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Medicina (Kaunas, Lithuania) May 2024Muscle properties are critical for performance and injury risk, with changes occurring due to physical exertion, aging, and neurological conditions. The MyotonPro... (Review)
Review
Muscle properties are critical for performance and injury risk, with changes occurring due to physical exertion, aging, and neurological conditions. The MyotonPro device offers a non-invasive method to comprehensively assess muscle biomechanical properties. This systematic review evaluates the reliability of MyotonPro across various muscles for diagnostic purposes. Following PRISMA guidelines, a comprehensive literature search was conducted in Medline (PubMed), Ovid (Med), Epistemonikos, Embase, Cochrane Library, Clinical trials.gov, and the WHO International Clinical Trials platform. Studies assessing the reliability of MyotonPro across different muscles were included. A methodological quality assessment was performed using established tools, and reviewers independently conducted data extraction. Statistical analysis involved summarizing intra-rater and inter-rater reliability measures across muscles. A total of 48 studies assessing 31 muscles were included in the systematic review. The intra-rater and inter-rater reliability were consistently high for parameters such as frequency and stiffness in muscles of the lower and upper extremities, as well as other muscle groups. Despite methodological heterogeneity and limited data on specific parameters, MyotonPro demonstrated promising reliability for diagnostic purposes across diverse patient populations. The findings suggest the potential of MyotonPro in clinical assessments for accurate diagnosis, treatment planning, and monitoring of muscle properties. Further research is needed to address limitations and enhance the applicability of MyotonPro in clinical practice. Reliable muscle assessments are crucial for optimizing treatment outcomes and improving patient care in various healthcare settings.
Topics: Humans; Reproducibility of Results; Muscle, Skeletal; Diagnostic Tests, Routine
PubMed: 38929468
DOI: 10.3390/medicina60060851 -
International Journal of Molecular... Jun 2024Haemoglobin disorders represent a heterogeneous group of inherited conditions that involve at least one genetic abnormality in one or more of the globin chains,... (Review)
Review
Haemoglobin disorders represent a heterogeneous group of inherited conditions that involve at least one genetic abnormality in one or more of the globin chains, resulting in changes in the structure, function, and/or amount of haemoglobin molecules, which are very important for their related clinical aspects. Detecting and characterizing these disorders depends primarily on laboratory methods that employ traditional approaches and, when necessary, newer methodologies essential for solving a number of diagnostic challenges. This review provides an overview of key laboratory techniques in the diagnosis of haemoglobinopathies, focusing on the challenges, advancements, and future directions in this field. Moreover, many haemoglobinopathies are benign and clinically silent, but it is not uncommon to find unexpected variants during routine laboratory tests. The present work reported a rare and clinically interesting case of identification of haemoglobin fractions in an adult man by the determination of glycated haemoglobin (HbA) during a routine laboratory assessment, highlighting how the correct use of laboratory data can modify and improve the patient's clinical management.
Topics: Humans; Hemoglobinopathies; Molecular Diagnostic Techniques; Hemoglobins; Male; Glycated Hemoglobin; Hemoglobins, Abnormal
PubMed: 38928486
DOI: 10.3390/ijms25126781 -
Health and Quality of Life Outcomes Jun 2024Colonoscopy is a valuable diagnostic tool but the procedure and the preparation for it cause anxiety and discomfort that impacts on patients' health-related quality of...
BACKGROUND
Colonoscopy is a valuable diagnostic tool but the procedure and the preparation for it cause anxiety and discomfort that impacts on patients' health-related quality of life (HRQoL). The 'disutility' of undergoing an invasive colonoscopy needs to be considered and accounted for in comprehensive cost-utility analyses that compare different diagnostic strategies, yet there is little empirical evidence that can be used in such studies. To fill this gap, we collected and analysed data on the effect of a colonoscopy examination on patients' HRQoL that can be used in economic evaluations.
METHODS
Patients scheduled to undergo a colonoscopy at a large NHS hospital were asked to complete the EuroQol EQ-5D-5 L instrument: (i) before the procedure, at the time of consent (T1), (ii) while undergoing bowel preparation (T2) and (iii) within 24 h after the procedure (T3). Complete responses were translated into preference-based HRQoL (utility) values using a UK-specific value set and were analysed using descriptive and inferential statistical analyses.
