Standardized Diagnostic Approach Research Articles

Recommendations for clinical implementation of blood-based biomarkers for Alzheimer's disease.

Blood-based biomarkers (BBM) for Alzheimer's disease (AD) are being increasingly used in clinical practice to support an AD diagnosis. In contrast to traditional diagnostic modalities, such as amyloid positron emission tomography and cerebrospinal fluid biomarkers, BBMs offer a more accessible and lower cost alternative for AD biomarker testing. Their unique scalability addresses the anticipated surge in demand for biomarker testing with the emergence of disease-modifying treatments (DMTs) that require confirmation of amyloid pathology. To facilitate the uptake of BBMs in clinical practice, The Global CEO Initiative on Alzheimer's Disease convened a BBM Workgroup to provide recommendations for two clinical implementational pathways for BBMs: one for current use for triaging and another for future use to confirm amyloid pathology. These pathways provide a standardized diagnostic approach with guidance on interpreting BBM test results. Integrating BBMs into clinical practice will simplify the diagnostic process and facilitate timely access to DMTs for eligible patients.

Challenges in Hypophosphatasia: Suspicion, Diagnosis, Genetics, Management, and Follow-Up.

Hypophosphatasia (HPP) is a rare genetic disorder caused by loss-of-function variants in the ALPL gene, leading to deficient tissue-nonspecific alkaline phosphatase (ALP) activity. This results in a distinctive biochemical profile marked by low serum ALP levels and elevated pyridoxal-5-phosphate (PLP). The clinical spectrum of HPP ranges from perinatal lethality to asymptomatic cases, presenting significant diagnostic and therapeutic challenges. Diagnosis of HPP relies on identifying the characteristic biochemical signature (low ALP, high PLP), concomitant with skeletal (osteomalacia, rickets, pseudofracture) or extraskeletal (muscle weakness, musculoskeletal pain, dental) manifestations. Current diagnostic frameworks lack uniformity, highlighting the imperative for a standardized diagnostic approach. Molecular genetic testing plays a pivotal role in making the diagnosis of HPP, but difficulties persist in diagnosing milder cases and correlating genotypes with phenotypes. Comprehensive multidisciplinary care is indispensable, with enzyme replacement therapy (ERT) proving efficacious in severe cases and more nuanced management approaches for milder presentations. Overcoming challenges in ERT initiation, treatment response assessment, dose titrations, and long-term surveillance necessitates further refinement of management guidelines. Mild forms of HPP and asymptomatic carriers of pathogenic ALPL variants pose substantial diagnosis and management challenges. Developing consensus-driven guidelines is crucial to enhance clinical outcomes and patient care.

A Misdiagnosed Familiar Brooke-Spiegler Syndrome: Case Report and Review of the Literature.

Aim of the report: Brooke-Spiegler syndrome (BSS) is a rare autosomal dominant disease characterized by the growth of cylindromas, spiradenomas, trichoepitheliomas, or their combination. These neoplasms usually begin in the second decade and progressively increase in number and size over the years. Diagnosis necessitates consideration of family history, clinical examination, histological findings, and genetic analysis. The aim of this paper is to explore the clinical overlap between Brooke-Spiegler syndrome (BSS) and neurofibromatosis type 1 (NF1). We aim to highlight the challenges associated with their differential diagnosis and emphasize the lack of standardized diagnostic criteria and treatment approaches. Case presentation: Hereby, we introduce the case of a 28-year-old male referred for suspicion of neurofibromatosis type 1 (NF1) who initially declined the recommended surgical excision for a scalp mass. After four years, he returned with larger masses of the scalp, and underwent excision of multiple masses, revealing cylindromas, spiradenomas, and spiradenocylindromas. Family history reported similar tumors in his father, who was also diagnosed with NF1 for the presence of multiple subcutaneous lesions on the scalp. Clinical overlap led to a genetic consultation, but testing for CYLD mutations yielded no significant variations. Despite this, the strong family history and consistent findings led to a revised diagnosis of Brooke-Spiegler syndrome, correcting the initial misdiagnosis of NF1 syndrome. Conclusions: Thanks to the evolving landscape of BSS research over the past two decades, its molecular underpinnings, clinical presentation, and histopathological features are now clearer. However, a thorough family history assessment is mandatory when BSS is suspected. It is our belief that a multidisciplinary approach and cooperation between specialists are essential when dealing with BSS. By sharing this case, we hope to underscore the importance of considering BSS as a differential diagnosis, especially in cases with atypical presentations or overlapping features with other syndromes like NF1.

