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European Urology Focus Jun 2024Diagnosis of primary and relapsed bladder carcinomas is accomplished by urethrocystoscopy, an invasive procedure, combined with urinary cytology, with limited... (Review)
Review
BACKGROUND AND OBJECTIVE
Diagnosis of primary and relapsed bladder carcinomas is accomplished by urethrocystoscopy, an invasive procedure, combined with urinary cytology, with limited sensitivity, resulting in a substantial burden. Thus, noninvasive biomarkers have been investigated, among which DNA methylation has shown promise. This systematic review and meta-analysis sought to assess the diagnostic accuracy of DNA methylation biomarkers reported in the literature for bladder cancer detection, pinpointing the most informative one.
METHODS
The search for this systematic review and meta-analysis was conducted on PubMed, Scopus, and Cochrane Library for relevant studies published until December 31, 2022. A meta-analysis was performed using a random-effect model, to compute the pooled sensitivity and specificity of the markers. PROSPERO's registration ID for the study is CRD42023397703.
KEY FINDINGS AND LIMITATIONS
Out of the 2297 studies retrieved, 68 were included in the final analysis, despite considerable heterogeneity. These involved 12 696 participants, of whom 5557 were diagnosed with bladder cancer. Using diagnostic odds ratio (DOR) as a comparative measure, the five most promising markers (pooled sensitivity, specificity, and DOR) were SALL3 (61%, 97%, and 55.67, respectively), PENK (77%, 93%, and 47.90, respectively), ZNF154 (87%, 90%, and 45.07, respectively), VIM (82%, 90%, and 44.81, respectively), and POU4F2 (81%, 89%, and 34.89, respectively). Urinary cytology identified bladder cancer with 55% sensitivity, 92% specificity, and 14.37 DOR.
CONCLUSIONS AND CLINICAL IMPLICATIONS
DNA methylation biomarkers disclose high accuracy for bladder cancer detection in urine. Nonetheless, validation studies in different clinical settings are scarce, hampering clinical use. The identified biomarkers should be prioritized in future validation studies.
PATIENT SUMMARY
In this meta-analysis, we include previously published studies that used urine samples of bladder cancer patients' from all around the globe. We were able to compare the diagnostic accuracy of noninvasive markers across different populations. We were able to conclude on the most promising DNA methylation markers to detect bladder cancer using urine.
PubMed: 38897871
DOI: 10.1016/j.euf.2024.05.024 -
Journal of Orthopaedic Surgery (Hong... 2024Fracture-related infections (FRIs) encompass a broad range of infections associated with bone fractures; they remain a significant clinical challenge. Here, we aimed to...
Role of bone single photon emission computed tomography/computed tomography in managing chronic fracture-related infections: Determining the depth of infection and avoiding unnecessary bone procedures.
PURPOSE
Fracture-related infections (FRIs) encompass a broad range of infections associated with bone fractures; they remain a significant clinical challenge. Here, we aimed to investigate the viability of focusing on soft-tissue management in patients suspected of chronic FRI, who exhibit no significant bony uptake on bone single photon emission computed tomography (SPECT)/computed tomography (CT) scans.
METHODS
Between January 2016 and January 2022, we managed 25 patients with chronic FRI or post-traumatic osteomyelitis using technetium 99m-methyl diphosphonate bone SPECT/CT to assess infection depth. Among them, 13 patients showing negligible bony uptake were included and categorized into two groups based on wound discharge reaching the bone/implant (Criteria 1, = 6) or not (Criteria 2, = 7).
RESULTS
Patients in the Criteria 1 group were treated with antibiotics and soft tissue debridement without bony procedure. The average duration of antibiotic therapy was 6.7 weeks. Treatments were individualized, including implant changes, local flaps, skin grafts, and negative pressure wound therapy. No recurrence was reported in the mean follow-up of 21.3 months. Patients in the Criteria 2 group were treated with oral antibiotics (mean duration: 5.9 weeks) and daily wound dressings. No recurrence was reported in the mean follow-up of 26.0 months, and no surgical interventions were required.
CONCLUSION
This study demonstrates the feasibility of focusing on soft-tissue management in patients with chronic FRI showing minimal bony uptake on bone SPECT/CT. Our treatment protocol avoided unnecessary surgical bone procedures, resulting in successful clinical outcomes with no recurrences.