RESULTS
Two-hundred and seventy-one patients with gastrointestinal symptoms referred for a colonoscopy provided complete EQ-5D-5 L questionnaires at all three assessment points. At T1, the mean EQ-5D-5 L value was 0.76 (95%CI: 0.734-0.786). This value dropped to 0.727 at T2 (95%CI: 0.7-0.754, before increasing again to 0.794 (95%CI: 0.768-0.819) at T3. Both changes were statistically significant (p-value < 0.001).
CONCLUSIONS
Preference-based HRQoL (utility) values reported by patients undergoing a colonoscopy dropped during bowel preparation and rose again shortly after the colonoscopy. This pattern was largely consistent across patients with different characteristics, symptoms and diagnoses.
Topics: Humans; Colonoscopy; Quality of Life; Female; Male; Middle Aged; Surveys and Questionnaires; Aged; United Kingdom; Adult; Cost-Benefit Analysis
PubMed: 38926801
DOI: 10.1186/s12955-024-02262-x -
Scientific Reports Jun 2024Medial displacement calcaneal osteotomy (MDCO) is the standard procedure for flatfoot. We investigated the effect of MDCO on the foot using a finite element analysis....
Medial displacement calcaneal osteotomy (MDCO) is the standard procedure for flatfoot. We investigated the effect of MDCO on the foot using a finite element analysis. Foot models were created from computed tomography data of 8 patients with flat feet. MDCO was performed on each model with bone translation distance of 4, 8, and 12 mm. The morphological changes, plantar pressures, and stress percentage on the talocrural and subtalar joints were evaluated before and after surgery. Morphological evaluation showed improvement in the medial longitudinal arch. The stress percentage of plantar pressure in the medial area decreased, and the stress percentage of plantar pressure in the mid- and lateral forefoot area increased. At the talocrural joint, the medial and middle stress percentage increased, while the lateral and posterior stress percentage decreased. In the subtalar joint, the stress percentage in the middle subtalar joint increased and that in the posterior subtalar joint decreased. Within the posterior subtalar joint, the anterior and medial stress percentage increased, while the posterior and lateral stress percentage decreased. Preoperative simulation using the finite element analysis may be useful in understanding postoperative morphological changes and loading conditions to perform patient-specific surgery.
Topics: Humans; Flatfoot; Finite Element Analysis; Osteotomy; Male; Female; Calcaneus; Adult; Tomography, X-Ray Computed; Stress, Mechanical; Young Adult; Subtalar Joint; Weight-Bearing; Biomechanical Phenomena; Middle Aged
PubMed: 38926451
DOI: 10.1038/s41598-024-65565-5 -
Nihon Hoshasen Gijutsu Gakkai Zasshi Jun 2024We evaluated the measurement accuracy of the CubeScan BioCon-900 (here after BioCon-900), a portable ultrasound imaging diagnostic device capable of measuring bladder...
PURPOSE
We evaluated the measurement accuracy of the CubeScan BioCon-900 (here after BioCon-900), a portable ultrasound imaging diagnostic device capable of measuring bladder volume, to determine if it can accurately assess bladder volume before intensity-modulated radiation therapy (IMRT) for prostate cancer.
METHODS
Bladder volume was measured from kV-Cone Beam computed tomography (CBCT) images obtained immediately before the administration of IMRT for prostate cancer using Halcyon. The bladder volume measured from kV-CBCT images (23 patients, total number of scans: 139) immediately before the IMRT procedure was used as the reference value. The difference between the bladder volume measured by the BioCon-900 was then calculated.
RESULTS
The bladder volume measured from kV-CBCT images was 117.5±49.4 cc. In contrast, the bladder volume obtained with BioCon-900 was 104.1±48.6 ml, resulting in an absolute mean difference of 18.4% and a correlation coefficient of 0.881. The measurements by BioCon-900 tended to be, on average, 11% smaller than the bladder volume measured by kV-CBCT imaging.
CONCLUSION
kV-CBCT images demonstrated a strong positive correlation between bladder volume and bladder urine output obtained with BioCon-900. BioCon-900 can be used before kV-CBCT imaging to accurately and conveniently assess bladder volume.
PubMed: 38925920
DOI: 10.6009/jjrt.2024-1461 -
Science Advances Jun 2024Lip language recognition urgently needs wearable and easy-to-use interfaces for interference-free and high-fidelity lip-reading acquisition and to develop accompanying...
