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Reumatologia Clinica Apr 2024Temporal arteritis (TA) is the most common form of systemic vasculitis. Its diagnosis is based on criteria proposed by the American College of Rheumatology (1990), and... (Observational Study)
Observational Study
UNLABELLED
Temporal arteritis (TA) is the most common form of systemic vasculitis. Its diagnosis is based on criteria proposed by the American College of Rheumatology (1990), and its treatment is high-dose corticosteroids. Our objective is to assess the cost of diagnosing TA, and secondarily, cost-effective analysis of different diagnostic strategies (clinical, biopsy, doppler ultrasound) and therapeutic strategies (corticosteroid suspension).
MATERIAL AND METHOD
Observational, retrospective study has been carried out on patients with AT (2012-2021). Demographic data, comorbidities, signs and symptoms suggestive of AT were collected. AT was diagnosed with a score ≥ 3 according to American College of Rheumatoloy criteria (ACR-SCORE). The costs of diagnosis and treatment modification were analysed.
RESULTS
Seventy-five patients have been included, median age 77 (46-87) years. Headache, temporal pain and jaw claudication were significant for the diagnosis of TA. Patients with a halo on Doppler ultrasound and a positive biopsy have significantly elevated ESR and CRP compared to patients who do not. The cost of the AT diagnosis was 414.7 euros/patient. If we use ACR-SCORE ≥ 3-echodoppler it is 167.2 є/patient (savings 59.6%) and ACR-SCORE ≥ 3-biopsy 339.75 є/patient (savings 18%). If the corticosteroid was removed and a biopsy was performed, 21.6 є/patient (94.7% savings), if the corticosteroid was removed and Doppler ultrasound was performed, 10.6 є/patient (97.4% savings).
CONCLUSIONS
Headache, temporary pain and jaw claudication are predictors of AT. Elevated ESR and CRP are predictors of positive biopsy and presence of halo on ultrasound. The uses of ACR-SCORE ≥ 3 with Doppler ultrasound or biopsy, and with corticosteroid suspension, are cost-effective.
Topics: Humans; Giant Cell Arteritis; Retrospective Studies; Aged; Cost-Benefit Analysis; Female; Male; Middle Aged; Aged, 80 and over; Ultrasonography, Doppler; Biopsy; Cost-Effectiveness Analysis
PubMed: 38614886
DOI: 10.1016/j.reumae.2024.04.003 -
Medical Ultrasonography Sep 2023Portal Venous Gas (PVG) provides an important differential diagnosis in the diagnose of intrahepatic reflexogenic structures. This review article is intended to provide... (Review)
Review
Portal Venous Gas (PVG) provides an important differential diagnosis in the diagnose of intrahepatic reflexogenic structures. This review article is intended to provide an overview of the current literature on the detection of PVG, its special forms and important differential diagnoses, it also shows possibilities for the diagnostic procedure in the case of sonographic detection of PVG.
Topics: Humans; Gases; Portal Vein; Ultrasonography; Diagnosis, Differential; Tomography, X-Ray Computed
PubMed: 36780605
DOI: 10.11152/mu-4010 -
The Journal of Infectious Diseases Dec 2023The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic posed an unpreceded threat to the management of other pandemics such as human... (Observational Study)
Observational Study
BACKGROUND
The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic posed an unpreceded threat to the management of other pandemics such as human immunodeficiency virus-1 (HIV-1) in the United States. The full impact of the SARS-CoV-2 pandemic on the HIV-1 pandemic needs to be evaluated.
METHODS
All individuals with newly reported HIV-1 diagnoses from NC State Laboratory of Public Health were enrolled in this prospective observational study, 2018-2021. We used a sequencing-based recency assay to identify recent HIV-1 infections and to determine the days postinfection (DPI) for each person at the time of diagnosis.
RESULTS
Sequencing used diagnostic serum samples from 814 individuals with new HIV-1 diagnoses spanning this 4-year period. Characteristics of individuals diagnosed in 2020 differed from those in other years. People of color diagnosed in 2021 were on average 6 months delayed in their diagnosis compared to those diagnosed in 2020. There was a trend that genetic networks were more known for individuals diagnosed in 2021. We observed no major integrase resistance mutations over the course of the study.
CONCLUSIONS
SARS-CoV-2 pandemic may contribute to the spread of HIV-1. Public health resources need to focus on restoring HIV-1 testing and interrupting active, ongoing, transmission.