Real-life management of patients with mild cognitive impairment: an Italian survey

BackgroundMild cognitive impairment (MCI) is a syndrome with heterogeneous underlying causes and different rates of disease progression, whose clinical heterogeneity leads to a wide variation in diagnostic and therapeutic approaches in clinical practice. The lack of uniform practical recommendations on diagnostic workup and treatment for MCI patients hinders optimal management of these patients, worsening their prognosis. Standardized guidelines for the investigation and follow-up of MCI are therefore urgently required.AimAim of our study was to assess the diagnostic and therapeutic approach to MCI patients in the setting of Italian Memory Clinics.MethodsA survey was delivered to a sample of Italian neurologists through two different phases: a first exploratory phase recording general information about the usual clinical management of patients with MCI, and a subsequent operative phase assessing the practical diagnostic and therapeutic decisions taken in a real life setting to manage subjects with MCI.ResultsA total of 121 neurologists participated to the first phase of the survey and 203 patients were enrolled in the second phase. Information gathered in the first phase of the survey highlighted a non-uniform use of diagnostic criteria and procedures for MCI, as well as a very heterogeneous therapeutic strategy among Italian neurologists. In the second phase, recorded data on diagnostic and therapeutic approach confirmed the large variability observed in the first phase of the survey.ConclusionsThe results of our study reflect a suboptimal management of MCI patients in Italy and highlight the need of standardized diagnostic and therapeutic approaches for this condition.

Synchronous multiple neuroendocrine primary lung cancer with endobronchial extension in a never smoker - An unusual manifestation

Synchronous Lung Cancer primaries (SLC) are uncommon, with diverse underlying histology, constituting only a small proportion. The scarcity also poses a challenge in formulating a standardized diagnostic approach. Consequently, the diagnostic and staging challenges for SLC are heightened, particularly when the tumors are located on opposite sides of the chest. We report an exceptionally rare phenomenon in synchronous multiple primary lung cancers with simultaneous occurrence of two neuroendocrine tumors with endobronchial extension, small cell carcinoma and typical carcinoid tumor. Immunohistochemistry proved valuable in confirming the diagnosis. Given the poor prognosis associated with such cases, an accurate diagnosis is crucial for determining appropriate treatment options.

Evidence of helminthic infestation and efficacy of anthelminthic treatment in children investigated for eosinophilia