Topics: Humans; Male; Female; Single Photon Emission Computed Tomography Computed Tomography; Middle Aged; Adult; Osteomyelitis; Aged; Fractures, Bone; Anti-Bacterial Agents; Chronic Disease; Debridement; Unnecessary Procedures; Retrospective Studies
PubMed: 38897599
DOI: 10.1177/10225536241264977 -
International Journal of Hyperthermia :... 2024Pelvic recurrences from rectal cancer present a challenging clinical scenario. Hyperthermia represents an innovative treatment option in combination with concurrent...
INTRODUCTION
Pelvic recurrences from rectal cancer present a challenging clinical scenario. Hyperthermia represents an innovative treatment option in combination with concurrent chemoradiation to enhance therapeutic effect. We provide the initial results of a prospective single center feasibility study (NCT02528175) for patients undergoing rectal cancer retreatment using concurrent chemoradiation and mild hyperthermia with MR-guided high intensity focused ultrasound (MR-HIFU).
METHODS
All patients were deemed ineligible for salvage surgery and were evaluated in a multidisciplinary fashion with a surgical oncologist, radiation oncologist and medical oncologist. Radiation was delivered to a dose of 30.6 Gy in 1.8 Gy per fraction with concurrent capecitabine. MR-HIFU was delivered on days 1, 8 and 15 of concurrent chemoradiation. Our primary objective was feasibility and toxicity.
RESULTS
Six patients (total 11 screened) were treated with concurrent chemoradiation and mild hyperthermia with MR-HIFU. Tumor size varied between 3.1-16.6 cm. Patients spent an average of 228 min in the MRI suite and sonication with the external transducer lasted an average of 35 min. There were no complications on the day of the MR-HIFU procedure and all acute toxicities (no grade >/=3 toxicities) resolved after completion of treatment. There were no late grade >/=3 toxicities.
CONCLUSION
Mild hyperthermia with MR-HIFU, in combination with concurrent chemoradiation for appropriately selected patients, is safe for localized pelvic recurrences from rectal cancer. The potential for MR-HIFU to be applied in the recurrent setting in rectal cancer treatment requires further technical development and prospective evaluation.
Topics: Humans; Rectal Neoplasms; Male; Salvage Therapy; Middle Aged; Female; Hyperthermia, Induced; Chemoradiotherapy; Aged; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; High-Intensity Focused Ultrasound Ablation; Prospective Studies; Adult
PubMed: 38897584
DOI: 10.1080/02656736.2024.2365385 -
Arquivos de Gastroenterologia 2024Intrahepatic biliary stone disease is a difficult condition to treat, due to anatomical complexity of biliary tract, association with colestasis, and high recurrence...
Intrahepatic biliary stone disease is a difficult condition to treat, due to anatomical complexity of biliary tract, association with colestasis, and high recurrence rates, with potential short- and long-term complications, such as cholangitis and secondary biliary cirrhosis. Removal of biliary stones via intraductal access can be achieved endoscopically or percutaneously, with preference for cholangioscopy-guided laser lithotripsy in complex cases. The surgical approach, despite its prolonged results, is a more invasive and risky procedure. The authors present a case of cholangioscopy with percutaneous laser biliary lithotripsy as an option for the treatment of intrahepatic biliary stone disease associated with biliary stricture following biliodigestive anastomosis due to bile duct injury following cholecystectomy, a safe and effective alternative with low morbidity and satisfactory outcomes in follow-up.
Topics: Humans; Lithotripsy, Laser; Gallstones; Bile Ducts, Intrahepatic; Treatment Outcome; Male; Female; Middle Aged; Endoscopy, Digestive System
PubMed: 38896577
DOI: 10.1590/S0004-2803.24612024-006 -
Frontiers in Neurology 2024Non-contrast computed tomography (CT) and CT angiography are the gold standard in neuroimaging diagnostics in the case of suspected stroke. CT perfusion (CTP) may play...
INTRODUCTION
Non-contrast computed tomography (CT) and CT angiography are the gold standard in neuroimaging diagnostics in the case of suspected stroke. CT perfusion (CTP) may play an important role in the diagnosis of stroke mimics (SM), but currently, it is not a standard part of the stroke diagnostic procedure. The project is a multicentre prospective observational clinical research focused on refining the diagnostics of stroke and stroke mimics (SM) in hospital care.
