100), respectively. The corresponding values were 68.7% (95% CI: 0.3, 99.9) and 96.1% (95% CI: 47, 100) for cytology, respectively. Conclusion: The EpCAM flow cytometry and cytology showed comparable performance in detecting metastatic effusions. The EpCAM flow cytometry might have a diagnostic value in decreasing the false-negative rate of cytomorphology, while maintaining excellent specificity.

Analysis of selected pro-inflammatory cytokines: IL-1β, IL-6, CXCL-8, and TNF-α in children with seizure disorders during acute infection. Is there a specific pro-inflammatory cytokine profile in these patients?

Introduction and objective: This study aimed to analyse the levels of selected pro-inflammatory cytokines in children with seizures during acute infection. Materials and methods: The study was conducted in the Department of Infectious Diseases and Child Neurology of the Poznan University of Medical Sciences from 19 January 2017 to 5 December 2020. Pro-inflammatory cytokines were measured in 64 patients with febrile seizures and 11 patients after an epileptic seizure in generalised epilepsy. The control group comprised 46 patients with delayed development. Serum pro-inflammatory cytokines were determined using the BioLegend’s ELISA MAX™ Deluxe Set. Pathogens were detected by standard diagnostic methods. Total white blood cell count, C-reactive protein and procalcitonin were determined using standard diagnostic methods. Results: Significantly higher levels of all analysed pro-inflammatory cytokines were found in patients with simple and simple plus febrile seizures; interleukin 6, CXCL-8 in those with complex febrile seizures; interleukin 6, CXCL-8, tumour necrosis factor α following epileptic seizure. The intensity of the inflammatory response in simple and simple plus febrile seizure patients corresponded to significantly higher levels of all pro-inflammatory cytokines and inflammatory markers. Pro-inflammatory profiles differed depending on the aetiology of the infection. Significantly higher levels interleukin 6, CXCL-8, tumour necrosis factor α were found in simple and simple plus febrile seizure patients infected with human herpesvirus-6 compared to the control group. Conclusions: In patients with febrile seizures and epileptic seizures, the involvement of interleukin 1β, interleukin 6, CXCL-8, and tumour necrosis factor α was confirmed in the inflammatory process, with a different distribution in the analysed groups. Pro-inflammatory cytokine profiles varied depending on the infectious aetiology.

Diagnostic capability of the scratch collapse test compared with other clinical diagnostic tests for diagnosis of carpal tunnel syndrome: a prospective case-control study

Background: Diagnostic performance of the scratch collapse test for carpal tunnel syndrome (CTS) is not clear. This study evaluated its diagnostic capability for CTS diagnosis in comparison with other widely used clinical CTS tests, including the Tinel’s sign, Phalen’s test, and Durkan’s test. Methods: In a prospective case-control study, 78 CTS patients and 78 group-matched healthy control subjects were included. The electrodiagnostic testing was regarded as a reference standard CTS diagnostic method. The tests were conducted separately for the case and control groups; the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the tests were calculated. Results: The sensitivity, specificity, PPV, NPV, and accuracy of CTS diagnosis were 7.7%, 100%, 100%, 52% and 53.8% for the scratch collapse test; 91%, 97.4%, 97.3%, 91.6%, and 94.2% for the Tinel’s sign test; 84.6%, 100%,100%, 88.6%, and 93.6% for the Phalen’s test; and 87.2%, 100%, 100%, 88.6%, and 93.6% for the Durkan’s test, respectively. Conclusions: Scratch collapse test has a low sensitivity and accuracy for diagnosing CTS. These results do not support its routine use for the diagnosis of CTS. Level of Evidence: Level III

The application of artificial neural networks in the detection of mandibular fractures using panoramic radiography.

Panoramic radiography is a standard diagnostic imaging method for dentists. However, it is challenging to detect mandibular trauma and fractures in panoramic radiographs due to the superimposed facial skeleton structures. The objective of this study was to develop a deep learning algorithm that is capable of detecting mandibular fractures and trauma automatically and compare its performance with general dentists. This is a retrospective diagnostic test accuracy study. This study used a two-stage deep learning framework. To train the model, 190 panoramic images were collected from four different sources. The mandible was first segmented using a U-net model. Then, to detect fractures, a model named Faster region-based convolutional neural network was applied. In the end, a comparison was made between the accuracy, specificity, and sensitivity of artificial intelligence and general dentists in trauma diagnosis. The mAP50 and mAP75 for object detection were 98.66% and 57.90%, respectively. The classification accuracy of the model was 91.67%. The sensitivity and specificity of the model were 100% and 83.33%, respectively. On the other hand, human-level diagnostic accuracy, sensitivity, and specificity were 87.22 ± 8.91, 82.22 ± 16.39, and 92.22 ± 6.33, respectively. Our framework can provide a level of performance better than general dentists when it comes to diagnosing trauma or fractures.