Background/Aim. The cause of eosinophilia often remains unelucidated. The aim of the study was to analyze causes and treatment approaches in children with eosinophilia in pediatric tertiary care hospital. Methods. The medical records of children investigated for eosinophilia (based on the International Classification of Diseases code D72.1) were retrospectively reviewed in the University Children?s Hospital, Belgrade, Serbia, from December 2011 to December 2022. A total of 105 children (62 boys; male:female ratio was 1:4) aged one month to 16.5 years (median 7.7 years) were diagnosed with eosinophilia. After excluding 15 of them due to incorrectly assigned diagnosis based on relative eosinophil number only, the remaining 90 children were grouped according to the severity of eosinophilia (mild, moderate or severe). Results. Serological analysis confirmed toxocariasis in six (6.7%) patients, while two (2.2%) had a confirmed nematode infestation (Ascaris lumbricoides and Enterobius vermicularis, respectively). Thirty-two (35.6%) children with eosinophilia and three with no true eosinophilia were diagnosed with helminthiasis ex juvantibus. Eosinophilia was ultimately explained by allergic/atopic conditions [19 (21.1%)], drug reactions [four (4.4%)], bacterial infections [nine (8.9%)], hematological problems [five (5.5%)], autoimmune disorders [three (3.3%)], unrelated congenital disorders (one), or as an isolated finding [seven (7.8%)]. In addition, one of the children without an increased absolute eosinophil number was diagnosed with eosinophilic esophagitis. A total of 56 (53.3%) children received anthelminthic treatment: 9 (90.0%) with severe eosinophilia, 19 (51.4%) with moderate, 23 (53.5%) with mild, and 5 (33.3%) children with no true eosinophilia. Most (42) of the children were given mebendazole only, while the remaining 14 (eight with severe, three with moderate, and three with mild) were also initially treated with mebendazole but subsequently shifted to albendazole due to the persistence of eosinophilia. In all treated children, eosinophilia and other relevant findings (if any) subsided in a matter of a few days to a few weeks after initializing treatment. Conclusion. Our results support the recommendation that unexplained eosinophilia of all levels of severity requires a standardized diagnostic approach. The results also provide some support for a potential rational basis for ex juvantibus administration of anthelminthic drugs in a fraction of children with eosinophilia without an obvious etiological explanation.

Fluoroquinolones for the Treatment of Tuberculosis: An Overview

According to the World Health Organization (WHO), tuberculosis (TB) remains one of the top 10 causes of death worldwide. Tuberculosis is a major global health threat. In 2022, an estimated 10 million people worldwide developed TB disease, and there were about 1.5 million TB-related deaths. TB primarily affects low- and middle-income countries, with the highest burden in Africa, Asia, and the Western Pacific regions. The WHO has launched the "End TB Strategy" with the aim of eliminating TB as a public health problem by 2035. Early diagnosis and prompt initiation of treatment are essential for effective TB control. WHO recommends a package of interventions known as "Directly Observed Treatment, Short-course" (DOTS) for TB control, which includes standardized diagnostic approaches, access to quality-assured drugs, and supportive treatment adherence measures. Tuberculosis (TB) remains a global health burden, necessitating the development of new therapeutic strategies. Fluoroquinolones (FQs) have emerged as promising agents in the treatment of TB due to their potent antimicrobial activity against Mycobacterium tuberculosis (Mtb) and their ability to penetrate intracellular compartments. This review aims to summarize the current knowledge on the use of FQs as antitubercular agents, highlighting their mechanisms of action, efficacy and limitations.

Proteomics-Based Approach for Detailing the Allergenic Profile of Cannabis Chemotypes.

Allergic sensitization to cannabis is an emerging public health concern and is difficult to clinically establish owing to lack of standardized diagnostic approaches. Attempts to develop diagnostic tools were largely hampered by the Schedule I restrictions on cannabis, which limited accessibility for research. Recently, however, hemp was removed from the classified list, and increased accessibility to hemp allows for the evaluation of its practical clinical value for allergy diagnosis. We hypothesized that the proteomic profile is preserved across different cannabis chemotypes and that hemp would be an ideal source of plant material for clinical testing. Using a proteomics-based approach, we examined whether distinct varieties of cannabis plant contain relevant allergens of cannabis. Cannabis extracts were generated from high tetrahydrocannabinol variety (Mx), high cannabidiol variety (V1-19) and mixed profile variety (B5) using a Plant Total Protein Extraction Kit. Hemp extracts were generated using other standardized methods. Protein samples were subjected to nanoscale tandem mass spectrometry. Acquired peptides sequences were examined against the Cannabis sativa database to establish protein identity. Non-specific lipid transfer protein (Can s 3) level was measured using a recently developed ELISA 2.0 assay. Proteomic analysis identified 49 distinct potential allergens in protein extracts from all chemotypes. Most importantly, clinically relevant and validated allergens, such as profilin (Can s 2), Can s 3 and Bet v 1-domain-containing protein 10 (Can s 5), were identified in all chemotypes at label-free quantification (LFP) intensities > 106. However, the oxygen evolving enhancer protein 2 (Can s 4) was not detected in any of the protein samples. Similarly, Can s 2, Can s 3 and Can s 5 peptides were also detected in hemp protein extracts. The validation of these findings using the ELISA 2.0 assay indicated that hemp extract contains 30-37 ng of Can s 3 allergen per µg of total protein. Our proteomic studies indicate that relevant cannabis allergens are consistently expressed across distinct cannabis chemotypes. Further, hemp may serve as an ideal practical substitute for clinical testing, since it expresses most allergens relevant to cannabis sensitization, including the validated major allergen Can s 3.