Topics: Humans; United States; SARS-CoV-2; COVID-19; HIV-1; Pandemics; High-Throughput Nucleotide Sequencing; COVID-19 Testing
PubMed: 37283544
DOI: 10.1093/infdis/jiad211 -
Basic and Clinical Neuroscience 2023Autism spectrum disorder (ASD) is a neurodevelopmental disorder with symptoms appearing from early childhood. Behavioral modifications, special education, and medicines... (Review)
Review
INTRODUCTION
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with symptoms appearing from early childhood. Behavioral modifications, special education, and medicines are used to treat ASD; however, the effectiveness of the treatments depends on early diagnosis of the disorder. The primary approach in diagnosing ASD is based on clinical interviews and valid scales. Still, methods based on brain imaging could also be possible diagnostic biomarkers for ASD.
METHODS
To identify the amount of information the functional magnetic resonance imaging (fMRI) reveals on ASD, we reviewed 292 task-based fMRI studies on ASD individuals. This study is part of a systematic review with the registration number CRD42017070975.
RESULTS
We observed that face perception, language, attention, and social processing tasks were mainly studied in ASD. In addition, 73 brain regions, nearly 83% of brain grey matter, showed an altered activation between the ASD and normal individuals during these four tasks, either in a lower or a higher activation.
CONCLUSION
Using imaging methods, such as fMRI, to diagnose and predict ASD is a great objective; research similar to the present study could be the initial step.
PubMed: 38628837
DOI: 10.32598/bcn.2021.1774.3 -
International Journal of Paleopathology Mar 2024This research aimed to address the underrepresentation of smallpox (osteomyelitis variolosa) in palaeopathology, providing a synthesis of published literature and... (Review)
Review
OBJECTIVE
This research aimed to address the underrepresentation of smallpox (osteomyelitis variolosa) in palaeopathology, providing a synthesis of published literature and presenting guidance for the identification of osteomyelitis variolosa in non-adult and adult skeletal remains.
MATERIALS AND METHODS
Literature regarding smallpox and published reports of individuals with osteomyelitis variolosa were synthesised and critiqued to produce clear diagnostic criteria for the identification of smallpox osteologically.
RESULTS
Associated osteological changes begin in non-adults, where skeletal morphology is rapidly changing. Characteristic lesions associated with non-adult osteomyelitis variolosa include inflammation and destructive remodelling of long-bone joints and metaphyses. Where childhood infection was survived, residual osteomyelitis variolosa lesions should also be visible in adults in the osteoarchaeological record.
CONCLUSIONS
Despite long-term clinical recognition, only limited osteological and archaeological evidence of osteomyelitis variolosa has yet emerged. With improved diagnostic criteria, osteomyelitis variolosa may be more frequently identified.
SIGNIFICANCE
This is the first synthesis of osteomyelitis variolosa encompassing both clinical and palaeopathological literature, providing detailed guidance for the identification of osteomyelitis variolosa in skeletal remains. It will lead to the increased identification of smallpox osteologically.
LIMITATIONS
Differential diagnoses should always be considered. The archaeological longevity of smallpox, and the potential for archaeological VARV to cause clinically recognised smallpox, is currently unknown. Characteristic bone changes in the archaeological record may be other, extinct human-infecting-orthopoxviruses.
SUGGESTIONS FOR FURTHER RESEARCH
Further consideration of the implications of age of smallpox contraction on bony pathology: whether epiphyses are affected differently due to state of fusion. Reassessment of individuals previously identified with smallpox-consistent lesions, but otherwise diagnosed.
Topics: Adult; Humans; Child; Smallpox; Body Remains; Variola virus; Osteomyelitis; Diagnosis, Differential
PubMed: 38159426
DOI: 10.1016/j.ijpp.2023.12.002 -
Frontiers in Public Health 2023Early detection of prediabetes and diabetes better prevents long-term health complications. FPG and HbA1c levels are some common laboratory tests utilized as tools to...
Discrepancy in diagnoses of diabetes and prediabetes using fasting plasma glucose and glycosylated hemoglobin and the underdiagnosis by ICD-10 coding: data from a tertiary hospital in Thailand.
BACKGROUND
Early detection of prediabetes and diabetes better prevents long-term health complications. FPG and HbA1c levels are some common laboratory tests utilized as tools to diagnose diabetes and prediabetes, but the agreement rate between these two diagnostic tests varies, which could lead to underdiagnosis and thus undertreatment. This study aimed to analyze the agreement rate between FPG and HbA1c, as well as the physicians' accuracy of using these results to make a prediabetes or diabetes diagnosis through ICD-10 coding at a tertiary care hospital in Bangkok, Thailand.
METHODS
A cross-sectional descriptive study was conducted using secondary data collected in a tertiary hospital's check-up clinic from August 16, 2019 to June 30, 2022 to study the prevalence and diagnosis of diabetes and prediabetes, determined through FPG and HbA1c laboratory results. We analyzed the two laboratory tests' diagnosis agreement rate and the physicians' accuracy of diagnosing diabetes and prediabetes in ICD-10 coding using the FPG and HbA1c results.