Designing stimuli-responsive upconversion nanoparticles based on a mimetic immunoassay for potential accurate diabetic nephropathy diagnosis.

Diabetic nephropathy (DN) is the most common microvascular complication associated with incurable diabetes. The gold standard diagnostic method for DN is based on the detection of proteinuria but it overlooks cases of non-proteinuria (NP-DN). To address this limitation, urinary sialic acid (SA) has been confirmed as an effective biomarker for various DNs. Herein, we constructed an ultrasensitive non-proteinuria assay platform to accurately diagnose DN within 20 min. This platform utilized the ninhydrin reaction between acidic ninhydrin and urinary sialic acid (SA) as an effective biomarker for various DNs. A compound with a maximum absorption peak at 470 nm was produced in this reaction and contributed to the fluorescence decrease of the blue-emission core-shell upconverting nanoparticles through the inner filter effect (IFE). By integrating the inner filter effect (IFE) with a mimetic immunoassay, the imperceptible color was converted into highly sensitive fluorescence signals. This protocol shows a stable and high sensitivity with a detection limit of 20 nmol L-1 and provides 100% positive prediction for urine samples, demonstrating its potential for clinical diagnosis and long-term monitoring of DN.

A case of melioidosis with hemoptysis: Strategies to isolate and identify Burkholderia pseudomallei

Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei with diverse clinical manifestations. Mortality is due to septic shock and pneumonia. Burkholderia pseudomallei is a Gram-negative rod with bipolar staining. Culture is the gold standard diagnostic test. Gram stain, biochemical reactions, and Poymyxin resistance aid in the identification of the organism. Case Description: A 52-year-old female with type 2 diabetes mellitus was hospitalized for a chronic cough. A sputum sample was collected for Culture and Acidfast staining. Burkholderia pseudomallei was isolated and the patient was prescribed appropriate antibiotic. On the 15th day of admission, patient expired following a bout of hemoptysis despite antibiotic therapy. Conclusion: Culture is the gold standard diagnostic method in melioidosis. Burholderia pseudomallei can be easily differentiated from other organisms by Gram stain, methylene blue stain, and screening for polymyxin sensitivity. Early diagnosis and appropriate antibiotic therapy are warranted in melioidosis.

The Efficacy of the Berlin Questionnaire and the Epworth Sleepiness Scale in Obstructive Sleep Apnea

Background: Obstructive sleep apnea (OSA) is a disease in which apneahypopnea attacks occur during sleep and is characterized by a reduction in blood oxygen saturation during sleep. The gold standard diagnostic method is polysomnography (PSG).However, PSG is a time-consuming method that is expensive and requires special equipment, and care has to be taken in patient selection for PSG. The aim of this study was to evaluate the efficacy of the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ) in predicting OSA through comparisons with PSG.

Métodos de diagnóstico convencionais e imunoistoquímica na detecção de espécies de Helicobacter gástricas em cães com gastropatia crônica

ABSTRACT An accurate diagnostic test for Helicobacter spp. infection in dogs is necessary but no gold standard diagnostic method has yet been established. The purpose of this study was to assess the sensitivity of conventional diagnostic methods as opposed to immunohistochemistry (IHC) in the detection of Helicobacter spp. in gastric samples of dogs with chronic gastropathy. Samples of gastric fundus, body and antrum were collected by gastroscopy from 13 domestic dogs presenting chronic vomit and submitted to the rapid urease test (RUT), cytopathology, histopathology with Hematoxylin-Eosin (HE) and Warthin-Starry (WS) stain, and IHC. Cohen's kappa coefficient was carried out to determine the agreement between techniques compared to IHC. Prevalence of colonization detected by IHC was 92% and was higher in the gastric fundus. The sensitivity of each technique in detecting Helicobacter spp. in the gastric fundus, body, and antrum, respectively, were as follows: RUT 50%, 70%, 17%; cytology 58%; 70%, 50%; HE 42%; 70%, 50%; WS 67%; 80%, 50%. We found that IHC was the most sensitive method for Helicobacter spp. diagnosis revealing that gastric fundus samples have higher presence of bacteria. Squash cytology enhances sensitivity and ancillary staining such as WS should be taken into consideration towards diagnosis.