Deep Learning Classification of Drusen, Choroidal Neovascularization, and Diabetic Macular Edema in Optical Coherence Tomography (OCT) Images.

Background Age-related macular degeneration (AMD), diabetic retinopathy (DR), drusen, choroidal neovascularization (CNV), and diabetic macular edema (DME) are significant causes of visual impairment globally. Optical coherence tomography (OCT) imaging has emerged as a valuable diagnostic tool for these ocular conditions. However, subjective interpretation and inter-observer variability highlight the need for standardized diagnostic approaches. Methods This study aimed to develop a robust deep learning model using artificial intelligence (AI) techniques for the automated detection of drusen, CNV, and DME in OCT images. A diverse dataset of 1,528 OCT images from Kaggle.com was used for model training. The performance metrics, including precision, recall, sensitivity, specificity, F1 score, and overall accuracy, were assessed to evaluate the model's effectiveness. Results The developed model achieved high precision (0.99), recall (0.962), sensitivity (0.985), specificity (0.987), F1 score (0.971), and overall accuracy (0.987) in classifying diseased and healthy OCT images. These results demonstrate the efficacy and efficiency of the model in distinguishing between retinal pathologies. Conclusion The study concludes that the developed deep learning model using AI techniques is highly effective in the automated detection of drusen, CNV, and DME in OCT images. Further validation studies and research efforts are necessary to evaluate the generalizability and integration of the model into clinical practice. Collaboration between clinicians, policymakers, and researchers is essential for advancing diagnostic tools and management strategies for AMD and DR. Integrating this technology into clinical workflows can positively impact patient care, particularly in settings with limited access to ophthalmologists. Future research should focus on collecting independent datasets, addressing potential biases, and assessing real-world effectiveness. Overall, the use of machine learning algorithms in conjunction with OCT imaging holds great potential for improving the detection and management of drusen, CNV, and DME, leading to enhanced patient outcomes and vision preservation.

Beyond Aortic Stenosis: Addressing the Challenges of Multivalvular Disease Assessment.

Aortic stenosis (AS) can often coexist with other valvular diseases or be combined with aortic regurgitation (AR), leading to unique pathophysiological conditions. The combination of affected valves can vary widely, resulting in a lack of standardized diagnostic or therapeutic approaches. Echocardiography is crucial in assessing patients with valvular heart disease (VHD), but careful consideration of the hemodynamic interactions between combined valvular defects is necessary. This is important as it may affect the reliability of commonly used echocardiographic parameters, making the diagnosis challenging. Therefore, a multimodality imaging approach, including computed tomography or cardiac magnetic resonance, is often not just beneficial but crucial. It represents the future of diagnostics in this intricate field due to its unprecedented capacity to quantify and comprehend valvular pathology. The absence of definitive data and guidelines for the therapeutic management of AS in the context of multiple valve lesions makes this condition particularly challenging. As a result, an individualized, case-by-case approach is necessary, guided primarily by the recommendations for the predominant valve lesion. This review aims to summarize the pathophysiology of AS in the context of multiple and mixed valve disease, with a focus on the hemodynamic implications, diagnostic challenges, and therapeutic options.