RESULTS
Among 8,024 asymptomatic participants, the period prevalence diagnosed through laboratory results was 5.8% for diabetes and 19.8% for prediabetes. Diabetes and prediabetes prevalence based on laboratory data differs from that of ICD-10 coding data. Specifically, 79.6% of diabetes patients and 32.3% of prediabetes patients were coded using the ICD-10 coding system. 4,094 individuals had both FPG and HbA1c data. The agreement rate for diagnosing diabetes and prediabetes between the two laboratory results is 89.5%, with Kappa statistics of 0.58. Using only one of the two laboratory results would have missed a substantial number of patients.
CONCLUSION
Our findings highlight screening test discrepancies and underdiagnosis issues that impede diagnostic accuracy enhancement and refined patient management strategies. Early diagnoses of prediabetes and diabetes, especially before symptoms arise, could increase health consciousness in individuals, thereby enabling the implementation of lifestyle modifications and prevention of serious health complications. We emphasize the importance of diagnosing these conditions using both FPG and HbA1c, along with subsequent accurate ICD-10 coding. Even though some hospitals lack certified HbA1c testing, we suggest enhancing the availability of HbA1c testing, which could benefit many people in Thailand.:https://www.thaiclinicaltrials.org, identifier [TCTR20230824003].
Topics: Humans; Prediabetic State; Glycated Hemoglobin; Tertiary Care Centers; Blood Glucose; Cross-Sectional Studies; International Classification of Diseases; Thailand; Diabetes Mellitus; Fasting
PubMed: 38192568
DOI: 10.3389/fpubh.2023.1322480 -
Nature Communications Apr 2024The diagnosis of inherited retinal degeneration (IRD) is challenging owing to its phenotypic and genotypic complexity. Clinical information is important before a genetic...
The diagnosis of inherited retinal degeneration (IRD) is challenging owing to its phenotypic and genotypic complexity. Clinical information is important before a genetic diagnosis is made. Metabolomics studies the entire picture of bioproducts, which are determined using genetic codes and biological reactions. We demonstrated that the common diagnoses of IRD, including retinitis pigmentosa (RP), cone-rod dystrophy (CRD), Stargardt disease (STGD), and Bietti's crystalline dystrophy (BCD), could be differentiated based on their metabolite heatmaps. Hundreds of metabolites were identified in the volcano plot compared with that of the control group in every IRD except BCD, considered as potential diagnosing markers. The phenotypes of CRD and STGD overlapped but could be differentiated by their metabolomic features with the assistance of a machine learning model with 100% accuracy. Moreover, EYS-, USH2A-associated, and other RP, sharing considerable similar characteristics in clinical findings, could also be diagnosed using the machine learning model with 85.7% accuracy. Further study would be needed to validate the results in an external dataset. By incorporating mass spectrometry and machine learning, a metabolomics-based diagnostic workflow for the clinical and molecular diagnoses of IRD was proposed in our study.
Topics: Humans; Metabolomics; Diagnosis, Differential; Retinal Degeneration; Machine Learning; Male; Female; Retinitis Pigmentosa; Stargardt Disease; Adult; Middle Aged; Adolescent; Young Adult; Biomarkers; Metabolome; Child; Cone-Rod Dystrophies; Mass Spectrometry; Macular Degeneration
PubMed: 38670966
DOI: 10.1038/s41467-024-47911-3 -
Pediatric Surgery International Nov 2023To determine the utility of contrast-enhanced voiding urography (CeVUS) in the treatment of vesicoureteral reflux (VUR) through ureterovesical reimplantation in children. (Review)
Review
BACKGROUND
To determine the utility of contrast-enhanced voiding urography (CeVUS) in the treatment of vesicoureteral reflux (VUR) through ureterovesical reimplantation in children.
METHODS
A total of 159 children with recurrent urinary tract infections were selected for CeVUS and voiding cystourethrography (VCUG) from December 2018 to December 2020, among whom 78 patients were eventually diagnosed with VUR. Overall, 60 pyelo-ureteric units (PUUs) were operated according to surgical indications. Accordingly, we determined the general clinical characteristics of all children, obtained two-dimensional ultrasound images, assessed the reflux status of children using the contrast-enhanced technique, and compared the obtained results via CeVUS and VCUG. Both imaging modalities were reperformed at 6, 12, and 18 months after surgery to evaluate postoperative outcomes. In particular, we assessed the consistency of the evaluation and calculated the diagnostic efficacy of CeVUS for different levels of reflux at different time points.