Lip language recognition urgently needs wearable and easy-to-use interfaces for interference-free and high-fidelity lip-reading acquisition and to develop accompanying data-efficient decoder-modeling methods. Existing solutions suffer from unreliable lip reading, are data hungry, and exhibit poor generalization. Here, we propose a wearable lip language decoding technology that enables interference-free and high-fidelity acquisition of lip movements and data-efficient recognition of fluent lip language based on wearable motion capture and continuous lip speech movement reconstruction. The method allows us to artificially generate any wanted continuous speech datasets from a very limited corpus of word samples from users. By using these artificial datasets to train the decoder, we achieve an average accuracy of 92.0% across individuals ( = 7) for actual continuous and fluent lip speech recognition for 93 English sentences, even observing no training burn on users because all training datasets are artificially generated. Our method greatly minimizes users' training/learning load and presents a data-efficient and easy-to-use paradigm for lip language recognition.
Topics: Humans; Wearable Electronic Devices; Speech; Language; Lip; Movement; Male; Female; Adult; Lipreading; Motion Capture
PubMed: 38924408
DOI: 10.1126/sciadv.ado9576 -
Cancer Medicine Jun 2024Accurate characterization of newly diagnosed a solid adnexal lesion is a key step in defining the most appropriate therapeutic approach. Despite guidance from the...
BACKGROUND
Accurate characterization of newly diagnosed a solid adnexal lesion is a key step in defining the most appropriate therapeutic approach. Despite guidance from the International Ovarian Tumor Analyzes Panel, the evaluation of these lesions can be challenging. Recent studies have demonstrated how machine learning techniques can be applied to clinical data to solve this diagnostic problem. However, ML models can often consider as black-boxes due to the difficulty of understanding the decision-making process used by the algorithm to obtain a specific result.
AIMS
For this purpose, we propose an Explainable Artificial Intelligence model trained on clinical characteristics and qualitative ultrasound indicators to predict solid adnexal masses diagnosis.
MATERIALS & METHODS
Since the diagnostic task was a three-class problem (benign tumor, invasive cancer, or ovarian metastasis), we proposed a waterfall classification model: a first model was trained and validated to discriminate benign versus malignant, a second model was trained to distinguish nonmetastatic versus metastatic malignant lesion which occurs when a patient is predicted to be malignant by the first model. Firstly, a stepwise feature selection procedure was implemented. The classification performances were validated on Leave One Out scheme.
RESULTS
The accuracy of the three-class model reaches an overall accuracy of 86.36%, and the precision per-class of the benign, nonmetastatic malignant, and metastatic malignant classes were 86.96%, 87.27%, and 77.78%, respectively.
DISCUSSION
SHapley Additive exPlanations were performed to visually show how the machine learning model made a specific decision. For each patient, the SHAP values expressed how each characteristic contributed to the classification result. Such information represents an added value for the clinical usability of a diagnostic system.
CONCLUSIONS
This is the first work that attempts to design an explainable machine-learning tool for the histological diagnosis of solid masses of the ovary.
Topics: Humans; Female; Machine Learning; Ultrasonography; Ovarian Neoplasms; Middle Aged; Adult; Adnexal Diseases; Aged; Algorithms; Diagnosis, Differential
PubMed: 38923847
DOI: 10.1002/cam4.7425 -
Clinics and Practice Jun 2024Emergency medicine in Romania has developed fast since inception. The need for faster diagnostic capabilities due to the high workload pre- and in-hospital made...
BACKGROUND
Emergency medicine in Romania has developed fast since inception. The need for faster diagnostic capabilities due to the high workload pre- and in-hospital made point-of-care ultrasound (POCUS) a logical next step. The advantages of POCUS are well known, but implementation presents challenges. Our goal was to study how a straightforward method of implementation would work locally.
METHODS
Two prospective observational studies were conducted at 6 months (prehospital) and 4 months (in-hospital). The protocol used was extended focused assessment sonography in trauma (eFAST), and the shock index (SI) was used to stratify patients. Voluntary sampling was conducted by emergency physicians. The primary outcomes were patient numbers, type of case use, results, and accuracy.
RESULTS
The prehospital study registered 34 patients: 41% traumas, 35% cardiac arrest, 18% shock, and 6% acute respiratory distress. The in-hospital study patients were 78: 36% traumas, 6% cardiac arrests, 41% shock, and 17% acute respiratory distress. A total of 88.5% of the cases were confirmed with definitive imagistic findings.
CONCLUSION
The studies mark an increase in POCUS usage and use in complicated cases. Providing supervision and feedback into clinical practice resulted in a further increase in POCUS usage, the second study having an 88.5% accuracy when compared to the final diagnostic proving the increased efficiency of a longitudinal training approach.