Наиболее значимые постнатальные факторы, влияющие на течение различных форм ретинопатии недоношенных

Purpose.To evaluate the most significant factors affecting the course of ROP. Material and methods. From 2009 to 2018, we examined 4120 children with ROP. The examination of children was carried out as part of a neonatal screening to detect ROP using standard diagnostic methods. Results. Against the background of prolonged oxygen therapy in children with broncho-pulmonary dysplasia (BPD), severe forms of ROP developed in 9.7% of cases, which is significantly lower than similar indicators in the pathology departments of premature and newborns. Among children with severe apnea, the onset of different-sized hemorrhages, mainly preretinal located in various parts of the fundus, mostly at the ends of the vascular arcades is observed in 70.4% of cases. In 25.9% of children with severe ROP, partial hemophthalmus appears. During blood transfusions in children with severe forms of ROP, the transition of the disease to a more severe stage was reduced in 64.0%, caliber and tortuosity of the retinal vessels increased in 79.8%, retinal edema and exudative manifestations intensified in 39,3%, hemorrhagic changes rose in 49,4%, extraretinal proliferation increased in 50.6%. Against the background of adenoviral epidemic keratoconjunctivitis (AEK) in children with severe forms of ROP, the exudation in the vitreous body sharply increased in 34.7%, retinal detachment developed in 4.1% of cases, even though the children had already undergone laser coagulation of the retina at the time of infection, fresh hemorrhages mainly at the ends of the vascular arcades appeared in 57.1%. Conclusions. Prolonged oxygen therapy under BPD reduces the severity of the ROP. The impact of blood transfusions is observed only in severe forms of ROP. Frequent episodes of apnea contribute to the development of intraocular hemorrhages during ROP. The course of adenoviral AEK exacerbates the course of severe forms of ROP. Key words: retinopathy of prematurity, blood transfusion, apnea, broncho-pulmonary dysplasia, adenoviral epidemic keratoconjunctivitis, risk factors of retinopathy of prematurity

Retrospective analysis of prostate cancer detection using mpMR/US-fusion and cognitive biopsy

Introduction. Transrectal biopsy under US-control has been standard diagnostic method for prostate cancer (PCa) detection for over 30 years. However, TRUS-guided biopsy is not without well-known drawbacks. MR-targeted biopsy methods were proposed to eliminate the drawbacks and improve detection rate of clinically significant Pca. Cognitive and mpMR/US-fusion biopsies have become the most widely used MR-targeted biopsies. However, there are contradictory data on detection of clinically significant Pca when comparing mpMR/US-fusion and cognitive biopsies.Objective. To compare the detection rate of clinically significant prostate cancer performing cognitive and mpMR/US-fusion biopsies.Materials and methods. Inclusion criteria: PSA > 2.0 ng/ml and/or a positive DRE, and/or a suspicious lesion on TRUS, and PI-RADSv2.1 score ≥ 3. The outcomes evaluated are the detection of clinically significant Pca (ISUP ≥ 2), the overall PСa detection, the detection of clinically insignificant Pca, histological yield (proportion of positive cores, maximum cancer core length).Results. Retrospective data analysis was performed: cognitive biopsy was performed in 102 patients and mpMR/US-fusion biopsy in 176 patients. The median age was 63 years, prostate volume 46 cc. The median PSA was 6.4 ng/ml in the mpMR/US-fusion and 6.7 ng/ml in the cognitive biopsy group. MpMR/US-fusion and cognitive biopsies were comparable about the detection rate of clinically significant (30.3% vs 25.0%; p=0.329) and overall Pca detection rate (50.5% and 42.1%; p = 0.176). It was detected to be less clinically insignificant Pca in the cognitive biopsy group (11.8% vs. 25.5%; p = 0.007). The proportion of positive cores (30.5% and 29.5% respectively; p = 0.754) and maximum cancer core length (6.6 mm vs 7.6 mm; p = 0.320) were equal when comparing cognitive and mpMR/US-fusion biopsies. The proportion of positive cores with clinically significant Pca was higher in the cognitive biopsy group (18.6% vs 13.1%; p = 0.029).Conclusion. Both cognitive and mpMR/US-fusion biopsies are equally accurate for clinically significant Pca detection. Therefore, cognitive biopsy may be an alternative to mpMR/US-fusion biopsy in hospitals where mpMR/US-fusion technology is not currently available.

Discomfort During Instillation Of Antihypertensives And Ocular Surface Condition In Glaucoma Patients

Background — An increase in the frequency of manifestations of dry eye syndrome (DES), against the background of hypotensive therapy, leads to a decrease in treatment adherence. After reformulation in the composition of a preservative-free preparation of a carbonic anhydrase inhibitor (CAI) (sodium benzoate was added), patient complaints of burning sensation during instillation became more frequent, which was the reason for our study. Objective — To evaluate the effect of sodium benzoate on the course of DES during local hypotensive therapy of glaucoma. Methods and Results — Group 1 consisted of 21 eyes with glaucoma receiving hypotensive therapy, Group 2 (20 eyes) included patients with suspected glaucoma not receiving therapy. Patients underwent standard diagnostic methods and examination of the ocular surface condition: tear break-up time test sensu Norn, Schirmer test, vital staining with lissamine green, and a survey based on the Ocular Surface Disease Index (OSDI) questionnaire. When a preservative-free CAI in combination therapy was replaced with the CAI containing sodium benzoate, no statistically significant change in IOP occurred after four weeks of treatment (p> 0.05). In both groups, the indicators characterizing the ocular surface condition did not change statistically significantly over the observation period. Conclusion — Replacement of preservative-free CAI in combination therapy of glaucoma with CAI with sodium benzoate does not lead to statistically significant changes in intraocular pressure. The ocular surface condition does not change statistically significantly over a month of observation. Instillation discomfort is not related to the pH of the preparation.