RESULTS
CeVUS showed considerable efficacy in the diagnosis of children with VUR. Notably, the diagnostic results of both CeVUS and VCUG achieved high agreement, with a kappa value of 0.966 (P < 0.001). The results of our follow-up at different stages and evaluation of postoperative efficacy revealed that CeVUS possessed substantial diagnostic efficacy and good consistency with VCUG.
CONCLUSION
CeVUS is an accurate and safe examination, with considerable clinical significance for diagnosing VUR in children, determining the treatment approach, conducting follow-up during treatment, and evaluating subsequent treatment outcomes.
Topics: Child; Humans; Infant; Vesico-Ureteral Reflux; Contrast Media; Ultrasonography; Urography; Ureter; Urination
PubMed: 38006461
DOI: 10.1007/s00383-023-05605-9 -
PloS One 2023In this review, we assessed the diagnostic efficiency of artificial intelligence (AI) models in detecting temporomandibular joint osteoarthritis (TMJOA) using... (Meta-Analysis)
Meta-Analysis
Artificial intelligence for detecting temporomandibular joint osteoarthritis using radiographic image data: A systematic review and meta-analysis of diagnostic test accuracy.
In this review, we assessed the diagnostic efficiency of artificial intelligence (AI) models in detecting temporomandibular joint osteoarthritis (TMJOA) using radiographic imaging data. Based upon the PRISMA guidelines, a systematic review of studies published between January 2010 and January 2023 was conducted using PubMed, Web of Science, Scopus, and Embase. Articles on the accuracy of AI to detect TMJOA or degenerative changes by radiographic imaging were selected. The characteristics and diagnostic information of each article were extracted. The quality of studies was assessed by the QUADAS-2 tool. Pooled data for sensitivity, specificity, and summary receiver operating characteristic curve (SROC) were calculated. Of 513 records identified through a database search, six met the inclusion criteria and were collected. The pooled sensitivity, specificity, and area under the curve (AUC) were 80%, 90%, and 92%, respectively. Substantial heterogeneity between AI models mainly arose from imaging modality, ethnicity, sex, techniques of AI, and sample size. This article confirmed AI models have enormous potential for diagnosing TMJOA automatically through radiographic imaging. Therefore, AI models appear to have enormous potential to diagnose TMJOA automatically using radiographic images. However, further studies are needed to evaluate AI more thoroughly.
Topics: Humans; Artificial Intelligence; ROC Curve; Temporomandibular Joint; Osteoarthritis; Diagnostic Tests, Routine
PubMed: 37450501
DOI: 10.1371/journal.pone.0288631 -
European Review For Medical and... Nov 2023The aim of this study was to investigate if inflammation biomarkers elabela, visfatin, and chemerin will be useful in the diagnosis of patients with COVID-19.
OBJECTIVE
The aim of this study was to investigate if inflammation biomarkers elabela, visfatin, and chemerin will be useful in the diagnosis of patients with COVID-19.
PATIENTS AND METHODS
This prospective case-control study included 33 patients with COVID-19 and 30 healthy matched controls. 33 patients, aged 18 years and older, diagnosed with COVID-19 and followed up for one month were included in the study. Blood samples were taken from the patients on the first day they were diagnosed with COVID-19, and levels of elabela (ELA), visfatin, chemerin, white blood cells (WBC), C-reactive protein (CRP) and procalcitonin (PCT) were assessed. Blood samples were also taken from 30 healthy volunteers for the control group. The ELA, visfatin and chemerin levels measured in the patients on day one were compared with those measured in the control group and with the WBC, CRP and PCT levels measured in the patients.
RESULTS
Visfatin levels measured in COVID-19 patients were significantly higher than in the healthy control group. There was no significant difference in ELA and chemerin levels between the two groups. A significant positive correlation was found between chemerin and visfatin levels in the patients. A significant negative correlation was found between the levels of ELA-chemerin and ELA-visfatin in the patients. There was no significant correlation between elabela, visfatin and chemerin levels and WBC, CRP, PCT levels.
CONCLUSIONS
Measurement of visfatin levels may be helpful in patients with COVID-19. However, two other biomarkers in our study, ELA and chemerin, were found not to be useful in diagnosing COVID-19. New inflammatory biomarkers may help to diagnose a disease in which the inflammatory response is at the forefront, such as COVID-19. New studies are needed on this subject.
Topics: Humans; Nicotinamide Phosphoribosyltransferase; Case-Control Studies; COVID-19; Biomarkers; Inflammation; C-Reactive Protein
PubMed: 38039049
DOI: 10.26355/eurrev_202311_34487