PubMed: 38921268
DOI: 10.3390/clinpract14030090 -
Microbiology Spectrum Jun 2024Primary cerebral phaeohyphomycosis is a life-threatening disease caused by neurotropic dematiaceous fungi. At present, there are no consensus guidelines regarding...
Primary cerebral phaeohyphomycosis is a life-threatening disease caused by neurotropic dematiaceous fungi. At present, there are no consensus guidelines regarding optimal antifungal therapy in such cases. Generally, a combination of antifungal agents is recommended for treatment. However, the activities of antifungal combinations against these fungi have not been investigated. In this study, we evaluated the activities of 13 double and five triple antifungal combinations against clinical isolates of ( = 7), ( = 2), and ( = 1), using a simplified checkerboard procedure. The minimum inhibitory concentrations (MICs) of nine antifungal drugs were determined by the broth microdilution method, and the interaction between antifungal agents in each combination was assessed by the fractional inhibitory concentration index. Excellent activity was observed for posaconazole and itraconazole. Flucytosine had potent activity against but was ineffective against , and . The echinocandins demonstrated high MICs for all the isolates. Synergistic interactions were observed for all the double combinations, except when itraconazole was combined with either amphotericin B or flucytosine. The combination of amphotericin B with caspofungin showed synergistic interactions against 40% of the isolates. Antagonism was observed with isavuconazole-flucytosine combination against two isolates. The triple combinations of caspofungin and flucytosine with amphotericin B or posaconazole were synergistic against one isolate of . For , synergy was observed for the triple combination of amphotericin B with caspofungin and flucytosine. Our results indicate that combination of caspofungin with amphotericin B or a triazole, with or without 5-flucytosine has great potential against neurotropic dematiaceous fungi.IMPORTANCEThis research uses a modified version of the checkerboard assay to standardize the testing of double and triple combinations of antifungal agents against neurotropic dematiaceous fungi. Antifungal combination therapy is associated with improved outcomes in cerebral phaeohyphomycosis. In this study, we demonstrate that posaconazole is the single most active antifungal drug against this group of fungi. The double combination of amphotericin B with caspofungin or a trizole, and the triple combinations of caspofungin and flucytosine with amphotericin B or posaconazole might hold promise in the treatment of cerebral phaeohyphomycosis. Our findings will guide in developing optimal therapeutic strategies for these refractory infections.
PubMed: 38920376
DOI: 10.1128/spectrum.00781-24 -
Frontiers in Immunology 2024Resection of colorectal liver metastasis is the standard of care for patients with Stage IV CRC. Despite undoubtedly improving the overall survival of patients, pHx for...
BACKGROUND
Resection of colorectal liver metastasis is the standard of care for patients with Stage IV CRC. Despite undoubtedly improving the overall survival of patients, pHx for colorectal liver metastasis frequently leads to disease recurrence. The contribution of this procedure to metastatic colorectal cancer at a molecular level is poorly understood. We designed a mouse model of orthograde metastatic colorectal cancer (CRC) to investigate the effect of partial hepatectomy (pHx) on tumor progression.
METHODS
CRC organoids were implanted into the cecal walls of wild type mice, and animals were screened for liver metastasis. At the time of metastasis, 1/3 partial hepatectomy was performed and the tumor burden was assessed longitudinally using MRI. After euthanasia, different tissues were analyzed for immunological and transcriptional changes using FACS, qPCR, RNA sequencing, and immunohistochemistry.
RESULTS
Mice that underwent pHx presented significant liver hypertrophy and an increased overall metastatic load compared with SHAM operated mice in MRI. Elevation in the metastatic volume was defined by an increase in liver metastasis without any effect on the growth of each metastasis. Concordantly, the livers of pHx mice were characterized by neutrophil and bacterial infiltration, inflammatory response, extracellular remodeling, and an increased abundance of tight junctions, resulting in the formation of a premetastatic niche, thus facilitating metastatic seeding.
CONCLUSIONS
Regenerative pathways following pHx accelerate colorectal metastasis to the liver by priming a premetastatic niche.
Topics: Animals; Colorectal Neoplasms; Hepatectomy; Mice; Liver Neoplasms; Liver; Tumor Microenvironment; Disease Models, Animal; Humans; Mice, Inbred C57BL; Inflammation; Male
PubMed: 38919609
DOI: 10.3389/fimmu.2024.1388272