<sup>99m</sup>Tc-1-Thio-D-Glucose in Lymphoma Patients: Safety, Pharmacokinetics and Dosimetric Characteristics

Purpose : To study the safety of 99m Tc-1-Thio-D-Glucose ( 99m Tc-TG) using, as well as its pharmacokinetics and dosimetric characteristics. Material and methods : The pharmacokinetics of 99mTc-TG was studied in 12 patients with lymphomas. The study was performed after a bolus injection of 729 ± 102 MBq 99m Tc-TG. Whole body anterior and posterior planar imaging was performed at 2, 4, 6, and 24 hours post-injection. In addition, all patients underwent SPECT/CT scanning at 2 hours and only SPECT at 4 and 6 hours after injection. To determine the dynamics of 99m Tc-TG accumulation in organs and tissues, the corresponding regions of interest (ROI) were outlined on each of the scans. Absorbed doses were calculated using a specialized OLINDA/EXM 1.1 program using phantoms of adult women and men. Results : The study showed that the administration of 99m Tc-TG is well tolerated by patients and is not accompanied by any side effects. The specified radiopharmaceutical has favorable dosimetric properties. Thus, in the present study, effective doses ranged from 5.0 to 9.8 mSv. SPECT/CT revealed high uptake of 99m Tc-TG in all nodular lesions detected according to standard diagnostic methods. There was also agreement between visualization of extranodal lesions using 99m Tc-TG SPECT/CT and standard diagnostic methods in all cases of the brain, neck, chest and abdomen lesions. In our study, the use of 99m Tc-TG SPECT/CT allowed us to detect a bone lesion that was not visualized on CT. This finding was an indication for an additional MRI examination, which confirmed a lymphoma lesion of the humerus. 2 hours after the injection of 99m Tc-TG, the tumor-background ratio reached 3.3 ± 1.2, then decreased to 2.30 ± 1.42 after 4 hours and then did not change significantly, so the optimal time for performing SPECT is 2 hours after the introduction of 99m Tc-TG. Conclusion : 99m Tc-TG is well tolerated by patients and has favorable dosimetric properties. 99m Tc-TG SPECT/CT may become the only method for molecular imaging of lymphoma in patients living in countries and regions with limited or no access to PET.

Breathing Pattern Disorders Distinguished from Healthy Breathing Patterns Using Optoelectronic Plethysmography.

There is no gold standard diagnostic method for breathing pattern disorders (BPD) which is commonly diagnosed through the exclusion of other pathologies. Optoelectronic plethysmography (OEP) is a 3D motion capture technique that provides a comprehensive noninvasive assessment of chest wall during rest and exercise. The purpose of this study was to determine if OEP can distinguish between active individuals classified with and without BPD at rest and during exercise. Forty-seven individuals with a healthy breathing pattern (HBP) and twenty-six individuals with a BPD performed a submaximal exercise challenge. OEP measured the movement of the chest wall through the calculation of timing, percentage contribution, and phase angle breathing pattern variables. A mixed model repeated measures ANOVA analysed the OEP variables between the groups classified as HBP and BPD at rest, during exercise, and after recovery. At rest, regional contribution variables including ribcage percentage contribution (HBP: 71% and BPD: 69%), abdominal ribcage contribution (HBP: 13% and BPD: 11%), abdomen percentage contribution (HBP: 29% and BPD: 31%), and ribcage and abdomen volume index (HPB: 2.5 and BPD: 2.2) were significantly (p < 0.05) different between groups. During exercise, BPD displayed significantly (p < 0.05) more asynchrony between various thoracic compartments including the ribcage and abdomen phase angle (HBP: -1.9 and BPD: -2.7), pulmonary ribcage and abdomen phase angle (HBP: -0.5 and BPD, 0.5), abdominal ribcage and shoulders phase angle (HBP: -0.3 and BPD: 0.6), and pulmonary ribcage and shoulders phase angle (HBP: 0.2 and BPD: 0.6). Additionally, the novel variables inhale deviation (HBP: 8.8% and BPD: 19.7%) and exhale deviation (HBP: -10.9% and BPD: -17.6%) were also significantly (p < 0.05) different between the groups during high intensity exercise. Regional contribution and phase angles measured via OEP can distinguish BPD from HBP at rest and during exercise. Characteristics of BPD include asynchronous and thoracic dominant breathing patterns that could form part of future objective criteria for the diagnosis of BPD.