The Coral Bleaching Automated Stress System (CBASS): A low‐cost, portable system for standardized empirical assessments of coral thermal limits

AbstractOcean warming is increasingly affecting marine ecosystems across the globe. Reef‐building corals are particularly affected by warming, with mass bleaching events increasing in frequency and leading to widespread coral mortality. Yet, some corals can resist or recover from bleaching better than others. Such variability in thermal resilience could be critical to reef persistence; however, the scientific community lacks standardized diagnostic approaches to rapidly and comparatively assess coral thermal vulnerability prior to bleaching events. We present the Coral Bleaching Automated Stress System (CBASS) as a low‐cost, open‐source, field‐portable experimental system for rapid empirical assessment of coral thermal thresholds using standardized temperature stress profiles and diagnostics. The CBASS consists of four or eight flow‐through experimental aquaria with independent water masses, lighting, and individual automated temperature controls capable of delivering custom modulating thermal profiles. The CBASS is used to conduct daily thermal stress exposures that typically include 3‐h temperature ramps to multiple target temperatures, a 3‐h hold period at the target temperatures, and a 1‐h ramp back down to ambient temperature, followed by an overnight recovery period. This mimics shallow water temperature profiles observed in coral reefs and prompts a rapid acute heat stress response that can serve as a diagnostic tool to identify putative thermotolerant corals for in‐depth assessments of adaptation mechanisms, targeted conservation, and possible use in restoration efforts. The CBASS is deployable within hours and can assay up to 40 coral fragments/aquaria/day, enabling high‐throughput, rapid determination of thermal thresholds for individual genotypes, populations, species, and sites using a standardized experimental framework.

Hypersensitivity pneumonitis: Principles in diagnosis and management.

Hypersensitivity pneumonitis: Principles in diagnosis and management.

Diagnostic approach and grading scheme for canine allergic conjunctivitis

BackgroundIn humans, allergic conjunctivitis is a well described disease. In contrast, allergic conjunctivitis has not received much attention from the veterinary community so far. Canine allergic conjunctivitis (cAC) is one of the possible manifestations associated with canine atopic dermatitis (cAD), being often underdiagnosed and undertreated. Our aim is to contribute to disease characterization and clinical stagingfor cAC severity.ResultsA retrospective observational study including 122 dogs that underwent a complete ophthalmological and dermatological examinations and diagnosed with allergic conjunctivitis was conducted. A total of six ophthalmic clinical signs were considered for disease characterization and clinical staging: conjunctival hyperemia, chemosis, ocular pruritus, epiphora, seromucoid to mucopurulent discharge and keratitis, classified from 0 (absent) to 3 (severe). Scores comprised between 1–5 were considered mild, 6–10 moderate and 11–18 severe. The majority of dogs (64%) presented with moderate cAC followed by 24% of mild stages and only 12% of severe presentations. The severity of allergic conjunctivitis was not correlated to sex or age at the time of diagnosis and all presented with a bilateral form of the disease. Chemosis (84%), hyperemia (83%) and ocular pruritus (79%) was observed in 55% of the cases. Seromucoid to mucopurulent discharge (62%) and epiphora (69%) were less frequent, with keratitis being the least encountered clinical sign (15%). The degree of keratitis showed a positive correlation with both severity and chronicity of cAC (rho = 0.21–0.29, p ≤ 0.02)). Severity of cAD and cAD were not significantly correlated (p-value = 0.4).Discussion and conclusionThe triad hyperemia, chemosis and ocular pruritus, already known in human medicine to be a reliable way of diagnosing human allergic conjunctivitis, also proved to be important in cAC Mild forms of the disease may pass unnoticed, ocular pruritus being hard to assess in canine patients.The proposed standardized diagnostic approach and novel grading scheme for cAC may be of value for both veterinary ophthalmologists and dermatologists, as well as general practitioners.

Proteomics-based approach for detailing allergenic profile of cannabis chemotypes

Allergic sensitization to cannabis is difficult to establish owing to lack of standardized diagnostic approaches. Using proteomics-based approach, we examined if distinct varieties of cannabis plant contain relevant allergens of cannabis.

Chronic Kidney Disease and Periodontitis Interplay-A Narrative Review.