AIM
This study aimed to evaluate the degree of specificity and sensitivity of multimodal CT (NCCT, CTA, and CTP) in the diagnosis of SM versus stroke.
METHODOLOGY
In this study, we will include 3,000 patients consecutively admitted to the comprehensive stroke centres with a diagnosis of suspected stroke. On the basis of clinical parameters and the results of multimodal CT and magnetic resonance imaging (MRI), the diagnosis of stroke and SM will be established. To clarify the significance of the use of the multimodal CT scan, the analysis will include a comparison of the blinded results for each imaging scan performed by radiologists and AI technology and a comparison of the initial and final diagnosis of the enrolled patients. Based on our results, we will compare the economic indicators and costs that would be saved by not providing inadequate treatment to patients with SM.
CONCLUSION
The expected outcome is to present an optimised diagnostic procedure that results in a faster and more accurate diagnosis, thereby eliminating the risk of inadequate treatment in patients with SM.
CLINICAL TRIAL REGISTRATION
clinicaltrials.gov, NCT06045455.
PubMed: 38895699
DOI: 10.3389/fneur.2024.1365986 -
Cureus May 2024Fine needle aspiration cytology (FNAC) for thyroid nodules has a high diagnostic accuracy, according to several studies worldwide. Patients who experienced preoperative...
INTRODUCTION
Fine needle aspiration cytology (FNAC) for thyroid nodules has a high diagnostic accuracy, according to several studies worldwide. Patients who experienced preoperative FNAC had more optimal surgical treatment than others who did not perform FNAC. Therefore, achieving an accurate FNAC procedure appears to be an important tool for the proper management of thyroid nodules. We aimed to study the accuracy and challenges of the thyroid FNAC diagnostic tool in the Al-Baha region, Kingdom of Saudi Arabia.
METHODS
The study involves 52 patients with thyroid nodules who underwent preoperative FNAC and postoperative histopathology with the same surgery and pathology team at Al-Baha region in 2022-2023.
RESULTS AND CONCLUSION
The mean age of the included patients was 47.7 years, with a female predominance. The diagnostic accuracy was 90%, and the main cause of inaccurate diagnosis was processing challenges, where the majority of cases were taken on the palpation-only technique, a few cases were ultrasound-guided, and the only technique used in the laboratory was conventional smears. The applied interrater reliability Cohen kappa coefficient (κ) for the clinical-histopathological agreement was "moderate agreement". We recommend using and evaluating more cytological techniques in addition to the currently used conventional smears in pathology laboratories to enhance the efficacy of the FNAC diagnosis of thyroid lesions.
PubMed: 38894793
DOI: 10.7759/cureus.60600 -
Sensors (Basel, Switzerland) Jun 2024(1) Background: Marker-based 3D motion capture systems (MBS) are considered the gold standard in gait analysis. However, they have limitations for which markerless... (Meta-Analysis)
Meta-Analysis Review
Accuracy, Validity, and Reliability of Markerless Camera-Based 3D Motion Capture Systems versus Marker-Based 3D Motion Capture Systems in Gait Analysis: A Systematic Review and Meta-Analysis.
(1) Background: Marker-based 3D motion capture systems (MBS) are considered the gold standard in gait analysis. However, they have limitations for which markerless camera-based 3D motion capture systems (MCBS) could provide a solution. The aim of this systematic review and meta-analysis is to compare the accuracy, validity, and reliability of MCBS and MBS. (2) Methods: A total of 2047 papers were systematically searched according to PRISMA guidelines on 7 February 2024, in two different databases: Pubmed (1339) and WoS (708). The COSMIN-tool and EBRO guidelines were used to assess risk of bias and level of evidence. (3) Results: After full text screening, 22 papers were included. Spatiotemporal parameters showed overall good to excellent accuracy, validity, and reliability. For kinematic variables, hip and knee showed moderate to excellent agreement between the systems, while for the ankle joint, poor concurrent validity and reliability were measured. The accuracy and concurrent validity of walking speed were considered excellent in all cases, with only a small bias. The meta-analysis of the inter-rater reliability and concurrent validity of walking speed, step time, and step length resulted in a good-to-excellent intraclass correlation coefficient (ICC) (0.81; 0.98). (4) Discussion and conclusions: MCBS are comparable in terms of accuracy, concurrent validity, and reliability to MBS in spatiotemporal parameters. Additionally, kinematic parameters for hip and knee in the sagittal plane are considered most valid and reliable but lack valid and accurate measurement outcomes in transverse and frontal planes. Customization and standardization of methodological procedures are necessary for future research to adequately compare protocols in clinical settings, with more attention to patient populations.