Periodontitis (PO), a chronic microbially-induced inflammation of the supporting tissues of the tooth, is linked to various systemic diseases. We analyze its bidirectional relationship to chronic kidney disease (CKD), a major health-care problem with impressive excess mortality. Overwhelming associative relationship between CKD and PO are analyzed. Major pathophysiologic mechanisms that link CKD to PO are then presented: systemic inflammation, endothelial dysfunction, and imbalance of oxidative stress characteristic of CKD have a role in PO development and might influence escape mechanisms of oral microbiota. Subclinical local and systemic inflammation induced by PO might influence in turn CKD outcomes. Homeostatic changes induced by CKD such as mineral bone disorders, acidosis, uremic milieu, or poor salivary flow are also relevant for the occurrence of PO. There is insufficient evidence to recommend a standardized diagnostic and therapeutic approach regarding association of PO to CKD.

Can Prenatal Diagnosis of Total Anomalous Pulmonary Venous Return (TAPVR) Using Routine Fetal Ultrasound be Improved? A Case-Control Study.

To determine the most common fetal ultrasound markers of total anomalous pulmonary venous return (TAPVR) during mid-trimester ultrasound using standardly obtained images and evaluate the performance of diagnostic algorithms for improving prenatal diagnosis. This was a matched case-control study at a regional referral centre (2005 to 2019). Cases of TAPVR were matched to controls 1 : 4 by date of birth and biologic sex. Postprocessing review of stored fetal ultrasound images was performed by two blinded and independent observers in a standardized fashion using nine sonographic markers: (i) left/right heart disproportion; (ii) abnormal distribution of great vessels; (iii) pulmonary vein entry into the left atrium (LA); (iv) confluence behind the LA; (v) abnormal coronary sinus; (vi) absence of the Coumadin ridge; (vii) aortic diameter; (viii) distance between LA and aorta; and (ix) post-LA space index >1.27. Descriptive and inferential statistics were used to present results and compare cases and controls. Diagnostic algorithms were compared by sensitivity/specificity. 21 cases of isolated TAPVR were matched to 84 controls (n = 105). The most common ultrasound marker of TAPVR was absence of pulmonary vein entry into the LA (42.9%), followed by abnormal Coumadin ridge (38.1%). Cases of TAPVR had significantly larger post-LA spaces than controls (p < 0.0001) and wider aortic diameters (p=0.006). A diagnostic algorithm stratifying on absence of pulmonary veins followed by an abnormal Coumadin ridge, can correctly identify cases of TAPVR with high specificity (90.5%) and moderate sensitivity (61.9%). Conversely, a diagnostic algorithm using the presence of any 3 abnormal markers had improved specificity (94.1%) but poorer sensitivity (23.8%). Using standardly obtained images from routine fetal ultrasound, improved prenatal detection of isolated TAPVR is possible. A standardized diagnostic approach can be highly specific for fetal TAPVR, however, algorithms that are sufficiently sensitive for screening in the general population are still needed.

Issues of diagnostic search of soft tissue sarcoma

Relevance. Soft tissue sarcoma is a heterogeneous group of relatively rare types of tumors, which demonstrates a huge variety of anatomical localization and histopathological characteristics. The rarity of soft tissue sarcomas combined with a variety of subtypes, forms of growth, progression and frequency of relapses makes it difficult to study them, make a correct diagnosis and early referral of patients for specialized care.The purpose of study. To analyze the problem of differential diagnosis of malignant and benign soft tissue neoplasms.Materials and methods. In the course of the work, current literary sources of domestic and foreign authors on a given topic were analyzed.Results. Since it is absolutely impossible to determine the clinical features of the presented sarcoma, soft tissue tumors showing any of the following signs are considered malignant until the opposite is proven: increasing in size, &gt;5 cm, deeply located and/or painful. The greater the number of these clinical signs present, the higher the risk that the soft tissue tumor will turn out to be malignant; at the same time, an increase in size is the best individual indicator. It is worth noting that the absence of concomitant constitutional symptoms, such as fever, chills, night sweats or unintentional weight loss, should not reduce the doctor's suspicion of malignancy.Conclusion. In order to avoid erroneous diagnoses, a standardized diagnostic approach should be followed, starting from the moment of collecting the patient's medical history, clinical examination and ending with the use of appropriate imaging methods and biopsy.

Issues of diagnostic search of soft tissue sarcoma

Relevance. Soft tissue sarcoma is a heterogeneous group of relatively rare types of tumors, which demonstrates a huge variety of anatomical localization and histopathological characteristics. The rarity of soft tissue sarcomas combined with a variety of subtypes, forms of growth, progression and frequency of relapses makes it difficult to study them, make a correct diagnosis and early referral of patients for specialized care.The purpose of study. To analyze the problem of differential diagnosis of malignant and benign soft tissue neoplasms.Materials and methods. In the course of the work, current literary sources of domestic and foreign authors on a given topic were analyzed.Results. Since it is absolutely impossible to determine the clinical features of the presented sarcoma, soft tissue tumors showing any of the following signs are considered malignant until the opposite is proven: increasing in size, &gt;5 cm, deeply located and/or painful. The greater the number of these clinical signs present, the higher the risk that the soft tissue tumor will turn out to be malignant; at the same time, an increase in size is the best individual indicator. It is worth noting that the absence of concomitant constitutional symptoms, such as fever, chills, night sweats or unintentional weight loss, should not reduce the doctor's suspicion of malignancy.Conclusion. In order to avoid erroneous diagnoses, a standardized diagnostic approach should be followed, starting from the moment of collecting the patient's medical history, clinical examination and ending with the use of appropriate imaging methods and biopsy.

Progress in COVID research and developments during pandemic.

The pandemic respiratory disease COVID‐19 has spread over the globe within a small span of time. Generally, there are two important points are being highlighted and considered towards the successful diagnosis and treatment process. The first point includes the reduction of the rate of infections and the next one is the decrease of the death rate. The major threat to public health globally progresses due to the absence of effective medication and widely accepted immunization for the COVID‐19. Whereas, understanding of host susceptibility, clinical features, adaptation of COVID‐19 to new environments, asymptomatic infection is difficult and challenging. Therefore, a rapid and an exact determination of pathogenic viruses play an important role in deciding treatments and preventing pandemic to save the people's lives. It is urgent to fix a standardized diagnostic approach for detecting the COVID‐19. Here, this systematic review describes all the current approaches using for screening and diagnosing the COVID‐19 infectious patient. The renaissance in pathogen due to host adaptability and new region, facing creates several obstacles in diagnosis, drug, and vaccine development process. The study shows that adaptation of accurate and affordable diagnostic tools based on candidate biomarkers using sensor and digital medicine technology can deliver effective diagnosis services at the mass level. Better prospects of public health management rely on diagnosis with high specificity and cost‐effective manner along with multidisciplinary research, specific policy, and technology adaptation. The proposed healthcare model with defined road map represents effective prognosis system.

Treatment experience of post-COVID cognitive impairment (clinical observation)

Post-Cognitive Impairment, including in the young population, is an urgent medical and social problem. It is known that COVID-19, even in the absence of direct brain damage associated with covid-associated stroke or encephalitis, regardless of the severity of the infection during the acute period and the age of patients, can cause long-term and maladaptive cognitive impairment. The pathogenesis of these disorders is complex, and it is not completely clear today and continues to be actively studied. There is also no standardized diagnostic and therapeutic approach in the management of patients with post-COVID cognitive impairment. The presented clinical observation demonstrates the experience of treating cognitive impairment after COVID-19 in a young patient using the available knowledge of pathogenesis. A review of modern publications on the problem of post-COVID cognitive impairment was carried out. Based on the available literature data, the role of various pathogenetic factors in the development of post-covid cognitive impairment in the presented patient is discussed. Based on a specific clinical example, the rationale for the choice of treatment strategies and the need to further increase knowledge about the postCOVID syndrome, conduct future research in the field of pathogenesis, diagnosis and treatment of post-COVID cognitive impairment, which will create an evidence base for the development of clinical recommendations, is given.