Topics: Humans; Gait Analysis; Gait; Imaging, Three-Dimensional; Biomechanical Phenomena; Reproducibility of Results; Motion Capture
PubMed: 38894476
DOI: 10.3390/s24113686 -
Sensors (Basel, Switzerland) May 2024One of the key challenges in Multi-Spectral Automatic Diagnostic (MAD) robot design is the precise targeting of narrow-angle cameras on a specific part of the equipment....
One of the key challenges in Multi-Spectral Automatic Diagnostic (MAD) robot design is the precise targeting of narrow-angle cameras on a specific part of the equipment. The paper shows that a low-cost MAD robot, whose navigation system is based on open-source ArduRover firmware and a pair of low-cost Ublox F9P GNSS receivers, can inspect the 8 × 4 degree ultraviolet camera bounding the targeting error within 0.5 degrees. To achieve this result, we propose a new targeting procedure that can be implemented without any modifications in ArduRover firmware and outperforms more expensive solutions based on LiDAR SLAM and UWB. This paper will be interesting to the developers of robotic systems for power equipment inspection because it proposes a simple and effective solution for MAD robots' camera targeting and provides the first quantitative analysis of the GNSS reception conditions during power equipment inspection. This analysis is based on the experimental results collected during the inspection of the overhead power transmission lines and equipment inspections on the open switchgear of different power plants. Moreover, it includes not only satellite, dilution of precision, and positioning/heading estimation accuracy but also the direct measurements of angular errors that could be achieved on operating power plants using GNSS-only camera targeting.
PubMed: 38894285
DOI: 10.3390/s24113494 -
Sensors (Basel, Switzerland) May 2024Motion Capture (MoCap) has become an integral tool in fields such as sports, medicine, and the entertainment industry. The cost of deploying high-end equipment and the... (Review)
Review
Motion Capture (MoCap) has become an integral tool in fields such as sports, medicine, and the entertainment industry. The cost of deploying high-end equipment and the lack of expertise and knowledge limit the usage of MoCap from its full potential, especially at beginner and intermediate levels of sports coaching. The challenges faced while developing affordable MoCap systems for such levels have been discussed in order to initiate an easily accessible system with minimal resources.
Topics: Humans; Athletic Performance; Cricket Sport; Motion Capture
PubMed: 38894175
DOI: 10.3390/s24113386 -
Sensors (Basel, Switzerland) May 2024Technological advancements have expanded the range of methods for capturing human body motion, including solutions involving inertial sensors (IMUs) and optical...
Technological advancements have expanded the range of methods for capturing human body motion, including solutions involving inertial sensors (IMUs) and optical alternatives. However, the rising complexity and costs associated with commercial solutions have prompted the exploration of more cost-effective alternatives. This paper presents a markerless optical motion capture system using a RealSense depth camera and intelligent computer vision algorithms. It facilitates precise posture assessment, the real-time calculation of joint angles, and acquisition of subject-specific anthropometric data for gait analysis. The proposed system stands out for its simplicity and affordability in comparison to complex commercial solutions. The gathered data are stored in comma-separated value (CSV) files, simplifying subsequent analysis and data mining. Preliminary tests, conducted in controlled laboratory environments and employing a commercial MEMS-IMU system as a reference, revealed a maximum relative error of 7.6% in anthropometric measurements, with a maximum absolute error of 4.67 cm at average height. Stride length measurements showed a maximum relative error of 11.2%. Static joint angle tests had a maximum average error of 10.2%, while dynamic joint angle tests showed a maximum average error of 9.06%. The proposed optical system offers sufficient accuracy for potential application in areas such as rehabilitation, sports analysis, and entertainment.
Topics: Humans; Algorithms; Anthropometry; Gait; Gait Analysis; Male; Biomechanical Phenomena; Adult; Motion Capture
PubMed: 38894161
DOI: 10.3390/s24113371